"The two words ‘information’ and ‘communication’ are often used interchangeably, but they signify quite different things. Information is giving out; communication is getting through." -- Sydney J. Harris

Implications of Cholesterol Guideline Changes on Diabetes and Vascular Measures

MN Community Measurement continually evaluates the validity of quality measures utilized by the community and our stakeholders. In late 2013, the American Heart Association and the American College of Cardiologists released new joint practice guidelines that shifted the focus on cholesterol management from a target LDL to the appropriate type and dose of statin.

The current Optimal Diabetes and Vascular Care measures include a component that evaluates how many patients achieved their target LDL in an effort to reduce their overall cardiovascular risk.

Upon direction from the MNCM Measurement and Review Committee (MARC), a sub-committee of the MNCM Board of Directors, a workgroup was recently convened to review the new guidelines and discuss the implications for measuring cholesterol management. The workgroup agreed cholesterol management is still an important component of reducing cardiovascular risk, and thus, recommended redesigning that component of both the diabetes and vascular measures to align with the new guidance.

Since data collected in 2014 is from 2013 dates of service when the clinical guidance changed very late in the year, there will be no change in the collection or reporting of 2014 data. In 2015, MNCM will collect data on LDL for both measures; however, that component will be suppressed from measure calculation and public reporting. We expect to collect and report on the measures under newly-designed cholesterol component specifications beginning in 2016.

In the meantime, medical groups have inquired about what they can do to help prepare for any potential data submission related to changes.

Based on the preliminary measure discussions, we suggest medical groups:

  • Review EMR medication / order system to identify the defined statin drug list, and be prepared to provide data elements including statin drug names, date of the most recent order for statin, and patient’s daily prescribed dose in milligrams.
  • Consider potential ways to capture defined contraindications especially for statin allergy, intolerance or drug-drug interactions as these are not definable by diagnosis code and will rely on EMR based fields.

These elements are subject to change following the measure development workgroup’s review and measure design later this year.

We will continue to keep you informed as we progress toward a redesigned measure for 2016 reporting year.

For greater detail on the current measures, guideline changes and the process to re-design the cholesterol component specifications, please read Cholesterol Components for Diabetes and Vascular Measures April 15,2014