Clinical quality measures required for meaningful use should focus on relevant, controllable metrics, according to a study published in the American Journal of Managed Care, EHR Intelligence reports (Heath, EHR Intelligence, 11/13).
Under the 2009 economic stimulus package, providers who demonstrate meaningful use of certified electronic health records can qualify for Medicaid and Medicare incentive payments.
Study Details
For the study, researchers from the Medical University of South Carolina conducted performance reviews of practices in the Primary (Care) Practices Research Network who had attested to Stage 1 of the meaningful use program. PPRNet is a national primary care practice-based research network that uses electronic health records.
The researchers selected 27 practices that had top scores in meaningful use attestation and invited the lead physician from each practice to attend one of three focus groups held between January 2014 and February 2014.
Study Results
Of the 27 physicians invited to the focus groups, 23 attended. After the meetings the researchers reviewed the discussions and identified eight themes to improve clinical quality measures.
The researchers concluded that clinical quality measures should:
- Be based on scientific evidence and national guidelines and should be relevant for primary providers;
- Include a few measures that focus on public health issues and apply to all providers (Litvin et al., American Journal of Managed Care, 11/13);
- Base metrics on outcomes that are consistent over time and favor population health management;
- Limit the burden on providers by eliminating unnecessary steps in reporting and focusing on quality care and not “checking boxes” (EHR Intelligence, 11/13);
- Include performance thresholds for a select group of quality measures (American Journal of Managed Care, 11/13);
- Encourage EHRs to have the capability capture patient-generated data;
- Take regional health issues into account to develop local clinical quality measures; and
- Use metrics that are proven effective and within a physician’s control, such as reporting population and public health measures.
The focus group also provided examples of poor clinical quality measures. For example, one measure requires providers to acknowledge receipt of a report from a specialist to indicate coordinated care.
The researchers wrote, “Although participants concurred that closing the loop with specialists is important for care management, there was debate about whose responsibility this was and that this measure could unfairly place additional burden on the primary care provider rather than the specialist who was receiving the revenue from providing the service” (EHR Intelligence, 11/13).
