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Making Meaningful Use Meaningful
How Meaningful EHR Use Can Improve Quality of Care


This fact sheet provides an overview of how 2014+ Meaningful Use EHR functions support quality measurement and quality improvement in practices, with Recommended Core measures highlighted in bold. This resource is intended for educational purposes only. Practices should work with their vendor to determine which MU objectives and CQMs their EHR system is certified to report on, and any specific workflow changes needed to ensure MU objectives are implemented properly and CQMs calculate properly in their specific EHR system.

Opportunity for Improvement EHR function (Stage 2 MU objectives are in blue) Related Clinical Quality Measure(s)
Determine which patients in the practice are receiving recommended care, and which are not.

Recording patient demographics and maintaining problem lists are essential to better management of your patient population and establishing a registry of patients with certain conditions.

Recording vital signs and e-notes in the patient record is necessary to identify patients at risk for diseases and track improvement on certain quality measures.

Recording patient lists by condition is a tool that relies on other information in the EHR, and is one of the first steps in quality improvement. For example, a practice can generate a list of all patients with hypertension and see who is overdue for a check-up.

Many CQMs rely on demographic and vital sign data (height, weight, blood pressure, BMI) to accurately track quality of care in the practice, for example:
  • NQF 0018: Controlling High Blood Pressure (CMS165v7)
  • NQF 0024: Weight Assessment and Counseling for Children and Adolescents (CMS155v7)
  • NQF 0059: Diabetes: HbA1c Poor Control (CMS122v7)
  • NQF 0064: Diabetes: LDL Management and Control (CMS163v5)
  • NQF 0070: CAD: Beta-Blocker Therapy for CAD Patients with Prior Myocardial Infarction (MI) (CMS145v7)
  • NQF 0075: IVD: Complete Lipid Panel and LDL Control (CMS182v6)
  • NQF 0081: Heart Failure (HF): Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy for Left Ventricular Systolic Dysfunction (LVSD) (CMS135v7)
  • NQF 0083: HF: Beta-Blocker Therapy for LVSD (CMS144v7)
  • NQF 0421: Adult Weight Screening and Follow-up (CMS69v7)
  • NQF TBD: Hypertension: Improvement in Blood Pressure (CMS65v8)
  • NQF TBD: Preventive Care and Screening: Cholesterol-Fasting Low Density Lipoprotein (LDL-C) Test Performed (CMS64v6)
  • NQF 1335: Children Who Have Dental Decay or Cavities (CMS75v7)
  • NQF 0060: Hemoglobin A1c Test for Pediatric Patients (CMS148v5)
  • NQF 0101: Screening for Future Fall Risk (CMS139v7)
  • NQF 0407: HIV/AIDS: RNA Control for Patients with HIV (CMS77v5)
  • NQF TBD: Functional Status Assessment for Knee Replacement (CMS66v7)
  • NQF TBD: Functional Status for Hip Replacement (CMS56v7)
  • NQF 0104: Major Depressive Disorder (MDD): Suicide Risk Assessment (CMS161v7)
  • NQF 0110: Bipolar Disorder and Major Depression: Appraisal for Alcohol or Chemical Substance Use (CMS169v7)
  • NQF 0418: Preventive Care and Screening: Screening for Clinical Depression and Follow-Up Plan (CMS2v8)
  • NQF 0565: Cataracts: 20/40 of Better Visual Acuity within 90 Days Following Cataract Surgery (CMS133v7)
Determine if there are accurate, up-to-date records of whether patients are on recommended medications and have received recommended diagnostic tests. Computerized Provider Order Entry (CPOE) is the most direct way to enter active medications and order labs and radiology in the EHR. See the above list for "medication use is measured in the following CQMs"
Determine if smoking is a risk factor for patients in the practice. Recording smoking status provides an opportunity to both track patients with this risk factor and maintain smoking status as part of the conversation at office visits. Smoking status is required in the following CQM:
  • NQF 0028: Preventive Care and Screening Measure Pair: a. Tobacco Use Assessment, b. Tobacco Cessation Intervention (CMS138v7)
Determine if evidence-based guidelines can be implemented more consistently. Use clinical decision support to remind practitioners to provide evidence-based care consistently thereby improving the quality of care delivered. All CQMs are sensitive to consistent practice habits. Some specific examples include:
  • NQF 0002: Appropriate Testing of for Children with Pharyngitis (CMS146v7)
  • NQF 0031: Breast Cancer Screening (CMS125v7)
  • NQF 0032: Cervical Cancer Screening (CMS124v7)
  • NQF 0033: Chlamydia Screening for Women (CMS153v7)
  • NQF 0034: Colorectal Cancer Screening (CMS130v7)
  • NQF 0036: Use of Appropriate Medications for Asthma (CMS126v5)
  • NQF 0038: Childhood Immunization Status (CMS117v7)
  • NQF 0041: Preventive Care and Screening: Influenza Immunization for Patients ≥ 50 Years Old (CMS147v8)
  • NQF 0043: Pneumonia Vaccination Status for Older Adults (CMS127v7)
  • NQF 0052: Low Back Pain: Use of Imaging Studies (CMS166v7)
  • NQF 0068: IVD: Use of Aspirin or Another Antithrombotic (CMS164v7)
  • NQF 0070: CAD: Beta-Blocker Therapy for CAD Patients with Prior Myocardial Infarction (MI) (CMS145v7)
  • NQF 0081: HF: ACE Inhibitor or ARB Therapy for LVSD (CMS135v7)
  • NQF 0083: HF: Beta-Blocker Therapy for LVSD (CMS144v7)
  • NQF 0385: Oncology Colon Cancer: Chemotherapy for Stage III Colon Cancer Patients (CMS141v6)
  • NQF 0387: Oncology Breast Cancer: Hormonal Therapy for Stage IC-IIIC Estrogen Receptor/Progesterone Receptor (ER/PR) Positive Breast Cancer (CMS140v5)
  • NQF 0384: Oncology Medical and Radiation: Pain Intensity Quantified (CMS157v7)
  • NQF 0389: Prostate Cancer: Avoidance of Overuse of Bone Scan for Staging Low Risk Prostate Cancer Patients (CMS129v8)
  • NQF 0022: Use of High-Risk Medications in the Elderly (CMS156v7)
  • NQF 0069: Appropriate Treatment for Children with Upper Respiratory Infection (URI) (CMS154v7)
  • NQF 0060: Hemoglobin A1c Test for Pediatric Patients (CMS148v5)
  • NQF 0405: HIV/AIDS: Pneumocystis jiroveci pneumonia (PCP) Prophylaxis (CMS52v7)
  • NQF 1401: Maternal Depression Screening (CMS82v6)
  • NQF 0608: Pregnant Women that had HBsAg Testing (CMS158v7)
  • NQF 1365: Child and Adolescent Major Depressive Disorder: Suicide Risk Assessment (CMS177v7)
  • NQF TBD: Preventive Care and Screening: Cholesterol-Fasting Low Density Lipoprotein (LDL-C) Test Performed (CMS61v6)
  • NQF TBD: Preventive Care and Screening: Risk-Stratified Cholesterol-Fasting Low Density Lipoprotein (LDL-C) Test Performed (CMS64v6)
  • NQF 0101: Screening for Future Fall Risk (CMS139v7)
  • NQF 0104: Major Depressive Disorder (MDD): Suicide Risk Assessment (CMS161v7)
  • NQF 0110: Bipolar Disorder and Major Depression: Appraisal for Alcohol or Chemical Substance Use (CMS169v7)
  • NQF 0418: Preventive Care and Screening: Screening for Clinical Depression and Follow-Up Plan (CMS2v8)
  • NQF TBD: Dementia: Cognitive Assessment (CMS149v7)
Determine if patients are motivated to become an active partner in managing chronic conditions or monitoring risk factors.

Use secure e-messaging to communicate to patients about relevant health information.

Providing patient education resources can also help patients understand their health conditions and educate them on ways to improve their health.

The following CQMs can be positively affected by engaging patients in managing chronic conditions or monitoring risk factors:
  • NQF 0004: Initiation and Engagement of Alcohol and Other Drug Dependence Treatment: a) Initiation, b) Engagement (CMS137v7)
  • NQF 0018: Controlling High Blood Pressure (CMS165v7)
  • NQF 0028: Preventive Care and Screening Measure Pair: a. Tobacco Use Assessment, b. Tobacco Cessation Intervention (CMS138v7)
  • NQF 0036: Use of Appropriate Medications for Asthma (CMS126v5)
  • NQF 0068: IVD: Use of Aspirin or Another Antithrombotic (CMS164v7)
  • NQF 0070: CAD: Beta-Blocker Therapy for CAD Patients with Prior Myocardial Infarction (MI) (CMS145v7)
  • NQF 0081: HF: ACE Inhibitor or ARB Therapy for LVSD (CMS135v7)
  • NQF 0083: HF: Beta-Blocker Therapy for LVSD (CMS144v7)
  • NQF 0384: Oncology Medical and Radiation: Pain Intensity Quantified (CMS157v7)
  • NQF 0407: HIV/AIDS: RNA Control for Patients with HIV (CMS77v5)
  • NQF 0405: HIV/AIDS: Pneumocystis jiroveci pneumonia (PCP) Prophylaxis (CMS52v7)
Determine if the practice consistently follows up regarding abnormal test results.

Incorporating clinical lab test results into the EHR can help office staff easily track test results and identify patients who are in need of follow-up, and accelerate the time in which clinical problems can be addressed.

Making imaging results and relevant information accessible through Certified Electronic Health Record Technology (CEHRT) can improve provider follow-up and reduce missed diagnoses.

The following CQMs require lab data:
  • NQF 0052: Low Back Pain: Use of Imaging Studies (CMS166v7)
  • NQF 0059: Diabetes: HbA1c Poor Control (CMS122v7)
  • NQF 0060: Hemoglobin A1c Test for Pediatric Patients (CMS148v5)
  • NQF 0062: Diabetes: Urine Screening (CMS135v7)
  • NQF 0064: Diabetes: LDL Management and Control (CMS163v5)
  • NQF 0075: IVD: Complete Lipid Panel and LDL Control (CMS182v6)
  • NQF 0564: Cataracts: Complications within 30 Days Following Cataract Surgery Requiring Additional Surgical Procedures (CMS132v7)
  • NQF 1335: Children Who Have Dental Decay or Cavities (CMS75v7)
  • NQF TBD: Closing the Referral Loop: Receipt of Specialist Report (CMS50v7)
  • NQF TBD: Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented (CMS22v7)
Determine if patients consistently receive follow-up care and are receiving the appropriate set of preventive care measures. Identifying patients who need reminders using clinically relevant information can assist practices in identifying patients who are in need of preventive care or disease management. The following CQMs track well-child visits and preventive care:
  • NQF 0024: Weight Assessment and Counseling for Children and Adolescents (CMS155v7)
  • NQF 0031: Breast Cancer Screening (CMS125v7)
  • NQF 0032: Cervical Cancer Screening (CMS124v7)
  • NQF 0033: Chlamydia Screening for Women (CMS153v7)
  • NQF 0034: Colorectal Cancer Screening (CMS130v7)
  • NQF 0038: Childhood Immunization Status (CMS117v7)
  • NQF 0421: Adult Weight Screening and Follow-up (CMS69v7)
  • NQF TBD: Hypertension: Improvement in Blood Pressure(CMS65v8)
  • NQF TBD: ADE Prevention and Monitoring: Warfarin Time in Therapeutic Range (CMS179v5)
  • NQF TBD: Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented (CMS22v7)
  • NQF TBD: Preventive Care and Screening: Cholesterol-Fasting Low Density Lipoprotein (LDL-C) Test Performed (CMS61v6)
  • NQF TBD: Preventive Care and Screening: Risk-Stratified Cholesterol-Fasting Low Density Lipoprotein (LDL-C) Test Performed (CMS64v6)
  • NQF TBD: Closing the Referral Loop: Receipt of Specialist Report (CMS50v7)
  • NQF 0418: Preventive Care and Screening: Screening for Clinical Depression and Follow-Up Plan (CMS2v8)
  • NQF 0108: ADHD: Follow-Up Care for Children Prescribed Attention Deficit/Hyperactivity Disorder (ADHD) Medication (CMS136v8)
  • NQF 1419: Primary Caries Prevention Intervention as Offered by Primary Care Providers, including Dentists (CMS74v8)
  • NQF 0060: Hemoglobin A1c Test for Pediatric Patients (CMS148v5)
  • NQF 0403: HIV/AIDS: Medical Visit (CMS62v5)
  • NQF 0608: Pregnant Women that had HBsAg Testing (CMS158v7)
  • NQF 0710: Depression Remission at 12 Months (CMS159v7)
Determine if there are delays in providing optimal care to patients who have just transitioned from one setting or provider to another.

Performing medication reconciliation when a patient is transferred to the practice can help accelerate an understanding of the patient's current health status and decrease chances of medication errors at a time of transfer.

Providing a summary of care record at a time of transfer or referral to another provider can do the same for colleagues.

Allowing patients to view, download, and transmit their information can empower the patient to participate in transitions of care.

The following CQMs involve transitions of care:
  • NQF 0004: Initiation and Engagement of Alcohol and Other Drug Dependence Treatment: a) Initiation, b) Engagement (CMS137v7)
  • NQF 0055: Diabetes: Eye Exam (CMS131v7)
  • NQF 0056: Diabetes: Foot Exam (CMS123v7)
  • NQF 0086: Primary Open Angle Glaucoma: Optic Nerve Evaluation (CMS143v7)
  • NQF 0088: Diabetic Retinopathy: Documentation of Presence or Absence of Macular Edema and Level of Severity of Retinopathy (CMS167v7)
  • NQF 0089: Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care (CMS142v7)
  • NQF 0105: Anti-depressant medication management: (a) Effective Acute Phase Treatment, (b) Effective Continuation Phase Treatment (Not Applicable)
  • NQF 0108: ADHD: Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication (CMS136v8)
  • NQF 0403: HIV/AIDS: Medical Visit (CMS62v5)
  • NQF TBD: Closing the Referral Loop: Receipt of Specialist Report (CMS50v7)
Determine ways that practices can assist with population-level disease surveillance and quality improvement.

Recording patient health history as structured data can increase the operability of practice-level data for quality measurement and improvement purposes.

Identifying and reporting specific cases to a state registry or specialized registry, such as cancer, will bolster the accuracy and completeness of state-level data.

All CQMs are relevant to patient health history and many can assist with population-level disease surveillance. Specific examples include:
  • NQF 0031: Breast Cancer Screening (CMS125v7)
  • NQF 0032: Cervical Cancer Screening (CMS124v7)
  • NQF 0034: Colorectal Cancer Screening (CMS130v7)
  • NQF 0385: Oncology Colon Cancer: Chemotherapy for Stage III Colon Cancer Patients (CMS141v6)
  • NQF 0387: Oncology Breast Cancer: Hormonal Therapy for Stage IC-IIIC Estrogen Receptor/Progesterone Receptor (ER/PR) Positive Breast Cancer (CMS140v5)
  • NQF 0031: Breast Cancer Screening (CMS125v7)
  • NQF 0032: Cervical Cancer Screening (CMS124v7)
  • NQF 0033: Chlamydia Screening for Women (CMS153v7)
  • NQF 0034: Colorectal Cancer Screening (CMS130v7)


Meaningful Use Clinical Quality Measures

Clinical Process/Effectiveness Domain

Care Coordination Domain

Efficient Use of Health Care Resources Domain

Patient & Family Engagement Domain

Patient Safety Domain

Population/Public Health Domain

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