Looking to EHRs to automate quality reporting

The Centers for Medicare and Medicaid Services (CMS) wants to help hospitals use electronic health records to automatically report patient data required to meet clinical quality standards.

In a request for information published Dec. 28 in the Federal Record, CMS says it wants to make quality reporting more efficient and less burdensome for hospitals. The idea: Use certified EHR technology to electronically report certain patient-level data to the Hospital Inpatient Quality Reporting (IQR) program.

The data would be reported using the Quality Reporting Document Architecture (QRDA) category 1, and required under both the quality reporting and Stage 2 of EHR Meaningful Use programs.

Stage 2 requires a four-step process for aggregated quality reporting, according to Bob Dolin, co-chair of the HL7 Structured Documents Work Group: capturing data, exporting data, calculating data and reporting data.

A certified EHR should be able to import a quality measure and create a report, Dolin said during a webinar on quality reporting from EHRs last year. Groups including HL7 are working on quality reporting standards to achieve this reporting, he said.

Ultimately, CMS wants to adopt data standards to help hospitals consistently capture, transmit and format data, and  a single set of electronic specifications for clinical quality measures under various quality reporting programs, according to the RFI.

"We envisage that hospitals will be able to switch primarily to EHR-based reporting of clinical quality data for many measures that are currently manually chart-abstracted and submitted to CMS for the Hospital IQR Program," CMS says.

CMS asks hospitals to provide information including:

  • Any plans to adopt EHR technology certified to the 2014 criteria during or before calendar year 2014.
  • Awareness of potential income loss for fiscal 2015 for failure to demonstrate Meaningful Use under the Medicare EHR incentive program.
  • Plans to electronically report clinical quality measure data on venous thromboembolism, stroke and emergency department measures under the fiscal 2014 Medicare EHR incentive program.
  • Plans to report data leveraging state or national health information exchange (HIE) initiatives, or to use a third party to report quality data.
  • Operational challenges to electronically reporting quality data.

Among questions it asks EHR vendors:

  • If and when their EHR technology will be certified to the 2014 Edition criteria.
  • Top three operational challenges for 2013-2015, and any mitigation plans.
  • Any data evaluation or validation methodologies for assessing the accuracy of clinical process of care quality data using QRDA category 1 standards.

Comments are due by Jan. 22.

To learn more:
- read the RFI
- here's background on the IQR program