What is GIQuIC?
GIQuIC Vision and Mission
History
Board of Directors and Partners
Why Participate in GIQuIC?
GIQuIC Measures

What is GIQuIC?


Click here to view an audio recording and slide presentation by Dr. Irving Pike giving an in-depth overview of GIQuIC.

GIQuIC is raising the bar on efficiency, effectiveness, and reliability in benchmarking.
 
Physicians from hospitals, universities, ambulatory surgery centers, and office-based endoscopy units nationwide are participating in this ground-breaking initiative by collecting and electronically reporting on quality indicators for colonoscopy.

Endoscopy data must be collected in a systematic method and used to measure the quality of endoscopy practices. Ongoing development and testing of metrics for specific endoscopy procedures is required. Critical to success is the need to report industry-wide performance against measurable processes and practices at the national level. GIQuIC objectives include the following:

  1. Establish a national GI endoscopy data repository for storage and maintenance of Endoscopy Quality Measures for GI Endoscopists who want to document and improve their endoscopy performance.
  2. Provide Benchmarking reports to participating physicians and facilities to support their quality improvement initiatives.
  3. Identify gaps in care and develop Endoscopy Quality Indicators to address gaps.
  4. Collect data that can be used by researchers conducting clinical outcomes studies and quality initiatives

The GIQuIC registry was built and is maintained by FIGmd, which has significant experience in healthcare registry development.

GIQuIC Vision and Mission


Vision
To set the standard for measuring and improving the quality of digestive health care.
Mission
To promote the highest quality delivery of digestive health care through:

  • Defining and measuring metrics
  • Performance evaluation
  • Analysis and statistical comparison
  • Continuous quality improvement
  • Research and education

History


David Bjorkman indicated providing the best possible patient care is the most important goal for GI Endoscopists. Measuring the quality of endoscopy services is at best challenging. The GI Endoscopist community has experienced increased pressure to track and report patient outcomes data (Bjorkman, 2006; Faigel et al 2006).3,4 For example, the Institute of Medicine’s (IOM) report To Err is Human: Building a Safer Health Systemincreased the public’s awareness of medical complications occurring in our nation’s hospitals.1 The Institute’s follow-up report, Crossing the Quality Chasm: A New Health System for the 21st Century, suggested widespread change is needed within the health care system to improve both quality of care and patient outcomes.2

Empirical data to grade Endoscopists’ performance for colonoscopy, esophagogastroduodenoscopy, endoscopic retrograde cholangiopancreatography, and endoscopic ultrasonography are lacking.3 GI Endoscopists formed a national task force to identify and develop quality indicators and suggest methods to collect, empirically analyze, and report endoscopy data.5-8 The goal of the task force was to provide valid and reliable comparative information for consumers and payers. It was the hope that these data would provide a practical, objective method to grade performance as well as prepare the industry for future reporting requirements from public and private insurers. The most important goal is to “provide the best possible patient care…and measure [Endoscopist’s] ability to achieve that goal” (Bjorkman, 2006, pg. 864).

From 2006-2009 Sentara Healthcare successfully completed a pilot project whereby physicians from across the country submitted colonoscopy quality indicator data6 to a central repository, using diverse methods of submission. This included extraction both from paper charts and endowriter software. These data collection strategies demonstrate different methodologies and devices, for recording endoscopy procedures, can benchmark using a central data repository. Additionally, benchmark reports can be used to provide physicians feedback on their performance.

In 2009, the two GI societies, The American College of Gastroenterology (ACG) and the American Society of Gastrointestinal Endoscopy (ASGE), agreed to take over the project and roll it out nationally. They jointly established the non-profit educational and scientific organization, The GI Quality Improvement Consortium, Ltd (GIQuIC).

  1. Institute of Medicine. (1999). To err is human: Building a safer health system. Washington D.C. National Academy Press.
  2. Institute of Medicine (2001).Crossing the Quality Chasm: A New Health System for the 21st Century. Washington D.C. National Academy Press.
  3. Bjorkman, David J.Measuring the quality of endoscopy. Gastrointestinal Endoscopy 63(4):S1-S2, 2006.
  4. Faigel, Douglas O., Pike, Irving, M., Baron, Todd H., et al. Quality indicators for gastrointestinal endoscopic procedures: An introduction. Gastrointestinal Endoscopy 63(4):S3-S9, 2006.
  5. Cohen, Jonathan, Safdi, Michael A., Deal, Stephen E., et al. Quality indicators for esophagogastroduodenoscopy. Gastrointestinal Endoscopy 63(4):S10-S15, 2006.
  6. Rex, Douglas, K., Petrini, John I., Baron, Todd H., et al. Quality indicators for colonoscopy. Gastrointestinal Endoscopy 63(4):S16-S28, 2006.
  7. Baron, Todd H., Petersen, Bret T., Mergener, Klaus, et al. Quality indicators for endoscopic retrograde cholangiopancreatography. Gastrointestinal Endoscopy 63(4):S29-S34, 2006.
  8. Jacobson, Brian C., Chak, Amitabh, Hoffman, Brenda, et al. Quality indicators for endoscopic ultrasonography. Gastrointestinal Endoscopy 63(4):S35-S38, 2006.

Board of Directors and Partners


GIQuIC Directors and Officers

Costas H. Kefalas, MD, MMM, FACG, FASGE • Director and President

Dr. Kefalas has been in practice at Akron Digestive Disease Consultants, in Akron, Ohio, since 2003. He is the Vice President of the group and practices general gastroenterology.  He is Professor of Internal Medicine at the Northeast Ohio Medical University. Dr. Kefalas is on the Active Medical Staff at Summa Health in Akron, where he also serves as a Physician Director on the Board of Directors and as the Chair of the Committee on Governance.

Dr. Kefalas has served on numerous national and state professional society boards and committees. He is currently a Trustee on the American College of Gastroenterology (ACG) Board of Trustees. He served as Chair of the ACG Board of Governors from 2016-2018, and from 2008-2014, he was the ACG Governor for Northern Ohio. From 2011-2020, he served as the ACG Representative to the Digestive Disease National Coalition (DDNC). From 2014-2016, Dr. Kefalas was the DDNC President. Dr. Kefalas is a member of the Reimbursement Committee and MACRA Work Group of the American Society for Gastrointestinal Endoscopy. He co-founded the Ohio Gastroenterology Society in 2009, and served as its Founding President from 2011-2013.

Dr. Kefalas completed a combined BS/MD program at the University of Akron and at the Northeast Ohio Medical University. He completed an Internal Medicine Residency at Summa Health and a Gastroenterology Fellowship at Baylor University Medical Center in Dallas, Texas. Dr. Kefalas also obtained a Master of Medical Management (MMM) from Carnegie Mellon University in Pittsburgh, Pennsylvania.  

Colleen M. Schmitt, MD, MHS, FASGE, FACG • Director and Vice-President

Dr. Schmitt practices at the gastrointestinal specialty arm and is President of Galen Medical Group. She was chief of the Division of Gastroenterology at the University of Tennessee College of Medicine, Chattanooga Unit and founder and Medical Director of Memorial Research Center. Dr. Schmitt attended Jacksonville State University where she graduated with a B.S. in Biology and earned her medical degree at the University of South Alabama. Dr. Schmitt completed her internship and residency at Beth Israel Hospital in Boston before completing joint fellowships in Gastroenterology at Duke University Medical Center and Health Services Research at the Durham VA Hospital, while finishing a Master’s degree in Biometry and Informatics.

Dr. Schmitt has served on committees and boards for local and national organizations. She is a past president of the American Society for Gastrointestinal Endoscopy (ASGE). From 2005 to 2009, she served as chair of the ASGE Health and Public Policy Committee and was a member of the Research Committee for several years. She is a past president of the Tennessee Society for Gastrointestinal Endoscopy and serves on the Board of Directors for the Chattanooga Hamilton County Medical Society, and is active with the Tennessee Medical Association. She is a founding physician for Volunteers in Medicine, and a volunteer for the Project Access, organizations that provide healthcare for the uninsured.

Brett Bernstein, MD, MBA, FASGE • Director and Secretary

Dr. Bernstein is the chief of gastroenterology at Mount Sinai Beth Israel and clinical associate professor of medicine. He currently serves as the co-director of clinical integration for gastroenterology and endoscopy for the Digestive Disease Institute of the Mount Sinai Health System. Dr. Bernstein has helped develop, implement and now monitor quality measurement and performance across all Mount Sinai Health System gastroenterology affiliates. After graduating from the Mount SInai School of Medicine, Dr. Bernstein completed post-graduate training at Mount SInai Beth Israel where he served as an internal medicine resident, chief medical resident, and gastroenterology fellow. He has served in numerous leadership roles over the course of his over three-decade career at MSBI including Director of Endoscopy, program director for the MSBI GI fellowship, and Chief Quality Officer for Beth Israel Ambulatory Services. In 2009, he founded Eastside Endoscopy, the first Manhattan based joint venture single specialty endoscopy center between Beth Israel and a large group of community based voluntary gastroenterologists. As the medical director of the Provider Partners of Mount Sinai IPA from 2015-2016, Dr. Bernstein helped in the development and implementation of a clinical integration program for over 3000 employed and community-based physicians in the Mount Sinai Health System. A national thought leader in endoscopic quality, Dr. Bernstein serves as a board member of GIQuIC, the largest national registry for GI quality data and also was chosen as the chair of the registry's new clinical measures committee. In addition, he now serves as the Co-chair of the Colonoscopy Quality Committee, NYC Colonoscopy Quality Initiative Cancer Prevention and Control Program (C5). He has numerous peer reviewed publications and most recently co-authored "Guidance for resuming GI endoscopy and practice operations after the COVID-19 pandemic" appearing in the September issue of Gastrointestinal Endoscopy.

Jay N. Yepuri, MD, MS, FACG • Director and and Treasurer

Dr. Yepuri is a partner with Digestive Health Associates of Texas (DHAT), one of the largest gastroenterology group practices in the United States. He practices general gastroenterology and Advanced Therapeutic Endoscopy.

Dr. Yepuri is a native of Louisville, Kentucky. He earned his undergraduate degree from the University of Pennsylvania and his medical degree from the University of Louisville School of Medicine. He went on to complete his residency in Internal Medicine and his fellowship in Digestive and Liver Diseases at Parkland Hospital/The University of Texas Southwestern Medical Center at Dallas. He subsequently completed a fellowship in Therapeutic Endoscopy with Midwest Gastroenterology Associates in Louisville, developing expertise in ERCP, EUS and other advanced endoscopic procedures.

Dr. Yepuri is a member of DHAT's Board of Directors and Executive Committee. He is a Past-President of the Texas Society for Gastroenterology and Endoscopy (TSGE) and a Past-President of the Texas Ambulatory Surgery Center Society (TASCS).

Dr. Yepuri is ACG Governor for Northern Texas. He serves on the ACG's Practice Management Committee and was co-course director for the Committee's Course in 2018 and 2019. Dr. Yepuri also serves as a Surveyor for the Accreditation Association for Ambulatory Health Care.

Katie Farah, MD • Director

As the current Chief Medical Officer of Allegheny Health Network/Wexford Hospital and with a background as its Chief Quality Officer for the Division of Gastroenterology, Dr. Farah plays a key role in ensuring the highest quality of care is being delivered to patients. Toward that end, she was instrumental in standardizing colorectal cancer screening and surveillance initiatives across Highmark Health and has led endoscopic reprocessing and infection prevention at Allegheny Health Network.

Dr. Farah was recognized for her efforts with the American College of Gastroenterology Service Award for Colorectal Cancer Outreach, Prevention, and Year-Round Excellence several years in a row. She was also featured in Pittsburgh Magazine in 2021 as one of Pittsburgh’s best doctors according to Castle Connolly Top Doctors healthcare research company and was singled out by Becker’s GI and Endoscopy magazine in 2018 as one of the top “physicians to know” in the country. She has published multiple papers in peer-reviewed journals and has been a featured presenter at a number of national meetings. 

A skilled gastroenterologist and therapeutic endoscopist, Dr. Farah specializes in pancreaticobiliary disease, colorectal cancer screening initiatives, and general gastroenterology. She earned her undergraduate degree and Doctor of Medicine at George Washington University in Washington D.C. and completed her internal medicine residency and gastroenterology fellowship at Allegheny General Hospital in Pittsburgh. Dr Farah is a member of the American College of Healthcare Executives and is also in the process of completing her Certified Physician Executive certification through the American Association for Physician Leadership as well as a Master of Medical Management degree from Carnegie Mellon University.

 

GIQuIC Partners

The American College of Gastroenterology (ACG) and the American Society for Gastrointestinal Endoscopy (ASGE) have worked together for more than a decade on finding ways to establish scientifically sound standards for training, credentialing and quality measurement. In 2009, ACG and ASGE jointly established the non-profit educational and scientific organization, The GI Quality Improvement Consortium, Ltd (GIQuIC). The registry was developed by Outcome Sciences.

Founded in 1932, the American College of Gastroenterology is an organization with an international membership of more than 12,000 individuals from 80 countries. The College is committed to serving the clinically oriented digestive disease specialist though its emphasis on scholarly practice, teaching and research. The mission of the College is to serve the evolving needs of physicians in the delivery of high quality, scientifically sound, humanistic, ethical, and cost-effective health care to gastroenterology patients. For more information, visit gi.org.

Since its founding in 1941, the American Society for Gastrointestinal Endoscopy (ASGE) has been dedicated to advancing patient care and digestive health by promoting excellence and innovation in gastrointestinal endoscopy. ASGE, with nearly 12,000 members worldwide, promotes the highest standards for endoscopic training and practice, fosters endoscopic research, recognizes distinguished contributions to endoscopy, and is the foremost resource for endoscopic education. Visit www.asge.org for more information.

GIQuIC has partnered with FIGmd, Inc., a company with significant experience in healthcare registry development. FIGmd is the leading provider of healthcare registries and web-based solutions for measuring, improving and reporting on quality of care and patient outcomes. FIGmd provides clinical data registry, analytics, data reporting, and assessment solutions to medical practices, specialty societies, medical professional associations, hospitals, health systems, medical boards and others. FIGmd's technologies, solutions and customization capabilities allow organizations to massively scale their projects in a timely and cost-effective manner. For more information on FIGmd's solutions, visit www.figmd.com..

Why Participate in GIQuIC?


Benefits of Participating in the GIQuIC Registry:

  • Perform ongoing, peer-based performance evaluation and quality improvement (a requirement of accrediting bodies)
  • Provide benchmarking reports to participating physicians and facilities to support quality improvement initiatives
  • Identify gaps in care and develop quality indicators to address gaps
  • Improve clinical and patient outcomes through higher quality procedural services
  • Set the stage for improved performance reimbursements from Medicare and insurance companies
  • Instill in patients your commitment to quality care by participating in a quality improvement program
  • Conduct clinical outcomes research
  • Monitor fellow's endoscopy skill development
  •  Each facility will receive a certificate that indicates participation in GIQuIC and overall commitment to quality in patient care
  • Each facility will receive marketing materials that explain the meaning behind participation in GIQuIC and a PR/Media Toolkit to help publicize the involvement with GIQuIC

GIQuIC Measures


GIQuIC's quality measures have been derived from the work of the ACG-ASGE Joint Task Force for the Development of GI Endoscopy Quality Indicators, published in April 2006, updated in 2015:

  • Am J Gastroenterol. 2015; 110:72–90.
  • Gastrointest Endosc. 2015;81:1-80

Among the many quality measures tracked in GIQuIC – adenoma detection rate, cecal intubation rate, and quality of bowel preparation are examples for improving colon cancer screenings and colon cancer detection. Benchmarking of colonoscopy performance for CRC screening provides physicians valuable insight for improving both the quality and cost-effectiveness of their practice. Physicians and facilities as a whole are able to objectively compare their performance measures to other endoscopists and facilities across the country.

Eleven colonoscopy measures and 12 esophagogastroduodenoscopy (EGD) measures are currently collected in the GIQuIC registry. Click here to view samples of the Colonoscopy Data Collection Form and EGD Data Collection Form.

The 11 colonoscopy measures are:

  1. History and physical documentation
  2. Informed consent documentation
  3. Adequacy of bowel prep
  4. Written discharge instructions- outpatient
  5. ASA category documentation
  6. Indication documentation
  7. Cecal intubation rate with photo documentation
    1. All colonoscopies – screening, surveillance and diagnostic
    2. Screening
  8. Adenoma detection rate – screening
    1. Female
    2. Male
  9. Withdrawal time
  10. Immediate adverse events
  11. Appropriate Surveillance Interval Measures

The 12 EGD measures are:

  1. Appropriate specimen acquisition in Barrett’s esophagus
  2. Appropriate management of new diagnoses of bleeding esophageal varices
  3. Appropriate endoscopic therapy for stigmata of peptic ulcer disease bleeding
  4. Appropriate anticoagulation management
  5. Appropriate antibiotic prophylaxis
  6. Helicobacter pylori status
  7. Immediate adverse events
  8. Indication documentation
  9. Written discharge instructions – outpatient
  10. Informed consent documentation
  11. History and physical documentation
  12. ASA category documentation