Your Practice Data Transparent? “Transparency” Is In The Eye of The Beholder.
by Jerry Stone

I read an article recently published in USA TODAY titled, “Transparency provides better look at health care”. Here’s an excerpt from the article that really got my attention.
 


“Shopping around for a heart bypass operation? If you are, you might be wondering about such things as the hospital's bypass-surgery death rate, how long you'll be in the hospital and how much the surgery costs. Until recently, people routinely endured life-and-death procedures without getting the kind of answers they demand when buying a home or car.”


(Click here to read the entire article by Steve Sternberg, USA TODAY).


I have spent the better part of my 30 years of professional life in the pursuit of transforming “raw” data into actionable information. The result? My colleagues and fellow decision-makers are equipped with the information they need to make better-informed decisions.

All across the country there are numerous efforts and initiatives requiring the collection of healthcare data in the hopes of identifying useful trends and “better-practices”. Oftentimes the intent of these programs is to determine whether or not physician practices and/or hospital organizations are performing up to certain third-party benchmarks. One such major initiative: the Tax Relief and Health Care Act of 2006 (TRHCA), which was signed by President Bush on December 20, 2006. The Centers for Medicare & Medicaid Services (CMS) has titled the program, Physician Quality Reporting Initiative, or PQRI. Recently I had an opportunity to listen in on the first part of a live PQRI teleconference focused on what I would call the “nuts-n-bolts” of collecting and reporting PQRI data. My first impression was very favorable. The resources being made available by the CMS to healthcare professionals as related to PQRI, through the use of your and my tax dollars, is impressive and reassuring. What was not so reassuring was the fact that when it comes to gathering “raw” data in a consistent way, in hopes of transforming that data into usable information, there is still no “magic bullet” or secret formula. Within just a few minutes of being on the call it became apparent, at least to me, that there were still many questions to be answered as to how the PQRI data should be collected and reported. (If you’d like to listen to an audio copy of the teleconference, or download a transcript of any of the previous teleconferences, click here…it’s part of the CMS resources mentioned earlier).

After all is said and done, accurate, consistent data collection is still dependent on effectively describing what needs to be collected, understanding those descriptions, and effectively implementing the data collection process. Effective communication and implementation are the first steps in making progress towards any goal, and perhaps the two most important aspects of any data collection process.

Data collection always starts out straightforward enough, but in reality, the need to pay special attention to detail, and to put redundant data accuracy checks in place, can make a straightforward simple task, a complicated, confusing exercise in futility when not implemented correctly. How can you, the front-line healthcare provider, be assured that your data is being collected, transposed, and interpreted accurately?

The short answer is; Always Keep a USABLE Set of Your Data.

The CMS is offering to pay a bonus to eligible professionals who participate in the 2007 PQRI as stated, “The bonus payment, subject to a cap, is the equivalent of 1.5% of total allowed charges for covered physician fee schedule services provided from July 1 through December 31, 2007.” (Click here to access the CMS’ information regarding PQRI bonus payments).

CMS has defined certain reporting thresholds as “when no more than three quality measures are applicable to services provided by an eligible professional, each such measure must be reported in at least 80% of the cases in which the measure is reportable. When four or more measures are applicable to the services provided by an eligible professional, the 80% threshold must be met on at least three of the measures reported.” (Click here to access the CMS’ information regarding PQRI reporting).

As the USA TODAY article suggests, most folks wouldn’t buy a new home or car without having collected a compressive set of information. Just as consumers are beginning to collect and use public information to make decisions regarding their healthcare, healthcare providers would be wise to have their own set of data readily available to know exactly what is, and what is not true and accurate.

If you are interested in trending and benchmarking certain PQRI data elements, as is prescribed by the CMS as part of the Physician Quality Reporting Initiative, for YOUR internal use, MedicalGPS would welcome the opportunity to serve you and your organization.

If you have questions please feel free to contact us on-line at www.MedicalGPS.com, or call us direct at (615) 467-6338.