Clinical Quality Measures (CQMs): Measuring and Monitoring Healthcare Quality

Clinical quality measures, also called CQMs, are tools that help us measure and monitor the quality of healthcare and the contribution of healthcare services toward improved health outcomes. In the past, quality measures primarily used data that came from claims, but as technology has improved and become more prominent in the healthcare setting, many quality measures now use data that comes from a provider’s electronic health record (EHR). These electronic CQMs (eCQMs) use EHR data to measure health outcomes, clinical processes, patient safety, efficient use of healthcare resources, care coordination, patient engagement, and population and public health improvement.

2014 brings a lot of changes to how CQMs are used under Centers for Medicare and Medicaid Services (CMS) quality reporting programs, including the Physician Quality Reporting System (PQRS) and the EHR Incentive Program (Meaningful Use). CMS has worked hard to align the quality reporting requirements under various programs. As a result, providers have the option to use the same set of quality measures to report CQMs for both PQRS and Meaningful Use.

To report a single set of quality measures for both Meaningful Use and PQRS, providers must use CQMs that come from Certified EHR Technology (CEHRT). Practice Fusion’s EHR 3.0 was recently certified as 2014 Certified Complete EHR, which means that providers can use Practice Fusion’s certified CQMs to report for both Meaningful Use and PQRS in 2014.

Meaningful Use CQM Reporting

Under the 2014 Medicare Physician Fee Schedule Final Rule, CMS made some changes to the rules that govern how providers will need to report CQMs for Meaningful Use.

  • Providers can manually submit CQM values during Meaningful Use attestation if they choose to. This option is now available to providers in any stage of Meaningful Use.

  • Providers who submit CQMs via Meaningful Use attestation can still use electronic submission through their EHR for the purposes of PQRS.

  • Providers who choose to submit CQMs electronically for the purposes of dual credit for PQRS and Meaningful Use will still be able to do this via their EHR vendor. Note that reporting will not occur until 2015 since the reporting period would be a full calendar year.

PQRS CQM Reporting

As in past years, PQRS offers multiple reporting mechanisms: claims, registry, or direct EHR. Providers who wish to report PQRS via their EHR will be required to report 9 measures covering at least 3 of the National Quality Strategy domains using CERHT. It is important to note that providers only have the option to report CQMs from their EHR if the certified CQMs are the most recently released version from CMS.

  • If a provider’s CEHRT does not contain patient data for at least 9 measures covering at least 3 domains, then the provider will need to report the measures for which there is Medicare patient data.

  • In order to use the EHR reporting option for PQRS, a provider must report on at least 1 measure for which there is Medicare patient data. As in past years, measures with a zero value denominator cannot be used for PQRS.

More information on CQMs

Providers who are interested in learning more about the detailed CQM specifications can use the United States Health Information Knowledgebase (USHIK), operated by the Agency for Healthcare Research and Quality (AHRQ), to locate specific measures and to find the detailed codes (categorized into Value Sets) that are included in the specifications of that measure. From the USHIK website, click on the link for Clinical Quality Measures, select the measure you want to know more about, and download the applicable codes as a PDF file, Excel file, or CSV file. Make sure you select the correct version of the measure. CMS will also be offering additional resources on CQM reporting sometime in early 2014, and Practice Fusion will continue to provide updates as information becomes available.

As your prepare for quality reporting in 2014, you should become familiar with the CQMs that are available in your certified EHR so that you can incorporate them into your daily workflow and make improvement to the care that you deliver, as needed.

Practice Fusion will be creating a detailed CQM calculation guide for Practice Fusion providers that will be available in the near future, and even more certified quality measures will be available later in the year. Quality measurement and reporting is a key part of improving our healthcare system, and Practice Fusion is dedicated to making that easier for healthcare providers in 2014.

Vendor name: Practice Fusion, Inc. Product Version: Practice Fusion EHR Version          
3.0 Date Certified: December 19, 2013 Drummond Group Inc. Certification Number: 12192013‐2260‐1 Tested and Certified Modules: 170.314(a)(1‐15); 170.314(b)(1‐5, 7); 170.314(c)(1‐3); 170.314(d)(1‐8); 170.314(e)(1‐3); 170.314(f)(1‐3); 170.314(g)(2‐4) Tested and Certified Clinical Quality Measures: CMS002v3; CMS050v2; CMS068v3; CMS069v2; CMS090v3; CMS122v2; CMS123v2; CMS130v2; CMS131v2; CMS138v2; CMS156v2; CMS165v2; CMS166v3 Additional software required: Updox Direct 2014 Pricing Transparency: Practice Fusion does not require any fees for the use of this certified product. An optional advertisement-free version, which is not required to meaningfully use this certified product, is available to users for a nominal fee.