Convened by the American Medical Association The Physician Consortium for Performance Improvement PCPI Update Progress on Strategic Initiatives Kathleen Blake, MD, MPH Vice President, Performance Improvement American Medical Association Executive Director, PCPI March 7, 2014
AMA-convened Physician Consortium for Performance Improvement (PCPI ) National, physician-led organization playing a leadership role in national efforts to improve health care >190 member organizations > 100 national specialty and state medical societies Medical boards Ancillary professional associations Experts in QI and measurement (e.g.. QIOs, IHI, TJC, NCQA) Government (e.g.. AHRQ, CMS) PCPI measure portfolio addresses >50 clinical areas with > 350 individual measures Developer of frameworks and tools for measure development, specification and testing 2
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PCPI Governance Update Chair: Frank Opelka, MD Vice-Chair: Richard Hellman, MD Implementation of bylaws changes Copyright sharing with societies Copyright transfer to peer-reviewed journals Addition of a limited voting member representative to the EC New measure approval process Three new committees 4
Measure Advisory Committee 2014 Chair: Joe Drozda, MD Key Initiatives New Measures Approval Process 10 Commandments of Electronic Quality Measurement Standard Set (s) of Data Elements 5
Measure Transition Update 350+ measure portfolio Catalogue and share measure attributes 142 measures in PQRS and MU 67 will be transferred to specialty societies 58 will be stewarded by AMA during 2014 AMA under contract to perform ecqm stewardship AMA under contract with societies 18 orphans 17 will be stewarded by NCQA 6
Measure Stewardship Update Identification of interested stewards Communication with CMS Measure steward webinar Dec 2013 Measure steward calls with CMS Jan 2014 Ongoing new steward recruitment AMA contracts to serve as measure steward AMA contracts to do NQF submission support 7
Measure Design & Advancement Training An in-depth review of the steps involved in measure construction April 10 th : Chicago, AMA HQ Deadline to register: March 24 th May 8 th : Washington, DC, AMA Office Deadline to register, April 17 th Register at: www.ama-assn.org/go/pcpitraining
PQRS Participation Tools 2014 ebook 9
Measure Development Web Module Coming soon to the PCPI website: April 2014
Stakeholder Outreach 45 medical specialty societies NCQA, ABMS, NQF, CMS Institute of Medicine Committee on Core Metrics for Better Health at Lower Cost SGR Repeal Legislation 11
Perspectives and Solutions A robust performance improvement enterprise is a public good Public-private partnerships are needed to move forward The first generation of measures will be replaced by something better (learn from experience) Improvement will come from the bottomup 12
From Process to Outcomes Outcomes Ad Hoc Committee Chair: Patrick Romano, MD Primary charge Create toolkit or framework for users creating outcomes measures relevant to their specialty Key issues to be addressed: Guiding conceptual framework (types of outcomes) Level of measurement and attribution Risk adjustment Feasibility of implementation & availability of data Secondary charge Identify high priority topic areas where outcomes measures are lacking and needed 13
Chair: Keith Mandel, MD Quality Improvement Closing the Referral Loop (1) Charge: To improve the satisfaction, quality and timeliness of the referral process for all patients being referred from a PCP to a Cardiologist (Dyad). 3 Focus Areas for Improvement Did the referring(requesting) physician get the answer to their question/get the help they asked for/needed? Did the specialist (receiving physician) get what they needed to do the referral that was requested? Did the patient feel that the care was coordinated and did they get what they needed? 14
Quality Improvement (2) Quality Improvement Interview Project Structured interviews with 5+ organizations Explore how different quality improvement models are selected by high-performing organizations and how well they work in specific contexts 15
National Quality Registry Network (NQRN) A voluntary network of registry stewards and others interested in advancing the development and use of registries to measure and improve patient outcomes Objectives: Promote the triple aim through expanded use of clinical registries Establish and disseminate leading practices for registries Identify clinical registry gaps, especially in national priority areas Advocate for and support a learning network to accelerate national registry development, maturation and expanded use Facilitate linkages among registries Respond to the needs of multiple stakeholders, including endusers of registry data NQRN National Quality Registry Network 16
Steering Committee Co-Chairs: David Shahian, MD, Lewis Sandy, MD Registry Stewards/Healthcare Provider Participants Society of Thoracic Surgeons David Shahian, MD American Society of Anesthesiologists Richard Dutton MD American College of Cardiology Kathleen Hewitt, RN, MSN Physician Consortium for Performance Improvement Frank Opelka, MD American Medical Association Modena Wilson, MD Registry Users United Healthcare Lewis Sandy, MD National Coalition for Cancer Survivorship Mike Kappell, MBA Pacific Business Group on Health Kate Chenok, MBA Center for Medical Consumers Art Levin, MPH Blue Cross Blue Shield Mass. Dana Gelb Safran, ScD Consumer Reports John Santa, MD, MPH Federal Government Centers for Medicare and Medicaid Services Chisara Asomugha, MD Staffed by the American Medical Association (AMA) Seth Blumenthal, MBA, Dana Richardson, RN, MHA NQRN National Quality Registry Network 17
NQRN Council Registry Stewards/Health care Provider Participants American Academy of Allergy, Asthma & Immunology American Academy of Family Physicians American Academy of Neurology American Academy of Ophthalmology American Academy of Otolaryngology American Academy of Pediatrics American Academy of Sleep Medicine American Association of Neurological Surgeons American Board of Medical Specialties American Board of Neurological Surgery American College of Cardiology American College of Chest Physicians American College of Emergency Physicians American College of Gastroenterology American College of Obstetricians and Gynecologists American College of Radiology American College of Rheumatology American College of Surgeons American Hospital Association American Medical Association American Nurses Association American Optometric Association American Orthopaedic Association American Society for Gastrointestinal Endoscopy American Society of Anesthesiologists American Society of Clinical Oncology American Society of Plastic Surgeons American Urological Association Council of Medical Specialty Societies Cystic Fibrosis Foundation Duke Clinical Research Institute New York Department of Health PatientsLikeMe Physician Consortium for Performance Improvement Radiation Oncology Institute Renal Physicians Association Society for Vascular Surgery Society of Interventional Radiology Foundation Society of Thoracic Surgeons Wisconsin Medical Society Registry Users America's Health Insurance Plans Blue Cross Blue Shield of Massachusetts California HealthCare Foundation Center for Medical Consumers Consumer Reports Informed Patient Institute International Consortium for Health Outcomes Measurement M2S National Coalition for Cancer Survivorship Pacific Business Group on Health Partners Healthcare - Massachusetts Quality Health Care Advisory Group Telligen UnitedHealth Group Federal Government Agency for Healthcare Research & Quality Centers for Medicare and Medicaid Services National Institute of Health Office of the National Coordinator for Health Information Technology Veterans Administration NQRN National Quality Registry Network 18
NQRN 2014 Priorities Establish & disseminate leading practices Leading Practices Webinars Maturational Framework (peer review journal, public version) Data standardization initiative Develop a registry learning network Maturational Framework (self-assessment tool) Registry Business Case Qualified Clinical Data Registry NQRN Web presence and collaboration portal Annual Registry Meeting April 22 Expand registry usage Mentoring Initiative (in progress) Promote Registry of Patient Registries (RoPR) Establish external partnerships/funding NQRN National Quality Registry Network 19
Final Thoughts Progress has been made in transferring stewardship of measures to clinical experts Multiple tools are now available for measure developers and users Progress on PCPI strategic objectives is evident PCPI is representing its members in a rapidly changing performance measurement and improvement environment PCPI is committed to communicating its value to its members and other stakeholders 20
Thank You! Kathleen Blake, MD, MPH Kathleen.Blake@ama-assn.org 21