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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: