1. UDS – NextGen Best Practice for Asthma
Presented By:
Sean Folweiler, Project Manager
Debra Pierce, NextGen EPM Analyst

2. Presentation Goals Introduce CVC and Presenters
Review 6B Section H – Asthma Pharmacological Therapy - UDS Measure
Review Asthma Data Elements
Data Sets
Review NextGen Workflow
HCCN grant recipients are required to conduct activities under each of the following three areas

3. Central Valley Collaborative
CVC Core Services
EHR Project Management
EHR Analytics
ePM Analytics
EHR Training
EHR Development and Design
Network Support for PMS and EHR
Custom Programming
CVC Supporting Services (CVC Membership is not required)
HIT Student Internship

4. Central Valley Collaborative
NextGen
EHR Training
EHR Support
EPM Support
Programming
Project Management
Billing Support

5. Staffing Sean Folweiler Melissa Davis Gregory Williams Jamie Swenson
PERSONNEL
FTE
Member Access
Director
0.5
Ray Parris
Project Manager 1
Sean Folweiler
Sr. Administrative Assistant
Melissa Davis
EHR Analyst
Gregory Williams
HIT Workforce Program Coordinator
Jamie Swenson
ePM Analyst
Debra Pierce
Programmer
Greg Johnson
Senior Application Support Trainer II
Teresa Weir
Network Administrator I
Juan Garcia
EHR Workflow Design Specialist
Lahila Pitts
Application Support Trainer
John Smith
Saaqib Rangoonwala

6. Central Valley Collaborative Membership (Core Members)
Golden Valley Health Centers – Merced, CA
Livingston Medical Group – Livingston, CA
United Health Centers – Parlier, CA
Valley Health Team – San Joaquin, CA
Omni Family Health – Bakersfield, CA
Gardner Family Health Centers – San Jose, CA
Asian Americans for Community Involvement – San Jose, CA

7. Geography

8. Core Members and QI Members

9. Our Mission

10. 6B Section H – Asthma Pharmacological Therapy
PERFORMANCE MEASURE: The performance measure is “Percentage of patients aged 5 through 40 with a diagnosis of mild, moderate, or severe persistent asthma who received or were prescribed accepted pharmacologic therapy.” This is calculated as follows: • Numerator: Number of patients in the denominator who received a prescription for or were provided inhaled corticosteroid or an accepted alternative medication. • Denominator: Number of patients who were 5 through 40 years of age at some point during the measurement year, who have been seen at least twice in the practice and who had at least one medical visit during the reporting year, who had an active diagnosis of persistent asthma OR a sample of these patients. For measurement year 2014, this includes patients with a date of birth between January 1,1974 and December 31, 2009.
***Measure from 2014 UDS Manual Ages are not correct for 2015.

11. 6B Section H – Asthma Pharmacological Therapy
TOTAL NUMBER OF PATIENTS AGE 5 THROUGH 40, COLUMN (A) Criteria: Enter the number of all patients who: • Were born on or after January 1, 1974 and on or before December 31, 2009 AND • Were last seen by health center while they were age 5 through 40 years AND • Have been seen at least twice (not necessarily in the current year) AND • Had at least one medical visit during 2014 AND • Were diagnosed with persistent11 asthma OR have persistent asthma as a current diagnosis on a chronic illness form or template Exclusions: • Allergic reaction to asthma medications • Individuals with a diagnosis of asthma who are discovered, upon review, to have intermittent mild asthma, not persistent asthma.
***Measure from 2014 UDS Manual Ages are not correct for 2015.

12. 6B Section H – Asthma Pharmacological Therapy
NUMBER OF PATIENTS WITH PERSISTENT ASTHMA WITH PHARMOCOLOGIC TREATMENT DOCUMENTED, COLUMN (C) Enter the total number of patients identified in Column B whose 2014 record demonstrates that they had • Received a prescription for or were using an inhaled corticosteroid OR • Received a prescription for or were using an acceptable pharmacological agent, specifically: inhaled steroid combinations, anti-asthmatic combinations, antibody inhibitor, leukotriene modifiers, mast cell stabilizers, or methylxanthines
***Measure from 2014 UDS Manual Ages are not correct for 2015.

13. 6B Quick Sheet
SECTION H: ASTHMA PHARMACOLOGICAL THERAPY – Column A includes all patients between 5 and 40 years of age as of December 31st currently diagnosed with persistent asthma, with at least 1 medical visit in the health center during the measurement year and at least 2 medical visits ever. – Column C includes the number of patients in column B for whom documentation demonstrates that appropriate pharmacologic therapy was provided. – Compliant: Copy of prescription or note that the prescription for inhaled corticosteroids or acceptable alternative was given during the current year is included in the chart of EHR. Acceptable alternative pharmacologic therapy: Leukotriene modifiers, Cromolyn sodium, Nedocromil sodium, Sustained release methylxanthines. – Exclusions: Patients with allergic reaction to asthma meds and intermittent asthma.
***

14. Data Elements Demographic Age Qualifying Encounter Date Asthma
ICD Codes (patient_diagnosis)
Patient Problems (SNOMED)
Asthma_.classification
Medication Source
Medication - RXNorm

15. ICD Data Set
Persistent Asthma
ICD9 – 493.x
ICD10 – J45.30 – J45.52

16. Patient Problem Data Set
– Severe Persistent Asthma
– Moderate persistent Asthma
– Mild Persistent Asthma
Exacerbation of Persistent Asthma

17. Asthma Persistent Classification Data Set

18. Medication Data Set 144 Medications Currently
Create an account
Search in Name for ‘Asthma’ and code system ‘RxNorm’

20. NextGen’s Interpretation
Considerations:
The most recent available medication update is required for accurate reporting.
The Preferred Asthma Therapy drug list is provided by the National Library of Medicine Value Set Authority Center.
Previous versions of this report required users to select an asthma severity classification on the Asthma Flowsheet template. This is no longer necessary – users can enter persistent asthma in the Problems Module to avoid using the asthma templates. Users can also specify persistent asthma with ICD-10 codes.

21. Best Practice Workflow

22. Best Practice Workflow Cont.

23. Best Practice Workflow Cont.

24. Best Practice Workflow Cont.

25. Outstanding Questions