Abstract
BackgroundSuccessful implementation of pay-for-quality (P4Q) programs mostly depends upon a valid, timely, and reliable data about quality measures generated by providers, and interpreted by payers. The aim of this study was to establish a data reporting method for P4Q program through an action research.MethodsQualitative method was used to align theory with action through a three-cycle action research. The study was conducted in September 15, 2015 to March 15, 2017, in East-Azerbaijan, Iran. The purposeful sampling was used to select participants. The participants included healthcare providers, staff in district health centers (DHC), experts, and managers in the provincial primary health center (PPHC). Data was collected by interviews, focus group discussions, and expert panels. Content analysis was used to synthesize the data. In each step, decisions about data reporting methods were made through a consensus of expert panel members.ResultsThe most important dimensions of data reporting method were data entry and accuracy, data reporting, data analysis and interpretations, the flexibility of method, and training. By establishment of an online data reporting system for the P4Q program, a major improvement was observed in the documentation of performance data, the satisfaction of health care providers and staff (e.g. either in DHCs or PPHC), improvement of the P4Q program and acceptance of the P4Q program by providers. Following the present study, the online system was expanded in Iran’s public health system for data collection and estimating the amount of incentive payments in P4Q program. Moreover, more improvements were achieved by linking the system to EMRs and also, providing automated feedback to providers about their own performance.ConclusionsA web-based computerized system with the capability of linking medical record and also its ability to provide feedback to healthcare providers was identified as an appropriate method of data reporting in the P4Q program from the viewpoints of participants in this study.
Highlights
Successful implementation of pay-for-quality (P4Q) programs mostly depends upon a valid, timely, and reliable data about quality measures generated by providers, and interpreted by payers
Recent studies have confirmed the worldwide interest in Pay-for-Quality (P4Q) program as a promising initiative to improve the quality of health care [1,2,3]
In action research steps, existing documents in district health centers (DHC) were reviewed in addition to three qualitative methods including interview, focus group discussion (FGD), and expert panel
Summary
Successful implementation of pay-for-quality (P4Q) programs mostly depends upon a valid, timely, and reliable data about quality measures generated by providers, and interpreted by payers. In the UK, acquiring minimal information technology (IT) standards has been designated as an eligibility criterion for participation in the quality payment program [13] Developing countries such as Iran have infrastructure problems and the use of IT is very limited in healthcare. Some of the main problems about the adoption of IT in Iran’s health system [14] are lack of standardized e-health applications, deployment and training barriers, and privacy and security concerns [15] Such basic problems affect the successful implementation of programs like the P4Q program that are largely depend on IT for data reporting. This study aimed to establish data reporting method for the P4Q program in Iran’s public health system based on viewpoints of stakeholders in district health centers (DHCs and PPHC)
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