Blue Nine QCDR

Our Quality Clinical Data Registry has 100% submission acceptance from CMS.

Background

Blue Nine QCDR was first created in 2017 and has been approved again in 2018. As a Qualified Clinical Data Registry (QCDR), we allow the users of Neptune™, our mobile anesthesia information management system (AIMS), to effortlessly capture Quality Payment Program (QPP) quality data at the point of care. In addition, we have a complimentary online portal (Triton™) specifically dedicated to facilitate pre- and post-operative data collection in a simple, provider-friendly manner. Using Triton™, any missing quality data can be supplemented on the portal at any time to ensure all reporting requirements are met. These two systems combined provide full perioperative data collection.

By working coordinately, Neptune™ and Triton™ are able to ensure that data is submitted accurately and is a direct representation of the care documented by healthcare providers. This coordination allows for a seamless transmission of remote data from each provider regardless of location that is synchronized to our central HIPAA-secure relational data repository. This secure repository houses the all the information needed to calculate and transmit each of the quality measures associated with each individual provider TIN/ NPI. At the end of the 2018 reporting period, all quality data will be analyzed for both completeness and accuracy before being sent to CMS.

The failure of a provider to participate in QPP for 2018 will result in a negative 4% adjustment to reimbursements in 2020. However, a provider using our system not only avoids this negative payment adjustment, but also has the best possible chance of receiving the maximum reimbursement bonus in 2020.

Supported Measures

  • Coronary Artery Bypass Graft (CABG): Preoperative Beta-Blocker in Patients with Isolated CABG Surgery (044)
  • Prevention of Central Venous Catheter (CVC) – Related Bloodstream Infections (076)
  • Documentation of Current Medications in the Medical Record (130)
  • Perioperative Temperature Management (424)
  • Post-Anesthetic Transfer of Care Measure: Procedure Room to a Post Anesthesia Care Unit (PACU) (426)
  • Post-Anesthetic Transfer of Care: Use of Checklist or Protocol for Direct Transfer of Care from Procedure Room to Intensive Care Unit (ICU) (427)
  • Prevention of Post-Operative Nausea and Vomiting (PONV) – Combination Therapy (430)
In addition to the above measures, Blue Nine also supports an additional 4 measures created by the Anesthesia Quality Institute (AQI) for the 2018 reporting year:

AQI50

QCDR Organization Name
AQI NACOR
Measure Title
Application of Lung-Protective Ventilation during General Anesthesia
Measure Description
Percentage of patients, aged 12 years and older, who undergo general anesthesia care that includes an endotracheal tube who had a median exhaled tidal volume less than 10 mL/kg of ideal body weight during positive pressure ventilation (PPV)
NQS Domain
Effective Clinical Care
Numerator
Patients who had a median exhaled tidal volume less than 10 mL/kg of ideal body weight during positive pressure ventilation (PPV).

Numerator Note: Positive pressure ventilation strategies include conservative tidal volume, lower peak airway pressures, positive end-expiratory pressure (PEEP) and lung-recruitment interventions to prevent atelectasis.
Denominator
Denominator (Exclusions/Exceptions)
-ASA Physical Status 5 or 6
-Patients continuously receiving inhaled medications (e.g. inhaled epoprostenol or nitric oxide)
-Patients with a diagnosis of pulmonary hypertension
-Patients who require hyperventilation for therapeutic reasons (e.g. elevated intracranial pressure, malignant hyperthermia, or thyroid storm)
-Patient was mechanically ventilated for
-Single-lung ventilation procedure

AQI54

QCDR Organization Name
AQI NACOR
Measure Title
Use of Pencil-Point Needle for Spinal Anesthesia
Measure Description
Percentage of patients, regardless of age, who undergo an obstetric procedure using spinal anesthesia where a pencil-point needle is used to access the intrathecal space
NQS Domain
Patient Safety
Numerator
Patients where a pencil-point needle is used to access the intrathecal space.

Numerator Definition: For the purposes of this measure, pencil-point needles include the following:
· Whitacre
· Sprotte
· Pencan
· Gertie Marx
Denominator
Denominator (Exclusions/Exceptions)
N/A

AQI56

QCDR Organization Name
AQI NACOR
Measure Title
Use of Neuraxial Techniques and/or Peripheral Nerve Blocks for Total Knee Arthroplasty (TKA)
Measure Description
Percentage of patients, regardless of age, that undergo total knee arthroplasty for whom neuraxial anesthesia and/or a peripheral nerve block is performed.
NQS Domain
Effective Clinical Care
Numerator
Patients for whom neuraxial anesthesia and/or a peripheral nerve block is performed.
Denominator
Denominator (Exclusions/Exceptions)
Denominator Exception: Documentation of patient reason(s) for not using either neuraxial anesthesia or a peripheral nerve block (e.g., patient refusal)

AQI59

QCDR Organization Name
AQI NACOR
Measure Title
Multimodal Pain Management
Measure Description
Percentage of patients, regardless of age, undergoing selected elective surgical procedures that were managed with multimodal pain medicine.
NQS Domain
Effective Clinical Care
Numerator
Patients for whom multimodal pain management is administered in the perioperative period from six hours prior to anesthesia start time until discharged from the postanesthesia care unit.

Numerator Definition: Multimodal pain management is defined as the use of two or more drugs and/or interventions, NOT including systemic opioids, that act by different mechanisms for providing analgesia. These drugs and/or interventions can be administered via the same route or by different routes. Opioids may be administered for pain relief when indicated but will not count towards this measure.

Numerator note: Documentation of qualifying medications or interventions provided from six hours prior to anesthesia start time through PACU discharge count toward meeting the numerator.
Denominator
Denominator (Exclusions/Exceptions)
Exception: Documented allergy to multiple classes of analgesics