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Indian Health Service The Federal Health Program for American Indians and Alaska Natives

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Clinical Reporting System (CRS)  

CRS 2008 (v8.0 and p1-p3)

CRS VERSION 8.0 PATCH 3

CRS Version 8.0 Patch 3 was released on October 7, 2008.

Key enhancements included in CRS Version 8.0 Patch 3 are shown below.

  • Executive Order (EO) Quality Transparency Measures Report: For the hard-coded report option, removed the patient beneficiary population prompt.

  • Area EO Quality Transparency Measures Report: (1) For the hard-coded report option, removed the prompt for report period. (2) In the roll and scroll version of CRS, added the prompt that asks the user if the report is to be run for the Area Aggregate report or for a facility report.

  • New 2009 National GPRA Report: Added menu option "GP9" that enables users to run the National GPRA Report for the report period of July 1, 2008 - June 30, 2009 (GPRA year 2009) using the performance measure logic as it exists in CRS 2008 Version 8.0 Patch 2.

  • New 2009 Area Aggregate National GPRA Report: Added menu option "AGP9" that runs the Area Aggregate National GPRA Report for the report period of July 1, 2008 - June 30, 2009 (GPRA year 2009) using the performance measure logic as it is exists in CRS 2008 Version 8.0 Patch 2.

  • GPRA Measure Forecast Patient List: In the sections describing how the performance measures can be met, updated all of the dates to reflect GPRA year 2009. Also corrected minor logic problems with four performance measures.

  • Updated CRS Graphical User Interface (Visual CRS): The GUI contains all functionality included in CRS 2008 Version 8.0 Patch 3.

CRS VERSION 8.0 PATCH 2

CRS Version 8.0 Patch 2 was released on August 12, 2008.

Key enhancements included in CRS Version 8.0 Patch 2 are shown below.

  • Prenatal HIV Testing: Rename to HIV Screening, add new denominator for User Population patients 13-64, add measure for number of HIV tests provided to User Population patients during the Report Period, remove HIV counseling numerator.

  • Revised Logic for the following National GPRA Topics:

    • Diabetes: Glycemic Control
    • Diabetes: Blood Pressure Control
    • Adult Immunizations: Influenza
    • Childhood Immunizations
    • Tobacco Use and Exposure Assessment
    • Tobacco Cessation
    • Alcohol Screening (FAS Prevention)
    • Depression Screening
    • Obesity Assessment
    • Childhood Weight Control
    • Comprehensive CVD-Related Assessment
    • HIV Screening

  • Revised Logic for several non-GPRA Topics. Refer to the CRS 8.0 Patch 2 Selected Measures Report Performance Measures Definitions and Logic document shown above.

  • New Executive Order Quality Transparency Measures Report: Used for national web reporting for all Federal IHS facilities of phase I quality measures harmonized with the VA and DoD.

  • Other National Measures Report: (1) Added functionality for user to run the hard-coded report or the user-defined report. The hard-coded option uses preset report parameters that are the same as the National GPRA Report (e.g. report period is hard coded to July 1, 2007 - June 30, 2008) and a user-defined option where the user provides all report parameters. (2) Added the Tobacco Cessation topic to this report that includes new, developmental GPRA logic. This logic is more effective at identifying a current tobacco user and will be analyzed and may become the GPRA logic for 2009 reporting. (3) Added third export file that is produced when the Area ONM Report is run.

  • Comprehensive National GPRA Export for 2007-2008: Updated CRS 2007 Version 7.0 (not CRS 2008 Version 8.0), National GPRA Reports menu by adding ,menu option "XP8" that will be used for creating a comprehensive export of National GPRA Report data for GPRA years 2007 and 2008. This data will be based on logic contained in CRS 2007 Version 7.0. This data is in support of the quality improvement initiative IHS is participating in along with colleagues from Harvard Medical School.

  • New Demo Patient Functionality: Ability to create a search template of patients from within CRS that represent the reporting facility's test patients. User will then enter the name of the search template at a new site parameter and CRS will exclude the patients from all CRS reports.

  • CMS Report: Add data elements to the patient lists for AMI, Heart Failure, Pneumonia, and Surgical Care Improvement Project such as patient's race, zip code, insurance information, and additional visit information. Change reporting periods to 1st, 2nd, 3rd, and 4th quarter reporting so they coincide with the CMS report periods and change patient population default from AI/AN only to all patients.

  • Updated CRS Graphical User Interface: The GUI contains all functionality included in CRS 2008 Version 8.0, including the updated CRS 2007 Version 7.0 for the Comprehensive National GPRA Export for 2007-2008.

CRS VERSION 8.0 PATCH 1

CRS Version 8.0 Patch 1 was released on June 13, 2008.
  • Fixes to the following Topics:
    • Cancer Screening: Mammogram Rates
    • Depression Screening
    • Diabetic Retinopathy
    • Tobacco Cessation
  • Revised Logic for the following National GPRA Topics:
    • Colorectal Cancer Screening
  • GPRA Measure Forecast Patient List: Revised Tobacco Cessation logic to recognize refusals done in the past year.

CRS VERSION 8.0

CRS 8.0 was released nationally on April 1, 2008.

Key enhancements included in CRS Version 8.0 are shown below.

  • Split the National GPRA Report and all related reports and patient lists into separate reports: National GPRA Report and a new Other National Measures Report.
  • All GPRA-related changes
  • New GPRA Measure Forecast Patient List Linked to the Scheduling Package
    • Allow user to enter a date range
    • Run list by patient name, clinic name, or facility/division for patients with scheduled visits during that date range
    • Apply the basic logic of the National GPRA Report
    • Users then have a list of all the GPRA screenings/tests the patient is due for at his/her upcoming visit
      • Different from current clinical reminders in EHR since not all of the logic is the same as the CRS logic
  • 4 New Performance Measure Topics
    • Sexually Transmitted Infection (STI) Screening
      • Patients diagnosed with a key STI ( i.e. GC, Chlamydia, syphilis, herpes) who are tested for other key STIs.
    • Heart Failure and Evaluation of LVS Function
      • Patients discharged for heart failure who had their LVS function evaluated prior to arrival, during hospitalization or have it planned for after discharge.
    • Alcohol Screening and Brief Intervention (ASBI) in the ER
    • Palliative Care
  • Redesign the existing CMS Report to split it into two separate reports for each of the CMS measures, where one report applies denominator exclusion logic and the second does not. Also provide a list for each measure category (e.g. Heart Failure) that lists all patients in that measure set with no exclusion logic applied.
  • Make CMS logic changes to existing measures
  • Add 4 new hospital measures to the existing CMS report. At this time, the measures are expected to be:
    • Pneumonia
      • Appropriate initial antibiotic selection
      • Influenza vaccination
    • Surgical Infection Prevention
      • Prophylactic antibiotic received within 1 hour prior to surgical incision
      • Prophylactic antibiotics discontinued within 24 hours after surgery end time
  • Make changes to the logic for HEDIS-based measures. This includes both HEDIS 2006 and 2007 logic changes.
  • Update CRS logic to look for patient education in two ways: 1) for codes with the disease state (current method) and 2) for the corresponding diagnoses mapped to that disease state.

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