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RTN1405_B4_E-measure Update (PI.02.01.03)

*TS: Benchmark – Moving Ahead: An Update on E-Measures [REF: IT, LDR, PI] The Source, May 2014, Vol 12, #5, Pg 16  JCs1405_B4

In March of 2012, TJC essentially declared that the Future of Performance Measures was something called E-Measures, also known as Electronically Specified Clinical Quality Measures (eCQMs).  E-Measures would facilitate the electronic capture and direct transmission of data from Electronic Health Records (EHR). A month later TJC announced an ePilot Program for these E-Measures. Now, as the title of this article indicates, an update is being provided.  The bottom line is that the process for replacing/converting TJC’s (and CMS’s) paper-based measures with E-Measures (i.e., retooling) is still alive and real progress is being made.  TJC is following the lead of/working closely with CMS in this matter so that its (TJC) measures will also be included in the federal eMeasures program. At this point the greatest challenge to further progress is in the need to convert inputs from various sources (to including text-based EHRs) and clinical disciplines, into a ‘national vocabulary’ that is standardized.  Currently, TJC’s and CMS’s ongoing ePilots are working with 16 measures related to Emergency Departments (eED), Stroke (eSTK) and Venous Thromboembolism (eVTE). CMS plans to release new measures each April for implementation in April of the following year. Although none of these are presently relevant to Psychiatry, the reader should be reminded of the history of core and accountability measures which also began in the medical/surgical arenas but eventually have come to include Psychiatry. There can be little doubt that ultimately, all accredited hospitals that transmit ORYX data and wish to comply with PI.02.01.03 will be affected by this movement to E-Measures.
Tip: LDR, PI and IT should consult SPHCC’s newest Custom Information Feed on Information Management/Performance Improvement (CIF_Perf Improv) to help track/stay abreast of this issue. Ms. Vera Hollen, MA, Senior Research Analyst at the National Research Institute shares her thoughts on this topic in the comments section of this article.

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2 responses to “RTN1405_B4_E-measure Update (PI.02.01.03)”

  1. Dr. Fields,

    The article in your newsletter is very accurate. You asked about the relationship between e-measures, core measures and accountability measures.

    Core measures resulted from an effort to standardize measurement across hospitals serving similar conditions (i.e., pneumonia, heart failure, etc.), Med/Surg hospitals are required to submit six core measure sets (up from four in 2013) to The Joint Commission. Psychiatry gets away with the one HBIPS core set (for now).

    The accountability rate is a summary over all core measures that meet the accountability standard. It’s a way to summarize all of the core data to provide a snapshot of the hospital’s performance. The Joint Commission has changed the way they compute the accountability rate for psychiatric hospitals a few times. In 2013 it was based on HBIPS 6-7. This year it is based on HBIPS 5, 6, 7. When The Joint Commission conducts its triennial on-site survey, hospitals that do not meet the threshold of performance on the accountability rate will receive an RFI.

    When eMeasures come to psychiatry, HBIPS will likely be first on the list. eMeasures are being scoped out for HBIPS, but there are several issues with progress and is likely years away from fruition. Some of the issues relate to standardizing with the national vocabulary (as you mentioned in your article). A bigger issue is that psychiatric facilities were left out of CMS’ EHR incentive payments. CMS seems to be organizing the pushing for eMeasures to streamline their many quality reporting programs. The CMS proposed rule for FY 2016 was released May 6, 2014. They are proposing asking Inpatient Psychiatric Facilities about their use of EHRs and if they routinely assess patient experience of care using a standardized collection protocol and a structured instrument.


    Vera Hollen, M.A.
    Senior Research Analyst
    Behavioral Healthcare Performance Measurement System (BHPMS) at
    National Association of State Mental Health Program Directors Research Institute, Inc. (NRI)


  2. Ms. Hollen,
    It is rare that we have a guest commentator with the depth of expertise that you have on this topic. I greatly appreciate the perspective and guidance you provided in helping to keep this review on track. Thanks again for sharing your knowledge and excellent insights.

    R. Fields, MD

    PS: I hope as eMeasures continue to evolve you will return to this forum from time to time and give us the further benefit of your insider’s understanding.

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