Appendix 3: Online Measure Nominations Template

SNAC-recommended Initial Core Set, September 18, 2009

This measure nominations template was created and used by SNAC members, Federal Quality Workgroup (FQW) members and others (via AHRQ staff) in August 2009 in order to collect a standardized set of information on all measures nominated for potential inclusion in the core set.

Select to access the Slides (PPT) [ - 984 KB]

Web Version

Slide 1

CHIPRA Login

Screenshot shows the login page for the CHIPRA Initial Core Measurement Set test Web site.

Slide 2

Welcome to the CHIPRA Initial Core Measurement Set

Screenshot shows the welcome page. The text on the page reads:

This template has 5 sections for completion:

1. Measure overview
2. Measure definition
3. Use(s) of measure
4. Validity and
5. Rationale for nomination

Please complete as many section as possible. If you are unable to find the information by the deadline for submission, please leave the relevant field blank. To be considered for the Initial Core Measurement Set, the template must be submitted by midnight EDST Monday, August 24, 2009.

Slide 3

Section I, Measure Overview

Screenshot shows blank fields to enter the measure name and steward as well as information about the measure nominator.

Slide 4

Section II, Measure Definition: Test Measure

Screenshot shows blank fields to enter the measure definition as well as detailed measure specifications.

Slide 5

Section III A, Use(s) of Measure

Screenshot shows blank fields to enter information on the type of entity, name, location, and population concerning the proposed measure.

Slide 6

Section III B, Use(s) of Measure

Screenshot shows blank fields to enter information on the payer groups(s) and programs concerning the proposed measure.

Slide 7

Section III C, Use(s) of Measure

Screenshot shows blank fields to enter information on the availability of socioeconomic and demographic data and on data source(s) for the proposed measure.

Slide 8

Section III D, Use(s) of Measure

Screenshot shows blank fields to enter information on the health information technology, performance data, and feasibility issues concerning the proposed measure.

Slide 9

Section IV, Validity

Screenshot shows fields to enter information regarding the underlying scientific soundness of the proposed measure as well as reliability and validity of the measure properties.

Slide 10

Section V, Rationale for Nomination

Screenshot contains a request to provide a brief and succinct rationale for nominating the proposed measure.