“Right now there is just a carrot for achieving quality measures, the 2% bonus on all Medicare payments under PQRI,” says Salahuddin Kazi, MD, chief of rheumatology at the Presbyterian Hospital of Dallas. “But not that far into the future, reporting outcomes and quality measures may become a stick with penalties attached. The registry is one way for rheumatologists to not only become accustomed to what soon may become required, but also to help us control formulation of quality elements used within the specialty.”
One Physician’s Experience
Donald Krause, MD, is medical director for quality improvement at St. Joseph Hospital in Bangor, Maine, and a practicing rheumatologist. He tested an earlier version of the RCR. “It was very easy to use, even though much had to be done manually because of the limitations of our office information system,” he says. “It took my medical assistant about four minutes per patient to identify appropriate patients, insert a checkoff sheet for the diagnosis into the chart, and enter information into the system following the visit. I especially liked that I could make sure that all of the quality indicators were done while the patient was still in front of me and correct anything missing immediately.”
With a newer electronic medical record (EMR) system that allows him to sort patients by diagnosis, the input time should be greatly reduced. RCR users without such EMR assistance will be able to use recently added upload functionality within the RCR to pull patients from their billing systems by diagnosis, alleviating some of the initial data entry in much the same way.
Dr. Krause also increased personal compliance with quality indicators and practice guidelines while using the RCR. A self-audit that he compiled saw his completion of indicators increase from 85% immediately before enrolling in the RCR to nearly 100% following RCR use. In addition, the RCR increased his efficiency by standardizing care for individual patients.
“We all think we are doing [well] and all think we are doing everything right,” he says. “But when we start looking at specific areas, there may be places where we could do better. I think the RCR will improve clinical care.”
Join the RCR Now!
If you would like to use the RCR in your practice, visit www.rheumatology.org/rcr for more information.
Early Stages of Program
Right now, the RCR is a first step towards what the ACR eventually hopes to achieve. Interoperability with EMR systems is an important ACR goal for the RCR—and demand from rheumatologists who use EMRs will help facilitate that functionality. Rheumatologists interested in contacting their EMR companies to encourage interoperability with the RCR should contact the ACR for information and advice on how to approach their EMR vendors.