The concept is for diplomates’ offices to give a card to a certain number of consecutive patients, who will then have the information needed to complete the survey.
Explore this issue:January 2012
The peer survey is still under development. It’s not been decided who exactly would be considered a peer.
“There are strengths and weaknesses in asking non-otolaryngologists to respond and using that as a measure,” Dr. Miller said. He said some boards use a “360 type of survey” with input from people like a hospital’s chief of staff, the head nurse of the operating room or referring doctors.
“We’re in the process of still deciding who will be surveyed,” he said. “We want to make sure that it’s meaningful.”
The most complex piece of Part IV would be the third component, which will involve entering patient information into a registry. This phase would be designed to help physicians meet the requirements of CMS Patient Quality Reporting System (PQRS), in which doctors can have a percentage added to their Medicare reimbursements if they report their data. Eventually, there will be a penalty for not reporting the data.
The Affordable Care Act includes a provision that provides a 0.5 percent bonus, above the PQRS bonus, if a doctor participates in “enhanced Part IV.” How “enhanced Part IV” is defined is still up in the air, but Part IV of MOC is being designed to help meet those requirements, he said. “We’re going to set them up… as much as we can such that whatever they enter will also meet PQRS requirements, so they wouldn’t have to enter the de-identified data twice,” Dr. Miller said.
The registry interface will include modules based on specialty areas, with three or four conditions for each specialty area.
“The diplomate will enter data on a series of patients with a particular condition,” Dr. Miller said. “They will select a condition that they see with some frequency. There will be an online form [on which] they will enter five to ten elected data points about those patients. The diplomate’s data will be compared to national standards and results of others filling out the same forms.”
Then areas of improvement would be identified, leading back to the beginning of the cycle. This is proving to be the most challenging component to design, Dr. Miller said.
“What are the conditions that we should measure in each specialty area and within each condition?” he said. “What are the specific fields that we should collect data on?” ABOto is working with the specialty societies to answer these questions.