title: Professional Practice Evaluation for Pathologists: The Development, Life, and Death of the Evalumetrics Program.
abstract: BACKGROUND
  - In 2008, the Joint Commission (JC) implemented a standard mandating formal monitoring of physician professional performance as part of the process of granting and maintaining practice privileges.
  
  
  OBJECTIVE
  - To create a pathology-specific management tool to aid pathologists in constructing a professional practice-monitoring program, thereby meeting the JC mandate.
  
  
  METHODS
  - A total of 105 College of American Pathologists (CAP)-defined metrics were created. Metrics were based on the job descriptions of pathologists' duties in the laboratory, and metric development was aided by experience from the Q-Probes and Q-Tracks programs. The program was offered in a Web-based format, allowing secure data entry, customization of metrics, and central data collection for future benchmarking.
  
  
  RESULTS
  - The program was live for 3 years, with 347 pathologists subscribed from 61 practices (median, 4 per institution; range, 1-35). Subscribers used 93 of the CAP-defined metrics and created 109 custom metrics. The median number of CAP-defined metrics used per pathologist was 5 (range, 1-43), and the median custom-defined metrics per pathologist was 2 (range, 1-5). Most frequently, 1 to 3 metrics were monitored (42.7%), with 20% each following 4 to 6 metrics, 5 to 9 metrics, or greater than 10 metrics. Anatomic pathology metrics were used more commonly than clinical pathology metrics. Owing to low registration, the program was discontinued in 2016.
  
  
  CONCLUSIONS
  - Through careful vetting of metrics it was possible to develop a pathologist-specific management tool to address the JC mandate. While this initial product failed, valuable metrics were developed and implementation knowledge was gained that may be used to address new regulatory requirements for emerging value-based payment systems.
authors.forename: Keith E
authors.initials: KE
authors.lastname: Volmar
authors.forename: Shannon J
authors.initials: SJ
authors.lastname: McCall
authors.forename: Ronald B
authors.initials: RB
authors.lastname: Schifman
authors.forename: Michael L
authors.initials: ML
authors.lastname: Talbert
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Tworek
authors.forename: Keren I
authors.initials: KI
authors.lastname: Hulkower
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Guidi
authors.forename: Raouf E
authors.initials: RE
authors.lastname: Nakhleh
authors.forename: Rhona J
authors.initials: RJ
authors.lastname: Souers
authors.forename: Christine P
authors.initials: CP
authors.lastname: Bashleben
authors.affiliation: From the Department of Pathology, Rex Pathology Associates, Raleigh, North Carolina (Dr Volmar); the Department of Pathology, Duke University Medical Center, Durham, North Carolina (Dr McCall); the Department of Pathology, Southern Arizona VA Healthcare System, Tucson (Dr Schifman); the Department of Pathology, Oklahoma University Health Science Center, Oklahoma City (Dr Talbert); the Department of Pathology, St. Joseph Mercy Hospital, Ann Arbor, Michigan (Dr Tworek); Structured Data Team (Dr Hulkower), Department of Biostatistics (Ms Souers), Department of Laboratory Improvement-Surveys (Ms Bashleben), Department of Laboratory Improvement-Biostatistics (Ms Blond), College of American Pathologists, Northfield, Illinois; the Department of Pathology, Newton-Wellesley Hospital, Newton, Massachusetts (Dr Guidi); and the Department of Pathology, Mayo Clinic Jacksonville, Jacksonville, Florida (Dr Nakhleh).
authors.forename: Barbara J
authors.initials: BJ
authors.lastname: Blond
mesh_terms: D000574:American Medical Association; D019985:Benchmarking / Q000379:methods*; D002983:Clinical Competence / Q000592:standards*; D006801:Humans; D020407:Internet; D000072142:Pathologists / Q000592:standards*; D010338:Pathology, Clinical / Q000592:standards*; D011364:Professional Practice / Q000592:standards*; D015203:Reproducibility of Results; D014481:United States