ABMS Member Boards Embrace Patient Registries
Registries help align MOC with QPP
The American Board of Medical Specialties (ABMS) Member Boards are increasingly incorporating the use of patient registries into their continuing certification process. Not only do registries target high-value, high-priority quality concerns and provide physicians with meaningful, actionable information, incorporating them helps align their Programs for Maintenance of Certification (ABMS MOC®) with federal and state quality incentive programs.
Also known as clinical data registries, patient registries can offer physicians information that will help them improve the quality and safety of patient care, for example, by comparing the effectiveness of different treatments for the same disease. When the Qualified Clinical Data Registry (QCDR) was introduced in 2014 as a reporting option under the Physician Quality Reporting System, which has since transitioned to the Merit-Based Incentive Payment System (MIPS) under the Quality Payment Program (QPP), it stimulated investment in registries for data collection and performance measurement. As it became easier to extract data from electronic health records (EHRs) and incorporate measures that matter to patients and physicians, registries quickly evolved to become the cornerstone of clinical quality and improvement activities within the specialties.
While many ABMS Member Boards have been providing physicians the opportunity to earn MOC credit for participating in externally developed patient registries, some Boards are taking registry use one step further by designing performance improvement initiatives supported by registry data.
Earlier this year, the American Board of Ophthalmology (ABOP) started a pilot program that enables ophthalmologists to create customized quality improvement (QI) projects using the data supplied through the American Academy of Ophthalmology’s IRIS® Registry. The data consist of 15 clinical quality measures and six QI measures reported monthly to participants of the IRIS Registry. Ophthalmologists can use the monthly reports to identify areas for improvement, set specific goals for each measure, outline the steps (changes in care delivery processes) to achieve these goals, and evaluate their success by analyzing subsequent monthly performance reports. After numerous improvement projects were successfully ushered through the pilot pipeline, ABOP made the pilot a permanent program in October. Board Certified ophthalmologists can now receive MOC credit for approved, completed projects.
The American Board of Otolaryngology (ABOto) has been partnering with the American Academy of Otolaryngology-Head and Neck Surgery for the past two years in the development of Reg-ent, a QCDR. Reg-ent is able to extract data from an otolaryngologist’s EHR for multiple purposes, including reporting quality measures for MIPS as payment shifts to performance under QPP. ABOto will be able to extract data from Reg-ent to provide feedback to Board Certified otolaryngologists and document improvement, thereby meeting MOC requirements without requiring data entry by the physicians.
The American Board of Family Medicine (ABFM) has taken registry use to the next level by launching its own national primary care registry in 2016. To date, more than 3,000 clinicians are using the PRIME Registry, which extracts patient data from the practice EHR and turns it into actionable measures that are presented in an easy to use dashboard.The dashboard displays 40-plus electronic Clinical Quality Measures at the clinician level, practice level, and even down to the individual patient level, to track patient care, and then target opportunities for improvement and follow up. The PRIME Registry is not only a QCDR, but also is approved to propose measures to CMS, providing an opportunity to influence the development of more meaningful measures in the future.
ABFM’s PRIME Registry offers tools that simplify and automate reporting for MIPS and the Center for Medicare & Medicaid Services’ Comprehensive Primary Care Plus or CPC+, and enable clinicians to use their measures data to create and implement a QI plan in their practice, simplifying Continuous Certification and aligning it with MIPS reporting requirements. ABFM also is working to integrate social determinants of health data with clinical data in the registry to help physicians understand the impact of social determinants on individual patients and populations they serve and use this information to improve intervention and care. This new tool, named the Population Health & Assessment Engine, will be available in June 2018.