Electronic clinical quality measures:
Unlocking opportunities for greater efficiency
Introduction
Electronic clinical quality measures (eCQMs) are becoming increasingly important in healthcare. With 59 percent of all healthcare payments currently linked to value and quality, quality measures such as eCQMs have growing potential to impact reimbursements. Additionally, in recent years CMS has begun publicly displaying eCQM data, giving these measures the potential to impact hospitals’ reputations as well.
However, managing eCQM submissions can pose significant challenges for hospital staff. Barriers include time-intensive validation processes, limitations in electronic health record (EHR) capabilities, and data integrity concerns. To overcome these barriers, facilities must have an approach that fosters both process and performance improvement and ensures data integrity without placing excessive demands on staff time and resources.
This white paper shares common challenges related to eCQM reporting and offers considerations for healthcare leaders evaluating solutions. It also discusses how hospital partners can benefit from Q-Centrix’s eCQM offering and outlines best practices for how hospitals can effectively manage these submissions.
of all healthcare payments are currently linked to value and quality
Challenges
Validation is time intensive.
Due to data accuracy concerns, data validation is crucial—but the time manual data validation requires adds up fast. Q-Centrix found that at a thirteen-hospital health system, eQCM validation activities can take staff one full day to complete.
EHR limitations.
Although many hospitals use EHRs to generate eCQM data, this often involves a great deal of manual work. Coded data elements for eCQMs typically differ from the data elements used in EHRs. Without an established workflow to circumvent this, errors can easily result.
Low data integrity.
Many EHR-based eCQMs have been shown to have incomplete or incorrect results—which is why data validation is so crucial.
Requirements are subject to change.
Changes in reporting guidelines, such as additional mandatory measures being added over time—or changes in how eCQMs may potentially impact reimbursements—may require staff to spend more time on validation and submissions, which can quickly become unsustainable.
Considerations for eCQM solutions
Considering the many challenges associated with eCQMs, it’s not surprising that many facilities seek out assistance for reporting and validation. In fact, developing partnerships with third parties has been cited as a successful strategy for managing eCQMs.
An effective solution should enhance data integrity and empower hospitals and health systems to:
- Develop clinical protocols better aligned with quality initiatives and reporting needs
- Reduce abstraction burdens
- Gain access to deeper insights to guide performance improvement and better decision-making
- Redeploy valuable clinical quality management resources from low-value data capture to high-value analysis and on-the floor clinician support
- Leverage their data to make process improvements and drive operational efficiency
What approach is right for you?
As healthcare leaders evaluate solutions for expanding their eCQM capabilities, they should consider the following questions:
Does the eCQM partner have the in-depth clinical knowledge needed to help you optimize data collection and extraction without affecting your clinical workflow?
Will you be able to easily gather and share the required data within your existing hospital information systems?
Will the solution work well with the reporting requirements of other organizations, such as The Joint Commission?
Is the partner’s technology certified by the Office of The National Coordinator (ONC) certification for all its electronic quality measures for both eligible hospitals and physicians?
Is the quality control process designed with sufficient safeguards, rigor, and transparency to enable hospitals to monitor and ensure data integrity?
Will the EHR/eCQM modules be easy to use?
Above all, can the partner help your executives and clinical staff make better use of the data results?
Q-Centrix’s eCQM offering
Q-Centrix’s enterprise Clinical Data Management (eCDM) approach—which supports hospital partners’ regulatory needs with a comprehensive solution consisting of clinical data capture, technology, insights, and data integrity—includes an eCQM offering as well, providing collaborative process and performance improvement support, in-depth reviews, analytics tools, and more.
Our expertise is extensive: Q-Centrix has reviewed 12,262 unique cases in eCQMs. Our 1,300 clinical data experts are qualified to review 100 percent of available or required eCQMs, and they receive ongoing education on industry requirements.
Q-Centrix’s eCQM offering, which blends human expertise and analytics, includes several key features and benefits:
In-depth reviews. Our data experts review your eCQM process in-depth to determine whether the information being pulled and submitted on your facility’s behalf is accurate. We help streamline the process, saving your team valuable time that can be directed toward addressing identified mapping and documentation opportunities.
Data transparency and analytics tools. Q-Centrix’s eCQM dashboard provides details into where mismatch trends exist, what mapping issues or documentation issues need to be addressed, and which measures are most affected.
Process and performance improvement support. Q-Centrix collaborates with you to help reduce fallouts. Our experts communicate areas of mismatch through both the dashboard and ongoing partner calls to identify the best solution for improvement.
Confidence in data integrity. Our service gives you confidence that the data you submit to CMS are highly accurate. With our help, you can ensure that CMS’s public reporting appropriately reflects your quality of care and maintain a strong reputation in your community.
Longstanding partnership. Q-Centrix is a constant source of support, from validating your build of new measures to providing ongoing feedback on data accuracy. Throughout whatever challenges our partners may face—employee turnover, difficulties aligning internal departments, ever-changing CMS requirements, and more—Q-Centrix is a stable source of clinical data expertise.
Best practices
Partner with a third party for validation.
Because data accuracy is a major challenge when generating and reporting eCQM data, validation is key. Relying on a third party can help facilities efficiently ensure high data integrity without burdening staff with time-intensive validation tasks.
Implement strategies to foster process and performance improvement.
A hospital partner Q-Centrix spoke with shared that submitting eCQM reports to hospital leadership on a quarterly basis helps their facility continually identify opportunities for process improvement, highlight measures relevant to the facility’s specific areas of interest, and keep leadership informed in a meaningful way.
Allow time for manual processes.
At facilities where staff must validate data themselves, quality leaders should plan for the time their team may need to spend on validation—which may be up to a day or longer— and reassign other duties accordingly.
Relying on a third party can help facilities efficiently ensure high data integrity without burdening staff with time-intensive validation tasks.
Conclusion
eCQMs are an essential component of meeting quality reporting program requirements. While facilities have many options for managing this work, these approaches typically do not provide effective solutions for data validation—nor do they empower facilities to use their data to guide process and performance improvement. Amid changing regulatory requirements and quality measures, the support of an expert third-party partner is invaluable in helping quality teams validate their data, streamline operations, drive process and performance improvement, and dedicate their time to where they are needed most.