Improvement in Stroke Performance Measures

Abstract

> Trust but verify. > > —Ronald Reagan Collecting and monitoring performance measure data are resource-intensive, requiring time and effort by a team that includes health care providers treating the patients and documenting their care, quality personnel monitoring and working to optimize performance rates, and quality abstractors, who extract information from the medical record. Recently, an additional group of people have become involved, informatics personnel, who strive to extract information electronically and improve performance measure adherence rates through improved electronic health record (EHR) functionality such as documentation templates and electronic reminders. Article see p 503 With the increased focus on measuring processes and outcomes of care, performance measurement will become increasingly widespread.1–3 The National Quality Forum (NQF), the nonprofit organization created to help improve the quality of health care,4 continues to endorse new measure sets. The Centers for Medicare and Medicaid Services (CMS) Voluntary Pay for Reporting Initiative, which began in 2005 with the voluntary hospital-based collection of 10 NQF-endorsed measures, continues to expand, with 76 measures planned by 2014.1 In addition to the increased burden of data collection, the stakes for performance are rising—the CMS “Pay for Reporting” program has become “Pay-for-Performance,” with reimbursement linked to adherence rates.5 Stroke, one of costliest conditions for Medicare and a leading cause of disability and mortality,6 has been a focus for performance measurement activities. Eight NQF-endorsed stroke performance measures are currently used as part of the voluntary Joint Commission Primary Stroke Center certification and will be part of the CMS Hospital Inpatient Prospective Payment System program beginning with 2013 stroke hospital discharges.1 In addition, collection of 7 stroke performance measures using certified EHR technology is required if hospitals wish to qualify for incentive payments through the CMS Electronic Health Record Meaningful Use Incentive program.7 Given the increased concentration …