Glossary

The Electronic Clinical Quality Improvement (eCQI) Resource Center User Group is a volunteer forum of eCQI Resource Center users that use the site to obtain resources necessary for electronic clinical quality measure (eCQM) development, implementation, reporting, and education on key eCQM and eCQI concepts and standards. The eCQI Resource Center User Group meets quarterly on the 3rd Tuesday at 3:00pm ET.

This document describes the versions of the standards and code systems used in conjunction with the updated eCQMs for potential use in CMS programs for a given reporting/performance period.

The Measure Collaboration Workspace Electronic Clinical Quality Measures (eCQM) Concepts Module gives users the ability to suggest new eCQM concepts and comment on other's suggested eCQM concepts.

CMS encourages all stakeholders, including patients and point of care clinicians, to suggest eCQM concepts and offer comments on others' suggested eCQM concepts. 

The eCQM Data Element Repository (DERep) provides clarification, definitions, and clinical focus for the data elements associated with electronic clinical quality measures (eCQMs) used in CMS quality reporting and incentive programs. Users can filter information by data element, eCQM, Quality Data Model (QDM) attribute, QDM category, QDM datatype, or QDM entities.

The electronic clinical quality measure (eCQM) Flows are flowcharts designed to assist in the interpretation of the eCQM logic and provide the calculation methodology to determine measure scores. These flows provide an overview of each of the population criteria components and associated data elements that lead to the inclusion, exclusion, or exception into the eCQM’s denominator and numerator, if applicable.

The eCQM flows are available for eligible clinician eCQMs, eligible hospital/critical access hospital eCQMs, and outpatient quality reporting eCQMs.

The Electronic Clinical Quality Measure (eCQM) Implementation Checklist assumes a health care practice/organization has determined which quality measures to report. The checklist provides the necessary technical steps health information technology developers, implementers, and health care organizations must take to update their systems and processes with the eCQM Annual Update for the upcoming reporting and performance periods. The most recent eCQM Annual Update should be applied to electronic health record systems for use in electronic quality reporting.

The Electronic Clinical Quality Measure (eCQM) Known Issues tracker provides implementation information for eCQMs with known technical issues for which a solution is under development but not yet available in a published eCQM specification. This includes discrepancies between eCQM narrative and logic, value sets, and/or technical, standard, or logic-related issues.

The Electronic Clinical Quality Measure (eCQM) Logic and Implementation Guidance is a resource document which provides guidance for understanding, using, and/or implementing eCQMs. This document includes useful context and details regarding topics such as Clinical Quality Language representation in the technical specifications, applying data elements and value sets/coding, and the ONC Project Tracking System (Jira) to provide feedback on the eCQMs.

The Electronic Clinical Quality Measure (eCQM) Testing Opportunities Module within the eCQI Resource Center’s Measure Collaboration Workspace enables eCQM developers to announce testing opportunities. This module allows developers to evaluate various aspects of eCQMs, including feasibility, reliability, validity, and usability. Interested parties wanting to participate in testing eCQMs should contact the eCQM developer directly.

An efficiency measure is the cost of care (inputs to the health system in the form of expenditures and other resources) associated with a specified level of health outcome.

Electronic case reporting is the automated generation and electronic submission of reportable diseases and conditions from an electronic health record to public health agencies. Each state has public health reporting requirements and relies on health care providers to report on certain conditions.

Electronic clinical quality improvement is the use of health information technology, and the functionality and data in an electronic health record and/or other health information technology, along with clinical best practices to support, leverage, and advance quality improvement initiatives.

An electronic clinical quality improvement (eCQI) implementer does many things to prepare processes and systems such as

• Putting measure data components into systems and workflow
• Using measures when conducting health care activities
• Providing information from measures to inform quality improvement (e.g., health information technology implementer, quality analyst, quality reporting validator)

An electronic clinical quality measure (eCQM) is a measure specified in a standard electronic format that uses data electronically extracted from electronic health records (EHR) and/or health information technology (IT) systems to measure the quality of health care provided.

An electronic health record (EHR) is also known as the electronic patient record, electronic medical record, or computerized patient record. An EHR is a “longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting. Included in this information are patient demographics, progress notes, problems, medications, vital signs, past medical history, immunizations, laboratory data, diagnoses and treatment, medications, allergies, immunizations as well as radiology images and laboratory results.” International Social Security Association. (n.d.). Information and communication technology- Guideline 91. Electronic health record system. Retrieved March 20, 2024, from https://ww1.issa.int/guidelines/ict/180156

An eligible clinician refers to a clinician who is eligible to participate in the Quality Payment Program through the Merit-based Incentive Payment System and similar participants of other CMS programs using electronic clinical quality measures for quality reporting such as Alternative Payment Model participants.

An eligible hospital is an acute care facility, e.g., Subsection (d) hospitals in the 50 states or District of Columbia paid under the Inpatient Prospective Payment System, and critical access hospitals, meeting eligibility requirements for Promoting Interoperability Program payment adjustments by adopting, implementing, or updating certified EHR technology.

An end user (sometimes end-user) is a person who ultimately uses or intends to ultimately use a guideline, measure, or its derivative products.

An environmental scan is the process of systematically reviewing and interpreting data to identify issues and opportunities influencing prioritization of current or future plans.

The Environmental Scan Support Tool (ESST) is a tool within the CMS Measures Inventory Tool (CMIT) environment, intended to automate environmental scans required in the information gathering process to develop and maintain quality measures. The ESST uses an automated natural language processing approach that rapidly scans literature in PubMed, PubMed Central, and CINAHL to

• Identify relevant documents (abstracts and full-text articles)
• Identify and extract the specific knowledge within each relevant document that applies to the measure’s potential opportunity for improvement

The Expression Logical Model (ELM) is a machine-readable representation of an electronic clinical quality measure’s logic and provides the information needed to automatically retrieve data from an electronic health record. The ELM file can be in eXtensible Markup Language (XML) (.xml) or JavaScript Object Notation (JSON) (.json).

eXtensible Markup Language (XML) is a markup language defining a set of rules for encoding documents in both a human-readable and machine-readable format.

An extensional value set is a set of concept codes and descriptors, in the form of an enumerated list, selected to serve a specific purpose.