Case Study: Empowering Health Care Organizations in Maryland via HDU

CRISP is both the state-designated Health Information Exchange (HIE) and a Health Data Utility (HDU). As the state HIE, CRISP organizes and governs organizational and technical processes for the maintenance transmittal, access or disclosure of electronic health care information between or among health care providers or entities through an interoperable system. Building and expanding on these critical HIE capabilities and infrastructure, as an HDU, CRISP collects, aggregates, and analyzes clinical information, public health data, claims data, health administrative and operations data to assist the state in the evaluation of public health interventions and health equity. Additionally, as a key characteristic of HDUs, CRISP maintains and benefits from a diverse and robust governance structure, including multiple committees with a broad array of engaged stakeholders.

CRISP has worked collaboratively with Maryland’s HSCRC for many years to support HSCRC’s various quality programs and payment initiatives. As an independent regulatory agency under Maryland’s Total Cost of Care Model, HSCRC has the authority to hold a portion of hospital revenue at-risk based on specified performance benchmarks.

In 2021, HSCRC approached CRISP with the request to partner in the collection of eCQMs in order to expand its reporting and transparency to the public. The idea behind the initiative was to enable the state to evaluate hospital performance, identify statewide areas for improvement, and incorporate benchmarks into policy development in a timely and consistent manner. Since providers were already accustomed to logging into CRISP to access clinical data, the decision was made to partner with CRISP on data collection to make the process as seamless as possible for hospitals.

As an HDU, CRISP maintains advanced technical infrastructure and services that are designed to serve a wide range of stakeholder needs.  It was recognized at the outset that this project required additional technical services that CRISP did not have internally. To better understand the capabilities of potential vendors and in recognizing the importance of identifying leaders in quality reporting and data collection, CRISP, in collaboration with HSCRC, surveyed existing vendors in this space through a Request for Information (RFI). The RFI allowed CRISP to understand existing eCQM vendor capabilities related to several factors, including the below use cases. 

1. Ability to both collect and transmit eCQMs from hospitals, to the HSCRC on a quarterly basis.
2. Knowledge of data collection for Hybrid Hospital-Wide Readmission measures. Vendors were asked to explain their understanding of hybrid measures, their experience in collecting then, and their approach to combining data from multiple data input streams.
3. Knowledge of physician-focused eCQMs for a potential project with another state agency at a later date.

Medisolv was selected as a partner given the company’s leadership in quality management software and its location in Maryland, providing the company with a deep understanding of the Maryland model and its structure.

Early in the project, the Maryland Health Care Commission (MHCC) became actively engaged as a fourth member of this partnership. MHCC is the state regulator that designates CRISP as the state HIE and HDU. MHCC uses the year-end data collected and publishes components of it on their consumer-facing website. This data informs consumers on critical aspects of patient care and population health including patient engagement, safety, prescribed medications, and treatment outcomes.