eMeasure Title Diabetes: Foot Exam
eMeasure Identifier
(Measure Authoring Tool)
123 eMeasure Version number 3
NQF Number 0056 GUID c0d72444-7c26-4863-9b51-8080f8928a85
Measurement Period January 1, 20xx through December 31, 20xx
Measure Steward National Committee for Quality Assurance
Measure Developer National Committee for Quality Assurance
Endorsed By National Quality Forum
Description
Percentage of patients aged 18-75 years of age with diabetes who had a foot exam during the measurement period.
Copyright
Physician Performance Measure (Measures) and related data specifications were developed by the National Committee for Quality Assurance (NCQA). 

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Disclaimer
These performance Measures are not clinical guidelines and do not establish a standard of medical care, and have not been tested for all potential applications.

THE MEASURES AND SPECIFICATIONS ARE PROVIDED “AS IS” WITHOUT WARRANTY OF ANY KIND.
 
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Measure Scoring Proportion
Measure Type Process
Stratification
None
Risk Adjustment
None
Rate Aggregation
None
Rationale
Diabetes mellitus (diabetes) is a group of diseases characterized by high blood glucose levels caused by the body's inability to correctly produce or utilize the hormone insulin. It is recognized as a leading cause of death and disability in the U.S. and is highly underreported as a cause of death. Diabetes may cause life-threatening, life-ending or life-altering complications, including poor circulation, nerve damage or neuropathy in the feet and eventual amputation. Nearly 60-70 percent of diabetics suffer from mild or severe nervous system damage. The consensus among established clinical guidelines is that patients with diabetes should have a foot exam soon after diagnosis and annually thereafter. Comprehensive foot care programs can lower amputation rates by 45-85 percent (American Diabetes Association 2009).
Clinical Recommendation Statement
American Diabetes Association (2009) Guidelines/ Recommendations:  Perform annual comprehensive foot examination to identify risk factors predictive of ulcers and amputations. The foot examination should include inspection, assessment of foot pulses, and testing for loss of protective sensation (10-g monofilament plus testing any one of: vibration using 128-Hz tuning fork, pinprick sensation, ankle reflexes, or vibration perception threshold).
Improvement Notation
Higher score indicates better quality
Reference
American Diabetes Association. 2009. “Standards of Medical Care in Diabetes-2009.” Diabetes Care 2009 32 (Suppl 1):S6-S12. doi:10.2337/dc09-S006.
Definition
Foot exam: visual inspection with either a sensory exam or a pulse exam
Guidance
Only patients with a diagnosis of Type 1 or Type 2 diabetes should be included in the denominator of this measure; patients with a diagnosis of secondary diabetes due to another condition should not be included.
Transmission Format
TBD
Initial Patient Population
Patients 18-75 years of age with diabetes with a visit during the measurement period
Denominator
Equals Initial Patient Population
Denominator Exclusions
None
Numerator
Patients who received visual, pulse and sensory foot examinations during the measurement period
Numerator Exclusions
Not Applicable
Denominator Exceptions
None
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