The Change Review Process (CRP) provides electronic clinical quality measure (eCQM) users the opportunity to review and comment on draft changes to the eCQM specifications and supporting resources under consideration by the measure steward. The CRP is conducted through the ONC Project Tracking System (Jira) website. The goal of the CRP is for eCQM implementers to comment on the potential impact of changes to measures so the Centers for Medicare & Medicaid Services (CMS) and measure stewards can make improvements to meet CMS’s intent of minimizing provider and vendor burden in the collection, capture, calculation, and reporting of eCQMs. To participate in the CRP, users must have a Jira account and log into the eCQM Issue Tracker (https://oncprojectracking.healthit.gov/support/projects/CQM/summary) where specific CRP tickets are posted for public comment and voting. Users can sign up for an account here (https://oncprojectracking.healthit.gov/support/secure/Signup!default.jspa).
Clinical Decision Support (CDS) is health information technology functionality that builds upon the foundation of an electronic health record (EHR) to provide persons involved in care processes with general and person-specific information, intelligently filtered and organized, at appropriate times, to enhance health and healthcare.
A Clinical Decision Support (CDS) developer is an individual or organization that translates knowledge to a structured and/or executable tool that aids in making evidence-informed decisions about a patient’s healthcare. CDS developers may or may not be the original knowledge authors (e.g., guideline developers, subject matter experts) or the final implementers. They are responsible for ensuring that the original clinical knowledge is reflected, accurately and consistently, in the appropriate standard coding schemes, e.g., CQL, and terminologies such as Current Procedural Terminology (CPT) and SNOMED CT, accounting appropriately for intellectual property and licensing.
A clinical quality measure (CQM) is a mechanism used for assessing the degree to which a provider competently and safely delivers clinical services that are appropriate for the patient in an optimal time frame. CQMs are a subset of the broader category of performance measures.
A code system is a managed collection of concepts with each concept represented by at least one internally unique code and a human readable description, e.g., SNOMED CT.
A comment period is the period of time the public has to respond to a request for public comment, such as a proposed rule, Request for Information, a new measure posted on the Measure Management System website, or some other document. The Administrative Procedure Act requires that federal agencies give the public an opportunity to participate in rulemaking. Executive Orders 12866 and 13563 provide that a comment period generally should be no less than 60 days, but the length of the comment period varies if not part of the rulemaking process.
A composite performance measure, also called composite measure, is a combination of two or more component measures, each of which individually reflects quality of care into a single performance measure with a single score.
A continuous variable is a measure score in which each individual value for the measure can fall anywhere along a continuous scale and can be aggregated using a variety of methods such as the calculation of a mean or median (for example, mean number of minutes between presentation of chest pain to the time of administration of thrombolytics).
The Critical Access Hospital (CAH) program is a federal program established in 1997 as part of the Balanced Budget Act and is designed to promote rural health planning, network development, and improve access to health services for rural residents of the state. CAHs represent a separate provider type with their own Medicare Conditions of Participation (CoP) as well as a separate payment method. The CoPs for CAHs are listed in the “Code of Federal Regulations” at 42 CFR 485 subpart F.