Electronic Clinical Quality Improvement (eCQI)
The Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) are working to improve the health of our nation by transforming care from a volume-based, provider-centered system to a value-based, patient-centered, learning health system. This work includes using quality measurement to improve care given to patients by measuring how patients are treated and, most importantly, how well those patients do afterward. Electronic clinical quality improvement (eCQI) provides common standards and shared technologies to monitor and analyze the quality of healthcare provided to patients and patient outcomes.
The eCQI Ecosystem was adopted from the HL7 Quality Improvement workgroup. The image highlights the ideal iterative flow of evidence-based information from research to clinical practice and measurement to evaluate clinical performance and outcomes for healthcare organizations. Please note that while it is depicted in a linear fashion the process if often interactive between stakeholders and phases as well as iterative.
Electronic clinical quality measures (eCQMs) measure the performance of hospitals, clinicians, and others who provide healthcare services. The “e” in eCQMs means that performance is measured using data extracted from an electronic health record (EHR) and/or health information technology (IT) system. eCQMs include data elements, terminology, logic, and definitions using Health Level Seven International (HL7) standards, which represent a clinical quality measure in an electronic document that can be captured, stored, shared, and read electronically.
Currently eCQMs primarily look back at recent activities to determine whether the evidence-based standard of care was adhered to for each patient. The next stage of quality improvement for healthcare transformation consists of using clinical decision support (CDS) and eCQMs together to improve quality. Rather than limiting quality improvement to retrospective measurement, we are moving to provide standards to express CDS that use evidence-based medicine and the patient’s own history, preferences, and data to customize care recommendations and actions for each individual patient. ONC’s Health IT enabled quality vision outlines how these innovations will ensure more consistent care across the nation, while facilitating better care aligned to evidence-based guidelines, less documentation burden to care providers, and ultimately, better patient outcomes.
CMS and many private payors are committed to value-based payment models that reward this transformation by incentivizing better outcomes and lower costs through quality improvements and efficiencies that better address patient needs and preferences.
CMS and ONC support this transformation by working to align measure components, tools, and standards through stakeholder engagement. Standards are essential to ensure data consistency, validity, and interoperability to be better able to share information, develop software, integrate data, and implement systems. The majority of tools and resources referenced within this website are openly available and are provided for stakeholder use. They provide a foundation for the development, testing, certification, implementation, reporting, and continuous evaluation of eCQMs and CDS tools.
The eCQI Resource Center is an effort to bring together stakeholders from across the eCQI community and provide a centralized location for news, information, tools, and standards related to eCQI and eCQMs.