Bonnie
is a software tool that allows eCQM developers to test and verify the behavior of their eCQM logic. The Bonnie application allows measure developers to independently load measures that they have constructed using the MAT and 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.
eCQMs
Electronic clinical quality measures (eCQMs) use data electronically extracted from electronic health records (EHRs) and/or health information technology systems to measure the quality of health care provided. The Centers for Medicare & Medicaid Services (CMS) use eCQMs in a variety of quality reporting and value-based purchasing programs.
There are several benefits of using eCQMs
- eCQMs use detailed clinical data to assess the outcomes of treatment by healthcare providers and organizations
- eCQMs reduce the burden of manual abstraction and reporting for provider organizations
- eCQMs foster the goal of access to real-time data for bedside quality improvement and clinical decision support
Hospitals, professionals, and clinicians use eCQMs to provide feedback on their care systems and to help them identify opportunities for clinical quality improvement. eCQMs are also used in reporting to CMS, The Joint Commission, and commercial insurance payers in programs that reimburse providers based on quality reporting.
Find eCQMs:
Eligible hospital (EH) and critical access hospital (CAH) eCQMs and supporting materials are on the eligible hospital/critical access hospital page of this website.
Eligible professional (EP) and eligible clinician eCQMs and supporting materials are on the eligible professional/eligible clinician page of this website.
Find Pre-rulemaking eCQMs:
CMS pre-rulemaking eCQMs include measures that are developed, but specifications are not finalized for reporting in a CMS program.
Eligible hospital (EH) and critical access hospital (CAH) pre-rulemaking eCQMs.
Eligible professional (EP) and eligible clinician pre-rulemaking eCQMs.
Report eCQMs:
For current CMS programs, eligible hospitals, critical access hospitals, eligible clinicians, and/or eligible professionals must use the most current version of eCQMs when reporting eCQMs. For hospital reporting guidance, visit QualityNet and the Quality Reporting Center for specific program reporting education. For clinician reporting guidance, visit the Quality Payment Programwebsite and the Quality Payment Program Resource Library. For information about the Promoting Interoperability Program, refer to the CMS Promoting Interoperability Program webpage.
For HHS programs using eCQMs, refer to specific program requirements.
Many different organizations may participate in the development and maintenance of eCQMs.The CMS Measures Management System is a standardized system and provides details on the process for developing and maintaining the quality measures used in CMS's various quality reporting and initiative programs. Information on the CQM and eCQM development lifecycle is available in the Blueprint for the CMS Measures Management System (Blueprint) and on the eCQM Lifecycle webpage. The CQL Style Guide is for use by measure developers. It provides examples to standardize expression of measure concepts across eCQMs and define a uniform “look and feel” to eCQM logic using CQL. The Guide provides a set of common best practices for implementation across CQL-based eCQMs used in CMS quality reporting programs.
eCQM Lifecycle:
The eCQM Lifecycle is a series of phases eCQMs progress through when being developed, tested, implemented, and updated. CMS provides several opportunities for stakeholders to engage throughout the measure lifecycle.
Updates to eCQMs:
CMS requires eCQMs approved for CMS programs to be updated annually to reflect changes in evidence-based medicine, code sets, and measure logic. CMS works with measure stewards, measure developers, and users of the eCQMs to ensure necessary changes are reflected in the Annual Update. Additionally, CMS may provide addenda to the eCQM Annual Update periodically within the year to ensure updated code systems are reflected in the eCQM specifications and supporting materials.
Structure of eCQMs:
To be reported from an EHR, eCQMs are made of electronic specifications. Health Quality Measure Format (HQMF), a Health Level Seven International (HL7) standard, is used for electronically documenting eCQM content. These electronic specifications include:
- Computable representation of the eCQM: Contains important details about the measure, how the data elements are defined, and the underlying logic of the measure calculation. The files include
- HQMF XML syntax. The HQMF includes a Header and a Body. The header identifies and classifies the document and provides important metadata about the measure. The body contains eCQM sections (e.g., definitions, population criteria, supplemental data elements).
- Clinical Quality Language (CQL)
- Expression Logical Model (ELM) XML document
ELM JavaScript Object Notation (JSON)
- The Human-readable representation of the eCQM displays the eCQM content in a human-readable format directly in a web browser, Hyper Text Markup Language (HTML) file (.html). This file does not include the underlying HQMF syntax, but the narrative content at the top of the HTML is extracted from the HQMF header.
A value set
and a direct reference code (DRC) convey specific coded values that are allowed for the data elements within the eCQM. Value sets are identified by an object identifier (OID) and include several metadata elements. The value set includes a list of codes (i.e., the value set “expansion code set”) acceptable or valid for a specific data element in the measure, descriptors of those codes, the code system from which the codes are derived, and the version of that code system. DRCs are specific codes that are referenced directly in the eCQM logic to describe a data element or one of its attributes. Value sets and DRCs are found in the Value Set Authority Center (VSAC).
Naming eCQMs:
CMS created a unique “CMS eCQM Identifier” to name eCQM files. The naming convention adds the eCQM identifier assigned to the eCQM in the Measure Authoring Tool (MAT) with the “eCQM Version Number”. “CMS” is placed in front of the number. The eCQM Version Number is used to indicate the published version of the eCQM. For example, based on this naming convention, eligible professional measure (NQF0056-Diabetes: Foot Exam) would be CMS123v1 for the first version of the measure.
eCQM Information | Value |
eCQM Identifier (MAT) | 123 |
eCQM Version number | 1 |
CMS eCQM identifier | CMS123v1 |
The eCQM tools and resources provide a foundation for the development, testing, certification, publication, implementation, reporting, and continuous evaluation of quality measures and their improvement. You can refine the tool list by selecting a category of interest and/or a role that best describes your needs, or you can also click a specific tool from the list below to view additional details.
tools and resources provide a foundation for the development, testing, certification, publication, implementation, reporting, and continuous evaluation of quality measures and their improvement. You can refine the tool list by selecting a category of interest and/or a role that best describes your needs, or you can also click a specific tool from the list below to view additional details. Bonnie
Who Uses Tool: Health IT Developer/Vendor, Measure Developer/Measure Steward
Bonnie User Group
Who Uses Tool: Measure Developer/Measure Steward
The Bonnie User Group is a community of users that benefit from shared experiences and questions. It allows the development team to easily reach out to the community for new releases, proposed features, and focus group opportunities. To join:
- Navigate to https://groups.google.com/forum/#!forum/bonnie
- Sign in with a google account or create an account tied to an existing email address: under “Choose your username” click “I prefer to use my current email address.”
- Click “Join group”
Binding Parameter Specification (BPS)
Who Uses Tool: Health IT Developer/Vendor, Implementers, Eligible Hospital and Critical Access Hospital, Eligible Professional and Eligible Clinician
The value set Binding Parameter Specification (BPS) is generated by the National Library of Medicine (NLM) and is a record of the value set metadata information that defines the code lists specified by current CMS eCQMs. Measure implementers and vendors use the BPS to track versions and other parameters that define the code lists for each eCQM release. 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.
CDS Connect
Who Uses Tool: CDS Developer, Health IT Developer/Vendor, Implementers, Payer, Eligible Professional and Eligible Clinician
Clinical Decision Support (CDS) Connect is a tool that is a web-based repository service which enables the 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.
Certified Health IT Product List (CHPL)
Who Uses Tool: Health IT Developer/Vendor, Eligible Hospital and Critical Access Hospital, Eligible Professional and Eligible Clinician
Certified Health IT Product List (CHPL) is a comprehensive and authoritative listing of all Health Information Technology certified by the ONC Health IT Certification program. All products listed are tested by an ONC-Authorized Testing Lab (ONC-ATL) 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.
Clinical Quality Framework
Who Uses Tool: CDS Developer, Health IT Developer/Vendor, Measure Developer/Measure Steward
The Clinical Quality Framework is a collaborative community of participants from the public and private sectors focused on providing tools, services and guidance to facilitate the harmonization of standards for clinical decision support (CDS) and electronic clinical quality measures (eCQM) use in clinical quality improvement.
Clinical Quality Language (CQL)
Who Uses Tool: Measure Developer/Measure Steward
Clinical Quality Language (CQL) is an HL7 standard for trial use (STU) and it is part of the effort to harmonize standards between electronic clinical quality measures (eCQMs) and clinical decision support (CDS). CQL provides the ability to express logic that is human readable yet structured enough for processing a query electronically.
CMS Measures Inventory Tool (CMIT)
Who Uses Tool: Health IT Developer/Vendor, Implementers, Measure Developer/Measure Steward, Payer, Eligible Hospital and Critical Access Hospital, Eligible Professional and Eligible Clinician
CMS Measures Inventory Tool (CMIT) is a repository for information about CMS measures. CMS and its partners use the inventory to inform stakeholders, to manage its measure portfolio, and to guide measure development. The functions allow users to find measures quickly, to compile and refine sets of related measures, to identify measures across the continuum of care, and will help coordinate measurement efforts across all conditions, settings, and populations.
CMS Quality Reporting Document Architecture (QRDA) Implementation Guides (IGs)
Who Uses Tool: Health IT Developer/Vendor, Implementers, Eligible Hospital and Critical Access Hospital, Eligible Professional and Eligible Clinician
The CMS Quality Reporting Document Architecture (QRDA) Implementation Guides (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.
CMS QRDA Pre-Submission Validation Tools Guide
Who Uses Tool: Health IT Developer/Vendor, Implementers, Eligible Hospital and Critical Access Hospital, Eligible Professional and Eligible Clinician
The CMS Quality Reporting Document Architecture (QRDA) Pre-Submission Validation Tools Guide is a resource which offers 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
CMS QualityNet Data Receiving Systems Edits Document
Who Uses Tool: Health IT Developer/Vendor, Implementers, Eligible Hospital and Critical Access Hospital, Eligible Professional and Eligible Clinician
Each year, the electronic clinical quality measure (eCQM) Data Receiving System Edits Document is developed to provide greater insight into the error messages generated by the CMS data receiving system when test and production Quality Reporting Document Architecture (QRDA) Category I files are submitted to the CMS receiving system within the QualityNet Secure Portal.
CQL Formatting and Usage Wiki
The Clinical Quality Language (CQL) Formatting and Usage Wiki is a collaborative workspace for the development of CQL formatting conventions and usage patterns for the representation of logic within quality measures. All users have edit rights to be able to submit edits, add comments and concerns. Items on the Wiki are a work in progress and subject to change.
CQL Formatting and Usage Wiki - eCQM Known Issues
Who Uses Tool: Health IT Developer/Vendor, Implementers, Measure Developer/Measure Steward
The eCQM Known Issues is a section in the Clinical Quality Language (CQL) Formatting and Usage Wiki that provides a listing of known issues relative to CQL-Based eCQM support.
CQL Style Guide
Who Uses Tool: Measure Developer/Measure Steward
The CQL Style Guide provides standardize expressions of measure concepts across eCQMs and defines a uniform “look and feel” to eCQM logic using CQL. The guide focuses on a set of common best practices that have been implemented across CQL-based eCQMs in CMS quality reporting programs. The style guide also promotes the use of consistent language within the framework of CQL, including libraries, aliases, definitions, and functions, as well as guidance on other conventions, such as operator precedence. Measure stewards or developers who are developing or specifying eCQMs for future inclusion in CMS programs should align with these best practices.
CQL-to-ELM Translator Reference Implementation
Who Uses Tool: Health IT Developer/Vendor, Implementers
The CQL-to- ELM Translator is a specification that describes a formal mechanism for translating the high-level CQL syntax into the canonical called Expression Logical Model (ELM) representation. 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.
Cypress
Who Uses Tool: Health IT Developer/Vendor
Cypress is an 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.
Cypress Tech Talks
Who Uses Tool: Health IT Developer/Vendor, Implementers
The Cypress Tech Talks are an open forum for discussing technical implementation and tool issues with the Cypress support team.
Cypress Validation Utility (CVU)
Who Uses Tool: Health IT Developer/Vendor, Implementers
The Cypress Validation Utility (CVU) conformance tool provides implementers with the ability to validate the conformance of QRDA Category I and Category III documents to the 2018 and 2019 CMS implementation guides.
- 2018 and 2019 CMS QRDA I Implementation Guides for Hospital Quality Reporting
- 2018 and 2019 CMS QRDA III Implementation Guides for Eligible Professionals and Eligible Clinicians
eCQI Resource Center
Who Uses Tool: CDS Developer, Health IT Developer/Vendor, Implementers, Measure Developer/Measure Steward, Payer, Eligible Hospital and Critical Access Hospital, Eligible Professional and Eligible Clinician
The eCQI Resource Center is a 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.”
eCQM Calculations Libraries and Technical Services
Who Uses Tool: Health IT Developer/Vendor, Implementers
The eCQM Calculations Libraries and Technical Services are open source libraries which provide support for loading and calculating eCQMs, generating Quality Data Model (QDM) types, and other libraries related to Clinical Quality Language (CQL) and Fast Healthcare Interoperability Resources (FHIR). Many of the libraries listed below are used within the Bonnie and Cypress tools and are actively supported.
CQM Models: A software library containing auto generated models based off of QDM.
CQM Execution: NPM module for calculating eCQMS written in CQL, using the CQM-Models library
CQM Reports: A library for import and export of reports for use with eCQMs.
CQM Parsers : A library for parsing CQL-based HQMF documents and parsing Measure Authoring Tool (MAT) eCQM packages into models based off of the CQM-Models library.
CQM Validators: A library for QRDA validation. It contains Schematron validators, and validators for QRDA-specific features (measure IDs, performance rates, result extraction, etc).
CQM Execution Service: A Dockerized Node-based service for calculating eCQMs which uses the CQM Execution module.
CQL Execution: A JavaScript CQL Execution framework that can execute CQL artifacts expressed as JSON ELM.
CQL to ELM Translation Service: A microservice wrapper for the CQL to ELM conversion library.
CQL Exec FHIR: A FHIR-based data source module for use with the CQL Execution Engine.
eCQM Flows
Who Uses Tool: Health IT Developer/Vendor, Implementers, Eligible Hospital and Critical Access Hospital, Eligible Professional and Eligible Clinician
The eCQM Flows are 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).
eCQM Logic and Implementation Guidance
Who Uses Tool: Health IT Developer/Vendor, Implementers, Eligible Hospital and Critical Access Hospital, Eligible Professional and Eligible Clinician
The eCQM Logic and Implementation Guidance is a resource document which provides guidance for understanding, using, and/or implementing eCQMs.
Federal Register
Who Uses Tool: CDS Developer, Consumer, Health IT Developer/Vendor, Implementers, Measure Developer/Measure Steward, Payer, Eligible Hospital and Critical Access Hospital, Eligible Professional and Eligible Clinician
The Federal Register is the 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).
Category: Reporting
Who Uses Tool: Health IT Developer/Vendor, Implementers, Eligible Hospital and Critical Access Hospital
The Centers for Medicare & Medicaid Services (CMS) and The Joint Commission (TJC) released guidance for reporting diagnostic test data in the Diagnostic Study Performed (V4) template of Quality Reporting Document Architecture (QRDA) Category I files. This affects the electronic clinical quality measure (eCQM) CMS31v6 - Hearing Screening Prior To Hospital Discharge only. The 2018 CMS QRDA Category I Implementation Guide (IG) for Hospital Quality Reporting allows for two ways of reporting the result of a diagnostic test in the Diagnostic Study Performed (V4) template:
- Using the element “value” inherited from its parent template Procedure Activity Observation (V2), or
- Using the contained template Result Observation (V3).
For 2018 reporting, CMS has aligned with TJC to only use the first option. Result data for the Diagnostic Study Performed template must be in the value element in order to be processed by CMS.
Result data provided in the template Result Observation (V3) will not be used by the QualityNet data receiving system during measure calculation of CMS31v6. The QRDA file will not be rejected, nor will a warning be returned, if the Result Observation (V3) template is used, and that the measure outcome of CMS31v6 from CMS may not match what is expected.
Guide to Reading eCQMs
Who Uses Tool: Health IT Developer/Vendor, Implementers, Eligible Hospital and Critical Access Hospital, Eligible Professional and Eligible Clinician
The Guide to Reading eCQMs is a resource to assist stakeholders in interpreting and understanding eCQMs. The guide provides information on eCQMs such as file naming conventions, understanding an eCQM human-readable rendition, value sets, QDM data criteria, and more.
Health Quality Measure Format (HQMF)
Who Uses Tool: Measure Developer/Measure Steward
Health Quality Measure Format (HQMF) is an HL7 standards-based representation of a quality measure as an electronic document. A quality measure expressed in this way is also referred to as an electronic clinical quality measure (eCQM).
HL7 Clinical Quality Language (CQL)-based Health Quality Measure Format (HQMF) Implementation Guide (IG)
Who Uses Tool: Health IT Developer/Vendor, Implementers, Measure Developer/Measure Steward
The CQL-based HQMF IG constrains the HL7 HQMF IG by utilizing both a domain analysis model called the Quality Data Model (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.
HL7 Quality Data Model (QDM)-based Health Quality Measure Format (HQMF) Implementation Guide (IG)
Who Uses Tool: Health IT Developer/Vendor, Implementers
The QDM-based HQMF IG constrains the HL7 HQMF IG by utilizing a domain analysis model called the QDM. This 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. No stand-alone QDM-based HQMF IG has been created since October 2016 and its functionality has been superseded by the CQL-based HQMF IG.
HL7 Quality Reporting Document Architecture (QRDA) Category I Implementation Guide (IG)
Who Uses Tool: Health IT Developer/Vendor, Implementers, Eligible Hospital and Critical Access Hospital
The HL7 Quality Reporting Document Architecture Category I Implementation Guide (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.
HL7 Quality Reporting Document Architecture (QRDA) Category III Implementation Guide (IG)
Who Uses Tool: Health IT Developer/Vendor, Implementers, Eligible Professional and Eligible Clinician
The HL7 Quality Reporting Document Architecture Category III Implementation Guide (HL7 QRDA III IG) describes constraints on HL7's Clinical Document Architecture Release 2 (CDA R2) to create a QRDA III document. QRDA Category III is for reporting aggregated quality measure data.
Measure Authoring Tool (MAT)
Who Uses Tool: Measure Developer/Measure Steward
The Measure Authoring Tool (MAT) is a web-based tool that allows measure developers to author eCQMs using Clinical Quality Language (CQL) and the Quality Data Model (QDM). The MAT provides the capability to express complex measure logic and export measures in several formats.
Measures Management System (MMS)
Who Uses Tool: Health IT Developer/Vendor, Measure Developer/Measure Steward, Payer, Eligible Hospital and Critical Access Hospital, Eligible Professional and Eligible Clinician
The Measures Management System (MMS) is a standardized system for developing and maintaining the quality measures used in CMS’s various quality initiatives and programs. The primary goal of the MMS is to provide guidance to measure developers to help them produce high-caliber healthcare quality measures.
Measures Management System (MMS) Blueprint
Who Uses Tool: Measure Developer/Measure Steward
The Measures Management System (MMS) Blueprint is a guidance document which provides a standardized system for developing and maintaining the quality measures used in various quality initiatives and programs. The Blueprint includes information on Measure Development Concepts, Measure Lifecycle, eCQM Lifecycle, as well as Tools, Appendices, and Forms.
NCQA eCQM Certification Program
Who Uses Tool: Health IT Developer/Vendor, Implementers
The National Committee for Quality Assurance (NCQA) eCQM Certification Program uses ONC-approved methodology for testing Health IT's ability to create accurate eCQMs. The NCQA eCQM Certification Program is for use in the ONC HIT Certification Program and is approved as an Authorized Test Lab (ATL).
NCQA eCQM Crosswalk
Who Uses Tool: Health IT Developer/Vendor, Implementers, Eligible Hospital and Critical Access Hospital, Eligible Professional and Eligible Clinician
The National Committee for Quality Assurance (NCQA) eCQM crosswalk identifies eCQMs that are tested under the NCQA eMeasure (eCQM) Certification program, accepted in the NCQA Patient Centered Medical Home 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.
ONC Project Tracking System (JIRA)
Who Uses Tool: CDS Developer, Health IT Developer/Vendor, Implementers, Measure Developer/Measure Steward, Eligible Hospital and Critical Access Hospital, Eligible Professional and Eligible Clinician
JIRA is a 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.
Pioneers in Quality
Who Uses Tool: Health IT Developer/Vendor, Implementers, Payer, Eligible Hospital and Critical Access Hospital
Pioneers in Quality is 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.
popHealth
Who Uses Tool: Health IT Developer/Vendor, Implementers, Eligible Hospital and Critical Access Hospital, Eligible Professional and Eligible Clinician
popHealth is an open source software tool that can automate the reporting of summary quality measures and streamline the exchange of summary quality data. popHealth can be used by developers to better understand quality measurement and reporting. The tool has also proven valuable for its individual parts: standardized data importer/exporter, user interface, and most importantly its quality measure engine, which is technology shared with Cypress.
Pre-Submission Validation Application (PSVA)
Who Uses Tool: Health IT Developer/Vendor, Implementers, Eligible Hospital and Critical Access Hospital
The Pre-Submission Validation Application (PSVA) is an 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 the Centers for Medicare & Medicaid Services (CMS). 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.
Quality Payment Program (QPP) Developer Tools
The Quality Payment Program (QPP) Developer Tools allow industry developers, who build software for participating clinicians, to integrate their software directly with CMS applications and data. Available tools include Submissions Application Programming Interface (API), Measures, Activities, and Benchmarks Repository, Submissions Schemas, and 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.
Quality Payment Program (QPP) Resource Library
Who Uses Tool: Health IT Developer/Vendor, Implementers, Eligible Professional and Eligible Clinician
The Quality Payment Program (QPP) Resource Library is the one-stop shop for all QPP resources. It provides educational materials that support clinicians’ participation in QPP.
Key 2019 resources include
• MIPS Participation & Eligibility Fact Sheet
• Quality Payment Program Access Guide
• MIPS Measure Specifications, Quality Benchmarks, MIPS Data Validation Criteria, and Technical User Guides
• QPP Final Rule Overview Fact Sheet and Executive Summary
All QPP webinar resources, including slides, transcripts and recordings from recent presentations, can be found on the QPP Webinar Library.
NQF Quality Positioning System (QPS)
Who Uses Tool: Health IT Developer/Vendor, Measure Developer/Measure Steward, Payer, Eligible Hospital and Critical Access Hospital, Eligible Professional and Eligible Clinician
The National Quality Forum (NQF) Quality Positioning System (QPS) is a web-based inventory tool developed by the 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.
QRDA Category I Conformance Statement Resource
Who Uses Tool: Health IT Developer/Vendor, Implementers, Eligible Hospital and Critical Access Hospital
The Quality Reporting Document Architecture (QRDA) Category I Conformance Statement Resource assists data submitters in resolving file upload errors by providing additional explanations and reference material to support successful submission. Since Calendar Year 2017, QRDA Category I files are submitted by Eligible Hospitals (EHs) to fulfill a portion of the mandatory eCQM reporting requirements for the CMS Hospital Inpatient Quality Reporting (IQR) and Promoting Interoperability Programs.
QRDA III Converter
The Quality Reporting Document Architecture (QRDA) III Converter tool 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 complies with the most current QRDA III Implementation Guide and can be successfully submitted to QPP.
Quality Data Model (QDM)
Who Uses Tool: Measure Developer/Measure Steward
The Quality Data Model (QDM) is an 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.
Quality Reporting Document Architecture (QRDA)
Who Uses Tool: Health IT Developer/Vendor, Implementers, Eligible Hospital and Critical Access Hospital, Eligible Professional and Eligible Clinician
The Quality Reporting Document Architecture (QRDA) is a standard document format for the exchange of electronic clinical quality measure (eCQM) data.
QualityNet
Who Uses Tool: Health IT Developer/Vendor, Implementers, Eligible Hospital and Critical Access Hospital
QualityNet is a website which provides healthcare quality improvement news, resources and data reporting tools, and applications. QualityNet is the only CMS-approved site for secure communications and healthcare quality data exchange between healthcare organizations and facilities.
Technical Release Notes (TRN) - eCQM Eligible Hospital/Critical Access Hospital
Who Uses Tool: Health IT Developer/Vendor, Implementers, Eligible Hospital and Critical Access Hospital
The Technical Release Notes (TRN) for Eligible Hospital and Critical Access Hospital eCQMs are resource files which provide an overview of technical changes in the eCQM Annual Update and addenda.
Technical Release Notes (TRN) - eCQM Eligible Professional/Clinician
Who Uses Tool: Health IT Developer/Vendor, Implementers, Eligible Professional and Eligible Clinician
The Technical Release Notes (TRN) for Eligible Professional/Clinician eCQMs are resource files which provide an overview of technical changes in the eCQM Annual Update and addenda.
Unified Medical Language System® (UMLS®)
Who Uses Tool: CDS Developer, Health IT Developer/Vendor, Implementers, Measure Developer/Measure Steward, Payer, Eligible Hospital and Critical Access Hospital, Eligible Professional and Eligible Clinician
The Unified Medical Language System® (UMLS®) is a 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.
The United States Health Information Knowledgebase (USHIK)
Who Uses Tool: Health IT Developer/Vendor, Implementers, Eligible Hospital and Critical Access Hospital, Eligible Professional and Eligible Clinician
The United States Health Information Knowledgebase (USHIK) is a 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 National Library of Medicine. Each eCQM release package is available in a single file, or can be downloaded as eligible hospital, eligible professional, and individual measure packages.
Value Set Authority Center (VSAC)
Who Uses Tool: CDS Developer, Health IT Developer/Vendor, Implementers, Measure Developer/Measure Steward, Payer, Eligible Hospital and Critical Access Hospital, Eligible Professional and Eligible Clinician
The Value Set Authority Center (VSAC) is a central repository for the official versions of value sets that support the electronic clinical quality measures. The National Library of Medicine maintains the VSAC 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, create new value sets, and maintain value set content consistent with current versions of the terminologies they use.
VSAC Collaboration Tool
Who Uses Tool: Measure Developer/Measure Steward
The Value Set Authority Center (VSAC) Collaboration Tool provides a central site where value set authors can post value sets for collaborative discussion. Teams can share threaded discussions about the value sets, view recent value set expansions posted by site members, organize their value sets by usage and by team’s workflow needs, collaborate with other measure developers to harmonize value sets, and receive activity and change notifications from VSAC.
eCQM Resources
Introduction to eCQMs
- eCQM 101 - Getting Started with Electronic Clinical Quality Measures for Quality Reporting- March 2019
- How to Implement eCQM Annual Updates - March 2019
- Introduction to Electronic Clinical Quality Measures (eCQMs) - December 7, 2016
- View webinar (YouTube)
- Slides
Developing eCQMs
- Pioneers in Quality™ Proven Practices: Establish your eCQM A-team – September 5, 2017
- Developing eCQMs for use in CMS Programs - August 17, 2017
Testing eCQMs
- Introduction to Electronic Clinical Quality Measures (eCQMs) Testing - February 8, 2017
- View webinar (YouTube)
- Slides
Implementing eCQMs
- eCQM Pre- and Post-Implementation Testing Overview - March 2019
- eCQM Implementation Checklist - April 17, 2017
- 36 short educational videos (YouTube) assist providers in implementing CMS Comprehensive Primary Care (CPC), several of which are specifically relevant to electronic clinical quality improvement:
Submitting/Reporting eCQMs
- Eligible Clinician New eCQMs Finalized for 2019 - March 11, 2019
- View webinar (YouTube)
- Slides
- 2018 Pioneers in Quality: Learnings from 2016 eCQM Results, Exceptions and Exclusions – May 2, 2018
- Pioneers in Quality™: Joint Commission 2017-2018 ORYX Reporting Requirements and eCQM Direct Submission– October 17, 2017
- Pioneers in Quality™ Proven Practices: Ensuring eCQM Accuracy – October 10, 2017
- Quality Reporting In CMS’ Post-Acute Care Quality Reporting Programs - August 17, 2017
- Pioneers in Quality™ Proven Practices: Keys to eCQM Success – August 14, 2017
- Pioneers in Quality™: Creating Your Proven Practices Submission – May 9, 2017
- Pioneers in Quality™ Kickoff to Hospital eCQM Reporting in 2017 – February 7, 2017
- HIMSS 2016 eCQM Submissions - Ready Set Go - March 2, 2016
eCQI Resources
- ONC's Innovations in the Use of Electronic Health Data for eMeasurement and Quality Improvement webinar YouTube - May 4, 2017
- Health Information Technology (IT) Curriculum Resources for Educators videos were funded by The Office of the National Coordinator for Health Information Technology (ONC) as part of the Workforce Development Programs and provide instructional materials covering areas relevant to improved care delivery. A number of the curriculum components cover electronic clinical quality improvement:
NOTE: Many of these components are over 1 GB in size. Downloading may take up to 10 minutes, depending on your connection.
- eCQI Toolkit - March 2017 and eCQI Resources from Mountain-Pacific Quality Health Quality Improvement Organization assist organizations with leveraging health information technology (HIT) and the Plan Do Study Act (PDSA) process improvement methodology to support and advance their health quality improvement initiatives.
Get Involved:
CMS provides several opportunities to provide input on eCQM development and updates, public calls for measures, comments on measures under development, and participation on technical expert panels. Visit the CMS Measures Management System Get Involved webpage and the Engage in eCQI page for a list of current opportunities.
Provide Feedback:
CMS, through the ONC Project Tracking System (JIRA), allows stakeholders to submit issues with eCQM implementation and development and receive feedback. Submit eCQM technical questions to the eCQM Issue Tracker.
Seek Help:
Information on various helpdesks and tools for eCQM help is found on the eCQI Resource Center Contact Us page.
Last Updated: May 10, 2019