The University of Rochester Medical Center (URMC) Primary Care Network has been recognized by the National Committee for Quality Assurance (NCQA) for the consistent high quality of care its physicians provide to patients with diabetes.
The Diabetes Recognition Program, a certification program established in partnership with the American Diabetes Association, recognizes physicians who use evidence-based, nationally recognized clinical measures for diabetes care and management.
“The certification reflects our commitment to our patients to deliver an aggressive and focused approach to treating diabetes,” said Betty Rabinowitz, M.D., medical director of the URMC Primary Care Network, which comprises 20 primary care practice sites owned by Strong Memorial and Highland hospitals.
"The NCQA certification also highlights our commitment to working with the patient as an integral member of the team,” noted Wallace E. Johnson, M.D., director of the UR Center for Primary Care. “In fact, engaging in a dynamic interaction with patients is a key factor behind why we have achieved such high quality."
John Buse, M.D., Ph.D., president of Medicine and Science of the American Diabetes Association, said “Clinicians who earn the Diabetes Recognition Program have an established track record of providing excellent diabetes care. These groups are the first place to look if you or a loved one has been diagnosed with diabetes.”
Achieving the certification involved a rigorous review process with the NCQA evaluating seven elements of diabetic care. Detailed chart reviews provided the information necessary to assess the quality of care provided to a large sample of diabetic patients in each of the primary care offices.
Diabetes was designated by the leadership team of the Primary Care Network as a top priority and a major continuous quality improvement activity 18 months ago. In deciding to apply for the Diabetes Recognition Program certification earlier this year, the primary care practices committed to achieving the NCQA diabetes patient care benchmarks for HbA1c, blood pressure control, microalbumin and lipid levels, eye and foot examinations, smoking status and counseling. Their efforts resulted in a score of 90 out of a possible 100 points.
The process began in January 2009 when the electronic medical records (EMR) system was programmed to capture all diabetes Physician Quality Reporting Initiative indicators, which were based on the Center for Medicare and Medicaid Services quality incentive program. This change allowed physicians in the network to receive weekly individual diabetic care reports for patients with scheduled appointments in the coming week.
Six months later, the Primary Care Network joined the HANYS Diabetes Campaign Collaborative, part of the New York State Health Foundation’s Diabetes Campaign. “We really appreciate the great support both HANYS and the state Diabetes Foundation provided to us throughout the certification process,” Rabinowitz said.
The process was further enhanced with EMR diabetes dashboards that allowed a physician to see detailed information about a particular patient and also a population of diabetics with the same health issues to determine which protocols are producing the best care.
“With information on both individual patients and patient populations,” Rabinowitz said, “a physician may decide to make a change in a treatment protocol right away, and can either call the patient or schedule an office visit right away.”
In addition, each practice in the network meets regularly to discuss topics related to diabetes and review pharmacologic protocols for diabetes, such as the appropriate use of the new insulins and oral agents.
“Our decision to apply for NCQA certification for our diabetes care program was certainly a prime motivator for the initiatives we implemented,” Rabinowitz said, “and we are proud to be recognized as part of an elite group of clinicians nationwide cited for expertise in providing the highest level of care to patients with diabetes.
“However, quality improvement has always been an integral part of the Primary Care Network’s mission. Going forward, our practices will continue to evaluate protocols and patient practices to ensure we maintain the high standards for which NCQA cited us,” she said.
NCQA is a private, non-profit organization dedicated to improving health care quality. It accredits and certifies a wide range of health care organizations and manages HEDIS.