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

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

3. PHASE Algorithm
Medications
Goals for:
Blood pressure
Statin
HbA1c

4. 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

5. 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

6. 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 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 years with a diagnosis of essential hypertension and diagnosed at least six months ago
Unduplicated patients in these three populations

7. 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

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

9. 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

10. 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 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.

11. 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)

12. 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%

13. 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

14. Questions About PHASE?