Start collecting patient data with EHR

If your practice has an electronic health record (EHR), the time has come to collect prospective health data on patients, said Bruce Bagley, MD, Medical Director of Quality Improvement, American Academy of Family Physicians.

Prospective data allows a practice to measure its performance, and performance measurement is the key to demonstrating value to payers, he said.

Growing numbers of health plans are instituting pay-for-performance programs and will eventually be joined by the federal government. "The grand vision is that initially 1% to 2% of physician compensation [for Medicaid and Medicare patients] will be pay-for-performance," said Dr Bagley.

The first step to collecting patient data is to get the needed systems in place and identify data with which to start. Dr Bagley advises that having something structured ahead of time is better than waiting to implement.

The data collection does not have to be perfect. "It's an evolutionary process. Sometimes you don't need what you collect or you have to add something," Dr Bagley noted. He told a story about his private practice's EHR not having a foot exam in its diabetes data sheet. "It was overlooked it, and we had to add it to the checklist," he said.

A set of 26 health measures such as hemoglobin A1c management and use of appropriate medication for asthma have been developed by a consortium of organizations, including the AAFP. The measures can be adopted and used by a medical practice.

Dr Bagley had sympathy for practices that have not yet instituted prospective health data collection with their EHR. "It's hard to do this stuff for recreation-&there's got to be some incentive," he said.