please reply to each  Mycha:  Hello All, CMS Quality Measures are designed to ensure that high-quality healthcare and best practices are adhered to across participating healthcare systems.  As discussed by CMS (2020), "Data on quality measures are collected or reported in a variety of ways, such as claims, assessment instruments, chart abstraction and registries” (para. 1). In hospital systems, electronic specifications gather information from the Electronic Health Record systems. E-specifications are a relatively easy method of obtaining information once proper coding systems are in place. More difficult measures to obtain are gathering information from patients and families related to their outcomes and patient satisfaction.  As discussed by (Deshpande & Schellhase (2015): To make patient safety metrics and their presentation more meaningful, cross-sector input from patients, families, providers, and payers should be actively sought.  Patient-reported outcome measures may prove better metrics for patient safety and quality than any currently in use. (p. 295) Measures related to outcomes and patient satisfaction are likely more difficult to attain due to stakeholders’ information regarding these measures is not captured within the EHR system. References: CMS. (2020, February 11). Quality Measures. https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/QualityMeasures. CMS. (2020, February 11). Electronic specifications for clinical quality measures. https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Electronic_Reporting_Spec. Deshpande, J.K., Green, A. & Schellhase, D.E. Measuring What Really Matters in Patient Safety. Curr Treat Options Peds 1, 286–297 (2015). https://doi.org/10.1007/s40746-015-0036-2 Paula: The CMS Quality Measures Inventory compiles data for a number of specific conditions provided in a variety patient care settings (CMS.gov).  The measures address outpatient, inpatient and private office practices for specific conditions with data submission standards developed with the National Quality Forum (NQF). There are different aspects to consider for the ease or difficulty in collection of data for the quality measures. The easiest data to collect is the concrete data such as length of admission for a specific disease process, particularly since this can easily be generated by the EHR. Data is more easily collected in an inpatient or outpatient setting of a healthcare institution secondary to available resources for data collection. Data based upon patient actions can be more difficult to collect particularly if subjective such as perceived functional improvement post laminectomy or mental health screenings. Additionally, small private offices may lack the resources to generate electronic data or to send the quality measures data to the program. Quality measures based in these areas are more difficult to collect and the validity of the subjective data needs to be considered.  Centers for Medicare & Medicaid Services (n.d.) Core Measures. https://www.cms.gov/Medicare/Quality-Initiatives-P... Andrew: The Centers for Medicare and Medicaid Services (CMS) core measures are designed to guide healthcare facilities and assure due diligence is done on behalf of the patient. Health care facilities that are in compliance with the CMS measures are provided funds for services rendered. While healthcare facilities not in compliance due to not receive funds for services rendered. The easiest compliance measure to collect is hospital readmissions. When it comes to patient discharges and readmission there is very little gray area. Patient readmittance can either be scheduled or not. Verifying as to why the patient was readmitted is more difficult and challenging. The most difficult standard to collect is admitting time for ED patients. In El Paso facilities it is not uncommon to admit non-citizen patients for emergency services. Unfortunately when non-citizens are brought from border patrol services often the process is not entirely medical. Often admittance depends on Border patrol providing a sitter or guardian to oversee and watch the patient as well as a translator. These additional steps can often impede physicians from directly admitting a patient until service is verified with border patrol. Often the collection of numerical data is the easiest to collect however when admissions are based a multiple factors beyond simple acuity of illness, Numerical data can often be misleading or inaccurate. Reference  The CMS Measure Inventory Tool (CMIT)  retrieved August 7th, 2019  from https://cmit.cms.gov/CMIT_public/ListMeasures

InstructionsSelect one of the following smaller nations:KoreaVietnamCambodiaCubaAnother smaller nation of your choice with instructor approvalFor the initial post, address the following in relation to your selection:Examine how Cold War policy by the main players affected the smaller nation.Examine why democracy was not successful in that nation.Describe the loss of personal liberties that were a result of democracy failing.Has the nation's political system changed since the Cold War? Explain.Use 1 APA source plus the textbook and reference in APA using cited list Duiker, W. J. (2015). Contemporary world history (6th ed.). Stamford, CT: Cengage Learning.