AQA Adopts Standard Measures for Cardiology and Cardiac Surgery

June 16, 2006 (Washington, DC) – At its spring meeting, the AQA alliance reached a new milestone by adopting two new sets of measures for practitioners: a starter set of eight measures for cardiology (AQA Starter Set for Cardiology [Microsoft Word file: 2 Pages/135 KB. More information on downloading files.]) and a starter set of 15 measures for cardiac surgery (AQA Starter Set for Cardiac Surgery [Microsoft Word file: 1 Page/36 KB. More information on downloading files.].)

Cardiology measures include the percentage of patients who are prescribed beta-blocker therapy after a heart attack, and the percentage of patients with coronary artery disease who are prescribed aspirin or other antiplatelet therapy. Cardiac surgery measures include proper timing of antibiotics prior to cardiac surgery and risk-adjusted operative mortality for coronary artery bypass graft patients.

AQA is the broad-based national coalition of more than 125 organizations working together on a strategy to measure, report on and improve physician performance. AQA’s role is to reach consensus across its broad membership and to facilitate the widespread implementation of standard measures. AQA’s member organizations represent dozens of physician specialties, consumers, employers, government, health insurance plans and accrediting and quality groups.

“In an era of intense focus on the concepts of measurement, public reporting and evidence-based medicine, AQA is a major force in advancing these concepts into practice, and working to further enhance patient care,” said AQA Steering Committee member John Tooker, MD, MBA, FACP, Executive Vice President and CEO, American College of Physicians.

AQA considers for adoption evidence-based measures, developed by such groups as the National Committee for Quality Assurance, the AMA-convened Physician Consortium for performance improvement, and others that have been through a review process by the National Quality Forum.

AQA already has adopted a starter set of 26 primary care measures targeting eight clinical areas. Many health insurance plans are working with network physicians and physician group practices to implement the primary care starter set. Additional sets of standard measures will be proposed for adoption at future AQA meetings.

“With the newly adopted cardiac surgery and cardiology measures, its original set of primary care measures, and additional measures in the pipeline, AQA is representing the broad spectrum of medical practice," said AQA Steering Committee member Fred H. Edwards, MD, FACS, Professor of Surgery, University of Florida Health Science Center. Dr. Edwards represents the Society of Thoracic Surgeons on the AQA Steering Committee.

Adoption of the new measures follows AQA’s March l announcement of six initial sites for a pilot project that will, for the first time, combine public sector and private sector data to measure and report on physician practice in a meaningful and transparent way for consumers and purchasers of health care, as well as practicing physicians.

While physicians work to deliver high quality care, there have not been sufficient data to help them identify areas needing improvement. When physicians are provided with meaningful information, they can take action to further improve care delivery. At the same time, useful information provided to consumers and purchasers will allow them to make more informed health care decisions that meet their needs.

Until recently, one roadblock to measuring and reporting of performance at the physician level has been that it is conducted piecemeal. Physicians with patients covered by various public and private programs have their performance measured separately, often against different sets of measures, for each group.

Many different private and public sector groups have attempted to step up to the challenge by designing models for assessing performance and reporting data. Yet, the proliferation of multiple, uncoordinated and sometimes conflicting initiatives has significant unintended consequences for different stakeholders.

Duplicative, piecemeal efforts:

Clearly, a standard, more comprehensive view of physician practice is needed, but until now no mechanisms existed to assess performance using standard measures or to aggregate data from various sources. The AQA pilot will tests approaches to aggregating and reporting data on physician performance.
The pilot launched in early May, and sites expect to report data publicly in 2007. Discussion continues about expansion of the pilot to additional sites.