Services Patients Need

Measure

Comment

Annual Visit

All Patients

Mammogram

Females ages 40 to 69

Colorectal Cancer Screen

Fecal Occult Blood q Yr or Colonoscopy q 10 yrs

LDL

Annually if have CAD or DM

Glaucoma screen

Annually for Patients over 64 yo, Eye Professionals Do this @ most Check-ups

Annual K+ and BUN or Creatinine

Patients on an ACE/ARB, Digoxin or Diuretic

Annual Serum Concentration

Patients Taking certain Seizure Medications: Phenobarbital, Phenytoin, Valproic Acid (divalproex), Carbamazepine

Flu Vaccine

All Patients annually

Pneumonia Vaccine

Once after age 65

DEXA scan

Once over age 64

DEXA scan

Within 6 months of any Fracture in a Female not already on Osteoporosis Medication

Disease Modifying anti-Rheumatic Drug (DMARD)

Patients with RA

Spirometry

Within 6 months for all New Diagnoses of COPD

ACE/ARB

All Hypertensive Patients with Diabetes

Screenings for Diabetic Patients

Measure

Comment

Retinal Exam by Eye Professional

Annually

Microalbumin

Annually

Hemoglobin A1C

Annually with latest result < 9

LDL

Annually with latest result < 100

Patient Focus

Measure

Comment

Patient Perception of Physician

Address Chief Complaint & advise patient of your assessment

BMI

Record in Chart

Access

Assure Effective, Prompt Patient Phone Access to Office and Arrange Timely Appointments

Perception of Wait Time for Referral

Promptly Send Referral for Authorization

Hypertension Control

Diagnose Hypertension and Control to < 140/90

Readmissions

Smooth Transitions to Outpatient Care Using Communication and Teamwork

Medications to Avoid (short acting are acceptable.)

Narcotics, Estrogen, Muscle Relaxers, Benzodiazepines (short acting are OK)