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CRS 2005 (versions 5.0 and 5.1)

CRS 2005 (BGP v5.1) was released for national deployment on June 16, 2005.

Key enhancements for this version are listed below.

CRS has been expanded beyond IHS clinical performance measures for biannual national GPRA reporting to encompass indicators defined by external organizations and includes HEDIS and Centers for Medicare and Medicaid (CMS) reports.

Key enhancements for CRS Version 5.1 include:

  • New CMS report, includes 10 quality measures for heart attack, heart failure, and pneumonia
  • 6 new indicators (also included in HEDIS report):
    • Topical Fluoride (GPRA indicator for 2005)
    • 3 CVD-related
    • Osteoporosis Management in Women
    • Asthma Quality of Care
  • Revisions to several existing indicators, including fixes for Childhood Immunizations (addition of CVX code 110 for Hepatitis B) and Mammography Screening (including refusals for certain CPT codes)
  • New Elder Care report for patients 55+
  • New Graphical User Interface (GUI)
    • Windows-based
    • In addition to current roll-and-scroll, users are not required to use the GUI


CRS Version 5.0 Patch 1 was released nationally on January 31, 2005. This patch includes the following changes and additions:

  • Added separate National GPRA report that allows users to select any date for the report end date or from quarters (e.g. September 30, December 31). This report is included in the Other National Reports option.
  • Revised National GPRA patient lists to allow users to select report end date.
  • Revised the Diabetes: Nephropathy GPRA indicator not to require the Estimated GFR lab test.
  • New requirement for users to have special access (i.e. key) to run patient lists and to edit the site parameters and site-defined lab taxonomies. Users must obtain security keys from their Site Managers to perform these functions.
  • Fixed the lookup of rectal procedures in the Colorectal Cancer Screening indicator.

CRS 2005 Version 5.0 contains 20 GPRA and 15 other clinical indicator topics. Click the CRS 2005 V5.0 IHS Clinical Performance Indicator Definitions and Logic link below for topic and individual indicator descriptions. Key enhancements for version 5.0 include:

  • Revised Cardiovascular Disease, Cholesterol Screening and Prenatal HIV Testing to GPRA indicators and added Childhood Immunizations, which is also a GPRA indicator.
  • Revision of GPRA numerator for Diabetes: Nephropathy Assessment to require patients to have both a positive urine protein or any microalbuminuria test AND an estimated GFR.
  • Addition of four other new indicator topics: Childhood Obesity Reduction, Chronic Kidney Disease Assessment, Comprehensive CVD-Related Assessment for At-Risk Patients, and Diabetes Comprehensive Care.
  • Renaming of Diabetes: Mental Health topic to Depression/Anxiety Screening and expansion of denominators for additional at-risk populations.
  • Changing logic and/or adding logic to 15 existing indicator topics, including addition of denominators and/or numerators and/or redefinition of logic to mirror HEDIS indicators, where appropriate.
  • New National GPRA report (replaces the GPRA Performance and Area Director Performance reports) includes 23 GPRA performance measures and 25 other key clinical indicators. This report predefines patient population as American Indian/Alaska Natives only (Classification of 01) and time frame as July 1, 2004 - June 30, 2005, with a Baseline Year of 2000.
  • New option to print Patient Lists for patients who meet or do not meet indicators included in the National GPRA report.
  • New Summary Detail Page that lists indicator performance by site added to the Area Aggregate National GPRA report.
  • New predefined local Elder Care report, in addition to Diabetes, CVD Prevention, and Women's Health reports.

IHS uses the Health Plan Employer Data and Information Set (HEDIS®) as a source for defining clinical performance measures. A separate HEDIS report is available, which contains only HEDIS indicators and is intended for use by sites interested in seeking NCQA certification. CRS v.5.0 includes 13 HEDIS indicator topics from the "Effectiveness of Care" performance section. Other features of the HEDIS report include:

  • User selects the communities to include in the report by selecting a Community taxonomy.
  • Provides an option for selecting different patient-type populations: American Indian and Alaska Native (AI/AN), non-AI/AN, or both.
  • Can be exported to the Area Office by the site for aggregation into an Area-wide HEDIS report.
  • May be run locally for individual communities to compare performance.

Key logic changes from version 5.0 include: New topic:

  • Osteoporosis Management in Women Who Had a Fracture
  • Beta-Blocker Treatment After a Heart Attack
  • Persistence of Beta-Blocker Treatment After a Heart Attack
  • Cholesterol Management After Acute Cardiovascular Event
  • Use of Appropriate Medications for People with Asthma
  • Changes to logic and/or additions to 8 existing indicator topics, including addition of denominators and/or numerators and/or redefinition of logic to mirror HEDIS indicator logic.

The CMS Hospital Quality Initiative, launched in 2003, uses a variety of tools to stimulate and support a significant improvement in the quality of hospital care. The National Voluntary Hospital Reporting Initiative (NVHRI) is one of many efforts in CMS's overall Hospital Quality Initiative. The reporting of the ten "starter set" measures comprises the first phase of the NVHRI. Section 501(b) of the Medicare Drug Prescription and Modernization Act of 2003 (MMA) effectively supersedes this phase. Section 501(b) of the MMA stipulates that eligible hospitals that do not submit their data to CMS using the ten measure starter set will be subject to reduction in their FY2005 payment by 0.4%.

The ten "starter set" measures are included in CRS version 5.1