EHR vendors are facing the arduous task of programming as many as 125 clinical quality measures (CQMs)—in addition to the development challenges presented by all the other new meaningful use requirements for Stage 2—and to do this in a relatively short period of time. To compound matters, the calendar is rapidly advancing and the specifications for these quality measures are not even available yet.
Is there a better way to approach quality measure reporting? I think so—and it seems so obvious to me! EHRs should not be doing all of the analysis—they should simply collect and report the data, and CMS or its designate should provide the analytics. A centralized approach would be much more efficient and would produce more consistent and reliable data.
Think of the time and resources being wasted. Why should each of the 472 vendors offering certified EHRs have to program the same 125 clinical quality measures—that’s the programming of a total of 59,000 measures—when they should not have to program any at all? This unnecessary cost will ultimately be passed on to physicians. And what about the effect on standardization and comparability of the data produced? Despite the certification requirements for each of the quality measures, minor variances in calculations are inevitable, and this compromises the value of the data for comparative purposes. Centralization would also allow changes to be implemented in a nimble and timely manner. With a centralized registry, new measures could be introduced, and changes to measure specifications that result from new research could be programmed and released immediately, without having to wait what could be years for each of the 472 vendors to develop, upgrade, and deploy the changes to the hundreds of thousands of physician-EHR users.
A model already exists for such an approach, and the infrastructure for data exchange is in place using one or more of the standards that are accepted in the industry today. Registries are already analyzing clinical data and identifying areas for quality improvement. It is critical that we think outside of the box to find opportunities like the above that eliminate unnecessary duplication of effort and free vendors to focus on areas of keen interest—like EHR usability and physician productivity.