Whether you are new or already familiar with the Meaningful Use program, fulfilling and reporting the clinical quality measures section can be confusing. Well, to be honest, the whole process for meeting all of the Meaningful Use criteria for optometrists can be confusing!

Meaningful Use Criteria for Optometrists: CQMs 101

We've put together a CQM 101 sheet that will give you a quick overview about what they are all about as well as some handy tips specific to the eyecare industry. Being at the end of 2013 puts us in an “awkward stage” because some of you might be completing Stage 1 while others are getting their systems ready for Stage 2 that begins January 1, 2014. For today, we’ll cover both Stage 1 and Stage 2 requirements.

Stage 1: Report 6 CQMs (3 Core and 3 Additional)

There are 3 core requirements you will need to report:

1. Hypertension: Blood Pressure Measurement
2. Preventive Care and Screening Measure Pair: a) Tobacco Use Assessment b) Tobacco Cessation Intervention
3. Adult Weight Screening and Follow-up

If the data produced by your EHR or your calculations indicates a zero for one or more of the core CQMs, then you must choose one or more alternate core CQMs from this list:

1. Weight Assessment and Counseling for Children and Adolescents
2. Preventive Care and Screening: Influenza Immunization for Patients 50 Years Old or Older
3. Childhood Immunization Status

There are 3 additional requirements to report that you choose from a list of 38. But these 5 measures are the most relevant to eyecare:

1. Primary Open Angle Glaucoma (POAG): Optic Nerve Evaluation
2. Diabetic Retinopathy: Documentation of Presence or Absence of Macular Edema and Level of Severity of Retinopathy
3. Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care
4. Smoking and Tobacco Use Cessation, Medical Assistance: (a) Advising Smokers and Tobacco Users to Quit, (b) Discussing Smoking and Tobacco Use Cessation Medications
5. Diabetes: Eye Exam

Stage 2: Report 9 CQMs

Before you begin Stage 2, make sure that your EHR software is certified for 2014. If it is certified, it will have been tested for enhanced CQM-related capabilities required by Stage 2.

Stage 2 will not require the submission of a core set of CQMs, instead you report on 9 of the 64 approved CQMs. CMS has identified two recommended core sets of CQMs, one for adults and one for children.

Adult Recommended Core Measures (View Full Table of Recommended Adult Measures)

• Controlling High Blood Pressure
• Use of High-Risk Medications in the Elderly
• Preventive Care and Screening:  Tobacco Use:  Screening and Cessation Intervention
• Use of Imaging Studies for Low Back Pain
• Preventive Care and Screening:  Screening for Clinical Depression and Follow-Up Plan
• Documentation of Current Medications in the Medical Record
• Preventive Care and Screening:  Body Mass Index (BMI) Screening and Follow-Up
• Closing the referral loop: receipt of specialist report
• Functional status assessment for complex chronic conditions

Pediatric Recommended Core Measures (View Full Table of Recommended Pediatric Measures)

• Appropriate Testing for Children with Pharyngitis
• Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents
• Chlamydia Screening for Women
• Use of Appropriate Medications for Asthma
• Childhood Immunization Status
• Appropriate Treatment for Children with Upper Respiratory Infection (URI)
• ADHD:  Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication
• Preventive Care and Screening:  Screening for Clinical Depression and Follow-Up Plan 
• Children who have dental decay or cavities

Reporting CQMs

Reporting CQMs during attestation is done differently depending on which year you begin reporting.

2013: There are 2 options for CQM reporting if you are currently in the process:

• Attestation
• Electronic Reporting Pilots through PQRS (Physician Quality Reporting System)
  • Check your eligibility for PRQS.

2014: Beginning in 2014, you will be required to report CQMs using the new 2014 criteria regardless of whether you are participating in Stage 1 or Stage 2 of the EHR Incentive Program. 

To successfully report CQMs electronically for 2014, the CMS provides a set of electronic specifications for Clinical Quality Measures (eCQMs) for electronic reporting. These electronic specifications contain multiple parts which allow certified EHR technology systems to be programmed to accurately capture, calculate, and report CQMs.

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