Primary Open Angle Glaucoma (POAG): Optic Nerve Evaluation (NQF 0086)

eMeasure Name Primary Open Angle Glaucoma (POAG): Optic Nerve Evaluation eMeasure Id 9BF86FD4-ADB1-49F1-B0B8-E58CC2FCC4F9
Version number 1 eMeasure Set Id 80D43FE9-112D-4E34-957D-71A431159DF8
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 POAG who have been seen for at least 2 office visits, who have an optic nerve head evaluation during one or more office visits 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
Changes in the optic nerve are one of two characteristics which currently define progression and thus worsening of glaucoma disease status (the other characteristic is visual field). There is a significant gap in documentation patterns of the optic nerve for both initial and follow-up care (Fremont, 2003), even among specialists (Lee, 2006). Examination of the optic nerve head and retinal nerve fiber layer provides valuable structural information about glaucomatous optic nerve damage. Visible structural alterations of the optic nerve head or retinal nerve fiber layer and development of peripapillary choroidal atrophy frequently occur before visual field defects can be detected. Careful study of the optic disc neural rim for small hemorrhages is important, since these hemorrhages can precede visual field loss and further optic nerve damage.
Clinical Recommendation Statement
The physical exam focuses on nine elements: visual acuity, pupils, slit-lamp biomicroscopy of the anterior segment, measurement of intraocular pressure (IOP), determination of central corneal thickness, gonioscopy, evaluation of optic nerve head and retinal nerve fiber layer, documentation of optic nerve head appearance, evaluation of fundus (through dilated pupil), and evaluation of the visual field (Level A: II Recommendation for optic nerve head evaluation) (AAO, 2005).
Improvement notation
Higher score indicates better quality
Measurement duration
12 month(s)
Reference
American Academy of Ophthalmology. Preferred Practice Patterns Committee. Primary Open-Angle Glaucoma. Limited Revision. 2005.
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 primary open-angle glaucoma (POAG).
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 primary open-angle glaucoma.
Definition
Denominator Exclusion(s): N/A
Definition
Numerator(s): Patients who have an optic nerve head evaluation during one or more office visits within 12 months.
Definition
Denominator Exception(s): Documentation of medical reason(s) for not performing an optic nerve head evaluation.
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