Prescriber Feedback Reports and Their Implications on Drug Utilization

Prescriber feedback reports can be utilized to work toward several goals, including the assurance of minimum standards, quality improvement, meeting quality or resource use performance targets, and explaining variations in care. While claims-derived reports can provide certain utility, robust data are required to provide meaningful insights. Accountable care organizations (ACOs) and integrated delivery networks (IDNs) can utilize data obtained through electronic medical record (EMR) access to provide prescribers with substantial actionable findings; however, prescriber feedback reports produced in-house do not come without challenges.

As ACOs and IDNs have access to rich data with meaningful insights through EMR access, providers are able to collaborate with appropriate peer comparators in identifying ways to optimize drug utilization. In comparison to claims reports, prescriber feedback reports produced in-house cover multiple payers, and prescribers may trust internal reports more than external reports. In comparison to claims-based reports, which can only provide prescribers with their utilization rates in comparison to the average, statistically adjusted prescriber feedback reports made available by in-house analyses provide prescribers with observed (actual) values, expected (modeled) values, and confidence intervals around the expected value. This provides more substantial insights, as patient variables are considered, and prescribers can see if they are prescribing differently than their peers in a statistically meaningful way. However, it should be noted that differences in prescribing are not necessarily good or bad; such differences simply indicate a need to look further into prescribing habits to assess appropriateness of care. In-house prescriber feedback reporting additionally allows for unblinded reporting, allowing for peer comparison. Though it should be noted that unblinded reports can lead to physician frustrations, proactive work can be done to ensure the information is conveyed in a way that will be received well and that sufficient context is provided.

Another advantage of in-house prescriber feedback reports in comparison to claims-derived reports is the timeliness of reporting. Whereas claims-derived reports generally are not provided until much after the data collection period, in-house reporting can allow for timely report delivery. Delivery of prescriber feedback reports can be completed both digitally and in person; however, in-person delivery allows for immediate live support and prompts group discussions, potentially prompting further investigation into differences. One notable disadvantage of in-person delivery in comparison to digital delivery, however, is that there may be significant lag time between data collection and the presentation of findings to prescribers, depending on logistical constraints. While in-house prescriber feedback reporting may be best initiated in person for level-setting physicians on the utility and processes, eventually switching to digital delivery may allow for faster delivery and more timely reporting to physicians.

Although the advantages of in-house prescriber feedback reports are clear, creating the infrastructure to develop such reports requires an abundance of work and resources. Project management, statistical support, data analysis, and clinical input for design and quality assurance are all crucial to successful development of in-house prescriber feedback reporting capabilities. However, though modeling and interface development take time, effort, and expertise, once developed, in-house prescriber feedback reporting processes can be efficiently maintained. While claims-derived prescriber feedback reports do provide certain utility, in-house prescriber feedback reporting processes developed by ACOs and IDNs can be tailored to provide meaningful insights and to focus on specific institutional trends, providing increased utility to both prescribers and health systems.

Source:

Low G, Weilburg J. Improving drug utilization with prescriber feedback reports. Presented at: 2022 Academy of Managed Care Pharmacy Nexus Annual Meeting; October 11-14, 2022; National Harbor, MD. Educational session M6.

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