Improving Clinical Quality Measures does not happen "automatically". Regardless of your specialty, submission method or technology platforms, there are common techniques.
Of course, some platforms do a better job than others. Here are a few of the methods our tools and staff enable.
Goal: Find patterns in how the highest level performers document their cases? What language or chart locations do lowest level performers not follow?
Tools: Provider-level reports showing physician outliers (both top and bottom)
Anticipated Mitigations: Communicate best practices from top performers; educate low performers.
Goal: Find patterns in encounters flagged as "not met" - inappropriately
Tools: Encounter-level reports filtered to isolate "not met" encounters.
Anticipated mitigations: Identify how inappropriate "not mets" are recorded, and clarify corrections to providers, IT staff and/or coders.
Goal: Identify patterns in encounters that are being inappropiately included or excluded in overall case count.
Tools: Encounter-level reports (typically showing CPT / ICD-10 coding), filtered to identify overall population for inclusion / exclusion.
Anticipated Mitigations: Find and correct discrepancies in IT and/or coding practices that inappropriately include / exclude encounters in measure population.
Goal: Seek out most relevant measures currently available based on patient volume and practice patterns.
Tools: CMS measure specifications and specialty sets; measure benchmark patterns; TIN and Provider level performance trends.
Anticipated Mitigations: Elimination of measures that perform poorly and consume physician attention; addition of any new measures; incorporation of QCDR-based specialty measures; includion into Virtual Groups (where appropriate)
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