CMS wants to make CQM standards tougher for EHRs, easier for EPs to meet

CMS has issued a request for information (RFI) asking for feedback to improve the way clinical quality measures are handled electronically in electronic health records (EHRs), which may lay extra burdens on EHR developers but make electronic reporting easier for providers.

Clincal quality measures (CQM) are tools that CMS uses to measure provider performance for its quality reporting programs such as the physician quality reporting system (PQRS).

CMS lists three categories for which it wants the public to offer advice:

1. Frequency of updating CQMs. Certification for health IT modules such as certified EHR technology (CEHRT) and clinical quality measure specifications are currently updated at different times, which can leave a lag between a CQM update and the requirements to which certified EHR systems are designed. CMS is considering requiring health IT modules to update whenever the CQMs are updated. (Electronic reporting of these measures is optional for most reporters in 2017 but will be mandatory in 2018.)

2. Increasing minimum CQM certification requirements. The current Office of the National Coordinator for Health IT (ONC) 2014 minimums for EHR reporting capacity are nine CQMs for EPs and 16 CQMs for eligible hospitals and critical access hospitals (CAHs). CMS admits this may leave some providers unable to “report on CQMs that are applicable to their patient population or scope of practice,” so it is considering several options, from minor changes to requiring health IT developers to certify health IT modules to all CQMs.

3. CQM testing and recertification. CMS and ONC want higher standards for testing CQM functionality as part of ONC’s Health IT Certification Program. “Our expectation,” they say, “is that as time progresses and technology improves, EHR systems will have to demonstrate they are able to perform to increasing levels of complexity, including requirements to identify errors, consume larger numbers of test cases and demonstrate stricter adherence to standards.”

The RFI has a 30-day comment period starting from its official posting date of Dec. 31, at which time you should be able to submit your information at regulations.gov.