Below are the nine recommended CQMs (out of 64) for the adult patient. Using the

Question

Below are the nine recommended CQMs (out of 64) for the adult patient. Using the documents listed in the Instructions above, write a brief description on each CQM [ IN YOUR OWN WORDS what each description means ]

DESCRIPTIONS FOUND HERE: https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/2014_CQM_AdultRecommend_CoreSetTable.pdf

a. Controlling High Blood Pressure

b. Use of High-Risk Medications in the Elderly

c. Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

d. Use of Imaging Studies for Low Back Pain

e. Preventive Care and Screening: Screening for Clinical Depression and Follow-Up Plan:

f. Documentation of Current Medications in the Medical Record

g. Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

h. Closing the referral loop: receipt of specialist report

i. Functional status assessment for complex chronic conditions

Explanation / Answer

a)Controlling blood pressure

1). Lose extra weight-

Blood pressure often increases as weight increases. Weight loss is one of the most effective lifestyle changes for controlling blood pressure. Losing just 10 pounds (4.5 kilograms) can help reduce your blood pressure.

2). Exercise regularly

Regular physical exercise at least 30 minutes most days of the week — can lower your blood pressure by 4 to 9 millimeters of mercury (mm Hg). It's important to be consistent because if you stop exercising, your blood pressure can rise again.

If you have slightly high blood pressure (prehypertension), exercise can help you avoid developing full-blown hypertension. If you already have hypertension, regular physical activity can bring your blood pressure down to safer levels. The best types of exercise for lowering blood pressure include walking, jogging, cycling, swimming or dancing. Strength training also can help reduce blood pressure. Talk to your doctor about developing an exercise program.

3). Eat a healthy diet

Eating a diet that is rich in whole grains, fruits, vegetables and low-fat dairy products and skimps on saturated fat and cholesterol can lower your blood pressure by up to 14 mm Hg. This eating plan is known as the Dietary Approaches to Stop Hypertension (DASH) diet.

4). Reduce your stress

Chronic stress is an important contributor to high blood pressure. Occasional stress also can contribute to high blood pressure if you react to stress by eating unhealthy food, drinking alcohol or smoking.

Take some time to think about what causes you to feel stressed, such as work, family, finances or illness. Once you know what's causing your stress, consider how you can eliminate or reduce stress.

5). Monitor your blood pressure at home and see your doctor regularly

Home monitoring can help you keep tabs on your blood pressure, make certain your lifestyle changes are working, and alert you and your doctor to potential health complications. Blood pressure monitors are available widely and without a prescription. Talk to your doctor about home monitoring before you get started.

6). Reduce sodium in your diet

Even a small reduction in the sodium in your diet can reduce blood pressure by 2 to 8 mm Hg. The effect of sodium intake on blood pressure varies among groups of people. In general, limit sodium to less than 2,300 milligrams (mg) a day or less.

7). Limit the amount of alcohol

Alcohol can be both good and bad for your health. In small amounts, it can potentially lower your blood pressure by 2 to 4 mm Hg.

But that protective effect is lost if you drink too much alcohol — generally more than one drink a day for women and for men older than age 65, or more than two a day for men age 65 and younger. One drink equals 12 ounces of beer, five ounces of wine or 1.5 ounces of 80-proof liquor.

Drinking more than moderate amounts of alcohol can actually raise blood pressure by several points. It can also reduce the effectiveness of blood pressure medications.

8). Get support

Supportive family and friends can help improve your health. They may encourage you to take care of yourself, drive you to the doctor's office or embark on an exercise program with you to keep your blood pressure low.

If you find you need support beyond your family and friends, consider joining a support group. This may put you in touch with people who can give you an emotional or morale boost and who can offer practical tips to cope with your condition.

b). Used of High risk medication

If managed carefully, High-Risk Medications can be utilized more strategically in the elderly to prevent adverse events and improve patient safety. The use of certain medications in elderly patients can result in poor health outcomes as a result of confusion, falls, and other factors affecting mortality.

By identifying which medications are on the list of High-Risk Medications, these medications can be monitored more closely and more carefully prescribed. Educating staff members and prescribers at your practice about High-Risk Medications could improve health outcomes for your patients. Understanding alternatives to high-risk medications that have a decreased potential for side effects in the elderly (like glimepiride opposed to glyburide) can help benefit your patients. Many High-Risk Medications may be non-formulary, or require preauthorization for them to be covered. This could result in your patients paying for them out-of-pocket. When reviewing a patient’s medications determine if the patient is taking any High-Risk Medications. If so, determine the appropriateness of these medications, whether or not the patient is experiencing any adverse effects, and consider more appropriate alternatives.

d). Use of Imaging Studies for low back pain

Low back pain affects three-quarters of adults at some time in their lives.Each year, 25–50 percent of American adults experience low back pain, making it one of the most common reasons for seeking health care services. Evidence shows that many patients diagnosed with low back pain receive excessive imaging which can lead to unnecessary worry and unneeded surgery. For the great majority of individuals who experience severe low back pain, pain improves within the first two weeks of onset. Avoiding imaging (i.e., X-ray, MRI, CT scans) for patients when there is no clinical necessity, can prevent unnecessary harm, unintended consequences to patients and reduce health care costs.

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