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PQRS: Making Transparency in Healthcare Work for You

Posted by Jerry Stone on Aug 8, 2016 2:23:00 PM

transparency in healthcareAccording to the Centers for Medicare & Medicaid Services, the Physician Quality Reporting System is, "a quality reporting program that encourages individual eligible professionals (EPs) and group practices to report information on the quality of care to Medicare. PQRS gives participating EPs and group practices the opportunity to assess the quality of care they provide to their patients, helping ensure that patients get the right care at the right time."

PQRS can also be used to encourage cookie-cutter treatment, a potential consequence that every healthcare facility must overcome. If the system is poorly used, it can make previously careful doctors put data extraction and expected protocols over patient well being. This doesn't happen because the system itself is defunct, but rather because PQRS is not used in a patient-centric way.

Using PQRS to Achieve Transparency in Healthcare

Before the IT world rose to its current ranks, patients were expected to choose risky surgeries based on less information than they collected when buying a home or choosing a school. Now that quality information is at their fingertips, they’re able to shop around for health care according to cost, outcome, and other factors. Quality measurements were intended to deliver reduced mortality rates, but information technology is not without its problems. Atypical patients should always be at the forefront of physicians’ minds when using the system.

Treat the Patient, Not the Numbers

The human tendency to treat numbers instead of patients has already been underlined by the way some laboratory results are handled. Efforts to treat people instead of data will thus not be a new skill to acquire, but merely one that must be channeled in new ways.

Patient Input

Patients have incredible value in the quality-reporting field. Their input can be used to guide reporting and the use of public records can offer enough transparency to drive future action. CMS’ purpose is to set a national quality strategy, not to highlight poor quality care. It’s thus critical that actionable goals be set and strategies for improvement be created. Negative data shouldn’t be feared. Instead, it should be viewed as an opportunity to move forward more efficiently in the future. The level of information patients and caregivers offer can prevent progress, so their participation must be actively encouraged.

Internal and External Data Usage

Analytics are only useful if they’re adapted to the correct audiences. While public records have the power to improve transparency in healthcare, raw data are useless. Performance information must be churned into something meaningful for every audience, from healthcare providers to patients.

CMS wants caregivers and patients to play a more active role in their care; a goal that can only be achieved in a transparent healthcare environment. Patient empowerment improves clinical outcomes within as little as a year, and mobile apps and partner websites can be used to support this by offering properly processed quality reporting data on accessible media. Physicians are equally useful in deciding how performance data can be tailored directly to their needs.

Ironically, the only way to develop an efficient database is by treating each patient as an individual, and allowing every patient the opportunity to provide feedback. Inadequate data fails to make room for challenging cases.

Initially, the process of collecting information demands that physicians spend more time with their patients than they ordinarily would, but ultimately, as long as analytics are used as frameworks alone, consultation times should speed up and outcomes improve. These comprehensive analytics can then be made available as part of patient empowerment efforts, achieving a level of transparency in healthcare that was once well nigh impossible.

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