Improvement of the quality payment program by improving data reporting process: an action research

Area of Science:

• Health Services Research
• Health Informatics
• Public Health Policy

Background:

• Pay-for-quality (P4Q) programs require reliable data for successful implementation.
• Data validity, timeliness, and accuracy are crucial for provider performance measurement and payer interpretation.
• Action research was employed to develop an effective data reporting method for P4Q initiatives.

Purpose of the Study:

• To establish and evaluate a data reporting method for pay-for-quality programs.
• To align theoretical frameworks with practical application in healthcare data management.
• To improve the efficiency and effectiveness of P4Q program implementation through enhanced data systems.

Main Methods:

• A qualitative approach utilizing three cycles of action research was conducted from September 2015 to March 2017 in East-Azerbaijan, Iran.
• Purposeful sampling included healthcare providers, district health center staff, experts, and provincial primary health center managers.
• Data collection involved interviews, focus group discussions, and expert panels, with content analysis used for synthesis. Decisions were consensus-based.

Main Results:

• Key dimensions identified for the data reporting method included data entry/accuracy, reporting, analysis/interpretation, flexibility, and training.
• Implementation of an online data reporting system significantly improved performance data documentation, provider/staff satisfaction, and P4Q program acceptance.
• The online system was expanded nationwide for data collection and incentive payment calculation, with further enhancements through EMR linkage and automated feedback.

Conclusions:

• A web-based computerized system, capable of linking to medical records and providing feedback, was identified as an optimal data reporting method for P4Q programs.
• Participant consensus highlighted the system's appropriateness and effectiveness in supporting P4Q initiatives.
• The study demonstrated a successful model for data reporting that enhances P4Q program performance and stakeholder satisfaction.