MU2 #11 – Quality Measures and Clinical Decision Support: Important Changes for Everyone

 In Articles, Meaningful Use

Requirements for Clinical Quality Measures (CQMs) are quite different in 2014 and apply BOTH to providers reporting Stage 2 and those still reporting under Stage 1:

Jeanne Chamberlin Director of EMR Consulting

Jeanne Chamberlin
Director of EMR Consulting

Number and Selection of Measures: All providers in 2014 must report on nine of 64 clinical quality measures. Many EHR vendors will offer only a limited number of measures, most commonly 9-12. Each measure has been assigned to one of six domains and you must select your measures so that you have at least one measure from each of three domains. There are no core or required measures, although CMS has provided two sets of nine recommended health measures – one focuses on adults and the other on children.

Three Ways to Report: CMS is working to link the CQM requirements of Meaningful Use with the reporting requirements of the Physician Quality Reporting Program (PQRS):

  • You can manually enter each numerator and denominator for each provider into the Attestation Website at the same time you complete your MU attestation just as you have done in previous years. This type of reporting meets MU requirements only, not PQRS requirements.
  • You may be able to electronically submit CQM data directly from your 2014 Certified EHR System at the end of the calendar year and have it count for both MU and PQRS. You must verify that your vendor has programmed eCQM v2 (June 2013) specifications. You must obtain an IACS password, generate a file for each patient, and batch upload these to CMS through the IACS portal.
  • Your EHR vendor may have a Data Submission service, which allows them to generate and submit aggregate (as opposed to patient-level) quality data for both MU and PQRS to CMS on your behalf. Submission will occur after the end of the calendar year, and many EHR vendors will charge a fee to utilize this service.

Minimum Values: CQMs reported for the MU program may have zero values in either the numerator or the denominator. CQMs reported through your EHR for the PQRS program must have at least one Medicare Fee for Service patient counted in the numerator and denominator of at least one measure.

A list of the 64 possible clinical quality measures can be reviewed HERE; however, you should work with your EHR vendor to understand which measures and reporting options are available to you.

Clinical Decision Support: In Stage 1, you were required to have one clinical decision support rule turned on throughout the reporting period. In Stage 2, you are required to have five clinical decision support rules turned on and four of these must be related to the clinical quality measures you are reporting. If less than four clinical quality measures apply to your patient population, you must still have five rules turned on, and they must relate to high-priority clinical conditions that you treat.

Part 2 of the Clinical Decision Support Measure requires you to also attest that you had drug-drug and drug-allergy interaction alerts turned on during the reporting period. This is the same as a core measure found in Stage 1 rules.

Visit the CMS Specification Sheet for each Stage 2 Measure: HERE

Need help unraveling the complexities of Meaningful Use? MSOC Health can help! Contact Jeanne Chamberlin, Director of EMR Consulting at 919-442-2422 or

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