Clinical Quality Indicators have become beacons for measuring care delivery standards. In June'08 CMS and HQA (Hospital Quality Alliance) started to public report 30 day mortality measures for AMI, HF and PN. Since then the reporting has included 30 readmission for these conditions and in-hospital adverse events. Based on claimms and administrative data, CMS calculates the following categories for public reporting
30 day risk standardized mortality measures
30 day risk standardized readmission rates
AHRQ Patient Safety Indicators
AHRQ Inpatient Quality Indicators
Hospital Acquired Conditions Measures (Includes Surgery Infection Prevention)
In addition, AHRQ has Pediatrics Quality Indicators and Patient Safety Indicators
While hospitals engage to collect and cogently present the KPI information - 3 questions need to be asked:
How did the organization identify who its key stakeholders for outcomes information were? How were the stakeholders' outcomes information needs determined? What were the stakeholders' information needs and preferred reporting formats?
Eligible hospitals and Critical Access Hospitals must report all 15 Clinical Quality Measures for Stage 1
In all 44 clinical quality measures were adopted for EPs. They appear in table 6 of the final rule (beginning p. 44398). The table includes the applicable NQF measure number and the PQRI implementation number, title, description, owner/steward. Where applicable, link are provided to existing electronic specifications. All of the measures have broad applicability to the range of Medicare-designated specialties and the services provided by EPs.
EPs must report clinical quality measures results (numerators, denominators, and exclusions) to CMS. Clinical Quality Measure Priorities PQRI measures 1, 2, 3, 5, and 7 represent CMS and Health and Human Services healthcare quality priorities. They address chronic conditions of diabetes, coronary artery disease, and heart disease. PQRI measures 66, 110 –115, and 128 support screening and prevention, also a high priority for CMS and HHS. Check out Table 6 of the Final Rule on MU
More to come....
Monday, April 11, 2011
Tuesday, February 8, 2011
ADVANCE for Health Information Professionals | Editorial
8 Great Issues to Watch in 2011 By Susan M Lucci, RHIT, CMT, AHDI-F
ADVANCE for Health Information Professionals | Editorial
ADVANCE for Health Information Professionals | Editorial
Monday, January 31, 2011
LSS and Healthcare reform
I was listening to some podcasts on guidonps.com. The speaker is Ron Wince, CEO of Guidon Performance Solutions. Some worthwhile nuggets from what I heard.
It seems everyone in healthcare is jumping on to LSS bandwagon, but mostly it has been used as a tactical toolbox until now. Off late people are realizing that they need to learn to do it well. LSS seems to be the bridge to bring about the socio-technical change. Hospitals are under pressure for a long time for reimbursement, cost and revenue realization. Health reform is driving this urgency. Key drivers pushing LSS adoption are (http://www.ache.org/pubs/research/ceoissues.cfm)
# Changes in revenue model from inpatient to outpatient
# Reimbursement rates going down
# Transparency issues
# Consumer education
# EMR adoption(financial incentives at risk)
It seems that current health reform will call for a management/financial reform.
Continuous Improvement seems to be something we must do everyday, but not everyone is mature enough to think that way. CI is about making the jump up from the last achieved level. Voice of the customer is the only guide to CI initiative. It is not uncommon to see that CI being a knee jerk response to a crisis. LSS is a combination of process refinement and leadership committment to work ON the business and not merely work IN the business. Is measurement an obsession or do we need a balance between results and KPI. Typically only 5% of the work done by an organization is value adding from a customer point of view !!!!!!!!!. 50% of the non value added activity can really be rid of immediately (it is neither regulotory nor compliance).
The IT footprint (human resources) in the healthcare providers is low and there will be a strong need for contracted IT. The health IT companies are likely to do well in the coming times. It is likely to take anywhere between 10 to 20 years before the healhcare bill to be implemented.
It seems everyone in healthcare is jumping on to LSS bandwagon, but mostly it has been used as a tactical toolbox until now. Off late people are realizing that they need to learn to do it well. LSS seems to be the bridge to bring about the socio-technical change. Hospitals are under pressure for a long time for reimbursement, cost and revenue realization. Health reform is driving this urgency. Key drivers pushing LSS adoption are (http://www.ache.org/pubs/research/ceoissues.cfm)
# Changes in revenue model from inpatient to outpatient
# Reimbursement rates going down
# Transparency issues
# Consumer education
# EMR adoption(financial incentives at risk)
It seems that current health reform will call for a management/financial reform.
Continuous Improvement seems to be something we must do everyday, but not everyone is mature enough to think that way. CI is about making the jump up from the last achieved level. Voice of the customer is the only guide to CI initiative. It is not uncommon to see that CI being a knee jerk response to a crisis. LSS is a combination of process refinement and leadership committment to work ON the business and not merely work IN the business. Is measurement an obsession or do we need a balance between results and KPI. Typically only 5% of the work done by an organization is value adding from a customer point of view !!!!!!!!!. 50% of the non value added activity can really be rid of immediately (it is neither regulotory nor compliance).
The IT footprint (human resources) in the healthcare providers is low and there will be a strong need for contracted IT. The health IT companies are likely to do well in the coming times. It is likely to take anywhere between 10 to 20 years before the healhcare bill to be implemented.
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