Overview of Current Quality Measures that can be Impacted by Ambulatory Pharmacists

Transcription

1 Overview of Current Quality Measures that can be Impacted by Ambulatory Pharmacists Measure Name Measure Domain Measure Focus Comment/Explanation CMS Value-based Purchasing Program (CMS VBP) AMI 30-day Mortality Rate Mortality 30-day Mortality Rate Mortality Heart failure 30-day Mortality Rate Mortality Pneumonia 30-day Mortality Rate Mortality Stroke 30-day Mortality Rate Mortality Medicare Spending per Beneficiary (Costs) Financial/Efficiency Spending CMS Hospital Readmissions Reduction Program (CMS HRRP) 30-day readmission rate Care Transitions Readmission HF 30-day readmission rate Care Transitions Readmission Pneumonia 30-day readmission rate Care Transitions Readmission Stroke 30-day readmission rate Care Transitions Readmission THA/TKA 30-day readmissions rate Care Transitions Readmission CMS Medicare Shared Savings Program (CMS MSSP) All Condition Readmissions Care Coordination Readmission CAHPS: Health Promotion & Education Patient Experience Patient Engagement CAHPS: Shared Dec. Making Patient Experience Patient Engagement Admissions Diabetes & A1C <8% Diabetes Diabetes & A1C>9% Diabetes Diabetes & ASA Use Diabetes Diabetes & BP< 140/90 Diabetes Diabetes & LDL< 100 Diabetes Diabetes & No Tobacco Use Diabetes HF Admissions HTN Control Influenza Immunization IVD & ASA or Anti-platelet Use

2 IVD & Lipid Profile with LDL<100 Med Reconcilation Post-Discharge Care Coordination Pneumococcal Vaccination Screening Risk for Falls Falls Tobacco Cessation Tobacco Cessation CMS Physician Quality Reporting Program Acute Otitis Externa (AOE): Systemic Antimicrobial Therapy Avoidance of Inappropriate Use Acute Otitis Externa (AOE): Topical Therapy Adult Kidney Disease: Patients On Erythropoiesis - Stimulating Agent (ESA) - Hemoglobin Level > 12.0 g/dl Kidney Disease HD or PD patients Antibiotic Treatment for Adults with Acute Bronchitis: Avoidance of Inappropriate Use Anticoagulation for Acute Pulmonary Embolus Patients VTE/PE and Anticoagulation : Pharmacologic Therapy for Persistent Prescribed long-acting controller : Tobacco Use: Intervention - Ambulatory Care Setting CAD: ACE Inhibitor or ARB Therapy for Patients with CAD and Diabetes and/or Left Ventricular Systolic Dysfunction (LVSD) Tobacco Cessation /CAD CAD: Antiplatelet Therapy /CAD Prescribed ASA or clopidogrel CAD: Beta-Blocker Therapy MI or LVSD (LVEF < 40%) /CAD Childhood Immunization Status % of children 2years of age who had all recommended vaccines by their second birthday Chronic Obstructive Pulmonary Disease (): Bronchodilator Therapy FEV1/FVC less than 70% and has symptoms and has proper Rx Chronic Obstructive Pulmonary Disease (): Spirometry Evaluation Coronary Artery Disease (CAD): Lipid Control Diabetes Mellitus: Daily Aspirin Use for Patients with Diabetes and Ischemic Vascular Disease Diabetes Diabetes Mellitus: Hemoglobin A1c Control Diabetes

3 (<8%) Diabetes Mellitus: Hemoglobin A1c Poor Control in Diabetes Mellitus Diabetes Mellitus: High Blood Pressure Control in Diabetes Mellitus Diabetes Mellitus: Low Density Lipoprotein (LDL-C) Control in Diabetes Mellitus Diabetes Age and most recent hemoglobin A1c greater than 9.0% Diabetes Age and most recent BP < 140/90 Diabetes Age and most recent LDL-C level in control (less than 100 mg/dl) Diabetes Mellitus: Urine Screening for Microalbumin or Medical Attention for Nephropathy in Diabetic Patients Diabetes Documentation of Current s in the Medical Record Must be for all meds and contain the name, dosage, frequency and route Drugs to be Avoided in the Elderly Geriatrics Emergency Medicine: Community-Acquired Pneumonia (CAP): Empiric Antibiotic Heart Failure: Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD) Heart Failure: Warfarin Therapy for Patients with Atrial Fibrillation Hematology: Multiple Myeloma: Treatment with Bisphosphonates Hematology: Myelodysplastic Syndrome (MDS): Documentation of Iron Stores in Patients Receiving Erythropoietin Therapy /LVSD /HF Hematology Hematology : Antiviral Treatment Prescribed : Counseling Regarding Risk of Alcohol Consumption : Counseling Regarding Use of Contraception Prior to Antiviral Therapy : Counseling Regarding Use of Contraception Prior to Antiviral Therapy : HCV Genotype Testing Prior to Treatment : HCV Ribonucleic Acid (RNA) Testing at Week 12 of Treatment : Hepatitis A Vaccination in Patients with HCV : Hepatitis B Vaccination in Patients with HCV Clnical - Safety Clnical - Safety Clnical Safety : Ribonucleic Acid (RNA) Testing testing was performed

4 Before Initiating Treatment within 6 months prior to initiation of antiviral treatment HF: ACE Inhibitor or ARB Therapy for Left Ventricular Systolic Dysfunction (LVSD) HIV/AIDS: Adolescent and Adult Patients with HIV/AIDS Who Are Prescribed Potent Antiretroviral Therapy HIV/AIDS: HIV RNA Control After Six Months of Potent Antiretroviral Therapy Hypertension (HTN): Blood Pressure Measurement Hypertension (HTN): Controlling High Blood Pressure Hypertension: Appropriate Use of Aspirin or Other Antiplatelet or Anticoagulant Therapy /HF HIV/AIDS HIV/AIDS /HTN Hypertension: Blood Pressure Control /HTN Hypertension: Blood Pressure Management Blood pressure < 140/90 mmhg OR patients with a blood pressure 140/90 mmhg and prescribed two or more meds Hypertension: Dietary and Physical Activity Modifications Appropriately Prescribed Hypertension: Low Density Lipoprotein (LDL- C) Control Inflammatory Bowel Disease (IBD): Assessment of Hepatitis B Virus (HBV) Status Before Initiating Anti- TNF (Tumor Necrosis Factor) Therapy Inflammatory Bowel Disease (IBD): Preventive Care: Corticosteroid Sparing Therapy Inflammatory Bowel Disease (IBD): Preventive Care: Influenza Immunization Inflammatory Bowel Disease (IBD): Preventive Care: Pneumococcal Immunization Inflammatory Bowel Disease (IBD): Testing for Latent Tuberculosis (TB) Before Initiating Anti-TNF (Tumor Necrosis Factor) Therapy /HTN /HTN GI GI GI Ischemic Vascular Disease (IVD): Blood Pressure Management Control /IVD Most recent blood pressure in control (less than 140/90 mmhg)

5 Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antithrombotic /IVD Major Depressive Disorder (MDD): Antidepressant During Acute Phase for Patients with MDD Depression Treated with antidepressant medication during the entire 84-day (12-week) acute treatment phase : After Discharge from an Inpatient Facility Care Coordination Provided within 60 days discharge Oncology: Medical and Radiation Plan of Care for Pain Pain Osteoarthritis (OA): Assessment for Use of Anti-Inflammatory or Analgesic Over-the- Counter (OTC) s Osteoarthritis Patients 21 years and over with OA dx Osteoporosis: Pharmacologic Therapy for Men and Women Aged 50 Years and Older Osteoporosis Pain Assessment and Follow-Up Pain Preventive Care and Screening: Cholesterol Fasting Low Density Lipoprotein (LDL) Test Performed AND Risk-Stratified Fasting LDL Preventive Care and Screening: Influenza Immunization Preventive Care and Screening: Pneumonia Vaccination for Patients 65 Years and Older Preventive Care and Screening: Pneumonia Vaccination for Patients 65 Years and Older Preventive Care and Screening: Screening for High Blood Pressure Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention Rheumatoid Arthritis (RA): Disease Modifying Anti-Rheumatic Drug (DMARD) Therapy /HTN Tobacco Cessation Rheumatoid Arthritis Rheumatoid Arthritis (RA): Glucocorticoid Management Screening or Therapy for Osteoporosis for Women Aged 65 Years and Older Rheumatoid Arthritis Plan for those on prolonged doses of prednisone 10 mg daily (or equivalent) with improvement or no change in disease activity Osteoporosis DXA at least once since age 60 or pharmacologic therapy prescribed Smoking and Tobacco Use Cessation, Medical Assistance: a. Advising to Quit, b. Discussing Cessation s, c. Discussing Cessation Strategies Tobacco Cessation Statin Therapy at Discharge after Lower Extremity Bypass (LEB) % Undergoing infrainguinal lower extremity bypass who are prescribed a statin

6 medication at discharge Stroke: Anticoagulant Therapy Prescribed for Atrial Fib at Discharge Stroke: Discharged on Antithrombotic Therapy Treatment for Children with Upper Respiratory (URI): Avoidance of Inappropriate Use Stroke Stroke Use of Appropriate s for ARRA/HITECH Certified EHR Incentive Program: Meaningful Use (MU) (LDL) Management ADE Prevention and Monitoring: Warfarin Time in Therapeutic Range ADHD: Follow-Up Care for Children Prescribed Meds Anticoagulation ADHD Anti-depressant Management Depression Appropriate Treatment for Children with Upper Respiratory (URI) CAD with LVSD and Beta-Blocker Therapy Childhood Immunization Status Controlling High Blood Pressure Diabetes & A1C>9% Diabetes Diabetes & LDL< 100 Diabetes Documentation of Current s in the Medical Record HF & LVSD and ACEI/ARB Therapy HF & LVSD and Beta-Blocker Therapy HIV/AIDS: Pneumocystis jiroveci pneumonia (PCP) Prophylaxis Hypertension: Improvement in blood pressure Influenza Immunization IVD & ASA or Anti-platelet Use IVD & Lipid Profile with LDL<100 Pneumococcal Vaccination Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented

7 Screening for Cholesterol Fasting Low Density Lipoprotein (LDL-C) Test Performed Screening for Future Fall Risk Falls Tobacco Cessation Tobacco Cessation Use of Appropriate s for Use of High-Risk s in the Elderly Safety/Geriatrics HEDIS Managed Care Program and Physician Program Adherence to Antipsychotic s for Individuals With Schizophrenia Mental Health/Schizophrenia Antibiotic Utilization Aspirin Use and Discussion CAHPS Health Plan Survey 5.0H, Adult Version Monitoring for People With Disease and Schizophrenia Cholesterol Management for Patients With Conditions Diabetes Monitoring for People With Diabetes and Schizophrenia Diabetes Screening for People With Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic s Patient Experience Patient Engagement Mental Health Mental Health Mental Health Flu Vaccinations for Adults Ages Flu Vaccinations for Adults Ages 65 and Older Medical Assistance With Smoking and Tobacco Use Cessation Tobacco Cessation Plan All-Cause Readmissions Care Coordination Readmission Pneumococcal Vaccination Status for Older Adults Relative Resource Use for People With Relative Resource Use for People With Diabetes Relative Resource Use for People With Hypertension Relative Resource Use for People With Financial/Efficiency Financial/Efficiency Financial/Efficiency Financial/Efficiency Diabetes Adherence to Antipsychotic s for Individuals With Schizophrenia Mental Health - Schizophrenia

8 Comprehensive Ischemic Vascular Disease Cholesterol Management for Patients With Conditions Adults Access to Preventive/ Ambulatory Health Services Annual Monitoring for Patients on Persistent s Access General Care Use Antidepressant Management Depression Appropriate Treatment for Children With Upper Respiratory Ratio Avoidance of Antibiotic Treatment in Adults With Acute Bronchitis Care for Older Adults Geriatrics Includes med reviews, etc Childhood Immunization Status Comprehensive Adult Diabetes Care Diabetes Controlling High Blood Pressure Disease Modifying Anti-Rheumatic Drug Therapy for Rheumatoid Arthritis Follow-Up Care for Children Prescribed ADHD Human Papillomavirus Vaccine for Female Adolescents Rheumatoid Arthritis ADHD for Adolescents Management for People With Post-Discharge Care Coordination Persistence of Beta-Blocker Treatment After a Heart Attack Pharmacotherapy Management of Exacerbation Potentially Harmful Drug-Disease Interactions in the Elderly Use of Appropriate s for People With Safety/Geriatrics Use of High-Risk s in the Elderly Safety/Geriatrics Use of Spirometry Testing in the Assessment and Diagnosis of CMS Star Ratings Program

9 Annual Flu Vaccine Care Cholesterol Screening /Lipid Care for Older Adults Review /Geriatri cs Controlling Blood Pressure /HTN Diabetes Care Blood Sugar Controlled Diabetes Diabetes Care Cholesterol Controlled Diabetes Diabetes Care Cholesterol Screening Diabetes Diabetes Dosage (DMD) measure (Display Measure) Safety Diabetes Treatment Care Coordination Diabetes Drug-Drug Interaction (DDI) measure (Display Measure) Safety High Risk Safety Adherence (ADH) for Oral Diabetes s Adherence for Cholesterol (Statins) Adherence for Hypertension (RAS Antagonists) MTM Completion Rate for Comprehensive Reviews (CMR) Osteoporosis Management in Women who had a Fracture Pharmacotherapy management of exacerbation (Display Measure) Adherence Adherence Adherence Management Osteoporosis Plan All-Cause Readmissions Care Coordination Readmission Reducing the Risk of Falling Falls Tables Recreated from ASHP Ambulatory Care Conference & Summit. March 2014