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Jedediah McClintic, Rishi Singh; Adherence To Physician Quality Reporting Standards For Diabetic Retinopathy and Age Related Macular Degeneration When Utilizing An Electronic Health Records System. Invest. Ophthalmol. Vis. Sci. 2012;53(14):1409.
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To determine the rate of adherence of clinicians to PQRS (formerly PQRI) measures for diabetic retinopathy and age related macular degeneration
The definitions set for ophthalmic measures with the 2011 PQRS were used for this analysis (available at https://www.cms.gov/pqrs/), specifically, measures for diabetic retinopathy (measures 18, 19) and AMD (measures 14, 140). The EHR system records for visits to a retina clinic at Cole Eye Institute during a 1 month period (September 2011) were reviewed for all encounters during the proceeding year (reviewed through September 2010) with eligible diagnoses of AMD (ICD of 362.50, 362.51, 362.52) or DM (ICD of 362.50, 362.51, 362.52). Compliance with 2011 PQRS measures for 131 charts were analyzed (n=131).
Results for measure 14 indicate a 100% compliance rate with dilated exam and a distinction of exudative versus nonexudative AMD, however an AREDS categorization of dry AMD was documented for only 6% of patients. For measure 140, patients were noted to be taking AREDS formula vitamins on medication lists or were counseled on such in 81% of encounters, though specific reference to counseling was documented in less than half of cases. In diabetic patients, results for measure 18 showed perfect compliance with dilated exam and distinction of NPDR versus PDR as well as noting the presence of ME. The severity of NPDR was rarely classified. Last, for measure 19, communication letters to primary providers were sent in 59% of cases
Compliance with PQRS for dilated exams in diabetic retinopathy and AMD are higher than reported by CMS, indicating a possible disjunction between proper practice and accurate reporting. Communication with managing physicians, however, remains an area in need of improvement. Broad distinction of severity of disease is always made, however classification within NPDR and nonexudative AMD is rarely documented
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