AIM Overview

Welcome to Assess, Improve, Measure, or AIM, the Gout Practice Improvement Module from the American College of Rheumatology. AIM is a Web-based self-evaluation of practice performance tool designed to guide a physician or physician-designated abstractor (usually office staff) through medical chart data abstraction using a series of questions related directly to evidence-based medicine quality indicators. AIM is designed for those physicians engaged in the American Board of Internal Medicine (ABIM) Maintenance of Certification program, or those physicians seeking a quality improvement or practice audit tool.

The data will culminate in an automated report enabling physicians to:

• Reflect on practice performance data
• Identify their practice strengths and areas in need of improvement
• Develop and implement an improvement plan
• Assess impact of change through re-measurement
• Report changes

AIM is equipped with comprehensive data reports and templates for the development of the physician improvement plan and impact statement. The improvement plan allows the physician to create a detailed course of action for practice improvement during the improvement phase. The impact statement, which signifies the completion of the module, allows the physician to reflect on his/her experience and practice performance.

As the program expands, rheumatology-related benchmarks will become evident allowing each physician to evaluate his/her practice on its own merit or against the aggregated performance statistics of other practices. AIM contains educational links to quality-related Web sites, and includes helpful hints for developing and adhering to the improvement plan.

AIM offers up to 20 AMA PRA Category 1 Credits^TM and 20 ABIM MOC practice performance points. Upon completion of the module, you will be instructed on how receive the credits and/or points you selected during the registration process.

AIM Template Overview

AIM is to be completed in the steps outlined below. To move forward to the next step, the previous requirements must be complete (e.g., all steps in Part 1 must be completed prior to moving on the Part 2, etc). The links within the site on the Main Menu page will only become available when the previous steps have been completed. Review the outline and directions below.

Part 1 - DATA COLLECTION - First Abstraction

Medical Chart Selection Guidelines

• Charts used must be of patients seen within the last 12 months.
• Charts are to be selected at random.
• Patients cannot be involved with clinical trials.
• Practice must have a large volume of gout patients to accommodate both abstraction phases; patient charts abstracted during the first abstraction can be used during second abstraction, but must have been seen since beginning the improvement plan phase. *Group practice numbers will vary based on number of participating physicians
• For the second abstraction, pull charts of patients that have been seen since beginning the improvement phase.
• Participants will be eligible for CME credits and ABIM MOC points.
• Abstract de-identified data from 25 gout patient charts. Group practice numbers will vary due to number of participating physicians. Abstractor or physician can complete this section (approximately 10 to 15 minutes per chart after training).
• Physician completes the Examine Systems surveys regarding practice characteristics and improvement processes within the practice (approximately 10 questions).
• If group, the lead physician would complete this component.
• Physician reviews the aggregate data report from the abstracted patient charts and identifies quality measures to be improved during the improvement phase. Physician approves and submits final report of the first abstraction.
• If group, all participating physicians would review the data and select the measure(s) in consultation. The lead physician would then complete the online portion of the template based on the group discussion.

• Physician develops the improvement plan by using the template provided within AIM: Gout. Once plan is approved and submitted, the physician can begin implementing plan into practice.
• If group, all participating physicians would participate in the development of the plan. The lead physician would then complete the online portion of the template based on the group discussion.
• Once plan is approved and submitted, group can begin implementing plan into practice.
• Improvement strategies should be for new and/or follow-up patients according to the number of gout patients seen within the practice.
• Many of the AIM: Gout quality indicators involve newly prescribed medications; therefore, pending the number of new gout patients, it may be difficult for AIM participants to fully measure the impact of their improvements in these areas. Seeing 25 to 30 new gout patients during the six-month improvement period may not be realistic. Please consider this during the development of the improvement plan.

• Similar to Part 1 - re-measure 25 charts to assess the impact of changes that took place during the improvement plan phase. . Abstractor or physician can complete this section (approximately 10 to 15 minutes per chart after training).
• Ideally, these charts should be different than those from the first abstraction and must be patients that have been seen since beginning the improvement phase.
• Physician completes the Examine Systems surveys regarding practice characteristics and improvement processes within the practice (approximately 10 questions).
• If group, the lead physician would complete this component.
• Physician reviews the aggregate data from the second abstraction of patient charts and approves the data report.

• Physician completes the impact statement by using the template provided within AIM: Gout. Impact statement offers comparison of first and second data abstractions. This signifies the completion of the module and pilot phase.
  • If group practice, all participating physicians would discuss the impact statement. The lead physician would then complete the online portion of the template based on the group discussion.

Group Practice Guidelines

• Practices with more than once physician participating in AIM can register as a group practice.
• Group practices must select one physician to be the lead physician. The lead physician:

  • Registers the group members and abstractors
  • Completes the Examine Systems surveys for the group
  • Approves the group report in both first and second abstractions
  • Develops and approves the improvement plan WITH group input and consensus
  • Ensures each group member adheres to the improvement plan during the six-month improvement phase
  • Develops and approves the impact statement WITH group input and consensus

Group chart selection requirements: group practices with fewer than five participants review at least 25 charts; groups with five or more participants review five charts each e.g., 10 participants review a total of 50 charts.

Help Desk

• Contact the ACR office for assistance at (404) 633-3777, ext 338, or send an email to PIM@rheumatology.org.
• Assistance is available Monday - Friday from 9:00 am – 5:00 pm ET.