The study was conducted by Mathematica Policy Research and sought to assess the accuracy and completeness of eCQM data, as well as evaluate hospital and CMS readiness to support the reporting and validation requirements of the Hospital Inpatient Quality Reporting Program. The study was conducted in the spring and summer of 2015 and included 29 hospitals.
The pilot study found that hospitals’ EHR environments were able to collect the required data, but many of the EHRs’ processing procedures were unable to create complete and accurate Quality Reporting Document Architecture – Category I files of patient-level data, which is required based on 2014 eCQM specifications.
Researchers matched EHR-generated data with data captured by CMS contractors, and data matching rates ranged from 12 percent to 49 percent, according to the study.
Staff at participating hospitals provided two primary challenges to eCQM submission data. First, much of the needed information was documented in EHR systems in free text notes or scanned documents rather than structured, discrete data fields. This meant such data elements were not able to be extracted into the QRDA files. Second, they said the clinical workflow was not aligned to permit efficient data mapping. Data elements were often documented in multiple locations during the clinical workflow, and hospital staff had to determine which event (i.e. when order was generated, when order was placed, when patient left facility, etc.) best corresponded to a specific measure, or how all the events should be summarized in order to produce the desired information to report.
“To address these challenges, CMS plans to increase outreach and education in the months ahead,” according to the study. “Since the pilot, CMS has updated the eCQM specifications to improve implementation without increasing the burden on hospitals.”
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