Improve and gain insight into your health plan’s performance when you leverage the right technology.

Created by the National Committee for Quality Assurance (NCQA), the Healthcare Effectiveness Data and Information Set (HEDIS) was initially used to help consumers compare health plans. Now, HEDIS has also become a primary method organizations use to track their performance progress from year to year, with the goal of boosting preventative care and improving patient experiences and outcomes.

Simple in concept, HEDIS uses a 5-star rating system which provides a cumulative score for 6 domains of care:

Though seemingly simple, HEDIS measurements involve collecting, auditing, and reporting to NCQA data from 90 different performance measures, and many organizations struggle to execute this process efficiently.

HEDIS Challenges: How Can Telehealth Help?

Record Retrieval

COVID-19 has exposed many weaknesses throughout the healthcare industry, and HEDIS quality measurements are no exception. While HEDIS can be an effective method of measuring performance and improvements, health plans that report HEDIS measurements must often carry out extremely time-consuming and costly processes. Health plans, for instance, need to rely on providers to respond to requests and pull patient records, which are often coming from disparate record systems and in paper form.

Luckily, telehealth solutions can help simplify and automate these complex and, traditionally, very manual processes. These solutions may include:

To further simplify measurements and improve patient outcomes, organizations may bring in telehealth vendors, such as iTether, that have the technology to improve the data retrieval and abstraction processes.

Patient Engagement

Health organizations may struggle to obtain the data they need to report to NCQA if patients aren’t engaged with the services that provide that data. By implementing patient engagement strategies, organizations encourage patients to be active members of their care, which can lead to improved patient compliance, higher HEDIS ratings, and better outcomes.

Many organizations choose to utilize web-based telehealth solutions such as innovative portals or mobile applications. Telehealth engagement efforts might also include implementing text-based reminder systems or targeted email campaigns. In any case, leveraging the latest technology to engage patients in their health care plans helps simplify HEDIS measurements and drive results.

Examples of Current HEDIS Measures that Use Telehealth

On top of administrative headaches, the need for in-person measurements has added additional stress as more patients, and providers, prefer the convenience and safety benefits of telehealth solutions, such as virtual appointments. To streamline HEDIS measures and keep members engaged, NCQA adjusted its regulations in 2021 to allow for more telehealth usage. Today, over 40 HEDIS measures can be performed using telehealth. Some of the most notable include:

Behavioral Health

Follow-up after emergency department visit for alcohol or drug abuse: A patient with a principal diagnosis of alcohol or drug abuse can complete their 7-day and 30-day follow-up with a practitioner through the telephone, a virtual check-in, or an e-visit.

Follow-up after hospitalization for mental illness: Similarly, individuals hospitalized for mental illness treatment are able to follow up with a practitioner through a telephone or telehealth visit.

Care of Older Adults

Pain assessment: Using standardized tools, providers can conduct pain assessments over the telephone or during a virtual check-in.

Controlling blood pressure: Patients can have their blood pressure measured remotely as long as it is done through a digital remote monitoring device that is then interpreted by the provider.

Care Coordination

Transitions of Care: HEDIS measures include four key points in the transition of care. One of these points is patient engagement after inpatient discharge, the requirements of which can be met through telehealth visits.

Measures Reported Using Electronic Clinical Data Systems

Depression screening: Including prenatal and postpartum screening, depression screening can be performed virtually using standardized tools.

Improving HEDIS Results with iTether

Telehealth is the answer to not just HEDIS compliance but also improved HEDIS measurements, and with iTether, health plans have the technology they need to get there. Connect with us today to learn more about how our integrated communication platform is helping health plans everywhere serve their members better.