The Healthcare Effectiveness Data and Information Set (HEDIS) is one of the most widely used sets of health care performance measure in the United States. The term “HEDIS” originated in the late 1980s as the product of a group of forward-thinking employers and quality experts, and was entrusted to NCQA in the early 1990s. The NCQA measurement development process has expanded the size and scope of HEDIS to include measures for physicians, PPOs and other organizations. [1]
Measure – Care for older adults (COA) – Pain
To comply with this measure
a pain assessment on adults older than 66 years old during the measurement year
must be present on the clinical record.[2]
To clarify the HEDIS measure specifications the NCQA
mentioned the following;
Necessary
Documentation
Clinical
documentation must include evidence of the pain assessment with a valid date of
service. (The pain assessment can be either positive or negative)
Important
Information
·
A specific number of evaluated body system
is not required.
·
Documentation of a positive or negative
pain assessment is acceptable.
·
Only one body system pain assessment
evaluation is needed for compliance.
Don’t
·
Pain assessment documentation associated
to an acute event of a single body system is not valid for compliance. (Ex, wisdom
tooth pain, chest pain, back pain, pain due to trauma)
·
A clinical note for pain treatment only is
not valid for compliance.
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