Meaningful Use should be driven by clinical quality, not mechanics

The Meaningful Use of electronic health records relies heavily on meeting clinical quality measures (CQMs). But the Medicare and Medicaid EHR incentive program also currently requires extensive documentation/attestation to a particular set of activities. As the incentive program moves out of Stage 1 and into Stages 2 and 3, blogger Michael Barr--a member of the Office of the National Coordinator for Health IT's Health Information Technology Policy Committee Meaningful Use Workgroup--wonders if there should be more of an emphasis on the measures, as opposed to the mechanics.

Barr, reporting about the workgroup's Oct. 6 hearing on Stage 3 of Meaningful Use, writes that speakers at the hearing pointed out flaws in the current CQMs, such as clinical errors, lack of clarify of data fields, and CQMs that were not designed or tested properly. However, there appeared to be consensus that the CQMs should be driving Meaningful Use.

Barr suggests that the current mechanical documentation/attestation requirements should be used more as a stepping stone, adding that they are not needed as the program progresses.

"Successfully reporting CQMs would...imply that the antecedent activities were accomplished," Barr writes. "Therefore, why not drop the requirements to report on anything but the CQMs and perhaps some process/structure metrics that are not directly associated with successful CQM reporting? CMS could provide the pre-requisite functionality requirements for each CQM as part of the measure specifications just as college course listings identify the basic courses needed prior to enrolling in an advanced course."

Barr adds that "[b]y emphasizing quality measures and allowing EPs and EHs to focus on attaining the CQM goals, the EHR Incentive program would become less about implementing change in order to check boxes on an attestation form and more about allowing health systems and practices to innovate around the expectation to enhance clinical quality."

To learn more:
- read the blog post
- here's a link to the Meaningful Use workgroup
- check out CMS' website about the Incentive Program's requirements