Percentage of patients aged 18 years and older with a diagnosis of heart failure with a current or prior left ventricular ejection fraction <=40% who were prescribed or already taking ACE inhibitor or ARB or ARNI therapy during the measurement period
Numerator
Patients who were prescribed or are already taking an ACE inhibitor or ARB or ARNI therapy during the measurement period.
- Medications can be prescribed through the script writer or entered into the Current Medications list in the patient's chart. The providers does NOT have to be the prescribing provider.
Denominator
All patients aged 18 years and older with two qualifying encounters during the measurement period and a diagnosis of heart failure on or before at least one qualifying encounter, with a current or prior LVEF<=40%
- 2 Encounters have an appropriate CPT code assigned to a visit
- Has Left Ventricular Ejection Fraction (LVEF) under 40% - Record in Review of Systems, Past Medical History, or Assessment any of the following:
- 'LVEF = 39' or 'LVEF 39' (or any other number between 0 and 39)
- 'EF = 39' or 'EF 39' (or any other number between 0 and 39)
- 'Ejection Fraction = 39' or 'Ejection Fraction 39' (or any other number between 0 and 39)
- 'Left Ventricular Ejection Fraction = 39' or 'Left Ventricular Ejection Fraction 39' (or any other number between 0 and 39)
- Left Ventricular Ejection Fraction < 40' or 'LVEF < 40' or 'EF < 40' or 'Ejection Fraction < 40'
Heart Failure diagnosis: Have an appropriate diagnosis in the patients problem list.
Denominator Exclusions
Patients with a history of heart transplant or with a Left ventricular Assist Device (LVAD) prior to the end of the outpatient encounter with Moderate or Severe LVSD
Heart Transplant is recorded in the following ways
- Text in Chart: the phrase "Heart Transplant" is entered in the Past Medical History, Assessment, or Plan fields of the note
- Diagnosis: a diagnosis of Heart Transplant Recipient
LVAD is recorded in the following ways
- Text In Chart: the following phrases are entered in Past Medical History:
- "LVAD"
- "Left ventricular Assist Device"
Denominator Exceptions
Documentation of medical reason(s) for not prescribing ACE inhibitor or ARB or ARNI therapy (e.g., pregnancy, renal failure due to ACEI, allergy, Intolerance, other medical reasons):
- Patient has Ace Inhibitor or angiotensin inhibitor listed the allergy section.
- Free Text "intolerance to Ace inhibitor" or "Intolerance to ARB" or "Intolerance to ARNI therapy" in assessment or plan section.
- Documentation of patient reason(s) for not prescribing ACE inhibitor or ARB or ARNI therapy (e.g., patient declined, other patient reasons).
- Free Text "Patient declines ACE Inhibitor" or "Patient declines ARB" or "Patient declines ARNI therapy " in assessment or plan
- Documentation of system reason(s) for not prescribing ACE inhibitor or ARB or ARNI therapy (e.g., other system reasons).
- Free Text "Patient not prescribed ACE Inhibitor" or "Patient not prescribed ARB" or "Patient not prescribed ARNI therapy " in assessment or plan