![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
Just so I can remember this day
Work nerdery from the email I just got.
New Quality Indicator: Clozapine Candidate with 4+ Inpatient/ER – MH
• Identifies individuals diagnosed with schizophrenia who had 4 or more emergency room visits or inpatient stays for mental health cause in the past year and who did not have any evidence of Clozapine in the past year. Excludes individuals with the following medical conditions in the past year: leukopenia agranulocytosis, neutrophil disorders, myocarditis, narrow angle glaucoma, malignant neoplasms, seizure disorders, Alzheimer’s or other degenerative brain disorders.
• This new indicator will be available in My QI Report and Statewide Reports within the “High Utilization – Inpat/ER” Indicator Set. It will also be available as a filter in Recipient Search under “Quality Flag” and in the Clinical Summary for identified clients.
*tears of joy*
There's always a 6 month delay on the reporting system because of course there is, but. This is really, really useful to me and what I do, and will also be very useful to "my" caseworkers (they don't actually work for me).
I know I have a few people who subscribe who actually care about this shit so if you're that person and wants to know why this makes me happy or why Clozapine is special or whatever other query you're welcome to ask and I'll get around to even answering but I certainly do not have the time at the moment to write a long entry explaining!
ETA that is totally unrelated but I didn't want to spam, I have discovered that Spyscape has a bookstore. It's a good thing I haven't been able to go to the museum itself yet because I would spend way too much money I don't have there.
New Quality Indicator: Clozapine Candidate with 4+ Inpatient/ER – MH
• Identifies individuals diagnosed with schizophrenia who had 4 or more emergency room visits or inpatient stays for mental health cause in the past year and who did not have any evidence of Clozapine in the past year. Excludes individuals with the following medical conditions in the past year: leukopenia agranulocytosis, neutrophil disorders, myocarditis, narrow angle glaucoma, malignant neoplasms, seizure disorders, Alzheimer’s or other degenerative brain disorders.
• This new indicator will be available in My QI Report and Statewide Reports within the “High Utilization – Inpat/ER” Indicator Set. It will also be available as a filter in Recipient Search under “Quality Flag” and in the Clinical Summary for identified clients.
*tears of joy*
There's always a 6 month delay on the reporting system because of course there is, but. This is really, really useful to me and what I do, and will also be very useful to "my" caseworkers (they don't actually work for me).
I know I have a few people who subscribe who actually care about this shit so if you're that person and wants to know why this makes me happy or why Clozapine is special or whatever other query you're welcome to ask and I'll get around to even answering but I certainly do not have the time at the moment to write a long entry explaining!
ETA that is totally unrelated but I didn't want to spam, I have discovered that Spyscape has a bookstore. It's a good thing I haven't been able to go to the museum itself yet because I would spend way too much money I don't have there.
no subject
no subject
no subject
So, you know, basically a way to catch people who've been falling through the cracks and hopefully get them onto a treatment course that will help?? Which does seem exciting and delightful, yes.
no subject
I'm surprised that ISN'T an immediate Google obviousness but there's probably been effort put in to not scaring patients who are on the drug. The answer is that clozapine has a lot of frightening nicknames and is not just not first line, but in fact last resort. The flag excludes all of those things because the first one listed there, agranulocytosis, is a very common side effect of clozapine, and it requires weekly bloodwork (which, yeah, getting 100% adherence on that with any population is impossible, but many of mine are homeless) to be able to monitor white cell status so you don't end up with clear thinking but otherwise dying patients. Clozapine agranulocytosis can be impossible to reverse, so everyone is hesitant to use it -- but it works VERY WELL, which is why it's so frustrating.
no subject
Aaaaand, yeah, that would explain the exclusion of patients with agranulocytosis and I'd bet that probably has something to do with the neutrophil disorders exclusions as well?
no subject
It does; basically any blood disease or most neurological ones (the ones listed up there are the ones that PSYCKES has flags for) will count you out of clozapine eligibility. THat's why having the computer calculate that for us and having it flag if someone is a candidate is so helpful; it cuts down on a lot of history research, especially as if someone might need clozapine we're talking an automatic bad historian through no fault of their own.
Unfortunately PSYCKES operates at an impressive delay because it's based on claims data. The other part oft hat email was letting me know that the flags will be updated tomorrow, at which point the data will be current as of July 1st! Except that's more of a mostly, because claims that happened in June could still be processing if they have extensions. Medicaid is supposed to only give you 90 days, but there are ways around that policy ... being 6 to 9 months out of date happens. Not often with ER, though, they are usually faster than the system and get things done within a month.