MANAGED CARE Q&A
The Patient-Centered Medical Home of the Future: Page 2 of 2
In addition to moving to an initial recognition followed by annual check-ins, the following are some of the other key changes:
• For the first time, we will assign each practice seeking recognition to a specific NCQA staff person. NCQA staff will support the recognition process by scheduling the check-ins, facilitate the selection of criteria to be satisfied at each check-in with an evaluator, coordinate the check-ins, and be the single point of contact for the practice.
• We designed the new Recognition platform to be as intuitive as possible, with clear indicators of progress, pending work, tasks to complete, and explanations of the criteria and evidence needed to meet the criteria.
• We reduced the documentation requirements. Instead of sending reams of documentation, practices will have the option of actually showing the reviewer the process through virtual screen-sharing during a live review.
• We plan to create short videos and other instructive material for the new platform. We have developed new education programs for recognized practices (such as “Strategies for Success as a PCMH, available at www.ncqa.org/pcmhstrategies), and will embed links to other NCQA educational content over time in the new platform.
FRMC: In particular, there seems to be some concern regarding practices’ ability to measure many key processes and data using current electronic medical records (EHR) and health information technology (IT) systems. Will it be possible for practices to meet the standards of the PCMH model without upgrading these systems? Or will recognition attempts require complete overhauls in some cases?
Practices will not need to do any significant upgrades to their EHR or health IT systems solely for the upcoming PCMH standards or the new Recognition process. We plan to introduce an option in 2017 for PCMH practices to electronically submit the results of clinical quality measures in lieu of documenting some quality-related activities required in the PCMH standards. The measure set from which practices will be able to choose is aligned with the EHR Incentive Program measures (also known as “Meaningful Use”). NCQA is currently engaged in discussions with several health IT vendors through which practices will be able to submit these measures. More details will be forthcoming.
If practices elect to submit electronic clinical quality measures, they may have to work with their health IT vendor to facilitate that data flow; however, this will be an optional reporting method that we hope will wind up saving practices time and effort.
NCQA’s health IT pre-validation program helps to identify technology vendors that have tested their systems against NCQA criteria. Practices that implement these solutions generally are able to get auto-credit towards some elements/factors in the recognition process depending on what the vendor tested against.
In future years, we hope to test health IT systems’ capabilities to submit metadata about workflow processes (eg, test tracking, turnaround time for online patient inquiries). However, much more work needs to be done before this is a reasonable option.
FRMC: Do you expect to make any more changes to the system as you receive feedback from stakeholders?
Just as in any good quality improvement project, we expect to learn as the implementation proceeds and make appropriate adjustments. The PCMH community has been extremely helpful and supportive when we solicited feedback, and we hope/expect that to continue. Our experience with the launch of the PCMH program will be critical to the successful migration of the PCSP Recognition program in 2018.