HBI Online User Manual - Blue Cross and Blue Shield of Alabama
Contents
1. 35 e ii m S INTELLIGENCE APPLIED 17 Hepatic Enzyme Monitoring for Statin Use After Initiating Therapy Demographics Numerator Exclusions L Member date of birth Please note that date of birth is not applicable to the inclusion criteria of this clinical quality measure and therefore cannot remove the member from the denominator However the information collected here will be applied to other self report measures when possible Each member will have an index date which represents the date on which the member filled a prescription for statin medication This date will appear on the HBIOnline system and is unique to each member in the measure denominator Member received at least 1 liver panel ALT or AST test on or between 1 month after the index date and 6 months after the index date Member filled a prescription for a statin between 1 day prior to the index date and 365 days prior to the index date E Member had an acute nonacute inpatient stay between 1 month after the index date and 6 months after the index date C Member refused service on or prior to the last day of the reporting period This information is collected for informational purposes only E The service was ordered however the member did not follow up on or prior to the last day of the reporting period This information is collected for informational purposes only L Member was deceased on or between 1 month after th2. Member had two unilateral mastectomy procedures on or prior to the last day of the reporting period Date of service needs to be different for each procedure Member had one bilateral mastectomy procedure on or prior to the last day of reporting period C Member refused service on or prior to the last day of the reporting period Please note that this is not a valid exclusion according to the NCQA Technical Specifications This information is collected for informational purposes only C The service was ordered however the member did not follow up on or prior to the last day of the reporting period Please note that this is not a valid exclusion according to the NCQA Technical Specifications This information is collected for informational purposes only Member was deceased as of the last day of the reporting period L Member is not female HBIONLINE PROVIDER PERFORMANCE WEB TOOL 2010 USER MANUAL 15 e ii m S INTELLIGENCE APPLIED 2 Cervical Cancer Screening Demographics Numerator Exclusions _ Member date of birth Member must be 24 64 years of age as of the last day of the reporting period Member received a pap smear on or between the date two years before the start of the reporting period and end of the reporting period C Member had a hysterectomy with no residual cervix on or prior to the last day of reporting period C Member refused service on or prior to the last d
3. 365 days prior to the index date and the index date HIV infection HIV asymptomatic L Cystic fibrosis _ Disorders of the immune system E Malignancy neoplasms L Chronic bronchitis Emphysema _ Bronchiectasis __ Extrinsic allergic alveolitis HBIONLINE PROVIDER PERFORMANCE WEB TOOL 2010 USER MANUAL 30 e i m S INTELLIGENCE APPLIED C Chronic airway pulmonary obstruction C Pneumoconiosis and other lung disease due to external agents C Other diseases of the respiratory system _ Tuberculosis HBI ONLI NE PROVI DER PERFORMANCE WEB TOOL 2010 USER MANUAL 31 J ii m S INTELLIGENCE APPLIED 14 Use of Spirometry Testing in the Assessment and Diagnosis of COPD Demographics Numerator Exclusions L Member date of birth Member must be 42 years of age or older as of the last day of the reporting period Each member will have an index date which represents the date on which the member left the hospital after being diagnosed with COPD in the denominator This date will appear on the HBIOnline system and is unique to each member in the measure denominator Member received at least one spirometry test on or between 730 days prior to the index date and 180 days after index date Each member will have a denominator DOS which represents a date in which the member was diagnosed with COPD in the denominator This date will appear on the HBIOnline system and is un
4. diagnosed with acute bronchitis on index date HBIONLINE PROVIDER PERFORMANCE WEB TOOL 2010 USER MANUAL e ii m S INTELLIGENCE APPLIED 13 Use of Narrow Spectrum Antibiotics for Patients with Acute Streptococcal Pharyngitis Demographics Numerator Exclusions L Member date of birth Please note that date of birth is not applicable to the inclusion criteria of this clinical quality measure and therefore cannot remove the member from the denominator However the information collected here will be applied to other self report measures when possible No self report data elements for the numerator of this measure Each member will have an index date which represents the date the member was diagnosed with streptococcal pharnygitis This date will appear on the HBIOnline system and is unique to each member in the measure denominator C Member had a previous diagnosis of acute streptococcal pharyngitis on or between 90 days prior to the index date and one day prior to the index date E Member was prescribed a narrow spectrum antibiotic on or between 30 days prior to the index date and one day prior to the index date C Member was prescribed antibiotics for treatment of another condition prior to 30 days prior to the index date and was still actively taking these antibiotics when diagnosed with acute streptococcal pharyngitis on the index date Member had a qualifying comorbid condition on or between
5. for the service or procedure as defined in the indicator Figure 5 Figure 5 Verify Member s Date of Birth Sell Hepert 007 Is the date of birth on record for this member correct HBIONLINE PROVIDER PERFORMANCE WEB TOOL 2010 USER MANUAL 11 IMS asus D If the member s date of birth is correct or if the member s corrected data of birth still makes him her eligible for the service as defined by the indicator providers will be asked to determine whether the service procedure was indeed provided The example below shows what would be requested to validate that the member received the MMR vaccination Note that when applicable providers will be requested to enter dates of service for when the service was provided according to what is documented in the medical chart In some cases test results may be required Data should be entered in the format as noted next to the entry field e g Date of service should be entered as MM DD YYYY Home Clinical Quality Report Member List Self Report Confirm Numerator Childhood Immunization Measles Mumps And Rubella MMR m Provider Name PRIXXXXX m Provider ID 40351798BE Date Of Birth Last Name 02 19 2003 DREXXXXX ERIXXXXX gt Was this member vaccinated or had history of disease Yes this member received a Measles Mumps and Rubella MMR combination immunization on or prior to the member s second birthday MM DD YYYY Date
6. is collected for informational purposes only C Member was deceased on or before the last day of the reporting period HBI ONLI NE PROVI DER PERFORMANCE WEB TOOL 2010 USER MANUAL 43 e m S INTELLIGENCE APPLIED 22 Childhood Immunizations DTaP DT Demographics C Member date of birth Member must be 2 years of age between the start and end of the reporting period Numerator Each member will have an index date which represents the member s second birthday This date will appear on the HBIOnline system and is unique to each member in the measure denominator L Member received at least 4 DTaP vaccinations occurring in the time period on or between 42 days after the member s birth date and the index date Exclusions C Member had an anaphylactic reaction to any vaccine or its components any time prior to the index date C Member had an instance of encephalopathy and poisoning resulting from the tetanus diphtheria or pertussis vaccine any time prior to the index date _ Parent refused vaccination on or prior to the index date This information is collected for informational purposes only The service was ordered however the parent did not follow up on or prior to the index date This information is collected for informational purposes only L Member was deceased on or before the index date HBIONLINE PROVIDER PERFORMANCE WEB TOOL 2010 USER MANUAL 44 e i m S INTELLIG
7. is not a valid exclusion according to the NCQA Technical Specifications This information is collected for informational purposes only _ This member was deceased on or before the last day of the reporting period HBIONLINE PROVIDER PERFORMANCE WEB TOOL 2010 USER MANUAL 24 m S INTELLIGENCE APPLIED 9 Childhood Immunizations MMR Demographics Numerator Exclusions L Member date of birth Member must be two years of age between the start and end of the reporting period C Member received a Measles Mumps and Rubella MMR combination immunization on or prior to the member s second birthday C Member received a combination of either 1 receipt of vaccination component s any time on or prior to the member s second birthday or 2 history of disease diagnosis for measles mumps and rubella any time on or prior to the member s second birthday Must select one from each of the groups below Measles Mumps Rubella _ Vaccination L Vaccination _ Vaccination _ History of _ History of _ History of Disease Disease Disease L Member had a contraindication to vaccinate on or prior to the member s second birthday Must select one of the following C HIV infected or asymptomatic HIV L Immunodeficiency including genetic congenital immunodeficiency syndromes C Cancer of lymphoreticular or histiocytic tissue C Multiple myeloma _ Leukemia Anaphylactic reaction C P
8. to the NCQA Technical Specifications This information is collected for informational purposes only C The service was ordered however the member did not follow up on or prior to the last day of the reporting period Please note that this is not a valid exclusion according to the NCQA Technical Specifications This information is collected for informational purposes only C Member was deceased on or before the last day of the reporting period HBI ONLI NE PROVI DER PERFORMANCE WEB TOOL 2010 USER MANUAL 23 e m S INTELLIGENCE APPLIED 8 Cholesterol Management for Patients with Cardiovascular Conditions Demographics Numerator Exclusions L Member date of birth Member must be 18 75 years of age as of the last day of the reporting period L Member received at least one LDL measurement test on or between the reporting period start date and the reporting period end date _ Member did not have a cardiovascular condition that would require regular monitoring of lipid levels as of the last day of the reporting period C Member refused service on or prior to the last day of the reporting period Please note that this is not a valid exclusion according to the NCQA Technical Specifications This information is collected for informational purposes only C The service was ordered however the member did not follow up on or prior to the last day of the reporting period Please note that this
9. to the NCQA Technical Specifications This information is collected for informational purposes only C The service was ordered however the member did not follow up on or prior to the last day of the reporting period Please note that this is not a valid exclusion according to the NCQA Technical Specifications This information is collected for informational purposes only C Member was deceased on or before the last day of the reporting period HBI ONLI NE PROVI DER PERFORMANCE WEB TOOL 2010 USER MANUAL 19 m S INTELLIGENCE APPLIED 6 Diabetic Retinal Exam Demographics Numerator Exclusions L Member date of birth Member must be 18 75 years of age as of the last day of the reporting period L Member had at least one screening exam for diabetic retinal disease conducted by an eye care professional i e ophthalmologist or optometrist on or between the start of the reporting period and end of the reporting period C Member had at least one office visit with an ophthalmologist or optometrist on or between the start of the reporting period and end of the reporting period _ Member received a retinal exam conducted by an ophthalmologist or optometrist in the year prior to the start of the reporting period which showed no evidence of retinopathy C Member was diagnosed with polycystic ovaries on or before the last day of the reporting period C Member was diagnosed with steroid induced
10. which represents the date the member delivered vaginally or via caesarean section This date will appear on the HBIOnline system and is unique to each member in the measure denominator Member received HIV counselling an HIV 1 and HIV 2 screening test or an HIV 1 screening test on or between 10 months prior to index date and index date _ Member had both CD4 count laboratory A HIV RNA level laboratory test on or between 10 N tests on or between 10 months prior to index D months prior to index date and index date date and index date Member was diagnosed with HIV AIDS on or between 10 months prior to index date and index date C Member was diagnosed with HIV AIDS before 10 months prior to index date Member refused service on or prior to the last day of the reporting period Please note that this is not a valid exclusion according to the NCQA 2010 Technical Specifications This information is collected for informational purposes only C The service was ordered however the member did not follow up on or prior to the last day of the reporting period Please note that this is not a valid exclusion according to the NCQA HBI ONLI NE PROVI DER PERFORMANCE WEB TOOL 2010 USER MANUAL 34 2010 Technical Specifications This information is collected for informational purposes only L Member is not female ims INTELLIGENCE APPLIED HBI ONLI NE PROVI DER PERFORMANCE WEB TOOL 2010 USER MANUAL
11. ELLIGENCE APPLIED 25 Annual Visual Field Tests for Patients with Glaucoma Demographics C Member date of birth Please note that date of birth is not applicable to the inclusion criteria of this clinical quality measure and therefore cannot remove the member from the denominator However the information collected here will be applied to other self report measures when possible Numerator Each member will have an index date which represents the date on which the member was diagnosed with glaucoma This date will appear on the HBIOnline system and is unique to each member in the measure denominator _ Member received at least 1 visual field test conducted by an ophthalmologist or optometrist on or between one day after the index date and 13 months after the index date Exclusions C Member has a history of blindness any time on or prior to the last day of the reporting period C Member refused service on or prior to the last day of the reporting period This information is collected for informational purposes only C The service was ordered however the member did not follow up on or prior to the last day of the reporting period This information is collected for informational purposes only L Member was deceased on or between one day after the index date and 13 months after the index date HBIONLINE PROVIDER PERFORMANCE WEB TOOL 2010 USER MANUAL 47
12. ENCE APPLIED 23 Appropriate Monitoring for Angiotensin Converting Enzyme Inhibitors Angiotensin Receptor Blockers Use Demographics Numerator Exclusions L Member date of birth Member must be at least 18 years of age as of the last day of the reporting period Member received a general lab that included a potassium lab value and a measure of kidney function i e creatinine or blood urea nitrogen on or between the start and end of the reporting period OR L Member received at least one serum potassium test on or between the start and end of the reporting period AND either of the following L Member received L Member received at at least one serum least one blood urea creatinine test on or nitrogen therapeutic between the start and OR monitoring test on or end of the reporting between the start and period end of the reporting period C Member had an acute nonacute inpatient stay on or between the start and end of the reporting period E Member refused service on or prior to the last day of the reporting period This information is collected for informational purposes only C The service was ordered however the member did not follow up on or prior to the last day of the reporting period This information is collected for informational purposes only C Member was deceased on or between the start and end of the reporting period HBIONLINE PROVIDER PERFORMANCE WEB TOOL 2010
13. IMS Payer Solutions HBI Online Provider Performance Reporting Web Tool 2010 USER MANUAL ALL RIGHTS RESERVED e m S INTELLIGENCE APPLIED Table of Contents l Backgr uNd saaa EEE OEELA EEEE EEE EEE EEEE AE EEEE EESTE 3 II Accessing the Web Tool sssssssssssssssssssrsrrrrnnnnnnnnnrnnnnnnnnnnnrnrtrrrrrrrrnrrerereennnrnnnnnnnt 3 Username and PASSW Ol 05 cevensonracssvsnnneansansannnanoanssasannannaassassaveanaassansasnvansdaadsaseaneas 3 IH Quality Performance R port cccccccc cece eee ee cece eee e eee e eect esses ees eae tes easEESeaaE EE SaEEES 4 Welcome PAGE lt enwconsarananbnncexe arenes sees eee oaieeeleeiet eee oie eee ero eee ease eee eee 4 Quality Performance Report Features lt ccccsssscessssnecesnaneacennanencsansnencannevensaaneuannannes 4 IV2 Self Report Feature ossidi roi iE E EDE E ELDE EELDE E SLOE EE ELEDE EELDE EEEESDDE EEE TELL ES 5 The Self Report Feature Explained cc cccccc cece cence eee eee eee eee ene e tees teat eee ene e ts 5 How the Self Report Feature Benefits Providers ccccccceceeceeeeeeeeeeeeeeeeeeeteeeeaeeees 6 Quality Indicators that have the Self Report Feature Available cccceeeee eee e eee 6 Getting Started with the Self Report Feature s sssssrrrrressrrrrrresrrrrrrersrrrrrrerrrrrn 7 Step 1 Download and Review List of Members Who Did Not Receive the BSI VIC Cs ans en cnocesonuuasexnaseostexsesanyssessuseusausnses
14. USER MANUAL 45 e m S INTELLIGENCE APPLIED 24 Appropriate Monitoring for Diuretics Demographics Numerator Exclusions L Member date of birth Member must be at least 18 years of age as of the last day of the reporting period C Member received a general lab that included a potassium lab value and a measure of kidney function i e creatinine or blood urea nitrogen on or between the start and end of the reporting period OR L Member received at least one serum potassium test on or between the start and end of the reporting period AND either of the following L Member received L Member received at at least one serum least one blood urea creatinine test on or nitrogen therapeutic between the start and OR monitoring test on or end of the reporting between the start and period end of the reporting period C Member had an acute nonacute inpatient stay on or between the start and end of the reporting period C Member refused service on or prior to the last day of the reporting period This information is collected for informational purposes only C The service was ordered however the member did not follow up on or prior to the last day of the reporting period This information is collected for informational purposes only C Member was deceased on or between the start and end of the reporting period HBIONLINE PROVIDER PERFORMANCE WEB TOOL 2010 USER MANUAL 46 e ii m S INT
15. and was still actively taking these antibiotics when diagnosed with pharyngitis on the index date C Member refused service on or prior to the last day of the reporting period Please note that this is not a valid exclusion according to the NCQA 2010 Technical Specifications This information is collected for informational purposes only C The service was ordered however the member did not follow up on or prior to the last day of the reporting period Please note that this is not a valid exclusion according to the NCQA 2010 Technical Specifications This information is collected for informational purposes only HBI ONLI NE PROVI DER PERFORMANCE WEB TOOL 2010 USER MANUAL 27 e m S INTELLIGENCE APPLIED 12 Avoidance of Antibiotic Treatment in Adults with Acute Bronchitis Demographics C Member date of birth Member must be 18 64 years of age between one year prior to the start of the reporting period and the end of the reporting period Numerator No self report data elements for the numerator of this measure Exclusions Each member will have an index date which represents the date the member was diagnosed with acute bronchitis This date will appear on the HBIOnline system and is unique to each member in the measure denominator E Member had a qualifying comorbid condition on or between 12 months prior to index date and index date C HIV infection HIV asymptomatic Cystic fibrosis Disord
16. arent refused vaccination on or prior to the member s second birthday Please note that this is not a valid exclusion according to the NCQA Technical Specifications Parent refusal is collected for informational purposes only C The service was ordered however the member did not follow up on or prior to the last day of the reporting period Please note that this is not a valid exclusion according to the NCQA Technical Specifications This information is collected for informational purposes only L Member was deceased on or before their second birthday HBIONLINE PROVIDER PERFORMANCE WEB TOOL 2010 USER MANUAL 25 m S INTELLIGENCE APPLIED 10 Childhood Immunizations VZV Demographics C Member date of birth Member must be two years of age between the start and end of the reporting period Numerator E Member received a chickenpox disease immunization on or prior to the member s second birthday C Member had a history of chickenpox disease on or prior to the member s second birthday Exclusions L Member had a contraindication to vaccinate on or prior to the member s second birthday Must select one of the following HIV infected or asymptomatic HIV L Immunodeficiency including genetic congenital immunodeficiency syndromes C Cancer of lymphoreticular or histiocytic tissue C Multiple myeloma _ Leukemia F Anaphylactic reaction _ Parent refused vaccination on or prior to the member
17. ay of the reporting period Please note that this is not a valid exclusion according to the NCQA Technical Specifications This information is collected for informational purposes only C The service was ordered however the member did not follow up on or prior to the last day of the reporting period Please note that this is not a valid exclusion according to the NCQA Technical Specifications This information is collected for informational purposes only C Member was deceased as of the last day of the reporting period _ Member is not female HBIONLINE PROVIDER PERFORMANCE WEB TOOL 2010 USER MANUAL 16 m S INTELLIGENCE APPLIED 3 Colorectal Cancer Screening Demographics C Member date of birth Member must be 51 75 years old as of the last day of the reporting period Numerator C Member had at least one fecal occult blood test FOBT on or between the start of the reporting period and the end of the reporting period C Member had at least one sigmoidoscopy on or between 4 years prior to the start of the reporting period and the end of the reporting period C Member had at least one colonoscopy on or between 9 years prior to the start of the reporting period and the end of the reporting period Exclusions C Member was diagnosed with colorectal cancer on or prior to the last day of the reporting period C Member had a total colectomy procedure on or prior to the last day of the repo
18. be made available to users for a 60 day period ending March 24 2011 A countdown is located on the top of the quality report screen indicates the number of days remaining to enter data into the system When the self report capability is closed data will be downloaded combined with the administrative claims data and reprocessed to derive a final score that combines data from both sources Users will be notified when the data has been updated to the website HBIONLINE PROVIDER PERFORMANCE WEB TOOL 2010 USER MANUAL e ms INTELLIGENCE APPLIED Appendix A Example of Self Report Module for Childhood I mmunizations MMR A Indicators for which providers can enter self reporting data have a self report icon located to the right of the indicator results in the summary scorecard To enter self report data click the self report icon for the indicator E See Figure 3 below Figure 3 Self Report Button Childhood Immunization Measles Mumps And Rubella MMR as 59 8 9 Self Report Members Who Did Not Receive the Service Completed 2 of 53 Total Members Eligible for Service Numerator 0 Denominator 2 No Change 0 1234 B A listing of all the members that were identified as being eligible for the denominator but did not receive the appropriate service procedure will be displayed Figure 4 Key data fields including the plan member identification number date of birth first name and last name will be di
19. conduct a final validation of the results to ensure accuracy In the event that a data entry error has occurred the provider should click edit to revisit the data entry forms The provider must confirm that the data displayed is correct and click submit to officially add the self reported data on which the provider s final scores will be based Figure 8 Figure 8 Self report data confirmation Home Clinical Quality Report Member List Self Report Confirm Childhood Immunization Measles Mumps And Rubella MMR m Provider Name PRIXXXXX m Provider ID 40351798BE 07 23 2003 MARAXXKK CALXXXXX gt This member Member had a contraindication to vaccinate Immunodeficiency including genetic congenital immunodeficiency syndromes 8 25 2004 Please verify that the summary above is correct You will not have the opportunity to edit once you click the submit button To make corrections please click the edit button below HBIONLINE PROVIDER PERFORMANCE WEB TOOL 2010 USER MANUAL 14 e ii m S INTELLIGENCE APPLIED Appendix B Self Report Module Checklists by I ndicator 1 Breast Cancer Screening Demographics Numerator Exclusions L Member date of birth Member must be 42 69 years of age as of the last day of the reporting period C Member received a mammogram on or between the date one year before the start of the reporting period and the end of the reporting period C
20. curettage on or between one year prior to the index date and the index date C Member received hysteroscopy with the pathology specimen submitted on the same date of service which was on or between one year prior to the index date and the index date C Member received endometrial ablation with the pathology specimen submitted on the same date of service which was on or between one year prior to the index date and the index date C Member had pathology of uterine sample sent prior to endometrial ablation on or between 7 days prior to the index date and 1 day prior to the index date C Member had endometrial ablation on or between one year prior to the index date and the index date C Member refused service on or prior to the last day of the reporting period This information is collected for informational purposes only C The service was ordered however the member did not follow up on or prior to the last day of the reporting period HBI ONLI NE PROVI DER PERFORMANCE WEB TOOL 2010 USER MANUAL 40 This information is collected for informational purposes only C Member was deceased on before the last day of the reporting period ims INTELLIGENCE APPLIED HBI ONLI NE PROVI DER PERFORMANCE WEB TOOL 2010 USER MANUAL 41 e i m S INTELLIGENCE APPLIED 21 Follow up Examination After Diagnosis and Treatment of Skin Cancer Demographics Numerator L Member date of birth Member m
21. dditional Measures for Physician Preview as well as historical reports for previous periods can be viewed by selecting a previous measurement period using the drop down box HBIONLINE PROVIDER PERFORMANCE WEB TOOL 2010 USER MANUAL e li m S INTELLIGENCE APPLIED Quality Indicator Results The quality indicators for which the user could be measured are listed in alphabetical order by title The user s indicator numerator denominator and rate are presented along with benchmarks located to the right Quality Indicator Abstracts The title of the indicator that is shown on the quality report is linked to an abstract a PDF document which outlines the clinical rationale clinical recommendations denominator inclusion criteria numerator inclusion criteria and attribution rules This document aims to provide transparency to the user with respect to how their indicator rates are derived Member Lists Users can drill down to the member level detail to identify for each indicator 1 members that were eligible for the recommended service 2 members that did not receive the recommended service A link to each member list is located below the indicator title A print friendly version of the page is available by clicking on the printer icon located on the upper right hand side of the member list Likewise the list of members can be downloaded in an electronic csv file for import to other external applications Other Relevan
22. e index date and 6 months after the index date HBIONLINE PROVIDER PERFORMANCE WEB TOOL 2010 USER MANUAL 36 e ii m S INTELLIGENCE APPLIED 18 Treatment of Coronary Artery Disease CAD or CAD Equivalent Use of Statins Demographics Numerator Exclusions _ Member date of birth Member must be 18 75 years of age as of the last day of the reporting period Each member will have an index date which represents the date on which the member was identified as having coronary artery disease or peripheral vascular disease This date will appear on the HBIOnline system and is unique to each member in the measure denominator C Member was confirmed as actively taking a statin medication on or between the index date and 365 days after the index date Please be prepared to select the applicable appropriate medication from a menu of options and supply the date of service where the patient taking this medication has been confirmed in the medical chart C Member was diagnosed with moysitis or rhabdomyolosis on or prior to the last day of the reporting period _ Member was diagnosed with acute renal disease on or between one year prior to the index date and one year after the index date C Member was diagnosed with liver dysfunction acute or chronic or alcoholism on or between one year prior to the index date and one year after the index date C Member was pregnant on or between the index date and 365 da
23. ers of the immune system Malignancy neoplasms Chronic bronchitis Emphysema Bronchiectasis Extrinsic allergic alveolitis Chronic airway pulmonary obstruction not otherwise classified L Pneumoconiosis and other lung disease due to external agents C Other diseases of the respiratory system L Tuberculosis OOOO C Member had a qualifying comorbid condition on or between 30 days prior to index date and 7 days after index date LC Intestinal infections _ Pertussis _ Bacterial infection unspecified Lyme disease and other arthropod borne diseases L Otitis media Acute sinusitis Fj Acute pharyngitis C Acute tonsillitis HBI ONLI NE PROVI DER PERFORMANCE WEB TOOL 2010 USER MANUAL 28 e li m S INTELLIGENCE APPLIED Chronic sinusitis Infections of the pharynx larynx tonsils adenoids Prostatitis Cellulitis mastoiditis other bone infections Acute lymphadenitis Impetigo Skin staph infections Pneumonia Gonococcal infections and venereal diseases Syphilis Chlamydia Inflammatory diseases female reproductive organs Infections of the kidney Cystitis or UTI Acne HOODOO L Member was prescribed antibiotics for treatment of another condition on or between 30 days prior to index date and one day prior to index date C Member was prescribed antibiotics for treatment of another condition before 30 days prior to index date and was still actively taking these antibiotics when
24. hildren with Pharyngitis Appropriate Work Up Prior to Endometrial Ablation Procedure Avoidance of Antibiotic Treatment in Adults with Acute Bronchitis Beta blocker Persistence Following a Heart Attack Breast Cancer Screening Cervical Cancer Screening Childhood Immunization Measles Mumps and Rubella MMR Childhood Immunization Varicella Zoster Virus VZV Childhood Immunization DTaP Cholesterol Management for Patients Cardiovascular Conditions Colorectal Cancer Screening Diabetic Retinal Exam Follow up Examination After Diagnosis and Treatment of Skin Cancer Glycosylated Hemoglobin HbAl1c Test for Diabetics Hepatic Enzyme Monitoring for Statin Use after Initiating Therapy LDL for Diabetes Medical Attention for Diabetic Nephropathy Prenatal Screening 1 Screening for HIV in Pregnancy Treatment of Coronary Artery Disease CAD or CAD Equivalent Use of Statins 23 Use of Long Term Control Drugs for Persistent Asthma 24 Use of Narrow Spectrum Antibiotics for Patients with Acute Streptococcal Pharyngitis Disease 25 Use of Spirometry Testing in the Assessment and Diagnosis of COPD eS PS aS eee NNNPRPRP PPP PPP NFOWANADUBWNFO Getting Started with the Self Report Feature Step 1 Download and Review List of Members Who Did Not Receive the Service Users can access a list of members who did not receive the service for the indicator by clicking the link with the same title just below the indicat
25. ing the box next to the appropriate entry Figure 7 Figure 7 Verify exclusion events for the member 07 23 2003 MARKKA CALKXRKRX gt This member was not vaccinated because C Member had a contraindication to vaccinate on or prior to the member s second birthday please check one I Hiv infected or asymptomatic HIV I immunodeficiency including genetic congenital immunodeficiency syndromes I Cancer of lymphoreticular or histiocytic tissue IE multiple myeloma I Leukemia M anaph ylactic reaction Date of Service for Diagnosis MM DDAYYYY if member had more than one enter the most recent date of service Parent service on or prior to 0 C The service was ordered however the parent did not follow up on or prior to member s second birthday Date Ordered lal MM DDAYYYY Please note that this is not a valid exclusion according to the NCQA 2010 Technica Specifications This information is collected for informational purposes only Member was deceased on or before their second birthday C other Please note that this entry is reserved for provider comment and does not automatically result in a change in the member s outcome for this measure HBIONLINE PROVIDER PERFORMANCE WEB TOOL 2010 USER MANUAL 13 IMS ss F A final confirmation page will be displayed that summarizes the data the provider has entered for the member From here providers are asked to
26. ique to each member in the measure denominator C Member had a previous diagnosis of chronic bronchitis chronic obstructive pulmonary disease COPD or emphysema on or between 730 days prior to the denominator DOS and the day before the denominator DOS E Member refused service on or prior to the last day of the reporting period Please note that this is not a valid exclusion according to the NCQA 2010 Technical Specifications This information is collected for informational purposes only _ The service was ordered however the member did not follow up on or prior to the last day of the reporting period Please note that this is not a valid exclusion according to the NCQA 2010 Technical Specifications This information is collected for informational purposes only C Member was deceased on or before the last day of the reporting period HBI ONLI NE PROVI DER PERFORMANCE WEB TOOL 2010 USER MANUAL 32 e ii m S INTELLIGENCE APPLIED 15 Use of Long Term Control Drugs for Persistent Asthma Demographics C Member date of birth Member must be 5 50 years of age as of the last day of the reporting period Numerator C Member was confirmed as actively taking a medication appropriate for long term control of persistent asthma on or between the start of the reporting period and the end of the reporting period Please be prepared to select the applicable appropriate medication from a menu of options and supply the da
27. mple if a colonoscopy was provided to a patient and the date of service was entered by a provider during one comment period the date of service for the colonoscopy will remain in the registry so that it will be incorporated into future assessment cycles where applicable e Each provider will have an opportunity to enter data for all members that did not receive a service based on the preliminary assessment When the comment period closes the ensuing analysis will be carried out at the member level This means that as long as the supplemental data shows that the member received the appropriate services all providers for whom the member is attributed will receive credit It does not matter which user submitted the data all providers will benefit Quality Indicators that have the Self Report Feature Available The system enables the self report feature for 25 indicators as listed below Please note that measures having the self report feature may be found in both the Active Measures and Additional Measures for Phyisician Preview sections of your report You can go to each of these sections by making your selection in the Reporting Period drop down box HBIONLINE PROVIDER PERFORMANCE WEB TOOL 2010 USER MANUAL e li m S INTELLIGENCE APPLIED Annual Visual Field Tests for Patients with Glaucoma Appropriate Monitoring for ACE I nhibitors ARBs Use Appropriate Monitoring for Members on Diuretics Appropriate Testing for C
28. of Service ri Enter date of service for vaccination O Yes this member received a combination of either 1 receipt of vaccination components any time on or prior to the member s second birthday or 2 history of disease diagnosis for measles mumps and rubella any time prior to or on the member s second birthday Measles check one Mumps check one Rubella check one Vaccination Vaccination vaccination History Of Disease History of Disease G History of Disease MMZDDAYYY ti MM DDAYYY MM DDAYYYY Enter date of service for vaccination or diagnosis Enter date of service for vaccination or diagnosis Enter date of service for vaccination or diagnosis No this member was not vaccinated on or prior to the member s second birthday a e HBIONLINE PROVIDER PERFORMANCE WEB TOOL 2010 USER MANUAL 12 IMS iss E If the provider has confirmed the date of birth and that the member did not receive the service as defined by the indicator the final option is to enable providers to indicate that the member was not eligible for the service if they meet one of the accepted exclusions Appropriate exclusions vary according to the indicator In the case of MMR vaccination members whose record indicate that they have a known contraindication to vaccinate should be noted here Providers can indicate whether the member met an exclusion by check
29. or name on the quality report Or this list can be accessed by clicking on the Self Report button E located to the right of the indicator title The member list can then be printed or downloaded to a csv file HBI ONLI NE PROVI DER PERFORMANCE WEB TOOL 2010 USER MANUAL e ii m S INTELLIGENCE APPLIED Step 2 Refer to the Medical Chart A member s outcome for a quality indicator can be changed in one of two ways 1 Members can be changed from a non numerator to a numerator positive outcome if the user can confirm that the service as recommended by the indicator was provided and 2 Members can be removed the eligible population for the measure if they meet certain criteria as defined by the indicator e g member has a contraindication or condition that would negate the need for the member to receive the service Users can utilize the checklists in Appendix B to better understand the services and the timeframes in which the services need to be provided for a given indicator Step 3 Enter Information Using HBI Online To enter medical chart information for a given member users should click the self report button i to begin entering data All members that did not receive the service will be displayed To enter data for a specific member identify their name and click the submit data link Blue Cross and Blue Shield of Alabama has granted providers an opportunity to supplement their admini
30. or gestational diabetes between one year before the start of the reporting period and the end of the reporting period C Member does not have diabetes steroid induced diabetes gestational diabetes or polycystic ovaries F Member refused service on or prior to the last day of the reporting period Please note that this is not a valid exclusion according to the NCQA Technical Specifications This information is collected for informational purposes only C The service was ordered however the member did not follow HBI ONLI NE PROVI DER PERFORMANCE WEB TOOL 2010 USER MANUAL 20 e i m S INTELLIGENCE APPLIED up on or prior to the last day of the reporting period Please note that this is not a valid exclusion according to the NCQA Technical Specifications This information is collected for informational purposes only C Member was deceased on or before the last day of the reporting period HBI ONLI NE PROVI DER PERFORMANCE WEB TOOL 2010 USER MANUAL 21 ims INTELLIGENCE APPLIED 7 Medical Attention for Diabetic Nephropathy Demographics Numerator Exclusions L Member date of birth Member must be 18 75 years of age as of the last day of the reporting period L Member received a microalbumin screening test on or between the start of the reporting period and end of the reporting period L Member had a diagnosis of chronic renal disease on or between the start of the reporting
31. ormance report Quality Performance Report Features The Quality Report summarizes key information regarding the user s quality performance assessment results and also serves as a gateway for accessing additional information and features of the system Figure 2 Figure 2 Sample Quality Performance Report Home Clinical Quality Report Clinical Quality Report m Provider Name PRIXXXXX m Reporting Period 2010 Program Year z m Specialty 2010 Program Year 2009 Program Year D 6 Days Remaining to Enter Medical Chart Data to System dh i le Annual visual field tests for glaucoma patients 80 0 73 6 2 Sei Report 12 15 Members Who Did Not Receive the Service 0of3 Total Members Eligible for Service Numerator 0 Denominator 0 No Change 0 Appropriate Monitoring For Angiotensin Converting Enzyme Inhibitors Angiotensin Receptor Blockers 47 4 0 0 9 Self Report Use 54 114 Completed 6 of 60 Members Who Did Not Receive the Service Numerator El Total Members Eligible for Service Denominator 2 No Change 3 Reporting Period The reporting period represents the one year time period upon which the analysis will be based which is listed at the top of the report screen The report will default to the Active consumer facing measures for the most recent report period that has been loaded to the system Measures for this same report period that are not consumer facing A
32. otension heart block gt 1 degree sinus bradycardia or COPD anytime prior to 180 days after the index date including the index date C Member was prescribed inhaled steroids anytime prior to 180 days after the index date including the index date F Member refused service on or prior to the last day of the reporting period This information is collected for informational purposes only C The service was ordered however the member did not follow up on or prior to the last day of the reporting period This information is collected for informational purposes only C Member was deceased as of the last day of the reporting period HBI ONLI NE PROVI DER PERFORMANCE WEB TOOL 2010 USER MANUAL 39 e m S INTELLIGENCE APPLIED 20 Appropriate Work Up Prior to Endometrial Ablation Procedure Demographics Numerator Exclusions L Member date of birth Please note that date of birth is not applicable to the inclusion criteria of this clinical quality measure and therefore cannot remove the member from the denominator However the information collected here will be applied to other self report measures when possible Each member will have an index date which represents the date on which the member received an endometrial ablation procedure This date will appear on the HBIOnline system and is unique to each member in the measure denominator C Member received endometrial sampling or dilation and
33. period and end of the reporting period L Member received dialysis services on or between the start of the reporting period and end of the reporting period C Member had a kidney transplant on or between the start of the reporting period and end of the reporting period C Member had treatment for diabetic nephropathy on or between the start of the reporting period and end of the reporting period C Member was put on ACE Inhibitor Angiotensin Receptor Blocker medication therapy on or between the start of the reporting period and end of the reporting period L Member had a positive result for a urine macro albumin test on or between the start of the reporting period and end of the reporting period C Member had a visit with a nephrologist on or between the start of the reporting period and end of the reporting period C Member was diagnosed with polycystic ovaries on or before the last day of the reporting period C Member was diagnosed with steroid induced or gestational diabetes between one year before the start of the reporting period HBI ONLI NE PROVI DER PERFORMANCE WEB TOOL 2010 USER MANUAL 22 e li m S INTELLIGENCE APPLIED and the end of the reporting period E Member does not have diabetes steroid induced diabetes gestational diabetes or polycystic ovaries C Member refused service on or prior to the last day of the reporting period Please note that this is not a valid exclusion according
34. porting period Please note that this is not a valid exclusion according to the NCQA Technical Specifications This information is collected for informational purposes only C The service was ordered however the member did not follow up on or prior to the last day of the reporting period Please note that this is not a valid exclusion according to the NCQA Technical Specifications This information is collected for informational purposes only C Member was deceased on or before the last day of the reporting period HBI ONLI NE PROVI DER PERFORMANCE WEB TOOL 2010 USER MANUAL 18 m S INTELLIGENCE APPLIED 5 LDL for Diabetics Demographics Numerator Exclusions L Member date of birth Member must be 18 75 years of age as of the last day of the reporting period L Member received at least one LDL measurement test on or between the start of the reporting period and end of the reporting period Member was diagnosed with polycystic ovaries on or before the last day of the reporting period C Member was diagnosed with steroid induced or gestational diabetes between one year before the start of the reporting period and the end of the reporting period F Member does not have diabetes steroid induced diabetes gestational diabetes or polycystic ovaries C Member refused service on or prior to the last day of the reporting period Please note that this is not a valid exclusion according
35. re to create a hybrid rate which represents a final performance rate comprised of both self reported and administrative claims data A reminder located near the top of the report page will indicate how many days remain available for users to enter data into the system The comment period for this reporting period will close March 24 2011 How the Self Report Feature Benefits Providers Quality performance results are used for a wide variety of initiatives Thus health plans want to give an opportunity to solicit feedback from providers to ensure that results are as accurate as possible HBIOnline provides a streamlined means of soliciting feedback from providers regarding their preliminary quality scores Whenever possible the system has been designed in a way to minimize the amount of time providers must spend reviewing cases e Rather than asking for a random sample from a provider s entire eligible population the tool only solicits feedback for non numerator cases e When there are common eligibility criteria across similar measures the tool exclude members across different measures where appropriate For example if a user finds that a patient identified with diabetes in fact does not have diabetes entry for one measure will effectively remove that member from all other applicable diabetes measures This is also the case with childhood immunizations e Data collected through the web tool is retained for future assessments For exa
36. rting period C Member refused service on or prior to the last day of the reporting period Please note that this is not a valid exclusion according to the NCQA Technical Specifications This information is collected for informational purposes only C The service was ordered however the member did not follow up on or prior to the last day of the reporting period Please note that this is not a valid exclusion according to the NCQA Technical Specifications This information is collected for informational purposes only E This member was deceased as of the last day of the reporting period HBI ONLI NE PROVI DER PERFORMANCE WEB TOOL 2010 USER MANUAL 17 m S INTELLIGENCE APPLIED 4 HbA1C Testing for Diabetics Demographics Numerator Exclusions _ Member date of birth Member must be 18 75 years of age as of the last day of the reporting period L Member received at least one HbA1C test on or between the start of the reporting period and end of the reporting period E Member was diagnosed with polycystic ovaries on or before the last day of the reporting period C Member was diagnosed with steroid induced or gestational diabetes between one year before the start of the reporting period and the end of the reporting period C Member does not have diabetes steroid induced diabetes gestational diabetes or polycystic ovaries C Member refused service on or prior to the last day of the re
37. s second birthday Please note that this is not a valid exclusion according to the NCQA Technical Specifications Parent refusal is collected for informational purposes only C The service was ordered however the member did not follow up on or prior to the last day of the reporting period Please note that this is not a valid exclusion according to the NCQA Technical Specifications This information is collected for informational purposes only L Member was deceased on or before their second birthday HBIONLINE PROVIDER PERFORMANCE WEB TOOL 2010 USER MANUAL 26 e m S INTELLIGENCE APPLIED 11 Appropriate Testing for Children with Pharyngitis Demographics Numerator Exclusions _ Member date of birth Member must be 2 18 years of age between six months prior to the start of the reporting period and six months prior to the end of the reporting period Each member will have an index date which represents the date the member was diagnosed with pharnygitis This date will appear on the HBIOnline system and is unique to each member in the measure denominator C Member received at least one strep test on or between 3 days prior to the index date and 3 days after the index date C Member was prescribed antibiotics on or between 30 days prior to the index date and one day prior to the index date C Member was prescribed antibiotics for treatment before 30 days prior to the index date
38. seexessusausencssussesussseesuacvesusssseesess 7 Step 2 Refer to the Medical Chart ssssssssssssssssssssrnrnrnrnrrrrrrrrrnnrrrrnrrrrrrrrrrnne 8 Step 3 Enter Information Using HBIOnline sssssssssssrrrrsssrrrrrnssrrrrrresrrrrrren gt 8 Appendix A Example of Self Report Module for Childhood Immunizations MMR 10 Appendix B Self Report Module Checklists by Indicator ceecee 15 HBIONLINE PROVIDER PERFORMANCE WEB TOOL 2010 USER MANUAL e li m S INTELLIGENCE APPLIED Background HBIOnline is a web based tool that enables providers to access their clinical quality performance assessment results any time day or night via an Internet connection HBlOnline is superior to existing paper based reporting strategies because among other things it provides a system that offers easy drill down capability inherent when using web technologies ability for health plans to maintain security over personal health information PHI and a convenient less resource intensive means of sharing information with providers Providers can log in to the secure site to view their own report information and identify among other things e The Clinical Quality Indicators for which they were scored e How each Clinical Quality Indicator is defined e Their numerator denominator and rates for each indicator and e All Blue Cross and Blue Shield of Alabama members that did not receive the service as measured by each clinical quali
39. splayed to facilitate record retrieval To enter self report data click on the self report data link to the corresponding member s name Figure 4 Start self report process for a member indicator combination Home Clinical Quality Report Member List Members who did not receive the service Childhood Immunization Measles Mumps And Rubella MMR m Members who received the service m Members who did not receive the service m Total Members Eligible for Service a amp 123456 11 24 2003 JUSXXXXX Add Self Report Data FLEO6XXXXXKXXXXXXRKK 11 21 2003 BRIXXXXX EDGXXXXX Add Self Report Data 241 C4XXXXXKKXXXXXKKK 08 27 2003 EDWXXXXX ELYXXXXX Add Self Report Data CEABSXXXXXXXXXXXXXX 02 19 2003 DREXXXXX ERIXXXXX Add Self Report Data 438ADKXXX tated 05 06 2003 HANXXXXX FINXXXXX Add Self Report Data 11BOLXXXXXXXXXXXXXK 11 12 2003 MADXXXXX FIOXXXXX Add Self Report Data 4DSIJEXXXXXXXXXXXXXK 09 16 2003 MACXXXXX FLUXXXXX Add Self Report Data 291S3KXAXXARKAAXAARAKA 01 31 2003 CHRXXXXX FLYXXXXX Add Self Report Data GCZCFXXXXXXKXXXXKKK 12 04 2003 CHRXXXXX FORXXXXX Add Self Report Data 25723XXXXXXXXXXXXXK 03 14 2003 KASXXXXX GAZXXXXX Add Self Report Data 123456 HBIONLINE PROVIDER PERFORMANCE WEB TOOL 2010 USER MANUAL 10 IMS iss C As a first step providers will be requested to verify the member s date of birth The application will automatically assess whether any corrections will deem the member ineligible
40. strative claims record for the purpose of providing a more comprehensive review and evaluation of clinical processes and care administration Critical to this purpose is the reliance by Blue Cross and Blue Shield of Alabama on the accuracy and completeness of data submitted by providers Prior to submitting data users will be required to attest and acknowledge the following e Data submitted through this website can be audited for both completeness and accuracy e Data submitted will be reviewed using analytic methods to determine whether it is applicable to the current clinical quality measures and if the data submitted aligns with the applicable time periods or other measure specifications Once data is submitted it cannot be updated or edited Users must accept these terms of use in order to proceed Upon acceptance users will be brought through a series of screens that ask specific questions about whether the member received services or met specific exclusion criteria relevant for the measure A date of service will need to have been documented for relevant services to qualify Upon confirming the data submission the record will be closed A data submitted confirmation will appear on the screen and the member record will indicate that as such A sample self report module is provided in Appendix A HBI ONLI NE PROVI DER PERFORMANCE WEB TOOL 2010 USER MANUAL e li m S INTELLIGENCE APPLIED The self report capability will
41. t Definitions Additional relevant definitions that are not included in the quality indicator abstracts are listed on the right hand side of the page under the Definitions heading Clicking on each term will open a separate window containing a definition of the term Sorting Records Users can click on any column title to resort results e g ascending or descending order IV Self Report Feature The Self Report Feature Explained In addition to accessing the clinical quality scores HBIOnline includes a self reporting functionality that enables providers to enter medical chart data to supplement that which is already available through the administrative claims data received from the health plan Preliminary rates by clinical quality metric will be posted on HBI Online during a comment period during which providers can review the medical chart of those members that were identified as having service gaps in selected indicators Blue Cross and Blue Shield of Alabama providers will have 60 days to enter data into the system If there is evidence that the member met certain exclusion criteria or if they did indeed HBIONLINE PROVIDER PERFORMANCE WEB TOOL 2010 USER MANUAL e li m S INTELLIGENCE APPLIED receive the service or procedure the provider can use this time period to report this information to HBIOnline Data that is captured through this process is incorporated into the IMS data processing infrastructu
42. te of service where patient taking this medication has been confirmed in the medical chart Exclusions Member does not have asthma C Member was diagnosed with emphysema COPD cystic fibrosis or acute respiratory failure on or prior to the end of the reporting period E Member refused service on or prior to the last day of the reporting period Please note that this is not a valid exclusion according to the NCQA 2010 Technical Specifications This information is collected for informational purposes only E The service was ordered however the member did not follow up on or prior to the last day of the reporting period Please note that this is not a valid exclusion according to the NCQA 2010 Technical Specifications This information is collected for informational purposes only E Member was deceased on or between the start of the reporting period and the end of the reporting period HBI ONLI NE PROVI DER PERFORMANCE WEB TOOL 2010 USER MANUAL 33 e m S INTELLIGENCE APPLIED 16 Prenatal Screening Screening for HIV in Pregnancy Demographics Numerator Exclusions L Member date of birth Please note that date of birth is not applicable to the inclusion criteria of this clinical quality measure and therefore cannot remove the member from the denominator However the information collected here will be applied to other self report measures when possible Each member will have an index date
43. ty indicator In addition to a provider s individual scores the report also includes aggregate Blue Cross and Blue Shield of Alabama network level performance as well as other peer group benchmarks where available HBIOnline can also incorporate a variety of administrative related resources regarding the plan s performance assessment program such as program details sample documents and news alerts Accessing the Web Tool Username and Passwords Blue Cross and Blue Shield of Alabama providers will access HBI Online through the health plan s secure Provider Access provider portal Thus users will not require a separate username and password to access their performance report In this set up the two systems talk to one another to make sure users automatically have secure access to their reports on HBIOnline once the user has successfully logged into Provider Access HBIONLINE PROVIDER PERFORMANCE WEB TOOL 2010 USER MANUAL e i ms INTELLIGENCE APPLIED Quality Performance Report Welcome Page Users will be directed to the welcome homepage upon successful login From here all users will be able to access the various components of the web tool To facilitate site navigation a toolbar appears at the top of every webpage which contains buttons that enable users to click and go directly to specific reports Users can click on the Quality Scorecard tab located on the toolbar to access their quality perf
44. ust be 19 91 years of age as of the last day of the reporting period Each member will have an index date which represents the date on which the member subsequent to a skin biopsy procedure was diagnosed with skin cancer This date will appear on the HBIOnline system and is unique to each member in the measure denominator _ Member received a skin cancer related follow up visit in an outpatient setting on or between 90 days after the index date and 365 days after the index date C Member received a skin procedure i e biopsy shaving of epidermal or dermal lesions benign or malignant excision destruction of skin lesions or MOHS micrographic surgery on or between 90 days after the index date and 365 days after the index date HBI ONLI NE PROVI DER PERFORMANCE WEB TOOL 2010 USER MANUAL 42 Exclusions e m S INTELLIGENCE APPLIED C Member had a diagnosis of malignant neoplasm of the vagina labia majora labia minora vulva unspecified prepuce skin of the breast any carcinoma in situ of the breast or genitourinary system or neoplasm of bone soft tissue or skin on or between the index date and 365 days after the index date C Member refused service on or prior to the last day of the reporting period This information is collected for informational purposes only E The service was ordered however the member did not follow up on or prior to the last day of the reporting period This information
45. ys after the index date C Member refused service on or prior to the last day of the reporting period Please note that this is not a valid exclusion according to the NCQA 2010 Technical Specifications This information is collected for informational purposes only HBI ONLI NE PROVI DER PERFORMANCE WEB TOOL 2010 USER MANUAL 37 e m S INTELLIGENCE APPLIED C The service was ordered however the member did not follow up on or prior to the last day of the reporting period Please note that this is not a valid exclusion according to the NCQA 2010 Technical Specifications This information is collected for informational purposes only L Member was deceased on or between the index date and 365 days after the index date HBIONLINE PROVIDER PERFORMANCE WEB TOOL 2010 USER MANUAL 38 e m S INTELLIGENCE APPLIED 19 Beta blocker Persistence Following a Heart Attack Demographics C Member date of birth Member must be at least 18 years of age as of the last day of the reporting period Numerator No self report data elements for the numerator of this measure Exclusions Each member will have an index date which represents the date on which the member was discharged from an acute care setting with an acute myocardial infarction AMI This date will appear on the HBIOnline system and is unique to each member in the measure denominator E Member had a previous diagnosis of asthma hyp
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