| Name | Value |
|---|---|
| NAME | VA-*IHD ELEVATED LDL REPORTING |
| PRINT NAME | IHD Elevated LDL Reporting |
| CLASS | NATIONAL |
| SPONSOR | OFFICE OF QUALITY & PERFORMANCE |
| USAGE | RX |
| EDIT HISTORY |
|
| DESCRIPTION | Compliance reporting measures the management of IHD patients whose most This national IHD Elevated LDL Reporting reminder is used monthly to roll up compliance totals for management of IHD patients whose most recent LDL is greater than or equal to 120mg/dl. This national reminder identifies patients with known IHD (i.e., a documented ICD-9 code for IHD in the last five years) who have had a serum lipid panel within the last two years, where the most recent LDL lab test (or documented outside LDL) is greater than or equal to 120 mg/dl. If a more recent record of an UNCONFIRMED IHD DIAGNOSIS is found, recent LDL is greater than or equal t0 120mg/dl as defined by the VA the reminder will not be applicable to the patient. External Peer Review Program (EPRP) performance measure and the maximum guideline recommended below: The VHA/DOD Clinical Practice Guideline for Management of Dyslipidemia recommends an LDL goal of <120 mg/dl for patients with Ischemic Heart Disease; and the NCEP Adult Treatment Panel II recommends a more stringent goal of <100 mg/dl. |
| FINDINGS |
|
| FUNCTION FINDINGS |
|
| TECHNICAL DESCRIPTION | This reminder is not for use in CPRS, hence there is no related reminder
No mapping necessary. Use the VA-ISCHEMIC HEART DISEASE
Reporting roll up will send totals for this reminder and facility for:
1) Reminder totals based on reminder evaluation:
applicable, not applicable, due, not due totals
CPRS vs. Reporting reminders: This VA-*IHD ELEVATED LDL REPORTING
reminder does not include orders placed, refused, or other defer
activities which clinicians use in CPRS to manage the VA-IHD ELEVATED
LDL clinical reminder. This Reporting reminder is restricted to Lab
results found during the reminder evaluation for each patient in the
denominator patient list.
reminder taxonomy distributed with this term.
UNCONFIRMED IHD DIAGNOSIS
Use the UNCONFIRMED IHD DIAGNOSIS health factor
distributed with this term or add any local health
factor representing an unconfirmed or incorrect IHD
diagnosis.
LDL Enter the Laboratory Test names from the Lab Package
dialog.
for calculated LDL and direct LDL with "I +V>0" in the
CONDITION field.
The Lab tests defined in this term will also be used
to update the following reminder terms' findings with
appropriate CONDITION values:
LDL <100
LDL 100-119
LDL 120-129
LDL >129
For the following OUTSIDE LDL Reminder Terms, use the health factors
distributed with the reminder term or enter the local Health Factor
used to represent these values.
OUTSIDE LDL <100
OUTSIDE LDL 100-119
OUTSIDE LDL 120-129
OUTSIDE LDL >129
National Roll-up:
Setup issues before using this reminder:
The national reporting criteria for VA-IHD QUERI are defined in the
Reminder Extract Parameter.
This national reminder is used by the VA-IHD QUERI Extract run monthly
to roll up compliance totals for LDL laboratory tests completed within
the past 2 years, where the most recent LDL result is greater than or
equal to 120 as of the end of the reporting period. The patients
evaluated for compliance are based on VA EPRP performance measure
reporting criteria. The performance measure reporting criteria are used
to create patient lists. The patient lists used with this reminder are
found in the Reminder Patient List file with the following naming
convention:
VA-*IHD QUERI yyyy Mnn PTS WITH QUALIFY AND ANCHOR VISIT
where yyyy is the calendar year, and nn is the month.
The patient lists are based on the VA-*IHD QUERI PTS WITH QUALIFY
AND ANCHOR VISIT Extract Finding Rule Set. The rule set will find
IHD patients of record within 5 years prior to the beginning of the
monthly reporting period who had a qualifying clinic visit and an
earlier (anchor) visit 13-24 months prior to the reporting period.
1. Use the Reminder Term options to map local representations of
Rules for building the patient list for the reporting patient
denominator are:
Rule 1: IHD Patients
Start with Patients with an IHD 410.nn, 411.nn, 412.nn, or 414.nn
diagnosis documented within 5 years prior to the beginning of the
reporting period.
Rule 2: Qualifying Visit
Find the subset of patients, from rule 1, who have a Qualifying
Visit during the one-month reporting period.
findings:
Qualifying Clinic Codes include:
Primary Care: 301 (General Internal Medicine), 322 (Women), 323
(Primary Care/Medicine), 350 (Geriatric), 531 and
563 (Mental Health Primary Care)
Specialty Care: 303 (Cardiology), 305 (Endocrinology/ Metabolism),
306 (Diabetes), 309 (Hypertension), 312
(Pulmonary/Chest)
Include patients that had a Qualifying Visit during the reporting
period and subsequently died before the end of the reporting
period.
Rule 3: Exclude patients from the patient subset resulting from
Rule 2 that have a primary discharge diagnosis of 410.nn within 60
days prior to the Qualifying Visit.
Rule 4: Anchor Visit
Find the subset of patients, after rule 3, with an Anchor
Visit 13-24 months prior to the beginning of the reporting period.
Use the same clinic codes used for the Qualifying Visit in Rule 2.
Rule 5: Associated Facility
The subset of patients resulting from the rules above are assigned
an associated facility that is used to accumulate national counts.
IHD DIAGNOSIS
The Associated Facility for each patient is based on the following
criteria:
1) Use the primary care facility assigned to the patient
2) If more than one primary care facility is assigned or no
primary care facility is assigned, then find which facility has
the most visits on the local VistA system in the last two years.
3) If the count of the number of visits is the same for multiple
facilities, use the facility associated with the most recent
visit between the tied facilities.
|
| CUSTOMIZED COHORT LOGIC | FI(1)&FF(2) |
| INTERNAL PATIENT COHORT LOGIC | FI(1)&FF(2) |
| PATIENT COHORT FINDINGS COUNT | 2 |
| PATIENT COHORT FINDINGS LIST | 1;FF2 |
| INTERNAL RESOLUTION LOGIC | (0)!FI(3)!FI(4)!'FI(5)!'FI(6)!'FI(7)!FI(8)!FI(14)!'FI(15)&FF(1) |
| RESOLUTION FINDINGS COUNT | 9 |
| RESOLUTION FINDINGS LIST | 3;4;5;6;7;8;14;15;FF1 |
| INFORMATION FINDINGS COUNT | 1 |
| INFORMATION FINDINGS LIST | 13 |
| WEB SITES |
|
| # OF GEN. COHORT FOUND LINES | 0 |
| # GEN. COHORT NOT FOUND LINES | 0 |
| # GEN. RES. FOUND LINES | 0 |
| # GEN. RES. NOT FOUND LINES | 0 |
| BASELINE AGE FINDINGS |
|
| # SUM. COHORT FOUND LINES | 0 |
| # SUM. COHORT NOT FOUND LINES | 0 |
| # SUM. RES. FOUND LINES | 0 |
| # SUM. RES. NOT FOUND LINES | 0 |