January 31, 2006

New NCQA Standards Promote Information Systems to Improve Clinical Quality in Doctors’ Offices; ABIM to Survey Board-Certified Internists Against the Standards

Cisco, Intel, Oracle, other Silicon Valley employers to reward doctors who meet Physician Practice Connections standards

WASHINGTON—The National Committee for Quality Assurance (NCQA) today released updated standards for Physician Practice Connections, a program that recognizes medical practices that make systematic use of clinical information to deliver excellent patient care. The American Board of Internal Medicine (ABIM) will incorporate PPC standards into its Maintenance of Certification program for 180,000 Diplomates.

The collaboration promises to introduce the program, and provide consistent guidance for quality improvement efforts using a harmonized set of measures, to a significant number of doctors over the next several years. Approximately 12,000 ABIM-certified physicians annually apply to maintain their certification; Maintenance of Certification is required once every 10 years. There are currently 124 PPC-Recognized practices nationwide, representing more than 1,400 physicians. The practices range in size from large to small; over half of all PPC-Recognized practices comprise four or fewer doctors.

Additionally, Cisco, Intel, Oracle, and other leading Silicon Valley technology firms today announced the formation of a consortium of employers, medical groups and independent practice associations (IPAs) that will reward doctors who meet PPC standards. The Silicon Valley Pay-for-Performance Consortium brings together some of the largest medical groups and IPAs in Northern California, including Camino Medical Group, Kaiser Permanente, Palo Alto Medical Foundation, San Jose Medical Group, Santa Clara County IPA, Santa Cruz Medical Foundation and Stanford Hospital and Clinics.

“Patients don’t see an electronic registry or practice-wide quality assessment when they visit their doctor,” said NCQA President Margaret E. O’Kane. “But they see a reminder to come in for a blood pressure check or an e-mail with lab results. This is the sort of follow-up that PPC-Recognized physicians perform every day—and patients notice and appreciate the difference.”

“Doctors who meet the PPC standards turn the wealth of patient data contained in their charts into a powerful asset that can mean the difference between managing a patient’s health and treating a patient’s symptoms,” said ABIM Executive Vice President F. Daniel Duffy, M.D. “These standards are a solid blueprint for doctors that want to create productive, evidence-based practice systems to serve their patients.”

NCQA’s Physician Practice Connections program has generated significant interest since its launch: the first version was developed for the employer-driven Bridges to Excellence pay-for-performance program, which uses it as the basis for paying rewards to doctors in several metropolitan areas. “Good medicine, at its heart, is getting the right information and using it to deliver the right care at the right time,” said Robert S. Galvin, M.D., Director of Global Healthcare, General Electric Corporation. “Doctors who use IT leverage the information they already have to improve their office processes and patient outcomes. As purchasers, we need to not just recognize, but reward doctors who take such a systematic approach—and encourage those that don’t to follow suit.”

Physicians also applauded the new standards. “The Physician Practice Connections program provides a framework for physicians to step back, assess their practices, and plan the necessary steps to redesign office systems,” said Bruce A. Bagley, M.D., Medical Director for Quality Improvement at the American Academy of Family Physicians. “Practices that achieve this recognition are likely to score better on clinical performance measures, patient satisfaction and financial metrics.”

The public sector has also voiced its support for the PPC program. On Capitol Hill, the program has been cited by the Medicare Payment Advisory Commission (MedPAC). The new program standards align with MedPAC’s call for measures assessing the use of IT in physicians’ quality improvement efforts. In a recent report to Congress, MedPAC recommended further development of clinical process measures such as those in PPC. The report also called for collaboration between the public and private sectors to expand their adoption in the health care marketplace.

Several recent studies, including the Institute of Medicine’s Fostering Rapid Advances in Health, have shown that use of electronic information systems help improve health care quality, enhance patient safety and reduce waste; yet such systems remain rare in today’s health care system, found in only about 15% of physician practices.

The revised PPC standards have been fine-tuned to make them consistent with other public and private initiatives promoting the adoption of practice-wide quality measurement and information technology in doctors’ offices. Under the new standards, physicians will be awarded Recognition at one of three levels based upon the number of standards they meet. The standards assess whether physicians:

• follow standards of care that are based on medical evidence,
  
• provide good access to patients seeking appointments, and by being available either on the telephone or through E-mail,
  
• maintain patient registries (lists of patients by diagnosis) for the purpose of measuring clinical quality practice-wide and identifying at-risk patients for appropriate follow-up;
  
• provide educational resources to patients to help them self-manage their conditions,
  
• use electronic systems to gather information about patients, maintain patient records, provide decision support, enter orders for prescriptions and lab tests and provide automated reminders about services or tests that patients need, and
  
• use electronic systems that interoperate with other systems using nationally accepted code sets to send, receive and integrate data such as test results from other organizations’ systems.

A searchable database of over 1,400 PPC-Recognized physicians is available online at http://recognition.ncqa.org. Physicians or others seeking more information about the program are encouraged to visit the NCQA PPC Web page.

NCQA is a private, non-profit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations and physicians. NCQA provides health care quality information free of charge through the Web and media in order to help consumers, employers and others make more informed health care choices.