Retooling of Paper-Based Measures

Collecting and reporting healthcare performance data is now a complex, time-consuming and  manual process for hospitals and physicians. Measure specifications are usually designed with the assumption that much of the clinical data will be “abstracted” by humans from documentation in the medical records.

Electronic health records contain information required for performance measurement, but that information can only be used for performance measurement, if captured as structured data using nationally approved standards.

Accessing the rich clinical data in EHRs requires that measures be developed in a way that allows EHRs to understand and collect the required information. eMeasures, also known as CQMs (Clinical Quality Measures), provide a framework where specifications  are developed to leverage EHR data directly, thus eliminating reliance on human “abstraction.”

This has the potential to drive greater standardization across the measures and greater confidence in comparing outcomes and provider performance with reduced abstraction burden for the provider community.

Driven by the Health Information Technology for Economic and Clinical Health (HITECH) Act, the Department of Health and Human Services requested that NQF convert, or “retool,” 113 NQF-endorsed quality measures from a paper-based format to an electronic “eMeasure” format. In July, 2010, 44 of these 113 measures were published in PDF format in the Centers for Medicare and Medicaid Services’ Electronic Health Record Incentive Program Final Rule.

NQF provided to CMS updates and general implementation guidance for those 44 measures, and public comment period on the 113 measures closed on April 1, 2011. NQF will provide CMS with a final report on these 113 retooled measures in early 2012, after reviewing the public and member comments.

In the near future, we anticipate many, if not most, existing “abstracted/paper based” measures will be “retooled” and specified as eMeasures by the measure stewards. NQF has supported many key initiatives in support of the EHR Meaningful Use Incentive program and worked in close collaboration with many members of the quality and health IT communities, including measure stewards.

Please share any of your experiences or insights on accessing clinical data in the EHR.  How do you access data to better study quality?