A Mixed Methods Task Analysis of the Implementation and Validation of EHR-Based Clinical Quality Measures

Area of Science:

• Health Informatics
• Cardiovascular Medicine
• Health Services Research

Background:

• Clinical Quality Measures (CQMs) are crucial for assessing and enhancing healthcare quality.
• Federal mandates have prioritized electronic health record (EHR)-based CQM reporting, making automated implementation a key focus for clinical and informatics professionals.
• However, the processes for CQM implementation and validation are often complex, time-consuming, and lack clear definition.

Purpose of the Study:

• To provide an overview of the CQM implementation and validation process within a collaborative project.
• To identify major roadblocks and bottlenecks encountered during the development of an analytics platform for cardiovascular quality measures.
• To offer recommendations for professionals engaged in healthcare quality assessment and improvement.

Main Methods:

• Utilized issue-tracking data from an agile and rigorous collaborative project.
• Employed a mixed-methods approach to analyze the CQM implementation and validation process.
• Focused on nine heart failure CQMs defined by the American College of Cardiology (ACC) as an exemplar.

Main Results:

• Detailed the practical challenges and complexities in implementing and validating EHR-based CQMs.
• Identified specific bottlenecks within the analytics platform development lifecycle.
• Documented the collaborative effort between clinical and informatics teams.

Conclusions:

• The implementation and validation of clinical quality measures require structured approaches to overcome inherent complexities.
• Recommendations are provided to streamline processes and mitigate challenges for future CQM initiatives.
• This work contributes to the broader understanding of optimizing healthcare quality assessment through improved EHR integration.