When Midwest Chest Consultants in St. Charles pulled their first monthly report for PQRS reporting from their Electronic Health Records (EHR), they immediately began to identify problems related to vaccination and smoking cessation.

“Our documentation for vaccinations was lacking,” said Jill Fritz, nurse practitioner at Midwest Chest Consultants. “I requested the staff ask EVERY patient if they have been vaccinated or would like to be vaccinated.”

Medical assistants are now asking patients if they have received or would like to receive their flu and/or pneumonia vaccination prior to the physician coming in. Then the physician or medical assistant documents this in the system.

In addition, Midwest Chest Consultants partners with a hospital where some patients may choose to get vaccinated instead. Fritz worked with the hospital to get a list of their patients that had received their vaccinations and updated their records to reflect this.

While no results are available yet for flu, pneumonia immunizations have improved from 38 percent to 58 percent.

Smoking cessation was more problematic. Midwest Chest Consultants knew they were doing smoking cessation screening but because it was not being documented correctly, they had no records to show how often. As a result, smoking cessation screening was at zero percent. Fritz loaded a new template into the program to capture the correct information. Within a month, smoking cessation screening went from zero to 100 percent.

“We have been able to streamline our processes and ensure we have accurate documentation,” said Fritz. “This is such a great learning experience, and I look forward to improving our patient care.”

Midwest Chest Consulting is working with Primaris as part of the PQRS EHR-based reporting initiative.

Primaris work with an EHR vendor has national impact for physician offices. Primaris has worked with the electronic health records (EHR) vendor to address issues providers are facing in regards to using their EHR for quality reporting.

Primaris worked with the vendor to ensure the right provider was being pulled. Both PQRS and meaningful use reports were pulling the primary care physician, not the provider the patient saw. As a result, nurse practitioners and physician assistants weren’t showing any patients and none of the providers would have met the 80 percent threshold required for PQRS.

Primaris also worked with the vendor to allow preventive measures to be linked to a flow sheet to document a mammogram or colonoscopy had been performed in the past without having to do a new order.

When the vendor made the flow sheet fix, they also developed a PQRS dashboard that would show all measures in one sheet for a physician with numerators and denominators.

Allowing the providers to see their numbers and where improvements need to be made will have a far-reaching, lasting quality improvement effect.