Quality measures in gastrointestinal endoscopy: the current state

Abstract

With the advent of better measures, we are beginning to understand that initial process and surrogate outcome measures (adenoma detection rate) can be improved to provide a better reflection of endoscopic quality. Importantly, however, even measures currently in use relate to important patient outcomes such as missed colon cancers. At a federal level, older cumbersome pay-for-performance initiatives have been combined into a new overarching program named the quality payment program within the centers for medicare and medicaid services. This program is an additional step toward furthering the progress from volume-to-value-based reimbursement. The legislation mandating the movement toward outcomes-linked (value) reimbursement is the medicare access and children's health insurance program reauthorization act, which was passed with overwhelming bipartisan support and will not be walked back by alterations of the affordable care act. Increasing portions of medicare reimbursement (and likely commercial to follow) will be linked to quality metrics, so familiarity with the underlying process and rationale will be important for all proceduralists.

How to Become a Physician Executive: From Fellowship to Leadership

“…Quality metrics are used to describe clinical or operational performance as well as health outcomes. 4 These metrics can now be generated in real time using electronic health record systems, 5 and enable executives to make timely, data-driven decisions that can be tied to achievable, measurable milestones. They also help executives to measure and communicate strategic successes and failures to colleagues, payers, and regulators.…”

“…2,3 Large, single specialty and multispecialty groups have become midsize employers with >$100 million in annual revenues and hundreds of employees. Practices of this size need physician leaders with sound business backgrounds who understand the need to demonstrate clinical quality, 4 can use real-time data captured from modern electronic health records, 5 will identify and implement cultural and infrastructure changes that enhance health value, and are able to lead colleagues through the complexities of current multispecialty practice. In this article, we discuss some critical learnings that you, as an early career gastroenterologist, can acquire so that you will be prepared to become a physician leader.…”

Cohortes de premedicación en endoscopia alta con Simeticona, N-acetylcisteina, Hedera helix y validación de escala visual

“…La endoscopia digestiva alta actualmente tiene indicadores de calidad pre-, trans-y posprocedimiento (1)(2)(3). En el momento intraprocedimiento es fundamental mejorar la visibilidad de la mucosa digestiva alta, usualmente obstruida por saliva, moco, burbujas y líquido gástrico.…”