How Can Gastroenterologists Keep Up With Quality Reporting Requirements?

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Two gastroenterologists discuss quality reporting requirements in the field and how to actively maintain compliance.

Ask a Gastroenterologist is a weekly series of questions posed to GI physicians around the country on business and clinical issues affecting the field of gastroenterology. We invite all gastroenterologists to submit responses. Next week's question: How can gastroenterologists keep up with quality reporting requirements in the field?

Please submit responses to Carrie Pallardy at This email address is being protected from spambots. You need JavaScript enabled to view it. by Thursday, May 8, at 5 p.m. CST.

Dr. James LeeJames Lee MD, AGAF, St. Joseph Hospital, Orange, Calif.: Gastroenterologists, like other physicians, are encouraged to improve quality of care with rising health cost in mind. One of the ways to achieve this goal is to require gastroenterologists to report certain quality measures to set standardized benchmarks in endoscopy practices.

To address some of these issues in 2009, the American College of Gastroenterology and the American Society for Gastrointestinal Endoscopy jointly established the non-profit educational and scientific organization, the GI Quality Improvement Consortium.

GIQuIC objectives include:
 
•    Establishment of a national endoscopy data repository for storage and maintenance of endoscopy quality measures for GI endoscopists who want to document and improve their endoscopy performance
•    Provide benchmarking reports to participating physicians and facilities to support their quality improvement initiatives
•    Identify gaps in care and develop endoscopy quality indicators to address gaps.

The GIQuIC registry was built and maintained by Quintiles Outcome.

Among the many quality measures tracked in GIQuIC are the following; adenoma detection rate, cecal intubation rate, quality of  bowel prep, appropriate specimen acquisition in Barrett's esophagus, adequate surveillance interval for patient with Barrett's esophagus, management of bleeding esophageal varices, appropriate anticoagulation management, appropriate antibiotic prophylaxis and adverse events reporting. These may serve as templates for each gastroenterologist to reflect on his or her own practice.

As value-based reimbursement begins to dominate the payment landscape, bundled payments for distinct procedures will become more common in GI practices. These may include a "surgical warranty" that covers the practice professional fees incurred by patients if a complication occurs. This may be an additional motivation to provide high quality care by tracking of quality and safety of procedures. One way to improve in this area may be an adoption of automated tracking system. To quote a recent article written by Francis et al in the Journal of Clinical Gastroenterology and Hepatology, "As in other industries, it is to our benefit to be innovators and early adopters of processes that will improve the quality of care that we provide."

Patrick TakahashiPatrick Takahashi, MD, CMIO and Chief of Gastroenterology Section of St. Vincent Medical Center, Los Angeles: Reporting requirements for gastroenterologists will become a necessary measure as regulatory agencies start to really look at best practice guidelines. For instance, looking at cecal intubation and withdrawal times, quality of preparation during colonoscopy, etc., will need to be reported consistently in order to meet value-based medicine standards.  

EHRs and documentation devices can suggest data elements which need to be entered, thus allowing physicians to remain in compliance, while having a database where the data can be easily accrued and sent off to respective locales on demand. The right choice for an EHR is paramount for both your endoscopy center and office going forward. Maintaining membership in respective national organizations such as the ASGE and ACG will also assist in receiving pertinent news regarding new regulatory guidelines that will be flooding our practices in the near future.  

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