Qualified Clinical Data Registries: How Wound Care Practitioners Can Make the Most Out of the Merit-Based Incentive Payment System.

Abstract

Significance: Wound care practitioners have no professional society to promote participation in a Qualified Clinical Data Registry (QCDR), which is essential to thrive under the Merit-Based Incentive Payment System (MIPS), and until recently have lacked relevant quality measures to report. Practitioners can now participate in the nonprofit U.S. Wound Registry (USWR) QCDR for MIPS credit, which can receive data from any certified electronic health record (EHR) and, in so doing, generate data useful for comparative effectiveness research. Recent Advances: For 2018, the Centers for Medicare and Medicaid Services (CMS) has approved 12 wound care and hyperbaric medicine-relevant quality measures and several clinical practice Improvement Activities, which can be reported for MIPS credit through the USWR. Several QCDR measures have met the CMS 3-year reporting criteria to establish national benchmark rates, likely enabling practitioners to achieve higher quality scores than possible with standard MIPS measures. The structured registry data generated have been harnessed to evaluate adherence to evidence-based clinical practice guidelines, understand real-world patient healing rates, and demonstrate the comparative effectiveness of wound therapies. Critical Issues: Wound care practitioners can participate in a QCDR for MIPS credit, which enables them to optimize their MIPS score, particularly if they transmit data directly from their EHR. Utilizing structured data for comparative effectiveness research may help ensure patient access to advanced therapeutics. Future Directions: By 2019, to overcome technological barriers to participation, USWR quality measures will be available as "apps" for EHRs that support the interface required to achieve the next stage of EHR certification as part of the open Application Programming Initiative.