NCQA Data Aggregator Validation Expands to Include FHIR Exchange

WASHINGTON, August 8, 2023 (Newswire.com) - The National Committee for Quality Assurance (NCQA) program that gives health care organizations confidence in the clinical data they use for quality reporting, value-based contracting and closing care gaps can now validate FHIR output files that Health Information Exchange (HIE) organizations, health IT vendors and any organization that aggregates clinical data can exchange across the health care ecosystem.

This summer, NCQA expanded the program so that participating organizations can elect to validate FHIR files that conform to the US Core Implementation Guide STU3 (v3.1.1). This aligns with CMS's efforts to encourage industry adoption of FHIR as a core technology underpinning government-required data sharing. The opportunity to use NCQA-approved FHIR files makes Data Aggregator Validation an attractive differentiator for organizations that have adopted FHIR.

"Accurate data is always a concern for any use case and the growth and change in clinical data pose new challenges such as the transition to FHIR," said NCQA Director of Product Management Arjun Sanyal. "NCQA's new FHIR output option aligns data exchange requirements with NCQA HEDIS CORE, CARIN v1.1.0 and US Core v3.1.1 standards, building confidence in the accuracy and integrity of the data being produced and exchanged." 

Cozeva, a unified data-driven platform for optimal population health and performance management that helps organizations align for value-based care, is among the first seeking the NCQA seal for its exchange of FHIR data. According to Cozeva CEO Khanh Nguyen, "We are excited to be the one of the first to participate in the Data Aggregator Validation FHIR program. Both NCQA and CMS promote advancing standardized data to fuel quality use cases using digital measures authored in Clinical Quality Language (CQL), and this program will help propel the industry forward."

About Data Aggregator Validation

Data Aggregator Validation confers the NCQA seal on a data stream. 

NCQA applies two categories of standards to ingestion, management and output of clinical data: 

• Process, System and Data standards assess rules and procedures for consuming, managing and aggregating data.
• Output Data Integrity standards test and review continuity of care document (CCD) and FHIR output files for primary source verification and adherence to the HL7 C-CDA R2.1 Implementation Guide (CCD IG) or the US Core Implementation Guide STU3 (v3.1.1) (FHIR IG).

Successful completion of the program results in one of two designations for participants: 

• Validated Data Stream: Organizations that perform all functions in the program requirements, including facilitating primary source verification, participate in the program as Responsible Parties. Responsible Parties each have one or more data streams validated by NCQA. Successful data streams are awarded the Validated Data Stream designation.
• Certified Data Partner: Organizations that are responsible for one or more program standards. An organization might be responsible for the management of the data and output of the CCD file, but not have legal access to the primary source to support PSV. They may support Responsible Parties in completion of the program. Organizations that meet selected program standards are awarded the Certified Data Partner designation.

The number of organizations pursuing Data Aggregator Validation, which takes 22 weeks, is the highest ever. More than 30 organizations have earned a Data Aggregator Validation status since the program launched in 2021.

NCQA will host a webinar at 1 p.m. ET on Tuesday, Aug. 15, discussing how FHIR transforms health care quality measurement and the evolution of Data Aggregator Validation.

About NCQA

NCQA is a private, nonprofit organization dedicated to improving health care quality. NCQA Accredits and Certifies a wide range of health care organizations. It also recognizes clinicians and practices in key areas of performance. NCQA's Healthcare Effectiveness Data and Information Set (HEDIS^®) is the most widely used performance measurement tool in health care. The organization received the prestigious James W. Rouse Excellence in Diversity Award for demonstrating a commitment to promoting a diverse, healthy workplace. NCQA's website (ncqa.org) contains information to help consumers, employers and others make informed health care choices. NCQA can also be found at Twitter @ncqa, and on LinkedIn at linkedin.com/company/ncqa.

Source: National Committee for Quality Assurance (NCQA)