Read the following article on AHIMA Leading and Influencing International Standards for HIM Practices: http://bok.ahima.org/doc?oid=302360#.Xd1MgJUUW70 (Links to an external site.)
Clinical quality measure developers create evidence-based standards used to assess the performance of providers in the provision of care. Developers include government agencies, accreditation organizations, and physician specialty groups among others. They select terminologies, classifications, and code sets as a way to express healthcare performance data used in the measure. For example, the National Committee for Quality Assurance (NCQA) may want to author an electronic Clinical Quality Measure (eCQM) for breast cancer screening. Using the web-based Measure Authoring Tool (MAT), NCQA decides to include mammograms as a population criterion. Having identified mammogram as one of the criteria, NCQA determines LOINC and HCPCS are necessary for the measure. Mammogram codes from these two systems are then selected to create the content for the breast cancer screening eCQM. Here is a link to the MAT website: https://www.emeasuretool.cms.gov/ (Links to an external site.)
For this discussion, review the Medicare Guidelines for MAT at https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/Guide_Reading_EP_Hospital_eCQMs.pdf (Links to an external site.)
Answer the following questions for this week’s discussion:
1. What purpose do terminologies, classifications, and code systems serve in an electronic Clinical Quality Measure (eCQM) or public health initiatives?
2. Why would NCQA choose LOINC and HCPCS for the electronic Clinical Quality Measure (eCQM) for breast cancer screening?
3. Why are the various types of organizations important to the development of the clinical quality measures?
Orlova, A., Warner, D., & Reyes, S. (2017). AHIMA leading and influencing international standards for HIM practices. Journal of AHIMA. 88(11), pp 22-29.
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