Table 1

Attributes and descriptions

SAIf you enter a target ARI diagnosis into the patient electronic health record, the EHR will prominently display a list of appropriate non-antibiotic prescription and non-prescription treatment alternatives to antibiotics
JAIf you order an antibiotic for a patient with an ARI, a new EHR screen will pop up that asks you to enter a short written justification for why the antibiotic prescription was necessary. What you write in this screen becomes part of the patient's permanent medical record, and therefore visible to other providers
PCEach other week, you and your peers will receive in your work mailboxes (or email) an updated ranking comparing your antibiotic prescribing rate to the top-performing (ie, ‘best’) decile of your clinical peers
P4PIf you are able to reduce your rate of antibiotic prescribing for all of your patients with ARI to the lowest 10th centile of your peers, you will receive a predetermined monthly reward payment of either $100 or $200
ATYour productivity management record system will change the RVU/visit time allowed for each patient with ARI to increase by 5 min per visit as you respond to the patient's concerns regarding the alternative treatments for their ARI diagnosis. If you achieve the antibiotic prescription reduction goal of reducing your antibiotic prescriptions by 50%, this 5 min per visit time will be preserved
  • ARI, acute respiratory tract infection; AT, additional time; EHR, Electronic Health Record; JA, Accountable Justifications; P4P, pay-for-performance; PC, Peer Comparison; RVU, relative value units; SA, Suggested Alternatives.