The advent of changing reimbursement frameworks moving from fee for service and volume based incentives to budget-based and shared savings methodologies has intensified the need for physicians to access meaningful, timely physician profile reporting.
There are many variations in what gets presented in physician profile reporting as well as how and when it is delivered. In July 2012, the American Medical Association launched their Physician Reporting Guidelines in an effort to provide a physician perspective in profile reporting. The guidelines called for the need to be easy to understand, easy to access and provide an opportunity for review of detailed data. While the AMA reporting guidelines also called for standardized reporting, that remains a significant work in progress.
Technology and data availability continue to improve and have given rise to sharing information through provider or physician portals. There is a great deal of work on the front end to gather data, select measures and validate all this data before release. Today, we scratch the surface of physician portals and share some examples and considerations in the design of the portal.
The critical elements in the design and implementation of a physician portal require early inclusion of physicians in the planning and design process. In accordance with the AMA Reporting Guidelines, it should also address ease of use, availability of actionable information and drill to their member detail.
Dashboards are a popular method for sharing information through a portal. They provide for an accessible, visual and portable look for physicians. This type of display can begin at a higher level such as the medical group and then allow for drill to individual providers and then to their members. Depending on the tool and data sources, the provider portal can include claims and EMR data reporting. Retrospective data is very valuable in providing insights into opportunities for change. The examples below are claims based and allow for review of the retrospective performance as well as provide transparency and insight into prospective issues, using risk assessment results and other mainstream methodologies.
Lastly, providing the option to submit feedback is a critical element for provider portals. Throughthe portal, the physician can be given access to submit requests to update or revise the data, and related results, based on additional information. The workflow of this process should be a significant consideration in the planning process to define standard reasons.
There is a great deal of planning involved in determining the specific metrics and the data visualization option but with early physician engagement and thorough data governance rules, the physician portal is a valuable tool in broadening the engagement of physicians.