Diabetes: Foot Exam (NQF 0056)

eMeasure Name Diabetes: Foot Exam eMeasure Id EC757284-BEE2-456F-8BFE-DC81DDE960FF
Version number 1 eMeasure Set Id 36F5458A-7C14-409C-80F7-6A4D56FC1014
Available Date No information Measurement Period January 1, 20xx through December 31, 20xx
Measure Steward National Committee for Quality Assurance
Endorsed by National Quality Forum
Description The percentage of patients aged 18-75 years with diabetes (type 1 or type 2) who had a foot exam (visual inspection, sensory exam with monofilament, or pulse exam).
Copyright
© National Committee for Quality Assurance. All Rights Reserved
Measure scoring Proportion
Measure type Process
Stratification
None
Risk Adjustment
None
Data Aggregation
Rationale
This measure assesses the percentage of patients in a specific age demographic who were diagnosed with type 1 or type 2 diabetes and who had a foot exam performed. Diabetes mellitus (diabetes) is a group of diseases characterized by high blood glucose levels caused by the body's inability to correctly produce or utilize the hormone insulin. It is recognized as a leading cause of death and disability in the U.S. and is highly underreported as a cause of death. Diabetes of either type may cause life-threatening, life-ending or life-altering complications, including poor circulation, nerve damage or neuropathy in the feet and eventual amputation. Nearly 60%-70% of diabetics suffer from mild or severe nervous system damage. The consensus among established clinical guidelines is that patients with both types of diabetes should have a foot exam soon after diagnosis and annually thereafter (ADA 2009). Comprehensive foot care programs can lower amputation rates by 45%-85%. This measure facilitates the prevention and long-term management of lower extremity-based complications for patients diagnosed with diabetes.
Clinical Recommendation Statement
American Diabetes Association Guidelines/ Recommendations:  Perform annual comprehensive foot examination to identify risk factors predictive of ulcers and amputations. The foot examination should include inspection, assessment of foot pulses, and testing for loss of protective sensation (10-g monofilament plus testing any one of: vibration using 128-Hz tuning fork, pinprick sensation, ankle reflexes, or vibration perception threshold).
Improvement notation
Higher score indicates better quality
Measurement duration
24 month(s)
Reference
America Diabetes Association.  Executive Summary: Standards of Medical Care in Diabetes-2009.  Diabetes Care January 2009 32:S6-S12; doi:10.2337/dc09-S006
Definition
Initial Patient Population(s): All patients 18 to 75 years of age during the measurement period
Definition
Denominator(s): Patients in the initial population with a diagnosis of diabetes and at least 2 non-acute inpatient or outpatient encounters, or currently receiving medications indicative of diabetes during the measurement period or in the 12 months prior to the measurement period
Definition
Denominator Exclusion(s): N/A
Definition
Numerator(s): A foot exam (visual inspection, sensory exam with monofilament, and pulse exam) during the measurement period
Definition
Denominator Exception(s): Patients with a diagnosis of polycystic ovaries, gestational diabetes or steroid-induced diabetes who did not have any face-to-face encounters in any setting, with a diagnosis of diabetes, during the measurement period or the 12 months prior to the measurement period
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