MACRA will affect every physician and every clinical encounter. Current systems have been designed to produce transactions to be billed. MACRA will require that clinical conditions have been addressed, and documented, in accordance with quality care guidelines. The only way to ensure that happens is to do it at the point of care.
The challenge is that physicians need to address all conditions, not just those covered by a MACRA requirement. One approach is to just add another set of things to do, slowing doctors down and getting in their way. This is the transactional approach: just another task.
Most current systems have different “tabs” which list problems, medications, labs, etc. Users must switch back-and-forth looking for data. The data cannot be organized by problem, since the systems lack any method for correlating information based on clinical condition. Adding another set of disconnected information to satisfy quality measures will only make it worse for users.
A better approach is to integrate quality care requirements for any condition with all the other issues the physician needs to address for a specific patient, and to work it into a physician’s typical workflow. A well-designed EHR should have a process running “in the background” which keeps track of all applicable quality measures and guidelines for the patient being seen. The status of all quality measures must be available, at any point in the encounter, in a format which ties all information together for any clinical issue.
This requires actionable, problem-oriented views of clinical data, where all information for any clinical issue is available, providing the instant access physicians need to be able to view, react to, and document, clinical information for every problem or issue addressed with the patient. This includes history and physical documentation, review of results, clinical assessments and treatment plans, as well as compliance with quality measures.
Guaranteeing MACRA compliance at the point of care can be accomplished by using a clinical knowledge engine which presents all relevant information for any clinical issue, so that MACRA quality measures are seamlessly included as part of the patient’s overall clinical picture, not as just another task to be added on to the already burdensome workflows of current systems.