Percentage of patients 18-75 years of age with diabetes and an active diagnosis of retinopathy in any part of the measurement period who had a retinal or dilated eye exam by an eye care professional during the measurement period or diabetics with no diagnosis of retinopathy in any part of the measurement period who had a retinal or dilated eye exam by an eye care professional during the measurement period or in the 12 months prior to the measurement period.
– DENOMINATOR
Patients 18-75 years of age with diabetes with a visit during the measurement period.
– NUMERATOR
Patients with an eye screening for diabetic retinal disease. This includes diabetics who had one of the following:
Diabetic with a diagnosis of retinopathy in any part of the measurement period and a retinal or dilated eye exam by an eye care professional in the measurement period.
Diabetic with no diagnosis of retinopathy in any part of the measurement period and a retinal or dilated eye exam by an eye care professional in the measurement period or the year prior to the measurement period
– DENOMINATOR EXCLUSIONS
Exclude patients who are in hospice care for any part of the measurement period.
Exclude patients 66 and older who are living long term in an institution for more than 90 consecutive days during the measurement period.
Exclude patients 66 and older with an indication of frailty for any part of the measurement period who meet any of the following criteria;
Advanced illness with two outpatient encounters during the measurement period or the year prior
OR advanced illness with one inpatient encounter during the measurement period or the year prior
OR taking dementia medications during the measurement period or the year prior
Exclude patients receiving palliative care during the measurement period.
– APPLICATION WORKFLOWFor Denominator:
All patients aged 18 – 75 years, with a diagnosis for diabetes and a visit during the measurement period, are considered for the denominator of this measure. To record an encounter, navigate to Patient > Provider Note > eSuperbill. Under the ‘Procedure- CPTs’ heading, enter the encounter code.
Office Visit
Annual Wellness Visit
Home Healthcare Services
Preventive Care Services – Initial Office Visit, 18 and Up
Preventive Care Services – Established Office Visit, 18 and Up
Ophthalmological Services
eSuperbill
To record the diabetes diagnosis, use the workflow Patient > Provider Note > Diagnoses, and click ‘Add’. Search for the diabetes diagnosis and add the diagnosis details. Then click ‘Save’. The diagnosis is added to the provider note.
Diabetes Diagnosis
For Numerator:
Patients satisfying any of the following conditions are included in the numerator:
Patient had a diagnosis for ‘Diabetic Retinopathy’ and a retinal exam performed during the measurement period. To record the diabetic retinopathy diagnosis, use the workflow Patient > Provider Note > Diagnosis, and click ‘Add’. Search for the diagnosis and add the diagnosis details. Then click ‘Save’. The diagnosis is added to the provider note.
To document retinal exam performed, navigate to Patient > Clinical > Evaluations. Click ‘+Evaluation’ and search for an intervention. Select ‘Performed’ from the ‘Status’ dropdown. Then click ‘Sign’ or ‘Save’.
Evaluation
Patient had a diagnosis for ‘Diabetic Retinopathy’ during the measurement period and a retinal exam performed during the measurement period or during the year prior to the measurement period. To record the diabetic retinopathy diagnosis, use the workflow Patient > Provider Note > Diagnosis, and click ‘Add’. Search for the diagnosis and add the diagnosis details. Then click ‘Save’. The diagnosis is added to the provider note.
To document retinal exam performed, navigate to Patient > Clinical > Evaluations. Click ‘+evaluation’ and search for an intervention. Select ‘Performed’ from the ‘Status’ dropdown. The click ‘Sign’ or ‘Save’.
For Denominator Exclusions:
Patients satisfying any of the following criteria are excluded from the denominator:
Patients who received hospice care during the measurement year. To document that patient is receiving hospice care outside of a hospital or long term care facility, navigate to Patient > Clinical > Evaluations. Use the below mentioned codes to order or perform an intervention:
385763009: Hospice Care (Regime/Therapy)
385765002: Hospice Care Management (Procedure)
Evaluation
To document an encounter inpatient, navigate to Patient > Clinical > Evaluations
Evaluation
Patients aged 65 years or older at the start of the measurement period who spent longer than 90 consecutive days in a long term care during the measurement period. To record the encounter, navigate to Patient > Provider Note > eSuperbill.
Evaluation
Patients 65 years of age or older with two or more outpatient encounters with advanced illness and fulfilling frailty criteria. Outpatient encounters should occur two years or less prior to the end of the measurement period. To document an outpatient encounter, navigate to Patient > Provider Note > eSuperbill. To document advanced illness diagnosis, use the workflow: Patient > Clinical > Diagnoses. Workflows for recording frailty criteria:
Frailty device ordered/applied during the measurement period: Patient > Clinical > Evaluations
Frailty diagnosis during the measurement period: Patient > Clinical > Diagnoses
Frailty symptoms during the measurement period: Patient > Clinical > Diagnoses or Patient > Clinical > Evaluations
Frailty encounter during the measurement period: Patient > Provider Note > eSuperbill
Patients 65 years of age or older having an inpatient encounter with advanced illness and fulfilling frailty criteria. Inpatient encounters should occur two years or less prior to the end of the measurement period. To document an inpatient encounter, navigate to Patient > Provider Note > eSuperbill. To document advanced illness diagnosis, use the workflow: Patient > Clinical > Diagnoses. Workflows for recording frailty criteria:
Frailty device ordered/applied during the measurement period: Patient > Clinical > Evaluations
Frailty diagnosis during the measurement period: Patient > Clinical > Diagnoses
Frailty symptoms during the measurement period: Patient > Clinical > Diagnoses or Patient > Clinical > Evaluations
Frailty encounter during the measurement period: Patient > Provider Note > eSuperbill
Patients 65 years of age or older taking dementia medication one year prior to or during the measurement period and fulfilling frailty criteria. Record the medication via the workflow Patient > Clinical > Prescription. Click ‘Add’ and search for the medication. Enter the medication details and click ‘Save’. Workflows for recording frailty criteria:
Frailty device ordered/applied during the measurement period: Patient > Clinical > Evaluations
Frailty diagnosis during the measurement period: Patient > Clinical > Diagnoses
Frailty symptoms during the measurement period: Patient > Clinical > Diagnoses or Patient > Clinical > Evaluations
Frailty encounter during the measurement period: Patient > Provider Note > eSuperbill
Patients receiving palliative care during the measurement period.
To record the ‘Palliative Care Encounter’ performed, use the workflow Patient > Provider Note > eSuperbill.
To record the ‘Palliative Care Intervention’ performed, use the workflow Patient > Clinical > Evaluations.
To record the ‘Functional Assessment of Chronic Illness Therapy’ assessment performed, navigate to Patient > Clinical > Evaluations.
