2491 lines
86 KiB
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2491 lines
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<a href="/measure-lifecycle/measure-conceptualization/information-gathering/conduct-environment-scan">
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<span>Analyze Data & Conduct Gap Analysis</span>
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<a href="/measure-lifecycle/measure-conceptualization/information-gathering/respecified-measures">
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<span>Respecified Measures</span>
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</a>
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</li>
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
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<a href="/measure-lifecycle/measure-conceptualization/information-gathering/justify-creation-new-measures">
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<span>Justify the Creation of New Measures</span>
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</a>
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</li>
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</ul>
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</li>
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<li class="usa-nav__submenu-item menu_level_2 is_expanded">
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<span>Business Case Development</span>
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<ul id="basic-nav-section-Business-Case-Development" class="usa-nav__submenu-list-2 is_collapsed " aria-controls="extended-mmega-nav-section-Business-Case-Development" >
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
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<a href="/measure-lifecycle/measure-conceptualization/business-case/overview">
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<span>Overview</span>
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</a>
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</li>
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
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<a href="/measure-lifecycle/measure-conceptualization/business-case/outcomes">
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<span>Documenting Outcomes, Benefits, & Costs</span>
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</a>
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</li>
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
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<a href="/measure-lifecycle/measure-conceptualization/business-case/best-practices">
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<span>Business Case Best Practices</span>
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</a>
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</li>
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</ul>
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</li>
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</ul>
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</div>
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<div class="desktop:grid-col-3">
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<div class="usa-nav__headermenu-item">
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<span><strong>Measure Specification</strong></span>
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<ul id="basic-nav-section-Measure-Specification" class="usa-nav__submenu-list-2 is_collapsed " aria-controls="extended-mmega-nav-section-Measure-Specification" >
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<a href="/measure-lifecycle/measure-specification/overview">
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<span>Overview</span>
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</a>
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</li>
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
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<a href="/measure-lifecycle/measure-specification/specifications-measure-category">
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<span>Specifications by Measure Category</span>
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</a>
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</li>
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
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<a href="/measure-lifecycle/measure-specification/define-data-sources">
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<span>Define Data Sources</span>
|
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</a>
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</li>
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<li class="usa-nav__submenu-item menu_level_2 is_expanded">
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<button id="usa-accordion__button_second-3 usa-nav__submenu-list-2" class="usa-accordion__button_second usa-nav__link is_expanded closed" aria-expanded="false" aria-controls="basic-nav-section-Measure-Specification">
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<span>Develop Specifications</span>
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</button>
|
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<ul id="basic-nav-section-Develop-Specifications" class="usa-nav__submenu-list-2 is_collapsed " aria-controls="extended-mmega-nav-section-Develop-Specifications" >
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
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<a href="/measure-lifecycle/measure-specification/develop-specification/overview">
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<span>Overview</span>
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</a>
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</li>
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
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<a href="/measure-lifecycle/measure-specification/develop-specification/target-initial-population">
|
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<span>Define the Target/Initial Population</span>
|
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</a>
|
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</li>
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
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<a href="/measure-lifecycle/measure-specification/develop-specification/denominator">
|
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<span>Define the Denominator</span>
|
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</a>
|
|
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|
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</li>
|
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
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<a href="/measure-lifecycle/measure-specification/develop-specification/numerator">
|
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<span>Define the Numerator and Exclusions</span>
|
|
</a>
|
|
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|
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</li>
|
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
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<a href="/measure-lifecycle/measure-specification/develop-specification/stratification">
|
|
<span>Define Stratification Scheme</span>
|
|
</a>
|
|
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|
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</li>
|
|
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
|
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|
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<a href="/measure-lifecycle/measure-specification/develop-specification/respecifying-registry-measures">
|
|
<span>Respecifying Registry Measures to Electronic Clinical Quality Measures (eCQMs)</span>
|
|
</a>
|
|
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|
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</li>
|
|
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|
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</ul>
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</li>
|
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<li class="usa-nav__submenu-item menu_level_2 is_expanded">
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<button id="usa-accordion__button_second-3 usa-nav__submenu-list-2" class="usa-accordion__button_second usa-nav__link is_expanded closed" aria-expanded="false" aria-controls="basic-nav-section-Measure-Specification">
|
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<span>Specify the Code</span>
|
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</button>
|
|
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<ul id="basic-nav-section-Specify-the-Code" class="usa-nav__submenu-list-2 is_collapsed " aria-controls="extended-mmega-nav-section-Specify-the-Code" >
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
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<a href="/measure-lifecycle/measure-specification/specify-code/overview">
|
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<span>Overview</span>
|
|
</a>
|
|
|
|
|
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</li>
|
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|
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
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|
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<a href="/measure-lifecycle/measure-specification/specify-code/code-systems-vocabularies-terminologies">
|
|
<span>Code Systems, Vocabularies, and Terminologies</span>
|
|
</a>
|
|
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|
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</li>
|
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|
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
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|
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<a href="/measure-lifecycle/measure-specification/specify-code/encode-clinical-information">
|
|
<span>Encoding Clinical Information</span>
|
|
</a>
|
|
|
|
|
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</li>
|
|
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
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<a href="/measure-lifecycle/measure-specification/specify-code/data-standards">
|
|
<span>Data Standards</span>
|
|
</a>
|
|
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|
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</li>
|
|
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|
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</ul>
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</li>
|
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<li class="usa-nav__submenu-item menu_level_2 is_expanded">
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|
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<span>Construct Data Protocol</span>
|
|
</button>
|
|
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|
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<ul id="basic-nav-section-Construct-Data-Protocol" class="usa-nav__submenu-list-2 is_collapsed " aria-controls="extended-mmega-nav-section-Construct-Data-Protocol" >
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
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<a href="/measure-lifecycle/measure-specification/data-protocol/overview">
|
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<span>Overview</span>
|
|
</a>
|
|
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|
|
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</li>
|
|
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|
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
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|
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<a href="/measure-lifecycle/measure-specification/data-protocol/key-terms">
|
|
<span>Define Key Terms, Data Elements, Codes, and Code Systems</span>
|
|
</a>
|
|
|
|
|
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</li>
|
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|
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
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|
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<a href="/measure-lifecycle/measure-specification/data-protocol/level-measurement-analysis">
|
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<span>Describe Level of Measurement & Sampling</span>
|
|
</a>
|
|
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|
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</li>
|
|
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|
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
|
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|
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<a href="/measure-lifecycle/measure-specification/data-protocol/risk-adjustment">
|
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<span>Determine Risk Adjustment</span>
|
|
</a>
|
|
|
|
|
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</li>
|
|
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|
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
|
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|
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<a href="/measure-lifecycle/measure-specification/data-protocol/time-interval">
|
|
<span>Define Any Time Intervals</span>
|
|
</a>
|
|
|
|
|
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</li>
|
|
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|
|
<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
|
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|
|
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|
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<a href="/measure-lifecycle/measure-specification/data-protocol/scoring">
|
|
<span>Describe Scoring & Calculation Algorithm</span>
|
|
</a>
|
|
|
|
|
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</li>
|
|
|
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|
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</ul>
|
|
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</li>
|
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|
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
|
|
|
|
|
|
|
<a href="/measure-lifecycle/measure-specification/document-measure">
|
|
<span>Document the Measures</span>
|
|
</a>
|
|
|
|
|
|
</li>
|
|
|
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|
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<li class="usa-nav__submenu-item menu_level_2 is_expanded">
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<span>Measure Harmonization</span>
|
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<ul id="basic-nav-section-Measure-Harmonization" class="usa-nav__submenu-list-2 is_collapsed " aria-controls="extended-mmega-nav-section-Measure-Harmonization" >
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
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<a href="/measure-lifecycle/measure-specification/measure-harmonization/overview">
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<span>Overview</span>
|
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</a>
|
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</li>
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
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<a href="/measure-lifecycle/measure-specification/measure-harmonization/alignment">
|
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<span>Measure Harmonization and Alignment</span>
|
|
</a>
|
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|
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</li>
|
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
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<a href="/measure-lifecycle/measure-specification/measure-harmonization/when-to-consider">
|
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<span>When to Consider Measure Harmonization</span>
|
|
</a>
|
|
|
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</li>
|
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</ul>
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</li>
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</ul>
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</div>
|
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<div class="desktop:grid-col-3">
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<div class="usa-nav__headermenu-item">
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<span><strong>Measure Testing</strong></span>
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</div>
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<a href="/measure-lifecycle/measure-testing/overview">
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<span>Overview</span>
|
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</a>
|
|
|
|
|
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</li>
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<li class="usa-nav__submenu-item menu_level_2 is_expanded">
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<span>Measure Testing Process</span>
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<ul id="basic-nav-section-Measure-Testing-Process" class="usa-nav__submenu-list-2 is_collapsed " aria-controls="extended-mmega-nav-section-Measure-Testing-Process" >
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<a href="/measure-lifecycle/measure-testing/process/overview">
|
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<span>Overview</span>
|
|
</a>
|
|
|
|
|
|
</li>
|
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|
|
|
|
<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
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|
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<a href="/measure-lifecycle/measure-testing/process/develop-workplan">
|
|
<span>Develop The Testing Work Plan</span>
|
|
</a>
|
|
|
|
|
|
</li>
|
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
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<a href="/measure-lifecycle/measure-testing/process/perform-sampl">
|
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<span>Perform Sampling</span>
|
|
</a>
|
|
|
|
|
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</li>
|
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
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<a href="/measure-lifecycle/measure-testing/process/implement-and-analyze">
|
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<span>Implement, Analyze, Refine & Retest</span>
|
|
</a>
|
|
|
|
|
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</li>
|
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
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<a href="/measure-lifecycle/measure-testing/process/summary">
|
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<span>Measure Testing Summary</span>
|
|
</a>
|
|
|
|
|
|
</li>
|
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
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|
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<a href="/measure-lifecycle/measure-testing/process/testing-respecified-measures">
|
|
<span>Testing Respecified Measures</span>
|
|
</a>
|
|
|
|
|
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</li>
|
|
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|
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</ul>
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</li>
|
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<li class="usa-nav__submenu-item menu_level_2 is_expanded">
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<span>Measure Evaluation Criteria</span>
|
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<ul id="basic-nav-section-Measure-Evaluation-Criteria" class="usa-nav__submenu-list-2 is_collapsed " aria-controls="extended-mmega-nav-section-Measure-Evaluation-Criteria" >
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
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<a href="/measure-lifecycle/measure-testing/evaluation-criteria/overview">
|
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<span>Overview</span>
|
|
</a>
|
|
|
|
|
|
</li>
|
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|
|
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
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<a href="/measure-lifecycle/measure-testing/evaluation-criteria/importance">
|
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<span>Importance</span>
|
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</a>
|
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</li>
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
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<a href="/measure-lifecycle/measure-testing/evaluation-criteria/scientific-acceptability">
|
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<span>Scientific Acceptability</span>
|
|
</a>
|
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</li>
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
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<a href="/measure-lifecycle/measure-testing/evaluation-criteria/feasibility">
|
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<span>Feasibility</span>
|
|
</a>
|
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</li>
|
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
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<div property="schema:text" class="field field--name-body field--type-text-with-summary field--label-hidden field__item"><h3>Review and Analyze Empirical Data, as Appropriate</h3><p>If empirical data are available, measure developers should analyze the data statistically to support the <abbr tabindex="0" title="<p>The importance criterion is the extent to which the specific measure focus is important to making significant gains in health care quality (e.g., safety, timeliness, effectiveness, efficiency, equity, patient centeredness) and improving health outcomes for a specific high-impact aspect of health care where there is variation in or overall poor performance.</p> " class="glossify-tooltip-tip" lang="en">importance</abbr> of the measure, identify gaps or variations in care, and provide incidence/prevalence information and other data, e.g., return on investment (ROI), necessary for development of the <abbr tabindex="0" title="<p>A <span class="glossify-exclude">business case</span> is a justification for a proposed project or undertaking on the basis of its expected commercial benefit. It exists if the entity realizes a financial return on its investment in a reasonable time frame. The entity may realize as profit, reduction in losses, or avoided costs. A <span class="glossify-exclude">business case</span> may also exist if the investor believes a positive indirect effect on organizational function and sustainability will accrue within a reasonable time frame (<a href="https://www.healthaffairs.org/doi/pdf/10.1377/hlthaff.22.2.17">Leatherman et al., 2003</a>). The <span class="glossify-exclude">business case</span> for a process measure relies on the financial return on the investment necessary to implement the intervention advocated by the measure. The <span class="glossify-exclude">business case</span> for other types of measures relies on the financial return resulting from improving the quality of care indicated by the measure.</p> " class="glossify-tooltip-tip" lang="en">business case</abbr>. Empirical data analysis may also provide quantitative evidence for inclusion or <abbr tabindex="0" title="<p>The <span class="glossify-exclude">denominator</span> is a statement describing the population evaluated by the performance measure and is the lower part of a fraction used to calculate a rate, proportion, or ratio. It can be the same as the target/initial population or a subset of the target/initial population to further constrain the population for the purpose of the measure. CV measures may refer to this as measure population.</p> " class="glossify-tooltip-tip" lang="en">denominator</abbr> exclusion and <abbr tabindex="0" title="<p>The <span class="glossify-exclude">numerator</span> is the upper portion of a fraction used to calculate a rate, proportion, or ratio. Also called the measure focus, it is the target process, condition, event, or outcome. <span class="glossify-exclude">Numerator</span> criteria are the processes or outcomes expected for each patient, procedure, or other unit of measurement defined in the denominator. A <span class="glossify-exclude">numerator</span> statement describes the action satisfying the conditions of the performance measure.</p> " class="glossify-tooltip-tip" lang="en">numerator</abbr> exclusion of a set of <abbr tabindex="0" title="<p>The <span class="glossify-exclude">population</span> is the total group of people of interest for a quality measure, sometimes called the target/initial <span class="glossify-exclude">population</span>. The measure <span class="glossify-exclude">population</span> is a defined subset appropriate to the measure set not excluded from the individual measure.</p> " class="glossify-tooltip-tip" lang="en">populations</abbr> or geographic regions or other considerations for development of the measure. </p><p>Measure developers can also analyze empirical data to test the <a href="/measure-lifecycle/measure-testing/evaluation-criteria/feasibility" data-entity-type="node" data-entity-uuid="9cedd4ac-6c05-4c15-a412-2b7ede9122de" data-entity-substitution="canonical" title="Feasibility">feasibility</a> of <abbr tabindex="0" title="<p>A data element is a basic unit of information with a unique meaning and subcategories (data items) of distinct value. National Institute of Standards and Technology. (n.d.). <em>Data element</em>. Computer Security Resource Center. Retrieved November 1, 2023, from&nbsp;<a href="https://csrc.nist.gov/glossary/term/data_element">https://csrc.nist.gov/glossary/term/data_element</a></p> " class="glossify-tooltip-tip" lang="en">data elements</abbr> required for a measure, such as data availability (including standardization) and accuracy of data information. They may use empirical data to help identify <abbr tabindex="0" title="<p><span class="glossify-exclude">Feasibility criteria</span> is the extent to which the specifications, including measure logic, require data that are readily available or easily captured without undue burden and implemented for performance measurement.</p> " class="glossify-tooltip-tip" lang="en">feasibility</abbr> concerns early in development of the measure. Measure developers may need to replace or revise data elements, consider an alternative measure type, assess implementation burden versus value of the measure, or recommend halting further development of the measure concept.</p><p>If developing a risk-adjusted measure, measure developers should assess feasibility of the risk variables early on. See the <a href="/media/13" data-entity-type="media" data-entity-uuid="4cc52d47-7585-4b21-a2ef-848bf1729d44" data-entity-substitution="media"><em>Risk Adjustment in Quality Measurement</em></a> supplemental material. </p><h3>Assess Information from Environmental Scan to Identify any Existing Measures</h3><p>If the <abbr tabindex="0" title="<p>An environmental scan is the process of systematically reviewing and interpreting data to identify issues and opportunities that will influence prioritization of current or future plans.</p> " class="glossify-tooltip-tip" lang="en">environmental scan</abbr> discovers <abbr tabindex="0" title="<p><span class="glossify-exclude">Related measures</span> are measures addressing either the same topic or the same population. This term is used when considering harmonization. See also Competing Measures.</p> " class="glossify-tooltip-tip" lang="en">related measures</abbr>, measure developers should evaluate the measures to assess whether they meet the needs of the project. If the measure developer finds a related measure with a measure focus appropriate to the needs of the project, but the measure <abbr tabindex="0" title="<p><span class="glossify-exclude">Specifications</span> are measure instructions addressing data elements, data sources, point of data collection, timing and frequency of data collection and reporting, specific instruments used (if appropriate), and implementation strategies.</p> " class="glossify-tooltip-tip" lang="en">specification</abbr> is for a different population, setting, or <abbr tabindex="0" title="<p><span class="glossify-exclude">Data sources</span> are the primary source document(s) used for data collection (e.g., billing or administrative data, encounter form, enrollment form, patient medical record).</p> " class="glossify-tooltip-tip" lang="en">data source</abbr>, the measure developer may be able to respecify the measure for the new use and test it for <abbr tabindex="0" title="<p><span class="glossify-exclude">Reliability</span> reflects the measure is well defined and precisely specified so measured entities can implement consistently within and across organizations and that it distinguishes differences in performance.</p> " class="glossify-tooltip-tip" lang="en">reliability</abbr> and <abbr tabindex="0" title="<p><span class="glossify-exclude">Validity</span> includes measure <span class="glossify-exclude">validity</span> (when the measure accurately represents the evaluated concept and achieves the intended purpose, meaning to measure quality) and data element <span class="glossify-exclude">validity</span>, which is the extent to which the information represented by the data element or code used in the measure reflects the actual concept or event intended.</p> " class="glossify-tooltip-tip" lang="en">validity</abbr> specific to the new population. </p><h3>Conduct a Measurement Gap Analysis </h3><p>The purpose of a gap analysis is to identify measure types or concepts that may be missing for the measure topic or focus. The measure developer uses information collected from the environmental scan, measure gap analysis, and other information gathering activities to identify existing competing or related measures before deciding to develop new measures. If no related or <abbr tabindex="0" title="<p><span class="glossify-exclude">Competing measures</span> address the same topic and the same population. Use this term when considering harmonization. See also Related Measures.</p> " class="glossify-tooltip-tip" lang="en">competing measures</abbr> can be respecified or adopted, then it is appropriate to develop a new measure. Measure developers should establish a framework to organize any existing measures, for example to break down existing measures by measure component and data elements to help identify overlaps and gaps. </p></div>
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<div class="views-row"><span class="views-field views-field-changed"><strong class="views-label views-label-changed">Last Updated: </strong><span class="field-content"><time datetime="2024-05-17T11:32:20-04:00">May 2024</time>
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