Quality measurement and improvement in rheumatology: Rheumatoid arthritis as a case study

Desai, Sonali; Yazdany, Jinoos

doi:10.1002/art.30605

Cited by 34 publications

(43 citation statements)

References 45 publications

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“…Early quality measures in rheumatology relied on administrative billing claims (1,2). Such measures have the advantage of collecting information from all of the clinicians and entities that have submitted bills for clinical care, thus capturing a broad picture of health care received.…”

Section: Discussionmentioning

confidence: 99%

“…Previous measures were often led by payers (e.g., Resolution Health, Ingenix), national quality organizations (e.g., National Committee on Quality Assurance), or other physician groups (e.g., the American Medical Association's PCPI) and implemented in both the private and public sectors. Measures were sometimes not aligned and rheumatologists had little leverage in revising measures that were either difficult to implement or not consistent with current evidence (2). The need for rheumatologists to lead measure development, therefore, became more pressing as regulatory requirements began to shift from small incentive programs to larger penalty programs.…”

Section: Discussionmentioning

confidence: 99%

“…Previous quality measurement efforts have relied on analyses of administrative billing claims, such as the National Committee on Quality Assurance disease-modifying antirheumatic drug measure (1), or on manual chart review, such as the American Medical Association's Physician Consortium for Performance Improvement's (PCPI) Physician Quality Reporting System measures (2). While there is some evidence that these programs have resulted in quality improvement, many have argued that current performance assessments have limited utility and do not support building a continuously learning health care system, as envisioned by the Institute of Medicine (1)(2)(3).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Methods for Developing the American College of Rheumatology's Electronic Clinical Quality Measures

Yazdany

Myslinski

Miller

et al. 2016

Arthritis Care & Research

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Methods for Developing the American College of Rheumatology's Electronic Clinical Quality Measures

Yazdany

Myslinski

Miller

et al. 2016

Arthritis Care & Research

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“…The concept of treating-to-target relies on adjusting therapy until a state of remission (or low disease activity) is achieved. Despite widespread endorsement from the rheumatology community, evidence suggests a significant gap in care in this area (4).…”

Section: Rheumatoid Arthritismentioning

confidence: 99%

Development of the American College of Rheumatology's Rheumatoid Arthritis Electronic Clinical Quality Measures

Yazdany

Robbins

Schmajuk

et al. 2016

Arthritis Care & Research

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“…They often represent minimum standards of care and are derived from quality indicators, which are statements about best practices that are associated with high-quality care. Quality indicators are usually specified in the following format: If (a specific clinical scenario), then (a clinical action) 1 . An oftencited example of a quality indicator would be if a patient has rheumatoid arthritis (RA), then they should be prescribed a disease-modifying antirheumatic drug (DMARD) 1 .…”

mentioning

confidence: 99%

A Systematic Review of Quality Measures for Inflammatory Arthritis

Cooper

Rouhi²,

Barber³

2017

J Rheumatol

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ABSTRACT. Objective. To conduct a systematic review and quality appraisal of quality measures for inflammatory arthritis, including rheumatoid arthritis (RA), spondyloarthritis, psoriatic arthritis (PsA), and juvenile idiopathic arthritis (JIA). Methods. Embase, MEDLINE, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) were searched from January 1, 2000, to October 23, 2016, using Medical Subject Headings terms for inflammatory arthritis and quality measures. A "grey literature" search of international arthritis organizations and quality measure libraries was also conducted. Two reviewers independently considered the papers for inclusion, with disagreements resolved by consensus. A modified guideline appraisal tool (AGREE II) was used to appraise the measure development process, which determined final inclusion. Quality measures are tools for measuring whether care provided is concordant with evidence-based practices. They often represent minimum standards of care and are derived from quality indicators, which are statements about best practices that are associated with high-quality care. Quality indicators are usually specified in the following format: If (a specific clinical scenario), then (a clinical action) 1 . An oftencited example of a quality indicator would be if a patient has rheumatoid arthritis (RA), then they should be prescribed a disease-modifying antirheumatic drug (DMARD) 1 . Quality indicators can be further specified into quality measures, which have a specific numerator, denominator, and exclusions and can be reported as a percentage representing a quality or performance measure (depending on whether the subject of measurement is associated with improved quality or just healthcare performance). Quality measures can be used for benchmarking and quality improvement efforts, and in some countries and jurisdictions, are used in pay-forperformance programs. An example of a quality measure based on the above quality indicator would be "the percentage of patients with RA who have been prescribed a DMARD." According to a classic Donabedian framework 2 , quality measures are often classified into process, structure, or outcome. Process measures determine whether clinical processes are concordant with evidence-based best practice and improved patient outcomes; structure measures record whether the health system or clinic infrastructures are present RheumatologyThe Journal of on May 11, 2018 -Published by www.jrheum.org Downloaded from to support best practices; and outcome measures determine the effect on the health status of the patient. While outcome measures may seem the most obvious to measure, patient outcomes are the result of many factors, some of which are beyond the control of physicians. Several domains of quality exist, and the most commonly cited framework is the Institute of Medicine's 6 Domains of Health Care Quality 3 : safety, effectiveness, patient-centeredness, timeliness, efficiency, and equity.The present systematic review of quality measures in rheumatology was...

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Quality measurement and improvement in rheumatology: Rheumatoid arthritis as a case study

Cited by 34 publications

References 45 publications

Methods for Developing the American College of Rheumatology's Electronic Clinical Quality Measures

Methods for Developing the American College of Rheumatology's Electronic Clinical Quality Measures

Development of the American College of Rheumatology's Rheumatoid Arthritis Electronic Clinical Quality Measures

A Systematic Review of Quality Measures for Inflammatory Arthritis

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