Administrative Health Data to Assess Performance in a Myelodysplastic Syndromes CME Initiative
Background: Using administrative health data for performance and quality improvement is appealing because such data are readily accessible, measurable, and scalable for a variety of continuing medical education (CME) programs.
Method: Here we provide a critical evaluation of how administrative health data can be used to evaluate a CME initia-tive designed to improve physician performance in the diagnosis of myelodysplastic syndromes (MDS). Steps involved in this process include identiﬁ cation of practice gaps; speciﬁ cation and validation of International Classiﬁ cation of Diseases, 9th Revision (ICD-9), and Current Procedural Terminology (CPT) codes that can be used as measures of performance, devel-opment, and implementation of effective CME (context-based, interactive learning with practical application); and direct measurement of performance at baseline and post CME.
Results: Using practice gaps in the diagnosis of MDS as a case study, the performance measure used was time from initial diagnosis of anemia (nonspeciﬁ c diagnosis) to ﬁ rst MDS diagnosis (speciﬁ c diagnosis). This coding speciﬁ cation was used to retrospectively evaluate performance among physician participants in our 2006 MDS CME activities. Compared with a control group of demographically similar physicians who did not attend our CME activities, physician participants in our 2006 CME activities diagnosed signiﬁ cantly more patients with MDS within 6 months of initial diagnosis of anemia and had a 29% lower median time to ﬁ rst diagnosis of MDS from the initial diagnosis of anemia.
Conclusion: Health insurance claims data can be used for performance evaluations of physicians participating in a CME activity who have adequate representation in an administrative healthcare database.
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