− Shared Decision-Making in Pediatrics: A National Perspective Pediatrics 2010;126;306:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3373306/
Here are some of the most frequently asked questions about NCQA’s various programs. If you don’t see what you are looking for in one of the entries below, you can ask a question through My NCQA.
If the condition is acute care management, the plan may be simpler than for a patient with a complex, chronic condition. The plan of care would include current medications, tests, treatment, patient/family self-care and important information about the family. While not every referral would have the same level of detail, be prepared to show a referral example for a patient that does have a care plan with the expected details.
Practices can use two methods to collect language need information:
1. Collect data from all patients and their families to create a report showing language needs.
2. Obtain data from an external source (e.g., data about the local community or its patient population).
Patients who do not speak English and patients from racial/ethnic minority groups may be less inclined to provide this information. Care should be taken to request the information using methods that respect multi-cultural differences.
Pediatric-specific resources:
Medical Home Data Portal state pages:
http://www.childhealthdata.org/browse/medicalhome
KIDS COUNT Data Center:
http://datacenter.kidscount.org/data/acrossstates/Rankings.aspx?ind=103
KM 12 categories A-C refer to needed services and are intended for routine, proactive reminders.
Category D addresses patients who miss routine visits, annual exams or follow-up appointments and need to be reminded to visit the practice for services.
Pediatric practices may want to look into quality improvement projects offered by state AAP chapters and national AAP. The AAP QI Webpage lists a variety of opportunities: https://www.aap.org/en-us/professional-resources/quality-improvement/Pages/ActivityList.aspx
If the asthma action plan enables patients to track/monitor their progress and document health information at home using a form or some other method of documentation with helpful instructions for self-management, then it would be acceptable.
Practices must provide a documented process for staff to follow to ensure that demographic and clinical data are available for the specialist, and either a report/log or an example showing that the process is followed (e.g., a screen shot of available information and how the information is made available to the specialist). If external referrals are made, the practice must specify the process for sharing information with those providers, as well.
If the clinical summary also includes the details of the patient’s care plan (i.e., information outlined in the criterion guidance), then it would meet the requirement. A clinical summary alone that does not include the patient’s care plan information would not meet the requirement.
Although the care plan can be made available via the patient portal, it is essential that all patients have access to the document. If patients are not registered for the portal, they will not have access. In those cases, practices should use an alternative method to provide the written care plan to patients to ensure that all patients have access after an appointment. Please note practices must document that the care plan is provided to the patient in the patient’s medical record.