Quality Measures

Q. How do measures differ from guidelines?
A. Quality measures are math equations to help understand how often health care services are consistent with current medical knowledge. Clinical Practice Guidelines are documents that include recommendations intended to optimize patient care that are based on an evidence-based systematic review. Guideline recommendations form the denominator and numerator statements of quality measures. 

Q. Why are there so many measures in a set, and do I have to do them all?
A. The measurement sets include multiple measures with strong evidence or guideline statements supporting best practices and known treatment gaps. Providers are encouraged to pick 1-2 measures most meaningful to their patient populations and start measuring there. This measure data can form a benchmark and be used to drive quality improvement in practice. There is no mandate to gather data for all measures.

Q. Am I required to use quality measures as part of my patient visit?
A.There is no requirement, but for individual providers participating in CMS' Merit-based Incentive Payment System (MIPS) there is a required quality component. As part of MIPS' program requirements, eligible providers must submit quality measure data to satisfy reporting requirements to be eligible for an incentive (bonus) payment.

Q. Are there other measures for neurology that the AAN did not develop?
A.Yes. The National Quality Measures Clearinghouse (NQMC) is a repository with hundreds of measures that are searchable by topic, specialty, or measure developer. There are many cross-cutting measures (depression screening, tobacco cessation) and neurology-specific measures (headache, imaging, oncology) that neurologists may find useful. The National Quality Forum maintains a database of measures it has endorsed.

Q. What is Patient Reported Outcome (PRO) data?

A. Patient Reported Outcome (PRO) measures or PROM use an instrument or scale to directly assess any report of a patient’s health
condition directly from that patient, without interpretation of the patient’s symptoms, feelings, or concerns by anyone else. Examples include the PHQ-9, PROMIS, and HIT-6. PRO-Performance Measures (PRO-PM) are performance measures based on PROM. An example is Percentage of patients with diagnosis of major depression or dysthymia with an initial PHQ-9 score >9 with a follow-up PHQ-9 score <5 at 6 months. Find more information on PRO tools and how to use them in practice.

Q. How can I propose a topic for a quality measurement set where I see a gap in care?
A. Contact quality@aan.com to send your ideas to AAN staff.