Event Digital Quality Measurement Solution

The vendor is required to provide digital quality measures solution (DQMS) by 2030 for all quality measures used in its reporting programs.
- Potential vendors with experience developing and deploying solutions that provide visibility into a digital quality measurement solution
- Obtain a rough order of magnitude estimate of the total cost of ownership to develop, implement, and maintain the solution
- Obtain information that may be used to develop to provide a digital quality measurement solution to the department.
- These DQMS utilize standardized digital data from one or more sources of health information that are captured and exchanged via interoperable systems; apply quality measure specifications that are standards-based and use code packages; and are computed in an integrated environment without requiring additional effort.
- DQMS expand upon the electronic clinical quality measures (ECQMS) commonly used in centers for medicare and Medicaid services (CMS) reporting programs.
- While ECQMS use data from electronic health records (EHRs), DQMS use data from an array of electronic sources (e.g., EHRs, claims data, hies).
- A platform capable of applying quality measure logic in near real-time and produce results for state Medicaid, the Medicaid managed care plans, and provider organizations and health systems that can be used for reporting (e.g., CMS core set, HEDIs), population health, and care gap closure.
- This solution must leverage fast health interoperability resources (FHIR) as the common data model and use machine-readable measure logic (e.g., clinical quality language (CQL)).
- Desired outcomes
•    Near real-time quality measure results for country-based programs such as healthcare effectiveness data and information set (HEDIS), CMS mips, and other federal or regional quality initiatives, in a digital format that can be used for reporting, population health, and quality improvement activities.
•    Interim care gap reports for providers and health systems to identify where patients have not received guideline-recommended services or interventions and to enable proactive patient care, improve patient outcomes, and facilitate value-based arrangements.
•    Certified HEDIs measure data for Medicaid managed care plans, leveraging validated data streams from assurance data aggregator validation program, to minimize administrative burden on health plans and providers associated with chart chasing and manual HEDIS audits.
•    Assessment capabilities for the quality of data ingested (e.g., clinical data, claims), to ensure measure results are accurate and complete.