NCQA program aims to validate data streams for quality programs

The initiative looks to facilitate the exchange of information from healthcare entities to improve reliability of data used for HEDIS.


A national non-profit organization continues to roll out a national program that aims to ensure the trustworthiness of aggregated clinical data used to support quality programs.

Most recently, the National Committee for Quality Assurance (NCQA) has validated the trustworthiness of information flowing through the Kansas Health Information Network. Also known as KNOZA, the Topeka-based HIE operates exchanges in eight other states in addition to Kansas.

The designation comes as part of NCQA’s Data Aggregator Validation program. KNOZA reported that it is part of the first NCQA cohort to voluntarily seek and earn the new validation. In late December, Manifest MedEx, a California non-profit health data network, announced it earned the Validated Data Stream designation from the Data Aggregator Validation program.

The initiative is an important step in finding ways to facilitate the effort to exchange data that is intended to improve care quality. NCQA’s program aims to assess both the process, system and data standards used that govern the ingesting, managing and aggregation of data, as well as measure the standards used to ensure output data integrity.

NCQA’s Data Aggregator Validation Program evaluates clinical data streams to help ensure that health plans, providers, government organizations and others can trust the accuracy of aggregated clinical data. It’s seen as a vital, early step in achieving NCQA’s vision of a digital measurement ecosystem; validated data flows also improve the efficiency of today’s quality measurement processes, it contends.

NCQA President Margaret O'Kane

“NCQA’s Data Aggregator Validation program helps identify clinical data that can be trusted and sets a high bar for how the data are managed,” said NCQA President Margaret O’Kane. “We are excited that organizations like KONZA are working to improve trust in clinical data and help ensure the data’s accuracy and broader usability.”

So far, 18 organizations are either seeking NCQA validation, have been validated or have been certified as partners. NCQA defines a certified data partner as one that has demonstrated capabilities to support data stream validation and findings from the certification, thus saving participants time in validating data streams.

Those receiving validation include health information exchanges and vendors that support data exchange between entities in healthcare.

NCQA says its validation process looks to achieve three main goals in ensuring trustworthiness:

  • Ensuring data accuracy throughout the process of data intake and output.
  • Saving time, which is particularly important as HIEs and other data aggregators are increasingly used as sources of supplemental data for reporting data for the Healthcare Effectiveness Data and Information Set (HEDIS), integral to reporting and other quality programs.
  • Offering assurance to contracting partners that data ingested from outside sources is accurate, and the NCQA validation can provide that extra level of comfort.

As HIEs and aggregators play a larger role in collecting health data, the NCQA program pays particular attention to organizations’ adherence to the NCQA Continuity of Care Document (CCD) Implementation Guide, as well as testing and reviewing CCD output files to see how well they match up with primary sources, known as primary source verification (PSV).

“NCQA validates one or many clusters of clinical data that are ingested, processed and ultimately output as CCD files,” the organization noted. “NCQA evaluates data streams from the point of ingestion through the output of the CCD file, ensuring standards and protocols are met, and that data provided from the original source accurately reflect the data reported for use as standard supplemental data for HEDIS or for other quality programs.”

KONZA worked in conjunction with data interoperability vendor Diameter Health to earn its NCQA validation. “By being among the first to successfully participate in Cohort 1 of the program, KONZA and Diameter Health are part of a small group of organizations to demonstrate they can meet the rigorous standards set by NCQA for data trustworthiness and usability for quality reporting,” said Diameter Health’s Chief Product Officer Ashley Basile.

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