HEDIS
To access the HEDIS portal in Health Endeavors, Click on the Quality Tab in the menu bar and click on HEDIS in the year you would like to review.
The first filter under Form Filters is for patient search. You can search for a patient by :
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Member ID - Patients identification number
Last Name - Patient Last Name
First Name - Patient First Name
MRN - Medical Record Number
DOB - Patient Date of Birth
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For DOB you must use the exact date. All other searches you can choose from one of the following options:
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Starts With - Based on patient data that begins with the text entered
Exact Match - Based on an Exact Match to patient data entered
Ends With - Based on patient data that ends with the text entered.
The next search filter is for TIN and Facility. You have the options to search by:
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TIN - Taxpayer Identification Number of practice patients belong to.
Facility Name - Name of Associated Care Facility
Facility Division - Choose from list of divisions for your organization (if applicable)
Sub-TIN - Choose from Sub-Tin of practice to which they belong
My NPI - National Provider Identification Number of provider patient belong to
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As above users may search by Starts with, Exact Match or Ends with.
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Module and Module Status - These filters will narrow the patient list search results based on patients with response data matching the choices in the 'Module Status' section for the quality measures chosen in the "Module' section. (Measures may vary depending on ACO)
Complete (C) - Quality measure is complete with a performance response.
Complete with Non-Performance Answer (CNP) - Quality measure is complete with a non-performance response
Exception (Medical, Patient, System Reason) (E) - Quality measure is exempt due to specific response circumstances
Skipped (S) - Patient does not qualify for this measure based on measure-specific restrictions such as age or gender.
Incomplete (I) - Patient response to this quality measure has not been submitted
Patient Questionnaire Status- Search filter shows patients whose overall questionnaire has one of the three primary Status. More than one status can be selected, and will display patients with one of the selected statuses.
Green - Questionnaire Completed
Blue - Questionnaire In Progress
Red - Questionnaire Not Started​
Deceased / Living Status Options - Search filter will show patients that are in the system as either alive or deceased. By default, both are selected.
Patient Population- If your ACO is tracking more than one Commercial Population, you will be able to select each one individually from the drop down or view all populations. All will be selected by default.
Once you have the desired search filters selected, click the button to generate results in the patient list. Alternatively, click the to remove all selected filters and start the search form anew.
Form Filters
Chart Filters
Chart Filters are located directly below the Form Filters. To access the chart Filters click on the green plus sign. These filters will show your ACOs current progress based on a ratio of responses for each measure. The bars in each row when added together, total 100% for each of the quality measures. Hover over a section of the bar and a pop-up will show the measure, type of response being measured, and the current number of patients in that response type. If you click on a section of the bar the patient grid will filter to those patients in the patient grid below. This will also adjust the filter options in the form filters above. This chart is updated with each commercial import.
Blue Bar - Indicates patients with a Performance Answer for the measure
Lavender Bar - Indicates Patients with an Exception (Medical, etc.)
Red Bar - Indicates Patients with a Non-Performance Answer for the measure
Gray Bar - Indicates Patients that are currently incomplete.
Patient Grid
Patient List - Can be found directly below the form and chart filters. By default all attributed patients are displayed. As filters are used, the list will become more specialized.
The first half of the patient list shows basic patient information. This includes patient's Member ID, MRN, First Name, Last Name, Date of Birth and living Status.
The next section shows Population, current Progress Score, Division, Practice, TIN, Sub-TIN, and NPI which the patient is assigned. And the last column is Questions. Clicking on the button in this column will show the patient quality measure questionnaire.
At the top of the patient list window there is a Clear Search Criteria button. This will remove any search filters and show all available patient data.
The far left Action column of the patient list contains links to two other sections. The right icon, which is a blue circle ( ), leads to the patient chart and claims data window. The left icon, a colored flag, ( ) leads to the quality measures questionnaire.
Patient Questionnaire
Clicking on the 'View Answers' button or the colored flag in the grid will open the Patient Questionnaire screen. HEDIS measures are only answered through claims data, so there is no option to manually update measure responses.
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Patients will be marked with an N/A response automatically when they do not have a diagnosis or do not qualify for a measure due to age or gender.
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Measure in RED have not been answered and measures in Blue have been completed.
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Clicking on a measure will open the answer box for review.
