Track 3: Measure Formats and Terminology, and Where We’re Headed

What’s the big idea?

NCQA and government payment programs use standard formats to display quality measures. This track will examine these formats and potential changes, and will focus on reference models, expression formats and terminology available for digital measurement (QDM-CQL, CQL-FHIR)—in particular, the potential movement to FHIR.

Why should I care?

There are misalignments across measures, in the definitions, clauses and value sets. These misalignments cause more work for developers, implementors and physicians. Removing these misalignments will make measure implementation more efficient.

Moving from CQL-QDM measures to CQL-FHIR will affect everyone in measure implementation, it’s time to understand these changes that are coming up.

What will I do?

Participants will get an overview of reference models, expression formats and terminology available for digital measurement (QDM-CQL, CQL-FHIR), in addition to experience with writing these formats. This track will also discuss the benefits of different models and the potential movement to FHIR, and provide hands-on examples of measure specification development. Use cases will include rheumatoid arthritis.

Who should attend?

Measure developers, quality measure implementors and anyone interested in how a measure is written and future changes in measure formats. No technical expertise is required. Introduction to the standard digital measure format will be discussed on Day 1 (July 16).


Track Lead:

Anne Smith, MHSA, RN, BSN, is Director of Measure Validation at the National Committee for Quality Assurance (NCQA). She is responsible for the annual updates for the electronic clinical quality measures (eCQM) used in the Centers for Medicare and Medicaid Services (CMS) programs and operation of the eCQM Certification program at NCQA. Prior to joining NCQA, Anne was Project Analyst at UnitedHealthCare where she worked to ensure data validity as a liaison between research sponsors and programming staff. She later focused on managing the integration of data and production of HEDIS reports for UnitedHealthCare health plans.


Track Faculty:

Lisa Anderson, MSN, RN-BC, is Project Director, eCQMs, Department of Quality Measurement, at The Joint Commission. She is responsible for the activities of The Joint Commission’s electronic clinical quality measure (eCQM) development team including the supervision of clinical informatics staff responsible for eCQM development, testing, and maintenance; and collaboration with external colleagues including government employees and contractors to deliver annual updates to eCQM specifications. She also collaborates with peers in the development of emerging standards for quality measurement by representing The Joint Commission on the HL7 Clinical Quality Language Formatting and Usage Work Group, participating in the HL7 Clinical Quality Information Work Group, and representing The Joint Commission at LOINC Committee meetings.

Carol Macumber, MS, PMP, is Vice President of Technology and Operations at Apelon. She has over 15 years of experience managing and supporting health information technology projects. Carol is a certified Project Management Professional (PMP). She has a Master degree in biomedical engineering and has worked on a wide variety of consulting projects including deploying terminology authoring tools at Canada Health Infoway, and Terminology Asset Management and capacity building for the Philippine Department of Health. Carol was the elected Affiliate Forum representative to the IHTSDO Technical Committee, is a Co-Chair of the HL7 Vocabulary Working Group and a Fellow of the American Medical Informatics Association (FAMIA).

Juliet Rubini, MS, MSN, PMP, is Principal Program Analyst at Mathematica. She has expertise in direct patient care, clinical informatics, and electronic quality measures. She brings knowledge of the Quality Data Model, Measure Authoring Tool, Value Set Authority Center, HL7 standards. She is an active member at HL7 and is currently co-chair of the Clinical Quality Information work group that develops and maintains standards for eCQM development and reporting. Prior to joining Mathematica, her work at the National Quality Forum centered on the Quality Data Model and other HL7 standards for electronic quality measurement.


Track Resources

Rheumatoid Arthritis: Transforming Care Delivery to a Value-Based Model (NCQA 2019)

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