1. QMWG Measures Framework Quality Measure Workgroup Report David Lansky Aug. 3, 2011

2. Summary of Activities Core plus Menu framework accepted by HIT Policy Committee Transmission Letter submitted for final approval by HIT Policy Committee for National Coordinator Measure Concept Recommendations from Tiger Teams accepted by ONC to guide novel e- measure development Joint hearing with Clinical Quality Workgroup/Standards Committee on e-measure standards and implementation

3. Core + Categorized Menu

4. Timeline of Activities Currently: Existing CMS e-measure development and testing contracts coordinated with ONC Late September: Award of ONC contract for measure development for Stage 2 and Stage 3 measures Late 2011: Measure concepts to be presented in MU Stage 2 NPRM Q2 2012: Measure numerator and denominators to be included in final rule

5. Future Activities of QM WG October 2011: –Receive feedback from providers/hospitals on implementation, report and use of measures for quality improvement (with MU WG) Fall 2011: –Explore clinical quality measure reporting and data infrastructure (e.g., role of data intermediaries, registries) –Joint discussion with Clinical Quality Workgroup/Standards Committee on implications of ICD-10 and potential use of SNOMED for clinical transactions –Explore linking future MU requirements for Clinical Decision Support to emerging measure concepts –Consider methodological recommendations: Infrastructure for capture and sharing of patient-reported data Define core set of data elements that are common to all e-measures and specify for MU?

6. Methodologic Issues Patient reported data--a vehicle is needed to capture data tagged to source (need CDA type standard and transport standard for self-reported race, ethnicity, language, and equity; perception of experience; and structured data for m-health/home devices) Delta measures—need guidance for methods that allow comparison of data points over time Problem lists--identify standards to consistently represent attributes and that can be used for reconciliation Capacity and scalability of EHRs—must be in step with increasing complexity of quality measures Attribution of provider—need standards to clarify assignment of “credit” to members of care teams