Article Figures & Data
Tables
Characteristic Number of Practices (%) Location Urban 110 (55.3) Rural 89 (44.7) Size (# providers) 1 (solo) 38 (19.1) 2 to 5 102 (51.3) 6 or more 59 (29.6) Ownership Independent 89 (44.7) Health System 78 (39.2) Federally Qualified Health Center 22 (11.1) Indian Health Service or Tribal 10 (5.0) Clinical Quality Measure Performance Blood Pressure Control 122 (61.3) Aspirin Use 134 (67.3) Tobacco Screening/Cessation 142 (71.4) Domain Proportion of Practices (n = 199) Leadership: What was leadership’s involvement in reporting? “Basic:” Organizational leadership is not directly involved in QI projects and may not have been aware that it is happening. 21.0% (n = 42) “Intermediate:” Organizational leadership finds QI projects to be consistent with the organization’s philosophy but are unwilling or unable to divert resources in the form of dedicated time, staffing, or training for improvements in reporting, or to remove barriers to having reliable data to assure its success. 38.5% (n = 79) “Advanced:” Organizational leadership view QI projects as an opportunity to obtain technical assistance for practice transformation in preparation for value-based reimbursement and appreciate the importance of reliable data to support this effort. Leadership makes resources available for reporting and remove barriers to using the data for improving care. 38.5% (n = 78) EHR Reporting Capability: Given the reporting capability of the EHR as deployed within the clinical delivery system thus far in the project, if the lead clinician (CEO/CMO/clinic chief/owner) were to ask for clinical reports that would meet both the reporting and QI requirements for the project, what would be available? “Basic:” Either no CQM reports are available, or canned quarterly year-to-date reports are limited to patients who have had an office visit during those time periods. 39.1% (n = 78) “Intermediate:” CQM reports with a 12-month rolling look back are limited to patients who have had an office visit during the same time period. 27.5% (n = 55) “Advanced:” CQM reports in which the denominator includes all active members of a target population within the panel or clinic regardless of whether they have been seen in the clinic, and the numerator includes patient-level data showing the most recent date and value in a rolling 12-month look back. 33.0% (n = 66) Staff Skills for Reporting: Given the staffing of the clinical site or delivery system, if the CEO/CMO were to ask for clinical reports that would meet both external reporting requirements and internal QI needs, is there someone available to respond to that request? “Basic:” There is no one in the clinic or in the delivery system with the skills to assure that available EHR features are optimized to modify data flow, and to build, run, and validate clinical quality reports. 21.5% (n = 43) “Intermediate:” There is a role for such a person in the clinic, which may or may not be filled or is done by a self-trained provider or “super-user”, but the ability to do so reliably is unstable due to turnover, other demands on that person’s time, or inadequate vendor support. 48.5% (n = 96) “Advanced:” The IT skills necessary for clinical quality reporting is available to the clinic in the form of an organized resource such as an “IT shop”, and there is a process in place to assure requests are completed including validation of custom clinical quality reports. 30.0% (n = 60) Abbreviations: QI, quality improvement; EHR, electronic health record; CQM, clinical quality improvement.
Advanced Leadership Advanced Skills Advanced EHR Reporting Capability Number of Practices (% of total) Number (%) Reporting 2 or more CQMs X 38 (19.1%) 13 (34.2%) X 11 (5.6) 5 (45.5) X 16 (8.0) 12 (75.0) X X 6 (3.0) 4 (66.7) X X 15 (15.2) 10 (66.7) X X 7 (3.5) 5 (71.4) X X X 28 (14.1) 21 (75.0) No No No 78 (39.2) 35 (44.8) Abbreviations: EHR, electronic health record; CQM, clinical quality improvement.
