Basics of New PHASE Reporting May 15, 2017 Redwood Community Health Coalition

PHASE Initiative Focuses on patients who have Abdominal Aortic Aneurysm, Coronary Artery Disease, Peripheral Artery Disease, Transient Ischemic Attack/Cerebrovascular Accident or Diabetes

PHASE Algorithm Medications Goals for: Blood pressure Statin HbA1c

2017 RCHC PHASE Reporting Data reported every quarter Measurement period Is one for the period of one year Previously, it was for a quarter For example, the measurement period for the quarter that just ended was 4/1/2016 to 3/21/2017

First Section: Patient Population Measures Old “REACH” section has been renamed “Patient population measures.” PHASE provides the ICD-10 codes for the reported patient populations

PHASE Reporting Patient Populations Report on the number of patients in defined populations who were seen at least once in the measurement period: Diabetes: patients aged 18-75 years with a diagnosis of diabetes and at least two primary care medical visits in the past two years ASCVD: patients aged 18 years and over with a diagnosis of ASCVD Hypertension: patients aged 18-85 years with a diagnosis of essential hypertension and diagnosed at least six months ago Unduplicated patients in these three populations

Second Section: Prescription Measures The medication measures were changed from all PHASE- eligible patients to patients with diabetes only Diabetes denominator is the same as the defined diabetes population (see last slide) except that the age rage is 55 to 75 years Diabetes prescriptions: statin and ACE/ARB NEW medication measure: patients in the hypertension denominator (see last slide) who have been prescribed an oral drug in the anti-hypertensive class

Anti-hypertensive Medications See the document “PHASE Clinical and Quality Measures: Oral Medication List for Hypertension” available from RCHC

Third Section: Screening and Follow-up The instructions give definitions for PRIME and UDS measures. Since most health centers are already familiar with the UDS measures, just report those Three UDS measures No change to definitions used by PHASE last year

Screening and Follow-up Measures Tobacco screening and follow-up. No change. BMI screening and follow-up. No change. Normal range: 2016 UDS Normal BMI: If aged 18-64 years, 18.5 ≤ BMI < 25; If aged 65+ years, 23 ≤ BMI < 30 2017 UDS Normal BMI: all ages 18+ years, 18.5 ≤ BMI < 25 Depression screening and follow-up. No change.

Fourth Section: Clinical Quality Measures Based on the defined populations of patients with diabetes and hypertension Diabetes controlled blood pressure (under 140/90 mmHg) Diabetes controlled A1c (under 9%) Hypertension controlled blood pressure (by what we call the “QIP” definition)

Diabetes Clinical Measures Take the last blood pressure and the last HbA1c in the measurement period If the denominator patient did not have a blood pressure or A1c in the measurement period, do NOT include him/her in the numerator Blood pressure numerator: < 140/90 mm Hg Blood sugar numerator: < 9%

Hypertension Clinical Measure Again, take the last blood pressure in the measurement period and if the patient did not have one, do NOT include him/her in the numerator Blood pressure numerator (the “QIP” definition): If < 60 years, BP < 140/90; If ≥ 60 years and has diabetes, BP < 140/90; If ≥ 60 years and does not have diabetes, BP < 150/90

Questions About PHASE?