Developers have indicated that it can be challenging to test eMeasures to the extent necessary to meet NQF endorsement criteria – at least until they have been more widely implemented. At the same time, there is interest in developing eMeasures for use in federal programs and obtaining NQF endorsement for those eMeasures. NQF endorsement may provide the impetus to implement measures; however, if a submitted measure with very limited testing does not meet NQF endorsement criteria, it could be prematurely abandoned.
In 2014, NQF piloted the eMeasure Approval for Trial Use Program for eMeasures that are ready for implementation, but cannot yet be adequately tested to meet NQF endorsement criteria. NQF uses the multistakeholder consensus process to evaluate and approve eMeasures for trial use that address important areas for performance measurement and quality improvement, though they may not have the requisite testing needed for NQF endorsement. These eMeasures must be assessed to be technically acceptable for implementation and the ability to conduct more robust reliability and validity testing that can take advantage of clinical data in EHRs.
In April 2015, the Consensus Standards Approval Committee (CSAC) agreed to make approval for trial use available for all eMeasures submitted to NQF. Approval for trial use is NOT time-limited endorsement as it carries no endorsement label. Furthermore, although the Trial Use Program is a pathway for measures to be potentially be considered for endorsement, it is not a mechanism by which measures should be considered that do not comply with NQF’s criteria regarding Important to Measure and Report, nor ones in which data to evaluate its Scientific Acceptability cannot reasonably be collected within an electronic health record. Measures approved for trial use will be so indicated on QPS. See Table 12 (PDF) for comparison of endorsement and approval for trial use.
eMeasure candidates for the Trial Use Program are initially screened by the eMeasure and Maintenance Measure Review team. Criteria for approval for Trial Use include:
Candidacy for approval for Trial Use are reviewed much like any eMeasure by the standing committee in a project, based on the standard NQF criteria. The main difference between Approval for Trial Use and standard endorsement is that the completion of measure testing is not needed prior to committee review to receive Approval for Trial Use status.
1030 15th Street NWSuite 800Washington DC 20005
202-783-1300 Main202-783-3434 Faxinfo@qualityforum.org