Large-Scale Automated Assessment of Radiologist Adherence to the Physician Quality Reporting System for Stroke (original) (raw)
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Journal of the American College of Radiology, 2013
The aim of this study was to examine radiologists' experiences during the first 4 years of Medicare's national physician pay-for-performance program and project near-future program outcomes for radiologists. Methods: Medicare Physician Quality Reporting System (PQRS) program data from 2007 through 2010 were analyzed, focusing on outcomes and trends for radiologists. Tiered scenario modeling was used to project potential near-future radiologist outcomes as the program transitions from bonuses to penalties.
Enhanced Quality Measurement Event Detection: An Application to Physician Reporting
eGEMs (Generating Evidence & Methods to improve patient outcomes), 2017
The wide-scale adoption of electronic health records (EHR)s has increased the availability of routinely collected clinical data in electronic form that can be used to improve the reporting of quality of care. However, the bulk of information in the EHR is in unstructured form (e.g., free-text clinical notes) and not amenable to automated reporting. Traditional methods are based on structured diagnostic and billing data that provide efficient, but inaccurate or incomplete summaries of actual or relevant care processes and patient outcomes. To assess the feasibility and benefit of implementing enhanced EHR-based physician quality measurement and reporting, which includes the analysis of unstructured free-text clinical notes, we conducted a retrospective study to compare traditional and enhanced approaches for reporting ten physician quality measures from multiple National Quality Strategy domains. We found that our enhanced approach enabled the calculation of five Physician Quality an...
The wide-scale adoption of electronic health records (EHR)s has increased the availability of routinely collected clinical data in electronic form that can be used to improve the reporting of quality of care. However, the bulk of information in the EHR is in unstructured form, e.g., free-text clinical notes, and not amenable to automated reporting. Traditional methods are based on structured diagnostic and billing data that provide efficient, but inaccurate or incomplete summaries of actual or relevant care processes and patient outcomes. To assess the feasibility and benefit of implementing enhanced EHR-based physician quality measurement and reporting, which includes the analysis of unstructured free-text clinical notes, we conducted a retrospective study to compare traditional and enhanced approaches for reporting ten physician quality measures from multiple National Quality Strategy domains. We found that our enhanced approach enabled the calculation of five Physician Quality and Performance System measures not measureable in billing or diagnostic codes and resulted in over a five-fold increase in event at an average precision of 88% (95% CI: 83-93%). Our work suggests that enhanced EHR-based quality measurement can increase event detection for establishing value-based payment arrangements and can expedite quality reporting for physician practices, which are increasingly burdened by the process of manual chart review for quality reporting.
A framework for improving radiology reporting
Journal of the American College of Radiology, 2005
The interpretative reports rendered by radiologists are the only tangible manifestation of their expertise, training, and experience. These documents are very often the primary means by which radiologists provide patient care. Radiology reports are extremely variable in form, content, and quality. The authors propose a framework for conceptualizing the reporting process and how it might be improved. This consists of standard language, a structured format, and consistent content. These attributes will be realized by modifying the clinical reporting process, including the creation, storage, transmission, and review of interpretative documents. The authors also point out that changes in training and evaluation must be a part of the process, because they are complementary to purely technical solutions.
Quality assessment and improvement: what radiologists do and think
American Journal of Roentgenology, 1994
OBJECTIVE. The main objectives of the study were as follows: first, to study the nature and extent of radiologists' Involvement In and their attitudes toward quality assessment (QA) and continuous quality improvement (CQI)Itotal quality management (TOM) in hospitals and in offices; and second, to ascertain whether differences in size, type, and location among hospitals and nonhospital radiology offices affect the QA and CQIITQM activities of radiologists. We analyzed data from a national survey conducted by the American College of Radiology (ACR) in 1993. MATERIALS AND METHODS. Questionnaires about QA and CQI/TQM activities and attitudes were mailed to 216 hospItal-affiliated diagnostic radiology group practices using a sample selected from the ACR master list of radiology practices in the United States. The response rate was 90%. A stratified random sample ensured representstlon of different geographic regions, various group sizes, and both academic and
Quality metrics currently used in academic radiology departments: results of the QUALMET survey
The British journal of radiology, 2017
We present the results of the 2015 quality metrics (QUALMET) survey, which was designed to assess the commonalities and variability of selected quality and productivity metrics currently employed by a large sample of academic radiology departments representing all regions in the USA. The survey of key radiology metrics was distributed in March-April of 2015 via personal e-mail to 112 academic radiology departments. There was a 34.8% institutional response rate. We found that most academic departments of radiology commonly utilize metrics of hand hygiene, report turn around time (RTAT), relative value unit (RVU) productivity, patient satisfaction and participation in peer review. RTAT targets were found to vary widely. The implementation of radiology peer review and the variety of ways in which peer review results are used within academic radiology departments, the use of clinical decision support tools and requirements for radiologist participation in Maintenance of Certification al...
Health Policy, 2011
Background: Medicare established the Physicians Quality Reporting Initiative (PQRI, recently renamed the Physicians Quality Reporting System) to increase reporting of quality metrics and promote healthcare quality. Objective: To identify characteristics of PQRI participants and examine their beliefs about its impact. Design: National survey of 4934 U.S. physicians, conducted June through October 2009. Setting: All practice settings. Participants: Randomly selected physicians categorized as primary care, medical specialists, surgeons, other specialists. Measurements: Beliefs about impact of PQRI reporting on quality. Results: The response rate was 49.8%. There were no significant differences between respondents and non-respondents by age, gender, specialty, and region. Thirty-eight percent participated in the PQRI, and were more likely than non-participants to be practice owners (69.0% vs. 57.1%, p < .0001) and to receive performance bonuses through their employer or practice (50.4% vs. 37.0%, p < .0001). Half of PQRI participants believed it had no impact on quality. Medical specialists (57.0%) and surgeons (55.1%) were more likely than primary care (40.4%) and other physicians (45.7%) to say that PQRI has no impact on quality (p = .004). Conclusions: Most PQRI participants believed it had little if any impact on quality. Medicare should identify the reasons behind physicians' negative views while it works to expand the Physicians Quality Reporting System.
Performance measures in radiology
Journal of the American College of Radiology, 2014
Performance measures in radiology play an increasingly significant role in health care quality assessment and now form the basis for a variety of pay-for-performance programs, including those administered by CMS. This article introduces the measure development process, beginning with topic selection, followed by measure development and testing, National Quality Forum endorsement, and implementation. Once implemented, measures may undergo further testing and be re-endorsed, modified, or retired. Radiologists should familiarize themselves with the measures relevant to their practice, develop ways to collect and report data efficiently, and implement the necessary practice changes to meet measure criteria and improve the quality of their practice.