Solutions Start to Emerge for Cumbersome EHR Reporting

Eric Schultz

Cota, a New York-based precision informatics company, has developed what it says will be a significant aid for oncology practices working to conform to the expectations of CMS’s Oncology Care Model (OCM), which is designed to encourage physicians to strive for better patient outcomes and lower costs. The new tool, Cota OCM, is one of many attempts recently to help physicians overcome the manually intensive and sometimes inflexible electronic health record (EHR) systems they are increasingly required to use for CMS reporting.

Cota, which for the past decade has been developing software for organizing and making better use of patient data, says its newest product will help oncology practices to simplify the process of meeting reporting requirements under the OCM, which CMS launched this year with 190 participating practices. The product takes account of the many different quality measures upon which practice performance may be measured and allows for automated data collection and reporting. The product is also adaptable for use with other CMS-based quality improvement programs. OCM participants have long been challenged by the difficulty of how to gather and report quality metrics data without using excessive amounts of staff time. Some practice administrators have complained of large manual data uploading tasks.

Whereas it is not clear how well Cota OCM will alleviate these problems, the company expressed confidence that its new product will significantly ease some of the difficulties physicians and practice administrators have experienced thus far with OCM reporting. “Participating in the OCM presents massive challenges to providers, as they lack the infrastructure and resources to comply with—much less succeed—in the program," said Eric Schultz, CEO of Cota. "Cota's OCM solution automates and reduces the burden of data gathering, quality metrics calculation, and reporting, while providing actionable insights that help providers maximize their incentive payments [under CMS payment models]."

Cota OCM is an outgrowth of what the company calls its nodal address system (CNA Guided Care Platform), a big data effort to collect and categorize large quantities of patient information and facilitate the analysis of that data in order to arrive at a better understanding of how specific therapies will work with individual patients.

The nodal address system from Cota takes raw structured and unstructured patient data from any EHR platform and converts it into a form usable for analysis.

The company says its newest offering automates many functions for the convenience of providers. “Cota OCM includes powerful capabilities such as automatically qualifying eligible patients and calculating all required practice-reported measures, automatically preparing and submitting data to CMS, and a new web interface for providers to optimize program performance,” the company said in a release. Company officials added that they will make human technical and oncology specific clinical experts available to support the OCM tool.

This year, CMS raised the standards for practices by requiring them to participate in quality improvement programs, show measurable progress, and eventually submit to potential financial penalties or reduced payments if they do not improve as required. The goal is to move away from a system that rewards physicians for volume-based billing rather than quality outcomes. Cota said its newest software product incorporates all recent changes to quality measure calculations issued recently by CMS and also debuts features enabling practices to analyze their performance by any combination of quality measure, physician, site, and patient to discover improvement opportunities.

"As CancerLinQ itself scales up to help doctors assess and improve their care in everyday practice, CancerLinQ Discovery will leverage our collaboration to enable the entire care and research community to explore some of our most pressing treatment and scientific challenges," said Clifford A. Hudis, MD, CEO of ASCO and chair of the CancerLinQ board.

A variation on this theme comes from Flatiron, a relatively new company that has been inking partnerships with cancer treatment centers in order to collect unidentified patient data from their EHRs and use it to investigate real-world outcomes. Whereas the FDA may base its drug approval decisions on trials that involve patients in relatively good health, Flatiron’s system is able to collect actual case examples of average patients who have used the same therapies. This enables researchers to look at results from real-world patient populations that are much larger than those examined in trials and get a better understanding of how drugs will work with the type of patients that are actually showing up in clinics.

The company bills its nodal address system as being able to precisely categorize patient factors, diseases, and intended therapies, enabling precision medicine at a large scale. Many other big data products and services have arisen in the age of powerful computing capability. ASCO has promoted its CancerLinQ service, which, like Cota, builds on the collaborative power of many institutions sharing information about patients and therapy outcomes. CancerLinQ also works to simplify the electronic record process so that physicians and other healthcare workers can more nimbly exchange data for large scale interpretive and discovery efforts. CancerLinQ now includes over 1.5 million patient records, and more than 70 oncology practices have agreed to contribute data to CancerLinQ's core quality improvement and data-sharing platform, ASCO said in a recent announcement about a collaboration with AstraZeneca.