This year, the American Board of Family Medicine is changing the way physicians perform chart review as part of their maintenance of certification.
Starting in January, the board replaced part 4 of the process—the traditional Computerized Office Record Review—with the new Performance in Practice Module. The PPM is a prospective system of evaluating and improving patient care.
“We'd really like to be able to assure our patients that family physicians are dedicated to performing quality medicine,” said Thomas Norris, M.D., president of the American Board of Family Medicine (ABFM) and vice dean for academic affairs at the University of Washington School of Medicine.
The new process will be similar to the old chart review system. Physicians will still be asked to submit information from selected patient records. However, whereas the old system was primarily aimed at maintaining high quality medical records, the new system will focus on evaluating systems of care and improving patient care, Dr. Norris said.
The information will be provided over the Internet and will be measured against evidence-based quality indicators. Physicians will receive feedback on their performance, and that information will be used to develop an individual quality improvement plan.
Later, physicians will be required to complete a follow-up record review to determine if their patient care has improved.
But the new process is likely to be less work for physicians than the old system, said ABFM executive director James C. Puffer, M.D. The system's prospective nature means that physicians won't spend as much time going back into records to extract information and that the board is requiring much less information from each of the patent charts, he said.
At press time, ABFM was finalizing its online instrument for completing the requirement. ABFM will offer physicians a choice of modules for either diabetes or hypertension this year. ABFM also plans to offer continuing medical education credit for the time spent completing the module.
In addition, the American Academy of Family Physicians has developed a program to aid physicians in completing the part 4 requirements of maintenance of certification. The program, called Measuring, Evaluating and Translating Research Into Care (METRIC), is awaiting approval from the American Board of Family Medicine.
METRIC is currently available for evaluation of diabetes care. AAFP plans to launch a coronary artery disease module in July and to continue to launch two new disease modules each year, according to Christine Pullman, METRIC program manager.
AAFP will also offer CME credit for physicians who complete the module.
The part 4 requirement was praised by Richard Feldman, M.D., chair of the board of the Indiana Academy of Family Medicine, who has been critical of other parts of the maintenance of certification process.
“It's probably the most important and positive addition that they've done to the whole program,” he said.
The new requirement gives physicians an opportunity to evaluate their performance and make positive changes in their practice routines, Dr. Feldman said, ultimately improving patient care.