HEDIS
(Healthcare Effectiveness Data & Information Set)
(Healthcare Effectiveness Data & Information Set)
HEDIS, HEDIS, HEDIS
Why do we measure HEDIS?
HEDIS values are used at MinuteClinic to measure quality patient care and provider adherence to Evidence Based Practice.
Quality Purpose
What is the purpose of ACO metrics?
The ACO aim is to improve the quality of patient care while lowering the cost of healthcare.
Pardon our CQI?
What is CQI and what does this measure?
MinuteClinic Quality and Safety Value Measures
Patient call backs scheduled for ED referrals
GOAL:
Target >85%; Stretch >90%
Tick Tock
Which one of the AN metrics are timed?
The amount of time it takes to register a patient in Epic.
Survey says…
What does NPS stand for?
Net Promotor Score
Tracking HEDIS
What HEDIS measures do we track at MinuteClinic?
1) Bronchitis
2) Pharyngitis
3) Upper Respiratory Tract Infections
ACO Metrics and Me
What ACO metrics are measured at MinuteClinic?
Follow up plan for elevated blood pressure and tobacco cessation counseling.
A case of the MIPS
What is MIPS and what values do we measure at MC?
CMS Quality Payment Program (Quality, Cost, Promoting Interoperability, Improvement Activities)
Medication Reconciliation: Goal >98% and Influenza Vaccination (10/1-3/31): Goal >85%
Ring, Ring, Ring
Can the AN complete patient call backs for labs and follow ups?
Yes. All except abnormal results, STI results, and urine cultures.
More than a score
What does NPS measure?
1) Calculates Patient Experience
2) How Likely Patient Will Recommend MinuteClinic
Sore throat, HEDIS, and Me
What’s the metric definition for Appropriate Treatment of Pharyngitis?
ALL Patients, regardless of age, who had a visit with ONLY a diagnosis of Acute Pharyngitis (ICD-10 code J02.9) who were NOT dispensed an antibiotic associated to Acute Pharyngitis diagnosis code AND received a NEGATIVE Group A streptococcus test.
The Pressure Is On
What is the definition of the Appropriate Follow-Up Plan for Elevated BP metric?
Percentage of patients aged 18 years and older who were screened for high blood pressure AND recommended follow-up plan is documented based on the current blood pressure (BP) reading as indicated.
All patients > 18 years of age with documented BP reading as follows:
*Ages 18-59 = Systolic >=140; Diastolic >=90
*Age 60+ = Systolic >=150; Diastolic >=90
Medication Measures
What does Medication Administration MIPS measure?
Patients 18 and older: document meds, reconcile meds, review medications, select “Mark as Reviewed”
STOP BANG!
When should a STOP BANG screening be completed?
Males 18 years and older
BMI >35
Age >50
PMH of HTN or DM
DOT exams
Dash On Over
Where can you find your NPS score?
Your provider dashboard houses your quality metrics including your NPS score. This is updated on the 6th of every month.
“I’ve got Bronchitis”
What is the Metric definition for appropriate treatment of Acute Bronchitis?
The measure reads ALL patients, regardless of age, with a diagnosis of Acute Bronchitis who were NOT dispensed an antibiotic prescription associated to the Acute Bronchitis diagnosis (ICD-10 code: J20.9).
GL treatment:
1. Observation
2. Short- acting beta agonist (I.e. Albuterol)
3. Antitussive (i.e. Dextromorphan)
Documentation Is Key
What documentation MUST be included when a patient's blood pressure is elevated?
Key documentation includes appropriate HPI, correct diagnosis selection from the Preference List, AND patient education/plan items selected from the Patient Education and Plan Items PCT List Only Smartset. **Note the last documented BP is the qualifying BP reading for the metric.
Phoning a Friend, Callbacks
What is the importance of metric definition for ED callback?
Percentage of patients who are referred to Emergency Department AND have a patient call back scheduled to follow up.
TOS=Time of Service
Where/When are TOS apts scheduled?
In the wrap up section of the chart prior to signing the visit.
#Goals
What is the NPS goal?
For Clinic Providers it is >85%
Measuring the Common Cold
What’s the Metric definition for Appropriate Treatment of URI?
ALL patients, regardless of age, were given a diagnosis of acute upper respiratory infection (URI) (ICD-10 code J06.9) and were NOT dispensed an antibiotic prescription.
Smoking & Tobacco Cessation
What is the Metric definition for Current Tobacco User & Cessation Counseling Given?
Percentage of patients aged 18 years and older who were screened as positive for current tobacco use during MinuteClinic visits AND patients received cessation counseling intervention if identified as a tobacco user. *Provider must mark as reviewed even if the AN did as well.
Callback Documentation Best Practices
Name a best practice when documenting ED call backs:
Always schedule the call through the Wrap Up Section so it is associated with that specific patient visit date. You can create an addendum on the same day if you forget while in the visit.
Needles, Veins, Blood...OH MY!
How should a phlebotomy attempts be documented?
One click the patient in as a separate visit and use CC of lab collection. Complete the Express Lane and ensure that the name of the person preforming phlebotomy is documented in the correct place.
“Like and subscribe”
Name a best practice for NPS:
Use the "I Strive for 10s" stickers by placing them on the folder given to patients with AVS and talk about the survey.