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November 2009 Issue

A hemoglobin AIC test is used to monitor blood sugar control. It is one of many outcomes measures being reported through PQRI.
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Diabetes Gets 'Self-Check' With Reporting System

Published November 2009

A closer look at the health records of a specific population of UC Health Diabetes Center patients was an eye-opener for center director Barbara Ramlo-Halsted, MD. Only one quarter of this group, all with diabetes and chronic kidney disease, met their goal for optimal blood sugar control.

While each individual case would have been flagged for better case management during a regular office visit, the newly mined data for the entire group was telling a story about a difficult-to-manage subset of patients.

“The ability to track this specific population showed us that there may be more than just individual differences among the patients,” says Ramlo-Halsted. “We could now see what could be a trend in their diabetes management and could re-think the way we care for and manage this entire group.”  

UC’s team of endocrinologists and diabetologists has joined the Physicians Quality Reporting Initiative (PQRI)—a three-year-old program aimed at improving patient outcomes through quality measures, reporting and incentives. Incentives are expected to be supported even further by health care stimulus dollars and offered to physician groups based on what is termed “meaningful use” of electronic medical records.

Reporting quality measures is one of the criteria for meaningful use.PQRI, which is run by the Centers for Medicare and Medicaid Services (CMS), requires clinicians to report specific quality measures, either through claims or patient registries, by capturing data during an office visit.

It was changes made to the Diabetes Center’s electronic medical record system in advance of PQRI reporting that allowed the center to enter and capture specific data about its chronic kidney disease patients.
“We have always tracked specific outcomes measures through time and labor intensive chart reviews, but have not been able to generate the kinds of reports we need,” says Ramlo-Halsted.

“Looking at bigger sets of data more frequently will help us to identify which patients or patient groups are doing well, and which need better case management on site or telephone support at home.”

The Diabetes Center has been tracking PQRI data since August and working out kinks in the system. In mid-October, it began submitting reports to CMS.

Team members say the initiative has provided a new look at workflow issues and has increased communication between physicians, clinical staff and the billing office. They see it as a starting point for capturing even more future data.

Kelly Fischbein, manager of quality initiatives for UC Health University of Cincinnati Physicians, says that tracking outcomes helps UC Health to better describe and quantify quality.

“It will also help others to understand what we are all about,” Fischbein adds.

Fischbein expects other UC Health specialties to begin using PQRI soon, but adds that preparing for this initiative is not simple.

“Changes must be made to the electronic medical record, and then there are edits on the billing side,” she says. “It’s a tremendous amount of work, but we think it serves as an important ‘self-check’ as we work to offer the highest quality of care.”

Learn more about PRQI at .

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