ORYX Update
JCAHO backs off a bit on ORYX deadline
To resolve discord, 2002 is new reporting target
The Joint Commission on Accreditation of Healthcare Organizations in Oakbrook Terrace, IL, is making an attempt to gradually iron out perceived problems with its ORYX initiative. At a recent meeting between Joint Com mission officials and representatives from state hospital associations and the American Hospital Association (AHA), it was decided that hospitals will be required to report ORYX core measure data beginning no sooner than 2002 — a revision of its original mandate to begin reporting this year.
Back in January, 17 state hospital associations sent a letter, accompanied by a supporting letter from the AHA in Chicago, to Joint Commission president Dennis S. O’Leary, MD, expressing concern about the new system for electronically collecting performance and outcomes data. (See the cover story in the March 1999 issue of Hospital Peer Review.) Concerns centered mainly on core measures and a perceived lack of input from hospitals on the initiative in general. Other state hospital associations, while not signatories to that letter, sent their own individual letters to the Joint Commission containing concerns about ORYX as well. Julia Roberts at the Joint Commission "can’t say just how many [additional] letters there were," but one was from the Healthcare Association of New York State (HANYS).
O’Leary responded by immediately calling for meetings with the associations to address their concerns. At the first such meeting in late February, discussions focused on identifying core measures, and it was agreed that there would be active field input to determine the priority measurement areas. Expert panels including representatives from both the Joint Commission and the hospital associations will establish appropriate objectives for measure sets, and there will be field review of the sets. Implementation of the measures will be phased in over the next couple of years with active participation by the state hospital associations.
The group also agreed that the number of ORYX measures required in the first stage of the initiative should be capped at between six and 10, and meeting participants affirmed a need to establish regular two-way communication between the Joint Commission and the hospital associations.
Cathy Ciccone, vice president of quality initiatives and research at HANYS in Albany, is her association’s representative to the ongoing ORYX meetings. HANYS was not one of the signatories to the January letter to the Joint Commission, but "that letter identified our concerns as well," she says. HANYS communicated its own concerns separately. "The Joint Commission is being very responsive to those concerns. It’s going well, but of course all the issues haven’t yet been unraveled. What we’re doing is building a framework that will resolve many of the issues that have been identified."
In mid-March, the Joint Commission sent letters to the CEOs of all state hospital associations and state medical societies to solicit input regarding priority areas for core measure sets. Similar letters went to other professional organizations, purchaser groups, and consumer organizations. It was hoped that the top six priority measurement areas could be established in time for the mid-May annual State Hospital Association Forum.
A Core Measurement Implementation Group, lead by Gary Carter, president of the New Jersey Hospital Association in Princeton, met in late March. The newly formed group’s purpose is to:
• develop a plan for implementing core measures by 2002;
• identify priority measurement areas;
• recommend clinical expert panel members to determine clinical logic and objectives for measure sets;
• provide advice on industry concerns and challenges;
• develop a process for field review of measures recommended by the panel.
For more information, call the ORYX Core Measures Line at (630) 792-3200.
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