The GPRO Totals Report is generated from the CMS GPRO Web Interface after Clinigence has uploaded your data from the Attributed Registry.
It can be difficult to understand exactly what the numbers on this report mean.
Each measure will have it's own section of the report that looks like this:
Each category will have a number of patients a link to the Details report and a Comments area.
What do the numbers mean?
| Report Title | CMS Definition | What Does This Mean in Relation to the Clinigence Registry? |
| All Ranked Patients | All ranked (sampled) patients in the module. | Unless otherwise requested, all patients in the CMS-provided Sample Patients file who are ranked for a measure are loaded into the Clinigence Attributed Registry. The maximum number in 2016 is 616. If CMS could not find 616 patients to rank for this measure, the number may be lower. (CMS will send up to 750 sample patients for PREV-13 for PY 2016) |
| All Confirmed and Complete | All ranked patients marked as Complete in the module, calculated when:
* Medical Record Found set to Yes * Module Confirmation set to Yes * All required measure data provided |
Only patients who have the data for this measure marked as Approved in the Clinigence Registry are uploaded to GPRO. The patients included in this number have no incomplete questions and no unapproved data for this specific measure. |
| All Skipped | All ranked patients in a module marked as Skipped for any reason in the module. |
Only patients who have the data for this measure marked as Approved in the Clinigence Registry are uploaded to GPRO Web Interface. Skipped patients, in this context, means any patient with complete and approved data in the Clinigence Registry that meets any of the following criteria: * Medical Record Not Found * Denominator Exclusion * Not Qualified for Sample * Other CMS Approved Reason * Not Confirmed for measure |
| All Incomplete |
All ranked patients in a module marked as Incomplete in the module. |
Only patients who have the data for this measure marked as Approved in the Clinigence Registry are uploaded to GPRO Web Interface. In the Clinigence Registry, these patients have questions that have not been answered or the patient data has not been approved. Patients with incomplete data will adversely affect your ability to reach the 2016 requirement of 248 consecutive completed patients. See the solution on Consecutively Completed Patients and Skipped Patients. |
| Consecutively Completed or Skipped | The number of patients, starting at rank #1, meeting the requirements to be counted as Confirmed and Completed or Skipped. The count stops with the first incomplete patient in the module. | Only patients who have the data for this measure marked as Approved in the Clinigence Registry are uploaded to GPRO Web Interface. If there are any Incomplete patients (with incomplete or unapproved data), then this will impact this count. The count starts at the patient ranked #1 and stops at the first incomplete patient. In the above example, the Consecutively Completed or Skipped is 16 - this indicates that the patient ranked #17 for this measure is Incomplete. |
| Medical Record Not Found | Consecutively skipped patients where the Medical Record Found is set to No. |
Only patients who have the data for this measure marked as Approved in the Clinigence Registry are uploaded to GPRO Web Interface. If any of the approved patients have a Medical Record Not Found = No, they will be counted in this category. |
| Not Confirmed | Consecutively completed patients where the Medical Record Found is set to Yes, but the disease module confirmation element is set to Not Confirmed for any reason. | Only patients who have the data for this measure marked as Approved in the Clinigence Registry are uploaded to GPRO Web Interface. If any of the approved patients have a Confirmed for Measure = No, they will be counted in this category. This includes patients who were not confirmed for Diagnosis, Gender, Age, No Qualifying Visit (CARE-3), or other Denominator Criteria. |
| Denominator Exclusion | Consecutively skipped patients where the Medical Record Found is set to Yes, but the disease module or measure module confirmation element is set to Denominator Exclusion. | Only patients who have the data for this measure marked as Approved in the Clinigence Registry are uploaded to GPRO Web Interface. If any of the approved patients have a No- Denominator Exclusion answer, they will be counted in this category. Denominator exclusions are specific to a measure (for example a bilateral mastectomy for the PREV-5 Breast Cancer Screening) and mean that the patient will not be counted in the denominator for the measure. |
| Not Qualified for Sample | Consecutively completed or skipped patients where the Medical Record Found is set to Not Qualified For Sample for any of the allowable reasons. Not Qualified for Sample is the total of In Hospice + Moved out of Country + Deceased + HMO Enrollment. | Only patients who have the data for this measure marked as Approved in the Clinigence Registry are uploaded to GPRO Web Interface. If any of the approved patients have Not Qualified for Sample answer, they will be included in this count. |
| No - Other CMS Approved Reason | Consecutively skipped patients where the Medical Record Found is set to Yes and the module confirmation element is set to No - Other CMS Approved Reason.
Note: this option should only be selected when an approval has been received from CMS in the form of a response to a QualityNet Help Desk inquiry. CMS has requested that a help Desk Ticket # be provided in the Help Desk Ticket # field. |
If you have created an incident/ticket with QualityNet to have a specific patient excluded for "Other CMS Approved Reason" you need to enter a support ticket with Clinigence at support.clinigence.com so that we can enter that information manually in the GPRO Web Interface. You must provide the patient name, HICAN, CMS Incident number, and which measure this reason applies to. |
| For Analysis | Consecutively confirmed and completed patients, starting with the patient ranked #1 in the module, where the Medical Record Found is set to Yes and the module confirmation element is set to Yes, and all required measure values have been provided. The count of For Analysis patients stops when at the first incomplete patient. Note that you may have confirmed and completed patients, but these patients will not be counted for analysis if there are lower ranked, but incomplete, patients in the module. The count starts with the first ranked patient in the module and stops at the first patient marked as Incomplete. |
Only patients who have the data for this measure marked as Approved in the Clinigence Registry are uploaded to GPRO. If you have incomplete or unapproved patients in the Clinigence Registry, it will impact this number. In the example above, there were 16 patients consecutively completed or skipped, but only 11 in the For Analysis count. Evidently the 5 patients who were skipped for any reason were deducted from the For Analysis count. When trying to reach the 2016 goal of 248 consecutive patients this number will indicate when you have reached that reporting threshold. See the solution on Consecutively Completed Patients and Skipped Patients. |
Comments in the GPRO Totals Report
| Comment Text | Description |
|
<skip rate>% - threshold of 10% not exceeded. |
Indicates the percentage of patients skipped within the consecutively confirmed and completed or skipped patients. This message only appears in the Medical Record Not Found, Not Confirmed, Denominator Exclusion, Not Qualified for Sample, or No - Other CMS Approved Reason row if skipped patients exist and the rate is less than the threshold of 10%. |
| You have reached the skip threshold for this module. Please ensure you are using appropriate skip reasons and continue your abstraction. | Indicates the percentage of patients skipped within the consecutively completed or skipped patients. This message only appears in the Medical Record Not Found, Not Confirmed, Denominator Exclusion, Not Qualified for Sample, or No - Other CMS Approved Reason row if the rate meets or exceeds the threshold of 10%. Suggestion: Review the skipped patients and ensure that you have supporting documentation for each skipped patient. |
| There are no consecutively confirmed and completed patients. The count starts with the first ranked patient in the module. | Indicates that there are no patient records for analysis. Note that you may have confirmed and completed patients, but these patients will not be counted for analysis if there are lower ranked, but incomplete, patients in the module. The count starts with the first ranked patient in the module and stops at the first patient marked as Incomplete.
This message only appears on the For Analysis row. |
| The minimum number of consecutively confirmed and completed patients for this module has not been met. | This indicates that the minimum requirement of consecutively confirmed and completed patients for a module has not been met. Note that you may have confirmed and completed patients, but these patients will not be counted for analysis if there are lower ranked, but incomplete, patients in the module. The count starts with the first ranked patient in the module and stops at the first patient marked as Incomplete.
This message only appears on the For Analysis row. |
| The minimum number of consecutively confirmed and completed patients for this module has been met. | Indicates that the number of consecutively confirmed and completed patients for the module meets the requirements for reporting (248 or 100% whichever is smaller). See the section on Consecutively Completed Patients and Skipped Patients. This message only appears on the For Analysis row. This message must appear for all 16 modules to meet the Web Interface reporting requirements. |