5 Quality Measures Pathology Synoptic Reporting Captures

  The National Quality Forum recently approved new measures that track cancer treatment. This is important for multiple reasons and will have a true impact on many physicians - including pathologists. These measures affect Centers for Medicare & Medicaid Services' (CMS) physician fee schedule and therefore how pathologists will be reimbursed in the coming year. Physician Quality Reporting System (PQRS) is designed to track specific quality measures to see how individual physicians are performing and CMS, in turn, uses PQRS to financially incentivize participants to utilize electronic medical data capture to report on these quality measures.

If you are a physician capturing these points of data, CMS gives you a bump in pay for the eligible cases, with the idea being that physicians are rewarded for taking time to help track treatment, practices, and other pieces of data that helps inform the medical community of either the effectiveness of a current treatment or provides greater insight into the current state of how a disease is affecting the populace.

For pathologists, there are 5 specific quality measures that they can capture which will lead to greater reimbursement. As College of American Pathologists (CAP) Economic Affairs Committee member, Emily E. Volk, MD, FCAP, explained to CAP's website:

Remember - this is individual pathologists, not labs or facilities as a whole. You, as a pathologists, will see a 0.5% bump in your individual pay (on those Medicare cases). And if they don't capture this data? Well not capturing has its consequences as well - for one thing, you'll avoid that 1.5% deduction in payments. "But next year is also the first year that all providers can be penalized for not participating," says Volk, who also reminds pathologists that they only have to "report on at least one measure" to "not be penalized."

So what are these measures? And how can pathologists ensure that they are correctly capturing the information? How does synoptic reporting figure into this?

But if you haven't adopted these checklists, now would be a good time to do so. And the best way would be to utilize the checklists in an electronic synoptic reporting format. CAP has developed electronic Cancer Checklists (eCCs), which is an electronic version of their cancer checklists - allowing pathologists to report on cancer cases using over 80 templates. The templates ensure that all requirements are meant, that best practices are followed, and that a comprehensive pathology report is generated that provides a complete understanding of the case.

By using eCCs, not only are you guaranteed to capture the previously mentioned quality measures on all cases, but you are helping to keep your cancer program accredited by the American College of Surgeons' Commission on Cancer, and it's one of the requirements if you want your lab/facility to be accredited by CAP as well. This means that, by using these eCCs, pathologists are meeting their individual quality measure reporting requirements, helping their lab reach CAP accreditation and helping to sustain their cancer program's ACS CoC accreditation. Additionally, pathologists are avoiding penalties, increasing their reimbursement, and helping to provide a better understanding of the status of cancer on a national level and the effectiveness of various treatments.

mTuitive is one of the vendors that offers CAP's eCCs; in fact, mTuitive was the first company to license SNOMED CT encoded CAP cancer checklists. As you can see in the snippet of a sample report above, by guiding pathologists through relevant, required fields using intuitive internal logic, a comprehensive synoptic report is generated. These responses aren't just capturing the quality measures but are also pieces of structured data that, when sent into cancer registries, national organizations can now search without the time- and money-consuming process of data abstraction. Like is compared to like; standardized, uniform language is used to eliminate any chance for subjective misinterpretation. By adopting synoptic reporting solutions that already incorporate CAP eCCs, pathologists are ensuring that they will receive increased reimbursement, they will help secure accreditation for their labs and their cancer programs, and they will produce a more comprehensive report that helps improve cancer treatment for many years to come.