|
|
December 11, 2006
The Medical Group Management Association (MGMA) is turning to the Internet to boost both the clinical and administrative acumen of its membership. At the organization’s annual conference in Las Vegas last month, the Englewood, Colo.-based MGMA unveiled an online tool for office-based physician groups to scrutinize their medical processes for safety risks and another to test the decision making of practice managers. The latter, called the Physician Practice Patient Safety Assessment available at www.physiciansafetytool.org, reviews ambulatory clinical pathways and protocols for potential patient safety risks and allows practices to submit their results to a database for benchmarking purposes. On the management side, the Medical Practice Simulation lets users act as the newly hired administrator of a 12-physician, primary care practice. As a means of improving management skills, the five-week exercise simulates business and personnel issues an executive would face over a three-year period. The simulation, based on historical data collected in MGMA surveys, is “way cool,” according to MGMA’s president and CEO, William F. Jessee, MD. “You can crash and burn the practice without getting fired,” he said. For a fee of $595 for MGMA members or $659 for nonmembers, users receive all course materials, weekly performance updates, and American College of Medical Practice Executives (ACMPE) educational credit. Registration for the next five-week course closes January 8. More information is available at www.mgma.org/pd/default.aspx?id=6772. The other new online resource, the Physician Practice Patient Safety Assessment, is free for those wishing to download a PDF version and fill out the questionnaire on paper. The online survey costs $200, but practices can submit their results electronically to a central database and receive aggregated scores from other practices for performance comparison. MGMA officials said the assessment is intended to help practices identify areas needing improvement, set a baseline to measure future progress, minimize exposure to malpractice liability, and, above all, deliver better care. Jessee said the organization has had conversations with a small number of medical liability insurers about the possibility of reducing premiums to practices that can demonstrate excellence. He declined to comment on whether any insurer was ready to start offering discounts but did say the MGMA’s legal counsel mentioned the possibility that the self-assessments could raise liability issues for some practices. Jessee advised practices to take self-assessment results seriously and be proactive in addressing any shortcomings. More than 200 physician practices tested the safety assessment prior to launch under a grant from The Commonwealth Fund. Also participating in the development were the Health Research and Educational Trust—a research affiliate of the American Hospital Association—and the Institute for Safe Medication Practices. Currently, the tool presents approximately 80 questions across five domains: medications; handoffs and transitions; surgery and anesthesia; human resources; and communication with and education of patients. An example is whether the practice is timely in communicating test results to patients and then confirms and documents that results have been received. The groups plan on expanding the assessment by asking practice managers what other kinds of safety-related clues they hope to discover in their practices and by using the benchmarking data to implement new safety measures. “The next step is to make available a large amount of tools,” said MGMA senior fellow Terry Hammons, MD. In other conference news, several trends identified by the MGMA may bode well for advancing the adoption of IT among physicians. According to an annual MGMA survey, IT costs for multispecialty practices increased 10.9% in 2005 to $10,093 per full-time physician. “We think this is a reflection of increased investments in information technology despite the operating climate,” Jessee said. The rise of pay for performance and other quality-based reimbursement plans should also push IT uptake. In his annual “state of healthcare in the U.S.” speech, Jessee said talks with the Centers for Medicare & Medicaid Services and others suggest that pay for performance eventually could make up 25% of physician income. “The time to start preparing for change is now,” Jessee said. “You need to be able to measure the performance of physicians in your practice using national quality measures.” He added, “Clearly, the likely expansion of pay
for performance is another reason to give serious consideration to making
an investment in electronic medical records.” Other factors suggesting a bull market for clinical IT is imminent include the new certification program for ambulatory electronic health records (EHRs) and Health and Human Services’ (HHS) relaxation of the Stark physician self-referral and Medicare anti-kickback rules to allow hospitals to provide EHR software to physicians. Still, the MGMA is telling its members to evaluate multiple systems, not just blindly accept whatever a hospital happens to offer. Meanwhile, the organization continues to push for legislation that would codify the Stark and antikickback exemptions as well as extend the safe harbors to hardware and network infrastructure. One bill the House of Representatives is considering would remove the requirement set by the HHS that physician practices contribute 15% of the cost of a donated EHR, according to MGMA Government Affairs Manager Robert Tennant. Many in the industry have said, however, that such a provision gives physicians a sense of ownership and thus an incentive to use the EHR, since something free often is perceived as having little value. — Neil Versel is a journalist in Chicago specializing
in HIT.
|
 |