Abstract
Purpose :
To evaluate the rate of compliance with the federal Physician Quality Reporting System (PQRS) measure #12 (NQF 0086) in patients undergoing surgery for neovascular glaucoma (NVG) and to compare the rate of compliance between paper charts and electronic medical records (EMR) at an academic tertiary care ophthalmology practice.
Methods :
A retrospective review of eyes with NVG that underwent either cyclophotocoagulation (CPC) or Ahmed glaucoma valve (AGV) implantation between January 2017 and September 2019, a time period before and after the conversion to EMR in 2018. Assessment of PQRS compliance was based on adequate physician documentation of the optic disc; this includes a direct measurement of cup-to-disc ratio, a description of the nerve, an illustration of the nerve, or mentioning of other reasons for not providing documentation (such as media opacity limiting view). Alpha= 0.05; t-tests and Fisher’s exact tests were used for comparisons.
Results :
45 eyes from 43 subjects were included. Forty (89%) met PQRS measure #12 prior to their surgery. Nine (23%) of 40 that met criteria were unable to have the optic nerve evaluation documented due to the presence of media opacities, such as vitreous hemorrhage. Five (13%) of 40 that met criteria did not have a documented cup-to-disc ratio but instead had descriptive words such as “pallor” or “NVD.” There was no significant difference in the rate of compliance based on surgery type (21/25 [84%] before CPC, 19/20 [95%] before AGV, P=0.36), sex (P=0.65), lens status (P=0.14), or etiology of NVG (P=1.0). The mean [95% confidence interval] cup-to-disc ratio prior to surgery was 0.74 [0.64-0.84]. There were no significant differences in cup-to-disc ratio based on pre-operative lens status (P=0.40), laterality (P=0.35), etiology of NVG (P=0.20), or sex (P=0.99). Further, no significant difference was noted in the rate of compliance whether the results were recorded on paper charts or on an EMR platform (21/25 [84%] on paper charts, 19/20 [95%] on EMR platform, P=0.36).
Conclusions :
Conversion from paper charts to EMR system at a large teaching academic institution can be effectively implemented while still maintaining a high compliance rate to PQRS quality measures.
This is a 2020 ARVO Annual Meeting abstract.