2/19/19. U068: Data Driven Dermatology: Who will define our specialty and how? Speakers. Health of our US healthcare system

Transcription

1 U068: Data Driven Dermatology: Who will define our specialty and how? Assistant Professor Director of Quality Improvement Department of Dermatology University of Wisconsin School of Medicine and Public Health Sunday March 3, :30-5:30 pm DISCLOSURE OF RELATIONSHIPS WITH INDUSTRY U068: Data Driven Dermatology: Who will define our specialty and how? DISCLOSURES None PHOTOGRAPHY & VIDEOTAPING ARE STRICTLY PROHIBITED IN ALL EDUCATIONAL SESSIONS CELL PHONES MUST BE PLACED ON VIBRATE OR TURNED OFF Violations of this policy will result in removal from the session and possible revocation of meeting registration. Session directors will be closely monitoring such occurrences. FOTOGRAFIA E FILMANDO SÃO ESTRITAMENTE PROIBIDOS EM TODAS AS SESSÕES EDUCACIONAIS TELEFONES CELULARES DEVEM SER COLOCADOS EM VIBRAR OU DESLIGADOS Violações desta política resultará na remoção de sessão e possível revogação do registo da reunião. Diretores de sessão irão acompanhar de perto tais ocorrências. Performance Measurement Committee, Deputy Chair Sylvia Parra, MD, FAAD Performance Measurement Committee, Chair Oliver Wisco, DO, FAAD, FACMS Patient, Safety, and Quality Committee, Chair Speakers Health of our US healthcare system What makes a good dermatologist? Or How can we show we are delivering high quality care? 1

2 Healthcare Spending $1.2 Trillion (1996) to $2.1 Trillion (2013) Spending increased 4.3% to $3.3 trillion (2016) $10,348 per person in % GDP Projected to grow at an average rate of 5.6 percent per year for (National Healthcare Expenditures) Maternal Mortality Rate Is Highest in the U.S. Maternal mortality ratio (maternal deaths/100,000 live births) among women ages SWE NOR SWIZ AU S GER CAN NETH FRA UK NZ US Data: Data reflect UNICEF estimates because of missing internationally comparable data for the U.S. National statistics are available for most countries from the OECD. Source: Munira Z. Gunja et al., What Is the Status of Women s Health and Health Care in the U.S. Compared to Ten Other Countries? (Commonwealth Fund, Dec. 2018). WHO Facts on Patient Safety 1/10 patients may be harmed when admitted to the hospital 1/300 change of harm when encountering healthcare (ambulatory) Patient harm is the 14 th leading cause of death worldwide (comparable to malaria and TB)* Hospital infections affect 14/100 admitted patients 1 million patients die every year from surgical complications 5% of adults in US experience a diagnostic error in outpatient healthcare each year *3 rd leading cause of death in the US 2

3 Conclusions: 1. Our healthcare is more expensive than other economically similar countries. How can we show we are delivering high quality care? 2. Despite spending more, we have lower quality healthcare than other countries. More confusion for patients Quality Patient Satisfaction Changing payment models in an effort to improve: Fee for service Reflect quantity Value based care Reflect quality 3

4 Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) MIPS= Merit-based Incentive Payment System How will we define quality? Maternal Mortality Rate Is Highest in the U.S. Maternal mortality ratio (maternal deaths/100,000 live births) among women ages Dermatology Data Important, but as dermatologists, how much does this reflect our clinical care? DataDerm is a clinical data registry which can be used for: 1) Comparative practice data ) MIPS reporting QCDR SWE NOR SWIZ AU S GER CAN NETH FRA UK NZ US Data: Data reflect UNICEF estimates because of missing internationally comparable data for the U.S. National statistics are available for most countries from the OECD. Source: Munira Z. Gunja et al., What Is the Status of Women s Health and Health Care in the U.S. Compared to Ten Other Countries? (Commonwealth Fund, Dec. 2018). 4

5 Qualified Clinical Data Registry Allows for reporting of 27 different including 5 dermatology specific 37 MIPS measure reporting though DataDerm 92 Practice Improvement activities also available 22 Approved for MIPS 5 Dermatology specific (QCDR) 10 Practice 7 AAD developed 5 AAD developed 10 AAD developed 22 MIPS Measures 5 QCDR - all developed by AAD Overutilization of imaging in melanoma Melanoma: Coordination of care Melanoma: recall system Biopsy follow up TB testing for biologic patients Psoriasis: clinical response to treatment BCC and SCC biopsy reporting time Medication reconciliation Care plan Influenza vaccination Pneumonia vaccination BMI screening and follow up Medication documentation Pain assessment and follow up Alcohol use screening Blood pressure screening HIV/STI screening Tobacco use, adults or adolescents Surgical risk assessment Melanoma reporting Closing the referral loop Psoriasis: assessment of psoriasis disease activity Psoriasis: screening for psoriatic arthritis Basal cell carcinoma/squamous cell carcinoma: mohs surgery for superficial basal cell carcinoma of the trunk for immune competent patients Basal cell carcinoma/squamous cell carcinoma: mohs surgery for squamous cell carcinoma in situ or keratoacanthoma type squamous cell carcinoma 1 cm or smaller on the trunk Biopsy: reporting time clinician to patient 5

6 Take home points: Fee for serviceà Value based payment and clinical quality MACRA created the Quality Payment Program Alternative APMs or MIPs (Merit Based Incentive Program) MIPS Quality and Practice Improvement requirements can be reported with DataDerm 6