How Clinical Trials Help Close HEDIS Gaps: A Story of Three Patients
In today’s value-based care environment, healthcare providers meet a growing list of quality metrics while also delivering compassionate, equitable, and evidence-based care. HEDIS (Healthcare Effectiveness Data and Information Set) measures serve as a national benchmark for these efforts—but for many practices, reaching those goals can feel like a constant uphill climb.
What if clinical trials, often seen as peripheral or academic, were reframed as powerful quality improvement tools? When integrated into routine care, clinical trials can help close care gaps, strengthen documentation, and improve outcomes in measurable ways.
Here are three examples of how patient participation in clinical trials can support a practice’s HEDIS performance:
Scenario 1: Closing the Preventive Care Gap
A physician refers an older adult with a history of hypertension to a cardiovascular outcomes trial. During pre-screening, the care team discovers the patient has not had a mammogram in several years. Before enrollment, the team ensures the patient completes the screening. As a result, the practice not only prepares the patient for trial participation but also closes a gap in care.
HEDIS Impact: Gaps in preventive screening are addressed through trial eligibility reviews, improving scores for breast cancer and other screening-related measures.
Scenario 2: Better Diabetes Control Through Monitoring
An older adult patient with type 2 diabetes struggles with adherence and has elevated A1c levels. After learning about a diabetes trial offering structured support and free testing supplies, the patient enrolls. Through consistent follow-ups, education, and monitoring, their A1c improves significantly.
HEDIS Impact: Enhanced engagement and glycemic control contribute to better performance on Hemoglobin A1c Control (HBD) measures.
Scenario 3: Asthma Management and Medication Adherence
A patient with moderate persistent asthma participates in a clinical trial evaluating a new inhaled therapy. As part of the study, the patient receives regular follow-ups, education on proper inhaler technique, and support to ensure consistent medication use. The structure of the trial helps the patient improve symptom control and reduces missed doses.
HEDIS Impact: Improved medication adherence and symptom management support performance on measures such as Medication Management for People with Asthma (MMA).
These scenarios illustrate how clinical trials can catalyze closing care gaps, improving adherence, and enhancing documentation—all while offering patients additional support and access to innovative care.
For providers and administrators, integrating clinical trials into routine practice isn’t just about innovation; it’s about improving the metrics that matter.
Interested in exploring how clinical trials can align with your quality improvement goals? Contact us to learn how we partner with practices to drive impact for patients and for performance.