Chlamydia Metric using the HEDIS Methodology

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Chlamydia Metric using the HEDIS Methodology

• Heather Halvorson, MD MPH
• Capt, USAF, MC
• Preventive Medicine Informatics Consultant
• AFMSA/SGRK

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HEDIS Methodology

• Percentage of women 16-25 years of age who were
  identified as being sexually active and who had
  at least one test for chlamydia during the
  measurement year.
• Continuous enrollment criteria
• Gap restriction
• Rates calculated
• 16-20 years olds
• 21-25 year olds
• Total

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HEDIS Methodology

• Eligible Population (Denominator)
• Number of sexually active women 16-25 years old
  continuously enrolled during the preceding 12
  months
  
• Identify sexual activity
• Pharmacy data
• Prescriptions for contraceptives
• Claims/encounter data
• Visit with specified code (contraceptive,
  infertility, pregnancy, post-partum)
  
• Visit with specific lab test (pap smear,
  pregnancy, sexually-transmitted infection)

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HEDIS Methodology, contd

• Numerator
• Number of 16-25 year old women continuously
  enrolled with at least one screening test for
  Chlamydia in the past 12 months
  
• Identify Chlamydia tests
• Claims/encounter data
• Visit or laboratory evidence of test
• Optional Exclusion
• Women identified as sexually active only by
  pregnancy test who had prescription for Accutane
  or X-ray within 7 days

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Measured population
Numerator
Eligible Population (Denominator)
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Chlamydia Metric Eligible Population
DoD Master Enroll
Direct Care (M2)
Input data pull
Network Care (M2)
Pharmacy (PTDS)
Eligible Population (Denominator)
ClinChem
Rad / Lab (M2)
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Chlamydia Metric Numerator
ClinChem
Direct Care (M2)
Screened Population (Numerator)
Input data pull
Network Care (M2)
Lab (M2)
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Chlamydia Metric Metric and
Action Lists

• Metric - screened
• Reported by total and age groups
• HEDIS reported national percentiles benchmark
• 50-75-90ile
• Action lists patients overdue for screening
• Unscreened eligible population without continuous
  enrollment restriction
  
• Reported for Active Duty
• Army, Navy, Marine Corps

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Chlamydia Screening Active Duty
90th
75th
50th
HEDIS National ile Benchmarks
1-year continuous enrollment criteria applied
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Chlamydia Screening Beneficiaries
90th
75th
50th
HEDIS National ile Benchmarks
1-year continuous enrollment criteria applied
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Limitations

• Methodology will identify women who are not
  sexually active, causing the screening rate to be
  falsely low
  
• Oral contraceptives used for other purposes
• Women receiving annual pap smear who are not
  sexually active
  
• Pregnancy tests done by protocol (i.e. pre-op,
  E.R. visit)
  
• Methodology may not capture all screening
• Dependents using Planned Parenthood, college
  clinics, or other non-network facility

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Questions?
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