Urology EHR Use Facilitates Active Surveillance as Surgery Substitute

September 21st, 2017 - By Matt Garnese

In the Spirit of Prostate Cancer Awareness Month, it’s important to remember how Electronic Health Records (EHR) systems can improve your urology practice’s workflow with a variety of templates and customized content, such as patient treatment plans, kidney CT scans, and cryotherapy for prostate conditions. In a recent study published by the National Institute of Health (NIH), researchers found that the use of EHR in urology made it easier to identify prostate cancer patients who were eligible for Active Surveillance (AS) as an alternative to surgery and radiation, potentially delaying some of the complications associated with these treatments.

Additionally, for urology practitioners who have implemented an EHR software system and are participating in the Quality Payment Program (QPP), there is some evidence that Advanced Alternative Payment Models (Advanced APMs) may provide an extra financial benefit.

The Benefits of Urology EHR Prostate Cancer Treatment

In an NIH study that examined the use of EHR to identify prostate cancer patients who qualify for AS, the researchers stated that “implementation of evidence-based criteria for detection of AS candidates are feasible using electronic health record data and provide a reasonable basis for delivery system evaluation of practice patterns and for quality improvement.” The researchers’ unique use of EHR software helped them gain new insights into how prostate cancer is being treated and how to increase the quality of care.

Essentially, the researchers used an EHR system to examine the health records of all patients who received prostate biopsies at Intermountain Healthcare from the beginning of 2013 to the end of 2014 and found that just 78 percent of the patients who met the criteria for AS treatment received it. In spite of that fact, the researchers say that “a majority of the men with prostate cancer receive immediate treatment with radiation or surgery. These therapies introduce complications including impotence and urinary incontinence.”

In the Discussion section of the study, the researchers state the following: “This analysis provides a basis for evaluating the efficiency improvements may have in the adoption of AS protocols, including such things as the use of decision aid tools to promote AS, and impacts on the quality and cost of prostate care.”

Financial Incentives for Urology EHR Use

In an article published by Urology Times, Bob Gatty discusses how Urologists can receive the higher financial incentives under the Medicare Access and CHIP Reauthorization Act (MACRA) through Advanced APMs. Although there are no approved Advanced APMs specifically for urology today, the Large Urology Group Practice Association (LUGPA) recently submitted an APM for approval by the CMS which focuses on AS.

Neal D. Shore, MD, president of LUGPA, said the following with regard to the underappreciation of AS: “It is clear that there has been over-treatment of many patients who have a low-risk disease because there has been a lack of understanding that many such patients can be very safely monitored. Not everybody with diagnosed prostate cancer needs to have active or interventional treatment.”

If CMS approves the APM, physicians who qualify would be exempt from MIPS and would potentially qualify for a 5% payment adjustment on all Medicare Part B services rendered between 2019 and 2024. They would also receive annual increases in payments starting in 2026.

As Prostate Cancer Awareness Week continues, we urge you to use your EHR urology software to innovate how you give your patients the best quality healthcare. Additionally, it’s always important to maintain good communication with your patients about their family history and lifestyle and to develop a proactive prostate health plan that includes regular cancer screenings.

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