How is your hospital, healthcare system, or clinic measuring up to national standards? Are your patients receiving proper and timely care? For many small and rural systems, these are difficult questions to answer without proper (and often third-party) support.
In late 2017, the Centers for Medicare and Medicaid Services
(CMS) introduced the Meaningful Measures initiative, with a goal to improve the
delivery of care while also reducing costs for both patients and providers
through the culling and prioritizing of existing quality measures. Part of this
initiative aimed to reduce the burden of reporting for providers. For large
hospitals in urban settings, it is likely there are employees whose roles are
dedicated to the encumbrance of quality reporting. When new quality initiatives
come down the pike, adjusting priorities may take some time, but these teams
are largely equipped to handle it. For smaller clinics, measuring success—let
alone demonstrating it—under complex and shifting quality standards is a huge
challenge. Small clinics are also less likely to have adequate health
information technology, which adds another layer of difficulty. There are
several options that should be considered as small providers look to improve
their quality performance.
Health information exchanges
As healthcare has moved more toward patient-centered care,
health information exchanges (HIEs) have increased in popularity. If a patient
had an emergent event at Big Hospital A but a follow-up appointment at Small
Clinic B, does Small Clinic B have access to the medical records completed at
Big Hospital A? HIEs help to improve the timely sharing of medical information among
providers, aiding in record completeness and informing better decision making
at the point of care. Many HIEs are free to join and work with a wide variety
of electronic health record (EHR) vendors. Additionally, these HIEs will often
provide analytics tools designed to help providers keep tabs on their quality
Upgraded EHR systems
The American Recovery and Reinvestment Act of 2009 saw the
call for nationwide adoption of EHR systems by all eligible providers. With
additional funding and incentives made available, a veritable swarm of EHR
vendors suddenly appeared, and today we’re left with hundreds of EHR platforms.
As time has passed, several large players have emerged, and these vendors,
though expensive, can offer up enhanced quality measure reporting at the click
of a button. Unfortunately, some of the price tags of the bigger EHR platforms
make them unfeasible for practices with small budgets. Still, grants may be
available for those who are in desperate need of an upgrade, and benefits
beyond quality measures are frequently seen.
EHR vendor support
It could be that a small clinic’s EHR vendor already has
quality measure capabilities, but the clinic lacks the staff or knowledge to
successfully retrieve and analyze the data. This is where an EHR vendor contact
can come in handy. Check your EHR vendor’s website or manual for contact
information, and fire away. They should be happy to show you the more advanced features
of your EHR, including quality measure reporting. It is also worth reaching out
to other clinics and practices that utilize the same EHR. Sharing challenges
and accomplishments in using an EHR vendor is a good way to learn.
Third-party contractors and software
Many smaller organizations choose to “outsource”
their quality measure tracking to third-party vendors who specialize in such
calculations. This is a wise choice for many, given that these third parties
can provide the technology and manpower that is lacking within the
organization. However, it’s prudent to thoroughly vet these types of vendors,
as the options are extensive within the healthcare industry. Some questions to
keep in mind include:
- How will quality measures be reported?
- On an aggregate level, or on the patient level? Will
individual physicians or clinics be able to see their overall performance?
- How are quality measure reports delivered?
- Is it a web-based dashboard? Is it interactive? Will
we need separate software to view results? Can I easily share the results with
- How often will results be updated?
- How often is the measure logic updated to
conform to specifications?
- Is there an extra annual fee for these updates?
- Is the vendor certified by the National
Committee for Quality Assurance?
- What other health plans use this technology?
- Is the vendor compliant with HIPAA regulations?
- How will data be transferred to you?
It’s important to find a vendor that will help your
organization reach and exceed its own unique goals. Do your research and you
will see benefits.
Keeping track of the myriad quality measures can be
overwhelming. Many small practices have found success in focusing their efforts
on a few measures, which can be a great way to build confidence and momentum
among staff. For clinical quality measures, diabetes, high blood pressure, and tobacco
use are popular for beginners to focus on, as well as high-impact for patients.
Using internet searches to find examples of workflows and processes other small
clinics have been successful with can help to ease the initial burden.
While small providers and clinics face challenges unseen by larger organizations when it comes to tracking their quality performance, these challenges are not insurmountable. Small providers and clinics will be able to succeed by utilizing the options above and several more support options available to them.
This blog post was first published by Katherine on LinkedIn.