QM task force focuses on decision support, MU

In response to its charge to provide a set of recommendations regarding clinical quality measurement (CQM) provisions in Centers for Medicare & Medicaid Services payment rules, the Health IT Policy Committee’s Quality Measurement Task Force focused on three areas.

Kathleen Blake, co-chair of the task force and senior principal researcher at Rand, presented the recommendations during the Health IT Policy Committee’s Aug. 11 meeting.

Those areas are: appropriate use criteria (AUC) for radiology clinical decision support; revision of certified EHR technology (CEHRT) to require clinical quality measures reporting; and Meaningful Use measures for accountable care organizations.

Regarding imaging CDS, Blake discussed several goals for certified health IT. Technology should support APIs as a means of gaining access to approved AUC that are updated regularly, in keeping with guidelines updates, and delivered through certified health IT tools.

Certified health IT should enable users to easily switch between approved AUC content providers. It also should allow the capture of additional information within established workflow about why AUC were not followed, to support continuous quality improvement and provide meaningful performance feedback that promotes learning, improves clinical decision-making and enables further refinement of decision support tools over time.

Certified health IT, according to the task force, should display seamless actionable recommendations to clinicians based on third-party data derived from AUCs. AUCs should be available in standardized formats that can be consumed by any certified health IT application.

The task force supports the direction of future expansion of the eCQMs to include more eligible providers when platforms are usable and have achieved the necessary level of interoperability, as a strategy for ensuring that more providers are being incentivized and rewarded to use more advanced functionality. The current measure does not provide incentives to innovate, Blake said.

The task force seeks additional measures that focus on the use of health IT to align with improving patient outcomes and offered recommendations to measure preventable harms, readmission rates, timely and reliable closing of the referral loop as one category of care transition between providers and medication reconciliation during transitions of care.

“This is an area of great need for innovation and the task force recommends supporting APIs during the early stages of development,” said Blake. Their recommendations include a technical requirement to demonstrate accurate and automatic collection of data during process of care.

Currently available CDS standards may not be ready to serve these needs today, she said, so the Office of the National Coordinator for Health IT should continue supporting pilot testing to assure the standards will be more mature when needed.