Kohli Marc, Schonlau Duane
University of California San Francisco-Radiology, 505 Parnassus Avenue M-391, San Francisco, CA, 94143, USA.
Mayo Clinic-Radiology, Jacksonville, FL, USA.
J Digit Imaging. 2016 Jun;29(3):297-300. doi: 10.1007/s10278-015-9835-z.
As part of its ongoing effort to improve healthcare quality, the Center of Medicare and Medicaid Services (CMS) has transitioned from monetary rewards to reimbursement penalties for noncompliance or nonparticipation with its quality measurement initiatives. More specifically, eligible providers who bill for CMS patient care, such as radiologists, will face a 2 % negative payment adjustment, if they fail to report adequate participation and compliance with sufficient CMS quality measures in 2015. Although several methods exist to report participation and compliance, each method requires the gathering of relevant studies and assessing the reports for compliance. To aid in this data gathering and to prevent reduced reimbursements, radiology groups should consider implementing automated processes to monitor compliance with these quality measure standards. This article describes one method of creating an automated report scanner, utilizing an open source interface engine called Mirth Connect, that may facilitate the data gathering and monitoring related to reporting compliance with CMS standard #195 Stenosis measurement in Ultrasound Carotid Imaging Reports. The process described in this article is currently utilized by a large multi-institutional radiology group to assess for report compliance and offers the user near real time surveillance of compliance with the quality measure.
作为持续提升医疗质量工作的一部分，医疗保险和医疗补助服务中心（CMS）已从对合规或参与其质量衡量举措给予金钱奖励，转变为对不合规或不参与进行报销处罚。更具体地说，为CMS患者护理计费的合格提供者，如放射科医生，如果在2015年未能报告足够的参与情况以及对足够数量的CMS质量指标的合规情况，将面临2%的负支付调整。尽管存在多种报告参与情况和合规情况的方法，但每种方法都需要收集相关研究并评估报告的合规性。为协助进行这种数据收集并防止报销减少，放射学小组应考虑实施自动化流程来监控对这些质量指标标准的合规情况。本文介绍了一种利用名为Mirth Connect的开源接口引擎创建自动化报告扫描器的方法，该方法可能有助于收集与报告符合CMS标准#195（颈动脉超声成像报告中的狭窄测量）相关的数据并进行监控。本文所述的流程目前被一个大型多机构放射学小组用于评估报告的合规性，并为用户提供对质量指标合规情况的近实时监测。
