Quality reporting’s toll on physician practices costs time and money

Quality reporting’s toll on physician practices costs time and money

• Modern Healthcare
• 14 Mar 2016
• By Sabriya Rice

Indiana University Health is in the midst of a multiyear effort to streamline the quality measures that front-line providers are expected to track. The information is intended to help monitor and improve the quality of healthcare, but collecting it also saps resources.

“It’s a lot of time and effort spent at the computer documenting things that don’t impact patient care,” said Dr. Jonathan Gottlieb, the Indianapolisbased system’s chief medical executive.

Researchers at Weill Cornell Medical College in New York City teamed up with the Medical Group Management Association to put a price on the time providers spend to enter the quality data into the electronic health record, keep track of newly introduced measures and create protocols to track and report them. The answer is about $15.4 billion a year, according to their study published March 7 in Health Affairs.

That’s “a large amount of money being wasted on checking this box and that box,” said lead study author Dr. Lawrence Casalino, chief of the division of health policy and economics at Weill Cornell. “It’s time physicians could spend on not rushing a patient, or thinking about a diagnosis more carefully.”

In the study, researchers surveyed 394 leaders from cardiology, orthopedics, primary care and internal medicine practices. They asked how much time specialty clinicians spend on tasks associated with collecting the data and then converted those hours into costs based on how much the clinicians are paid.

Across all specialties, licensed practical nurses and medical assistants spent the most time. For example, between 2014 and 2015, LPNs and medical assistants in primary-care settings spent an average of 7.8 hours a week on quality reporting tasks. That’s about $9,119 a year for each clinician. The authors noted several limitations of the study. Practices with stronger negative feelings about quality measures may have been more likely to respond, which could have distorted the estimates.

IU Health set up a clinical economics committee to keep track of what measures must be reported for each department or specialty, as well as the rewards and penalties on the line. For clinicians, however, the team is striving to boil down all of the measures to the basics. By the beginning of 2017, IU Health plans to cut the number of measures specialty doctors must track to about 10 or fewer. The system did the same last year for its hospital measures, cutting the number of inpatient metrics clinicians must input from 199 to 10.

“Someone needs to pay attention,” Gottlieb said. “But we want our doctors and nurses to focus on measures that contribute directly to the welfare of the patient.”