The Reports Tab > Clinical Decision Support > Viewing Clinical Guidelines by Condition

Viewing Clinical Guidelines by Condition

For each medical condition that is being monitored for patient care, there may be one or more clinical guidelines that are evaluated for compliance. There are various sources for the guidelines used by Clinical Decision Support, including:

• Centers for Medicare & Medicaid Services (CMS)

• American Medical Association (AMA)

• Centers for Disease Control and Prevention (CDC)

• American Cancer Society®

• US Food and Drug Administration (FDA)

• American Academy of Family Physicians

• American Heart Association®

• National Institutes of Health (NIH)

• World Health Organization

• National Kidney Foundation®

Note: You can view full references for a particular guideline by selecting the Show References check box while viewing patient care recommendations. If no references are available, the sources appear instead. For more information, see View Care Recommendations for a Patient.

You can view the individual guidelines for a patient population alert, as well as the percentages of compliance by the patient population being monitored for that condition, by accessing the guidelines by condition page. For more information on viewing patient compliance details by individual guidelines, see View Clinical Guidelines by Condition.

Note: The patient compliance information that is available on the Guidelines by Condition page can be filtered by the provider that is designated as the patient’s primary provider in the system or can display all of the patients in the organization (including those patients who have not designated a primary provider). If you are a provider, the compliance percentages on the page are initially filtered to only show the patients for whom you are the primary provider (if any). You can change the filter, if you want, to another provider or to Entire Organization to see the patient compliance percentages for the entire organization (including those patients who have not designated a primary provider).

For more information on specifying a primary provider for a patient, see Managing Patient Details.

Understanding the Compliance Calculations

Compliance percentages display on the Quick View page and the guidelines by condition page. These percentages indicate the percentage of the patients in the population who are in compliance for the specific condition. The population is defined as the total number of patients in your organization who have been identified, or diagnosed, with the specific condition that is being monitored. Each condition that is being monitored may have multiple guidelines for which compliance is calculated. Only patients who are 100% compliant for all of the guidelines for a condition are considered compliant for that condition.

Notes:

• Alerts or recommendations can be dismissed for a patient; this functionality can be reached by clicking Guidelines from the Reports tab or the from Care Recommendations tab. Dismissed alerts or recommendations do not affect the compliance calculation. Dismissed items do not display on the patient summary page and are indicated with strikethrough text on the non-compliant patients list. For information on dismissing patient alerts and recommendations, see View Care Recommendations for a Patient. Information from encounter notes that have been declared erroneous will not be used for compliance calculations.

• Exceptions apply to some compliance measures which cause applicable patients to be ignored when compliance calculations are performed.

Compliance percentages are calculated using the number of patients in your organization who are 100% compliant for all of the guidelines for a specific condition, and dividing that number by the total number of patients being monitored for that condition. If three patients are monitored for a condition and only one is compliant, your organization is 33% compliant for that condition.

Other factors that may affect compliance percentages include the following:

• Dismissals. If a patient alert or recommendation is dismissed for a period of time or permanently, the patient is still counted as part of the non-compliant patient population during the length of the dismissal. For more information on dismissing patient alerts and recommendations, see View Care Recommendations for a Patient. For more information on viewing the non-compliant patients list, see View the Non-Compliant Patients List.

• Exclusions/Exceptions. Some clinical guidelines allow for patient exclusions or exceptions for situations when it is not appropriate to count a patient as part of the patient population that is used for calculating the measure percentage. Exclusions and exceptions are automatically applied to compliance calculations for the measures to which they apply, but you can also manually add exceptions (per patient) for some of the clinical quality measures.

You can view the count of patient exclusions and/or exceptions, if applicable, on the guidelines by condition page.

View Clinical Guidelines by Condition