Quality of care in rheumatic diseases: performance measures and improvement.
OBJECTIVE
To acquaint rheumatologists with pay-for-performance and the American College of Rheumatology quality initiative, and to suggest how practice process redesigns and effective measurement of performance and disease outcomes will help rheumatologists document and improve the quality of rheumatic disease care.


RESULTS
The options for treating rheumatic diseases have improved, but many patients are not achieving optimal outcomes. Pay for performance programs being introduced by Medicare and other insurers will link provider revenues to quality indicators, requiring rheumatologists to measure, document, and improve their patients' outcomes. Expected rheumatology manpower losses will also require greater practice efficiency and increased reliance on inter-disciplinary care teams. Some publications advocate improving healthcare by expanding research to improve knowledge transfer from clinical studies to clinical practice; others suggest continuous process improvement methods to improve delivery of care processes. Practical disease activity measurements and rheumatology practice improvements are being reported that suggest a positive future.


CONCLUSIONS
Rheumatologists need to recognize the need to improve delivery of care and patient outcomes, measure and document clinical performance, and learn the methods for managing clinical process improvement.
Harrington
J Timothy
JT
Department of Medicine, University of Wisconsin School of Medicine and Public Health, One South Park Street, Madison, WI 53715, USA. tim.harrington@uwmf.wisc.edu
D019468:Disease Management; D006801:Humans; D006278:Medicare; D019984:Quality Indicators, Health Care; D012052:Reimbursement, Incentive; D012216:Rheumatic Diseases / Q000188:drug therapy* / Q000191:economics; D012219:Rheumatology / Q000592:standards / Q000639:trends; D012720:Severity of Illness Index; D014481:United States