State Medicaid
This use case scenario enables healthcare providers to send and validate clinical quality measures electronically for Medicaid Promoting Interoperability attestation.
About this Scenario
Clinical quality measures (CQMs) are measures of healthcare quality generated in a clinical setting by using information such as lab results, vital signs, symptoms, x-rays, etc. CQMs, when properly utilized, can help transform healthcare delivery to improve care for patients and help transform healthcare payment to be quality-based instead of volume-based.
Electronic clinical quality measures, called eCQMs, are clinical quality measures that are electronically captured or calculated locally in a clinical setting. For example, in a clinic’s electronic health record (EHR) system, and then potentially transported electronically and securely to a centralized repository for analysis and comparison with other clinics.
Reporting certain CQMs is a requirement for Promoting Interoperability for both Medicaid and Medicare EHR incentive programs.