As the health industry continues to edge closer toward a patient-centric care landscape, Electronic Clinical Quality Measures (eCQMs) are becoming an essential piece for helping to hit the mark on improved treatment outcomes.
Consider eCQMs a scorecard for a health system to see how well it manages patient care. These measures can identify how well a facility is maintaining and improving cases of chronic illness and how effectively medications are administered or adhered to. eCQMs can even help systems compare efficiency models.
The Centers for Medicare and Medicaid introduced Electronic Clinical Quality Measures in December 2017 to monitor care standards and value-based purchasing systems, where reimbursement is tied to the quality of care. While other quality reporting programs like MIPS CQMS provide a similar function using different data sources, in this guide we’ll check out eCQMs, how they are reported, and their potential impact on enhancing the entire health care system.
eCQMs are measures specified in a standard electronic format to extract data from Electronic Health Records or other health information systems. This standard format means hospitals, health care providers, and other players can have a simplified approach to collecting, analyzing, and assessing valuable patient health information.
What started as voluntary reporting by health systems soon became a mandatory feature for hospital systems for the Hospital Inpatient Quality Reporting Program and the Medicare Promoting Interoperability Program (previously known as the EHR Incentive Program). Since 2016, CMS quality reporting has called for health care systems to implement these measures to assess clinical and administrative performance accurately.
From the data derived from record systems, eligible professionals can analyze patient safety, care coordination, how efficiently resources are utilized, and how effectively these players are executing clinical processes. Simply put, eCQMs provide a digital tracker of a health system's capacity to provide high-quality care, the processes to achieve this structure of care, plus how health outcomes reflect the interventions taken by health professionals.
As an electronic measure of health standards, it's up to developers to program eCQMs to evaluate data from a facility's electronic health record. The reporting requirements rest on value sets which are essentially a predetermined list of options or choices during development.
These value sets introduce consistency and harmonization into different clinical concepts. Through standardization, health data is structured to ensure it is easily retrieved and examined. For instance, a value set can represent aspects like diagnoses, medications, procedures, and other observations. eCQM platforms are then integrated with EHRs so the data to be reported through these measures are collected and stored by the critical access hospital, or other health record systems.
eCQMs collate quality data on different aspects of patient care like:
Developers stay updated on the appropriate technical steps for preparing and implementing eCQMs through the eCQM Annual Update Implementation User Guide. As explained by the eCQI resource center, every year the CMS prepares new eCQM measures to be reported by everyone from an eligible clinician, hospital, or critical access hospitals during the performance period.
Before eCQMs, health systems needed manual paper-based surveys to patients, providers, and other staff members to assess various aspects of care. Other measures like patient interviews and direct incident reports also gave feedback on administration within health facilities.
By introducing electronic and digital measures, these platforms provide an increased measure of accuracy, plus other benefits in providing care.
eCQMs offer a two-fold benefit for improving efficiency when extracting data from EHR systems. Not only do these platforms eliminate the need to extract the clinical fields to be measured manually, these measures automate data collection, promising that valuable health data is consistently and continuously updated for accurate assessment.
By operating on a strict standards-based system, eCQMs are applied consistently across EHR systems and IT software. These electronic measures adopt uniform definitions, coding concepts, data formats, and terminology so health players assess data under the same rules and coding systems like SNOMED and LOINC. This uniform clinical quality language and concepts not only improve consistency, but are another way to encourage interoperability across healthcare.
eCQMs are a significant intervention to improve patient outcomes. By integrating these platforms with EHRs, an eligible clinician is equipped with a clinical decision support system using data aggregated from hundreds or thousands of patient encounters.
This broad data set also means players can identify patients at risk of severe conditions like chronic illnesses using information obtained from past health cases. Because eCQMs work with large-scale data, these platforms can have a huge influence in recognizing trends in patient populations, helping to recognize patients due for preventive services according to their age, health status, or other markers for eligible professionals to identify a potential health risk.
eCQMs represent the next phase of improving healthcare across different stages of delivery. As preventative, treatment, and aftercare measures, these platforms set the tone for continuous improvement for eligible professionals and settings alike.