Although the Centers for Medicare and Medicaid Services established the Physician Quality Reporting System in 2006, for the past few years the pay-for-reporting program has pretty much been relegated to the back burner for most physician practices. Not by choice as much as by necessity.
Physicians have focused primarily on implementing electronic health records to meet Meaningful Use Stage 1 requirements. More recently some doctors have shifted their attention to actually starting to use the technology as directed by MU Stage 2. Many practices, however, are still reeling from EHR implementation fatigue and usability challenges and, instead, are concentrating efforts on learning how to adjust the workflows of their office staff and clinical teams in a way that supports optimal patient care and reform incentive models.
In other words, the work being performed around EHRs has been more so about data acquisition and minimizing disruptions (or overcoming resistance). Little thought is given to what to do with the new abundance of data, which has led to low PQRS reporting numbers.
Other factors that have kept PQRS on the back burner include:
* Confusion with MU and PQRS, which tend to be approached as two separate data capture and reporting programs. While they can be reported separately, PQRS can also be a part of MU. Leveraging ones data aggregation and IT platforms to support the other can reduce the overall workload while allowing practices to take advantage of incentives in both programs.
* Lack of clarity among primary care and specialist physicians on how to combine resources harmoniously to address preventive health screenings and treatments. Many are uncertain of the others role.
* A general lack of comfort among some physicians (especially smaller practices or independent practitioners) with regard to the pace of change and the level of practice leadership required to shepherd the entire care team to collaboratively meet the intent and goals of the PQRS quality measures. They arent clear what to do, so they dont do anything.
Now is the time turn up the heat on PQRS, however. I am beginning to see physicians focusing on getting data out of their EHRs and actually doing something with it. That bodes well for quality reporting and the quality of care overall. The data and keys to improving outcomes, lowering costs and increasing patient satisfaction are there, inside the EHR.
One way to improve PQRS reporting is for physicians to join forces with other smaller practices. It is no different than medical school students forming study groups to make a challenging amount of information more manageable. By pooling resources they can share best practices and lessons learned in order to make PQRS reporting a part of their workflows instead of a separate task.
Physicians can also take advantage of existing technologies and expertise that will help them shortcut the journey. Most EHR vendors have modules that support PQRS reporting. By installing those modules and actively using them, practices can access the information they need for PQRS reports out of their EHRs quickly and easily and with a minimum of disruption.
Working with consultants and experts to guide their practices through the process will further shorten the learning curve and ensure they are maximizing the value of their technology investment. Keep in mind that these technologies, and indeed PQRS reporting itself, are not the primary focus of physicians; theyre merely elements buzzing around the practice of medicine. By working with consultants who are focused on the processes around PQRS, solo physicians and small practices can meet compliance requirements without being distracted from patient care.
One additional strategy to improve PQRS reporting is to take a hard look at the office workflows and employ each team members skills to their fullest potential. An evaluation of each employees knowledge level and skill strengths and weaknesses should be performed whether the PQRS infrastructure is being developed internally or by a consultant. Taking this step allows the physician to become the coordinator and leader in care without having to personally perform all the mandated tasks and documentation.
After all the trials and tribulations subside in implementing their EHRs, practitioners and small practices may feel an understandable desire to ignore new technology-driven programs for a while. In the case of PQRS reporting, however, that would be a mistake.
The groundwork has been laid. With a little extra effort, practices can determine their best path for quickly taking advantage of the incentives, avoiding future penalties, and contributing to improvements in the quality and cost of care.
Helen Bremford, RN, is a director of advisory services at consultancy CTG Health Solutions. She can be reached at email@example.com.
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