eCQMs

The value set Binding Parameter Specification (BPS) is generated by the National Library of Medicine (NLM).  It is a record of the value set metadata information that defines the value set code lists specified by published CMS eCQMs. Measure implementers and vendors can use the BPS to track versions and other parameters that define the value set code lists for each eCQM release. The BPS contains the same information as its predecessor, the discontinued Data Element Catalog (DEC), as well as additional parameters. Users can access the BPS metadata file, for any released set of CMS eCQM value set files, through the NLM's Value Set Authority Center Downloadable Resources.

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.

Resource which details the different aspects of multiple QRDA validation tools that are available to submitters. It is intended to give users a single point of reference for these tools and assist them in selecting the most appropriate tool to meet their individual needs. The tool covers:

• Cypress QRDA Validation Utility
• Pre-Submission Validation Application (PSVA)
• CMS Data Receiving System, within the QualityNet Secure Portal

This document provides a listing of known issues relative to CQL-Based eCQM support.

CQL Style Guide provides examples to standardize expression of measure concepts across eCQMs and define a uniform “look and feel” to eCQM logic using CQL. The guide focuses on a set of common best practices implemented across CQL-based eCQMs in CMS reporting programs and also promotes the use of consistent language within the framework of CQL, including libraries, aliases, definitions, functions and conventions.

Open source testing tool used by vendors to certify their EHRs and health information technology (IT) modules for calculating eCQMs. Cypress is an official testing tool for the ONC EHR Certification Program. Testing involves Cypress generating synthetic patient records for the subset of published eCQMs selected for certification and testing the ability of the EHR systems and health IT modules to accurately record, import, calculate, filter, and report eCQMs. The Cypress test data are available in QRDA Category I for import into an EHR system. Cypress tests an EHR system’s ability to generate accurate QRDA Category I and Category III documents for reporting to CMS. Learn more about the Cypress Tool by visiting the Cypress website and reading the Cypress User Guide.

Conformance validation tool which provides implementers with the ability to validate the conformance of QRDA Category I and Category III documents to the 2016, 2017, and 2018 CMS implementation guides:

• 2016 (EP/EH)
• 2017 (EP/EH)
• 2018 (EH Only)

and HL7 implementation guides:

• QRDA Category I (R3, R3.1, R4)
• QRDA Category III (R1, R2.1)

Website which provides eCQI resources and connections with the community of professionals who are dedicated to electronic clinical quality improvement for better health. It provides eCQM electronic specifications along with tool and resource links. It serves as “the one-stop shop for the most current resources to support electronic clinical quality improvement.”

Flowcharts designed to assist in interpretation of the eCQM logic and calculation methodology for reporting rates. These flows provide an overview of each of the population criteria components and associated data elements that lead to the inclusion or exclusions into the eCQM’s quality action (numerator).

Official daily publication for rules, proposed rules, and notices of federal agencies and organizations, as well as executive orders and other presidential documents. The Federal Register is published by the Office of the Federal Register, National Archives and Records Administration (NARA). 

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 constraints 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.

Collaboration platform hosted by the HHS’s Office of National Coordinator for Health Information Technology (ONC) which supports the implementation of health information technology. It provides internal and external users with a common place to transparently log, prioritize, and discuss issues with appropriate subject matter experts on many topics. CMS uses JIRA during most phases of the eCQM measure lifecycle, including development, implementation, and maintenance. JIRA supports projects such as CMS’s annual Measures under Consideration process and ONC’s health IT certification program.

Key topic areas covered include the eCQM Issue Tracker (eCQM implementation), QDM Issue Tracker (QDM measure logic), QRDA Issue Tracker (QRDA implementation), Bonnie Issue Tracker (eCQM testing), and USHIK feedback. Policy questions are not covered in JIRA.

Web-based tool that allows measure developers to author eCQMs using the Quality Data Model (QDM). The tool provides the capability to express measure logic and export measures. The MAT provides the capability to express complex measure logic and export measures in several formats, including a human-readable document which can be viewed in a web browser (HTML), a CQL file containing the CQL library in its entirety, and for integration into Electronic Health Records (EHRs), the MAT provides an eCQM HQMF XML document, an Expression Logical Model (ELM) XML document, and a corresponding JavaScript Object Notation (JSON) file. Measure developers use both Bonnie and MAT to promote test driven development. Refer to the MAT User Guide for more information.

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.

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.

The Quality Payment Program Resource Library is the one-stop shop for all QPP resources. It provides participating eligible clinicians and implementers with general and regulatory QPP information. 
Key resources include:
• MIPS Participation & Overview Fact Sheet and Scoring Guide
• Enterprise Identity Data Management (EIDM) User Guide
• MIPS Measures, Benchmarks, Validation Criteria, and Technical User Guides 
• QPP Final Rule, Fact Sheet, and Executive Summary

Resource which assists data submitters in resolving file upload errors by providing additional explanations and reference material to support successful submission.

As of Calendar Year 2017, Quality Reporting Document Architecture (QRDA) Category I files are submitted by Eligible Hospitals (EHs) to fulfill a portion of the mandatory electronic Clinical Quality Measure (eCQM) reporting requirements for the Centers for Medicare & Medicaid Services (CMS) Hospital Inpatient Quality Reporting (IQR) and Medicare Electronic Health Record (EHR) Incentive Programs.

Cypress testing environment which contains resources and tools for the QRDA Category I and Category III standards. The QRDA Validator provides implementers with the ability to validate the conformance of HL7 QRDA Category I, R2 and QRDA Category III, R3 standards. Note that CMS programs may have additional program specific requirements for QRDA submissions to these programs, which are specified in the CMS QRDA Implementation Guide. 

Resource file which provides 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.

Central repository for the official versions of value sets that support the electronic Clinical Quality Measures. The National Library of Medicine (NLM) maintains the NLM Value Set Authority Center and provides downloadable access to the value sets and the Binding Parameter Specification. The VSAC provides measure developers with tools to search existing value sets, collaborate with other measure developers to harmonize value sets, to create new value sets, and to maintain value set content consistent with current versions of the terminologies they use.

Value sets are lists of specific values (terms and their codes) used to describe clinical and administrative concepts in the quality measures. They provide groupings of unique values along with a standard description or definition from one or more standard vocabularies used to describe the same clinical concept (e.g., diabetes, clinical visit, demographics) within the quality measures.

Information on how value sets are created, used, and updated is available in the VSAC Support Center.

Note: Viewing and/or downloading proprietary value sets, such as those using AMA copyrighted CPT codes or SNOMED CT codes, from NLM-VSAC or AHRQ-USHIK requires a free Unified Medical Language System® Metathesaurus License (UMLS), (available at https://uts.nlm.nih.gov/license.html). It is expected that any use of value sets is consistent with these licensing requirements and copyright protections.