March 29.2011
All materials © 2011, National Committee for Quality Assurance

NCQA PCMH Overview March 29, 2011 2

What is the Record Review WorkbooK?
• Elements PCMH 3C, 3D, 4A
− Require medical record abstraction of data
− Need % of patients for each factor based on numerator and denominator
• Two methods to collect and submit patient data
– Method #1 - report from the electronic system
– Method #2 – Record Review Workbook
• Excel workbook in the Survey Tool
• Tool to identify sample of patients and abstract data needed for Elements 3C, 3D, 4A
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Overview of Steps
1.
Find RRWB in Survey Tool
2.
Download and save file to computer
3.
Review RRWB instructions and data needed from patient records
4.
Select patient records to review
5.
Review patient records for data
6.
Enter data in RRWB
7.
Enter % and Yes or No in Survey Tool
8.
Link Workbook to Survey Tool
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RRWB = Supplemental Worksheet
Click here
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RRWB Tabs
Three tabs
 Instructions
 Patient Conditions
 Record Review
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RRWB: Enter Important Conditions
Enter three important conditions here including an unhealthy behavior/mental health or substance abuse AND high-risk or complex patients, IF you are including them.
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RRWB: Enter Conditions
Please choose “High Risk/
Complex” from the drop down list or leave it blank if not applicable for the patient sample
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RRWB: Enter Conditions
Enter conditions from drop down menu, for example:
 Diabetes
 Hypertension
 Depression
 High Risk/Complex
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RRWB: % of Patients that Met Factor
Patients that Met Factor
 Number (33/48)
 Percent (69%)
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RRWB: Choosing Patients
~ Use same 48 patients for EACH Workbook Element ~
STEP #1
• Select patients with at least one condition identified in Elements 3A and 3B using
 Scheduling system or
 Registries
• Sort by last visit date
:
STEP #2
• Sort by date of last visit
• Identify a start date (e.g. 4/1/11)
• Go back a month (e.g. 3/1/11)
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RRWB: Choosing Patients (cont.)
~ Use same 48 patients for 3C, 3D, 4A ~
STEP #3
•
Identify patients with appt./billing system or registry on 3/1 with at least one important condition-related visit
• Choose equal numbers of patients for each condition from Elements 3A and 3B

3 conditions: 16 patients
 4 conditions: 12 patients
 2 conditions: 24 patients
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RRWB: Choosing Patients (cont.)
~ Use same 48 patients for 3C, 3D, 4A ~
STEP #4
•
Continue choosing patients going back on consecutive dates until all 48 patients are selected
• Keep a list that identifies patients if more information needed
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PCMH 3C: Care Management
Entering NOT USED in row 1
“grays” out the column
Response Options
 Yes
 No
 Not Used
 Not applicable
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RRWB Calculates the Score
Patient count

Must have 48 patients
 Fewer than 48 patients calculates as “0”
Score to enter in survey tool
 YES or NO
 Percentage
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Enter RRWB Responses in Survey Tool
Enter responses
From RRWB
 Yes or No
AND
 Percent
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Enter Percent from Each Column
Enter Percent
79
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View Percentages
Percent for each factor
Factor 1: 79
Factor 2: 87
Factor 3: 57
Factor 4: 77
Factor 5: 0
Factor 6: 90
Factor 7: 90 Most patient did not miss any appointments
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