To receive Medicare and Medicaid reimbursements under the Health Information Technology for Economic and Clinical Health (HITECH) Act, hospitals must do more than simply meet federal meaningful use criteria; they also must report on 15 hospital quality measures.
As defined in the meaningful use final rule, hospital quality measures "consist of measures of processes, experience and/or outcomes of patient care, observations, or treatment that relate to one or more quality aims for health care, such as effective, safe, efficient, patient-centered, equitable and timely care." Preference has been given to measures endorsed by the National Quality Forum, for two reasons: First, the HITECH Act requires it; second, the NQF complies with National Technology Transfer and Advancement Act requirements.
For fiscal year 2011 -- the first year in which hospitals are eligible for reimbursement -- organizations must use certified electronic health record (EHR) technology to collect data on the relevant hospital quality measures, then, as the meaningful use final rule puts it, "use an attestation methodology to submit summary information."
For fiscal year 2012 and beyond, this information must be submitted using a certified EHR system,
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provided that the Department of Health & Human Services (HHS) is able to receive electronic submissions by that time. If not, paper submissions will suffice. In the meaningful use final rule, HHS said that it will announce its readiness in the Federal Register. This chart lists the 15 hospital quality measures required under Stage 1 of meaningful use. (The final rule's clinical quality measures, which pertain to eligible providers, are covered in a separate chart.) For each measure, the number of the NQF measure, an additional alphanumeric identifier, the measure's developer and a description are provided. Additional information can be found on the electronic specifications page of the Centers for Medicare & Medicaid Services (CMS) website.
| | | | |
| | ED1-1 | CMS, OFMQ2 | Median time, ED arrival to departure (admitted) |
| | ED-2 | CMS, OFMQ | Median time, ED arrival to departure (outpatient) |
| | Stroke-2 | TJC3 | Number of ischemic stroke patients who were prescribed antithrombotic therapy at hospital discharge |
| | Stroke-3 | TJC | Number of ischemic stroke patients with atrial fibrillation/flutter who were prescribed anticoagulation therapy at hospital discharge |
| | Stroke-4 | TJC | Number of acute ischemic stroke patients who arrived within two hours of feeling unwell and for whom IV tPA4 was initiated within three hours of feeling unwell |
| | Stroke-5 | TJC | Number of ischemic stroke patients who were administered antithrombotic therapy by the end of their second day in the hospital |
| | Stroke-6 | TJC | Number of ischemic stroke patients with high cholesterol or on lipid-lowering medication before arrival who were prescribed statin medication at hospital discharge |
| | Stroke-8 | TJC | Number of ischemic or hemorrhagic stroke patients, or their caregivers, who were given educational materials during their stay |
| | Stroke-01 | TJC | Number of ischemic or hemorrhagic stroke patients who were assessed for rehabilitation |
| | VTE5-1 | TJC | Number of patients who received VTE treatment (or can document why it was not given) within 24 hours of arrival |
| | VTE-2 | TJC | Number of patients who received VTE treatment (or can document why it was not given) within 24 hours of their admission to ICU6 |
| | VTE-3 | TJC | Number of patients with confirmed VTE who received an overlap of injected anticoagulation and warfarin therapy |
| | VTE-4 | TJC | Number of patients with confirmed VTE who received IV UFH7 therapy doses and had platelet counts monitored using defined parameters |
| | VTE-5 | TJC | Number of patients with confirmed VTE who at discharge were taking warfarin with written instructions that address compliance issues, dietary advice, monitoring, and drug reactions and interactions |
| | VTE-6 | TJC | Number of patients diagnosed with confirmed VTE during hospitalization who did not receive VTE treatment between their arrival and the day before the date when VTE diagnostic testing was ordered |
1 ED: Emergency department
2 OFMQ: Oklahoma Foundation for Medical Quality
3 TJC: The Joint Commission
4 IV tPA: Intravenous Tissue plasminogen activator
5 VTE: Venous thromboembolism
6 ICU: Intensive care unit
7 IV UFH: Intravenous unfractionated heparin
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This was first published in October 2010
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