Electronic Clinical Quality Measures Basics
CMS has finalized the Electronic clinical quality measure (eCQM) definition: eCQMs are measures specified in a standard electronic format that use data electronically extracted from electronic health records (EHR) and/or health information technology (IT) systems to measure the quality of health care provided. CMS eCQMs measure many aspects of patient care, including:
- Patient and Family Engagement
- Patient Safety
- Care Coordination
- Population/Public Health
- Efficient Use of Healthcare Resources
- Clinical Process/Effectiveness
Health care providers are required to electronically report eCQMs, which use data from EHRs and/or health information technology systems to measure health care quality. To report eCQMs successfully, health care providers must adhere to the requirements identified by the CMS quality program in which they intend to participate.
Each year, CMS makes updates to the eCQMs approved for CMS programs to reflect changes in:
- Evidence-based Medicine
- Code Sets
- Measure Logic
Important to the development of eCQMs is the use of value sets. Value sets contain lists of codes and corresponding terms used by developers and implementers to accurately capture patient data in the EHR system. CMS has published Value Set Guidance to help developers in the design and maintenance of value sets, including areas of naming, description, content choice, and harmonization. Value set guidance can be viewed under the Resources menu of the Electronic Clinical Quality Improvement (eCQI) Resource Center.
To successfully participate in the Medicare and Medicaid Promoting Interoperability Programs, CMS requires EPs, eligible hospitals, CAHs, and dual-eligible hospitals to report on eCQMs. These eCQMs are determined by CMS and require the use of certified electronic health record technology (CEHRT).
For calendar year (CY) 2022, Medicare Promoting Interoperability Program participants are required to report on three self-selected eCQMs and the Safe Use of Opioids – Concurrent Prescribing eCQM from the set of nine available. The reporting period is three self-selected quarters of CY 2022 data.