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Is the healthcare industry ready for electronic clinical quality measures (eCQMs)?

eCQMs are quickly becoming the standard for quality measure reporting — but many clinicians, hospital systems and health IT vendors are not yet ready for the change.

The Centers for Medicare & Medicaid Services (CMS) now require healthcare providers participating in the Hospital Inpatient Quality Reporting Program to submit quality data that is extracted directly from Electronic Health Records (EHRs). These electronic measures — the eCQMs — replace traditional methods of quality reporting based on manual abstraction. Other payers are also moving towards eCQMs to support emerging value-based purchasing models.

But are these new, automatically extracted quality measures really equivalent to manually abstracted data? In many cases, the answer is no. Human readers can easily flip through a patient record to find data that is out of place or provided in a non-standard format. They can also use their background knowledge and professional judgment to interpret information in the health record and reconcile discrepancies.

eCQMS rely on algorithms to automatically pull information from the EHR. This has the potential to vastly reduce the administrative burden of quality measure data collection and reporting. However, if the data is not recorded in the correct format and in the right place in the record, the eCQM algorithm may not find it.

Before eCQM data can reliably replace human manual extraction, the industry must overcome several barriers. Some of these barriers involve the technology. EHR vendors must ensure that system architecture is able to handle the data and logic models used by CMS and other payers. They also must ensure that the user interface provides appropriate guidance and support to minimize errors in EHR data entry.

Other barriers must be addressed at the human level. Hospital administrators must ensure that staff have appropriate training in eCQMs and understand the importance of proper data entry in the EHR.

Individual clinicians should remember that they have a voice, too. Improving the eCQM process will take participation by everyone in the healthcare and health IT ecosystem.

Visit battelle.org/health-analytics to learn why effective healthcare quality improvement requires clear, accurate data.