AMIA wants 'fundamental overhaul' of eCQMs

The Centers for Medicare & Medicaid Services has extended the cutoff date for public comment on its request for information (RFI) regarding the certification frequency and requirements for reporting of quality measures under federal programs.

The RFI, issued Dec. 31, 2015, seeks public comment regarding several items related to the certification of health IT, including electronic health record products used for reporting to CMS certain quality reporting, such as the Physician Quality Reporting System and the Hospital Inpatient Quality Reporting program. CMS also requested comment on how often to require recertification, the number of clinical quality measures (CQMs) required for certification and testing of certified health IT modules.

Comments originally were due Feb. 1; the deadline now been extended to Feb. 16.

Initial feedback may not be as positive as CMS may have hoped. The American Medical Informatics Association (AMIA) criticizes the focus on enhanced certification, saying that it doesn't address the "fundamental deficiencies" and challenges with generating electronic CQMs (eCQMs) and reporting them, and that the task "overshadows" any benefit they provide.

"This focus on certification is therefore problematic because it suggests a view that certification enhancements are a promising way to address the problems with quality measurement that have emerged and we do not believe this is the case," AMIA President and CEO Doug Fridsma and Thomas Payne, M.D., medical director of IT services at University of Washington Medicine and AMIA board chair, say in a letter to CMS Acting Administrator Andy Slavitt. "Providers have very little confidence in eCQM accuracy and completeness; health IT developers spend an inordinate amount of resources devoted to eCQMs, which presents an opportunity cost for other customer priorities; and there is little time for the stakeholders to incorporate updates into their products and workflows."

AMIA recommends that quality measure development be overhauled, and said that the Medicare Access and CHIP Reauthorization Act provides CMS with a "rare opportunity" to do so.

Health IT Now Executive Director Joel White provided some feedback, as well, noting in a letter to Slavitt that his organization does not support requiring recertification every time a new certified EHR technology version is released. He also says that Health IT Now supports in-the-field testing, as long as it doesn't add an undue burden on developers or providers.

CQMs are a major part of the Meaningful Use and other programs. Clinicians may need more assistance and better EHRs in order to meet them, however.

To learn more:
- here's the extension (.pdf)
- read AMIA's comments (.pdf)
- check out the Health IT Now letter (.pdf)

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