Objective 3: Clinical Decision Support
Clinical Quality Measures

Clinical quality measures (CQMs) are tools that help measure and track the quality of health care services that eligible professionals (EPs), eligible hospitals, and critical access hospitals (CAHs) provide. Measuring and reporting CQMs helps to ensure that our health care system is delivering effective, safe, efficient, patient-centered, equitable, and timely care. CQMs 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

EPs must select 6 approved Clinical Quality measures.

For the EHR reporting period in 2019, providers will attest to a full year of CQM reporting unless it is their first year of MU reporting then it can be any continuous 90-day period in that calendar year. For 2020, the reporting period is reduced to 90-days.

Submission methods available are electronically submitting via a QRDA file format or manually entering numerator and denominators at the time of attestation.

Physician Fee Schedule Rule adds the requirement of submitting one outcome measure and also finalizes reporting periods for 2019.

For Stage 3, EPs must satisfy both of the following measures in order to meet the objective:

  • 1) Implement 5 CDS interventions related to 4 or more clinical quality measures (CQMs) at a relevant point in patient care for the entire PI reporting period.
  • 2) The EP has enabled and implemented the functionality for drug-drug and drug-allergy interaction checks for the entire PI reporting period.

For Measure 2 above, an EP who writes fewer than 100 medication orders during the EHR reporting period may take an exclusion.

eCQMs

Promote evidence-based clinical processes

  • Measure preventing and treating priority conditions
  • Improve outcomes by identifying deficiencies in safety and accessibility
  • Reduce provider burden (e.g., administrative time by streamlining measurement)
  • Improve functional assessment of chronic conditions
  • Facilitate care coordination across settings
  • Reduce preventable hospital readmissions
  • Decrease medication errors
  • Promote appropriate usage of diagnostic testing and screening

 

Providers attesting as individuals for the Medicaid eligibility are allowed to submit a group eCQM QRDA or an individual eCQM QRDA. If you have a larger group of providers and have your eCQM data in a QRDA III file format this could save you time submitting this way rather than entering each individual’s CQM’s manually. For eligible professionals, the format needs to be QRDA III (the QRDA I file format is only for hospitals only).

Resources

2020 and 2021 Clinical Decision Support (Objective 3 of 8)

eCQI Resource Center: QRDA - Quality Reporting Document Architecture

2020 CQM specifications

2021 CQM specifications

2020 eCQM Telehealth Guidance Language (healthit.gov)