Bridging Quality, Interoperability, and Terminology Through the Updated Malnutrition Care Score

The Malnutrition Care Score, formerly the Global Malnutrition Composite Score, is the first nutrition-focused electronic clinical quality measure (eCQM) in the Centers for Medicare and Medicaid Services Inpatient Quality Reporting program, placing credentialed nutrition and dietetics practitioners at the forefront of evidence-based malnutrition care. eCQMs consist of Elements and Measure Observations analyzed by computer logic, resulting in scores reported directly to the Centers for Medicare and Medicaid Services. This measure uses standardized health terminologies, as well as workflows, guided by the Nutrition Care Process and its terminology for effective communication and quality measurement. Value sets, essential to the functionality of eCQMs, arise from these health terminologies and contain terms and numerical codes to accurately capture workflows, interventions, and conditions. Machine readability of codes facilitates electronic data retrieval and efficient interoperability among health care systems' electronic health records. To support the standardization of eCQMs, data elements are collected using discrete fields, providing comparable data points for accurate data extraction and measurement. Thus, information flows from clinician documentation into file submission to the Centers for Medicare and Medicaid Services. By partnering with facility staff members and leaders, credentialed nutrition and dietetics practitioners can ensure that discrete fields are optimized to support data capture through a well-structured electronic health record. The Malnutrition Care Score enhances the value of credentialed nutrition and dietetics practitioners by promoting the utilization of broad skill sets to facilitate evidence-based malnutrition care, supporting the selection of the Malnutrition Care Score for facility quality reporting.