Things to Consider in Choosing a Physician Profiling System

Not only is The Joint Commission's 2007 Standards for Physician Core Competencies reporting a requirement, it is also the right thing to do! The Ongoing Professional Practice Evaluation (OPPE) requires we measure and evaluate physician performance on a "regular basis." As importantly, consumers continue to demand quality care at affordable costs. Regular performance reviews, quality objectives and reduced cost should not be the exceptions; they should and can be the rule. Finding solutions to help make "predictable quality at a predictable cost" are not as easy as they may first appear. Providing physicians with feedback on their performance relative to care processes and outcomes is essential to resolving the "predictability" challenge. There are many solutions that tout their ability to provide this type of analytics but, at what "cost?" This article examines a few issues to consider before "signing on the bottom line."

General Considerations

1.	Where's the data? Physician performance data includes patient encounters, risk and quality events, financial and patient satisfaction, to name but a few data sources. Data sources are scattered throughout your network in multiple formats.
	Take Away: Make sure you can access all of the needed data to automatically present a single physician profile for each doctor. To ensure the highest integrity reporting to physicians, you want to reduce, and ideally eliminate, multiple copies of the same data in your organization. That way, if the data are changed or corrected, the correct data will be available for your reporting.
2.	Performance measures will change over time. Specific measures that you begin with will undoubtedly change over time. Some measures will become obsolete over time (older core measures).
	Take Away: Choose a solution that allows easy removal and easy creation of performance measures to continuously improve performance.
3.	Who is truly different? Bar charts, pie graphs, speedometers, etc. are fun to look at, but do they provide statistical analyses? Physician performance data will naturally vary over time; how will you know when there is a real trend or unusual variation given past performance?
	Take Away: It is extremely important to identify any and all unusual changes in a physician's performance by finding and analyzing "outliers" through the use of statistical process control (SPC).
4.	Deploy/Implement. As discussed earlier, addressing the OPPE requirements and improving patient care is of paramount importance. You will want to begin assessing physician performance immediately to help execute on your objectives.
	Take Away: Select a system that can be installed and implemented in days; not weeks and months.

Department Chair/CMO Considerations

1.	Managing the "team" as well as individuals. OPPE addresses individual physician performance but the real opportunity should include managing the team performance. Understanding the performance of physician groups or specialties is important to your predictable quality at predictable cost objectives.
	Take Away: Look for solutions that give the Department Chair/CMO the tools necessary to measure the performance of their team (as well as individuals) to easily identify who on their team is truly performing "differently" than others.
2.	Changes to the process. Practicing continuous process improvement requires the use of various tools. If a change is made to the process, we want to know whether the change has produced the desired result. Tools that allow the leader to record a comment in the analysis, to include a corrective action plan and to allow the system to automatically compare and track performance pre- and post-corrective action is a necessary component of your system.
	Take Away: Insist upon tools that make it easy for leadership to use and communicate process changes and how they impact outcomes and results.
3.	Efficient and effective time management. Physician leader time is valuable, so make sure the individual physicians have seen and reviewed their profile prior to meeting with the department chair/CMO. Individual physicians should have validated their data and if they find an issue (e.g. attribution) with the data, report the data issue and to get it resolved prior to leadership's review. Additionally, allow the individual physician to take a more active role in explaining their performance by providing an easy, electronic means to add explanation of their performance.
	Take Away: Make performance review by the department chair/CMO efficient and effective.
4.	Tracking tasks. Who is due for an evaluation? Who is past due? Historically, what were the evaluation comments documented for each physician?
	Take Away: Provide automated email alerts to physician leaders of upcoming tasks needing their attention.
5.	Keep Chiefs in the loop. Look for solutions that can automatically notify the Chiefs of any significant changes to their team's performance on measures. You may want to notify them when a new period of data arrives that their team's performance is trending up for Average Cost or let them know when there is some other unusual variation given past performance.
	Take Away: Provide automated email alerts to physician leaders of significant changes in the performance of their team.

Individual Physician Considerations

1.	Manage what you measure. Provide automated alerts to physicians of upcoming OPPE reviews. Present performance summaries that are easy to use and interpret and allow interactive drilldown to encounter-level information. Allow blinded comparison to peers and to risk-adjusted data.
	Take Away: Make sure the physicians are kept informed of upcoming reviews, completed reviews and allow access to their secure, performance scorecards.
2.	Remove doubts. To increase success of your physician profile efforts, you will need physician buy-in. Doctors have had reasons to be suspect of the data being collected about them. When the doctor accesses his/her performance data and believes there to be a data integrity issue, make it easy for him/her to report the data issue. After all, who better to recognize patient data issues than the physician caring for that patient!
	Take Away: Make sure your solution can help you improve the quality of the data in your systems.

Summary

Understanding physician performance and applying lessons learned is the "right thing to do." Creating an environment to capitalize on improving quality while reducing costs isn't as hard as you may think…it all boils down to finding a solution that is flexible, addresses numerous stakeholders, is easy to use and powerful in understanding variations in care and doesn't cost the farm…and the horses and the tractors and the …. There is one solution out there that can provide everything you need at a price you can afford. Care to guess which one that is?

As always, if we can help, please give the experts at Midas+ Statit Solutions a call at 520-750-4147. We would be happy to help you find "predictable quality at a predictable cost."