1. E-QUAL Chest Pain Kick Off

2. E-QUAL Emergency Quality Network
National quality movement, supported by CMS
Enrolling over 24,000 Emergency clinicians over the next 4 years to participate in quality improvement activities focused on:
Improving outcomes for patients with sepsis
Reducing avoidable imaging in low risk patients by implementation of ACEP’s Choosing Wisely recommendations
Improving the value of ED evaluation for low risk chest pain by reducing avoidable testing and admissions
What is EQUAL

3. We have enrolled in E-QUAL
Our next quality improvement project is on reducing avoidable testing and admissions for low risk chest pain patients
Our plan:
Utilize E-QUAL resources to:
Reduce chest pain admissions+ report our data
= meet CMS requirements
= increase our revenue!

4. Why did we join E-QUAL?
To improve our ability to reduce avoidable testing and admissions for low risk chest pain patients
Meet CMS requirements
E-QUAL initiatives are aligned with CMS hospital quality reporting and payment initiatives
Improve revenue
Improve patient outcomes
Rural-specific resources and support
Best practices, rural considerations, implementation assistance
Reduction in liability through standardization
CME & MOC credits

5. E-QUAL and MOC Part IV Credit
E-QUAL will be listed on the ABEM drop down list of opportunities
ED Director will need to be listed attesting that the individual participated in E-QUAL.
E-QUAL hopes to develop “automatic” credit soon
E-QUAL and CME Credit
All E-QUAL webinars/podcasts will be associated with eCME credit.
To obtain credit visit the E-QUAL homepage

6. Why are we quality reporting?
There is a new Medicare physician reimbursement program – links quality to reimbursement
This is the Merit-based Incentive Payment System (MIPS)
Concept behind MIPS
High quality care + data reporting
= better MIPS performance
= larger Medicare reimbursement

7. MIPS Merit-based Incentive Payment System
New Medicare reimbursement program that links quality and data reporting to reimbursement
Medicare reimbursement
Automatic reimbursement increases from
After 2019, reimbursement will be based on our performance under MIPS
MIPS has two categories for measuring the performance of Emergency clinicians
Quality
Sepsis care is one of the quality measures
Clinical Practice Improvement Activities (CPIA)
E-QUAL is likely a high-value CPIA
E-QUAL is considered an activity for CPIA

8. Chest Pain Initiative Goal:
Improving the value of ED chest pain evaluation by reducing avoidable admissions in low risk patients with chest pain.
Provide real-life examples of rural ED’s who have successfully implemented low-risk chest pain protocols
How to interface with local cardiologist/s
Use of telemedicine
Risk stratification tools

9. What will we gain from E-QUAL’s chest pain rural series?
Webinar/Podcast series tailored for the rural setting
Guidelines and Materials focused on the rural EDs
Examples of successful rural ED’s low-risk CP protocols
Update on most recent ED-oriented chest pain literature
Data collection tools
Educational Resources and Lectures for CME