Dr Matthew Pickering Describes Challenges of New Measure Implementation

Measure developers have a number of challenges to consider when developing a new measure and getting it implemented, explained Matthew Pickering, PharmD, RPh, associate director of research and quality strategies at the Pharmacy Quality Alliance (PQA).

Does the Pharmacy Quality Alliance consider measurement fatigue when creating new quality measures? And what are the challenges of getting new measures implemented?
So measure implementation is very challenging. You can spend a lot of time and resources on developing a really good measure, but if that measure is never implemented, the impact it has is never really realized. So with measure implementation there are several challenges to consider. And as a measure developer, you have to consider those challenges along the way. Those challenges can be for one: who are the implementers. And PQA is not an implementer. We develop measures, but we don't implement. So CMS is an implementer of quality measures. So who are these implementers?

And after you identify them, for 2: how do you engage them? And when do you engage them? How do you engage these measure implementers about the value of the measures that are coming through your pipeline? Or the value of the measures that are already out there? And when you engage them, these implementers have their own set timelines for when they're going to implemen measures or when they're going to decide on what new measures to look for. So when do you enage them in these processes. Because you need to be able to do that and figure out where interests align as measure concepts are generated and as you continue to develop measures through the pipeline

And then the third thing is to consider, obviously, measurement burden and fatigue. Which is another challenge with implementation. And this is a realy concern. It's a real concern with implementers, measure developers, those being held accountable for the measures. And PQA is very well aware of this. We strive to develop measures were there are gaps, where there are gaps in care.

We also work with other measure developers, such as the National Committee for Quality Assurance to try to harmonize our measures, to try to make sure that measure specifications are the same across all of these entities so there isn't this measurement burden. And ultimately, mitigating that measurement fatigue.
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