eMeasure Title Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care
eMeasure Identifier
(Measure Authoring Tool)
142 eMeasure Version number 1
NQF Number 0089 GUID 53d6d7c3-43fb-4d24-8099-17e74c022c05
Measurement Period January 1, 20xx through December 31, 20xx
Measure Steward American Medical Association-convened Physician Consortium for Performance Improvement(R) (AMA-PCPI)
Measure Developer American Medical Association-convened Physician Consortium for Performance Improvement(R) (AMA-PCPI)
Measure Developer National Committee for Quality Assurance
Endorsed By National Quality Forum
Description
Percentage of patients aged 18 years and older with a diagnosis of diabetic retinopathy who had a dilated macular or fundus exam performed with documented communication to the physician who manages the ongoing care of the patient with diabetes mellitus regarding the findings of the macular or fundus exam at least once within 12 months
Copyright
Copyright 2012 American Medical Association and National Committee for Quality Assurance. All Rights Reserved.
Disclaimer
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Measure Scoring Proportion
Measure Type Process
Stratification
None
Risk Adjustment
None
Rate Aggregation
None
Rationale
The physician that manages the on-going care of the patient with diabetes should be aware of the patient's dilated eye examination and severity of retinopathy to manage the on-going diabetes care. Such communication is important in assisting the physician to better manage the diabetes. Several studies have shown that better management of diabetes is directly related to lower rates of development of diabetic eye disease (Diabetes Control and Complications Trial – DCCT, UK Prospective Diabetes Study – UKPDS).
Clinical Recommendation Statement
While it is clearly the responsibility of the ophthalmologist to manage eye disease, it is also the ophthalmologist's responsibility to ensure that patients with diabetes are referred for appropriate management of their systemic condition. It is the realm of the patient's family physician, internist or endocrinologist to manage the systemic diabetes. The ophthalmologist should communicate with the attending physician (Level A: III Recommendation) (AAO, 2003).
Improvement Notation
Higher score indicates better quality
Reference
American Academy of Ophthalmology. Preferred Practice Patterns Committee. Diabetic Retinopathy. 2003.
Definition
Communication – May include documentation in the medical record indicating that the findings of the dilated macular or fundus exam were communicated (e.g., verbally, by letter) with the clinician managing the patient’s diabetic care OR a copy of a letter in the medical record to the clinician managing the patient’s diabetic care outlining the findings of the dilated macular or fundus exam.

Findings-includes level of severity of retinopathy AND the presence or absence of macular edema.
Guidance
None
Transmission Format
TBD
Initial Patient Population
All patients aged 18 years and older with a diagnosis of diabetic retinopathy
Denominator
Equals Initial Patient Population who had a dilated macular or fundus exam performed
Denominator Exclusions
None
Numerator
Patients with documentation, at least once within 12 months, of the findings of the dilated macular or fundus exam via communication to the physician who manages the patient’s diabetic care
Numerator Exclusions
Not Applicable
Denominator Exceptions
Documentation of medical reason(s) for not communicating the findings of the dilated macular or fundus exam to the physician who manages the ongoing care of the patient with diabetes

Documentation of patient reason(s) for not communicating the findings of the dilated macular or fundus exam to the physician who manages the on-going care of the patient with diabetes
Measure Population
Not Applicable
Measure Observations
Not Applicable
Supplemental Data Elements
For every patient evaluated by this measure also identify payer, race, ethnicity and sex.

Table of Contents


Population criteria

Data criteria (QDM Data Elements)

Reporting Stratification

Supplemental Data Elements




Measure Set
None