Hematology Quality Metrics

Hematology Quality Measures

ASH SCD Quality Measure Open for CMS Public Comment!

Centers for Medicare & Medicaid Services (CMS) is considering adoption of ASH’s new sickle cell disease (SCD) quality measure in its Hospital Outpatient Quality Reporting Program (HOQR) and Rural Emergency Hospital Quality Reporting Program (REHQR):

Median Time to Pain Medication for Patients with a Diagnosis of Sickle Cell Disease (SCD) with Vaso-Occlusive Episode (VOE)

ASH encourages members of the SCD community to submit comments for inclusion of this measure in CMS programs by December 30, 2024.

Timely and Equitable Pain Management for Sickle Cell Disease in the Emergency Department

In partnership with a panel of clinical and patient experts, including emergency physicians, and the Health Services Advisory Group (HSAG), ASH has developed two facility-level electronic clinical quality measures (eCQMs) addressing timely and equitable pain management in the emergency department for individuals living with sickle cell disease:

Median Time to Pain Medication for Patients with a Diagnosis of Sickle Cell Disease (SCD) with Vaso-Occlusive Episode (VOE):
Median time (in minutes) from Emergency Department (ED) arrival to initial administration of pain medication for all patients, regardless of age, with a principal encounter diagnosis of SCD with VOE
Difference in Median Times to Pain Medication Between Patients with a Diagnosis of Sickle Cell Disease (SCD) with Vaso-Occlusive Episode (VOE) and Renal Colic:
Difference in median times from ED arrival to initial administration of pain medication between adult patients with a principal diagnosis of SCD with VOE and adult patients with a principal diagnosis of renal colic.

Improving Diagnosis of VTE in the Emergency Department

In partnership with a panel of clinical and patient experts, including emergency physicians, and the Health Services Advisory Group (HSAG), ASH has developed measures that aim to improve the diagnosis of venous thromboembolism (VTE) using Clinical Pretest Probability Tools. This effort was supported in part with funding from the Gordon and Betty Moore Foundation:

Survey of Pulmonary Embolism Risk Stratification Methods in the ED & Barriers to Electronic Health Record Documentation

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Lack of Standardized Coding Limits Accuracy of Electronic Clinical Quality Measure for Pulmonary Embolism Diagnosis

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Multisite Implementation of Electronic Health Record Tools for Clinical Pre-Test Probability of Pulmonary Embolism in the Emergency Department

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Previously Developed Measures

Externally Developed Quality Measures

The following externally developed measures may be of interest to practicing hematologists. Quality measures posted reflect those which were determined to be clinically relevant and valuable, feasible for use, and the result of a rigorous evaluation of evidence and development process. This listing as updated on February 13, 2023, and is provided as a reference only. ASH does not endorse externally developed measures.

Individual Clinician Level Measurement

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Program: Merit-Based Incentive Payment System Program ,/li>
Measure Type: Process
CMIT Ref No. 00313-C-MIPS, NQF endorsement #326

Program: Doctors & Clinicians Compare
Measure Type: Process
CMIT Ref No. 0539-C-PC, NQF endorsement #0384

Program: Merit-Based Incentive Payment System
Measure Type: Process
CMIT Ref No. 05809-E-MIPS, NQF endorsement #0384e

Program: Merit-Based Incentive Payment System
Measure Type: Process
CMIT Ref No. 00542-C-MIPS, NQF endorsement #0383

Program: Doctors & Clinicians Compare
Measure Type: Process
CMIT Ref No. 00816-C-PC, NQF endorsement #0022

Program: Merit-Based Incentive Payment System Program
Measure Type: Process
CMIT Ref No. 00816-C-MIPS, NQF endorsement #0022

Program: Merit-Based Incentive Payment System Program
Measure Type: Outcome
CMIT Ref No. 02893-C-MIPS, NQF endorsement #0213

Program: Merit-Based Incentive Payment System Program
Measure Type: Process
CMIT Ref No. 02896-C-MIPS, NQF endorsement #0210

Program: Merit-Based Incentive Payment System
Measure Type: Outcome
CMIT Ref No. 02948-C-MIPS, NQF endorsement #0216

Program: Marketplace Quality Rating System
Measure Type: Patient-Reported Outcome-Based Performance Measure (PRO-PM)
CMIT Ref No. 02901-C-MQRS, NQF endorsement #0006

ONSQIR22 (QCDR measure)
Oncology QCDR Powered by Premier, Inc

NQF 0450
American Academy of Neurology (AAN)

NQF 0218

Facility Level Measurement

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Institute for Clinical Systems Improvement (ICSI)

Institute for Clinical Systems Improvement (ICSI)

Institute for Clinical Systems Improvement (ICSI)

Program: Hospital Compare
Measure Type: Composite
CMIT Ref No. 00104-C-HC, NQF endorsement #0531

Program: Prospective Payment System – Exempt Cancer Hospital Quality Reporting
Measure Type: Process
CMIT Ref No. 00542-C-PCHQR, NQF endorsement #0383

Program: Prospective Payment System – Exempt Cancer Hospital Quality Reporting
Measure Type: Outcome
CMIT Ref No. 02806-C-PCHQR, NQF endorsement #3490

Program: Hospital Outpatient Reporting
Measure Type: Outcome
CMIT Ref No. 02929-C-HOQR, NQF endorsement #3490

Program: Hospital Compare
Measure Type: Outcome
CMIT Ref No. 02929-HC, NQF endorsement #3490

Program: Prospective Payment System – Exempt Cancer Hospital Quality Reporting
Measure Type: Process
CMIT Ref No. 05733-C-PCHQR, NQF endorsement #0210

Program: Prospective Payment System – Exempt Cancer Hospital Quality Reporting
Measure Type: Intermediate Outcome
CMIT Ref No. 05734-C-PCHQR, NQF endorsement #0213

Program: Prospective Payment System – Exempt Cancer Hospital Quality Reporting
Measure Type: Process
CMIT Ref No. 05735-C-PCHQR, NQF endorsement #0215

Institute for Clinical Systems Improvement (ICSI)

Program: Prospective Payment System – Exempt Cancer Hospital Quality Reporting
Measure Type: Intermediate Outcome
CMIT Ref No. 05736-C-PCHQR, NQF endorsement #0216

Program: Hospital Inpatient Quality Reporting
Measure Type: Process
CMIT Ref No. 03341-E-HIQR, NQF endorsement #3316e

Program: Prospective Payment System – Exempt Cancer Hospital Quality Reporting
Measure Type: Outcome
CMIT Ref No. 06030-C-PCHQR, NQF endorsement #3188

Program: Marketplace Quality Rating System
Measure Type: Process
CMIT Ref No. 05848-C-MQRS, NQF endorsement #3541

Program: Marketplace Quality Rating System
Measure Type: Patient-Reported Outcome-Based Performance Measure (PRO-PM)
CMIT Ref No. 02802-C-MQRS, NQF endorsement #0006

Program: Marketplace Quality Rating System
Measure Type: Patient-Reported Outcome-Based Performance Measure (PRO-PM)
CMIT Ref No. 02830-C-MQRS, NQF endorsement #0006

Program: Marketplace Quality Rating System
Measure Type: Patient-Reported Outcome-Based Performance Measure (PRO-PM)
CMIT Ref No. 02885-C-MQRS, NQF endorsement #0006

Program: Marketplace Quality Rating System
Measure Type: Patient-Reported Outcome-Based Performance Measure (PRO-PM)
CMIT Ref No. 028985-C-MQRS, NQF endorsement #0006

Program: Marketplace Quality Rating System
Measure Type: Patient-Reported Outcome-Based Performance Measure (PRO-PM)
CMIT Ref No. 02899-C-MQRS, NQF endorsement #0006

Q-Metric (University of Michigan)

Institute for Clinical Systems Improvement (ICSI)

Q-Metric (University of Michigan)

Q-Metric (University of Michigan)

Q-Metric (University of Michigan)

Q-Metric (University of Michigan)

Institute for Clinical Systems Improvement (ICSI)

Institute for Clinical Systems Improvement (ICSI)

Institute for Clinical Systems Improvement (ICSI)

Institute for Clinical Systems Improvement (ICSI)

Institute for Clinical Systems Improvement (ICSI)

Institute for Clinical Systems Improvement (ICSI)

Institute for Clinical Systems Improvement (ICSI)

Q-Metric (University of Michigan)

Q-Metric (University of Michigan

Health Plan

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Q-METRIC (University of Michigan)

Q-METRIC (University of Michigan)

State

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Q-METRIC (University of Michigan)

Q-METRIC (University of Michigan)

Q-METRIC (University of Michigan)

Q-METRIC (University of Michigan)

All Levels

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NQF 0217
Measure Type: Process

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Clinicians

Hematology Quality Measures

Timely and Equitable Pain Management for Sickle Cell Disease in the Emergency Department

Improving Diagnosis of VTE in the Emergency Department

Previously Developed Measures

MYELODYSPLASTIC SYNDROMES AND ACUTE LEUKEMIAS MEASURES - HEMATOLOGY MEASURE #1: MYELODYSPLASTIC SYNDROME (MDS) AND ACUTE LEUKEMIAS: BASELINE CYTOGENETIC TESTING PERFORMED ON BONE MARROW

MYELODYSPLASTIC SYNDROMES MEASURE - HEMATOLOGY MEASURE #2: MYELODYSPLASTIC SYNDROME (MDS): DOCUMENTATION OF IRON STORES IN PATIENTS RECEIVING ERYTHROPOIETIN THERAPY

MULTIPLE MYELOMA MEASURE - HEMATOLOGY MEASURE #3: MULTIPLE MYELOMA: TREATMENT WITH BISPHOSPHONATES

CHRONIC LYMPHOCYTIC LEUKEMIA MEASURE - HEMATOLOGY MEASURE #4: CHRONIC LYMPHOCYTIC LEUKEMIA (CLL): BASELINE FLOW CYTOMETRY

Externally Developed Quality Measures

Individual Clinician Level Measurement

Facility Level Measurement

Health Plan

State

All Levels

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Hematology Quality Measures

Timely and Equitable Pain Management for Sickle Cell Disease in the Emergency Department

Improving Diagnosis of VTE in the Emergency Department

Previously Developed Measures

MYELODYSPLASTIC SYNDROMES AND ACUTE LEUKEMIAS MEASURES - HEMATOLOGY MEASURE #1: MYELODYSPLASTIC SYNDROME (MDS) AND ACUTE LEUKEMIAS: BASELINE CYTOGENETIC TESTING PERFORMED ON BONE MARROW

MYELODYSPLASTIC SYNDROMES MEASURE - HEMATOLOGY MEASURE #2: MYELODYSPLASTIC SYNDROME (MDS): DOCUMENTATION OF IRON STORES IN PATIENTS RECEIVING ERYTHROPOIETIN THERAPY

MULTIPLE MYELOMA MEASURE - HEMATOLOGY MEASURE #3: MULTIPLE MYELOMA: TREATMENT WITH BISPHOSPHONATES

CHRONIC LYMPHOCYTIC LEUKEMIA MEASURE - HEMATOLOGY MEASURE #4: CHRONIC LYMPHOCYTIC LEUKEMIA (CLL): BASELINE FLOW CYTOMETRY

Externally Developed Quality Measures

Individual Clinician Level Measurement

Advance Care Plan

Oncology: Medical and Radiation Pain Intensity Quantified

Oncology: Medical and Radiation Pain Intensity Quantified

Oncology: Medical and Radiation Plan of Care for Pain

Use of High-Risk Medications in Older Adults

Use of High-Risk Medications in Older Adults

Percentage of Patients Who Died from Cancer Admitted to the Intensive Care Unit (ICU) in the Last 30 Days of Life

Percentage of Patients Who Died from Cancer Receiving Chemotherapy in the Last 14 Days of Life

Percentage of Patients Who Died from Cancer Admitted to Hospice for Less than 3 Days

Rating of Specialist

PCR Test with MR2 or greater result (BCR-ABL1 transcript level <= 1% [IS]} for patients receiving TKI for at least 6 months for Chronic Myelogenous Leukemia

Perioperative Pulmonary Embolism or Deep Vein Thrombosis Rate (PSI 12)

Surgery Patients Who Received Appropriate Venous Thromboembolism Prophylaxis Within 24 Hours Prior to Surgery to 24 Hours After Surgery

Facility Level Measurement

VENOUS THROMBOEMBOLISM (VTE) DIAGNOSIS AND TREATMENT: PERCENTAGE OF PATIENTS WITH VTE WHO RECEIVE ONGOING WARFARIN THERAPY WITH DOCUMENTATION IN THE MEDICAL RECORD INDICATING A CURRENT INR IS AVAILABLE AND IS USED TO MONITOR AND ADJUST THERAPY

VENOUS THROMBOEMBOLISM (VTE) DIAGNOSIS AND TREATMENT: PERCENTAGE OF HOSPITALIZED PATIENTS ON PRESCRIBED HEPARIN OR LOW-MOLECULAR-WEIGHT HEPARIN WHO HAVE APPROPRIATE BASELINE LABORATORY TESTS DOCUMENTED.

VENOUS THROMBOEMBOLISM (VTE) DIAGNOSIS AND TREATMENT: PERCENTAGE OF ADULT HOSPITALIZED PATIENTS WHO HAVE A VTE RISK ASSESSMENT WITHIN 24 HOURS OF ADMISSION.

VCMS RECALIBRATED PATIENT SAFETY INDICATOR (PSI) 90 (CMS PSI 90)

ONCOLOGY: MEDICAL AND RADIATION – PLAN OF CARE FOR MODERATE TO SEVERE PAIN

ADMISSIONS AND EMERGENCY DEPARTMENT (ED) VISITS FOR PATIENTS RECEIVING OUTPATIENT CHEMOTHERAPY

ADMISSIONS AND EMERGENCY DEPARTMENT (ED) VISITS FOR PATIENTS RECEIVING OUTPATIENT CHEMOTHERAPY

ADMISSIONS AND EMERGENCY DEPARTMENT (ED) VISITS FOR PATIENTS RECEIVING OUTPATIENT CHEMOTHERAPY

PERCENTAGE OF PATIENTS WHO DIED FROM CANCER RECEIVING CHEMOTHERAPY IN THE LAST 14 DAYS OF LIFE

PERCENTAGE OF PATIENTS WHO DIED FROM CANCER ADMITTED TO THE INTENSIVE CARE UNIT (ICU) IN THE LAST 30 DAYS OF LIFE

PERCENTAGE OF PATIENTS WHO DIED FROM CANCER NOT ADMITTED TO HOSPICE

VENOUS THROMBOEMBOLISM (VTE) DIAGNOSIS AND TREATMENT: PERCENTAGE OF PATIENTS WITH VTE WHO ARE INITIALLY PRESCRIBED WARFARIN THERAPY WITH DOCUMENTATION IN THE MEDICAL RECORD INDICATING A BASELINE INR WAS OBTAINED

PERCENTAGE OF PATIENTS WHO DIED FROM CANCER ADMITTED TO HOSPICE FOR LESS THAN 3 DAYS

SAFE USE OF OPIOIDS – CONCURRENT PRESCRIBING

30-DAY UNPLANNED READMISSIONS FOR CANCER PATIENTS

ANNUAL MONITORING FOR PERSONS ON LONG-TERM OPIOID THERAPY

ACCESS TO CARE

CARE COORDINATION

PLAN ADMINISTRATION

RATING OF ALL HEALTH CARE

RATING OF HEALTH PLAN

SICKLE CELL DISEASE (SCD): PERCENTAGE OF CHILDREN YOUNGER THAN 18 YEARS OF AGE IDENTIFIED AS HAVING SCD PRESENTING TO AN ED WITH SEVERE PAIN WHO HAD A PARENTERAL ANALGESIC WITHIN 60 MINUTES FOLLOWING INITIAL CONTACT DURING THE MEASUREMENT YEAR.

VENOUS THROMBOEMBOLISM (VTE) DIAGNOSIS AND TREATMENT: PERCENTAGE OF VTE PATIENTS WHO HAVE A HIGH CLINICAL PRETEST PROBABILITY (CPTP) (SCORE GREATER THAN 6) FOR PE WHO RECEIVED ANTICOAGULATION PRIOR TO DIAGNOSTIC EVALUATION

SICKLE CELL DISEASE (SCD): PERCENTAGE OF CHILDREN YOUNGER THAN 18 YEARS OF AGE IDENTIFIED AS HAVING SICKLE CELL ANEMIA WHO RECEIVED ANTICIPATORY GUIDANCE REGARDING THE RISKS AND BENEFITS OF TREATMENT WITH HYDROXYUREA AS PART OF OUTPATIENT CARE DURING THE MEASUREMENT YEAR.

SICKLE CELL DISEASE (SCD): PERCENTAGE OF CHILDREN AGES 1 TO 18 YEARS WITH SICKLE CELL ANEMIA (SCA) WHO WERE DISPENSED HYDROXYUREA FOR AT LEAST 300 DAYS WITHIN THE MEASUREMENT YEAR.

SICKLE CELL DISEASE (SCD): PERCENTAGE OF CHILDREN YOUNGER THAN 18 YEARS OF AGE IDENTIFIED AS HAVING SCD PRESENTING TO AN ED WITH SEVERE PAIN WHO HAD A PAIN ASSESSMENT WITHIN 30 MINUTES FOLLOWING ANALGESIC ADMINISTRATION DURING THE MEASUREMENT YEAR.

SICKLE CELL DISEASE (SCD): PERCENTAGE OF CHILDREN YOUNGER THAN 18 YEARS OF AGE IDENTIFIED AS HAVING SCD AND ON A CHRONIC TRANSFUSION PROGRAM WHO RECEIVED MONITORING OF HEMOGLOBIN S LEVELS IMMEDIATELY PRIOR TO EACH TRANSFUSION DURING THE MEASUREMENT YEAR.

VENOUS THROMBOEMBOLISM (VTE) DIAGNOSIS AND TREATMENT: PERCENTAGE OF PATIENTS WITH VTE WHO ARE PRESCRIBED UFH AND/OR LMWH WHO HAVE BASELINE LABORATORY TESTS DOCUMENTED IN THEIR MEDICAL RECORD

VENOUS THROMBOEMBOLISM (VTE) DIAGNOSIS AND TREATMENT: PERCENTAGE OF PATIENTS WITH SUSPECTED VTE WHO HAVE A CLINICAL PRETEST PROBABILITY (CPTP) ASSESSMENT COMPLETED

VENOUS THROMBOEMBOLISM (VTE) DIAGNOSIS AND TREATMENT: PERCENTAGE OF PATIENTS WITH VTE WHO ARE PRESCRIBED UFH AND LMWH WHO HAVE APPROPRIATE LABORATORY TESTS (PLATELETS, PTT FOR THOSE ON UFH) AVAILABLE TO MONITOR AND ADJUST THERAPY.

VENOUS THROMBOEMBOLISM (VTE) DIAGNOSIS AND TREATMENT: PERCENTAGE OF PATIENTS WITH VTE TREATED WITH UFH WHO RECEIVE HEPARIN TREATMENT FOR AT LEAST FIVE DAYS AFTER THE INITIATION OF WARFARIN THERAPY AND UNTIL INR IS GREATER THAN OR EQUAL TO 2.0 FOR TWO CONSECUTIVE DAYS.

VENOUS THROMBOEMBOLISM (VTE) DIAGNOSIS AND TREATMENT: PERCENTAGE OF ADULT HOSPITALIZED PATIENTS RECEIVING HEPARIN THERAPY FOR VTE PROPHYLAXIS WHO HAVE A BASELINE PLATELET COUNT BEFORE STARTING HEPARIN AND THEN A PLATELET COUNT EVERY OTHER DAY OVER THE COURSE OF 14 DAYS.

VENOUS THROMBOEMBOLISM (VTE) DIAGNOSIS AND TREATMENT: PERCENTAGE OF HOSPITALIZED PATIENTS WHO HAVE A BASELINE INTERNATIONAL NORMALIZED RATIO WHEN INITIALLY PRESCRIBED WARFARIN.

DIAGNOSIS AND TREATMENT OF ISCHEMIC STROKE: PERCENTAGE OF PATIENTS WITH ISCHEMIC STROKE WITH PARALYSIS OR OTHER REASON FOR IMMOBILITY RECEIVING APPROPRIATE PREVENTION FOR VTE (SUBCUTANEOUS HEPARIN OR PNEUMATIC COMPRESSION DEVICE)

SICKLE CELL DISEASE (SCD): PERCENTAGE OF CHILDREN YOUNGER THAN 18 YEARS OF AGE IDENTIFIED AS HAVING SCD WHO HAD: (1) A PULSE OXIMETRY READING, (2) A COMPLETE BLOOD COUNT, AND (3) A RETICULOCYTE COUNT PERFORMED WITHIN THE SAME 7-DAY PERIOD AS PART OF OUTPATIENT CARE DURING THE MEASUREMENT YEAR.

Health Plan

ANTIBIOTIC PROPHYLAXIS AMONG CHILDREN WITH SICKLE CELL ANEMIA

TRANSCRANIAL DOPPLER ULTRASONOGRAPHY SCREENING AMONG CHILDREN WITH SICKLE CELL ANEMIA

State

SICKLE CELL DISEASE (SCD): PERCENTAGE OF CHILDREN IN A STATE AGES 2THROUGH 15 YEARS OLD WITH SICKLE CELL DISEASE WHO RECEIVED TRANSCRANIAL DOPPLER (TCD) ULTRASONOGRAPHY DURING THE MEASUREMENT YEAR.

SICKLE CELL DISEASE (SCD): PERCENTAGE OF CHILDREN WITH A NEWBORN SCREEN POSITIVE FOR SCD WHO RECEIVE APPROPRIATE PREVENTIVE ANTIBIOTICS BY 3 MONTHS OF AGE.

SICKLE CELL DISEASE (SCD): PERCENTAGE OF CHILDREN IN A STATE AGES BETWEEN 3 MONTHS AND 5 YEARS DIAGNOSED WITH SCD WHO RECEIVED APPROPRIATE ANTIBIOTIC PROPHYLAXIS FOR AT LEAST 300 DAYS DURING THE MEASUREMENT YEAR.

SICKLE CELL DISEASE (SCD): PERCENTAGE OF CHILDREN WHO, HAVING INITIALLY TESTED POSITIVE FOR SCD THROUGH NEWBORN SCREENING, RECEIVED CONFIRMATORY TESTING BY 3 MONTHS OF AGE.

All Levels

SURGERY PATIENTS WITH RECOMMENDED VENOUS THROMBOEMBOLISM (VTE) PROPHYLAXIS ORDERED