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In order to report quality measures from an electronic health record (EHR), electronic specifications must be developed that include the data elements, logic and definitions for that measure in a format that can be captured or stored in the EHR so that the data can be sent or shared electronically with other entities in a structured, standardized format, and unaltered. ARRA HITECH Electronic Specifications Introduction These electronic specifications are derived from certified EHRs. As part of the criteria for satisfying meaningful use, clinical quality measures results (numerators, denominators, and exclusions) must be reported to CMS. Below are electronic specifications for eligible professionals and eligible hospitals/CAHs. Specific details regarding the reporting of the specifications for eligible professionals and eligible hospitals/CAHs are described below. Each electronic specification contains four main components: - Measure Overview/Description - This contains the measure title, description, number, measurement period, measure steward, and other relevant information to the measure.
- Measure Logic - This contains the population criteria and measure logic for the numerator, denominator and exclusion categories. The measure logic contains the algorithm used to calculate performance.
- Measure Code Lists - This contains all of the codes pertaining to the measure.
- QDS Elements - This lists and describes each Quality Data Set (QDS) data element associated with the measure. The QDS is a model of information that contains the standard element, the quality data element, and the data flow attributes. It is a way to describe clinical concepts in a standardized format so individuals (i.e., providers, researchers, measure developers) monitoring clinical performance and outcomes can clearly and concisely communicate necessary information. The QDS model also describes information in a manner that allows EHR and other clinical electronic system vendors to unambiguously interpret the data and clearly locate the data required.
Eligible Professionals (EPs) Eligible professionals must report from the table of 44 clinical quality measures which includes, 3 Core, 3 Alternate Core, and 38 additional CQMs. - Core CQMs - EPs must report on 3 required core CQMs, and if the denominator of 1 or more of the required core measures is 0, then EPs are required to report results for up to 3 alternate core measures.
- EPs also must also select 3 additional CQMs from a set of 38 CQMs (excluding the core/alternate core measures). It is acceptable to have a '0' denominator provided the EP does not have an applicable population.
In sum, EPs must report on 6 total measures: 3 required core measures (substituting alternate core measures where necessary) and 3 additional measures. A maximum of 9 measures would be reported if the EP needed to attest to the 3 required core, the three alternate core, and the 3 additional measures. To view the 44 measure specifications, click on EP Measure Specifications under Downloads below. Additionally under Downloads, the file Eligible Professional Clinical Quality Measure identifies the specific number of numerators, denominators, and exclusions reported for these measures. Reporting will require a numeric value for each numerator, denominator, and exclusion, if applicable. Eligible Hospitals and CAHs Eligible hospitals and CAHs must report all 15 CQMs. Follow the Related Link Outside CMS HITSP Technical Note below to view the electronic specifications. For the two Emergency Department (ED) Throughput measures, ED-1/NQF 0495 and ED-2/NQF 0497, there is information on the numerators/denominators/exclusionsunder Downloads Emergency Department Throughput Measures Stratification. The link for the HITSP Technical Note will take you to information for HITSP Technical Note 906 v1.1 and contain the HITSP eMeasure specifications. To note, these specifications include QRDA reporting requirements which are not used for ARRA HITECH reporting in 2011 and 2012. Use of both documents are required for numerator/denominator/exclusion reporting. PQRI CMS accepts PRQI quality measures data extracted from a qualified EHR product for a limited subset of PQRI quality measures. For the electronic specifications for those quality measures that have been developed for PQRI, click on Related Links Inside CMS below. For the electronic specifications for those quality measures that have been developed for CMS programs, click on the Related Links Inside CMS below for PQRI measures or the Related Links Outside CMS below for hospital measures.
Page Last Modified: 08/30/2010 7:10:33 AM
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