Skip to main content
Sister Publication Links
  • ESG: THE NEW IMPERATIVE
Subscribe
  • My Account
  • Login
  • Subscribe
  • News
    • Current News
    • COVID-19
    • Providers
    • Insurance
    • Government
    • Finance
    • Technology
    • Safety & Quality
    • Transformation
    • People
    • Regional News
    • Digital Edition (Web Version)
    • Patients
    • Operations
    • Care Delivery
    • Payment
    • Midwest
    • Northeast
    • South
    • West
  • Digital Health
  • Insights
    • ACA 10 Years After
    • Best Practices
    • Special Reports
    • Innovations
  • Data/Lists
    • Rankings/Lists
    • Interactive Databases
    • Data Points
  • Op-Ed
    • Bold Moves
    • Breaking Bias
    • Commentaries
    • Letters
    • Vital Signs Blog
    • From the Editor
  • Awards
    • Nominate/Eligibility
    • 100 Most Influential People
    • 50 Most Influential Clinical Executives
    • Best Places to Work in Healthcare
    • Excellence in Governance
    • Health Care Hall of Fame
    • Healthcare Marketing Impact Awards
    • Top 25 Emerging Leaders
    • Top 25 Innovators
    • Diversity in Healthcare
    • Women in Healthcare
    • - Luminaries
    • - Top 25 Diversity Leaders
    • - Leaders to Watch
    • - Luminaries
    • - Top 25 Women Leaders
    • - Women to Watch
  • Events
    • Conferences
    • Galas
    • Virtual Briefings
    • Webinars
    • Custom Media Event: ESG Summit
    • Transformation Summit
    • Women Leaders in Healthcare Conference
    • Social Determinants of Health Symposium
    • Leadership Symposium
    • Health Care Hall of Fame Gala
    • Top 25 Women Leaders Gala
    • Best Places to Work Awards Gala
    • Top 25 Diversity Leaders Gala
    • - Hospital of the Future
    • - Value Based Care
    • - Supply Chain Revenue Cycle
    • - Hospital at Home
    • - Workplace of the Future
    • - Strategic Marketing
    • - Virtual Health
  • Listen
    • Podcast - Next Up
    • Podcast - Beyond the Byline
    • Sponsored Podcast - Healthcare Insider
    • Video Series - The Check Up
    • Sponsored Video Series - One on One
  • MORE +
    • Advertise
    • Media Kit
    • Newsletters
    • Jobs
    • People on the Move
    • Reprints & Licensing
MENU
Breadcrumb
  1. Home
  2. Providers
December 17, 2013 12:00 AM

GAO report says CMS' rule on quality reporting system may be too vague

Andis Robeznieks
  • Tweet
  • Share
  • Share
  • Email
  • More
    Reprints Print

    A new CMS rule on clinical data registries aimed at boosting participation in its Physician Quality Reporting System could be too vague to provide meaningful data but, according to a new U.S. Government Accountability Office report (PDF), one solution could be to require electronic health-record vendors to develop products that make it easier to extract the data that registries use.

    Some viewed the flexible approach the CMS took in developing its rule on the clinical data registry program as increasing the opportunities for physicians—specialists in particular—to participate in the PQRS. But the GAO said otherwise.

    The new rule was in response to congressional mandates included in the last-minute deal reached to avert the fiscal cliff last year. That legislation, the American Tax Relief Act of 2012 also ordered the GAO to study how registries could improve healthcare quality and efficiency.

    The GAO reviewed studies assessing the impact of registries, interviewed officials from organizations operating existing registries, convened an expert panel to discuss registry requirements and oversight, and reviewed documents and interviewed officials from the CMS and HHS' Office of the National Coordinator for Health Information Technology.

    The agency concluded that the flexible approach may “provide minimal impetus to (clinical data registries) to take full advantage of their specific opportunities to promote the quality and efficiency of care.” Also, the GAO said, the CMS did not provide details on how it would interpret or enforce the program's requirements.

    By collecting large amounts of standardized clinical data over long periods of time, clinical data registries can track and interpret healthcare trends and assess physician performance. For example, the Society of Thoracic Surgeons' national database, which has been collecting data since 1989, has shown that increased use of guideline-recommended treatments has led to lower rates for mortality and postoperative stroke.

    However, the GAO said, exclusive use of clinical data has correlated to a lack of studies that examine efficiency and costs. To address that problem, according to the report, privacy concerns must be addressed so that clinical registry data can be linked to payers' administrative data.

    One exception cited is a Blue Cross and Blue Shield of Michigan report showing how the use of a regional surgical registry led to 2,500 fewer patients suffering surgical complications each year, which translated into an annual savings of $20 million.

    Standardizing data sets collected by EHRs could help. The GAO noted that different EHRs may not differentiate between occasional and heavy smokers. Sometimes the word “pneumonia” may not appear in an EHR, so manual analysis of x-rays, stethoscope breath sounds and other data is required for inputting into a clinical data registry.

    “If CDRs could receive and aggregate electronically extracted data from EHR systems, the need for manual abstraction by trained professional staff could be reduced or eliminated,” the GAO wrote. “Reducing the burden of manual data abstraction could have a number of long-term benefits, including reducing costs for physicians to participate in the CDR, reducing the amount of time a practice spends on CDR data collection activities, and increasing overall participation of physicians in CDRs.”

    Through its meaningful-use program, the GAO recommends that HHS “influence the extent to which EHR systems are designed and implemented to collect data needed by CDRs to assess physician performance.”

    Unless clinical data registries can overcome variations in content, storage and other specifications, they will not be able to take full advantage of an EHR's ability to collect and transmit data, the GAO concluded.

    “Changes to EHR capabilities that would enable them to collect such data within existing standards are clearly feasible, but are not high priorities for providers and IT vendors because they are not included in the current set of meaningful use requirements for the EHR incentive program,” the GAO wrote. “As HHS determines what the next cycle of meaningful-use requirements should comprise, identifying data elements for measures commonly needed by CDRs and including them in meaningful-use requirements could substantially assist qualified CDRs in adapting health IT to make data collection less costly and more timely.”

    Follow Andis Robeznieks on Twitter: @MHARobeznieks

    Letter
    to the
    Editor

    Send us a letter

    Have an opinion about this story? Click here to submit a Letter to the Editor, and we may publish it in print.

    Recommended for You
    Dr. Alex Jahangir
    Q&A with Dr. Alex Jahangir of Vanderbilt Medical Center: 'It really was a big private-public partnership'
    rural-health2_i.png
    Readmissions and rural hospitals
    Sponsored Content
    Modern Healthcare A.M. Newsletter: Sign up to receive a comprehensive weekday morning newsletter designed for busy healthcare executives who need the latest and most important healthcare news and analysis.
    Get Newsletters

    Sign up for enewsletters and alerts to receive breaking news and in-depth coverage of healthcare events and trends, as they happen, right to your inbox.

    Subscribe Today
    MH Magazine Cover

    MH magazine offers content that sheds light on healthcare leaders’ complex choices and touch points—from strategy, governance, leadership development and finance to operations, clinical care, and marketing.

    Subscribe
    Connect with Us
    • LinkedIn
    • Twitter
    • Facebook
    • RSS

    Our Mission

    Modern Healthcare empowers industry leaders to succeed by providing unbiased reporting of the news, insights, analysis and data.

    Contact Us

    (877) 812-1581

    Email us

     

    Resources
    • Contact Us
    • Advertise with Us
    • Ad Choices Ad Choices
    • Sitemap
    Editorial Dept
    • Submission Guidelines
    • Code of Ethics
    • Awards
    • About Us
    Legal
    • Terms and Conditions
    • Privacy Policy
    • Privacy Request
    Modern Healthcare
    Copyright © 1996-2022. Crain Communications, Inc. All Rights Reserved.
    • News
      • Current News
      • COVID-19
      • Providers
      • Insurance
      • Government
      • Finance
      • Technology
      • Safety & Quality
      • Transformation
        • Patients
        • Operations
        • Care Delivery
        • Payment
      • People
      • Regional News
        • Midwest
        • Northeast
        • South
        • West
      • Digital Edition (Web Version)
    • Digital Health
    • Insights
      • ACA 10 Years After
      • Best Practices
      • Special Reports
      • Innovations
    • Data/Lists
      • Rankings/Lists
      • Interactive Databases
      • Data Points
    • Op-Ed
      • Bold Moves
      • Breaking Bias
      • Commentaries
      • Letters
      • Vital Signs Blog
      • From the Editor
    • Awards
      • Nominate/Eligibility
      • 100 Most Influential People
      • 50 Most Influential Clinical Executives
      • Best Places to Work in Healthcare
      • Excellence in Governance
      • Health Care Hall of Fame
      • Healthcare Marketing Impact Awards
      • Top 25 Emerging Leaders
      • Top 25 Innovators
      • Diversity in Healthcare
        • - Luminaries
        • - Top 25 Diversity Leaders
        • - Leaders to Watch
      • Women in Healthcare
        • - Luminaries
        • - Top 25 Women Leaders
        • - Women to Watch
    • Events
      • Conferences
        • Transformation Summit
        • Women Leaders in Healthcare Conference
        • Social Determinants of Health Symposium
        • Leadership Symposium
      • Galas
        • Health Care Hall of Fame Gala
        • Top 25 Women Leaders Gala
        • Best Places to Work Awards Gala
        • Top 25 Diversity Leaders Gala
      • Virtual Briefings
        • - Hospital of the Future
        • - Value Based Care
        • - Supply Chain Revenue Cycle
        • - Hospital at Home
        • - Workplace of the Future
        • - Strategic Marketing
        • - Virtual Health
      • Webinars
      • Custom Media Event: ESG Summit
    • Listen
      • Podcast - Next Up
      • Podcast - Beyond the Byline
      • Sponsored Podcast - Healthcare Insider
      • Video Series - The Check Up
      • Sponsored Video Series - One on One
    • MORE +
      • Advertise
      • Media Kit
      • Newsletters
      • Jobs
      • People on the Move
      • Reprints & Licensing