Process
The AMA-convened Physician Consortium for Performance Improvement® (PCPI®) measure development process contains a series of steps or a cycle of activities.
Review of evidence, gaps, data for impact
- Consider existing guideline recommendations and the strength of evidence
- Consider gaps in care, variation, cost and frequency data
Measure development/enhancement
- Identify and review eligible populations for each measure (denominator statements) including any needed inclusions and/or exclusions
- Identify and review eligible services or outcomes that should be provided and achieved for the defined populations (numerator statements)
- Consider and identify performance measures addressing quality-of-care problems including underuse and overuse
- Consider measures of process, outcome and structure
- Consider possible unintended consequences of measure use
- Consider the measure's agreement with existing consortium measures
Measure specification (includes electronic health record [EHR] specifications)
Develop relevant technical specifications by data source, including Current Procedural Terminology (CPT®) Category II codes.
Measure testing
Where feasible, performance measures may be tested as resources are available.
- Review relevant technical specifications by data source, including CPT Category II codes based on measure updates
Measure and specification reevaluation
- Review relevant technical specifications by data source, including CPT Category II codes and EHR specifications, based on updates to the measures
National endorsement selection
- Consider use of measures for accountability (e.g., pay-for-reporting or pay-for-performance initiatives, maintenance of certification programs, public reporting)
Implementation and integration for quality improvement (QI)
- Identify performance measures addressing quality improvement that may need more data prior to public reporting
Feedback (from QI collaboratives, providers, consumers, public/private purchasers)
- Solicit consortium and public comment on the recommended draft performance measure(s)
- Review comments received
- Revise and modify the draft performance measure(s) as deemed appropriate by the work group
- Post public comments and responses to the PCPI website
The Measures Development Methodology and Oversight (MDMO) Advisory Committee of the AMA-convened Physician Consortium for Performance Improvement® (PCPI™) has formulated a number of position papers to guide measure development. These include:
- Composite measures framework
- PCPI position statement: the evidence base required for measures development
- Guidance for requesting PCPI review and approval of measures developed independently by PCPI voting members
- Specification and categorization of measures exclusions: recommendations to PCPI work groups
- Recommendations to PCPI work groups on outcome measures
