CMS Sematrix: A Tool to Aid the Development of Clinical Quality Measures (CQMs)

TL;DR

CMS Sematrix is an automated tool designed to assist in developing and maintaining clinical quality measures by efficiently identifying relevant healthcare literature, significantly reducing manual effort and costs.

Contribution

The paper introduces CMS Sematrix, a novel automated system that streamlines literature review processes for clinical quality measure development and maintenance.

Findings

Reduces approximately 818 labor hours per review

Saves around $122,000 in costs per environmental scan

Enhances efficiency in evidence evaluation for CQMs

Abstract

As part of the effort to improve quality and to reduce national healthcare costs, the Centers for Medicare and Medicaid Services (CMS) are responsible for creating and maintaining an array of clinical quality measures (CQMs) for assessing healthcare structure, process, outcome, and patient experience across various conditions, clinical specialties, and settings. The development and maintenance of CQMs involves substantial and ongoing evaluation of the evidence on the measure's properties: importance, reliability, validity, feasibility, and usability. As such, CMS conducts monthly environmental scans of the published clinical and health service literature. Conducting time consuming, exhaustive evaluations of the ever-changing healthcare literature presents one of the largest challenges to an evidence-based approach to healthcare quality improvement. Thus, it is imperative to leverage automated techniques to aid CMS in the identification of clinical and health services literature relevant to CQMs. Additionally, the estimated labor hours and related cost savings of using CMS Sematrix compared to a traditional literature review are roughly 818 hours and 122,000 dollars for a single monthly environmental scan.