By Maureen McKinney
May 6, 2008 | The Centers for Medicare and Medicaid Services (CMS) announced the six vendors that will participate in an upcoming pilot project using Physician Quality Reporting Initiative (PQRI) measures, which are extracted directly from electronic health record systems. The project is one of the requirements of the Medicare Physician Fee Schedule 2008, which mandated testing of PQRI measures using EHRs and also dictated the nomination process for vendors.
After CMS formally announced it was looking for partners in December 2007, interested companies volunteered by providing basic information such as their solutions’ security features and ability to segment out Medicare fee-for-service patients, said Brian Lancaster, director of physician strategy at Cerner.
Cerner is one of the participating vendors, along with eClinicalWorks, NextGen Healthcare Information Systems, DocSite, Allscripts, and Anceta.
According to Dr. Michael Rapp, director of the PQRI program at CMS, the purpose of the pilot is to see if utilizing data from EHRs will actually be a feasible method of collecting quality measures for the agency.
“The Physician Quality Reporting Initiative (PQRI) makes it possible for physicians and other eligible professionals to receive a financial incentive to report data on PQRI quality measures,” Rapp said in an email. “For 2007, professionals were only able to submit data using claims. For 2008, they can use both claims and registries to submit quality data. During 2008, we are testing the submission of quality data from Electronic Health Records, for possible future implementation.”
During the pilot project, vendors will submit data for five PQRI measures—three related to diabetes, one related to coronary artery disease, and one related to heart failure—to a CMS data warehouse for assessment. Cerner has partnered with long-time client, the University of Missouri, for the duration of the project and will use data from the medical center’s EHR.
Extracting quality from an electronic health record rather than from claims data holds several advantages, said Lancaster. The data capture is built directly into the workflow and physicians can act on the information as they see it, he explained. In addition, if EHR data proves to a be a viable source of quality measures, it could give Cerner an advantage in marketing to physicians who want higher levels of reimbursement as well as improved care.
“We’re hoping this boosts EHR adoption because it will be used for pay-for-performance and for providing quality care to patients,” Lancaster said. “Capturing that data during workflow will be a big feature for physicians.”
Hal Williamson, professor and chair of family and community medicine at the University of Missouri, agreed and said the university’s primary reason for collaborating with Cerner on this and past projects is the desire to steer away from using claims data for quality—a process he said requires multiple steps and must be done after care is administered.
“The extracting of information right out of medical record is direct, faster, and easier,” Williamson said. “Our physicians have really responded well to this, and we’ve heard a lot of ‘wows.’ Right now, the reality is just that CMS is trying to figure out if they can really do this.”
Data submissions for the pilot will end in September 2008, and at that time, CMS will assess the data and decide if they will allow future EHR-based submission of data for payment, the agency said.