Each work group has representation from various areas of healthcare. “My work group had about 20 or 25 people, which is probably typical,” says Dr. Torcson. “The AMA provided a methodologist, and there was a CMS representative on the work group.” The work group first met face to face to review relevant evidence-based clinical guidelines and scame up with five to eight measures. These were then reworked through phone calls and e-mails before going before the entire PCPI for approval.
Other SHM representatives participated in relevant PCPI work groups as well. “PPC member Greg Seymann from San Diego participated in a geriatric work group that was convened for the same reason” as the ED group, says Dr. Torcson. “His group looked at creating a number of measures that were relative to both inpatient and outpatient geriatric patients. Some of these measures are now part of the Medicare Physician Quality Reporting Initiative.”
Another SHM member, James C. Pile. MD, FACP, participated in a work group on developing measures for outpatient administration of IV antibiotics. Pile is a staff physician in the Department of General Internal Medicine, Section of Hospital Medicine, at The Cleveland Clinic in Ohio.
In each group, SHM representatives were able to help shape measures that reflect the unique knowledge and perspective of hospital medicine.
“A hospitalist brings the perspective of having seen how these measures are actually incorporated into a practice, how they are actually applied to patient care,” Dr. Torcson points out. “These work groups to develop additional performance measures are ongoing. The PCPI has a rigorous agenda for what they want to accomplish over the next few years.”
SHM to Lead the Way on Care Transitions
The PCPI has asked SHM to be the lead organization for a performance measure development work group on care coordination and care transitions.
“This will be groundbreaking work around this important aspect of care that is very process-focused as opposed to disease-focused,” says Dr. Torcson. “It’s very appropriate that SHM was asked to be the lead group for this. This area of performance improvement is perfect for what hospitalists do.”
The PCPI plans to have care transition performance measures ready for adoption by 2009.
SHM and the Big Three
CMS is also collaborating with the National Quality Forum (NQF) and Ambulatory Quality Alliance (AQA). “The PCPI, AQA, and NQF are the most influential organizations right now for quality and performance measures,” says Dr. Torcson.
The NQF, a unique public and private collaborative, develops consensus standards on different measures submitted to it. “I have had the opportunity to participate on an NQF Steering Committee for performance measure endorsement,” says Dr. Torcson.
The AQA is responsible for standardizing performance measurement and reporting, and developing measures for efficiency to be included in forthcoming Medicare P4P programs. “The AQA is charged with implementing performance measures and bringing them to the marketplace,” explains Dr. Torcson. “SHM is not involved in the AQA process yet.”
Membership in SHM means you are able to access the latest information on issues like CMS reporting initiatives and have representation in the decision-making process.
“I think it’s the responsibility of a professional society to not only be informed on what’s happening on a national level, but to have some influence,” says Dr. Torcson. “And SHM has done a great job in being well-positioned to influence the national agenda on quality and performance improvement.” TH
Jane Jerrard writes frequently for The Hospitalist.