10 Must Haves In A Clinical Quality Management System
Throughout the country, clinics and practices are tackling the problem of quality improvement--not only to meet new pay-per-performance standards, but also to provide a higher level of care.
Many providers are finding that a well-chosen CQMS supports their efforts and greatly improves their success.
This ongoing series will highlight ten essential features for any clinical quality improvement system.
The Must Haves 1.
An all-problem, all-patient registry of clinically-verified information not dependent on billing optimization 2.
Problems documented in a structured and coded manner, using clinical terminology 3.
cA sophisticated rules engine of clinical care guidelines that thinks like a physician, not like a computer system 4.
Point-of-care functionality to provide easy identification of due items and increase visit efficiency 5.
Tools to reach patients due for services but not scheduled for a visit 6.
On-demand reporting providing actionable data for quality improvement 7.
Features to allow the entire care team to focus on quality 8.
Extensibility to other HIT systems to share relevant clinical information 9.
Vendor-supported, secure and scalable technology 10.
A customizable framework to meet the unique needs of a practice # 1: An all-patient, all-problem registry of clinically-validated information not dependent on billing optimization.
To truly achieve clinical quality improvement, practices need to focus comprehensively on care delivery and track all patients and all patient problems.
Simply tracking a subset of patients or a few chronic diseases is cumbersome and rarely results in long-term improvement.
Often, the only data available for documenting a patient's problems is administrative data, the data used for billing.
This information was never intended to be a source of clinical information on a patient and, as such, does not provide the necessary picture of information when delivering care.
The difficulty of culling usable knowledge from this source of incomplete and unrepresentative information is frustrating for practices trying to meet quality benchmarks and improve their level of care.
Seeing a complete picture of a patient population.
A Clinical Quality Management System uses a registry to capture patient information.
An effective registry must track the entire patient population of a practice and the entire set of problems associated with each patient.
It also must track problems in a manner unbiased by the needs of administrative data and verifiable by a clinician.
An effective registry must track the entire patient population of a practice and the entire set of problems associated with each patient in a manner unbiased by the needs of administrative data and verifiable by a clinician.
With an all-patient, all-problem registry of clinically-verified information, a practice benefits in many ways: o Allows providers to manage all of their patients, and manage them based on multi-morbidity issues.
For example, patients with both diabetes and depression can have different treatment recommendations than those with just diabetes.
o Ensures care decisions are based on an accurate, documented set of problems.
o Helps practices meet the needs of existing pay-per-performance programs and provides a solid foundation for meeting future quality initiatives yet to be defined.
o Correctly identifies patient populations, ensuring quality calculations are based on the correct denominator of a population measure to avoid negative financial implications.
o Improves the delivery of care by allowing providers to track patient episodes of care, supplying a complete picture of a condition as it progresses over time.
o Makes the CQMS an integral part of every patient visit, ensuring the system becomes part of a practice's standard workflow.
Choosing an effective registry.
When evaluating different clinical quality management systems, ensure the registry component tracks all patients and all patient problems.
Registries that are limited in their scope will add little long-term benefit and will be costly; building registries on a diagnosis-by-diagnosis basis is expensive and time-consuming.
Make certain that the registry only uses clinically-verified information.
Using administrative data that is not reviewed by a clinician can lead to incorrect care and waste a provider's time.
Finally, providers should consider how use of the registry will incorporate into their daily operations.
A well-designed CQMS will be developed with clinical workflow in mind and should integrate transparently into a practice's routine activities.
Choosing the right system for quality improvement is crucial to any 21st century medical practice.
The registry is a key component of any strong Clinical Quality Management System and should be evaluated against the highest of standards.
Next issue: Problems documented in a structured and coded manner, using clinical terminology
Many providers are finding that a well-chosen CQMS supports their efforts and greatly improves their success.
This ongoing series will highlight ten essential features for any clinical quality improvement system.
The Must Haves 1.
An all-problem, all-patient registry of clinically-verified information not dependent on billing optimization 2.
Problems documented in a structured and coded manner, using clinical terminology 3.
cA sophisticated rules engine of clinical care guidelines that thinks like a physician, not like a computer system 4.
Point-of-care functionality to provide easy identification of due items and increase visit efficiency 5.
Tools to reach patients due for services but not scheduled for a visit 6.
On-demand reporting providing actionable data for quality improvement 7.
Features to allow the entire care team to focus on quality 8.
Extensibility to other HIT systems to share relevant clinical information 9.
Vendor-supported, secure and scalable technology 10.
A customizable framework to meet the unique needs of a practice # 1: An all-patient, all-problem registry of clinically-validated information not dependent on billing optimization.
To truly achieve clinical quality improvement, practices need to focus comprehensively on care delivery and track all patients and all patient problems.
Simply tracking a subset of patients or a few chronic diseases is cumbersome and rarely results in long-term improvement.
Often, the only data available for documenting a patient's problems is administrative data, the data used for billing.
This information was never intended to be a source of clinical information on a patient and, as such, does not provide the necessary picture of information when delivering care.
The difficulty of culling usable knowledge from this source of incomplete and unrepresentative information is frustrating for practices trying to meet quality benchmarks and improve their level of care.
Seeing a complete picture of a patient population.
A Clinical Quality Management System uses a registry to capture patient information.
An effective registry must track the entire patient population of a practice and the entire set of problems associated with each patient.
It also must track problems in a manner unbiased by the needs of administrative data and verifiable by a clinician.
An effective registry must track the entire patient population of a practice and the entire set of problems associated with each patient in a manner unbiased by the needs of administrative data and verifiable by a clinician.
With an all-patient, all-problem registry of clinically-verified information, a practice benefits in many ways: o Allows providers to manage all of their patients, and manage them based on multi-morbidity issues.
For example, patients with both diabetes and depression can have different treatment recommendations than those with just diabetes.
o Ensures care decisions are based on an accurate, documented set of problems.
o Helps practices meet the needs of existing pay-per-performance programs and provides a solid foundation for meeting future quality initiatives yet to be defined.
o Correctly identifies patient populations, ensuring quality calculations are based on the correct denominator of a population measure to avoid negative financial implications.
o Improves the delivery of care by allowing providers to track patient episodes of care, supplying a complete picture of a condition as it progresses over time.
o Makes the CQMS an integral part of every patient visit, ensuring the system becomes part of a practice's standard workflow.
Choosing an effective registry.
When evaluating different clinical quality management systems, ensure the registry component tracks all patients and all patient problems.
Registries that are limited in their scope will add little long-term benefit and will be costly; building registries on a diagnosis-by-diagnosis basis is expensive and time-consuming.
Make certain that the registry only uses clinically-verified information.
Using administrative data that is not reviewed by a clinician can lead to incorrect care and waste a provider's time.
Finally, providers should consider how use of the registry will incorporate into their daily operations.
A well-designed CQMS will be developed with clinical workflow in mind and should integrate transparently into a practice's routine activities.
Choosing the right system for quality improvement is crucial to any 21st century medical practice.
The registry is a key component of any strong Clinical Quality Management System and should be evaluated against the highest of standards.
Next issue: Problems documented in a structured and coded manner, using clinical terminology
Source...