Rheumatologists can and should leverage the investments that the ACR has already made in the quality area, including utilizing emerging technology, she concluded. “Quality-measure testing requires multidisciplinary input, and the information gathered must be feasible, valid, and useful,” she said. “Standardizing clinically rich data will minimize the burden for clinicians in chart review and will lead to quality improvement. Rheumatologists will be increasingly rewarded, and they will improve their patients’ outcomes.”
Demonstrate Quality
Rheumatologists should incorporate new quality measures to show their worth and respond aggressively to a financial healthcare crisis, said Eric Newman, MD, director of the department of rheumatology at the Geisinger Health System in Danville, Pa. Rising costs in healthcare will create a shift toward new, less costly models of care, Dr. Newman said. He described a future system where primary-care physicians might care for the bulk of rheumatology patients.
“Before you throw tomatoes at me, let me just ask: Are rheumatologists part of the team? Everything we do can technically be done by primary care. We prescribe drugs, they prescribe drugs. We inject joints, they inject joints,” said Dr. Newman. Successful rheumatologists will understand and respect healthcare systems, become a part of an involved healthcare team, implement problem-solving techniques, and measure quality, he said.
He urged his colleagues to create a team model to provide comprehensive patient care, and to utilize new technology. Dr. Newman helped developed the Patient Centric Electronic Redesign, a platform that collects and measures rheumatology patient data. Most importantly, rheumatologists must abandon the older, hierarchical model of care where the doctor sat at the top of a pyramid. This model creates separate reporting lines and no forum for quality and process improvement, he said. He advised the audience to embrace a new, collaborative model where problems are solved as a team. “Redesign your care team and empower them,” he said. “Your best ideas will not come from your physicians.”
Measuring patient outcomes will help rheumatologists and their teams improve patient care, Dr. Newman said. “You don’t understand what you don’t measure, and the pearl is that you can quantify success as you succeed.” Quality measurement tools can provide “real-time data, objective measures, and we get to see them in the context of the care we are giving,” he said.
Harness the Web
Rheumatologists must take advantage of the data from existing web-based tools to implement evidence-based quality measures, said Salahuddin Kazi, MD, associate professor of internal medicine at the University of Texas Southwestern Medical Center in Dallas. More effective, rheumatology-specific electronic health record (EHR) programs or platforms are needed, he said.