Person and Family Engagement

Measure developers should center person and caregiver perspectives throughout the Measure Lifecycle. They can gather input through informal conversations, focus groups, or by including persons and caregivers on technical expert panel (TEP). Before starting a measure or quality project, developers should create a plan for how they will involve persons and family representatives at each stage. They should set clear expectations for all participants and use established guidance such as the Patient-Centered Outcomes Research Institute (PCORI) Engagement Rubric, the Pharmacy Quality Alliance’s Patient Engagement in Quality Measurement Rubric, and best practices for qualitative research. Additional resources are available in the Person and Family Engagement (PFE) supplemental material and the PFE Toolkit.

PCORI's Concepts Applicable to PFE

Concepts highlighted by PCORI applicable to person/family member engagement in the measure development process include

• Reciprocal Relationships: Define roles and decision-making authority of all involved collaboratively and clearly.
• Co-Learning: It is important to ensure participants understand the measure development process, PFE, and person-centeredness.
• Partnership: Value the time and contributions of person partners. Time commitment and attendance requests for persons need to be thoughtful and reasonable. The research team is committed to diversity and demonstrates cultural competency, including disability accommodations, as appropriate.
• Trust, Transparency, Honesty: Encourage measure developers to express commitment to open and honest communication with person stakeholders, in a meaningful and usable way, and ensure to make major decisions inclusively.

Technical Expert Panels (TEPs)

TEPs are one of the most commonly used interested party engagement methods and bring together representatives including marginalized communities, to obtain balanced input. Measure developers and others should include persons and family member representatives on their TEPs to gain vital perspectives on what is important and useful to measure and evaluate.

Refer to the Technical Expert Panels supplemental material for step-by-step instructions on how to establish and conduct TEPs. Several templates are available to assist with the management and documentation of TEPs.

Public Comments

Public comment periods invite broad input and support transparency. Early feedback helps identify issues, reduce rework, and strengthen measures before implementation. Developers may solicit public comment at the points that best support their project needs. CMS recommends a public comment period for each stage of the Measure Lifecycle with most quality projects to prevent errors and reduce rework in later stages. Once resolution of issues occurs, the measures will perform better when proposed for use and implemented in specific programs or the quality project more meaningful to the interested parties. For example, comments may be requested before a fully specified measure is submitted for the Measures Under Consideration List or for CMS consensus‑based entity (CBE) endorsement. Comments collected during development complement those collected during the CBE endorsement process. Public comments obtained during measure development (and maintenance) are separate from—and complementary to—the public comments obtained during the CMS CBE endorsement process.

Several templates are available to assist in posting public comments and documentation.

Other Types of Engagement

Measure developers and others desiring interested party engagement can also engage interested parties through other methods. For example, measure developers may interview subject matter experts, convene focus groups and/or working groups, and present other opportunities for people to weigh in on measure concepts outside of the more formal TEP and public comment periods.

Example 

The Measure Collaboration Workspace (MC Workspace) has an eCQM Concepts module permiting anyone with an Electronic Clinical Quality Improvement (eCQI) Resource Center account to suggest a concept for an electronic clinical quality measure (eCQM). Interested parties have the option to submit an eCQM concept for feedback from other interested parties and, ultimately, to CMS for review, which is outside of the pre-rulemaking process. While the MC Workspace is likely to attract health care and health information technology professionals, anyone with an interest in eCQI can get an account.

See the Other Types of Involvement page for more information.