CQMs: Time for a breather?

August 4, 2014 in Medical Technology

 It has been five years since the American Recovery and Reinvestment Act of 2009 launched a mad scramble among healthcare providers for a share of billions in technology improvement dollars. 

Meaningful use, its stages of progression and ultimate goal of creating a connected, efficient and effective healthcare system, has become an all-consuming preoccupation for the hospital C-suite, clinicians and IT staff.

With the stakes so high, deadlines so tight and fiscal pressures undulating through provider organizations, at least one consultant believes now might be a good time to take a break and assess the progress to date.

“Everyone is feeling this, so maybe we should take a break,” says Toni Robak, director of consulting for Franklin, Tenn.-based MEDHOST. “After five years, perhaps it would be helpful to take a step back.”

In helping MEDHOST clients, Robak has been focused on MU and gap analysis in both Stages 1 and 2. Clients are both integrated delivery networks and stand-alone hospitals that need help with process improvement. In helping to navigate clients through the complex maze of tasks, Robak says the tension has been palpable.

“There is a lot of money tied to this and it seems as if the regulations change on a weekly basis,” she said. “Even the smallest hospitals have hundreds of thousands of dollars at stake.”

Five years along, the majority of MEDHOST clients are in Stage 2, dealing with clinical quality measures and how they differ from core measures. Because CQMs rely on structure and codified data, the shift is toward electronically quantifying quality measures – an important aspect to the roadmap for transitioning from fee-for-service to quality-mandated outcomes.

“The scale of change is daunting – no one knows what is coming around the corner and a lot of money and resources are tied to it,” Robak said. The difference between CQMs and core measures is that core measures take a lot of manual processes, documentation and review, where CQMs can pull the data and drill down into measures that weren’t met.”

Ultimately, the MU and CQM initiatives come down to fine-tuning processes because so much money is at stake, Robak says.

“What hits home is that these mandates may determine whether a hospital will keep its doors open or closed,” she said.

CQM options

At Pittsburgh-based Stoltenberg Consulting, clients are in various stages of MU development and ICD-10 conversion, and progress has been good in some areas while being stunted in others, says Shane Pilcher, vice president.

“We are helping them align their budgets, resources and activities toward the changes,” he said. “Each one is in a certain place on their roadmap.”

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Article source: http://www.healthcareitnews.com/news/cqms-time-breather

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