eCQMs

Community of Bonnie users that benefit from one another’s experience and questions, and allows the development team to easily reach out to the community regarding new releases, proposed features, and focus group opportunities.  Follow these instructions to join:

• Navigate to https://groups.google.com/forum/#!forum/bonnie
• Sign into a google account, or create one
• You can create a google account tied to an existing email address: under “Choose your username” click “I prefer to use my current email address.”
• Click “Join group”
• Adjust your preferred settings in the pop-up dialog to indicate how you wish to receive group messages. You can change these settings later

• Click “Join this group”

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.

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

Registry and repository of health care-related metadata, specifications, and standards. The CMS Quality Programs portal provides the ability to view, download, and compare eCQM specifications, data elements, value sets, and codes released by CMS and NLM. Each eCQM release package is available in a single file, or can be downloaded as eligible hospital, eligible professional, and individual measure packages. These files are available in PDF, Excel, CSV, HQMF XML, or XML. UHSIK provides the ability for public comments to be received on measures and measure updates under consideration. This knowledgebase is produced by the Agency for Healthcare Research and Quality (AHRQ) in partnership with CMS and NLM.

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.

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.