CMS seeks feedback for potential EHR measure on antipsychotic use

The Centers for Medicare & Medicaid Services is soliciting comments from hospitals and others regarding creating a new electronic health record measure on the use of antipsychotics in older adults in an inpatient hospital setting.

CMS periodically develops and re-engineers electronic clinical quality measures (eCQMs) for its reporting programs. This request for comment, issued April 22, states that CMS aims to understand "the scope of antipsychotic use, the potential for quality improvement opportunities and the possible unintended consequences of implementing an antipsychotic measure in an acute inpatient hospital setting."

CMS also provides several documents on which the public can review and comment, such as the proposed numerator and denominator, the rationale for the measure and population criteria.

The agency notes that antipsychotics often are used off label as a method of treating patients in an acute confused state despite conflicting evidence regarding their effectiveness. It also states that hospital use of antipsychotics varies greatly, and that a measure could reduce inappropriate use and the unnecessary continuation of the drugs after a patient's discharge, which could lead to better outcomes.

The agency explains that it aims to understand if the measure is likely to:

  • Increase our understanding of the magnitude of antipsychotics prescribed and administered in the inpatient setting
  • Promote improvement in prescribing practices and reduce variation in use of antipsychotics
  • Collect data that is feasible to obtain from electronic data sources without undue burden
  • Address a quality gap that is important enough to justify potential changes in workflow to enable discrete measurement of antipsychotics and non-pharmacologic interventions
  • Provide information that is a useful indicator of appropriate, patient-centered care

Comments must be submitted via the eCQM issue tracker, and are due May 15.

To learn more:
- here's the solicitation