Praxis and Quality Reporting

Praxis, pay-for-performance (P4P) and quality: How does it work?

Every reporting initiative requires that you 1) Adjust your workflow, then 2) Query your database and report results. Praxis lets you make these adjustments instantly, and in the way that works best for you. No other EHR makes reporting this effortless. Where do you want to take your practice? Praxis will get you there.

Adjust your workflow: Clinical Practice Guidelines (CPGs) provide medical advice, even entire treatment protocols, at the point of care. They work like agents, and are triggered when a patient meets certain criteria determined by the physician. Implementing and following CPGs is what allows you to report to pay-for-performance programs.

Praxis EMR's CPGs are the most powerful in medicine, and are built by the practitioner, for the practitioner- with all of the specifications you can imagine. The possibilities are endless. Some examples: "Provide all hypertensive patients with diet and exercise counseling." "Email all diabetic patients who have not come in for follow-up exams in the last 6 months." CPGs appear at the point of care, and only when they are needed, prompting you to fulfill quality measures.

CPGs in Praxis are triggered based on the encounter, not the diagnosis. There are hundreds of ways that an encounter can meet certain criteria (for instance, hypertensive patient over 60, or children under 3yrs who are in need of immunizations). This is a critical difference between Praxis and template EHRs. Templates miss the crucial point that a diagnosis is entirely separate from clinical criteria- in other words, many different people with different diagnoses fulfill the same criteria. Praxis CPGs ensure that you provide the appropriate care for the appropriate case, every time.

What's more, all CPGs appear in your own words, and are placed on your screen exactly where and how you want them to appear. Praxis EMR's dynamic field feature lets you see CPGs in your own language, while any report you export uses the language required by the third party program. Once you have established your CPGs, Praxis remembers them for all similar encounters in the future, allowing our doctors to hit 100% thresholds without disturbing their workflow. No template does this.

Query your database and report results: Praxis has the most powerful Query Engine out there. The Query Engine allows you to write your chart notes in free text, then query any data in your Praxis system with ease. To report to third parties, simply build CPGs around the appropriate quality measures, then build a query based on those measures. You are limited only by your imagination (for example, "What percentage of your hypertensive patients were given diet and exercise counseling?" or even "What percentage of patients over 47 who are both hypertensive and diabetic received smoking cessation advice?"). You can adjust your queries or build new ones in seconds. The Query Engine also presents endless possibilities for organizations interested in clinical research.

Best of all, Praxis is dynamic. As new quality measures are released or new programs are introduced, you can change your CPGs and your queries again- instantly! If you find a new program to report to, you can set up the necessary practice guidelines in minutes: no waiting for your software developer to build something new.

Why templates don't work for reporting

No template EHR does what Praxis does. But why don't templates work for reporting? Templates confine you to limitations set by the template manufacturer. Let's see how templates handle the same reporting steps:

Adjust your workflow: With templates, every change to your workflow requires a change to your templates, or a completely new template. You must depend on a software developer to hard-code any adjustments, and then install them in your system. Most EHR vendors charge for this service- some up to thousands of dollars. Those that don't charge can take weeks and months to create new templates.

Further, most templates guide you based on the diagnosis, not the encounter. This backwards thinking is not how medicine is practiced, and makes certain cases fall through the cracks. Many template manufacturers create dashboards to make up for this weakness, and claim that dashboards help users gauge the fulfillment of quality measures. Not true- dashboards are a waste of physician's time and a product of improper EHR design.

Query your database and report results: With templates, your software company needs to create and release a query for each and every template, every time. With Praxis, you create your own and adjust them in seconds. Overall, templates limit and restrict doctors, and this is never clearer than when trying to report to third parties.

The incompatibility between templates and reporting is one of the biggest sources of physician frustration today. The rigidity of templates makes reporting a hassle- many doctors say the feel like data clerks. What's more, they are completely dependent on their EHR companies to help them participate in any P4P or reporting program. Don't let your EHR company define medical quality for you.

Bottom line? Praxis liberates you and allows you to provide the best care possible, all while meeting quality criteria and reaping the benefits of pay-for-performance programs. There is no better way to attest to Meaningful Use, PQRS, PCMH, NCQA, or any other reporting initiative.

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