Getting Ready for Performance Measurement

Physicians concerned about the ultimate impact of performance measures on reimbursement and practice operations might begin to prepare themselves in a few simple ways, Kevin B. Weiss, MD, professor of medicine, Northwestern University, Chicago, said at the American College of Physicians Annual Session here.

Weiss advised physicians to pick an area of clinical quality improvement that is important to them and their practice, such as hypertension or diabetes, and to prioritize using measures from the Ambulatory Care Quality Alliance (AQA) or Center for Medicare and Medicaid Services Physician Voluntary Reporting Program (CMS PVRP).

The AQA core set includes 26 measures covering the entire lifespan of patients. The PVRP is smaller, including only 17 measures of which 7 are primary care-oriented."You can't go wrong picking measures out of either of those sets," Dr. Weiss said.After identifying an area, physicians can evaluate their performance by picking 10 to 15 charts at random. If they find they are already doing 80 to 90%, they should go on to review another area.

"This is not a very scientific way of doing things, but if you are already doing fairly well, you may not have room to improve," Dr. Weiss said.

Weiss also recommended beginning to build a small registry of the population at risk, starting a practice-based, team-oriented quality improvement activity, and considering a Practice Improvement Module for maintenance of Certification if it aligns.

Physicians who are looking into the purchase of an electronic health record system should focus on data management capacity as much as capabilities for charting and document management. "If the system doesn't give you the ability to get performance measurements, think twice about it," he said.