The incomparable Mandi Bishop just pointed out to me an amazing ONC dashboard that’s tracking issues with the clinical quality measures (CQM). I don’t know how I’d never seen this before, but it’s a treasure trove of amazing information. I’m proud of ONC for being this transparent in their efforts to make the clinical quality measures as effective as possible.
It’s also an amazing illustration of how hard it is to get these clinical quality measures correct. As Mandi pointed out to me, Beta-blockers, for example, can’t be tolerated by Asian-Americans, but that’s a required CQM: prescribe beta-blockers within 24 hours of surgery for cardiac patients. That’s scary to think that a clinical quality measure could actually do harm versus improving quality.
We’ve heard this from doctors for a really long time. Medicine is complicated and each patient is unique. This dashboard illustrates many of those challenges.
Personally I think that the clinical quality measures were a step too far in the EHR incentive program. Although, I’ve long wished that all the incentive money would have been focused on establishing a standard for EHR interoperability and then paying organizations that were interoperable. That would do more impact for good on healthcare than these clinical quality measures.
What are your thoughts and experiences with clinical quality measures?
