1. A Mixed Methods Task Analysis of the Implementation and Validation of
EHR-Based Clinical Quality Measures
Nicole G. Weiskopf, PhD, Faiza J. Khan, MBBS, MBI, Deborah Woodcock, MBA, David
A. Dorr, MD, MS, Aaron M. Cohen, MD, MS
Department of Medical Informatics & Clinical Epidemiology, OHSU, Portland, OR
Abstract
Clinical quality measures (CQMs) are an important tool for the assessment and improvement of healthcare quality.
Federal requirements initially set forth in the American Recovery and Reinvestment Act, and advanced in subsequent
stages of the requirements, codified electronic health record (EHR)-based CQM reporting, and have made
automated CQM implementation a priority amongst the clinical and informatics communities. Nevertheless, the
processes surrounding CQM implementation and validation remain complex, time-consuming, and largely
undefined. We collected issue-tracking data during the course of an agile and rigorous collaborative project to build
an analytics platform for the Knight Cardiovascular Institute at OHSU, with nine heart failure CQMs defined by the
American College of Cardiology (ACC) as an exemplar. Using a mixed methods approach we provide an overview
of our CQM implementation and validation process, identify major roadblocks and bottlenecks, and make
recommendations for other professionals working in the area of healthcare quality assessment and improvement.