GIQuIC entered the colorectal screening scene more than a decade ago and the evolution of use in my practice spans a 6-year timeframe. Though we were considered early adopters of the program, there was initially no distinct incentive to utilize the program outside of appealing to the intrinsic desire of physicians to improve the quality, efficiency and safety of the care they provide.
However, the rapid transformation of the health care environment over the last 2 to 3 years, from a purely fee-for-service environment to a value-based one, accelerated interest among the hospital-based endoscopy units and ambulatory surgical centers (ASCs). GIQuIC went from a personal improvement tool to an essential part of practice. It easily showed quality improvement and aided in compliance with governmental and commercial value-based payment programs.
Figure 1. This chart developed using GIQuIC shows qulaity improvement and aids in compliance with value-based payment programs.
Source: Brett Bernstein, MD, MBA, FASGE
Approximately 5 years ago, I initiated a program at several ASCs whereby individual report cards were distributed quarterly to physicians. Performance on quality metrics derived from the GIQuIC database on colonoscopy quality – including adenoma detection rates, cecal intubation rates and screening interval documentation, among others – were compared internally to peers as well as externally to national performance benchmarks. While initially 30% to 40% of our physicians were failing to meet national benchmarks on at least one metric, we quickly saw this drop to 10% to 15% within 1 year.
Over a 5-year period, we have seen our ADRs improve 5% to 12% across our affiliated centers and hospital-based endoscopy units. This is particularly impressive as we now know that every 1% increase in ADR is associated with a 3% reduction in colon cancer incidence and a 5% decrease in mortality. Within 2 years of introducing the program, we used our improvements in ADR and reduction in inappropriate surveillance recalls at one of our affiliated ASCs to successfully negotiate a 30% increase in technical fees with a major commercial insurance carrier.
As the program’s real-time reporting capabilities have improved, we have been able to further drive improvement in ADRs among those failing to meet the national benchmark. We utilized the society-based CME/MOC modules to create a program for both educational and remediation purposes.
Finally, the recently streamlined GIQuIC platform enabled many of our affiliated physicians to successfully participate in the MIPS program through its designation as a Quality Clinical Data Registry (QCDR). The function of GIQuIC as a QCDR allows for successful reporting on the quality, improvement activities, and promotion of interoperability components of the program.
The value proposition for the use of GIQuIC on both an organizational and individual basis has only continued to grow with the rapid changes in our practice environment. I anticipate more value as the platform improves and we, as gastroenterologists, are required to deliver even more data to show practice improvement.
Corley DA, et al. N Engl J Med. 2014;doi:10.1056/NEJMoa1309086.
Brett Bernstein, MD, MBA, FASGE, is a GIQuIC Board member; Chief, Division of Gastroenterology Mount Sinai Downtown; and Medical Director, Eastside Endoscopy, LLC. He can be reached at Brett.Bernstein@mountsinai.org.
Disclosures: Bernstein reports no relevant financial disclosures.