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Quality Reporting and Integration with Electronic Health Records

In light of recent national initiatives to encourage physicians and other health care professionals to adopt and implement Electronic Health Records (EHRs) in their practices, here are some of the current AMA-convened Physician Consortium for Performance Improvement® (PCPI®) activities to promote use of these measures within EHRs.

Integration with EHRs (Health Quality Measure Format [HQMF] and eMeasure)

The Collaborative for Performance Measure Integration with EHRs—cosponsored by the American Medical Association (AMA), National Committee for Quality Assurance (NCQA) and the HIMSS Electronic Health Record Association (EHRA)—works with measure developers, EHR providers and clinical users of EHRs to advance the use of measures within EHRs. As part of its work, the collaborative developed a standard HQMF for use by EHRs and other IT providers to incorporate measure specifications within their systems.

In Spring 2009, The National Quality Forum (NQF) funded an initiative to take the prototype HQMF XML, now referred to as an "eMeasure," and align it with constructs previously defined by HL7—including the HL7 Reference Information Model (RIM). The HQMF eMeasure was balloted and subsequently approved as an HL7 Draft Standard for Trial Use (DSTU) in February 2010.

Data Elements for EHR Integration

AMA PCPI staff identifies the data elements required to collect and report quality measures from an EHR. The identification of data elements is the first step in developing specifications for implementation of EHR.

The data elements that follow according to the NQF's Quality Model, Version 2.1 (QDM) is a framework that can be used to clearly define concepts used in quality measures and clinical care. It provides a standardized method to describe data elements for EHR capture. Additional background information on the QDM can be found on the NQF website.