HIT Standards CommitteeHIT Standards Committee

Clinical Quality Measures Workgroup Report

Jim WalkerKaren Kmetik

June 22, 2011

ACTIVITIES SINCE LAST REPORT

• Joint Hearing on MU1 and needs for MU2 (May 19):– Quality MeasuresWG, HITPC– Clinical Quality WG, HITSC

• June 20 Code set selection for the fundamental categories of the QDM.– Vocabulary Work Group, HITSC– CQMWG, HITSC

Updated Measures Framework (aligned with NQS)

Core Measures

1. Adult Weight Screening and Follow-up2. Hypertension: Blood Pressure Management3. Preventative Care and Screening Measure Pair

a. Tobacco Use Assessmentb. Tobacco Cessation Intervention

Alternate Core Measures

1. Childhood Immunization Status2. Preventative Care and Screening: Influenza

Immunization for Patients >= 503. Weight Assessment and Counseling for

Children Adolescents

Menu Set Measures

16.6667%

16.6667%

16.6667%

16.6667%

16.6667%

16.6667%

CORE

Population & Public Health

Patient Safety

Efficiency

Patient & Family

Engagement

Care Coordination

MENU

ClinicalProcess

PROPOSED MODEL

• Core is maintained and additional measures are added.– Providers pick measures from the core

list.

• Menu is maintained and additional measures are added.– Menu measures are stratified into the 6

domain areas.– Providers pick measures from the menu

list (at least one from each domain).

CODE SET SELECTION

• Working with Vocabulary Task Force to assign code set(s) to the fundamental concepts in the NQF’s Quality Data Model v.3 (QDM)

• Preparatory Interviews– Work group members– Measure developers– other subject matter experts

• First joint meeting June 20.• Review of the QDM’s fundamental

concepts for clarity and streamlining under way.

Upcoming Issues

– Problem lists: attributes for reconciliation

– Patient reported outcomes: including standardized tools for implementation in EHRs

– Exclusions: Establish requirements for management of non-standardized patient situations (e.g., participation in clinical trials).

– Plan of care: Identify components and standards for documenting care plans.

Issues from the HITPC Quality Measures WG

• Longitudinal/delta measures: Identify types, applications, and standards.

• Attribution of actions to specific actors• Capacity of EHRs to handle increasingly

complex measures