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Providers are encouraged to apply today for the electronic clinical quality measure (eCQM) solution that helps them extract eCQMs once and report them to several approved entities. The solution, which is funded by the Colorado State Innovation Model (SIM), will help practices succeed with alternative payment models and reduce the provider burden of reporting. SIM practices can apply for phase 2 now. SIM is a federally funded, governor’s office initiative that helps practices integrate physical and behavioral health and gain the skills they need to succeed with APMs. Learn more about SIM in this quick video.
All SIM practices (cohort 1, cohort 2 and cohort 3) are eligible to apply for the eCQM solution. This is an investment in practices that are interested submitting eCQMs for alternative payment models.
The following organizations are working with SIM practices to use the eCQM solution under the umbrella name Health Data Colorado (HDCo):
Colorado Community Managed Care Network (CCMCN):
CCMCN is a not-for-profit organization supporting Colorado healthcare communities by providing data management, quality reporting, data analysis and performance improvement strategies empowering organizations that provide services to Colorado's vulnerable residents. CCMCN builds upon its 20 years as nationally recognized HRSA Health Center Controlled Network (HCCN) for Colorado and with this experience, CCMCN can ensure that providers have the healthcare technology strategies they need to be successful.
CORHIO is an established health information exchange with 13,000 network users primarily along the Front Range, Eastern Plains and some of the mountain towns. CORHIO is a contractor with the Colorado State Innovation Model working with practices to extract electronic clinical quality measures automatically from electronic health record systems using CORHIO’s established processes and years of experience in this area.
Quality Health Network (QHN):
QHN is a not-for-profit health information exchange partnership that has a mission to facilitate the availability of information to optimize the health of our communities, improve economic efficiencies of patient care and bring value to its stakeholders.
New tool helps SIM practices report eCQMs
Helping health care providers succeed with alternative payment models (APMs) that reward the value (versus volume) of health care delivered requires the ability to collect, report and use data in actionable ways. The Colorado State Innovation Model (SIM) launched an electronic clinical quality measure (eCQM) solution in May to help practices report eCQMs while reducing the administrative burden of doing so.
This partnership has been called the first to leverage blockchain technology for HIPAA-compliant data aggregation and reporting in Colorado. Learn more about blockchain technology, which will be delivered for the SIM eCQM solution by BurstIQ, a Denver-based blockchain-based healthcare application company.
This solution represents three-plus years of research and investigation by the SIM team and a large group of stakeholders to identify the most meaningful health information technology investment that would help practices succeed with APMs.
“It’s exciting to see this investment take shape and help providers report the kind of data that will be required for participation in APMs while alleviating some of the reporting burden,” says Barbara Martin, RN, MSN, ACNP-BC, MPH, SIM director. “The SIM investment paves the way for future success in Colorado.”
Ten practices participated in the first pilot phase of the eCQM solution from May to July, which included reporting of three measures (A1C, hypertension and depression screen) and data validation. The application will remain open for the second and third phases. Ideal candidates for participation include practices that can quickly mobilize staff and representatives from EHR vendors for weekly meetings and validation sessions with the eCQM extraction vendor (one of the three HIOs).
Now in its second phase, about 190 providers will use this solution, which is offered through three health information organizations (HIOs) that are implementing this solution with SIM funding under the umbrella name Health Data Colorado (HDCo). The solution will automate the extraction of field-level clinical data from the electronic health records (EHRs) for eCQM calculation and validation.
Checks and balances
A unique aspect to SIM’s validation efforts is the creation of feedback reports to practices that help enumerate the quality and completeness of extracted data for a given measure. For example, in the case of the substance use disorder, tobacco measure (CMS 138), data associated with this measure in the eCQM feedback report might show that some of the data elements for measure calculation are missing a value on a certain percentage of patients thus preventing those patients from being included in the numerator or denominator.
This feedback report gives practices and eCQM vendors the ability to ascertain if the data gap is related to a technical mapping issue in the measure extraction process, a backend issue with how the certified EHR is coding the measure elements or an end-user workflow issue in the source EHR. A very important aspect in this process is the handoff to the practice clinical health information technology advisor (CHITA) from the eCQM vendor if the issue is related to a workflow in the source EHR.
The eCQM solution, which automates extraction of field-level clinical data from SIM practice EHRs for eCQM calculation and validation, will be developed on a technical framework that enables re-use of extracted field level source data. This data will be leveraged to automatically calculate eCQMs and provide the foundation for future use cases.
It will receive source data from EHRs and potentially other sources (flat files, registries, ADT, HIEs, the All Payer Claims Database, health plans, social determinants of health, lab vendors and other data sources), extract the appropriate data and synthesize it to accurately calculate eCQM numerators and denominators. Once calculated, the eCQM solution will relay extracted eCQM numerators and denominators in an industry standard format to the Shared Practice Improvement Tool (SPLIT). The next phase will include additional provider-approved entities which may include the state’s Enterprise Service Bus for Medicaid, the Centers for Medicare & Medicaid Services and other interested commercial payers.
Learn more and apply:
NOTE: If the above podcast does not play, please click here to download the audio file.