Harmonization is the standardization of specifications for related measures with the same measure focus (e.g., influenza immunization of patients in hospitals or nursing homes); related measures for the same target population (e.g., eye exam and Hemoglobin A1c for patients with diabetes); or definitions applicable to many measures (e.g., age designation for children) so that they are uniform or compatible, unless the measure developer can justify differences (i.e., dictated by the evidence). The dimensions of harmonization can include numerator, denominator, exclusion, calculation, and data source and collection instructions. The extent of harmonization depends on the relationship of the measures, the evidence for the specific measure focus, and differences in data sources. Value sets used in measures (especially eCQMs) should be harmonized when the intended meaning is the same. Harmonization of logic in eCQMs is beneficial when the data source in the EHR is the same.
Health Care Disparities
Health care disparities generally refer to differences between groups in access to, use of, quality of care, or health coverage. (CMS. 2021. Paving the way to equity: A progress report 2015-2021. Retrieved November 8, 2021, from https://www.cms.gov/files/document/paving-way-equity-cms-omh-progress-report.pdf)
Health disparities typically refers to higher burdens of illness, mortality, injury, or quality of life experienced by one group relative to another (CMS. 2021. Paving the way to equity: A progress report 2015-2021. Retrieved November 8, 2021, from https://www.cms.gov/files/document/paving-way-equity-cms-omh-progress-report.pdf)
Health Information Technology (Health IT)
Per Section 3000 of the HITECH Act, the term ‘health information technology’ means “hardware, software, integrated technologies or related licenses, intellectual property, upgrades, or packaged solutions sold as services that are designed for or support the use by healthcare entities or patients for the electronic creation, maintenance, access, or exchange of health information.”
Health Information Technology for Economic and Clinical Health (HITECH) Act
The Health Information Technology for Economic and Clinical Health (HITECH) Act is a provision within American Recovery and Reinvestment Act that authorizes incentive payments through Medicare and Medicaid to hospitals and clinicians toward meaningful use of EHRs.
Health Level Seven International (HL7)
HL7 is a standards-developing organization that provides framework and standards for the exchange, integration, sharing, and retrieval of electronic health information that supports clinical practice and the management, delivery, and evaluation of health services.
Health Quality Measure Format (HQMF)
HQMF is a standards-based representation of quality measures as electronic documents. Refer to a quality measure expressed in this way as an eCQM.
Hosmer-Lemeshow Test (HL Test)
The HL test is a goodness of fit test for logistic regression, especially for risk prediction models. A goodness-of-fit test tells you how well your data fits the model. Specifically, the HL test calculates if the observed event rates match the expected event rates in population subgroups. The test is only used for binary response variables (i.e., a variable with two outcomes such as alive or dead, yes or no).
A hybrid measure is a quality measure that uses more than one source of data for measure calculation. Current hybrid measures use claims data and electronic clinical data from electronic health records to calculate measure results.