BASIC COMPONENT

Promote reporting of blood pressure and A1c measures; and as able, initiate activities that promote clinical innovations, team-based care, and self-monitoring of blood pressure.

Proportion of health care systems reporting on National Quality Forum (NQF) Measure 18

What is NQF Measure 18?
Where is NQF 18 Reported?
Who Reports NQF 18?

NQF 18 & ICD 9 Codes (More information to come)

This section will describe the current ICD 9 hypertension codes included and excluded in the NQF 18 measure. Additionally help you understand what is in the ICD 9 hypertension codes and how health systems/health care providers use them for reporting, managing patient populations and quality care.

Optional Measures

Proportion of health care systems reporting on National Quality Forum (NQF) Measure 59

What is NQF Measure 59?
Where is NQF 59 Reported?
Who Reports NQF 59?

NQF 59 & ICD 9 Codes (More information to come)

This section will describe the current ICD 9 diabetes codes included and excluded in the NQF 59 measure. Additionally help you understand what is in the ICD 9 diabetes codes and how health systems/health care providers use them for reporting, managing patient populations and quality care.

Team Based Care

Proportion of health care systems with policies or systems to encourage a multi-disciplinary team approach to blood pressure control;
Proportion of patients in health care systems with policies or systems to encourage a multi-disciplinary team approach to blood pressure control;

Self-Monitoring

Proportion of health care systems with policies or systems to encourage self monitoring of high blood pressure;
Proportion of patients in health care systems with policies or systems to encourage self monitoring of high blood pressure;

Electronic Health Records

Proportion of health care systems with electronic health records appropriate for treating patients with high blood pressure;
Proportion of patients in health care systems with electronic health records appropriate for treating patients with high blood pressure

Basic Component Public Health Strategies

The purpose of this performance measure is to move states toward having the capacity to report state-level blood pressure control measures (as in the enhanced component of FOA 1305). The performance measure captures the number of health care systems in the state that report National Quality Forum (NQF) Measure 18 to promote quality improvement and population reporting of quality improvement data. (CDC DRAFT Operational 1305-)

Learn the healthcare language and landscape. See the Glossary Button for common Acronyms and Glossary of Terms.
Identify which providers/health systems are reporting NQF measure 18 and/or measure 59 to NCQA by going to NCQA Recognition Directory . NQF 18 will be the “Heart & Stroke Recognition” and NQF 59 is the “Diabetes Recognition Program”. You can find further information on how to access this site by going to the “Who Reports NQF 18” and/or “Who Reports NQF 59” presentations.
Identify which health centers are reporting NQF measure 18 and/or measure 59 to the Uniform Data System by going to the HRSA Health Center Profile . You will then have the opportunity to select your state and health center. You can then find the clinical measures reported for the past several years. You can find further information on how to access this site by going to the “Who Reports NQF 18” and/or “Who Reports NQF 59” presentations.
Contact your local Quality Improvement Organization (QIO) to discuss any clinical reporting and/or initiatives (i.e. Patient Centered Medical Home initiate) and explore the possibility of receiving access to the reported data.
Once you are aware of health centers/providers not reporting, meet with quality improvement representative and/or case manager from hospital system or health center. Discuss their current reporting capabilities and clinical quality improvement work.
Share information regarding state and national initiatives related to high blood pressure and diabetes, such as Million Hearts and National Diabetes Prevention Program.
Promote the National Diabetes Prevention Program to address the need for Type 2 diabetes prevention.
Convene a meeting with key stakeholders, such as your state/regional Quality Improvement Organization, Primary Care Association, Local retail Pharmacist, Local primary care leader (physician or non-physician such as Nurse Practitioner or Physician Assistant), and RN/Case Manager, to discuss methods of team-based care. Explore possible lines of communication and the exchange of health related information amongst mutual patients. Review national models (i.e. Ashville Pharmacy project)
Review tools within the Resource & Links button for Home Blood Pressure Monitoring to identify possible action steps. Your action steps may include; scanning your environment for existing efforts, identify the prominent insurance carriers in your state and talk with the benefits managers to promote coverage of home blood pressure monitoring equipment, work with health care providers to promote training of staff in how to teach patients about home blood pressure monitoring, and educate the community about the importance of blood pressure control and home monitoring (Self-Measured Blood Pressure Monitoring-Action Steps for Public Health Practitioners)
Convene a meeting with key stakeholders, such as your state/regional Quality Improvement Organization, Primary Care Association, Local retail Pharmacist, Local primary care leader (physician or non-physician such as Nurse Practitioner or Physician Assistant), and RN/Case Manager, to discuss home blood pressure monitoring and possible action steps.
Review your state’s population health related to high blood pressure and diabetes. Share the information with healthcare providers/health systems and communities to increase awareness of health improvement.
Share information about existing programs for those with diabetes and high blood pressure with communities and healthcare providers/systems leading to an improvement in awareness and potentially self-management techniques.
Sponsor/partner with/host learning collaboratives to support healthcare transformation in areas such as implementing electronic health records, team-based care, chronic disease self-management and medication adherence.

Promote awareness of high blood pressure among patients.

Proportion of adults in the state aware that they have high blood pressure

The purpose of Strategy 5 is for States to increase the healthcare providers’ awareness of the level of undiagnosed hypertension. The focus is specific to health systems and the care system design (protocols, clinical decision supports, and health IT) they have in place to assure that those with hypertension get properly diagnosed and treated. Note: This is not about increasing the public’s awareness, or the patients’ awareness.

Measurement Example

Numerator – Number of patients with a documented diagnosis of high blood pressure or hypertension in the EHR system (proxy for awareness)

Denominator – Number of adult patients in a defined health care system with high blood pressure (inclusive of undiagnosed and diagnosed)

Further details forthcoming from the CDC 1305 Basic Component Operationalized Performance Measures Guidance