A. the Diabetes Quality Initiative Beginning in 2006 Focused on Meeting NCQA

Elizabeth Family Medicine

Diagnosis Code Diagnosis Code Description Count 401.9 HYPERTENSION NOS 3,283 V20.2 ROUTIN CHILD HEALTH EXAM 1,868 250.00 DMII WO CMP NT ST UNCNTR 1,305 V70.0 ROUTINE MEDICAL EXAM 1,207 724.2 LUMBAGO 744 272.4 HYPERLIPIDEMIA NEC/NOS 672 729.5 PAIN IN LIMB 598 477.9 ALLERGIC RHINITIS NOS 581 465.9 ACUTE URI NOS 576 V22.1 SUPERVIS OTH NORMAL PREG 549 311 DEPRESSIVE DISORDER NEC 511 250.02 DMII WO CMP NT ST UNCNTR 450 305.1 TOBACCO USE DISORDER 450 719.46 JOINT PAIN-L/LEG 443 493.90 ASTHMA, UNSPECIFIED, UNSPECIFIED 425

The three clinically important conditions selected for the multi-site survey were based on volume of patients seen for that disease state and QI initiatives in progress. All three conditions are in the top 15 most frequently seen list for Elizabeth Family Medicine. Other activities are summarized below.

Diabetes a. The Diabetes Quality Initiative beginning in 2006 focused on meeting NCQA Physician Recognition standards. b. Diabetes Disease Management Plan implemented 2009 to include the distribution of diabetes performance reports, unblinded practice ranking for A1c measures, and target goals for A1c. Checklist of best practices to be reviewed by Practice Based Medical Director with providers. c. Health Maintenance Module built in Cerner (electronic medical record), that includes alerts for diabetes measures based on ADA guidelines. d. Leadership for the Ambulatory networks of Carolinas Healthcare System has focused in 2010 on determining an appropriate care measure set for diabetes. This measure set, approved by providers using Delphi Polling, utilizes measures defined by ADA metrics. e. Patient education materials from the American Diabetic Association available on Synapse, the CHS intranet.

Hypertension a. Patient education materials available for self monitoring on Synapse, the CHS intranet. b. Patient education materials and activities coordinated by marketing in conjunction with National Health Observances c. Use of JNC 7 Guidelines for treatment of hypertension. d. Hypertension, and use of DASH diet, included as a Resident project for 2010. Asthma a. Leadership for the Ambulatory networks of Carolinas Healthcare System has focused in 2010 on determining an appropriate care measure set for Asthma. This measure set utilizes measures defined by the NHLBI and NC state Medicaid metrics. b. Point of care alerts for asthma measures based on NHLBI guidelines were vetted through leadership groups in 1st and 2nd quarter of 2010. These prompts were released and available for use in the electronic medical record in June 2010. c. Health Maintenance Module built in Cerner (electronic medical record), that includes alerts for asthma measures based on NHLBI guidelines.