The Impact of Federal Quality Measurement for Ambulatory Providers

U.S. Government Accountability Office (GAO), "ELECTRONIC HEALTH RECORD PROGRAMS: Participation Has Increased, but Action Needed to Achieve Goals, Including Improved Quality of Care." March 2014

ABSTRACT: GAO conducted this study to assess the extent of current and expected participation in the EHR programs, (2) examined information reported by providers and others to measure meaningful use in the EHR programs, (3) evaluated HHS efforts to ensure that EHR data can be reliably used to measure quality of care, and (4) evaluated HHS efforts to assess the effect of the EHR programs on program goals related to adoption and meaningful use of EHRs and improved outcomes. GAO analyzed data from CMS and other sources; reviewed applicable statutes, regulations, and guidance; and interviewed officials from HHS and stakeholder groups. The report concludes with a series of recommendations for a comprehensive HHS strategy to better ensure the reliability of CQM data collected using EHRs and develop and use outcome-oriented performance measures to monitor progress toward goals.

W. James Stackhouse, "The Perils of Quality Improvement Activities: A Physician's Perspective." North Carolina Journal of Medicine. April 2013.

ABSTRACT: Clinical quality measurement remains an elusive goal, and it has the potential to result in adverse outcomes and unexpected consequences. Practicing physicians are wary of current efforts but should remain professionally committed to the development of effective, evidence-based quality measures.

Jacqueline R. Halladay, "Cost to Primary Care Practices of Responding to Payer Requests for Quality and Performance Data" Annals of Family Medicine Nov 1, 2009

ABSTRACT: The costs of a quality-reporting program vary greatly by program and are important to anticipate and understand when undertaking quality improvement work. Incentives that would likely improve practice participation include financial payment, quality improvement skills training, and technical assistance with electronic system troubleshooting.