Pulmonology Coding Alert

Check out this outcome measures report from AHRQ.

You know yourself that you’ve got your own way of describing your asthma patients’ conditions and their treatment outcomes and your documentation reflects this. That’s all well and good, but having a resource that standardizes these descriptions can be a real bonus when you’re reporting or tracking your asthma outcomes and need measures that are more global and less subjective.

The good news is there’s just such are resource.

In its April 2019 white paper, “Standardized Library of Asthma Outcome Measures,” the Agency for Healthcare Research and Quality (AHRQ) provides two sets of charts which are the result of research and input from a special Asthma Workgroup, made up of clinical subject matter experts, payers, federal partners and patient representatives who convened to create and assess the asthma outcome measures included in the report.

Big Data Condensed and Sorted

The AHRQ research includes analysis of 4 key data sources to identify overlaps in asthma-related treatment and results, including data from the Electronic Clinical Quality Improvement Resource Center, the National Institutes of Health’s Value Set Authority Center and its Common Data Element Resource Portal, and the HL7 Standards.

EHR limitations: You ask, “Doesn’t EHR capture this information?” The answer is “partially.” EHR data “often will not contain all the requisite components of an outcome definition” that would makes it possible to use it for computation and analysis, the ACRQ paper indicates.

Take a Look at the Outcomes

The data is organized in two user-friendly sections.

The first chart (Appendix A of the white paper) includes the Workgroup’s definitions of the minimum set of asthma outcome measures. Here’s a sampling of what you’ll find:

The second chart (Appendix B in separately-downloadable Excel format) contains the definitions, the recommended reporting timeframe, “the initial population for measurement (e.g., all asthma patients, all asthma patients ages 12 and older), the outcome-focused population (patients who experienced the outcome of interest), and the data criteria and value sets,” according to the intro to the AHRQ paper.

Note These Special Challenges

The workgroup found accurately representing the outcome measures that focused on change over time was especially difficult, including in particular:

• change in medication dosage; and
• change in pulmonary function over a 12-month period.

These measures require multiple measurements in the data representations, the report indicates.

Solution: The workgroup recommended using the first and last measurement within the parameter of “interval of interest” (generally 12 months).

No way to measure: For outcomes occurring outside of a clinical setting, such as missed work/school days due to asthma, asthma-related quality of life, and medication adherence), the report group indicated that “condition-specific instruments” for assessing those outcomes “may not exist.”

Resource: To read the AHRQ white paper which includes Appendix A and to separately download Appendix B of the study, go to https://effectivehealthcare.ahrq.gov/topics/library-asthma/white-paper.