It’s a Team Effort: Incorporating Augmented Intelligence in Quality Reporting

July 11 2019

NCQA Digital Summit workshop - streamlining HEDIS reporting with NLP

Fractured Fairy Tale - the Price of Quality

Recently, an esteemed colleague pointed out an eye-opening research article to me when we were on the subject of Quality Measures and the expenses that occur in the digital age: "US Physician Practices Spend More Than $15.4 Billion Annually To Report Quality Measures".

This article was published in 2016, however I am willing to wager that this annual expense has not gone down in the past couple of years. This expense is accrued by not only hospital care organizations (HCOs) but by the insurance companies (payers) as well, all in the name of trying to make our population healthier.

We know that time equates to money in the workforce. How much time does this reporting take on the clinical side in addition to required duties for patient care? No wonder we are facing a clinician burnout epidemic. Medscape’s 2019 report determined that 44% of physicians described themselves as being burned out. And this report only mentioned the physicians, on nursing.org statistics nurses only reported a burnout rate of 15.6%. Which almost sounds like a relief until you learn 41% of nurses reported they felt “unengaged”. How frightening would it to be to be under the care of a nurse that was “checked-out” of his/her job? Burned-out and checked out. How do we achieve better outcomes this way? And how do we know payers are obtaining the correct information from the clinical staff?

How Natural Language Processing (NLP) can help fix this quality fracture

In the U.S. we have a huge number of professionals spread throughout our nation who are devoted to the task of quality measures - all in the hopes of obtaining better outcomes. One such group is now coming together annually in an interactive event focused on innovative solutions to the burdens of quality measurement at the Digital Quality Summit. This group is focused on Healthcare Effectiveness Data and Information Set (HEDIS) which is a performance improvement tool for the payer side. However, in order to obtain this information they need the clinical HCO staff to send it - so it’s a team effort. And this team needs to win for the better health of our country!

Linguamatics is honored to be presenting, once again, at the National Committee for Quality Assurance (NCQA). As part of Linguamatics collaboration with NCQA staff, and our IQVIA Observational Health Data Sciences and Informatics (OHDSI) colleagues, we will present the development of an investigative Linguamatics NLP/Observational Medical Outcomes Partnership (OMOP) model to help ease reporting needs.


To learn more, download our HEDIS fact sheet. If you want more information, do not hesitate to contact us.