DAL Display Audit Logic

If unexpected results are obtained when running the electronic audit from RPMS, it is often helpful to review the programming logic to determine how data is evaluated for determination of a “YES” or “NO” answer for a given data point. You may then determine whether data is being entered correctly at your facility to be reflected in the audit. The data included in the audit may change from year to year as may the logic. Therefore, when reviewing the audit logic, you must first select the year you are using for the electronic audit. Begin by selecting DAL Display Audit Logic from the options in the DA Diabetic QA Audit menu and enter the audit year.

DM03   2003 Diabetes Program Audit ...
   DM01   2001 Diabetes Program Audit ...
   DM20   2000 Diabetes Program Audit ...
   DM99   1999 Diabetes Program Audit ...
   DM96   1996 Diabetes Program Audit ...
   TS     Taxonomy Setup
   FS     Flow Sheet Setup
   PLDX   Patients w/no Diagnosis of DM on Problem List
   NDOO   DM Register Pts w/no recorded DM Date of Onset
   DAL    Display Audit Logic
   APCL   List Patients on a Register w/an Appointment
   DMV    DM Register Patients and Select Values in 4 Months
   DPCS   Display a Patient's DIABETES CARE SUMMARY
   HSRG   Print Health Summary for DM Patients W/Appt

Select Diabetes QA Audit Menu Option: DAL <ENTER>

Select the Audit Year

Select PCC MAN REPORTS DM AUDIT TEXT AUDIT YEAR: 2003 <ENTER>

A screen of audit items is displayed and you may select the number in front of the data element for which you would like to review the audit logic.

1) AUDIT DATE            20) LAST 3 BP'S           39) HBA1C VALUES
2) FACILITY NAME         21) FOOT EXAM - COMPLETE 40) LAST 3 BLOOD SUGARS
3) AREA                  22) DIABETIC EYE EXAM     41) CREATININE
4) SERVICE UNIT          23) DENTAL EXAM           42) TOTAL CHOLESTEROL
5) FACILITY CODE         24) DIET INSTUCTION       43) HDL CHOLESTEROL
6) #OF PATIENTS ON DM R 25) EXERCISE INSTRUCTION 44) LDL CHOLESTEROL
7) REVIEWER              26) DM EDUCATION (OTHER) 45) TRIGLYCERIDES
8) CHART #               27) DM THERAPY            46) URINALYSIS
9) DOB                   28) ACE INHIBITOR         47) PROTEINURIA
10) GENDER               29) ASPIRIN/ANTI-PLATELE 48) MICROALBUMINURIA
11) PRIMARY CARE PROVIDE 30) LIPID LOWERING AGENT 49) SELF MONITORING OF BG
12) DATE OF DIABETES DIA 31) FLU VACCINE           50) SDM - IS PATIENT PAR
13) TYPE OF DIABETES     32) PNEUMOVAX EVER        51) LAST AST DATE
14) TOBACCO USE          33) TD IN PAST 10 YEARS   52) LAST ALT DATE
15) REFERRED FOR CESSATI 34) PPD STATUS            53) PAP SMEAR IN PAST YEAR
16) HEIGHT               35) IF PPD POS, INH TX C 54) MAMMOGRAM IN PAST YEAR
17) WEIGHT               36) IF PPD NEG, LAST PPD 55) TRIBAL AFFILIATION
18) BMI                  37) TB STATUS (TB CODE)   56) COMMUNITY

Note that the number of data elements cannot all be displayed on one screen. The ↑ and ↓ arrows may be used to review the additional data elements.

OUTPUT BROWSER May 28, 2003 12:13:12 Page: 1 of 2
DM AUDIT LOGIC DESCRIPTIONS

DIABETIC EYE EXAM
Has a diabetic eye exam been done?
The logic used in determining if a diabetic eye exam has been done is as follows:
The system looks for the last documented Diabetic Eye Exam in the patient's computer record. If that exam was done in the year prior to the date of audit then a Yes will display. No further processing is done.

If no exam is found then all visits in the time period are scanned for documentation of CPT code 92012, 92250, 92014, 92015, 92004 or 92002.

If none of theses CPT codes are found, then all PCC Visits in the year prior to the end of the audit are scanned for a non-DNKA, non-Refraction visit to an Optometrist or Opthalmologist (24, 79, 08) or an Optometry or Opthalmology Clinic (17, 18, 64 or A2). If found, then a yes and an indication of what was found is displayed. If none of the above is found,then the refusals file is checked for documentation of a patient refusal or no response to followup of a diabetic eye exam. If found, a note

+ Enter ?? for more actions

+ NEXT SCREEN - PREVIOUS SCREEN Q QUIT
Select Action: +//

The audit currently displays refusals of service for examinations, education topics, and immunizations. In order to display these refusals on the audit, the refusals must be documented by the provider and data must be recorded in a specific manner in PCC. Situations in which medical care can not be rendered because of contra-indications or patients who fail to respond to followup also require special documentation and data entry mnemonics. In general refusals for service are displayed in the refusal column on the audit while medical contraindications and lack of followup are tallied in the “NO” category. Refer to pages XXX for documentation on recording patient refusals, failure to respond to followup, or medical contraindications in PCC,

DAL Display Audit Logic DRAFT