www.ohiokepro.com
Vol. 2 No. 5
May/June 2005
DOQ-IT Project Designed to Improve
Quality of Care
Quality of Care
By Sandy Gallagher, MPA, Quality Improvement Project Super visor
T
he push for electronic health records
(EHRs) is on! President George W. Bush
stated in April 2004 that EHRs should be
made available to all Americans. In May 2004,
the President appointed David Brailer, MD, PhD,
as the National Health Information Technology
Coordinator. At a Januar y 2005 visit to the
Cleveland Clinic the President said, "Most
industries in America have used information
technology to make their businesses more cost-
effective, more efficient, and more productive.
And the tr uth of the matter is, health care
hasn't. We've got fantastic pharmaceuticals
that help save lives, but we've got docs still
writing records by hand."
(EHRs) is on! President George W. Bush
stated in April 2004 that EHRs should be
made available to all Americans. In May 2004,
the President appointed David Brailer, MD, PhD,
as the National Health Information Technology
Coordinator. At a Januar y 2005 visit to the
Cleveland Clinic the President said, "Most
industries in America have used information
technology to make their businesses more cost-
effective, more efficient, and more productive.
And the tr uth of the matter is, health care
hasn't. We've got fantastic pharmaceuticals
that help save lives, but we've got docs still
writing records by hand."
A recent sur vey conducted by Medical Economics magazine of
primar y care physicians suppor ts the President's contention. In
August 2004, the magazine mailed sur veys to 10,000 office-based
MDs and DOs. From the 1,916 physicians who returned the sur vey,
Medical Economics determined the following:
The number of primar y care physicians who have EHRs has grown
to 15 percent but is still a small percentage of all generalists.
Of all the physicians who said they are using an EHR, one-half
have had them for less than two years.
Twenty-three percent of respondents say they plan to acquire
an EHR within the next 12 months.
primar y care physicians suppor ts the President's contention. In
August 2004, the magazine mailed sur veys to 10,000 office-based
MDs and DOs. From the 1,916 physicians who returned the sur vey,
Medical Economics determined the following:
The number of primar y care physicians who have EHRs has grown
to 15 percent but is still a small percentage of all generalists.
Of all the physicians who said they are using an EHR, one-half
have had them for less than two years.
Twenty-three percent of respondents say they plan to acquire
an EHR within the next 12 months.
the use of EHRs and information technology (IT) in primar y care
physician offices. National suppor t was obtained from physician
organizations such as the Academy of Family Physicians and
several subspecialties.
physician offices. National suppor t was obtained from physician
organizations such as the Academy of Family Physicians and
several subspecialties.
Recent studies and reports indicate IT can play a
significant role in improving the quality of patient care.
significant role in improving the quality of patient care.
Saving lives
Recognizing EHRs could save as much as $140 billion in healthcare
costs and prevent thousands of patients' deaths due to medical
errors, the Centers for Medicare & Medicaid Ser vices (CMS) began
a pilot program in four states called the Doctors' Office Quality-
Information Technology (DOQ-IT) project. The pilot's goals were to
improve quality of care, enhance patient safety, and maximize
efficiency for ser vices provided to Medicare beneficiaries by promoting
Recognizing EHRs could save as much as $140 billion in healthcare
costs and prevent thousands of patients' deaths due to medical
errors, the Centers for Medicare & Medicaid Ser vices (CMS) began
a pilot program in four states called the Doctors' Office Quality-
Information Technology (DOQ-IT) project. The pilot's goals were to
improve quality of care, enhance patient safety, and maximize
efficiency for ser vices provided to Medicare beneficiaries by promoting
Recent studies and repor ts indicate IT can play a significant role in
improving the quality of patient care. The Institute of Medicine's
2002 repor t, Crossing the Quality Chasm, called for a design of new
systems that prevent, detect, and minimize hazards and the likelihood
of error. The repor t urged the implementation of "a system in which
it is hard to make a mistake and easy to do the right thing." The
repor t also stated "information technology must play a central role
improving the quality of patient care. The Institute of Medicine's
2002 repor t, Crossing the Quality Chasm, called for a design of new
systems that prevent, detect, and minimize hazards and the likelihood
of error. The repor t urged the implementation of "a system in which
it is hard to make a mistake and easy to do the right thing." The
repor t also stated "information technology must play a central role
Continued on pg. 2
DOQ-IT Project Designed to Improve Quality of Care (cont'd.)
in the redesign of the healthcare system if a substantial improve-
ment in quality and safety is to be achieved over the
coming decade."
ment in quality and safety is to be achieved over the
coming decade."
Dr. Brailer notes an estimated 50,000 to 100,000 people die each
year from medical errors and EHRs could help physicians and patients
keep better track of treatments. EHRs help to organize and
standardize patients' records so they can easily be shared with others.
year from medical errors and EHRs could help physicians and patients
keep better track of treatments. EHRs help to organize and
standardize patients' records so they can easily be shared with others.
Studies indicate IT systems can:
Improve access to patient information
Reduce errors and improve quality of care
Create more efficient physician offices
Improve billing accuracy
Reduce transcription costs
Improve access to patient information
Reduce errors and improve quality of care
Create more efficient physician offices
Improve billing accuracy
Reduce transcription costs
The Medicare Prescription Drug, Improvement and Modernization Act
of 2003 encourages the use of health information technology to
manage the clinical care of Medicare beneficiaries. CMS will require
standards to facilitate electronic prescribing. Medicare Prescription
Drug Plan (PDP) sponsors will be required to offer e-prescribing
by 2006.
of 2003 encourages the use of health information technology to
manage the clinical care of Medicare beneficiaries. CMS will require
standards to facilitate electronic prescribing. Medicare Prescription
Drug Plan (PDP) sponsors will be required to offer e-prescribing
by 2006.
CMS expands project
CMS has expanded the DOQ-IT project nationally, with Quality
Improvement Organizations (QIOs) such as Ohio KePRO tasked by
CMS to promote:
Adoption of EHRs in physician offices
Workflow changes as related to population management/patient
self-management
Data repor ting to a clinical warehouse
CMS has expanded the DOQ-IT project nationally, with Quality
Improvement Organizations (QIOs) such as Ohio KePRO tasked by
CMS to promote:
Adoption of EHRs in physician offices
Workflow changes as related to population management/patient
self-management
Data repor ting to a clinical warehouse
Par ticipation in DOQ-IT is voluntar y. Ohio KePRO will work with
physician offices by helping them select an EHR system and offer
guidance with respect to implementation. Ohio KePRO's ser vices are
free of charge to par ticipating physicians.
physician offices by helping them select an EHR system and offer
guidance with respect to implementation. Ohio KePRO's ser vices are
free of charge to par ticipating physicians.
Ohio KePRO can help
Ohio KePRO will also work through DOQ-IT to help physicians adopt
care management processes on the following five quality measures:
diabetes, hear t failure, hyper tension, preventive health, and coronar y
ar ter y disease (CAD). Data from two of these measures--diabetes
and CAD--will be repor ted electronically to a data warehouse. The
end result of DOQ-IT will likely be Pay-for-Performance contracts, with
reimbursement tied to electronic repor ting of data on various quality
measures. Physician public repor ting of quality measures may follow,
similar to what is now in place for nursing homes, home health
agencies, and hospitals.
Ohio KePRO will also work through DOQ-IT to help physicians adopt
care management processes on the following five quality measures:
diabetes, hear t failure, hyper tension, preventive health, and coronar y
ar ter y disease (CAD). Data from two of these measures--diabetes
and CAD--will be repor ted electronically to a data warehouse. The
end result of DOQ-IT will likely be Pay-for-Performance contracts, with
reimbursement tied to electronic repor ting of data on various quality
measures. Physician public repor ting of quality measures may follow,
similar to what is now in place for nursing homes, home health
agencies, and hospitals.
Ohio KePRO's services
are free of charge to
participating physicians.
are free of charge to
participating physicians.
Ohio KePRO has hired experienced staff from healthcare software
companies to assist physician offices with selection and implemen-
tation of an EHR system. Ohio KePRO's staff can help physician
offices select vendors, offer guidance to achieve office efficiency,
and repor t data to CMS. Ohio KePRO's ser vices and suppor t are
free of charge. For those physician offices with EHR systems that
would like to par ticipate in DOQ-IT, Ohio KePRO can provide
assistance with the data repor ting and the care management
aspects of the project.
companies to assist physician offices with selection and implemen-
tation of an EHR system. Ohio KePRO's staff can help physician
offices select vendors, offer guidance to achieve office efficiency,
and repor t data to CMS. Ohio KePRO's ser vices and suppor t are
free of charge. For those physician offices with EHR systems that
would like to par ticipate in DOQ-IT, Ohio KePRO can provide
assistance with the data repor ting and the care management
aspects of the project.
Physicians interested in par ticipating in DOQ-IT should contact the
Ohio KePRO Physician Office Team at 1-800-385-5080; e-mail:
droffice@ohqio.sdps.org.
Ohio KePRO Physician Office Team at 1-800-385-5080; e-mail:
droffice@ohqio.sdps.org.
2
Ohio KePRO's Project to Focus on
Underser ved Populations
Underser ved Populations
By Bonnie Hollopeter, LPN, CPHQ, Quality Improvement Project Super visor
D
uring the 8th Scope of Work (SOW), which runs from August 1, 2005 to July 31, 2008, Ohio
KePRO will work to improve results of clinical performance measures for six clinical quality
indicators for underser ved Medicare beneficiaries being treated in the physician office setting. The
three categories for the clinical measures are diabetes, adult immunizations, and mammography.
There are three indicators for diabetes, two for adult immunizations, and one for mammography.
The underser ved population will consist of African American Medicare beneficiaries, who
comprise 10.4 percent of the total Medicare beneficiar y population in Ohio.
KePRO will work to improve results of clinical performance measures for six clinical quality
indicators for underser ved Medicare beneficiaries being treated in the physician office setting. The
three categories for the clinical measures are diabetes, adult immunizations, and mammography.
There are three indicators for diabetes, two for adult immunizations, and one for mammography.
The underser ved population will consist of African American Medicare beneficiaries, who
comprise 10.4 percent of the total Medicare beneficiar y population in Ohio.
Ohio KePRO will work with an Identified Par ticipant Group (IPG) to
promote systems improvement through Doctors' Office Quality-
Information Technology (DOQ-IT) project activities (see the related
ar ticle on page 1). Ohio KePRO will work with a second IPG on
provider and practice system changes related to cultural competency
and 13 culturally and linguistically appropriate ser vices (CLAS)
standards, which were developed by the Depar tment of Health and
Human Ser vices Office of Minority Health and Resources for Cross-
Cultural Health Care. Ohio KePRO intends to recruit 20 to 50
practices for par ticipation in the cultural competency IPG.
promote systems improvement through Doctors' Office Quality-
Information Technology (DOQ-IT) project activities (see the related
ar ticle on page 1). Ohio KePRO will work with a second IPG on
provider and practice system changes related to cultural competency
and 13 culturally and linguistically appropriate ser vices (CLAS)
standards, which were developed by the Depar tment of Health and
Human Ser vices Office of Minority Health and Resources for Cross-
Cultural Health Care. Ohio KePRO intends to recruit 20 to 50
practices for par ticipation in the cultural competency IPG.
Ohio KePRO intends to
recruit 20 to 50 practices for
participation in the cultural
competency IPG.
recruit 20 to 50 practices for
participation in the cultural
competency IPG.
What is cultural competency?
Exper ts often define culturally competent care as "patient-centered"
care. According to the Institute of Medicine's repor t Crossing the
Quality Chasm: A New Health System for the 21st Centur y, patient-
centered care establishes a par tnership among practitioners,
patients, and their families (when appropriate) to ensure healthcare
decisions respect patients' wants, needs, and preferences, and
patients have the education and suppor t they need to make
decisions and par ticipate in their own care. Among the qualities
encompassed by patient-centered care are compassion, empathy,
and responsiveness to the needs, values, and expressed preferences
of the individual patient.
Exper ts often define culturally competent care as "patient-centered"
care. According to the Institute of Medicine's repor t Crossing the
Quality Chasm: A New Health System for the 21st Centur y, patient-
centered care establishes a par tnership among practitioners,
patients, and their families (when appropriate) to ensure healthcare
decisions respect patients' wants, needs, and preferences, and
patients have the education and suppor t they need to make
decisions and par ticipate in their own care. Among the qualities
encompassed by patient-centered care are compassion, empathy,
and responsiveness to the needs, values, and expressed preferences
of the individual patient.
If you are interested in joining an IPG or would like more information,
please contact the Physician Office Team at 1-800-385-5080;
e-mail: droffice@ohqio.sdps.org.
please contact the Physician Office Team at 1-800-385-5080;
e-mail: droffice@ohqio.sdps.org.
Ohio KePRO's Physician Office Team to Offer
Numerous CME Oppor tunities
Numerous CME Oppor tunities
O
hio KePRO will continue to offer oppor tunities for healthcare providers to earn continuing
medical education (CME) credits during the 8th Scope of Work (SOW). A summar y of the
CME program is given below:
medical education (CME) credits during the 8th Scope of Work (SOW). A summar y of the
CME program is given below:
Categor y 1 CME Credits offered at no charge for quality
improvement in the clinical office setting
10 Categor y 1 credits per clinical topic in Year 1.
6 Categor y 1 credits per clinical topic in subsequent years.
improvement in the clinical office setting
10 Categor y 1 credits per clinical topic in Year 1.
6 Categor y 1 credits per clinical topic in subsequent years.
Eligibility
Provider must be an MD, DO, PA, or NP providing care to
Medicare beneficiaries.
Provider must be an MD, DO, PA, or NP providing care to
Medicare beneficiaries.
Continued on back
3
CME Oppor tunities
(cont'd. from page 3)
CALENDAR OF EVENTS
Provider must agree to work with Ohio
KePRO on one or more of its outpatient
quality improvement projects.
Provider must complete a CME enrollment
form for each clinical topic area for which
CME credit is desired.
KePRO on one or more of its outpatient
quality improvement projects.
Provider must complete a CME enrollment
form for each clinical topic area for which
CME credit is desired.
May
Healthy V ision Month
National American Stroke Month
National Ar thritis Month
National Osteoporosis Awareness
and Prevention Month
Older Americans Month
Healthy V ision Month
National American Stroke Month
National Ar thritis Month
National Osteoporosis Awareness
and Prevention Month
Older Americans Month
June
Prostate Cancer Awareness Day 19th
National Men's Health Week
13th 19th
Prostate Cancer Awareness Day 19th
National Men's Health Week
13th 19th
Requirements for par ticipating
Under take a quality improvement process
addressing one or more CMS-defined
quality measures in topic area.
Institute and maintain an ongoing
measurement system. (The measurement
system must generate data the provider
can use to assess performance on the
specified measure.)
Periodically review data from measurement
system to assess impact of quality
improvement inter vention.
Provide information requested by Ohio
KePRO necessar y to validate that CME
requirements have been met.
Under take a quality improvement process
addressing one or more CMS-defined
quality measures in topic area.
Institute and maintain an ongoing
measurement system. (The measurement
system must generate data the provider
can use to assess performance on the
specified measure.)
Periodically review data from measurement
system to assess impact of quality
improvement inter vention.
Provide information requested by Ohio
KePRO necessar y to validate that CME
requirements have been met.
Please note:
Ohio KePRO's office will be closed on May 30, 2005, in obser vance of Memorial Day.
Ohio KePRO's office will be closed on May 30, 2005, in obser vance of Memorial Day.
Publication No. 4031-OH-002-5/2005. This material was prepared by Ohio KePRO, the
Medicare Quality Improvement Organization for Ohio, under contract with the Centers for
Medicare & Medicaid Ser vices (CMS), an agency of the U.S. Depar tment of Health and
Human Ser vices. The contents presented do not necessarily reflect CMS policy.
Medicare Quality Improvement Organization for Ohio, under contract with the Centers for
Medicare & Medicaid Ser vices (CMS), an agency of the U.S. Depar tment of Health and
Human Ser vices. The contents presented do not necessarily reflect CMS policy.
Clinical Topics
Congestive hear t failure (CHF), coronar y
ar ter y disease (CAD), Hyper tension,
Preventive Care, and Diabetes.
Congestive hear t failure (CHF), coronar y
ar ter y disease (CAD), Hyper tension,
Preventive Care, and Diabetes.
Validation
Ohio KePRO will periodically validate that
all requirements have been met for each
calendar quar ter for which provider is
requesting CME credit.
Provider may be requested to complete an
online sur vey regarding its experience with
Ohio KePRO's CME program.
Ohio KePRO will periodically validate that
all requirements have been met for each
calendar quar ter for which provider is
requesting CME credit.
Provider may be requested to complete an
online sur vey regarding its experience with
Ohio KePRO's CME program.
For additional information about Ohio KePRO's CME
program, please contact the Physician Office Team at
1-800-385-5080; e-mail: droffice@ohqio.sdps.org.
program, please contact the Physician Office Team at
1-800-385-5080; e-mail: droffice@ohqio.sdps.org.
Ohio KePRO Physician Office Team
Alice Stollenwerk Petrulis, MD, FACP Kerri Gilligan, RN
Meghan Harris, MS Marsha Hopper, RN
Bonnie Hollopeter, LPN, CPHQ Kathleen Korosi, MPA
Sandy Gallagher, MPA Svetlana Marchuk, BS
Steve Cramer, BS Marilyn Daniels Monteiro
Leslie Crowe, LPN, BS Patricia Moynihan, AAB
Executive Editor : Suzana C. Iveljic, MBA Editor : Robert A. Feigenbaum, MS
Alice Stollenwerk Petrulis, MD, FACP Kerri Gilligan, RN
Meghan Harris, MS Marsha Hopper, RN
Bonnie Hollopeter, LPN, CPHQ Kathleen Korosi, MPA
Sandy Gallagher, MPA Svetlana Marchuk, BS
Steve Cramer, BS Marilyn Daniels Monteiro
Leslie Crowe, LPN, BS Patricia Moynihan, AAB
Executive Editor : Suzana C. Iveljic, MBA Editor : Robert A. Feigenbaum, MS
Lori Myers, LPN
Julie Ondercin, RHIA, CPHQ
Linda Wozniak, LPN
Dan Ziemnik, BA
Julie Ondercin, RHIA, CPHQ
Linda Wozniak, LPN
Dan Ziemnik, BA
T H E M AY / J U N E 2 0 0 5 I S S U E O F Q U A L I T Y C O N N E C T I O N H A S A R R I V E D !
The Newsletter of the Physician Office Quality Improvement Initiative
The Newsletter of the Physician Office Quality Improvement Initiative
Ohio KePRO Provider QIC Line--Your Quality Improvement Connection: 1-800-385-5080
Medicare Help Line: 1-800-MEDICARE (1-800-633-4227) e-mail: droffice@ohqio.sdps.org
Medicare Help Line: 1-800-MEDICARE (1-800-633-4227) e-mail: droffice@ohqio.sdps.org