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The Centers for Medicare & Medicaid Services (CMS) has published the final 2014 clinical quality measures (CQMs) for eligible professionals and eligible hospitals seeking to attest for meaningful use.
Beginning in 2014, the reporting of clinical quality measures will change for all providers. Electronic health record (EHR) technology that has been certified to the 2014 standards and capabilities will contain new CQM criteria.
Eligible professionals (EPs), eligible hospitals and critical access hospitals will report using their respective new 2014 criteria – regardless of whether they're taking part in participating in Stage 1 or Stage 2 meaningful use.
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In addition to these quality measures, CMS has published the specifications for electronic reporting and access to the related data elements and value sets.
The value sets define clinical concepts, providing a list of numerical values – such as code values from ICD-9 and SNOMED CT – and individual descriptions for the clinical concepts (diabetes, clinical visit, etc.) used to define the quality measures. Each clinical concept referenced in a clinical quality measure is represented by a set of code values (a value set) it may take on.
The value sets of the electronic specifications are the code values that the data elements (the clinical concepts) of the CQMs in an EHR may take on, CMS officials point out.
These sets allow providers to compute and export the measure results uniformly, and to report them in attestation. Vendors, EPs and eligible hospitals may access the value sets via the National Library of Medicine Value Set Authority Center (VSAC). The value sets are available to view and download via several file formats an APIs (application programming interface).
Additionally, the Data Element Catalog, which identifies data element names required for capture in EHR technology under the ONC certification program, are also available via the VSAC.
CMS has also posted Human Readable files of the e-specifications for EPs and eligible hospitals that explain the measure, measure sponsor, measure rationale and how the measure is calculated.
CMS has made several resources available to help providers and vendors navigate the new quality measures:
- United States Healthcare Knowledge Database – AHRQ's website with both MU1 and MU2 CQMs and other HIT resources. This site provides a number of formats for viewing, downloading and comparing versions of CQMs and their value sets.
- Implementation Guide to the 2014 CQMs – Guidance for understanding and using the final CQMs, the Human Readable files and the e-specifications.
- Release Notes – A comparison of the previous Stage 1 CQMs that are in effect through 2013, with the 2014 CQMs. (Technical release notes for 2014 eCQMs for Eligible Professionals; Technical Release Note 2014 eCQMs for Eligible Hospitals.)
- CQM Tipsheet – An overview of the CQMs, including the number of measures EPs and eligible hospitals must report, CQM reporting options, and reporting and submission periods.
Certification of EHR technologies requires that software products and EHR modules be tested, as applicable, for their capabilities to accurately capture, calculate and report the CQM results. The ONC has commissioned the development of the open source Cypress certification tool, officials say.
Cypress has encoded the measure logic required in a software implementation; the process for submitting the Cypress tool for official approval to be used in the ONC Certification Program is currently under way. Visit healthit.gov/cypress for more information.