Astrata and Smile CDR Digital Quality Measurement Engine

Author: Smile CDR

Smile CDR, a leading health data and integration platform, and Astrata, a market driver in Quality NLP and analytics, announced a partnership to produce the next generation of Quality technology. The new eMeasure application reflects transformational changes in the way NCQA delivers and computes Quality measures. Scheduled for release in September 2021, eMeasure will be more efficient, flexible, scalable, extensible, and robust than existing HEDIS engines, while producing accurate, close-to-real-time clinical rates across entire populations. Leveraging Astrata's decades of experience with clinically focused Natural Language Processing, eMeasure is poised to combine structured and unstructured data for NCQA-certified HEDIS measure packages, ACA, State, and custom measures, opening avenues for unprecedented exploration and insight into a health plan's universe of data.

"Smile CDR is a data and integration platform. Our clients get the most value when they use our integrated applications to help them ingest, transform, enrich, analyze, and share their data," says Duncan Weatherston, CEO, Smile CDR. "Now, because of our partnership with Astrata, our customers can leverage their strategic investment with Smile CDR and benefit from Astrata's innovative and transformative HEDIS engine, which will provide significant value with a high ROI," he added.

Rebecca Jacobson, Astrata's president, says, "eMeasure represents another significant milestone in Astrata's mission to provide outstanding value and innovation for health plans working toward transforming their Quality programs."

Transformational Technology, Life-Changing Potential

Health plans have long relied on HEDIS technologies to generate the quality metrics that drive value-based care reimbursements and quality bonus payments. But HEDIS technology has been saddled with decades-old inefficiencies, including the 800+ page paper HEDIS specification that vendors must translate into the code that runs HEDIS engines, and the lagging, reactive nature of the claims data used for verification.

Recognizing these and other limitations, CMS recently announced that it is moving up its deadline to transition to fully digital quality measurement by five years from 2030 to 2025[1], a move supported by NCQA[2]. Starting this year, NCQA will distribute HEDIS measures in computable measure packages that will eliminate the need to recode the specification, resulting in reduced costs and increased flexibility. Astrata's eMeasure engine is designed to ingest NCQA measure packages, run on data stored in the Smile CDR FHIR® server, and produce HEDIS output files.

At the same time, health plans are gearing up to add electronic medical record (EMR) data, Care Management data, and Health Information Exchange data to the claims data currently used for computing HEDIS measures. eMeasure is designed from the ground up to integrate with FHIR-based clinical data repositories such as Smile CDR, where its CQL measurement logic will automatically tie digital HEDIS packages to allowable clinical events. Rather than waiting weeks or months for claims data to reflect healthcare delivery, the eMeasure HEDIS engine will be able to combine different data sources to produce much earlier insights that can drive meaningful intervention.

Focusing on the encounter rather than the claim provides richer, more actionable quality data with the potential to open up vast new avenues for developing, delivering, testing, and deploying truly transformational, population-wide healthcare initiatives. Open APIs from FHIR-based data repositories like Astrata's Constellation will allow health plans to develop flexible analytics tools to leverage this data to drive a variety of care management and population health initiatives.

At its release, eMeasure will be the first HEDIS engine product on the market capable of consuming native NCQA measure packages and generating clinical quality rates using FHIR-based clinical data.

Check out the press release for more information.