In 2011, we published a paper entitled, “Why is it hard to do the right thing in wound care?” in which we documented that only 17% of venous ulcers were treated with adequate compression every time they were seen at a wound center. Those statistics were shocking. What were the patients treated with? Patients with large, active venous ulcers were told to elevate their legs, wrapped with ace bandages, put in single layer tubigrip or provided with TED hose. That’s when the USWR conceived the program we began calling, “Do the Right Thing” to raise the standard of care for patients with chronic wounds. We weren’t able to get CMS to put a well designed venous compression measure into the PQRS system, but we developed one of our own within the USWR in 2014. That measure requires clinicians to put patients in adequate compression at each visit, with “adequate” being defined as a system that can provide at least 30 mmHg at the ankle (e.g. multilayer bandages, Unna’s boot, etc.).
In 2016 (5 years after our original study), we looked at USWR data on compression again. The news is somewhat better. The average performance rate across the board for clinicians reporting data to the USWR is now 51% (up from 17% in 5 years). That’s a huge improvement, but the story does not end there.
A few of those practitioners (13%) selected the venous compression measure as one of their PQRS measures in 2016. Among those who reported the venous compression measure to CMS, the performance rate was 80.4%. These data from the USWR demonstrate how quality reporting can play a role in raising the bar on the standard of care for venous ulcers, and help clinicians “Do the Right Thing.”
Be a practitioner who does the right thing in 2017. Participate in MIPS through the USWR.
Caroline Fife, MD Twitter | Facebook | LinkedIn