Quality Clinical Data Registries, or QCDR, are the future of quality measure reporting as the Centers for Medicaid and Medicare has stated their intent to move away from claims-based reporting.
As a result, the American College of Emergency Physicians has created a CMS-approved application called Clinical Emergency Data Registry, or CEDR for short in order to provide emergency physicians with an efficient way to provide this data to CMS.
How to Get Started With CEDR
While CEDR is not the only reporting platform available, after exploring many options for our emergency medicine clients, we believe that CEDR provides the most efficient way to report to CMS. CEDR not only will report quality measures on 100 percent of patients, versus just Medicare patients, but will provide each clinician with the ability to view their quality performance on a quarterly basis.
The following explains our experience to date regarding how to get started with CEDR and the common issues we have faced.
The first step is applying to participate in the program. ACEP has made this step easy and all you have to do is complete the online Interest Form and Detailed Application in the CEDR online portal. The application will require key data such as group size, number of hospital EDs served, annual ED census, number of emergency clinician providers, and the contact information for each ED.
After you express interest by applying, you will move on to the contracting part of the process. While applying to CEDR is free, the cost to participate is 10 cents per visit. The process will then require key actions from the physician group and then additional steps taken by the hospitals your group serves.
The clinician or group will sign a participation agreement, business associate agreement, and data use agreement for HIPAA compliance.
Once those steps are taken by the group, the hospital will need to fill out the same set of documents. In order to facilitate that process, we have created a letter template that you can send to your hospital administrator to assist with notification. The letter communicates your intent to join CEDR, the benefits to the practice, to the hospital and to patients and the absolute necessity the hospital will support the implementation. Hospitals have great concerns over third party access to their medical records and the letter should help by educating them on the benefits to giving access to CEDR.
- Data Collection & Visualization
Once documentation is executed by the clinicians and the hospital, your group will move to the technical implementation phase with FIGmd for onboarding. FIGmd is the company ACEP/CEDR has contracted to provide the technology to extract 500+ data elements from the EHR and from your billing vendor, which are needed to populate the quality measures and report them to CMS.
There are two methods of data collection: data pull and data push.
- The standard pull method involves the installation of a piece of software known as the Registry Practice Connector (RPC) which runs as a Windows service. This service is integrated with the Electronic Health Record (EHR) database using read-only credentials for the back end RDBMS (i.e. Microsoft SQL Server, etc.). The data extracts are limited to clinical quality measure data from encounters of providers participating in the registry and queries are based on the specific NPI numbers of those providers. CEDR must have hospital cooperation to be successful as this device resides on the hospital’s system or the EHR system. This data pull method usually takes 9-10 weeks to complete.
- The push method requires more resources from the ED as they are responsible for mapping their own clinical data elements. CEDR will provide standard templates and data requirements. The file formats accepted for this method are CCDA, .xls/.xlsx, or .txt with pipe delimiters. They do not accept .pdf files or scanned images. The ED determines the frequency of push intervals; however, one per month is the minimum. CEDR will provide credentials and can accommodate an FTP server provided by the ED.
Once the data has been sent to CEDR through one of the two methods above, your ED group will be given access to their CEDR dashboard where you can view data, query data and measure performance quarterly. Clinicians can also view their individual performances and determine which measures they want to report.
All in all, it is important to understand that the move to value-based care is upon us and being able to report quality data to CMS will be a key aspect of that transition. Whether you use CEDR or another method of reporting, it is important to make this a priority so that your revenue is not negatively impacted tomorrow.