A national database will be switched on later this summer to begin receiving clinical information from hundreds of physicians in four states as the CMS' Doctor's Office Quality-Information Technology project moves forward.
Mark Hennessey, director of marketing and business development for the Iowa Foundation for Medical Care, told attendees at the recent 2005 TEPR healthcare trade show in Salt Lake City that the physician office clinical data warehouse where information for the program will be stored should be up and running by September. The foundation is developing the data warehouse and is serving as a program liaison with IT vendors under contract with the CMS.
The Doctor's Office Quality-Information Technology project, or DOQ-IT, is a two-year program that will demonstrate how to improve the quality of care, patient safety and efficiency of services to Medicare patients through the effective use of healthcare IT, particularly electronic medical-record systems.
During an afternoon of presentations about DOQ-IT at the TEPR show, Hennessey outlined progress so far. Some healthcare IT systems vendors are testing their products now to send DOQ-IT program information electronically to the warehouse, he says.
Vendors can apply for certification that their software can handle DOQ-IT data through the Certification Commission for Health Information Technology, or CCHIT, a private-sector group that will test electronic medical records and other healthcare IT systems to ensure they meet minimum standards of effectiveness and have the capacity to communicate with other systems.
"We will rely on CCHIT to certify that a vendor's application can handle DOQ-IT data transmissions," Hennessey says. Physicians can report data to the warehouse daily, weekly or monthly, but data analysis and reports back to the practices will be performed monthly, he says.
The demonstration will be run in Arkansas, California, Massachusetts and Utah, where physicians who volunteer for the program will use clinical performance measures developed by the CMS and the American Medical Association's Physician Consortium for Performance Improvement in five healthcare categories: hypertension, coronary artery disease, preventive care, diabetes and heart failure.
Practices don't have to gather and report data on all of the performance measures, which allows them to focus on areas that fit their practices and where they believe they have strengths or need improvement, Hennessey says.
John Weir, senior project manager at Lumetra, the California quality-improvement organization under Medicare that will oversee the DOQ-IT program in that state, says 80% of participating physician groups will have 10 physicians or fewer and won't be required to have an EMR system to be accepted, at least at first.
"We do expect them, when they don't have one, to select and acquire a system within 12 months," he says. Vendors, for their software to be eligible for the program, also must sign letters of intent that they will make their systems capable of transmitting data for 38 measurements electronically.
One goal of the program is to help physicians prepare for using an EMR, preparing data, receiving feedback and applying the information to improve care.
HealthInsight, a Utah quality-improvement organization, three years ago began recruiting a target group of physician practices to work on a data-driven quality improvement program, says Sharon Donnelly, the organization's DOQ-IT project manager.
Today, it has identified 150 groups. Donnelly says HealthInsight won't recommend a specific EMR product, but it will help groups perform a self-assessment to determine whether they are ready to adopt an EMR system, and help them plan and set goals for the system, select one and implement it.
For now, the DOQ-IT program provides no financial incentives for physicians to install or maintain healthcare IT systems, although Donnelly says she thinks that will happen in the future.
"In the long run, I believe that's how they (the CMS) are going to incent(ivize) people," she says.