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My QI Diabetes HM Compliance

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Screening tests are wonderful tools used to detect problems before they start! ... Screening can detect pre-cancerous 'polyps' which can be removed, preventing the ... – PowerPoint PPT presentation

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Title: My QI Diabetes HM Compliance


1
My QIDiabetes HM Compliance
  • Tom LeBlanc, MS2
  • Roxboro Family Practice
  • Dr. Lance Walker, D.O.

2
Part I - The Chart Audit
  • Looking at yearly HbA1c and eye exam compliance
    for diabetic patients
  • 62 records randomly selected
  • 104 total charts reviewed
  • Selection of diabetic patients dictated by
    diagnosis/billing code-sorted list

3
Results A1c
82 compliance HEDIS reported is 80
4
Results A1c
5
Results Eye Exam
6
Results Eye Exam
7
Analysis
  • Problems
  • 1. The practice tends not to find out if/when eye
    exams were performed
  • 2. Discussions of the importance of yearly eye
    exams, if they take place at all, are poorly
    documented as there is no standardized way of
    doing so

8
What Now?
  • EMR Electronic Medical Records
  • SOAPware
  • Already equipped to keep track of health
    maintenance interventions
  • Pops up reminders each time the medical record is
    accessed
  • Downsides
  • You can just press cancel
  • The tests need to be entered manually

9
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10
Diabetic HM Protocol
  • HM protocol for diabetic patients
  • Must be manually added when a patient is
    diagnosed with DM
  • Contents
  • HbA1c every 6 months
  • BMP yearly
  • Cholesterol yearly
  • Eye exam yearly
  • Foot Exam yearly
  • Microalbumin yearly
  • Physical Exam yearly

11
Diabetic HM Interventions
  • The HM module enables you to do a search based on
    an HM protocol or even a specific test!
  • So you can quickly generate a list of patients
    not up to date on, for example, their A1c!
  • Then, using this list, you can easily print
    letters to send to each patient!

12
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16
Part II - The HM-Saver
  • Premise patients in waiting rooms and exam rooms
    are a captive audience
  • Why not use this to our advantage?
  • We can use this venue to promote preventive care!
  • Each exam room contains a computer, with a
    screensaver running

17
Welcome to Roxboro Family Practice!
  • We hope you enjoy your visit
  • The slides that follow contain helpful
    information about your health
  • Please feel free to ask us any questions you have
    about this information

18
Why should I have yearly exams?
  • Heart disease, cancer, and stroke are the three
    leading causes of death in the U.S.
  • Lifetime risk for developing cancer is about 1 in
    every 2 men, and 1 in every 3 women!
  • In most cases, these diseases are either
    preventable or can be detected early, making
    treatment easier and more effective
  • So come in for your annual physical! ?

19
Is My Blood Pressure High?
  • Normal blood pressure is 120/80
  • High blood pressure puts you at risk for heart
    failure, stroke, heart attack, and kidney failure
  • 1 in 4 adult Americans has high blood pressure,
    yet 1 in every 3 of these are unaware they have a
    problem!
  • What can I do?
  • Weight loss losing a few pounds is the BEST way
    to lower your pressure!
  • Exercise regular aerobic exercise helps
    decrease your pressure
  • Diet cut back on your salt intake (less canned
    food, less eating out), eat more fruits and
    vegetables
  • Medication many medications are available to
    help control high blood pressure not improved by
    lifestyle changes

20
Is My Cholesterol High?
  • High cholesterol puts you at risk for heart
    disease, stroke, and heart attack
  • Half of Americans over age 20 have high
    cholesterol
  • The American Heart Association recommends
    cholesterol testing every 5 years for everyone
    over age 20
  • What can I do to lower my cholesterol?
  • Eat more fiber whole grain bread, cereals, etc.
  • Eat more fish
  • Eat more vegetables and less red meat
  • Cut back on fast food, packaged foods, etc.
  • Exercise at least 30 minutes 4-5 days per week

21
Screening Tests
  • Screening tests are wonderful tools used to
    detect problems before they start!
  • Common screening tests include
  • Breast Cancer Mammogram
  • Colon Cancer Stool Cards, Colonoscopy
  • Cervical Cancer Pap smear
  • Diabetes blood sugar test
  • Prostate Cancer PSA test
  • Lets take a closer look at why its important to
    detect these problems early

22
Diabetes
Over 18 million Americans have diabetes
  • Symptoms frequent urination, excessive thirst,
    blurred vision, fatigue, weight loss
  • Many people live with diabetes for years without
    even knowing they have it
  • But uncontrolled diabetes is very damaging to the
    body, eventually causing
  • Blindness
  • Kidney failure
  • Frequent infection
  • Amputation
  • You may be at risk, so find out when you were
    last tested!
  • Adults over 45 should be tested at least every 3
    years

23
Skin Cancer
  • Over 1 million new cases each year in the U.S.
    its the most common cancer
  • Prevention avoid direct sun exposure from
    10am-4pm, and use sunblock (at least SPF 15)
  • The best detector is yourself!
  • Keep an eye on those moles
  • Look for the ABCDs
  • Appearance is it raised or flat?
  • Border are there jagged edges or irregular
    borders?
  • Color is it dark in color, or irregularly
    colored?
  • Diameter how big is it? Greater or less than
    6cm?
  • Has it changed size or appearance since you
    started watching it?

24
Colon Cancer
  • About 150,000 new cases of colon cancer will be
    diagnosed this year, and over 57,000 Americans
    will die of colon cancer
  • Risk factors
  • American diet (low fiber, high fat, few fruits
    and vegetables)
  • Lack of physical activity
  • Smoking
  • Family history
  • Screening beginning at age 50, men and women
    should have
  • Stool card testing every year
  • Colonoscopy every 10 years
  • Screening can detect pre-cancerous polyps which
    can be removed, preventing the development of
    cancer!

25
Breast Cancer Facts
  • 1 in every 7 women living in the U.S. will
    develop breast cancer in their lifetime!
  • Every woman is at risk, but risk increases with
  • Age the single greatest risk factor
  • A family history of breast cancer
  • Delayed childbearing, or having no children
  • Not breast feeding
  • Obesity
  • Hormone replacement therapy
  • Over 200,000 new cases of breast cancer will be
    diagnosed in the U.S. this year
  • About 40,000 American women will die from breast
    cancer this year
  • Only lung cancer causes more cancer deaths in
    women

26
Breast Cancer Screening
  • There are three components of comprehensive
    breast cancer screening
  • Self Exam breast self-exams are a very
    important part of breast cancer screening
  • The idea is to become familiar with your own
    breast tissue, making you better at detecting
    changes than your doctor, who generally only
    examines you once a year
  • Yearly Exam you should receive a breast exam at
    your yearly visit, but its important that you do
    routine self-exams at home
  • Mammogram the American Cancer Society
    recommends screening every 1-2 years after age 40

27
Pap Smear
  • Screening test for cervical cancer
  • Cervical cancer is the leading cause of death
    from cancer in developing countries, where pap
    testing is not available
  • Cervical cancer is VERY treatable, if detected
    early
  • Who should be tested?
  • All women ages 21-30, once per year
  • If under 21, 3 years after first intercourse
  • Women over age 30, every 2-3 years if previous 3
    tests were normal

28
Prostate Cancer
  • The second most common cancer in men (2nd to skin
    cancer)
  • Risk is increased in
  • African American men
  • Men with a family history
  • Screening
  • PSA blood test and digital rectal exam every year
    beginning at 50

29
Do I need a flu shot?
  • Facts
  • Each year about 114,000 Americans are
    hospitalized and 36,000 die because of the flu
  • You CANNOT get the flu from a flu shot
  • Flu shots dont always stop you from getting the
    flu, but can help make it less severe
  • The best time to get your flu shot is October or
    November
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