NEW YORK STATE DEPARTMENT OF HEALTH AIDS INSTITUTE

Transcription

1 NEW YORK STATE DEPARTMENT OF HEALTH AIDS INSTITUTE EHIVQUAL ADULT HIV AMBULATORY CARE QUALITY OF CARE INDICATOR DEFINITIONS A GUIDE FOR PROVIDERS OF AMBULATORY CARE SERVICES * * For use with ehivqual, an electronic web-based program for quality of care data collection and review REVIEW PERIOD(S): CALENDAR YEAR 2013 (1/1/ /31/2013) AND OPTIONALLY: CALENDAR YEAR 2012 (1/1/ /31/2012) 6/2/2014 ehivqual Indicator Definitions Page 1 of 53

2 TABLE OF CONTENTS Indicator Retention Rates Visit Frequency (12-month) (All Patients) Visit Frequency (24-month) New Patient Visit Frequency Adolescent Transition Visit Frequency Viral Load Suppression Always Suppressed within Review Period Last Viral Load of Review Period Antiretroviral Therapy & Baseline Resistance Test Sexually Transmitted Infections Syphilis Testing & Treatment Gonorrhea Testing & Treatment Chlamydia Testing & Treatment Sexual History Taking Anal, Oral, and Genital Sexual History Taking Hepatitis C (HCV) Screening & Management Gynecology Care Pap Test Mental Health Screening & Treatment Substance Use Screening & Abuse Treatment Tobacco Use Screening & Cessation Counseling PCP Prophylaxis Mammography Digital Rectal Exam Anal Pap Test Colon Cancer Screening & Follow-Up Diabetes Screening & Management Diabetes Screening, Control, and Management Care Coordination Patient Involvement Definition: Pages 5 Algorithm: Pages 26, 27, 28 Definition: Page 6 Algorithm: Page 29 Definition: Page 7 Algorithm: Page 30, 31 Definition: Pages 8,9 Algorithm: Pages 32, 33, 34 Definition: Page 10 Algorithm: Page 35 Definition: Pages 11 Algorithm: Page 36, 37, 38 Definition: Page 12 Algorithm: Page 39 Definition: Page 13 Algorithm: Page 40 Definition: Page 14 Algorithm: Pages 41, 42 Definition: Page 15 Algorithm: Page 43 Definition: Page 16 Algorithm: Page 44 Definition: Page 17 Algorithm: Page 45 Definition: Page 18 Algorithm: Pages 46 Definition: Page 19 Algorithm: Pages 47 Definition: Page 20 Algorithm: Pages 48, 49, 50 Definition: Page 21 Algorithm: Pages 51, 52 Definition: Page 22 Algorithm: Page 53 Resources Additional Resources ehivqual 2013 Measure Summary Page 4 6/2/2014 ehivqual Indicator Definitions Page 2 of 53

3 Section 1: Indicator Definitions 6/2/2014 ehivqual Indicator Definitions Page 3 of 53

4 ehivqual 2013 Measure Summary Retention Rates (Pages 5) - Rate of patients retained in care - Rate of patients retained in care during the 24-month measurement period - Rate of newly enrolled patients retained in care - Rate of newly enrolled patients transitioned from an adolescent care program retained in care Viral Load Suppression (Page 6) - Rate of patients suppressed at all HIV viral load tests - Rate of patients suppressed at last HIV viral load test Antiretroviral Therapy & Baseline Resistance Test (Page 7) - Rate of patients on ART - Rate of newly treated patients who received a baseline resistance test Sexually Transmitted Infections (Pages 8, 9) - Rate of patients who received a syphilis test - Rate of patients treated following a positive result from a syphilis test - Rate of patients who had a genital/extragenital test for Chlamydia - Rate of patients treated following a positive Chlamydia test - Rate of patients who had a genital/extragenital test for gonorrhea - Rate of patients treated following a positive gonorrhea test Sexual History Taking (Page 10) - Rate of patients asked about sexual activity - Rate of patients asked about anal sexual activity - Rate of patients asked about oral sexual activity - Rate of patients asked about genital sexual activity Hepatitis C (HCV) Screening & Management (Page 11) - Rate of patients for whom hepatitis C status is known - Rate of patients for whom an HCV RNA assay was performed - Rate of HCV RNA+ patients with a documented discussion of further treatment or evaluation - Rate of patients who have a negative known HCV serostatus and are at a high risk for infection who are retested for HCV Gynecology Care Pap Test (Page 12) - Rate of female and transgender with biological cervix patients who received a Pap test Mental Health Screening & Treatment (Page 13) - Rate of patients for whom a mental health screening was performed - Rate of patients with a problem identified as a result of a mental health screening for whom a referral to treatment was made - Rate of patients referred to mental health treatment who kept the referral appointment Substance Use Screening & Abuse Treatment (Page 14) - Rate of patients with whom substance use was discussed/assessed - Rate of patients identified as current users for which referrals were made for substance use treatment - Rate of patients identified as past users for whom relapse prevention or ongoing treatment was discussed Tobacco Use Screening & Cessation Counseling (Page 15) - Rate of patients with whom tobacco used was discussed/assessed - Rate of patients identified as tobacco users with whom tobacco use cessation was discussed PCP Prophylaxis (Page 16) - Rate of patients with CD4<200 cells/mm 3 prescribed PCP prophylaxis Mammography (Page 17) - Rate of female patients aged 40 years and older who received a mammogram Digital Rectal Exam, Anal Pap Test, Colonoscopy (Pages 18, 19, 20) - Rate of patients for whom a digital rectal exam was performed - Rate of at-risk patients for whom a high-resolution anoscopy (HRA) or anal pap test was performed - Rate of patients aged years of age, or if African American, who received an appropriate colon cancer screening - Rate of patients with an abnormal colon cancer screening with a follow-up colonoscopy documented Diabetes Screening & Management (Page 21) - Rate of patients diagnosed with diabetes (type 1 or type 2) whose most recent HbA1c was <8.0%. - Rate of patients with any random blood sugar > 100 mg/dl who received diabetes screening - Rate of diabetic patients for whom serum creatinine measurement was performed - Rate of diabetic patients for whom a retinal exam was performed Care Coordination Patient Involvement (Page 22) - Rate of patients involved in care coordination planning 6/2/2014 ehivqual Indicator Definitions Page 4 of 53

5 Retention Rates Visit Frequency (12-month) (All Patients) Percentage of patients who were retained in care. Number of patients who had at least one primary care visit in the first six months of the review period. Number of patients with at least one visit in the first six months of the review period and in the second six months of the review period. Visit Frequency (24-month) Percentage of patients who were retained in care during the review period and the previous year. All patients whose first medical visit in the clinic occurred at least 6 months prior to the start of the review period. Number of patients who had at least one medical visit in each 6-month period of the review period and the previous year with a minimum of 60 days between the first medical visit in the prior 6-month period and the last medical visit in the subsequent 6-month period. (Measurement period is a consecutive 24-month period of time.) Exclusion(s): - Patients who are documented to be deceased at any time in the measurement year. - Patients who were incarcerated for greater than 90 days of the measurement year. - Patients who were known to relocate out of the service area or transferred medical care at any time in the measurement year. New Patient Visit Frequency Percentage of newly enrolled patients who were retained in care. Number of patients who were newly enrolled to Number of patients who had at least one medical visit in care (not seen in previous two years), with at least each 4-month period of the measurement year. one medical visit in the clinic in the first 4 months of the measurement year. Exclusion(s): - Patients who are documented to be deceased at any time in the measurement year. - Patients who were incarcerated for greater than 90 days of the measurement year. - Patients who were known to relocate out of the service area or transferred medical care at any time in the measurement year. Adolescent Transition Visit Frequency Percentage of new patients transitioned from an adolescent care program who were retained in care. Number of patients who were newly enrolled to Number of patients who had at least one medical visit in care (never seen before), and transitioned from an each 4-month period of the measurement year. adolescent care program, who had at least one medical visit in the clinic in the first 4 months of the measurement year. Exclusion(s): - Patients who are documented to be deceased at any time in the measurement year. - Patients who were incarcerated for greater than 90 days of the measurement year. - Patients who were known to relocate out of the service area or transferred medical care at any time in the measurement year. 6/2/2014 ehivqual Indicator Definitions Page 5 of 53

6 Viral Load Suppression Always Suppressed within Review Period Percentage of patients who were suppressed at all HIV viral load tests. All patients. Note: Report includes <50 copies/mm 3 and <200 copies/mm 3. Suppressed at Last VL of Review Period Percentage of patients who were suppressed at last HIV viral load test. All patients. Note: Report includes <50 copies/mm 3 and <200 copies/mm 3. Number of patients with a HIV viral load test below the level of detectability for the assay used at all HIV viral load tests during the measurement year. Number of patients with a HIV viral load test below the level of detectability for the assay used at last HIV viral load test during the measurement year. 6/2/2014 ehivqual Indicator Definitions Page 6 of 53

7 Antiretroviral Therapy & Baseline Resistance Test Antiretroviral Therapy Percentage of patients on ART. All patients. Number of patients who were prescribed an ART drug at any time during the review period. Baseline Resistance Test Percentage of newly treated patients who received a baseline resistance test. Number of patients who had one or more VL values recorded as >500 copies/mm 3 during the review period prior to ARV initiation, were ARVnaïve at the start of the review period, and initiated ARV therapy during the review period. Number of patients for whom a baseline resistance test was performed any time prior to ARV-initiation, either during the review period OR at any time preceding it. 6/2/2014 ehivqual Indicator Definitions Page 7 of 53

8 Sexually Transmitted Infections Syphilis Testing & Treatment Syphilis Testing Percentage of patients who received a syphilis test. All patients. Number of patients who received a syphilis test during the review period. Syphilis Treatment for Positives Percentage of patients who were treated following a positive result from a syphilis test. Number of patients who tested positive for Number of patients who were treated following a positive syphilis during the review period. serum syphilis test result during the review period. Exclusion(s): Patients for whom there is a documented existing syphilis infection. Gonorrhea Testing & Treatment Genital Gonorrhea Testing Percentage of patients who had a genital test for gonorrhea. All patients. Number of patients who had one or more genital (urine, cervical, urethral, or vaginal) tests for gonorrhea performed during the review period. Rectal Gonorrhea Testing Among MSM and MtF Transgender Patients Percentage of MSM or MtF transgender patients who had a rectal test for gonorrhea. Number of MSM or MtF transgender patients. Number of MSM or MtF transgender patients who had one or more rectal tests (nucleic acid test or culture) for gonorrhea performed during the review period. Pharyngeal Gonorrhea Testing Among MSM and MtF Transgender Patients Percentage of MSM or MtF transgender patients who had a pharyngeal test for gonorrhea. Number of MSM or MtF transgender patients. Number of MSM or MtF transgender patients who had one or more pharyngeal tests (nucleic acid test or culture) for gonorrhea performed during the review period. 6/2/2014 ehivqual Indicator Definitions Page 8 of 53

9 Gonorrhea Treatment Percentage of patients who were treated following a positive gonorrhea test. Number of patients who tested positive for Number of patients who were treated following a positive gonorrhea during the review period. gonorrhea test result during the review period. Note: Indicator is calculated separately for each anatomical region. Chlamydia Testing & Treatment Genital Chlamydia Testing Percentage of patients who had a genital test for Chlamydia. All patients. Number of patients who had one or more genital (urine, cervical, urethral, or vaginal) tests for Chlamydia performed during the review period. Rectal Chlamydia Testing Among MSM and MtF Transgender Patients Percentage of MSM or MtF transgender patients who had a rectal test for Chlamydia. Number of MSM or MtF transgender patients. Number of MSM or MtF transgender patients who had one or more rectal tests (nucleic acid test or culture) for Chlamydia performed during the review period. Chlamydia Treatment Percentage of patients who were treated following a positive Chlamydia test. Number of patients who tested positive for Number of patients who were treated following a positive Chlamydia during the review period. Chlamydia test result during the review period. Note: Indicator is calculated separately for each anatomical region. 6/2/2014 ehivqual Indicator Definitions Page 9 of 53

10 Sexual History Taking Sexual History Taking Percentage of patients who were asked about sexual activity. All patients. Number of patients who were asked about sexual activity during the review period. Anal Sexual History Taking Percentage of patients who were asked about anal sexual activity during a sexual history. Number of patients who were asked about sexual activity during the review period. Number of patients who were asked about anal sexual activity. Oral Sexual History Taking Percentage of patients who were asked about oral sexual activity during a sexual history. Number of patients who were asked about sexual activity during the review period. Number of patients who were asked about oral sexual activity. Genital Sexual History Taking Percentage of patients who were asked about genital sexual activity during a sexual history. Number of patients who were asked about sexual activity during the review period. Number of patients who were asked about genital sexual activity. 6/2/2014 ehivqual Indicator Definitions Page 10 of 53

11 Hepatitis C (HCV) Screening & Management Hepatitis C (HCV) Status Percentage of patients for whom hepatitis C status is known. All patients. Number of patients whose HCV status was documented in the medical record at the end of the review period based upon either an antibody test and/or RNA assay. Hepatitis C (HCV) RNA Assay for Positives Percentage of patients for whom an HCV RNA assay was performed. Number of patients whose HCV serostatus is positive during the first nine months of the review period or known to be positive at the start of the review period. Number of patients for whom an HCV RNA assay was performed. Hepatitis C (HCV) Further Evaluation of RNA Positive Patients Percentage of HCV RNA+ patients with a documented discussion of further treatment or evaluation. Number of HCV RNA+ patients. Number of patients with documented discussion of further treatment or evaluation during the review period. Exclusion(s): Patients with treatment administered at the time of the last known RNA assay. Hepatitis C (HCV) Retest for Negatives, High Risk Percentage of patients who have a known negative HCV serostatus and are at a high risk for infection who are retested for HCV. Number of patients whose HCV serostatus is negative at the start of the review period and are at high risk for infection as defined by active IDU, multiple partners, MSM without barrier protection, new abnormal LFTs. Number of patients who were retested for HCV during the review period. 6/2/2014 ehivqual Indicator Definitions Page 11 of 53

12 Gynecology Care Pap Test Gynecology Care Pap Test Percentage of female and transgender with biological cervix patients who received a Pap test. Number of female and transgender patients with biological cervix who were > 18 years old or reported having a history of sexual activity. Number of patients who had a Pap test recorded during the review period. 6/2/2014 ehivqual Indicator Definitions Page 12 of 53

13 Mental Health Screening & Treatment Mental Health Screening Percentage of patients for whom a mental health screening was performed. All patients. Number of patients for whom all required components of the mental health screening were performed during the review period. Components of the mental health screening include: screenings for depression, anxiety and PTSD, and assessments for domestic violence, cognitive function, sleeping habits and appetite. Mental Health Referral for Treatment Made Percentage of patients with a problem identified as a result of a mental health screening for whom a referral for treatment was made. Number of patients with either depression, Number of patients for whom a referral for treatment was anxiety, PTSD and/or a cognitive function made during the review period. problem identified through screening during the review period. Note: Indicator is calculated separately for each condition. Mental Health Appointment Kept Percentage of patients referred to mental health treatment who kept the referral appointment. Number of patients with either depression, Number of patients who kept the referral appointment. anxiety, PTSD and/or a cognitive function problem identified through screening during the review period for whom a referral for treatment was made. Note: Indicator is calculated separately for each condition. 6/2/2014 ehivqual Indicator Definitions Page 13 of 53

14 Substance Use Screening & Abuse Treatment Substance Use Screening Percentage of patients with whom substance use was discussed/assessed. All patients. Number of patients who had a discussion/assessment about substance use during the review period with the following breakdown of users: i. Current (within last 6 months) ii. Past (6 or more months) iii. Never (no history of substance use) Substance Abuse Treatment for Current Users Percentage of patients identified as current users for which referrals were made for substance use treatment. Number of patients who abused drugs* in the 0-6 Number of patients for whom referrals for substance abuse months prior to the date of assessment who were treatment have been made. not in treatment during the review period. Note: *Amphetamines, benzodiazepines, cocaine/crack, crystal methamphetamine, ecstasy, hallucinogens (PCP, LSD, other), heroin, inhalants (glue, nitrous oxide), ketamine, prescription opioids (Vicodin, Codeine), problem alcohol or other substance. Substance Abuse Treatment for Past Users Percentage of patients identified as past users with whom relapse prevention or ongoing treatment was discussed. Number of patients who used drugs* in the 6-24 Number of patients with whom relapse prevention or months prior to the date of assessment. ongoing treatment has been discussed. Note: *Amphetamines, benzodiazepines, cocaine/crack, crystal methamphetamine, ecstasy, hallucinogens (PCP, LSD, other), heroin, inhalants (glue, nitrous oxide), ketamine, prescription opioids (Vicodin, Codeine), problem alcohol or other substance. 6/2/2014 ehivqual Indicator Definitions Page 14 of 53

15 Tobacco Use Screening & Cessation Counseling Tobacco Use Screening Percentage of patients with whom tobacco use was discussed/assessed. All patients. Number of patients with whom tobacco use was discussed/assessed during the review period. Tobacco Cessation Counseling Percentage of patients identified as tobacco users with whom tobacco use cessation was discussed. Number of patients identified as tobacco users following a tobacco use screening performed during the review period. Number of patients with whom tobacco use cessation was discussed during the review period. 6/2/2014 ehivqual Indicator Definitions Page 15 of 53

16 PCP Prophylaxis PCP Prophylaxis Percentage of patients with CD4 <200 cells/mm 3 who were prescribed PCP prophylaxis. Number of patients who had one or more Cd4 Number of patients who had PCP prophylaxis prescribed counts recorded as <200 cells/mm 3 during the at any point in the review period. review period. Exclusion(s): Patients for whom the depressed CD4 count occurred during the first six months of the review period and all other CD4 counts recorded within the review period (at least one other count) were >200 cells/mm 3. 6/2/2014 ehivqual Indicator Definitions Page 16 of 53

17 Mammography Mammography Percentage of female patients aged 40 years and older who received a mammogram. Number of female patients who are aged 40 years and older. Number of patients who received a mammogram either during the review period or the twelve months preceding the start of the review period. 6/2/2014 ehivqual Indicator Definitions Page 17 of 53

18 Digital Rectal Exam Digital Rectal Exam Percentage of patients for whom a digital rectal exam was performed. All patients. Number of patients for whom a digital rectal exam was performed during the review period. 6/2/2014 ehivqual Indicator Definitions Page 18 of 53

19 Anal Pap Test Anal Pap Test Percentage of at-risk patients for whom a high-resolution anoscopy (HRA) or anal pap test was performed. Number of patients who are: MSM; OR female and have confirmed genital cancerous or precancerous lesions; OR otherwise have a history of anogenital condyloma. Number of patients for whom an HRA or anal pap test was performed during the review period. 6/2/2014 ehivqual Indicator Definitions Page 19 of 53

20 Colon Cancer Screening & Follow-Up Colon Cancer Screening Percentage of patients aged years of age, or if African-American, who received an appropriate colon cancer screening. Number of patients who are years of age, or if African American, years of age. Number of patients who received one of the following colon cancer screenings: fecal occult blood test (FOBT, guaiac or immunochemical) during the review period; flexible sigmoidoscopy (FSIG) either during the review period or the four years preceding the start of the review period; colonoscopy performed either during the review period or the nine years preceding the start of the review period. Colon Cancer Screening Follow-Up Percentage of patients with an abnormal colon cancer screening with a follow-up colonoscopy documented. Number of patients with a positive FOBT or FSIG during the review period. Number of patients with a follow-up colonoscopy documented within 60 days of the positive screening. 6/2/2014 ehivqual Indicator Definitions Page 20 of 53

21 Diabetes Screening & Management Diabetic Control Among Diabetic Patients Percentage of patients diagnosed with diabetes (type 1 or type 2) whose most recent HbA1c was <8.0%. Number of patients diagnosed with diabetes (type Number of patients whose most recent HbA1c was <8.0% 1 or type 2). (performed during the review period). Note: Report includes four additional categories: less than 7%; greater than or equal to 7% and less than 8%; greater than or equal to 8% and less than or equal to 9%; and greater than 9% (Poor Control). Diabetes Screening Percentage of patients with any random blood sugar > 100 mg/dl who received diabetes screening. Number of patients without a history of previous diabetes and with any random blood sugar (RBS) > 100 mg/dl during the review period. Number of patients with a fasting serum glucose test result, Oral Glucose Tolerance Test (OGTT) result, and/or HbA1c test result during the review period. Diabetes Management Serum Creatinine Percentage of diabetic patients for whom serum creatinine measurement was performed. Number of patients with a known or new diagnosis of diabetes during the review period. Number of patients for whom a serum creatinine was measured during the review period. Diabetes Management Retinal Exam Percentage of diabetic patients for whom a retinal exam was performed. Number of patients with a known or new diagnosis of diabetes during the review period. Number of patients for whom a retinal exam was performed during the review period. 6/2/2014 ehivqual Indicator Definitions Page 21 of 53

22 Care Coordination Patient Involvement Patient Involvement in Care Coordination Planning Percentage of patients who were involved in care coordination planning. Number of patients receiving supportive services 1 from an outside agency during the review period 2. Number of patients for whom there is evidence of patient s involvement in the coordination of these services 3. Note: 1 Case management, mental health, substance use, treatment adherence, and/or other supportive service 2 As evidenced by a discussion or other form of documentation 3 The creation, updating, or discussion of a care coordination plan; case conferencing; conversation regarding care 6/2/2014 ehivqual Indicator Definitions Page 22 of 53

23 Appendix: Indicator Algorithms 6/2/2014 ehivqual Indicator Definitions Page 23 of 53

24 Indicator Algorithm Key 6/2/2014 ehivqual Indicator Definitions Page 24 of 53

25 Patient Profile Indicator Algorithm 6/2/2014 ehivqual Indicator Definitions Page 25 of 53

26 Clinical Visits Indicator Algorithm (page 1 of 3) 6/2/2014 ehivqual Indicator Definitions Page 26 of 53

27 Clinical Visits Indicator Algorithm (page 2 of 3) 6/2/2014 ehivqual Indicator Definitions Page 27 of 53

28 Clinical Visits Indicator Algorithm (page 3 of 3) 6/2/2014 ehivqual Indicator Definitions Page 28 of 53

29 Viral Load Monitoring Indicator Algorithm 6/2/2014 ehivqual Indicator Definitions Page 29 of 53

30 Antiretroviral Therapy Indicator Algorithm 6/2/2014 ehivqual Indicator Definitions Page 30 of 53

31 Baseline Resistance Test Indicator Algorithm 6/2/2014 ehivqual Indicator Definitions Page 31 of 53

32 Sexually Transmitted Infections Indicator Algorithms (page 1 of 3) 6/2/2014 ehivqual Indicator Definitions Page 32 of 53

33 Sexually Transmitted Infections Indicator Algorithms (page 2 of 3) 6/2/2014 ehivqual Indicator Definitions Page 33 of 53

34 Sexually Transmitted Infections Indicator Algorithms (page 3 of 3) 6/2/2014 ehivqual Indicator Definitions Page 34 of 53

35 Sexual History Taking Indicator Algorithm 6/2/2014 ehivqual Indicator Definitions Page 35 of 53

36 Hepatitis C (HCV) Screening & Management Indicator Algorithm (page 1 of 3) 6/2/2014 ehivqual Indicator Definitions Page 36 of 53

37 Hepatitis C (HCV) Screening & Management Indicator Algorithm (page 2 of 3) 6/2/2014 ehivqual Indicator Definitions Page 37 of 53

38 Hepatitis C (HCV) Screening & Management Indicator Algorithm (page 3 of 3) 6/2/2014 ehivqual Indicator Definitions Page 38 of 53

39 Gynecology Care Pap Test Indicator Algorithm 6/2/2014 ehivqual Indicator Definitions Page 39 of 53

40 Mental Health Screening & Treatment Indicator Algorithm 6/2/2014 ehivqual Indicator Definitions Page 40 of 53

41 Substance Use Screening & Abuse Treatment Indicator Algorithm (page 1 of 2) 6/2/2014 ehivqual Indicator Definitions Page 41 of 53

42 Substance Use Screening & Abuse Treatment Indicator Algorithm (page 2 of 2) 6/2/2014 ehivqual Indicator Definitions Page 42 of 53

43 Tobacco Use Screening & Cessation Counseling Indicator Algorithm 6/2/2014 ehivqual Indicator Definitions Page 43 of 53

44 PCP Prophylaxis Indicator Algorithm 6/2/2014 ehivqual Indicator Definitions Page 44 of 53

45 Mammography Indicator Algorithm 6/2/2014 ehivqual Indicator Definitions Page 45 of 53

46 Digital Rectal Exam Indicator Algorithm 6/2/2014 ehivqual Indicator Definitions Page 46 of 53

47 Anal Pap Test Indicator Algorithm 6/2/2014 ehivqual Indicator Definitions Page 47 of 53

48 Colon Cancer Screening & Follow-Up Indicator Algorithm (page 1 of 3) 6/2/2014 ehivqual Indicator Definitions Page 48 of 53

49 Colon Cancer Screening & Follow-Up Indicator Algorithm (page 2 of 3) 6/2/2014 ehivqual Indicator Definitions Page 49 of 53

50 Colon Cancer Screening & Follow-Up Indicator Algorithm (page 3 of 3) 6/2/2014 ehivqual Indicator Definitions Page 50 of 53

51 Diabetes Screening & Management Indicator Algorithm (page 1 of 2) 6/2/2014 ehivqual Indicator Definitions Page 51 of 53

52 Diabetes Screening & Management Indicator Algorithm (page 2 of 2) 6/2/2014 ehivqual Indicator Definitions Page 52 of 53

53 Care Coordination Indicator Algorithm 6/2/2014 ehivqual Indicator Definitions Page 53 of 53