After many months of preparation, the American Academy of Family Physicians (AAFP)'s Center for Health IT launched its clinical data repository (CDR) pilot project in September to explore ways in which administrative and clinical data can be leveraged to benefit AAFP members.
According to Steven Waldren, M.D., director of the Center for Health IT, the 12-month pilot is closely tied to long-term AAFP strategies aimed at helping family physicians improve practice revenue and enhance the quality of care delivered to patients. “No. 1 is to assist doctors in making the most cost-effective, high-quality care decisions they can,” he says. “We wanted to be able to give them the tools to do that.”
The pilot also fulfills a directive from the AAFP’s 2008 Congress of Delegates, which adopted a resolution that asked the organization to explore the creation and ownership of a secure clinical data repository. The resolution stated that family physicians should be able to both submit and retrieve clinical data from an AAFP-operated CDR, and that doing so would help members qualify for revenue boosters such as pay-for-performance bonuses and patient-centered medical home recognition programs.
To get a representative sample of its 100,000 member practices for the pilot, characteristics like geographic and practice size diversity were taken into consideration. Thirteen practices were selected for the pilot, which included practices that were a part of a larger delivery network, in the 10 to 20 -physician range, and some solo practices.
The CDR pilot represents a partnership between the AAFP and Emdeon, the nation's largest healthcare claims processing company, based in Nashville, Tenn. Emdeon will bring its data management and distribution resources to the partnership, while AAFP will bring clinical, healthcare operations, and health informatics expertise. Emdeon, which already connects many AAFP practices, will also be supplying technical support and web-based training to the practices.
Pilot practices will be able to retrieve clinical data from the repository to help their practices identify gaps in care they want to focus on, and the data will give them better visibility into their patient population. Waldren says that phase two of the pilot recently started, which started flowing in medication and lab data into the CDR to provide quality reporting analytics.
In addition, Waldren says better data—such as the charting of dollars paid by private insurers for particular procedures and evaluation and management codes—would help physicians make better decisions when it comes time to negotiate payer contracts. The data from the repository also allows practices to evaluate which pay for performance contracts they should be committing to because with the CDR they have an view of their population and specific compliance of certain disease classes, he adds. “We’re able to capture some of that data and provide it back to them to give them a snapshot so they can make good decisions from a business perspective,” Waldren says. “They have the ability to look at their entire practice as opposed to a health plan that is only going to look at patients that are with that particular plan.”
Waldren foresees that the CDR will eventually be the heart of the patient-centered medical home (PCMH), as it will allow practices to analyze patient mix, disease mix, and procedure mix; and benchmark their practice data against that of their peers. “Having the ability of the CDR that can say, ‘these are the types of reports that you can get as an ACO from this practice, and these are the quality measures that are being tracked, and you can see how those practices relate to their peers,’” says Waldren. “I think having some of those capabilities would be very beneficial to the ACO.”
In Q2 2012, the AAFP will evaluate the pilot to determine if physicians will be willing to pay a subscription fee for the use of the CDR and if the repository can be rolled out to scale. Waldren sees further iterations of this project to incorporate additional data sources from outside the practice, from hospitals or urgent care clinics, into the repository.
“I think there is an enormous amount of potential as we look toward the future of improving quality and decreasing cost of care,” Waldren says. “So we’re excited by the potential.”