NCQA’s Expansion of the ECDS Standard and What it Means for HEDIS Reporting in 2022

HEDIS season is coming up and everyone is prepping for early submission. But before you head into the June 2022 reporting frenzy, there is a critical enhancement that the NCQA added across multiple measures that are going to change the way you prepare your HEDIS submissions this season and in the years to come.

The Electronic Clinical Data Systems (ECDS) measure provides health plans with a defined method to collect and report structured electronic data for HEDIS quality measurement and improvement. ECDS measures are just one part of NCQA’s strategy to move towards greater use and sharing of standardized electronic data across systems and providers, aligned with the health care industry’s larger move toward adopting and using digital measures.

Despite being a gradual rollout, health plans are questioning how these ECDS standards will affect reporting and ratings going into this HEDIS season and beyond. We take a closer look at the rollout, which measures will be transitioned first, and what health plans can do now to prepare for the coming upgrades and changes.

ECDS and the Future of HEDIS

Back in 2015, the NCQA initiated a multi-year process to transform the HEDIS quality measurement, beginning with the specification of the first ECDS measure. An ECDS is a network of data containing a plan member’s personal health information and records of their experiences and interactions within the healthcare system.

The HEDIS ECDS Reporting Standard provides health plans with a method to collect and report structured electronic clinical data for HEDIS quality measurement and improvement. It represents a step forward in adapting HEDIS to accommodate all the information available in electronic clinical datasets used for patient care and quality improvement. It also promotes health information exchange (HIE) initiatives, which is the secure sharing of patient medical information electronically.

The ECDS architecture was designed in part to help HEDIS implementers understand how healthcare IT can increase the efficiency of quality reporting. According to Kelly Cieciorka, Director of Quality at Vital Data Technology, a provider of health IT solutions connecting healthcare ecosystems, “moving HEDIS to a fully digital, electronic clinical data system unburdens providers and allows for the easy exchange of patient information across the entire health plan ecosystem. It really represents an optimal reporting method that leverages all the clinical data available at the point of care.”

Health organizations that report HEDIS using ECDS encourage near real-time exchange of the information needed to provide high-quality services, ensuring that they reach the right people at the right time. It also provides an incentive to connect to other sources of data and support other care-related activities, including evidence-based decision support, quality management, and the reporting of outcomes.                                                

Movement Toward Digital HEDIS Measurement and Reporting in 2022 and Beyond

Because NCQA has indicated that transitioning to digital measures is a significant priority for HEDIS measurement, it is critical that plans understand and begin preparing for the digital future of HEDIS now to maintain and enhance their rating. Measurement Year (MY) 2020 and 2021 HEDIS specifications include eight digitized versions of existing measures reported using the traditional method, and 11 measures specified using the ECDS format.

11 Measures Currently Available for ECDS Reporting for MY 2021

8 Measures Originally Introduced Into HEDIS with ECDS Reporting:

• Prenatal Immunization Status
• Adult Immunization Status
• Depression Screening and Follow-Up for Adolescents and Adults
• Utilization of the PHQ-9 to Monitor Depression Symptoms for Adolescents and Adults
• Depression Remission or Response for Adolescents and Adults
• Unhealthy Alcohol Use Screening and Follow-Up
• Prenatal Depression Screening and Follow-Up
• Postpartum Depression Screening and Follow-Up

3 Existing HEDIS Measures Specified for ECDS Reporting:

• Breast Cancer Screening
• Follow-Up Care for Children Prescribed ADHD Medication
• Colorectal Cancer Screening

For MY 2021, NCQA will also allow voluntary reporting for three additional HEDIS measures: Childhood Immunization Status, Immunizations for Adolescents, and Metabolic Monitoring for Children and Adolescents on Antipsychotics. NCQA plans to release a number of additional digital measures for MY 2022 and MY 2023, with the goal by 2024 and beyond to have ECDS reporting for all HEDIS measures.

Steps Health Plans Can Take Now to Prepare for the Transition to ECDS

Health plans can expect NCQA to incrementally transition more existing measures to the ECDS framework and continue to introduce new measures over the next several years. Steps plans can take now to prepare for coming public reporting and continued accreditation include:

• Compare measures that are transitioning from traditional reporting to ECDS reporting to ensure capture of the same population.
• Because the ECDS framework allows for the incorporation of additional data sources, make sure to evaluate every single source.
• Expect challenges utilizing electronic clinical data that may be from new sources and require new processes.
• Share best practices, facilitate the adoption of digital standards, and collaborate to build and enhance the larger digital measurement community.

Health plans also need to ensure that they’re partnering with a HEDIS vendor that has not only been certified, but that also has in-depth knowledge around these recent changes so they can navigate HEDIS season smoothly and without any surprises.

If you have any questions or want to learn more, click below to talk with one of our Quality Improvement experts.