The application of Web-based information technology
and data analysis tools to the quality improvement
process enhances the capability and capacity
of leading healthcare organizations to conduct
performance improvement projects and gain "actionable
information" to assist with decision making.
Each time we turn around there is another reason
why this becomes of greater importance whether
we are talking about core measures, P4P or physician
profiles. This brief article will outline some
of the challenges in creating and maintaining
profiles and how Statit piMD overcomes the hurdles;
a prescription for success. First, some history…
One of the most fundamental questions to be
addressed when debating solutions for improving
healthcare services is to ask, "How do
we know when the healthcare services we provide
are good?" The answer is deceptively simple
but also hides the complexity in the process:"Measure
those services!" So far so good! Measuring
those services by regularly accessing and analyzing
the data for significant events or outliers
over time helps us understand if and/or when
our process is not behaving properly. Unusual
or unpredictable process behavior can often
result in poor outcomes and high costs. Okay,
you say, we are all on board with improving
the quality of services, lowering costs and
ensuring reimbursement from payers, but have
you seen the shape of our data lately? Do you
know how many physicians we would need to create
reports for? How can I simply and securely make
this information available to the targeted doctor?
We run our physician profiles every quarter
- do we have to manually create these each period?
How can the CMO review the physician profile,
sign off on the review and trigger an automated
alert for the next review? Do we have to provide
separate reports for internal vs. external use…the
Joint Commission or CMS for instance? And on
and on and on (these are some of the challenges
referenced earlier in the "complexity in
the process" remark.) How can Statit piMD
help?!?!?
First, get into the lotus position, take several
cleansing breaths in and out and picture yourself
on a white, sandy beach in the Bahamas. Now
that we have reduced our blood pressure, let's
tackle the task at hand. First, it is all about
the data! Where are the data necessary for the
physician profile located and who is responsible
for collecting, validating and communicating
information about them? Statit piMD makes a
perpetual connection to the aggregated data
(Excel, MS Access or database) by utilizing
a simple, yet powerful function that allows
the user to connect to the data source of choice.
Once this connection is successfully made, the
connection is permanent. Once the data source
is updated, Statit piMD automatically "detects"
the new or changed data and updates the reports
including the dashboard, scorecard and trend
output.
Let's take a look at an example profile utilizing
cardiac data. As each profile is confidential,
the user login and password information tells
Statit piMD which profile to return. In our
example, we have logged in with the credentials
of Dr. Debra Carson. The resulting scorecard
was returned. (Note: All data is fictitious,
as is Dr. Debra Carson.)
You can see a wealth of information provided
including a status button (red, yellow or green
stoplight), an indication of how our current
"My Total" information compared to
last period, the Indicator itself (more on this
later), as well as My Total compared to the
Peer Total, an internal target, any statistical
process control (SPC) alert and lastly, the
most recent and available data. By the way,
each physician profile is created automatically
in Statit piMD. The data feeding the profile
provides for dynamic and actionable information.
This information is available to the physician
via a browser window. Let's open up the HF 3
indicator, as there appears to be a potential
issue with the current period, and drill down
into the information.
Dr. Carson can now see the aggregated information
available on this portion of the profile. Granted,
the record only shows 2 records or patients
for this period, but the idea is clear; once
we see a value lower than our target and/or
relative to peer or, more importantly, some
unusual and statistically significant data,
we can drill down to the patient encounter to
ascertain what took place. Of equal importance,
what if Dr. Carson wanted to see information
about the specific patients she attended? She
would simply click on the Root Cause Analysis
link at the top of the output and then view
the resulting information, drilling through
user selected levels to the patient encounters.
In this way, Dr. Carson could view each patient
record to understand where, and where not, HF
3 protocol was delivered.
Equally important to the physician's need to
access her information to help understand where
there are opportunities to improve, is that
of the CMO or Medical Director. The CMO is under
constant pressure to find ways to improve the
quality of care provided and the associated
costs. Tracking the results of each physician
and comparing his or her results to a peer group
is critically important. The CMO has the ability
to determine who he wants to see and create
a scorecard for any and all physicians. For
example, with the proper credentials, a CMO
could access individual physicians in the following
manner:
The list of attendings can potentially be a
long list, providing the CMO with the ability
to determine exactly who he wants to see and
when. The CMO can also bring up each physician
scorecard, drill down to the indicator detail
and add any annotation/comment and corrective
action necessary for improvement. Lastly, the
CMO can "sign off" on the review,
easing the burden on the recredentialing process.
We will explain much more about how Statit
piMD provides the necessary physician profiling
information in our upcoming webinar entitled
Physician
Profile: "Quality" Reports for the
Enterprise. For data access, automation,
secure and confidential access by physicians
and administrators, the ability to proactively
close the quality loop and ensure critical steps
in the credentialing process, Statit piMD is
the right prescription for success!
