eCQM submission to the CMS Inpatient Quality Reporting (IQR) program is winding down. The final deadline for submission is March 13. As the Director of Electronic Measures at Medisolv, this last year was a bit of a whirlwind for me and our whole team. When I sat down to debrief with my team, I noticed something; from the client’s perspective, it took a very short amount of their time to complete the submission process, less than one hour in fact.

In this week’s blog I thought I would take our readers under the hood of the Medisolv eCQM submission car. We reveal all the steps we take to complete one submission for each client. I also broke down the approximate time it takes each client to complete the submission steps.

Prep Work

So, before you get worked up thinking J.K. Rowling’s magical world is real and one spell will fix all of your eCQM submission woes, remember that this one hour of submission time is a small part of a year-long cyclical process that involves a ton of work leading up to the actual act of submission.

Before the submission process even begins, Medisolv has worked diligently with the client to set up their eCQMs, a process that involves implementation, validation, testing, troubleshooting, updating, etc.

During the implementation process and even after the initial set up, Medisolv makes client education a top priority. Each Medisolv client receives an individual clinical consultant, and throughout the year, the client receives education from the consultant on various topics including the requirements for the CMS IQR program. Additionally, as measure specifications are updated, the client is educated on those changes and given advice for updating the eCQM mapping and adjusting clinical workflows.

When submission time starts looming, clients begin the following submission process.

Authorization

Client time: 10 minutes

In the weeks leading up to the opening of the CMS portal for submission, the client visits QualityNet and authorizes Medisolv to submit the eCQM measures on their hospital’s behalf.

Snapshot

Client time: ~30 minutes

When the submission window officially opens, the client goes into the ENCOR product and presses the “Snapshot” button. This handy little tool allows the client to take a snapshot of the measures as they were/are in a certain time frame.

In 2016, hospitals could choose to submit either quarter three or quarter four data to CMS. Once the client decides which quarter they would like to submit, the client clicks that snapshot button and voila! The database shows the measures and results as they were exactly during the designated time frame.

Now to be fair, the actual process of the tool creating the snapshot varies based on the size of the database. For some hospitals with large databases, it might take 30 minutes, and for others, it takes only five.

Measure Selection & Authorization

Client time: 2 minutes

We encourage all clients to be studying their measure results on a frequent basis so the actual measure selection part should be completed in no time at all. In fact, I strongly suggest that this decision is made in advance as a part of the prep work mentioned above. The measures selected, to the best of your ability, should accurately reflect the quality of care being performed in your hospital.

The ENCOR software features a submission management tool that allows the client to select their measures for submission (and because you've been monitoring your measure results regularly, you know which you want to submit at this point, right?!). They also select the snapshot to be used and signs off to give approval for Medisolv to submit their measures to CMS. 

Submission

Client time: 0 mins

At this point, the client portion is over. It took a total of 42 minutes of a client’s time to complete the entire process. Now it’s Medisolv’s turn to submit the file to CMS. While each submission is completely different, there are similar steps that Medisolv takes with each client.

1. Medisolv reviews the measures the client selected to look for any mistakes.
2. Medisolv authorizes the creation of the QRDA file.
3. Once authorized, our system automatically creates the QRDA file.
4. Medisolv submits the QRDA file to CMS via QualityNet.
5. Once submitted, we receive back a summary that shows how many files were submitted, accepted and rejected.
6. For any rejected files, we troubleshoot the problems, fix it and then resubmit.
7. Once all files are submitted and accepted, we send our clients the final submission PDF that shows them proof of submission.

And that’s it! Of course, you probably guessed correctly that even though the steps seem simple, the Medisolv team puts in a lot of blood, sweat and tears behind the scenes. Ok, well maybe not the blood part.

In conclusion, to have a submission time of less than one hour, it takes a lot of hard work over a period of time. You probably aren't surprised to hear that. If you would like to learn a little bit more about what Medisolv discovered during our submission process, check out the webinar below. I'll be giving an overview of this process in more detail and we will also cover some of the common errors we found during our submissions.

ON-DEMAND WEBINAR:

Overcoming Challenges with eCQMs

An eCQM submission strategy for your hospital

Held on: July 2017

Medisolv will share a yearly eCQM strategy that takes you from initial implementation all the way through submission to CMS. We will point out common pitfalls that many hospitals struggled with and how to overcome those problems in advance.

From this webinar you will:

• Understand and keep up with the regulatory requirements and specifications;
• Learn required eCQM data element mapping updates for the correct specification version;
• Assess and choose the measures for submission to the IQR program;
• Implement changes to Clinical Workflows;
• And create hospital-wide adoption of Quality initiatives.