Aims and objectives
Medical reimbursements in the United States are transitioning from fee-for-service to pay-for-performance.
The Physician Quality Reimbursement System (PQRS) requires that physicians report quality metrics to data registries to prevent negative payment adjustments [1].
Recently the PQRS system has been replaced by the Quality Payment Program,
but the determination of clinical outcomes remains a core principle in this reimbursement scheme [2].
The American College of Radiology has proposed several Qualified Clinical Data Registry (QCDR) metrics that require radiology-pathology correlation,
but extraction of this information from electronic...
Methods and materials
We developed a structured reporting system that captures key radiology and pathology images,
records voice descriptions of image findings,
tags the images with metadata using SNOMED terminology,
and assembles a multimedia report with related radiology and pathology information linked in graphical disease timelines (figure 1).
The system,
called ViSionTM,
has been presented previously at the ECR 2013 [5]
During the past year we expanded the ontology (i.e.,
controlledvocabularywith defined relationships between terms) used to tag the radiological exams with terminology to encompass other medical events...
Results
The structured reporting system has been demonstrated for use with PQRS measure #147 (correlation with existing imaging studies for all patients undergoing bone scintigraphy),
QCDR #1 (CT colonography true positive rate) and QCDR #2 (CT colonography clinically significant extracolonic findings).
Correlating image findings from narrative descriptive reports can be tedious,
time-consuming,
and costly due to the need for human abstractors as illustrated in figure 4.
ViSionTM allows for the direct and accuratecorrelation of specific findings from serial exams to identify concordant and discordant findings for...
Conclusion
Multimedia structured reporting provides a means to automate radiology-pathology correlation and generate PQRS and QCDR quality metrics in order to satisfy pay-for-performance requirements.
Personal information
Disclosure: David J.
Vining is the founder and CEO of VisionSR,
Inc.,
which has licensed intellectual property from the Unversity of Texas MD Anderson Cancer Center related to the ViSionTMmultimedia structured reporting technology.
For more information,
please contact:
David J.
Vining,
MD
Email:
[email protected]
or
Email:
[email protected]
Website: www.visionsr.com
Video demonstration:https://www.youtube.com/watch?v=Tc1UEQVqGC4
References
“Physician Quality Reporting System.”CMS.gov Centers for Medicare & Medicaid Services,
11 October 2017,
www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/index.html?redirect=%2FPQRI%2F.
“Quality Payment Program.”CMS.gov Centers for Medicare & Medicaid Services,
qpp.cms.gov/.
"ACR National Radiology Data Registry." American College of Radiology.
https://www.acr.org/Practice-Management-Quality-Informatics/Registries
"Qualified Clinical Data Registry (QCDR) Measures Supported 2018." American College of Radiology,
4 January 2018.
https://www.acr.org/-/media/ACR/Files/Registries/QCDR/QCDR-Measures-Supported-2018.pdf?la=en
Vining DJ,
Salem U,
Duran C,
et.
al.
“A Vision for Global Multimedia Structured Reporting.”ECR 2013 / C-1784 / A Vision for Global Multimedia Structured Reporting - EPOS™,
European Congress of Radiology 2013,
3 February...