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www.MyMipsScore.com
MIPS on FHIR
Pawan Jindal MD, MS(HI)
Founder & President, MyMipsScore
®
www.MyMipsScore.com
Agenda
• Quality Payment Program Overview
• The Challenges In Quality Reporting
• Implementing a FHIR Based Quality Reporting Solution
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What Is Quality Payment Program?
A Program under which payments of eligible Medicare Part B providers are
adjusted based on their performance.
The Quality Payment Program has two tracks you can choose from:
– Advanced Alternative Payment Models (APMs) or
– The Merit-based Incentive Payment System (MIPS)
www.MyMipsScore.com
MIPS Vs Previous Programs
1. Absolute vs Score• Scored across 4 categories
• MIPS Scoring System - Points= $$
• Relative to peers
2. The score has financial implications
3. Reputational impact on both providers
and vendors
https://www.mymipsscore.com/mips-calculator/
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Quality Score is NOT based ONLY on performance rate
Quality Score
1. Selection of Measures
2. Submission Method
3. Bonus Points
2 providers with same performance rate, for same measures, could have different MIPS scores
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2014 / 2015
EHR
QRDA IC1
QRDA IIIC3
Performance
RatesC2
EHR Certification & MIPS
• Performance Rate vs Score
• 9 vs 271 Measures
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How much pie is healthy for me?
Certification only gives you the Performance Rate
Performance Rate + ???? = MIPS Score
• How many calories?
• Who ate it?
• What else did you eat?
• How much exercise did you do?
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What is MyMipsScore™ ?
A Patent Pending MIPS Score Simulator to analyze all 271 quality measures in real time
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The Problem?
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QRDA IQRDA III Claims
Patient Data filtered
by CQMs
C-CDA
Data aggregated by CQMs
No Patient data
Integration Options With EHR
EHR
Patient data filtered
based on the
purpose of C-CDA
Limited clinical data
• Most EHRs are certified for reporting on selected measures
• The cost of manual extraction of data vs benefits
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FHIR® to the rescue
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2014 / 2015
EHR
QRDA IC1
QRDA IIIC3
Performance
RatesC2
EHR Certification & MIPS
MyMipsScore™
MIPS Score
Analytics For
All Measures
FHIR Server
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Identifying FHIR “Resources”
1. US Core Implementation Guide
2. HQMF & QRDA-I Analysis
3. Registry Measures Definitions
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Patient
EncounterEncounter
Encounter
ObservationObservation
ObservationObservation
Observation
MedicationMedication
MedicationMedication
Medication
ProcedureProcedure
Other Resources
Bundle
Entry
Exporting Data From EHR
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EHR/PM
FHIR Bundle
(one per
patient)
The Bigger Picture
FHIR API
Cool App 1 Cool App 2MyMipsScore™
App
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Technology Stack
• Front End App
– Android
– iOS
– Windows 10
– Web Version Coming Soon
• FHIR Server
– ASP.NET Core
– Azure Cosmos DB
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Current Status & Next Steps
• EHRs Pilot
• 2015 EHR Edition Certification
• Connect to existing FHIR implementations
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www.MyMipsScore.com
More Resources
https://www.mymipsscore.com/mips-
blog/2017/6/26/can-mips-on-fhir-burn-qrda-and-ccdahttps://www.mymipsscore.com/mips-
blog/2017/12/3/azure-cosmos-db-hl7-fhir-a-match-
made-in-heaven
