eCQMs

Software tool that allows eCQM developers to test and verify the behavior of their eCQM logic. The main goal of the Bonnie application is to reduce the number of defects in eCQMs by providing a robust and automated testing framework. The Bonnie application allows measure developers to independently load measures that they have constructed using the MAT. Developers can then use the measure metadata to build a synthetic patient test deck for each measure from the clinical elements defined during the measure development process. By using measure metadata as a basis for building synthetic patients, developers can quickly and efficiently create a test deck for a measure. The Bonnie application helps measure developers execute the measure logic against the constructed patient test deck and evaluate whether the logic aligns with the intent of the measure.

Web-based repository service which enables the Clinical Decision Support (CDS) community to identify evidence-based standards of care, translate and codify information into an interoperable standard, and leverage tooling to promote a collaborative model of CDS development. 

Comprehensive and authoritative listing of all certified Health Information Technology which have been certified by the ONC Health IT Certification program. All products listed on the CHPL have been tested by an ONC-Authorized Testing Labs (ONC-ATLs) and certified by an ONC-Authorized Certification Body (ONC-ACB) to meet criteria adopted by the Secretary of the Department of Health and Human Services (HHS).

For additional information on how to navigate the CHPL, please refer to the CHPL Public User Guide.

Repository of record for information about CMS measures used to promote healthcare quality and quality improvement. CMS and its partners use this measure inventory to inform stakeholders, to manage its measure portfolio, and to guide measure development. The inventory contains information describing each of the measures including title, numerator, denominator, exclusions, various identifiers, type, status, usage by program, steward, healthcare priorities, and other attributes. The intuitive and user-friendly functions allow you to find measures quickly and to compile and refine sets of related measures. The tool increases transparency, can be used to identify measures across the continuum of care, and will help coordinate measurement efforts across all conditions, settings, and populations.

These IGs are based on the HL7 QRDA IGs. CMS's QRDA Category I IG is used for Hospital Quality Reporting (HQR), and CMS's QRDA Category III IG is used for the Eligible Clinicians and Eligible Professionals Programs that address aggregate reporting requirements for Comprehensive Primary Care Plus (CPC+) and Merit-Based Incentive Payment System (MIPS) programs. HL7 Quality Reporting Document Architecture (QRDA) Implementation Guides (IGs) These IGs describe constrains on HL7's Clinical Document Architecture Release 2 (CDA R2) to create QRDA documents. QRDA Category I is for reporting quality data at the individual patient level. QRDA Category III is for reporting aggregated quality measure data

CQl tools which provide a "sandbox" where electronic Clinical Quality Measure (eCQMs) developers and implementers can "play" with the Clinical Quality Language (CQL). The tools allows users to get a feel for what CQL looks like and how to write proper expressions in this new and powerful language.

More specifically, CQL Online is a syntax directed editor for writing expressions in CQL. It is open source and intended for educational purposes.

The HL7 CQL specification defines both a high-level, author friendly syntax for expressing clinical knowledge, as well as a machine friendly, syntax-independent canonical representation of clinical knowledge called Expression Logical Model (ELM). The high level syntax is designed to support measure and decision support authors, while the canonical representation is designed to support point-to-point sharing and machine processing applications.

The specification describes a formal mechanism for translating the high-level CQL syntax into the canonical ELM representation. This project provides a reference implementation of that translation. The translation component is designed to support use within an Integrated Development Environment (IDE), and has several options and features focused on providing translation support in such an environment. The reference implementation is intended to be used in support of CQF implementations as a tool to enable CQL output to be uniformly and automatically translated into ELM XML or JSON documents for sharing and distribution to support implementation, integration, translation, and execution of CQL-based artifacts.

The CQL-to-ELM Translator is substantially complete, supporting all language constructs of the latest version of CQL (Release 1 STU 2 (1.2)), as well as a broad range of functionality to support use of the translator in an Integrated Development Environment. Implementations making use of the translator can submit issues and track resolution progress through the Issues tracker in the Github repository.

Open forum for discussing technical implementation and tool issues with the Cypress support team.

Webpage designed to support the eCQI implementation activities of the entire care team.  The page provides links to resources and past presentations on implementing eCQMs.

Open source libraries which provide a proof-of-concept implementation of eCQMs against patient information represented in Fast Healthcare Interoperability Resources (FHIR). These libraries reuse the calculation engine developed within Bonnie and Cypress and adapt it to a FHIR data model. They can be used as a starting point for an implementation of eCQMs from FHIR-based data.

  
fhir-patient-api maps the current Quality Data Model (QDM) based eCQMs to FHIR resources.

node-qme a “patient source”, which is responsible for using the fhir-patient-api to retrieve patients from a database and send them to eCQM code for calculation.

node-cqm-engine  monitors requests for eCQM calculations and executes them. It also aggregates the results from individual patient measure results into a result for the entire patient population.

ecqm server  a server application that provides RESTful interfaces for eCQM calculation.

ecqm-frontend  a software package that provides a web-based interface for users to create and view the results of eCQM calculations.

The CQL-based HQMF IG constrains the HL7 HQMF IG by utilizing both a domain analysis model called the QDM and an expression logic called CQL. QDM allows quality measure developers to describe clearly and unambiguously the data required to calculate quality measures. QDM data types are mapped to the HQMF templates. CQL allows the sharing of unambiguous logic among eCQMs and can be used with multiple data models.

The HL7 QRDA I IG describes constrains on HL7's Clinical Document Architecture Release 2 (CDA R2) to create a QRDA I document. QRDA Category I is for reporting quality data at the individual patient level.

Kaizen, or continuous improvement, is a long-term approach to work that systematically seeks to achieve incremental changes in order to improve efficiency and quality. It focuses on removing process waste and maximizing value to the customer (in this case the patient). CMS and ONC have focused on eCQM development and implementation.

Resource document which provides guidance for understanding, using, and/or implementing eCQMs.

Guidance document which provides a standardized system for developing and maintaining the quality measures used in various quality initiatives and programs. Includes information on Measure Development Concepts, Measure Lifecycle, eCQM Lifecycle, as well as Tools, Appendices, and Forms.

Crosswalk which identifies eCQMs that are tested under the NCQA eMeasure (eCQM) Certification program, accepted in the NCQA PCMH Recognition Program, as well as those selected as core America’s Health Insurance Plans (AHIP)/CMS eCQMs and used within NCQA’s Healthcare Effectiveness Data and Information Set (HEDIS®) reporting. 

The same eCQMs that are used for CMS Quality Payment Program (QPP) reporting can also be submitted for recognition under NCQA’s Patient-Centered Medical Home (PCMH) recognition programs.

Web-based inventory tool developed by the National Quality Forum (NQF) to help people select and use NQF-endorsed measures. It allows a user to search for NQF-endorsed measures in a number of ways: export search results; and view types of measures. Using QPS, a user can find NQF-endorsed measures on particular topics, track and get reminders about measures that are important to them, provide feedback on measures, and see which measures others are using.

NQF-endorsed measures have undergone careful review by expert multistakeholder committees made up of doctors, hospitals and other providers, employers, health plans, public agencies, community coalitions, and patients –most of whom use measures on a daily basis to ensure better care. QPS is designed to help anyone interested in quality measurement. Information in QPS is updated daily as measures move through NQF processes. By adding measures to a portfolio in QPS, users can receive email notification of changes to individual measures.

Submission guidance for eMeasures is at: www.qualityforum.org/Electronic_Quality_Measures.aspx

A Joint Commission program to assist hospitals on their journey towards electronic clinical quality measure adoption  including educational programs (e.g., webinars for CEUs), a resource portal, recognition categories, an advisory council, a modified annual report, speaker’s bureau outreach, a peer–to–peer solution exchange, as well as having a strong focus on partnering with hospitals to provide the highest level of quality care for patients and their families.

Application Program Interface (API) which provides vendors, hospitals and providers with a method for validating eCQM files within their own system/environment prior to submission and for securely transporting valid files to Centers for Medicare & Medicaid Services (CMS). The PSVA tool assists in identifying and correcting Quality Reporting Document Architecture (QRDA) Category I file format errors for test and production files prior to data submission to the CMS eCQM data receiving system QualityNet Secure Portal. The PSVA tool has three interfaces as part of the download package and a user is able to select the option that best meets their needs. The PSVA tool can be accessed on the QualityNet Secure Portal.

Converter tool which converts QRDA III files to the QPP JSON (JavaScript Object Notation) format for Quality Payment Program (QPP) data submission. The tool can also be used to test whether QRDA III files can be consumed by QPP and allows you to see whether it meets these standards:

• Complies with the most current QRDA III Implementation Guide 
  
• Can be successfully submitted to QPP

This tool does not have the same functionality as the Cypress tool and cannot be used to test QRDA III files against the full range of possible uses. For more information, visit the Quality Payment Program website.

Designed for IT developers and available in the CMS Github repository.

Information model that defines relationships between patients and clinical concepts in a standardized format to enable electronic quality performance measurement. The model is the current structure for electronically representing quality measure concepts for stakeholders involved in electronic quality measurement development and reporting. The QDM provides the language that defines the criteria for clinical quality measurement. It allows the electronic definition of a clinical concept via its data elements and provides the vocabulary to relate them to each other. By relating attributes between data elements and using filtering functions, the QDM provides a method to construct complex clinical representations for eCQMs.

Developer tools for the Quality Payment Program allow industry developers who build software for participating clinicians to integrate their software directly with CMS applications and data. 

The following tools are available:

• Submissions Application Programming Interface (API)
• Measures, Activities, and Benchmarks Repository
• Submissions Schemas
• QRDA III Conversion Tool Open Source Package

These include documentation for reporting eCQMs used in the QPP program through QRDA-III, QPP JSON or QPP XML formats.

Resource files which provide an overview of technical changes in the eCQM Annual Update and addenda.

Set of files and software that bring together health and biomedical vocabularies and standards to enable interoperability between computer systems. UMLS® is used to enhance or develop applications, such as electronic health records, classification tools, dictionaries and language translators.  Use of UMLS allows end users to view codes used in value sets such as CPT and ICD-10.