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Development, Maintenance, and Support of Hospital Clinical Quality Measures: Recovery eMeasures

As part of the American Recovery and Reinvestment Act of 2009, the Healthcare Information Technology for Economic and Clinical Health (HITECH) Act established incentives for hospitals and other providers to adopt electronic health records. The HITECH Act required hospitals to report on 15 clinical quality measures drawn from the National Quality Forum to continue to receive Medicare and Medicaid payment.

Additional efforts were needed to ensure that clinical quality measures (CQMs) included the data elements, logic, and definitions for each, in a format that can be captured or stored in a hospital electronic health record, so that the data can be shared electronically with other health care entities in a structured, standardized, and reliable format.

Abt Associates and our partners assisted the Centers for Medicare & Medicaid Services (CMS) with the Development, Maintenance and Support of Clinical Quality Measures for the HITECH Act, in order to assist the Centers for Medicare & Medicaid Services’ (CMS) Quality Measurement and Health Assessment Group in specifying new CQMs and in retooling existing CQMs that could be calculated from electronic health record data.

This project ran from 2011 through 2014 and involved several major activities, including:
  • An environmental scan to identify existing measures to be retooled, gaps in the available inpatient hospital CQMs, and potential new CQMs to be specified as eMeasures;
  • Vetting of plans for new and retooled CQMs with technical experts and CQM/eMeasure stakeholders;
  • Retooling of existing CQMs, which involves electronically specifying existing measures, such as specifying data elements and their location in the electronic health record, developing code sets using appropriate standards, and creating the eMeasure using the National Quality Forum’s Measure Authoring Tool;
  • Reviewing the new electronic specifications against the existing manual specifications with measure stewards and measure developers to ensure accuracy of interpretation and specification; and
  • Testing new and retooled eMeasures for scientific acceptability, such as CQM reliability and validity. 
North America