IM Quality Measures™

IM Quality Measures™

For those of you already familiar with the module, here is a quick measure status color coding refresher:

Green is good! You're done with this measure and you met the recommended quality guidelines!

"Go for the green - it helps the team!"

Yellow means you're not done yet! There are still unanswered questions for this measure!

"Don't settle for yellow - ask the fellow!"

Red is bad! You're done with this measure, but you may want to go back, address your treatment deficiencies if possible, then change your answers to relect your improved performance!

"Red is bad - it makes patients sad!"

For new users, please see the full documentation for the module that follows. There is also a training video showing how the module works at the bottom of this page.

Purpose:
The IM Quality Measures™ module prompts physicians during the the course of their normal billing, to assist them in documenting and reporting their performance on standardized quality of care measurements. Currently, these measures are defined by the 2007 Physicians Quality Reporting Initiative (PQRI).

Measure Selection/Activation:
A predetermined list of CPT/ICD combinations (or CPTs alone, in some cases) have been flagged for quality measure tracking during the 2008 PQRI reporting period. Of the 119 measures constructed by CMS, 10 will initially be available for reporting in the IM Quality Measures™ module (additional measures may be added throughout the reporting period). Individual practices may elect to report on any number of those 10 measures, and your administrator should be able to inform you about which measures have been activated for your group.

Functions:

Measure Data Entry
Measure Questionnaire

When a bill is saved containing a CPT/ICD combination that requires further documentation related to the performance of an active quality measure, a measure pop-up window will appear to alert the user a measure has been triggered. A short list of qualifying questions may need to be answered to determine whether or not the patient truly qualifies for the measure being tracked, but any qualifying questions for which data already exist within the IM Practice Manager™ database will be answered automatically. Based on the answers provided in the qualifying question(s), the appropriate measure questions (if any) will then appear. A "Details" button will appear to the right of each measure title, which provides an in-depth description, rationale, and the clinical recommendation statements for the measure.

The answer for all questions (qualifying or measure) will always default to "Unknown" initially, and users may defer any question by leaving "Unknown" as the answer when saving the measure questionnaire pop-up window. Any measure questions that are deferred will continue to appear for consideration each time an existing bill is edited or a new bill is created for that patient. Only deferred/unanswered measure questions will appear in the measure pop-up initiated by the entry of or editing of a bill.

Each time a patient is selected from the patient list, the measure tests will re-screen that patient for applicable measures (to determine if measure definitions or patient qualifications for a measure may have changed in relation to any existing bills). If new measures are found to apply, the Quality Measures tab (described below) will change color to indicate there are unanswered questions. If previously triggered measures no longer apply, the measure data will automatically be removed. If the editing of a bill results in a previously triggered measure no longer applying, those questions and answers will be automatically removed from the system as well. Deleting a bill also results in the deletion of data related to any measures initially triggered by that bill.

Measure Status Review
The status of each measure will be indicated by a status icon and color coding system:

	Green indicates the measure questionnaire has been completed and indicates satisfactory quality performance (i.e. "all of the measure questions have been answered, and the questionnaire answers confirm I performed - and documented the performance of - the recommended quality of care benchmark in the course of treatment, or I did not perform the quality of care benchmark due to documented circumstances that rendered it inappropriate").
	Yellow indicates the measure questionnaire is incomplete (i.e. "I was not sure of the questionnaire answer(s), so I have not yet been able to verify performance of the quality of care benchmark"). Performance of the quality of care benchmark will be assumed to have been omitted if the measure is not completed by the time the bill that triggered the measure is submitted.
	Red indicates the measure questionnaire has been completed, but indicates unsatisfactory quality performance (i.e. "all of the measure questions have been answered, and I have confirmed I did not perform the recommended quality of care benchmark in the course of treatment, and have not documented any circumstances that rendered it inappropriate").

The Quality Measures tab is located just to the right of the "Charges" and "Demographics" sub-tabs on the main "BILLS" tab, and the color of the Quality Measures tab will serve as an alert system, indicating the status of measures triggered for that patient. If there have been no measures triggered for the patient, the tab label will be grayed out, and the tab background will have no color. If there is only one measure for the patient, the tab coloration will simply match the status coloration of that measure. If there are multiple measures, however, the status tab coloration will reflect the status of the measures according to a hierarchy of urgency. Incomplete questionnaires (yellow) are considered the most urgent (since they are potential positive results that will be reported as negatives if left unanswered), so any combination of measure states that include at least one incomplete measure will result in a yellow Quality Measures tab. Complete measure questionnaires reflecting unsatisfactory quality performance (red) have the second highest priority (since they alert physicians to the possibility of poor quality performance), so any group of measures that have at least one red measure state and no yellow measures will result in a red Quality Measures tab. Therefore, the Quality Measures tab will only be green when all applicable measure questionnaires have been completed and they all indicate satisfactory quality performance.

Measure Status Pop-up

Mousing over the Quality Measures tab will open a status overview pop-up window, showing the date, status, and description of each measure triggered for that patient. The status overview pop-up window allows users to quickly review the status of each measure triggered for the patient, which will clarify how the status/coloration of individual measures relate to the current coloration of the Quality Measures tab. A yellow entry with a measure description of "Age Unknown" will appear when a qualifying question related to patient age was left unanswered (so the system has not yet been able to evaluate measure applicability). Moving the mouse from the Quality Measures tab will close the status overview pop-up window.

Measure Data Review
Clicking on the Quality Measures tab will open the IM Quality Measures™ questionnaire history for that patient. That version of the questionnaire window (as opposed to the one that appears during billing, which only has unanswered questions listed) will show all measure questions generated for the patient to that point (both answered and unanswered). Answers will be editable for all questions there unless the bill initiating that measure question has already been sent (in which case the measure answer has already been sent as well, and can no longer be changed).

Video of the IM Quality Measures™ Module in Action:
(Depending on your computer system, you may need to grant Internet Explorer permission to use Active-X Controls and/or the Windows Media Player extension to view the video. Look for a small message bar at the top of this window asking for your decision and grant permission through the options available there.)

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