Testing of a Risk-Standardized Complication Rate Electronic Clinical Quality Measure (eCQM) for Total Hip and/or...

Area of Science:

• Health Services Research
• Medical Informatics
• Quality Improvement

Background:

• Existing quality measures for total hip arthroplasty (THA) and total knee arthroplasty (TKA) are claims-based.
• These measures lack risk-adjustment for social determinants of health (SDOH) and comprehensive data integration.

Purpose of the Study:

• To retool existing claims-based measures into an electronic clinical quality measure (eCQM).
• To assess the risk-standardized complication rate (RSCR) following elective primary THA and TKA at the clinician group level.
• To incorporate SDOH risk-adjustment and leverage electronic health records (EHRs).

Main Methods:

• Converted NQF1550 and NQF3493 into an eCQM.
• Included risk-adjustment for SDOH.
• Utilized EHR data for inpatient and outpatient procedures and complications.
• Tested the measure across two diverse healthcare systems.

Main Results:

• The overall RSCR within 90 days post-THA/TKA was 3.60% at Site 1 and 3.70% at Site 2.
• The novel eCQM demonstrated feasibility across different healthcare settings.
• The measure successfully integrated EHR data and SDOH.

Conclusions:

• The developed eCQM offers a more comprehensive and accurate assessment of complication rates after THA and TKA.
• This measure enhances quality evaluation by including SDOH and utilizing EHR data.
• The eCQM is suitable for use in quality reporting programs like the Merit-Based Incentive Payment System (MIPS).