By Chris Madden, MD and Jennifer Koontz, MD
AMSSM is excited to announce a new partnership with CECity that will bring considerable value to members in the realm of Quality Measure (QM) use and reporting. AMSSM and its Quality Measures Subcommittee (QMSC), part of the Practice and Policy Committee, has carefully developed a plan to educate members about QMs and their importance in clinical practice and practice transformation. Look for emails, listserv announcements, a new section in Practice Tools, and an exciting session at next year’s Annual Meeting.
What are Quality Measures (QMs)? Quality Measures are tools that help us measure or quantify healthcare processes, outcomes, patient perceptions and organizational structure and/or systems that are associated with the ability to provide high-quality health care and/or that relate to one or more quality goals for health care. These goals include: effective, safe, efficient, patient-centered, equitable and timely care.
Why are QMs important? Quality Measures and other practice transformation movements are here to stay and will likely shape the future of medicine, whether it be within ACOs, medical homes, private practices linked together via organized medical neighborhoods, individual payer negotiations and projects, etc. AMSSM is developing this area so members can begin using quality measures in practice, to increase quality of care and to be able to participate in incentives and avoid penalty programs (there are many more reasons, but keeping it simple for now). Nobody is sure what the “final product” of all of this will be (and if anyone claims they know, including us, don’t trust them!), but it will likely involve a mix of the above. As an organization we need to march along with these changes so we are strategically positioned for evolved care models.
How do I use QMs? 1. Start by making yourself aware of which QMs are available – there is a comprehensive list available through CMS: (Physician Quality Reporting) Measures List. 2. Next, evaluate whether you are already using and documenting measures and/or if you could integrate measures into your practice flow. If you have paper charts you may want to utilize tools such as questionnaires and flow sheets, triggered by certain clinical situations or diagnoses, to fulfill documentation requirements. Chart look backs and period reviews can retrieve needed data. If you use an electronic health record (EHR), many systems have already integrated some measures (e.g., EHR Incentive/Meaningful Use), so check to see which measures are available within your EHR, and if your EHR is a certified Vendor for CMS reporting (there are few). Many EHRs also allow you to add or program QMs into them. Independent of the setup, QM reporting from an EHR needs to be available via a searchable HER registry or wizard and some EHRs allow you to develop individual searches as needed. 3. Ultimately, you need to be able to extract QMs data from any system in a standardized, reliable manner. MedConcert™ and the PQRIwizard make downloadable spreadsheets available to guide and document appropriate QM data extraction and organization. CECity is an approved CMS vendor, so data from the spreadsheets can be uploaded to and submitted through their PQRIwizard App, which is now available to AMSSM members for a $100 discount per year compared to a non-member. The fee for using the PQRIwizard App is often more than covered by the amount of income that will be lost if practitioners do not submit QMs to the CMS PQRI Reporting Program, which penalizes physicians 1.5-2% reimbursement/year starting in 2015. Note there is a small 0.5% incentive payment for submitting prior to 2015. Important EHR Incentive and PQRS Reporting Program incentive and disincentive material may be reviewed at: Medicare EHR Incentive Program.
Who is CECity and what is MedConcert™? CECity.com, Inc. is the leading provider of cloud-based quality reporting, performance improvement and lifelong learning platforms. As the health care industry’s leading software as a service (SaaS) provider, CECity offers solutions for continuing medical education (CME), Maintenance of Certification (MOC), performance improvement (PI and PI-CME), registries, pay for reporting (including the Physician Quality Reporting Initiative (PQRI) and Lifelong Learning Portfolios). MedConcert™ is the healthcare industry’s first multi‐tenant, cloud‐based platform designed to connect and align all stakeholders in a meaningful way to cost-effectively scale and spread continuous performance improvement, streamline access to incentives, support lifelong learning and enable care coordination efforts across walls. Review details at: MedConcert™ MedConcert™ hosts a variety of programs called Apps, one of which is PQRIwizard, the App we suggest members plug into. PQRIwizard supports the PQRISincentive payment program. PQRIwizard allows reporting of Measure Groups or Individual Measures via Registry. It is an easy-to-use online tool to help physicians and other eligible professionals quickly and easily participate in PQRI. Similar to online tax preparation software, the PQRIwizard helps guide professionals through a few easy steps to rapidly collect, validate and report their PQRI data to CMS.
How do I plug into these resources? AMSSM will be sending out an announcement and invitation to sign up for the AMSSM MedConcert™ product in the next few weeks. There is no charge or obligation to sign up. Once you have an account you have the ability to access any of the Apps within MedConcert™. Some Apps are free and others are associated with a charge per member. AMSSM has negotiated a $100 discount for members for the PQRIwizard App.
Which QMs should I choose? AMSSM has identified common existing QMs pertinent to sports medicine only and to combined sports medicine and primary care practices by surveying the membership, evaluating comprehensive measure lists and factoring in national health care expenditures. We have chosen to work with CECity to make a broad range of measures available to members to satisfy variable practice demographics and settings, while also attempting to eliminate non-pertinent measures for our members. AMSSM is exploring whether CECity will be able to organize measures into practice-specific list groupings:Sports Medicine Only: Most Common; Sports Medicine Only: Other; Sports Medicine and Primary Care: Most Common; Sports Medicine and Primary Care: Other to streamline the selection process for members. Choose individual Measures or Measure Groups that are most pertinent to your practice situation. Another nice feature of MedConcert™ is the ability to compare your personal performance and AMSSM’s ability to compare organizational member performance reflected by QMs to national benchmarks. Identifying performance gaps, which can also be addressed using other resources and links in MedConcert™, is pivotal to enhancing quality in care.
What are the QMs reporting requirements and how can I get started? Please note that if you are already tracking QMs and wish to report them for 2012 using PQRIwizard you have until March 2013 to report. After this date, any use of PQRIwizard will apply to 2013 QMs. Once you are ready to use PQRIwizard, simply open the program and click on the Launch Measure Selection Guide tab, then select the PQRS Reporting tab. At that point, most of us (unless you have a CMS vendor-certified direct reporting EHR) will select the Report from other Data Sources that will take you to the PQRIwizard tab which will bring you to a screen that outlines the two reporting methods and requirements (above).
What are potential future implications of QMs? In addition to everything highlighted above, which we are labeling Phase1 and represents the first 1-2 years of action for the Quality Measures Subcommittee, AMSSM hopes to accomplish three goals in Phase 2: 1) increased awareness and involvement with QMs and practice transformation activities; 2) recruitment of insightful, interested members to the QM Subcommittee; and 3) moving forward with sports medicine profession-specific measure development, implementation and development of a national database similar to that of STS National Database that will accomplish varying needs (field-specific care metrics, quality and safety monitoring, research and more). CECity has the capability to host sports-medicine similar to what STS did, and they can help us build our own database to use in any way we envision. AMSSM also hopes to work with the Foundation to incentivize research and involvement in this important, evolving area. More information is available in the new “Quality Measures and Practice Transformation” section on the website by logging in through “Member Log-in”; under “MEMBER-ONLY CONTENT” under “Advocacy”, click on “Quality Measures”; then click on “Quality Measures” on the Sports Medicine Practice Tools. Thank you for taking the time to read this introductory article about the exciting new work AMSSM is doing in Quality Measures. Please watch for an invitation to join MedConcert™ and information on using the PQRIwizard. If you would like to become more involved with QM activities and would like to join the QM Subcommittee, or if you have any questions, please direct them to Jennifer Koontz, MD, AMSSM QMSC Chair, at: firstname.lastname@example.org.
The conclusions and opinions in this news article should not be interpreted as official statements of the American Medical Society for Sports Medicine.