Physician Compare website makes quality-performance monitoring more important than ever

Product reviews and recommendations are an elemental part of many consumers' paths to purchase.

But for the most part, these opinions are based on subjective impressions and observations. Better information is gleaned from objective sources, such as Consumer Reports, that use measures specifically designed to quantify the value of services and goods. That capability is now entering the healthcare sphere by way of the Physician Compare website.

Created by the Centers for Medicare and Medicaid Services in 2010, the site was originally just a searchable directory of providers operating within the Medicare arena. Since then, it has added more valuable information, such as whether a provider has participated in the Physician Quality Reporting System and the Meaningful Use initiative. Now, Physician Compare is poised to begin publicly posting provider information derived from statistically viable and CMS-approved measurement instruments.

As healthcare transitions into a value-based system, the use of patient-reported outcome measurement tools has greatly accelerated. Patients can now quantify their satisfaction, experience, and assessment of their overall quality of life throughout their care. Collectively, these reports contribute to a physician's quality performance score, which will be published on the Physician Compare website beginning in 2017.

The rationale behind sharing patient-reported outcome data publicly is to encourage patients to effectively participate in making informed decisions about their own healthcare. According to Dr. Patrick Conway, director of CMS' Innovation Center, "Offering a strong set of meaningful quality measures on the site will ultimately help consumers make decisions, and it will encourage quality improvement among the clinician community, who shares CMS's strong commitment to the best possible patient care."

The healthcare industry is on the cusp of a quality revolution, and delivering patient satisfaction is now more important than ever.

The Incentive for Transparency and Patient-Reported Quality

In healthcare's value-based transition, the transparency of quality performance scores will shift both how providers deliver services and how patients perceive those services.

The feedback from these market forces will give patients a voice, and patient experience and satisfaction will affect providers' quality performance processes. As providers begin competing on the basis of patient-reported outcomes, more of them will become agents of change in furthering the transition to a value-based healthcare system.

Though often used interchangeably, patient satisfaction and patient experience are different measurements. Patient satisfaction relates to how a service meets the individual's expectations, while patient experience focuses on what happens during the process of receiving healthcare.

An initial 30-day test of the publication of patient satisfaction and experience information according to 2015 PQRS data occurred from Oct. 12 to Nov. 11, 2016. As the Merit-Based Incentive Performance System begins, quality scores from MIPS' 2017 initial performance period will eventually be published through the Physician Compare website as well.

Healthcare consumers will then be able to compare providers that offer similar services on the basis of shared measures. Providers that strive to deliver the best patient experience and satisfaction will be rewarded with higher quality scores, and higher scores create a competitive market advantage.

How to Choose the Right PROM Tools

The publication of quality performance scores on the Physician Compare site underscores the emerging importance of utilizing patient-recorded outcome measurement tools that best evaluate patient-facing processes. It also highlights the importance of using data collection technologies that not only gather that data, but also offer the ability to audit and, if warranted, modify quality procedures.

The right tools can produce quality feedback loops by closely monitoring quality-measures information reported by patients. These loops make it possible to audit and iterate improvements to quality processes using real-time access to patient-reported quality outcomes measurements.

Tools that have garnered consensus recommendation provide optimal results. The careful selection of the right measurement tools to collect outcomes data enables easier aggregation of those data into clinical registries for benchmarking and research purposes.

For guidance, specialty societies now recommend practice area-specific best practices and tools, such as the Instruments for Collection of Orthopaedic Quality Data cultivated by the American Association of Orthopaedic Surgeons.

Global initiatives to settle on common measurements are another valuable source. The Patient-Reported Outcomes Measurement Information System, or PROMIS, and the International Consortium for Health Outcomes Measurement, known as ICHOM, are excellent examples that span a wide range of practice specialties.

4 Steps Toward Leveraging Patient-Reported Quality Data

In the new era of value-based healthcare, the ability to collect quality outcomes information from patients is fundamental. The data informs multiple factors regarding a provider's operation. Maximizing the value of this data is vital to improving patient satisfaction. Four things to consider when utilizing PROM data are:

1. Collecting the information.

The first step to benefiting from data is to collect the information, so adopt outcomes measurements processes that will generate the highest patient compliance possible.
Measurement instruments should be user-centric in design, such as electronic forms that utilize best practices in user experience and interaction, to ensure ease of use. Tools that fully reflect the practice, such as the specialty and global initiatives mentioned above, will offer more opportunities for effective quality improvement.

2. Reviewing the data.

Regularly check the data gathered from patients to ensure a clear picture of the practice's quality performance status.

Providers' abilities to audit their performance scores in real time will significantly accelerate this transition, and smaller practices can now leverage insights from this data. This empowers a much wider spectrum of providers across the country, enabling the revolution of not only individual healthcare, but also population healthcare.

Introducing a process to audit patient-reported outcome information offers the ability to assess quality scores throughout any given performance period. Deficiencies in reported patient information will highlight where to introduce corrective measures to remedy any quality performance shortcomings.

3. Starting with CAHPS.

Consider the items covered by the Consumer Assessment of Healthcare Providers and Systems surveys as a starting point.

Patient experience is the aggregation of all the patients' interactions with the provider, and the provider's culture directly influences patients' perceptions. A culture of cooperation, communication, and friendliness will positively affect a patient's experience and therefore the overall quality performance score.

4. Communicating and collaborating with patients.

Cultivate from the initial meeting between a provider and patient an atmosphere of strong, collaborative communication to develop a clear picture of reasonable care expectations.

At its core, patient satisfaction lies in whether the patient's expectations are met. Collaborative communication with the patient produces a common understanding of the patient's desired outcome, allowing the establishment of reasonable care expectations. If patients can meet their own desired results, then the overall quality performance score will increase.

Current patient-reported outcomes collection along with historical data can already be seamlessly transitioned into the workflow with no data loss. The publication quality scores derived from this data will create a landscape where credible, verified reviews and recommendations can empower patients to make strong, informed decisions about where they receive their healthcare.

Keith Politte, J.D., is the strategic communications manager at OBERD, where he identifies and disseminates emerging opportunities in the transition to value-based healthcare. He is part of a multi-specialty team providing outcomes data collection and analytical solutions benefiting multiple medical practice specialties.

The views, opinions and positions expressed within these guest posts are those of the author alone and do not represent those of Becker's Hospital Review/Becker's Healthcare. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them.

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