In response to a recent Request for Information on Quality
Measurement Enabled by Health IT (RFI) from the Agency for
Healthcare Research and Quality (AHRQ), the American Hospital
Association (AHA) commented that accurate quality measures cannot
be achieved without reconfiguring the e-measures currently used to
achieve Stage 1 meaningful use (Stage 1) for electronic health
records (EHRs) under the Health Information Technology for Economic
and Clinical Health Act (HITECH). The AHA agreed that automated
quality measurements have the potential to be crucial tools for
improving the quality of care in the healthcare system. However,
the AHA pointed out, clinical quality measures (CQMs) used in Stage
1 contained "known errors and were not properly field
tested." The AHA called for all future CQMs for hospitals to
be endorsed through the National Quality Forum (NQF).
The AHA also called for more provider involvement in the design
and testing of EHRs. Currently, there may not be much incentive for
provider involvement because the data collection is burdensome and
the real-time feedback desired by providers is unavailable.
Furthermore, as was noted in a complementary AHRQ report to the
RFI, there are more than 80 different programs by a variety of
actors, both government and private, seeking to improve quality
measurement enabled by health IT. The AHA noted that the multitude
of initiatives creates confusion and sometimes contrasting
Overall, AHRQ plans to use the RFI responses to create a summary
report for the summer of 2013. Additionally, the Centers for
Medicare and Medicaid Services (CMS) announced the Final Rule for
Stage 2 meaningful use on Aug. 23, 2012. The Final Rule will be
implemented in 2014. The rule amends the reporting requirements for
CQMs and adds more CQM choices for hospitals. Finally, CQMs used in
Stage 2 have "either undergone feasibility testing in EHR
systems and clinical settings or were finalized in Stage 1 final
rule ... and have been updated based on experiences with reporting
those CQMs." As of Sept. 26, 2012, a complete list of the new
CQMs is still pending.
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