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Measure Conceptualization

Information Gathering

Information gathering activities include an environmental scan (e.g., review of literature, search for clinical practice guidelines and existing measures, input from experts, other related activities) and empirical data analysis. These activities yield information that will guide prioritization of topics or conditions, gap analysis, the business case, and the compilation of existing related and competing measures. While a part of measure conceptualization, information gathering activities occur in other stages and steps, such as respecification and reevaluation.

Information Gathering Knowledge Base

Comprehensive information gathering should result in a significant knowledge base that yields 

  • Quality goals
  • Relative strength or weakness of scientific evidence pertinent to the topics or conditions of interest
  • Information for business case development including exploration of underlying costs associated with the condition, procedure, or health care issue to contribute to an eventual return on investment calculation
  • Evidence of either general agreement or diverse and conflicting views on the quality issues pertinent to the topics or conditions of interest

Measure Evaluation

The five measure evaluation criteriaimportance, scientific acceptability, feasibility, usability and use, and related and competing measures—serve as a guide for gathering information and for identifying priority topics/conditions and measurement areas. The fifth criterion—consideration of related and competing measures—refers to measure harmonization; measure developers should consider this criterion from the very beginning of the measure development process.

Information gathering consists of eight steps, which may not occur sequentially:

  • Identify the target health care quality issue and determine its priority area by clearly defining the nature of the measure's focus and scope of the measure's construct and its relation to health care needs and quality improvement. The measure developer should consider quality priorities as well as Medicare, Medicaid, and other payor top volume and top cost conditions, as appropriate.
  • Conduct an environmental scan (see Conduct an Environmental Scan and the Environmental Scans for Quality Measurement supplemental material)
  • Analyze empirical data, when available
  • Evaluate information collected during the environmental scan and empirical data analysis
  • Conduct a measurement gap analysis to identify areas for new measure development
  • Justify creation of a new measure
  • Apply measure evaluation criteria
  • Prepare an initial list of measures or measure topics

Additional details about these steps are provided from the left navigation and the Environmental Scans for Quality Measurement supplemental material. Several templates are available to guide documentation of information gathering (Information Gathering Report Template and Instructions), measure information (Measure Information Form and Instructions), and measure justification (Measure Justification Form and Instructions).

Review Prior Work

Early in measure conceptualization, it is important for measure developers to consider what other measure developers have learned regarding feasibility or scientific evidence from existing measures, previous measure concepts, or measure data elements. Examination of prior work allows the measure developer to use data elements previously identified as feasible in the measure they are developing and/or determine ways to improve feasibility. Awareness of prior work also helps the measure developer identify possible unintended negative consequences and avoid or mitigate them to avoid rework later in the process.

Last Updated: Dec 2022