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Updated: Oct 9, 2025

E-Patient Counseling Trial E-PACO: Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy
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Measuring and Improving Evidence-Based Patient Care Using a Web-Based Gamified Approach in Primary Care (QualityIQ):

Trever Burgon1, Linda Casebeer2, Holly Aasen2

  • 1QURE Healthcare, San Francisco, CA, United States.

Journal of Medical Internet Research
|December 23, 2021
PubMed
Summary

QualityIQ, a novel simulation tool, significantly improved primary care physicians' evidence-based clinical decisions and adherence to Merit-Based Incentive Payment System (MIPS) measures. The tool demonstrated scalable engagement and enhanced quality care across various conditions.

Keywords:
MIPScare standardizationcase simulationcontinuing educationdecision-supportfeedbackgamificationmedical educationoutcomephysician engagementquality improvementserious gamesimulationvalue-based care

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Area of Science:

  • Medical Education
  • Health Informatics
  • Clinical Quality Improvement

Background:

  • Unwarranted clinical practice variability leads to suboptimal patient outcomes and inefficient healthcare.
  • Addressing this variability is crucial for improving care quality and reducing costs.

Purpose of the Study:

  • To introduce QualityIQ, a novel patient simulation tool.
  • To assess QualityIQ's effectiveness in aligning primary care physicians' decisions with Merit-Based Incentive Payment System (MIPS) best practices.

Main Methods:

  • Developed an automated QualityIQ platform with real-time, evidence-based feedback and gamified peer benchmarking.
  • Conducted a cross-sectional study with primary care physicians randomized to continuing medical education (CME) or non-CME arms.
  • Physicians completed 8 simulated weekly cases; outcomes included participation, quality score changes, and adherence to MIPS measures.

Main Results:

  • Achieved strong engagement: 75% of participants completed at least 6 of 8 cases.
  • Demonstrated significant improvements in evidence-based decisions for conditions like diabetes (+8.3%) and osteoarthritis (+7.6%).
  • Showed marked increases in MIPS quality measures, including diabetes eye exams (+22%) and depression screening (+11%).

Conclusions:

  • QualityIQ effectively improves evidence-based care decisions among practicing physicians.
  • Short, detailed case simulations with real-time feedback and peer benchmarking are key drivers of improvement.
  • While CME availability did not impact enrollment, it correlated with higher case completion rates.