GAO: 'Comprehensive strategy needed' for MU CQMs

EHR adoption is rising among eligible professionals and hospitals, but the Department of Health & Human Services (HHS) lacks a comprehensive strategy to ensure it can reliably use clinical quality measures (CQMs) collected in EHRs for quality measurement activities, according to an 81-page report released by the General Accounting Office (GAO).

“Without a comprehensive strategy, efforts to address reliability issues (in accordance with the internal control standard requiring relevant and reliable information) and improve quality and efficiency may be limited,” according to the report.

The GAO analyzed data from the Centers for Medicare & Medicaid Services (CMS) and other sources, reviewed laws, regulations and guidance and conducted interviews with HHS officials and stakeholder groups. It looked at current and expected participation in the EHR programs; evaluated HHS' efforts to ensure EHR data can be used to measure quality of care; reviewed HHS' efforts to assess how the program is meeting adoption and Meaningful Use goals, as well as improved outcomes; and reviewed data reported by providers and others to measure Meaningful Use.  

The GAO advised HHS to direct CMS and the Office of the National Coordinator for Health IT to take the following actions to more effectively use CQMs to assess provider performance:

  • Develop a comprehensive strategy for ensuring that CQM data collected and reported using certified EHR technology are reliable, including testing for and mitigation of reliability issues arising from variance in certified EHR systems tested to different CQM specifications.
  • Develop performance measures to assess outcomes of the EHR programs—including any effects on healthcare quality, efficiency and patient safety and other healthcare reform efforts that are intended to work toward similar outcomes.
  • Use the information these performance measures provide to make program adjustments, as appropriate, to better achieve program goals.

HHS agreed that monitoring is important, but did not say whether they agreed with the recommendations.