eCQM Patient Gap Report
The eCQM patient gap report is a feature that helps practices identify patients that fail to meet Clinical Quality Measures for CMS reporting enabling practices to meet Quality Payment Program requirements to receive incentive payments from the government. The project was done to help practices target where they are falling short on measures, my role was lead designer in visual and interaction, and I collaborated with PMs, engineering, user research, customer support, legal, and education.
The current design for the eCQM patient gap report falls short in providing useful information for practices to target patients that are not being counted towards their reporting scores. The eCQM dashboard serves as one program practices participate in to receive inceptive payment for following government approved workflow requirements. These Quality Payment Programs are immensely comprehensive, prescriptive, and complex in how practices should provide care to their patients. Practice Fusion’s commitment to be a partner to small, independent practices means understanding the challenges practices face in reporting, practice workflow, and measuring success.
- Improve data presented on gap report table
- Update visual styling to match improved visual systems
- Gain deeper understanding of practice workflows and participation of QPP
- Make recommendations in strategy and designs to further support our users
- Provide interaction and visual design that improve usability of gap report
- Partner with user research to create and conduct user interviews
- Partner with UI engineers to execute accurate implementation of designs
Improvement of current design
The current design of the eCQM patient gap report fails to identify which patients do not fall into the numerator score of quality measures. This failure creates more stress, confusion, and frustration for our users who already feel the time pressure for reporting. Our dashboard helps our users track how well they are meeting measure requirements for measures their practice are committed to such as depression screenings or diabetes checks. Each measure tracks a practice’s ability to follow government enforced workflow changes, patients can fall into the denominator of the score which means that patient is within the patient group that will contribute to the score of the measure. If a patient doesn’t fall into the numerator, the practice has failed somewhere within their workflow to have that patient be counted towards their score. The gap report is crucial in informing the practice of which patients they have failed to provide government approved level of care.
The product team and I collaborated to identified the required changes to improve the effectiveness and information presented to the gap report such as:
- Numerator column
- Denominator column
- Measure details: Measure name, Provide/Group, Performance year, CMS ID
- Filters: Numerator, Denominator, Denominator Exception, Denominator Exclusion
- Print/download functionality
During development of these improved designs, I collaborated closely with our UI engineers and development team. I had regular design reviews and checkins with my UI engineer and worked closely with user research to create a Mixpanel tracking plan. In developing the Mixpanel tracking, we wanted to track usage of filters, the clickthrough of specific patients, etc to gain a deeper understanding of user workflows.
After development, this feature was available for a small group of users which allowed us to beta test these design improvements. User research and I collaborated to create user research plans and scripts to conduct interviews to gain deeper insight into the design improvements as well as a holistic view of our users experience with the eCQM dashboard and their journey with Quality Payment Programs.
Our user research team synthesized the information gathered from the interviews and organized feedback into workflow step categories. These key insights gave us an idea of how practices prepare for reporting. We found the design updates improved practice workflow, it helped inform users of which patients were failing to meet measure requirements. However, users were clear to provide further design expectations and improvements, areas for further investigation include:
- Non-numerator filtering
- Display of NUM/DENOM numbers up front
- Patient and measure specific alerts
- Reports page bug
- Screenings/Interventions/Assessments section within the Patient Summary
- More clarity within Knowledge base articles
- With this feedback, I was able to provide design improvements that would be easy wins for us and make an impact on our users. Additions to the measure information, like adding NUM/DENOM up front would be simple to execute and provide more clarity for users.
- Adding an additional filter, Non-numerator, would provide a more complete solution to help identify patients who are not being counted. This filter option would be another simply executed improvement to the gap report.
- Adding a section on the patient summary for Screenings/Interventions/Assessments has been highly requested and crucial information for practices. It is known issue that S/I/A information being stored in Encounters is highly inefficient and requires users to scrub through countless encounters to retrieve S/I/A data. Having a section on the summary that aggregates all patient S/I/As would save hours of work and streamline workflows. This also brings attention to the poorly designed S/I/A module that could use some design love. This improvement would require more time and effort to execute. Additionally, I provided concepts around an alerts section that would live additionally on the patient summary that would house QPP specific alerts along with CMS alerts. Alerts has been another heavily requested area that would require more time and effort to execute effectively.
This project entailed cosmetic improvements and additional functionality to the gap report, however, allowed opportunity with the help of user research to gain a deeper understanding of practice’s experience with Quality Payment Programs. I see several opportunities for Practice Fusion to improve the eCQM dashboard and live up to the promise to be a partner for our practices and help them be successful.