Synchronized if all of these conditions are met:

• The patient has confirmed Heart Failure (HF).
• The patient has confirmed Coronary Artery Disease (CAD).

Synchronized if all of these conditions are met:

• The patient has confirmed HF.
• The patient has confirmed Preventive Care (PC) and is ranked under PC-1.

Background information:

• The required codes to determine LDL-C are different between the Diabetes Mellitus (DM) and CAD topics.
• During manual abstraction, it is assumed that in most cases the values of LDL-C elements on both topics are the same.

Synchronized if all of these conditions are met:

• The user opted to synchronize the LDL-C measure for the patient.
• The patient has confirmed DM.
• The patient has confirmed HF.

Effect to data status:
The data status of DM and CAD will be affected by the LDL-C inconsistencies if the user opted to synchronize the LDL-C measure between DM and CAD and one of the elements has a different value.

• The DM and CAD topics will be marked incomplete if all of the following conditions are met:

• The patient has a confirmed DM condition.
• The patient has a confirmed CAD condition.
• The value of one of the LDL-C elements is different between topics.
• The user opted to synchronize LDL-C under DM and CAD.

Effect to warnings:
It is possible that a patient's data status is complete, even though a warning is raised due to some possible inconsistencies.

• The patient will be marked as having warnings if all of the following conditions are met:

• The patient has a confirmed DM condition.
• The patient has a confirmed CAD condition.
• The value of one of the LDL-C elements is different between topics.
• The user opted not to synchronize LDL-C under DM and CAD.

Background information:

• The values are not automatically synchronized since DM Confirmed has exclusions and the codes are different.
• This inconsistency will not cause any topic to be marked as incomplete.

Checked for consistency if all of these conditions are met:

• The patient has confirmed DM.
• The patient has confirmed CAD.

Effect to warnings:
The patient will be marked as having warnings if any of the following conditions is met:

• DM: Confirmed = "No" or "No-Med. Reason" and CAD: Has Diabetes = "Yes".
• DM: Confirmed = "Yes" and CAD : Has Diabetes = "No".

Background information:

• These elements are checked for consistency, but the values are not automatically synchronized because they have different parent elements.
• These elements have the same definitions and set of codes.
• HF: Beta Blocker is available only if HF : Has LVSD = "Yes".
• CAD: Beta Blocker is available only if CAD: History of MI = "Yes".

Checked for consistency if all of these conditions are met:

• The patient has a confirmed HF condition.
• The patient has a confirmed CAD condition.
• The patient's HF: Has LVSD = "Yes".
• The patient's CAD: History of MI = "Yes".

Effect to data status:

• If "HF: Beta Blocker Drug" and "CAD: Beta Blocker Drug" elements are inconsistent and the conditions above are met, the HF and CAD topics will be marked as incomplete.

Background information:

• These elements are checked for consistency, but the values are not automatically synchronized because they have different parent elements.
• These elements have the same definitions and set of codes.
• HF: ACE-I/ARB is available only if HF: Has LVSD = "Yes".
• CAD: ACE-I/ARB is available only if CAD: Has Diabetes = "Yes" or CAD: Has LVSD = "Yes".

Checked for consistency if all of these conditions are met:

• The patient has a confirmed HF condition.
• The patient has a confirmed CAD condition.
• The patient's HF: Has LVSD = "Yes".
• The patient’s CAD: Has Diabetes = "Yes" or CAD: Has LVSD = "Yes".

Effect to data status:

• If the "HF: ACE-I/ARB Drug" and "CAD: ACE-I/ARB Drug" elements are inconsistent and the above conditions are met, the HF and CAD topics will be marked as incomplete.

Background information:

• If a patient has a confirmed DM, HF or CAD then the patient has a chronic condition.  For most cases, this is assumed to be true during manual abstraction.
• There are differences in the coding of disease confirmation of DM, HF and CAD when compared to the PC topic.  Because of these differences it is possible for a patient to have a DM, HF or CAD confirmed but the PC to be not confirmed.

Checked for consistency if all of these conditions are met:

• The patient has a confirmed DM, HF or CAD.
• The patient's PC: Condition Confirmed = "No".

Effect to warnings:

• If the conditions above are met then the record will be flagged as having a warning with PC confirmation as the source.

Background information:

• If a patient has "Med. Rec. Not Found" in a confirmation element, then the same item should be selected for other topics that the patient is ranked.
• The option "Med. Rec. Not Found" in the confirmation element should only be used if the patient’s chart could not be found.
• The options "No - Med. Reasons", "Yes" and "No" indicate that the patient's chart exists.

Checked for consistency if all of these conditions are met:

• One of the patient’s topic has "No - Med. Reasons", "Yes" or "No" in the confirmation element.
• One of the patient’s topic has "Med. Rec. Not Found" in the confirmation element.

Effect to warnings:

• If conditions above are met then the record will be flagged as having a warning. The source of the warning will be the topics with "Med. Rec. Not Found" in the confirmation element.

Background information:

• LDL-C test is one of the components of lipid profile.
• If a lipid profile was done, it is assumed that a LDL-C test was performed.

CAD-5 & DM-4
An inconsistency warning is raised if all of these conditions are met:

• The patient has a confirmed CAD condition.
• The patient has a confirmed DM condition.
• The patient’s "CAD: Lipid Profile Performed" = "Yes".
• The patient’s "DM: LDL-C Test" = "No".

Effect to warnings:

• If conditions above are met then the record will be flagged as having a warning. The source of the warning will be the DM topic.

CAD-5 & CAD-6
An inconsistency warning is raised if all of these conditions are met:

• The patient has a confirmed CAD condition.
• The patient’s "CAD: Lipid Profile Performed" = "Yes".
• The patient’s "CAD: LDL-C Test" = "No".

Effect to warnings:

• If conditions above are met then the record will be flagged as having a warning. The source of the warning will be the CAD topic.

Background information:

• If the patient received ACE Inhibitor/ARB therapy during the measurement period, it is assumed that the patient had medical attention for nephropathy.

DM-6 & HF-7
An inconsistency warning is raised if all of these conditions are met:

• The patient has a confirmed DM condition.
• The patient has a confirmed HF condition.
• The patient’s "DM: Med. Attention Nephropathy" = "No".
• The patient’s "HF: ACE-I/ARB" = "Yes".

Effect to warnings:

• If conditions above are met then the record will be flagged as having a warning. The source of the warning will be the DM topic.

DM-6 & CAD-7
An inconsistency warning is raised if all of these conditions are met:

• The patient has a confirmed DM condition.
• The patient has a confirmed CAD condition.
• The patient’s "DM: Med. Attention Nephropathy" = "No".
• The patient’s "CAD: ACE-I/ARB" = "Yes".

Effect to warnings:

• If conditions above are met then the record will be flagged as having a warning. The source of the warning will be the DM topic.

Background information:

• The BP under DM refers to the most recent BP within the measurement period regardless of the provider.
• The BP under PC-1 refers to the BP on the visit to an MCMP provider.