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Development of quality measures has become critical with the new healthcare environment that demands the practice of quality medicine. The AMA-Physician Consortium for Performance Improvement® (PCPI) has taken the lead on measure development and currently has developed measurement sets in 43 clinical areas and preventive care encompassing more than 260 individual measures. These measures are used by carriers and CMS to determine that a physician is practicing “quality” medicine. An overly simplified example is in the care of diabetics. One diabetic measure is whether the physician has obtained a HgbA1c within the past year. This must be documented in the medical record for the physician to receive appropriate reimbursement. For further information on measure development, please access the AMA website and search for AMA-PCPI.

As Allergist/Immunologists, there have been very few measures developed that apply to the diseases that we treat and those that have been developed (e.g. asthma) are very rudimentary. With this in mind, the AAAAI and ACAAI have formed a taskforce to develop measures. The hope is that these measures will contribute to improvement in the quality of care delivered by A/I specialists; and, secondarily, that these measures will be available for the physician to use if and when the time comes that outside entities require them.

Over the past two years we have asked you to review measures for the practice of subcutaneous immunotherapy and urticaria. This year, we are developing measures for Rhinitis.
After years of treating patients with rhinitis, there still exist some discrepancies in the approach to this disease amongst physicians. These measures have been developed based on the draft of the latest Rhinitis practice parameter. The individual measures as illustrated on the accompanying document consist of the following:

  • The measure
  • The numerator consisting of patients meeting the measure
  • The denominator consisting of all patients eligible to meet the measure
  • The denominator exclusions for why measure could not be met on individual patient
  • The supporting guideline and reference for the measure

These measures will be disseminated to the allergy community for a 30 day review and feedback period for evaluating the appropriateness of each individual measure in a clinical setting, the practicality of completing these measures, and the necessity of these individual measures. We would appreciate all constructive comments and criticism regarding the need and practicality of each of these measures. All comments will be dutifully reviewed by the group. Thank you in advance for your efforts to help us develop the best measures for rhinitis!

Mark Corbett MD, University of Louisville
Robert Nathan MD, University of Colorado Health Sciences Center

Phil Lieberman MD, University of Tennessee Memphis
Jonathan A. Bernstein MD, University of Cincinnati
Mark Dykewicz MD, Saint Louis University
Warner Carr MD, Southern California Research Center

Task Force Co-Chairs

Michael Blaiss MD, University of Tennessee
Michael Schatz, MD, MS, University of California, San Diego Health Systems

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