View source for PQRI XML Output for CQM

=Summary=
* The CQM reports located at Reports->Clinical->Quality Measures need to be able to export in PQRI 2009 XML format
** NIST Test is 170.304(j)
** [http://www.cms.gov/pqri/2009/itemdetail.asp?itemid=CMS1232976 2009 PQRI Program on CMS.GOV]
** [[File:PQRI2009RegistryXMLSpecsFinal508.pdf]] - PDF for the PQRI 2009 XML Spec
** [[File:PQRI_Simplified_2009.pdf]] - PDF with a detailed explanation of PRQI 2009

* Links of interest
** [http://geekdoctor.blogspot.com/2011/01/pqrl-xml-submissions-required-for.html Summary Analysis of PQRI XML Submission]

==Functional Requirements==

* Add a button to the existing Report to export in the PQRI format
* Enhance database, tables to include all elements (bold)
** Submission-period-from-date
** Submission-period-to-date
** '''Submission method'''
** '''Measure group'''
** Provider - ''Name?''
** National Provider Identifier
** '''PQRI measure'''
** PQRI measure number - ''what if it's a NQF # or there are both PQRI and NQF?''
** Eligible instances (reporting denominator)
** Meets performance (performance numerator)
** '''Performance exclusion instances'''
** Performance not met instances
** Reporting rate
** Performance rate
1. file_audit_data

=== Research Notes, need to merge with above === 
1. file_audit_data
:The data in this section can be generated at the submit time and doesn'tneed to be in the database.
2. registry
:This data needs to come from the datsbase and none of it is being captured.
:The schema/GUI needs to be extended to capture this data.
3. measure-group
:This data needs to come from the datsbase and is not being captured.
:The schema/GUI needs to be extended to capture this data.
4. provider
:npi: avaiable
:tin: available
:waiver-signed: not available
:encounter-from/to-date: available
:measure-group-stat: I don't believe this is can be generated at submission time today(correct me if I'm wrong)
:pqri-measure
:pqri-measure-number: There's a cqm_code in the clinical_rules table. But, I think we need pqri codes.
:eligible-instances: This can be generated at submission time meets-performance-instances: This can be generated at submission time
:performance-exclusion-instances: This can be generated at submission time
:performance-not-met-instances: This can be generated at submission time
:reporting-rate: This can be generated at submission time
:performance-rate: This can be generated at submission time

=== Definitions ===
'''Measure Groups'''

Measures groups are subsets of PQRI measures that have in common a focus on a particular clinical condition or aspect of care. The denominator coding of the measures defines the condition or aspect of care.

There are about 7 measure groups identified by CMS:
A = Diabetes Mellitis C = CKD D = Preventive Care E = Peri-operative Care F = Rheumatoid Arthritis G = Back Pain H = CABG
The example in my XML was for "C" (CKD aka Chronic Kidney Disease)

'''Registry-Based Reporting'''

CMS will accept quality measure results on 2009 Physician Quality Reporting Initiative (PQRI) measures submitted by qualified registries on behalf of their participants. The 2008 CMS certified PQRI registries that submitted successfully for 2008 are approved for 2009.

Registries approved by CMS have met a list of criteria, including:

* Report data by both National Provider Identifier and Taxpayer Identification Number.
* Separate and report on Medicare Part B patients only.
* Provide PQRI measure numbers and titles.
* Ability to transmit data in a CMS-approved XML format.

Registries must agree to provide CMS access to review the Medicare beneficiary data on which 2008PQRI registry-based submissions are founded.

Eligible professionals whose quality measure results are successfully submitted on their behalf by a registry and who have satisfied the applicable criteria for satisfactorily reporting for either the January-December or July-December reporting period may earn an incentive payment equal to 2.0% of their total allowed charges for Medicare Physician Fee Schedule (MPFS) covered professional services furnished during the applicable reporting period.

Here are examples of a couple of CMS PQRI Certified Registries:
:American Board of Family Medicine, Inc(www.theabfm.org)
:NCAQ(ncqa.org)
:Providence Physician Division(www.providence.org/oregon)

'''XML Example'''
<pre>
<submission type="PQRI-REGISTRY" option="PAYMENT" version="2.0" xsi:noNamespaceSchemaLocation="Registry_Payment.xsd">
−
<file_audit_data>
<create-date>01-23-2009</create-date>
<create-time>23:01</create-time>
<create-by>RegistryA</create-by>
<version>1.0</version>
<file-number>1</file-number>
<number-of-files>1</number-of-files>
</file_audit_data>
−
<registry>
<registry-name>Model Registry</registry-name>
<registry-id>125789123</registry-id>
<submission-method>A</submission-method>
</registry>
−
<measure-group ID="C">
−
<provider>
<npi>1257894658</npi>
<tin>125789465</tin>
<waiver-signed>Y</waiver-signed>
<encounter-from-date>01-01-2009</encounter-from-date>
<encounter-to-date>12-31-2009</encounter-to-date>
−
<measure-group-stat>
<ffs-patient-count>2</ffs-patient-count>
<group-reporting-rate-numerator>20</group-reporting-rate-numerator>
<group-eligible-instances>30</group-eligible-instances>
<group-reporting-rate>100.00</group-reporting-rate>
</measure-group-stat>
−
<pqri-measure>
<pqri-measure-number>119</pqri-measure-number>
<eligible-instances>100</eligible-instances>
<meets-performance-instances>70</meets-performance-instances>
<performance-exclusion-instances>20</performance-exclusion-instances>
<performance-not-met-instances>10</performance-not-met-instances>
<reporting-rate>100.00</reporting-rate>
<performance-rate>88.00</performance-rate>
</pqri-measure>
</provider>
</measure-group>
</submission>
</pre>

[[Category:Certification]][[Category:Clinical Decision Rules]]