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What is HEDIS?

What is HEDIS?

The Healthcare Effectiveness Data and Information Set (HEDIS) includes more than 90 clinical measures to report on and improve the quality of patient care. These measures cover six domains: effectiveness, access, experience, utilization, descriptive information, and electronic systems. It is a toolset that many payers across the country utilize to understand how physicians and health systems are treating patients and measure outcomes for quality patient care.

The measures of the HEDIS system can help physicians, managed care organizations, PPOs, and other healthcare institutions improve patient care. Over 191 million people across the United States are enrolled in a health plan that utilizes the HEDIS reporting model. 

Benefits of Health Effectiveness Data Information Set (HEDIS)

HEDIS measures are designed to quantify the quality of care across six domains that directly impact the experience and outcome for patients. 

HEDIS Improves Care Effectiveness and Experience

The "Effectiveness of Care," "Experience of Care," and "Access to Care" represent three of the most important domains in the HEDIS performance model. In these domains, some of the measures help to track and improve preventative health and screening programs; behavioral health care; medication management; and care coordination

With a focus on these primary domains, HEDIS helps institutions and providers recognize where patient care can be improved. An example of this is the addition of depression and mental health screenings at primary care visits. Furthermore, HEDIS helps them track the results of the changes they implement. This is how the six domains of HEDIS can link to real-world insights and improvements. 

Increases Patient Data Utilization 

By measuring how patient data is accessed, collected, and utilized by healthcare providers, HEDIS improves patient data utilization and, in turn, improves the timeliness and accuracy of response, diagnosis, and treatment for various medical conditions.

This supports both the "Utilization and Risk-Adjusted Utilization" domain and also factors into the "Effectiveness of Care." For example, HEDIS measures how often providers review and update patient information, helping them recognize opportunities to use it more frequently and effectively.

Encourages Record Digitization and Accessibility 

In the shift toward digital record-keeping, one of the six primary domains is known as "Measures Reported Using Electronic Clinical Data Systems." Under this domain, HEDIS tracks how information is reported and what is kept within electronic clinical data systems, thereby helping institutions realize the value of moving to digital record-keeping systems.

As part of this system, institutions can measure how electronic systems are being utilized to track immunization status, depression screenings, alcohol use, remissions, and more. Additionally, this domain goes hand-in-hand with "Health Plan Descriptive Information," which is the final domain in the HEDIS performance model. 

Improve Your HEDIS Scores with Your EHR

Modernizing your practice, reducing backend labor, and improving patient care all go hand-in-hand. Thoroughly understanding frameworks and tools, such as the HEDIS performance model, can help you get there. However, it's not easy to implement these complex changes on your own. If you're looking for experienced consultants to help improve your HEDIS scores and physician satisfaction, TempDev can help. Explore our consulting services today and contact us here to discuss next steps.


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