Costs and Limitations

Certification Edition

2015

Product/Version

Certification Date

12/31/2018

Certification Number

15.04.04.2696.Clin.05.00.0.181231

Certification Criteria & Functionality

170.314(c)(1-3): recording, calculating and reporting clinical quality measures (CQMs)
170.314(d)(1-3,5,12,13): user authentication, access control, and audit trail.
170.314(g)(4-5): quality management system and accessibility-centered design.

Clinical Quality Measures Certified

1. CMS161v10: Adult Major Depressive Disorder (MDD): Suicide Risk Assessment
2. CMS128v10: Anti-Depressant Medication Management
3. CMS146v10: Appropriate Testing for Pharyngitis
4. CMS154v10: Appropriate Treatment for Upper Respiratory Infection (URI)
5. CMS249v4: Appropriate Use of DXA Scans in Women Under 65 Years Who Do Not Meet the Risk Factor Profile for Osteoporotic Fracture
6. CMS645v5: Bone Density Evaluation for Patients with Prostate Cancer and Receiving Androgen Deprivation Therapy
7. CMS125v10: Breast Cancer Screening
8. CMS133v10: Cataracts: 20/40 or Better Visual Acuity within 90 Days Following Cataract Surgery
9. CMS124v10: Cervical Cancer Screening
10. CMS177v10: Child and Adolescent Major Depressive Disorder (MDD): Suicide Risk Assessment
11. CMS117v10: Childhood Immunization Status
12. CMS75v10: Children Who Have Dental Decay or Cavities
13. CMS153v10: Chlamydia Screening for Women
14. CMS50v10: Closing the Referral Loop: Receipt of Specialist Report
15. CMS130v10: Colorectal Cancer Screening
16. CMS165v10: Controlling High Blood Pressure
17. CMS145v10: Coronary Artery Disease (CAD): Beta-Blocker Therapy - Prior Myocardial Infarction (MI) or Left Ventricular Systolic Dysfunction (LVEF < 40%)
18. CMS149v10: Dementia: Cognitive Assessment
19. CMS159v10: Depression Remission at Twelve Months
20. CMS131v10: Diabetes: Eye Exam
21. CMS122v10: Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)
22. CMS134v10: Diabetes: Medical Attention for Nephropathy
23. CMS142v10: Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care
24. CMS68v11: Documentation of Current Medications in the Medical Record
25. CMS139v10: Falls: Screening for Future Fall Risk
26. CMS136v11: Follow-Up Care for Children Prescribed ADHD Medication (ADD)
27. CMS56v10: Functional Status Assessment for Total Hip Replacement
28. CMS66v10: Functional Status Assessment for Total Knee Replacement
29. CMS90v11: Functional Status Assessments for Heart Failure
30. CMS135v10: Heart Failure (HF): Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) or Angiotensin Receptor-Neprilysin Inhibitor (ARNI) Therapy for Left Ventricular Systolic Dysfunction (LVSD)
31. CMS144v10: Heart Failure (HF): Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD)
32. CMS349v4: HIV Screening
33. CMS137v10: Initiation and Engagement of Alcohol and Other Drug Dependence Treatment
34. CMS646v2: Intravesical Bacillus-Calmette Guerin for Non-muscle Invasive Bladder Cancer
35. CMS157v10: Oncology: Medical and Radiation - Pain Intensity Quantified
36. CMS127v10: Pneumococcal Vaccination Status for Older Adults
37. CMS69v10: Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
38. CMS147v11: Preventive Care and Screening: Influenza Immunization
39. CMS2v11: Preventive Care and Screening: Screening for Depression and Follow-Up Plan
40. CMS22v10: Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented
41. CMS138v10: Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
42. CMS74v11: Primary Caries Prevention Intervention as Offered by Primary Care Providers, including Dentists
43. CMS143v10: Primary Open-Angle Glaucoma (POAG): Optic Nerve Evaluation
44. CMS129v11: Prostate Cancer: Avoidance of Overuse of Bone Scan for Staging Low Risk Prostate Cancer Patients
45. CMS347v5: Statin Therapy for the Prevention and Treatment of Cardiovascular Disease
46. CMS155v10: Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents

Additional Software Relied Upon

N/A

ONC Disclaimer

This Health IT Module is 2015 Edition compliant and has been certified by an ONC-ACB in accordance with the applicable certification criteria adopted by the Secretary of Health and Human Services. This certification does not represent an endorsement by the U.S. Department of Health and Human Services.

Costs & Limitations

Clinigence offers clinical quality measure (CQM) analytics, including recording, calculating, and reporting (170.314(c)(1-3)) on an annual software-as-a-service (SaaS) contract. The service allows healthcare providers to aggregate patient data from various sources, including electronic health record (EHR) systems, track performance at the organization, practice and individual provider level in near real-time, and report to different outside agencies. Service costs are based on organization size (e.g. number of providers, patients, etc.) and the number of CQMs and are charged on a periodical basis (annual, monthly, etc.) One-time setup fees may be charged based on the number and type of data sources.

There are no technical or practical limitations associated with this service.