EPRP QUARTERLY UPDATE Fourth Quarter FY 2011 WVMI-Confidential and Proprietary WVMI-Confidential and Proprietary CGPI CGPI CHANGES No Changes to These Modules:       TVG CHF IHF DM SMI SCI Core  Minor wording change to PI question offmedrx  The CKD.

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Transcript EPRP QUARTERLY UPDATE Fourth Quarter FY 2011 WVMI-Confidential and Proprietary WVMI-Confidential and Proprietary CGPI CGPI CHANGES No Changes to These Modules:       TVG CHF IHF DM SMI SCI Core  Minor wording change to PI question offmedrx  The CKD.

EPRP QUARTERLY UPDATE
Fourth Quarter FY 2011
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CGPI
CGPI CHANGES
No Changes to These
Modules:






TVG
CHF
IHF
DM
SMI
SCI
Core
 Minor
wording
change to PI question
offmedrx
 The CKD module has
been deleted
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
Other Changes Include:
FRAIL ELDERLY
Catnum 54 patients with an inpatient stay at this
VAMC in the past year (length of stay>= 48 hours)
will get a new Frail Elderly instrument
 Details of the new instrument will be covered in a
separate presentation.

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MH MODULE
Brief Alcohol Counseling [alcbac, question 27]
 Please note the changes to the Acceptable
Provider definition:


Acceptable provider: For a “provider” to be deemed acceptable to
perform brief alcohol counseling, he/she must be a MD/DO,
Psychologist, LCSW, LCSW-C, LMSW, LISW, NP, CNS, RN, PA,
MS Level counselor, or Addictions therapist. A trainee with
appropriate co-signature, or other allied health professional who
by virtue of educational background AND approved
credentialing, privileging, and/or scope of practice, has been
determined by the facility to be capable of brief alcohol
counseling, may perform the counseling.
It is important that you check the signature line for the
credentials of the author of the note documenting
brief alcohol counseling
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
SUICIDE RISK EVALUATION
Please note important changes to the
definition/decision rules of question 90 [deprisk]
and question 142 [ptsdrisk].
 The requirement for a summary or conclusion
statement of the risk of suicide has been deleted
 The clinical reminder from Patient Care Services is
acceptable when certain conditions are met.
 The same wording was also added to the
definition/decision rules for question 162
[mhtxrsk]
 Please consult with your RM or WVMI if you are
uncertain as to whether the documentation in the
record meets the intent of the question

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SUICIDE RISK EVALUATION

Acceptable Provider Documentation of Suicide
Risk Evaluation:
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A clinical reminder is available from Patient Care
Services (PCS) and is acceptable if all required elements
(feelings of hopelessness, suicidal thoughts, suicide
plans if having suicidal thoughts, and history of suicide
attempts) of the reminder are completed by the
provider and contained in the medical record; OR
 If the PCS Clinical Reminder is NOT used, there must
be at a minimum, a notation by the provider that the
suicide risk evaluation was completed. The provider
notation is an attestation that hopelessness, suicidal
thoughts, suicide plan if having suicidal thoughts, and
history of suicide attempts were addressed with the
patient.

MHRSKSU


If the provider documents the patient is demonstrating
suicidal ideation/behavior or is at risk for suicide, enter
“1” for outcome. If the provider documents the patient
is not demonstrating suicidal ideation/behavior or is
not at risk for suicide, enter “2” for outcome. The term
‘risk’ does not need to be present to answer the outcome
question.
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Some additional guidance (below in red) is also
provided in the rules for question 163 regarding
outcome of the suicide behavior/ideation
evaluation
ACCEPTABLE PROVIDER
Please note the changes to the definition of
Acceptable Providers who can perform a suicide
ideation/behavior evaluation
 See questions 90 [deprisk], 142 [ptsdrisk] and 162
[mhtxrsk]


Acceptable Provider: For a “provider” to be deemed
acceptable for suicide risk evaluation he/she must be an
MD, DO, PhD or PsyD Psychologist, LCSW, LCSW-C,
LMSW, LISW, NP, CNS, or PA. Trainees in ANY of
these categories may complete a suicide risk evaluation
with appropriate co-signature.
Please note the credentials of the author of a
progress note documenting a suicide risk
evaluation
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
SHARED MODULE CHANGES

There is a change to the order of the lipid questions


If the answer to protinyr is no (urinalysis for
protein not done in the past year), the question
macroalb (and subsequent date question) will be
skipped

The CKD lab questions were deleted
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The questions asking for the cholesterol, HDL and
triglyceride values now precede the LDL questions
SHARED MODULE CHANGES
 An

liraglutide (Victoza)
 Only
the generic names will be displayed in
the drug table

Refer to your drug handbook to find the generic
name if the trade name is documented in the
record
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addition was made to the list of antidiabetes drugs in the rules for q41
[poantidm], q43 [chgdmrx], and q44
[addmrx]
REVISED DEFINITION/DECISION RULESSHARED MODULE

Reasons for not prescribing a beta-blocker [question
104 , nobetab]
Documented beta-blocker allergy/sensitivity/intolerance
counts regardless of type of reaction
 Documented beta-blocker allergy/sensitivity/intolerance to one
beta blocker is acceptable as allergy to all BBs
 EXCLUDE (do not count) allergy to BB eye drops


Severely de-compensated heart failure:

there must be a specific diagnosis documented by the
physician/APN/PA to choose option 10
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The format of the definition/decision rules has been
changed and allows easier correlation to the answer
options
 A couple of the rules have been expanded for clarification

REVISED DEFINITION/DECISION RULESSHARED MODULE
 Acerx
Definition of ACEI expanded


ACEI: Angiotensin converting enzyme inhibitors;
ACEIs may be described as RAS (renin-angiotensin
system) or RAAS (renin-angiotensin-aldosterone
system) blockers/inhibitors
Brand names added to list of ACEIs
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
[question 105]
ACEINOT [QUESTION 107]

INCLUDE: AS described as moderate, severe, 3+, 4+,
critical or significant; degree of severity not specified;
aortic valve area of less than 1.0 square cm; subaortic
stenosis, moderate/severe, or degree of severity not
specified
 EXCLUDE: aortic insufficiency/regurgitation only; AS
described as 1+ or 2+; AS using qualifiers: cannot
exclude, cannot rule out, may have, may have had, may
indicate, possible, suggestive of, suspect, or suspicious

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
The format of the definition/decision rules
has been changed and allows easier
correlation to the answer options
Moderate/Severe Aortic Stenosis has
clarifications
REVISED DEFINITION/DECISION RULES-SHARED
MODULE
Arbrx [question 108]


ARB: Angiotensin receptor
blockers or angiotensin II
receptor antagonists (AIIRA);
ARBs may be described as
RAS (renin-angiotensin
system) or RAAS (reninangiotensin-aldosterone
system) blockers/inhibitors
 Brand
names added
to list of ARBs
 Changes
as noted
in aceinot
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Definition of ARB
expanded
Contrarb [question 110]
OP MEDICATION RECONCILIATION MODULE
There is a significant change in this module which
affects several questions
 In question 1, you will look for an outpatient clinic
visit during the past year at which a
physician/APN/PA administered, prescribed, or
modified medications
 Outpatient clinic encounter includes Nexus Clinics
AND several specialty clinics

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Please refer to the list of clinics in the
definition/decision rules of new question 1 [opmedrx]
 Also note there is a list of clinics that are not included
(exclusion list) and that for purposes of this question
psychology group visits are not included

OP MED RECON
If there is no outpatient visit in the past year at
which a physician/APN/PA administered,
prescribed, or modified medications, the case is
excluded from the Medication Reconciliation
module after question 1.
 If there was such a visit, you will enter the date of
the visit at which a physician/APN/PA
administered, prescribed, or modified medications
in question 2 [medrxdt]
 You will select the name of the clinic from a drop
down list of clinics in question 3 [medclin]

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OP MED RECON
Questions 4 through 9 of this module are
unchanged from the previous quarter EXCEPT
now the question will display the date you entered
in medrxdt (date of the most recent OP visit at
which a physician/APN/PA administered,
prescribed, or modified medications).
 You will answer the questions based on
documentation in the notes for that visit

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CGPI SCORING CHANGES
No changes to CGPI scoring in 4Q FY2011
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
TBI

No changes to TBI questions, rules or scoring for
4QFY11
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HBPC
HBPC ADMISSION DATE

Admission to HBPC is the visit in which a full
assessment of the patient is initiated
 The date of this visit is the only acceptable HBPC
admission date.
 Disregard earlier notes that refer only to HBPC
admission.


Please be sure to follow this rule when entering the
date of admission to HBPC.
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The definition/decision rules for entering the
HBPC admission date have been clarified [question
7, admisdt]
HBPC-BEHAVIORAL TRIGGERS
Please note the change to the rules for
documentation of behavioral triggers [question 22
behvtrig]
 For HBPC admissions that occur on or after July 1,
2011, the ONLY ACCEPTABLE DATA SOURCE
for this data element is the HBPC admission
assessment.
 Remember that the date of admission to HBPC
must be July 1, 2011 or > for this new rule to apply
and you will not have those cases immediately

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FOLLOW

COGNITIVE ASSESSMENT
Follow-up for cognitive impairment may include, but is
not limited to: taking a medical history, performing a
neurological exam, psych consult, blood work, brain
imaging, supportive counseling, care planning for
dementia or other similar diagnosis, caregiver
education, neuropsychological testing, or depression
screening.
Please remember that there must be clinician
documentation that the follow up was done in
relation to the patient’s cognitive impairment (not
new)
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Some additional examples of follow up of a positive
cognitive assessment have been added to question
29 [addfolo]


UP OF
HBPC SCORING

There are no changes to HBPC scoring or the exit
report for 4QFY2011
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ACS
REASONS

FOR
NO BETA-BLOCKER
There are some changes to the definition/decision
rules for the three beta blocker questions in ACS

As noted in CGPI, the rules have been reformatted
and some changes made for clarification of the
answer options
The most significant change is in the rules for option 3;
2nd or 3rd degree HB on ECG and no pacemaker
 Please review the includes and excludes terms

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Betanone [question 35 Initial Presentation Module]
 Betanon1 [question 31 After Admission Module]
 Nodcbb [question 16 Discharge Module]

REASONS
ARB
FOR NOT
PRESCRIBING
AN
ACEI
AND
Please review the changes to the rules for
questions 3 [noacewhy[ and 6 [acsnoarb] in the
Discharge module
 The definition/decision rules have been
reformatted for clarification and correlation to the
answer options.
 Please review the rules carefully

Note the changes to the rules for aortic stenosis
(included terms and excluded terms)
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
CARDIOLOGY INVOLVEMENT-DATE

AND
TIME
Questions 41 and 42 [carddt and cardtme] in the Initial
Presentation module
 Questions 37 and 38 [carddt1 and cardtme1] in the
After Admission module
 Questions 11 and 12 [carddt2 and cardtme2] in the
Transfer In module

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There are clarifications to the definition/decision
rules for entering the date and time of Cardiology
involvement
CARDIOLOGY INVOLVEMENT DATE

TIME
Inter-rater reliability scores for these questions need
improvement, so please read the rules carefully
Pay special attention to the rules for entering time of
cardiology involvement
If a cardiologist was the attending physician, or saw the
patient in consultation enter the time the cardiology note was
started.
 If there was cardiology consultation by telephone or
telemedicine, and recommendations were made to the
attending physician, enter the time the attending physician
documented the telephone or telemedicine consult was
completed.
 If a cardiac catheterization or PCI was performed at this
VAMC, use the start time of the cath or PCI as the
documented time of cardiology involvement, unless the
patient was seen by cardiology pre-procedure.

WVMI-Confidential and Proprietary

AND
NO CHANGES

No changes to
Validation
 History and Assessment
 Revascularization
 Continuing Care and Assessment

No changes to ACS exit report or scoring
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
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IHF
RULES REVISIONS

Changes to





The changes to these questions are the same as
noted previously in the comparable questions in
ACS
 There are no other changes to IHF

WVMI-Confidential and Proprietary

Contace3
Contrarb
Contrabb
Noacewhy
Noarbdc
Nobbatdc
IHF SCORING

There are no changes to IHF scoring or to the Exit
Report
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PNEUMONIA
PN ACUTE CARE MODULE

Heltrisk (question 1)
There are no changes to content of the
definition/decision rules but they have been
reformatted for better understanding and correlation to
the bulleted points in the question
 Please note: If there is physician/nurse
practitioner/physician assistant documentation that the
patient has ‘healthcare associated pneumonia’, ‘HCAP’,
or ‘nosocomial pneumonia’, select “1.”

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PN SCORING

No changes to the scoring or exit report for
Pneumonia
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SURGICAL CARE
NEW FEATURE

An ICD-9 “checker” is now built into all inpatient
software (not just SC)
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If you enter an invalid code (numbers that are not a real
ICD-9 code), you will get an error message as you
attempt to exit the module
 You will be unable to exit the module until a valid code
has been entered.
 Both procedure codes and diagnosis codes will be
checked for validity

PRINCIPAL PROCEDURE CODE
[QUESTION 7, PRINPX]



The Surgical Care software will continue to warn you if
the principal procedure code you entered is not on Table
5.10


Consult with your Regional Manager or WVMI if you are
unsure
If the principal procedure is not on Table 5.10, the case will be
excluded. Do not search for another code and enter that one
just because it is on Table 5.10 if it is NOT the principal
procedure.
Enter xx.xx to indicate no procedure was performed
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
Since VA records do not identify the principal
procedure, it is important to determine the correct code
to enter when there are multiple procedures during one
admission
Use the definition of principal procedure as guidance
SC
Bioname
[Question 38]

No changes to the
Informed Consent
module
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There are some
highlighted changes to
the definition/decision
rules
 These are mainly
wording or formatting
changes for added
clarification

Informed Consent
FRAIL ELDERLY-INPATIENT INSTRUMENT


more information on that in a separate presentation
WVMI-Confidential and Proprietary
If the age of the SC patient is >= 75 years and the
length of stay is >=48 hours, the case will get the
new Frail Elderly inpatient instrument
SC SCORING

No changes to SC scoring or Exit Report for
4QFY2011
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VTE
MINOR CHANGES
The only changes to VTE are minor
wording/formatting changes in the
definition/decision rules for a few questions
 There are no changes to VTE scoring

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HBIPS
ADMISSION DATE
[QUESTION 1, ADMDT]

If there are multiple inpatient orders, use the order
that most accurately reflects the date that the patient
was admitted. The admission date should not be
abstracted from the earliest admission order without
regards to substantiating documentation. If
documentation suggests that the earliest admission
order does not reflect the date the patient was
admitted to inpatient care, this date should not be
used.
 ONLY ALLOWABLE SOURCES: Physician orders,
face sheet

WVMI-Confidential and Proprietary
There are changes to the definition/decision rules
consistent with the changes made in other inpatient
instruments in 3Q FY2011
REFRNEXT
[QUESTION 18]

Please note this important change to the
definition/decision rules
When a patient checks himself out of a hospital against
the advice of his doctor (AMA) this is not the same as an
elopement. The patient should still be offered a referral
to a next level of care provider. If the patient refuses the
referral, select “2.” If the patient checks out AMA and is
not offered a referral to next level of care provider, select
“5.”
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
SCORING CHANGE

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The only change to HBIPS scoring for 4Q FY2011 is
the discharge date parameter for inclusion which is
now >=04/01/2011
COMMON MODULES

No changes to:





No changes to the Nursing Exit Report/scoring
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
Fall Assessment
Prevention
Delirium Risk
Blood Management
Inpatient Medication Reconciliation
PILOT EXIT REPORT
CKD indicators were deleted
 New Frail Elderly indicators were added

Change to mrec 23, 24, 25, 26, 27, 28, 29, and 33 to
add exclusion if optmedrx=2 (no medication was
administered, prescribed, or modified at an
outpatient clinic visit in the past year)
 Wording at the top of the Pilot report has been
revised to reflect the changes to the content of the
report

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More on these with FE education
 Details provided in exit report guide

QUESTIONS????
Please call your RM or WVMI if you have questions
about any topic
 Please complete the required learning assessment
using the questions and this presentation as
references

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4TH QUARTER REVIEW
OF 7/11/2011
WILL START THE WEEK
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