1. All materials © 2011, National Committee for Quality Assurance NCQA’s Patient-Centered Medical Home (PCMH) Program March 29.2011

2. 2 NCQA PCMH Overview March 29, 2011 Record Review Workbook (RRWB)

3. 3 NCQA PCMH Overview March 29, 2011 What is the Record Review WorkbooK? Elements PCMH 3C, 3D, 4A −Require medical record abstraction of data −Need % of patients for each factor based on numerator and denominator Two methods to collect and submit patient data –Method #1 - report from the electronic system –Method #2 – Record Review Workbook Excel workbook in the Survey Tool Tool to identify sample of patients and abstract data needed for Elements 3C, 3D, 4A

4. 4 NCQA PCMH Overview March 29, 2011 Overview of Steps 1.Find RRWB in Survey Tool 2.Download and save file to computer 3.Review RRWB instructions and data needed from patient records 4.Select patient records to review 5.Review patient records for data 6.Enter data in RRWB 7.Enter % and Yes or No in Survey Tool 8.Link Workbook to Survey Tool

5. 5 NCQA PCMH Overview March 29, 2011 RRWB = Supplemental Worksheet Click here

6. 6 NCQA PCMH Overview March 29, 2011 RRWB Tabs Three tabs Instructions Patient Conditions Record Review

7. 7 NCQA PCMH Overview March 29, 2011 RRWB: Enter Important Conditions Enter three important conditions here including an unhealthy behavior/mental health or substance abuse AND high-risk or complex patients, IF you are including them.

8. 8 NCQA PCMH Overview March 29, 2011 RRWB: Enter Conditions Please choose “High Risk/ Complex” from the drop down list or leave it blank if not applicable for the patient sample

9. 9 NCQA PCMH Overview March 29, 2011 RRWB: Enter Conditions Enter conditions from drop down menu, for example: Diabetes Hypertension Depression High Risk/Complex

10. 10 NCQA PCMH Overview March 29, 2011 RRWB: % of Patients that Met Factor Patients that Met Factor Number (33/48) Percent (69%)

11. 11 NCQA PCMH Overview March 29, 2011 RRWB: Choosing Patients ~ Use same 48 patients for EACH Workbook Element ~ STEP #1 Select patients with at least one condition identified in Elements 3A and 3B using : Scheduling system or Registries Sort by last visit date STEP #2 Sort by date of last visit Identify a start date (e.g. 4/1/11) Go back a month (e.g. 3/1/11)

12. 12 NCQA PCMH Overview March 29, 2011 RRWB: Choosing Patients (cont.) ~ Use same 48 patients for 3C, 3D, 4A ~ STEP #3 Identify patients with appt./billing system or registry on 3/1 with at least one important condition-related visit Choose equal numbers of patients for each condition from Elements 3A and 3B 3 conditions: 16 patients 4 conditions: 12 patients 2 conditions: 24 patients

13. 13 NCQA PCMH Overview March 29, 2011 RRWB: Choosing Patients (cont.) ~ Use same 48 patients for 3C, 3D, 4A ~ STEP #4 Continue choosing patients going back on consecutive dates until all 48 patients are selected Keep a list that identifies patients if more information needed

14. 14 NCQA PCMH Overview March 29, 2011 PCMH 3C: Care Management Entering NOT USED in row 1 “grays” out the column Response Options Yes No Not Used Not applicable

15. 15 NCQA PCMH Overview March 29, 2011 RRWB Calculates the Score Patient count  Must have 48 patients  Fewer than 48 patients calculates as “0” Score to enter in survey tool  YES or NO  Percentage

16. 16 NCQA PCMH Overview March 29, 2011 Enter RRWB Responses in Survey Tool Enter responses From RRWB Yes or No AND Percent

17. 17 NCQA PCMH Overview March 29, 2011 Enter Percent from Each Column Enter Percent 79

18. 18 NCQA PCMH Overview March 29, 2011 View Percentages Percent for each factor Factor 1: 79 Factor 2: 87 Factor 3: 57 Factor 4: 77 Factor 5: 0 Factor 6: 90 Factor 7: 90 Most patient did not miss any appointments