Straight Talk Tuesday

Chartbook on Effective Treatment, National Healthcare Quality and Disparities.

This Effective Treatment chartbook is part of a family of documents and tools that support the National Healthcare Quality and Disparities Report (QDR). The QDR includes annual reports to Congress mandated in the Healthcare Research and Quality Act of 1999. It includes a summary of trends across measures of effective treatment and figures illustrating select measures of effective treatment. There is some cool stuff but here’s what’s really bothering me is the following:

Since November is National Diabetes Awareness Month, I thought I’d focus on the diabetes measures. The measures for diabetes are: 1) Receipt of four recommended diabetes services, 2) People with current diabetes who have a written diabetes management plan, 3) Adults age 40 and over with diagnosed diabetes with hemoglobin A1c and blood pressure under control, 4) Hospital admissions for uncontrolled diabetes and 5) New cases of end stage renal disease due to diabetes.

When the USWR was meeting with CMS, they told us they didn’t want any “paper compliance measures,” meaning measures that you could just check off and say, “Yep, did that.” Well, hate to say it, but that’s what a written plan of care measure sounds like to me. And, I know all of you are anxious to see the national data on diabetic foot ulcer offloading, and the data on diabetic patients who got foot screening or proper footwear! I mean, those would be terrific measures for National Quality of Care, right? The American Podiatric Medical Society spent a small fortune getting a comprehensive diabetic foot exam measure prepared as an electronic clinical quality measure and it’s a fantastic measure. The USWR reports it as well as a more general foot screening, DFU amputation measure and DFU off-loading. It seems like those would be logical things to follow nationally, don’t you think?

Report  http://www.ahrq.gov/research/findings/nhqrdr/2014chartbooks/effectivetx/index.html

http://www.ahrq.gov/sites/default/files/wysiwyg/research/findings/nhqrdr/2014chartbooks/effectivetx/2014nhqdr-effdiabetes.pdf


Caroline Fife, MD

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