Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care (NQF 0089)

eMeasure Name Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care eMeasure Id 63244AC9-0A52-44FB-A73A-58BFB7F6F8F2
Version number 1 eMeasure Set Id C30F37DC-97CF-4BC2-BEA9-2076088BA073
Available Date No information Measurement Period January 1, 20xx through December 31, 20xx
Measure Steward American Medical Association - Physician Consortium for Performance Improvement
Endorsed by National Quality Forum
Description Percentage of patients aged 18 years and older with a diagnosis of diabetic retinopathy who had a dilated macular or fundus exam performed with documented communication to the physician who manages the on-going care of the patient with diabetes mellitus regarding the findings of the macular or fundus exam at least once within 12 months
Copyright
© 2010 American Medical Association and/or National Committee for Quality Assurance. All Rights Reserved
Measure scoring Proportion
Measure type Process
Stratification
None
Risk Adjustment
None
Data Aggregation
Rationale
The physician that manages the on-going care of the patient with diabetes should be aware of the patient's dilated eye examination and severity of retinopathy to manage the on-going diabetes care. Such communication is important in assisting the physician to better manage the diabetes. Several studies have shown that better management of diabetes is directly related to lower rates of development of diabetic eye disease (Diabetes Control and Complications Trial – DCCT, UK Prospective Diabetes Study – UKPDS).
Clinical Recommendation Statement
While it is clearly the responsibility of the ophthalmologist to manage eye disease, it is also the ophthalmologist's responsibility to ensure that patients with diabetes are referred for appropriate management of their systemic condition. It is the realm of the patient's family physician, internist or endocrinologist to manage the systemic diabetes. The ophthalmologist should communicate with the attending physician (Level A: III Recommendation) (AAO, 2003).
Improvement notation
Higher score indicates better quality
Measurement duration
12 month(s)
Reference
American Academy of Ophthalmology. Preferred Practice Patterns Committee. Diabetic Retinopathy. 2003.
Definition
Initial Patient Population(s): Patient Age:  Patients aged 18 years and older at the beginning of the measurement period.
Diagnosis Active:  Patient has a documented diagnosis of diabetic retinopathy. 
Encounter:  At least 2 visits with the physician, physician's assistant, or nurse practitioner during the measurement period.
Definition
Denominator(s): All patients aged 18 years and older with a diagnosis of diabetic retinopathy who had a dilated macular or fundus exam performed.
Definition
Denominator Exclusion(s): N/A
Definition
Numerator(s): Patients with documentation, at least once within 12 months, of the findings of the dilated macular or fundus exam via communication to the physician who manages the patient's diabetic care.
Definition
Denominator Exception(s): Documentation of medical reason(s) for not communicating the findings of the dilated macular or fundus exam to the physician who manages the ongoing care of the patient with diabetes.

Documentation of patient reason(s) for not communicating the findings of the dilated macular or fundus exam to the physician who manages the on-going care of the patient with diabetes.
Guidance
Supplemental Data Elements
Report "Patient Characteristic: Gender" using "Gender HL7 Value Set (2.16.840.1.113883.1.11.1)"; Report "Patient Characteristic: Race" using "Race CDC Value Set (2.16.840.1.114222.4.11.836)"; Report "Patient Characteristic: Ethnicity" using "Ethnicity CDC Value Set (2.16.840.1.114222.4.11.837)"; Report "Patient Characteristic: Payer" using "Payer Source of Payment Typology Value Set (2.16.840.1.113883.3.221.5)".

Table of Contents


Population criteria

Data criteria (QDM Data Elements)

Supplemental Data Elements




Measure set CLINICAL QUALITY MEASURE SET 2011-2012