solution

CareDiscovery Quality Measures (CDQM)

Uncover quality of care best practices for the strategic and financial growth of your organization

Compare your performance against industry standards or set targets to identify and trend measure performance

Patient safety and quality of care are key drivers in healthcare reform, and organizations like The Joint Commission (TJC) have developed accreditation policies to ensure that hospitals comply with well-established safety and clinical standards. Strict submission deadlines and revisions notwithstanding. Hospitals need smarter processes that optimally utilize the massive inflow of patient data while containing compliance-related costs.

Virtusa helps alleviate the pains of regulatory reporting with the CareDiscovery Quality Measures (CDQM) and CareDiscovery Electronic Quality Measures (CDeQM) solution. This solution, in partnership with IBM, supports CMS compliance and core measure reporting requirements. It provides accurate, on-time, and comprehensive records making it the tool of choice for regulatory reporting.

Our reporting solutions help hospitals report to CMS to receive incentives through the hospital quality reporting programs.

CareDiscovery Quality Measures (CDQM)

CDQM combines patient data from different sources such as patient billing systems and EHRs, to define data elements needed for abstraction of clinical quality measures. It helps hospitals achieve compliance with CMS and TJC to protect market share. Using the optional concurrent or expedite modules, CDQM enables hospitals to analyze health cases while patients are still in-house and care is being delivered, giving providers the opportunity to improve quality and patient outcomes for the future.

CareDiscovery Electronic Quality Measures (CDeQM)

CDeQM provides a comprehensive data submission manual that defines the data elements needed for calculation of electronic clinical quality measures (eCQMs).

Measuring and reporting eCOMs allows hospitals to deliver effective, safe, efficient, patient-centric, equitable, and timely care.

Benefits

  • Increased patient satisfaction by improving care
  • Improve quality of care by allowing providers to focus more on patient care while reducing administrative work
  • Achieve regulatory compliance by making on-time submission to CMS and TJC
  • Streamline workflows by customizing abstraction of data (CDQM only)
  • Compare against benchmarks to identify and measure performance
  • Save time by identifying data issues before submissions

Additional information
Care Discovery Electronic Quality Measures Mandatory Disclosure
Certificate of EHR Compliance: EHR Module (Inpatient) IBM CareDiscovery Electronic Quality Measures

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Frequently Asked Questions
What are Virtusa's CareDiscovery Quality Measures (CDQM)?

Virtusa's CareDiscovery Quality Measures (CDQM) is a regulatory reporting solution, in partnership with IBM, that helps hospitals achieve compliance with CMS and TJC. Hospitals can easily report to payer organizations to receive incentives through hospital quality reporting programs. CMS obtains timely reports of quality measures through core reporting requirements, monitoring hospital performance to ensure health standards and to improve reimbursements. Hospitals obtain a better understanding of health performance, all while maintaining service standards that minimize regulatory penalties. 

Virtusa's CareDiscovery Quality Measures (CDQM) combines patient data from different sources, such as patient billing systems and EHRs, to define data elements needed for abstracting clinical quality measures. CDQM allows hospitals to use analytic insights to measure performance and improve value-based care. Advanced reporting modules will enable hospitals to optimize patient data by making comprehensive records that establish how well regulatory standards are maintained. Hospitals can manage risk potential and implement new protocols that lessen incident reporting by CMS and TJC accreditation policies. 

  1. Virtusa's CareDiscovery Quality Measures is an easy-to-integrate solution that helps healthcare compliance teams and administrators oversee hospital regulatory reporting better to align health operations with Course Management System (CMS) and The Joint Commission (TJC) standards. Benefits include:
  2. Increased patient satisfaction with better treatment coordination
  3. Improved quality of care by allowing providers to focus more on patient care while reducing administrative work
  4. Achieve regulatory compliance by making an on-time submission to CMS and TJC
  5. Streamline workflows by customizing the abstraction of data (CDQM only)
  6. Compare against benchmarks to identify and measure performance
  7. Save time by identifying issues before submissions

Virtusa's CareDiscovery Electronic Quality Measures (CDeQM) is a solution that gives hospitals a data submission manual that defines data elements needed for calculating electronic clinical quality measures (eCQMs). The eCQMs allow hospitals to deliver effective, safe, efficient, patient-centric, equitable, and timely care. 

Quality of care is measured by electronic quality measures (eCQMs). eCQMs are software tools that measure hospital performance by analyzing provider electronic health records (EHRs) or other data from healthcare IT systems. eCQMs measure patient data based on service efficiency, clinical outcomes, resource allocation, and care coordination. Quality measures can also be collected through claims reports, health instruments, and clinical registries to improve performance and evaluate healthcare standards. Hospitals and clinical providers are required to follow health standards approved by CMS regulations. CMS helps healthcare providers maintain compliance by publishing a list of codes healthcare IT teams must use to capture patient data that helps quantify healthcare processes and outcomes. 

Quality measures track healthcare standards set to meet institutional goals, focusing on a provider's ability to deliver safe, accurate, and effective care. Three measures of medical care quality include:

  • Structural Measures: Tracking healthcare organizations' structure, organization, and systems through quality measure domains. A structure measure ensures the maintenance of health profiles, analyzes ratios of available providers within a network, and an organization's ability to keep up with population demands for care. 
  • Process Measures: Measuring the type and amount of health services, tests, and preventative treatments a given population receives. This quality care measure provides information about how many people with a given condition, like high blood pressure, have the appropriate tests performed to track and monitor health progress. 
  • Outcome Measures: Evidence of favorable health outcomes through the correct care initiatives, tests, and routines. These are measurements of patient health status after a provider performs routine or specialized treatments. 

Quality Indicators (QIs) are evidence-based measurements of a healthcare organization's overall performance. QIs can be used for comparative analysis of patient data within healthcare IT systems to identify structural problems, progress improvements, and priority issues. Providers can monitor QIs to improve on targeted areas that show low performance. The four types of quality indicators in healthcare include:

  • Prevention Quality Indicators: Prevention Quality Indicators (PQIs) capture data from patient discharge rates to understand areas for improvement regarding value-based care. The data helps develop better ways of administrating preventative health services and assisting providers in pinpointing the type of services needed based on demographic information. 
  • Inpatient Quality Indicators: Inpatient Quality Indicators (IQIs) show data on patients being treated inside hospitals. These measurements are based on patient mortality rates regarding health conditions, treatment protocols, and surgical outcomes. IQIs can be used to improve service areas with low patient success rates. 
  • Patient Safety Indicators: Patient Safety Indicators (PSIs) measure the quality of safety protocols and the number of negative health outcomes within hospitals. PSIs help hospitals target areas within the care process that can potentially lead to health complications or even death. 
  • Pediatric Quality Indicators: Pediatric Quality Indicators (PDIs) show data on children's health status when undertaking hospital care. PDIs analyze systems and processes that lead to negative pediatric health outcomes. 

Quality improvement in healthcare measures outcomes based on targets, goals, and urgencies that help build efficient processes and simplify healthcare delivery. Quality measures, like CMS' Meaningful Measures Framework, are used to define essential tasks, procedures, and engagement methods that require monitoring to fulfill program requirements or to identify burdensome administrative procedures. Examples of quality improvement in healthcare include:

  • Building databases accessible to providers that list dangerous drug combinations
  • Tracking and publicizing administrative errors that lead to negative medical outcomes
  • Online feedback channels or email campaigns that provide direct reporting of patient experiences to healthcare managers
  • Developing correct methods of measuring mortality rates that factor in risk, comorbidity, and severity of illness
  • Using evidence of clinical best practices to guide the creation of high-standard performance measures
  • Digital technology helps improve the overall system by measuring provider performance and health outcomes based on various care settings. 

Challenges to managing compliance and reporting requirements include maintaining the security and privacy of patient data, adhering to new regulations, and training workers to navigate regulatory procedures. Digital technology can help hospitals keep up with the demands of complex regulatory environments while maintaining value-based care. Reporting solutions equipped with artificial intelligence and Internet of Things (IoT) network operation gain real-time insights into compliance issues. Hospitals can assess the data to create thorough risk management practices. Advanced analytics enable quicker processing of quality measures, helping ease the administrative burden of creating quality compliance reports. Modern technology solutions, like cognitive computing, can collect, process, and analyze large amounts of data to help providers create effective quality improvement measures. Automation can help compliance teams see updated reports on how well hospitals maintain institutional goals set by CMS regulations. 

Hospitals require accurate reporting to maintain high-standard services, understand problem areas, and implement corrective solutions. High administration costs create inefficient case resolution, inadequate patient follow-up care, and disconnected health information. Legacy systems often make essential information difficult to access, delivering slow and disjointed electronic health records (EHRs). Lack of data interoperability between various healthcare IT systems slows down sharing of important health information and increases the risk of errors due to manual efforts. Reliance on outdated health IT infrastructure creates obstacles to accurate compliance and regulatory reporting, making it harder for hospitals to keep up to date with CMS standards. 

Hospitals can invest in digital technology solutions, like Virtusa's CareDiscovery Quality Measures (CDQM), to benefit from advanced data management that provides quick and accurate reporting methods. Digital technology can help healthcare systems combine multiple data sources effectively, making patient information easier to analyze. IT systems can also be enhanced with intuitive interfaces, software integrations, and simplified data aggregation. This helps hospitals easily create reports and send data to compliance administrators. Investing in predictive analytics allows hospitals to gain a deeper knowledge of system weaknesses, ineffective health protocols, and negative patient health outcomes. This makes it easier to use real-time data as a source for assessing and reporting on quality measures for compliance. 

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