Using Data to Drive Care Team Transformation Gabrielle Langlinais and Kim Baker

Why collect data? Measure of quality Personal needs of your practice Referring practices Contract obligations Hospital partners Insurance contracts Personal needs of your practice To participate in the Merit-based Incentive Payment System (MIPS)

Sources of data Electronic Health Record (EHR) Many have data metrics Picture Archiving and Communication System (PACS) Mammography Reporting System (MRS) National database National Radiology Data Registry (NRDR) Scheduling data Radimetrics CT radiation dose data Qualtrics Collection of patient satisfaction surveys

Collecting and comparing data Picture Archiving and Communication System (PACS) Data Analytic Software (Montage) Search radiology reports for keywords

PACS data Critical result communication (pneumothorax, intracranial hemorrhage) Is there documentation of communication to ordering caregiver? Appropriateness of recommendations (recommend correlation with CT) Are recommended tests really necessary? Addendums Quality metric for radiologists

Radiology Circle of Tests gomerblog.com

Mammography Reporting System Database to track mammography recommendations and follow-up Are patients getting their follow-up tests? Are patients returning for their routine screening?

Collecting and comparing data Qualified Clinical Data Registry (QCDR) American College of Radiology (ACR) National Radiology Data Registry (NRDR)

National database National Radiology Data Registry (NRDR) Dose Index Registry (DIR) Collects CT radiation dose and compares to other practices National Mammography Database Registry (NMD) Benchmarking regarding Cancer detection rates Positive predictive value rates Recall rates

RIA TCPi data project RIA Clinical review team Started 2011 Reviews scheduled exams to ensure proper test is ordered Saves patient: Time Money Radiation dose For each referring practice, RIA has collected data on the examination requests that are altered Data collected from scheduling database Data available for a TCPi project!

CT Abdomen and Pelvis Do It Right the First Time One of the most frequently altered exam requests CT abdomen and pelvis (with and without contrast → with contrast only) Potential for quality improvement project Collect data Educate practice re: proper indications for contrast Collect and report on data following education

Using data to drive clinical care Quantify number of pediatric cases read by pediatric radiologists Led to scheduling changes and over-read of pediatric cases performed after hours Recommended exams Number of recommended exams not in excess of national benchmarks Addendums Number in keeping with scores from random peer review Not excessive for any single radiologist

What Data should I collect, and why?

Support and Alignment Networks (SANs) partnered with CMS American College of Emergency Physicians American College of Physicians, Inc. HCD International, Inc. Patient Centered Primary Care Foundation The American Board of Family Medicine, Inc. Network for Regional Healthcare Improvement American College of Radiology American Psychiatric Association American Medical Association National Nursing Centers Consortium

Practice Transformation Networks Partnered with CMS Arizona Health-e Connection Baptist Health System, Inc. Children's Hospital of Orange County Colorado Department of Health Care Policy & Financing Community Care of North Carolina, Inc. Community Health Center Association of Connecticut, Inc. Consortium for Southeastern Hypertension Control Health Partners Delmarva, LLC

Resources QPP MIPS TCPi and SANs https://qpp.cms.gov/learn/getprepared https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Value-Based-Programs/MACRA-MIPS-and-APMs/Merit-based-Incentive-Payment-System-MIPS-Overview-slides.pdf TCPi and SANs https://innovation.cms.gov/initiatives/Transforming-Clinical-Practices/

Resources CMS approved QCDRs MIPS and Data MIPS Scoring https://qpp.cms.gov/docs/QPP_MIPS_2017_Qualified_Registries.pdf MIPS and Data https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Value-Based-Programs/MACRA-MIPS-and-APMs/Quality-Payment-Program-MIPS-NPRM-Slides.pdf MIPS Scoring https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Value-Based-Programs/MACRA-MIPS-and-APMs/MIPS-Scoring-Methodology-slide-deck.pdf

Grazie mille