Practice Support Newsletter

October 2023

Measure of the Month

Screening for Breast Cancer

October is Breast Cancer Awareness Month. It is a great time to focus on patient education and awareness. Look at your report for Screening for Breast Cancer and set goals for improvement if needed.  

What is the measure?

• Percentage of women 50-74 who have had a screening mammogram in the last 27 months prior to the end of the measurement period.
• Current Measurement period – January 1, 2022 – December 31, 2023  
• 27 months allows for a 3-month grace period (mammogram October 2021 would count towards numerator)
• Numerator – Women with one or more screening mammograms on or between October 1st two years prior to measurement period and the end of the measurement period.
• Denominator – Women 50–74 who have had a visit by the end of the measurement period.

Steps your practice can take to improve screening rates:

• Kick off a patient education campaign this month
• Access free Breast Cancer Resources to Share | CDC

• Implement standing orders for screening mammograms
• Scan QR code for an example of a standing order
• Run reports monthly to identify patients who are due for breast cancer screening
• Implement patient reminder systems – text, email, phone
• Provider reminders
• Pre-visit planning
• Huddles
• EHR (Electronic Health Record) point of care reminders
• Identify and help reduce patient barriers
• Transportation
• Cost
• Availability of service
• Partner with community organizations or businesses to offer mobile mammography

Regulatory Reminders –

Ask the Experts: Immunize.org Answers Questions about Vaccine Storage and Handling

What type of device should be used for measuring temperatures in a vaccine storage unit? 

Every vaccine storage unit must have a temperature monitoring device (TMD). CDC recommends that vaccines be monitored using a “digital data logger” (DDL). A DDL provides the most accurate storage unit temperature information, including a detailed record of how long a unit has been operating outside the recommended temperature range (referred to as a “temperature excursion”). Unlike a simple minimum/maximum thermometer, which only shows the coldest and warmest temperatures reached in a unit, a DDL provides a log of the temperature recorded at preset intervals (at least every 30 minutes is recommended). 

Many DDLs use a buffered temperature probe, which is the most accurate way to measure actual vaccine temperatures. Temperatures measured by a buffered probe match vaccine temperatures more closely than those measured by standard thermometers, which tend to reflect only air temperature. Temperature data from a DDL can either be downloaded to a computer using special software or retrieved from a website. The software or website may also allow you to set the frequency of temperature readings. Reviewing DDL data regularly is critical to ensure temperature excursions that could damage vaccines do not go on without being addressed. It is important to decide whether independent software or a website program works best for your facility.

Additional questions/answers related to storage and handling along with specific vaccine questions/answers can be found at Ask the Experts: Experts Answer Questions About Vaccines (immunize.org) The full CDC Vaccine Storage and Handling Toolkit is available online.

Diversity Moment: Minimizing Implicit Bias in Primary Care Practices

As the communities we serve become more diverse, there is a need to ensure that practices are being inclusive of the patient population. With this can come unconscious bias. The Joint Commission, in a 2016 Quick Alert, notes: Implicit (subconscious) bias refers to the attitudes or stereotypes that affect our understanding, actions and decisions in an unconscious manner. 

Three quick ways to minimize implicit (unconscious) bias in the primary care practice setting: 

• Find out where the problem lies. Sometimes it is difficult to know where the issue is, especially with unconscious (implicit) bias, unless it is brought to your attention. The practice can do this by collecting feedback data from patient experience surveys, collection boxes or patient interviews.
• The Agency for Healthcare and Research Quality (AHRQ) as well as other organizations have Teach-Back Methods that can be used to help patients understand their doctor visit, diagnosis and any aftercare instructions that are provided. This involves talking to the patient slowly and clearly and ensuring that they can articulate the information you provided during the visit. See Use the Teach-Back Method: Tool #5 | Agency for Healthcare Research and Quality (ahrq.gov) for additional tools.
• Get to know others as individuals. As you become more familiar with your teammates and patients, focus on the positive behaviors and not the negative stereotypes. One good tip is to find ways that you are similar.

Stay tuned for Part 2 of Minimizing Implicit Bias in a future newsletter. Next time, we will focus less on the WHAT and talk about WHY, as in why it is important to reduce implicit bias in primary care.

Vaccine Pricing – Medicare Part B

Seasonal Influenza and Covid-19 pricing has been updated for Medicare Part B. Please bookmark the page for future reference as effective dates continue to change.

New Z Code Infographic

Z codes are a set of ICD-10-CM codes used to report social, economic, and environmental determinants known to affect health and health-related outcomes. Nine broad categories of Z codes represent various hazardous socioeconomic, and environmental conditions. Z codes can be used in any health setting and by any provider as a tool for identifying a range of issues related to education and literacy, employment, housing, ability to obtain adequate amounts of food or safe drinking water, and occupational exposure to toxic agents, dust, or radiation. The infographic is embedded as part of CMS’s Data Tools: Improving the Collection of SDOH Data with ICD-10-CM Z Codes.

Updated Security Risk Assessment Tool – Now Available

The Security Risk Assessment (SRA) Tool is designed to help small and medium sized healthcare organizations assess their security risks. In addition to helping a practice better understand areas where PHI (Protected Health Information) could be at risk, the tool helps organizations ensure that they are compliant with HIPAA's administrative, physical, and technical safeguards. The new tool, user guide as well as many other privacy and security resources for providers may be found on HealthIT.gov. 

Updates included in SRA version 3.4

• Remediation Report – Track response to vulnerabilities inside the tool
• Glossary & tool tips – Hover over terms to get more information
• HICP 2023 edition references
• Bug fixes, usability improvements

Interested in learning more about the SRA Tool? 

Register to view the recorded webinar:
An Overview for Small and Medium Practices

Don't let gossip undermine your clinic site!
– Northwest AHEC

Gossip among staff and providers can upset your patients, undermine morale and affect your reputation in your community. Controlling gossip is essential to successful medical clinic management. Northwest AHEC Practice Support created a quick way to learn more about how to address and manage gossip in your workplace. Check it out!