Unhealthy Alcohol Use

Screening & Counselling

Alerts
Bob Marley, MD, Clinical Director

Chris Manaois, Developer

HCIN 600
Population Health Analytics

December 13, 2020

We request project approval for…

DEPLOYING AN EHR NOTIFICATIONS TO BE BETTER TRACKING OF THE INTERVENTION

IDENTIFYING PATIENTS SENT TO PATIENTS AND PATIENTS THAT WILL INCREASE
WHO REQUIRE PROVIDERS VIA EHR MIPS COMPLIANCE
UNHEALTHY ALCOHOL ALERTS
USE COUNSELING

Date Required: January 2021

Reason: To begin implementation immediately
 Situation, Background, Assessment,
Recommendation (SBAR)
Situation:
Complete Measure 431:
Preventive Care and Screening: Unhealthy
Alcohol Use: Screening & Brief
Counseling, as required by MIPS
Assessment:
This intervention will ensure compliance
of preventive care and screening of
unhealthy alcohol use, improve quality
and reduce human error
Background:
Clinical teams may fail to monitor
timelines of patients requiring unhealthy
alcohol use management care which can
lead to delays and aggravation of alcohol
use
Recommendation:
The EHR can automatically
inform and populate orders and
notifications
 Justification
 2020 MIPS Measure 431: Preventive Care and Screening:
1 Quality Measure: Unhealthy Alcohol Use: Screening & Brief Counseling

 Unhealthy alcohol use refers to a spectrum in which alcohol is consumed that

increases health risk consequences to the diagnosis of alcohol use disorder (Bazzi
& Saitz, 2018).
 It is estimated that about 37 million adults in the US (1 in every 6) binge drink
2 Rationale: once a week (CDC, n.d.).
 Unhealthy alcohol use can lead to dangerous and risky behavior (driving under the
influence, violence, etc.) and/or can also lead to serious medical conditions
(alcohol dependence, cirrhosis of the liver, etc.).

3 Baseline Data:  In 2017, only 38% of adults reported being asked about binge drinking during the
past 2 years.
90% of adults being screened and counselled on unhealthy alcohol use in 24
4 Measure Target: months

Eligible physicians who fail to report data under Medicare’s 2019 Quality Payment
5 Dollars at risk: Program will be subject to a 7% penalty in 2021.
 Intervention

 All patients aged 18 and above.

Exclusions:
 Patients already screened for unhealthy alcohol
The Who use within the last 24 months
1  Patients under the age of 18
(Denominator)
 Patients who have not received brief
counselling if identified as an unhealthy
alcohol user.

The What  Assessment of Unhealthy Alcohol Use Screening

2 & Documentation of Unhealthy Alcohol Use
(Numerator) Counselling

The When
3  24 Months
(Timing)
 Process changes

 Risk Score Assessment:

4 How (EHR tools) Alcohol Use Disorders Identification Test (AUDIT)
Reporting: https://www.drugabuse.gov/sites/default/files/audit.pdf

5 By Whom:  Clinical Staff and/or Healthcare provider

Process flow – As Is
Process flow – Proposed
 Conceptual Diagram

24 Months

Unhealthy Alcohol
Use Screening &
Counselling

Alcohol Use
Disorders
Identification Test
(AUDIT)
Clinical Staff,
Healthcare Provider

All Adults, 18
and over
 Project Management

Quality care committee, Alcohol Management Quality

Primary stakeholders: Committee, Primary care providers, clinical staff, patients

Primary Quality Care committee, Alcohol Management

Established level of consensus?
Quality committee have the highest level of consensus.
  Only Primary Quality Care committee and Alcohol
  Management Quality committee agree on need and priority

Patients will receive notifications about unhealthy alcohol

Impact on patient experience? use screening when due.

 Providers will be more efficient in keeping track of

screening timelines as well as identify potential further
Impact on provider/caregiver experience? +/- harm to patients.
tasks, efficiency, usability, etc.  Caregivers will be able to manage and keep track of
time and appointments for patients.
 Cost/Benefit Analysis
Cost to implement the reminder/alert in the
electronic healthcare system is MINIMAL.

The intervention will INCREASE

COMPLIANCE in Unhealthy Alcohol Use
Screening which can potentially INCREASE
MIPS Incentives.

PROJECT SERVICE LINE IMPACT

Quality
Safety
Efficiency
Effectiveness
For any Questions,
feel free to contact:
cmanaois@sandiego.edu