Integration of PQRI and EHR reporting

Section 3002(d) of the ACA requires CMS to move toward integration of EHR measures with respect to the PQRI program. The AMA strongly supports efforts to streamline the clinical quality measures used in both the PQRI and EHR reporting programs. We encourage CMS to work with the PCPI to improve the development, and accelerate the testing, of clinically relevant measures for all Medicare physician specialties.

In order to align the two programs, clear program objectives must first be established. Currently, PQRI is a pay-for-reporting program and the CMS EHR Incentive Program is to demonstrate meaningful use of a certified EHR system. After the program objectives have been established and aligned, the measures and format for reporting the measures must then be aligned. The steps that the AMA recommends to achieve alignment of the PQRI and EHR Incentive program include:

•    Establish common program objectives;

•    Align the measures and establish a common format for reporting;

•    Once the “measures” and “reporting format” have been finalized and are aligned, the measures should be tested to see if they can be implemented in an EHR system; and

•    Upon completion of system testing, the measures should be piloted in an actual clinical environment. Pilots are very common in information technology. In fact, any technology implementation or rollout typically has a pilot test completed. Pilot testing provides real world results and feedback in a selected and controlled environment. Upon completion of pilot testing, an evaluation will need to be performed to determine that the results meet the original program objectives.