Seguridad Health Measures Implementation Guide

Chapter 1: Introduction

Introduction

Chapter 2: Implementation

Implementation

Chapter 3: Choose My Pharmacy® Core Measure Set

Seguridad Health Measures®

Chapter 4: Choose My Pharmacy® Measure Specifications

Assessment of Renal Function in Older Adults
Assessment of Weights in Pediatrics
Known Allergy Status
Medication Indication
Electronic Care Plan Accessibility
Point of Care Testing Structure
Employee Vaccination Rate
Advanced Pharmacy Technicians
Improving Pain Management Safety
Improving Diabetes Safety
Identifying Social Determinants of Health

Chapter 5: Choose My Pharmacy® PMS Support

PioneerRx
ComputerRx
Liberty
Rx30
QS/1
MicroMerchant
BestRx
FSI Foundation Systems

Chapter 6: Choose My Pharmacy® Report Card FAQs

Chapter 1: Introduction

Introduction

Thank you joining Seguridad’s measurement system, Choose My Pharmacy™. Our vision is to help patients choose pharmacies in a transparent, quality-focused manner. We believe choosing a pharmacy is about more than convenience – it’s about high-quality care versus a commodity. We can achieve this vision through our mission to provide a patient-centric evaluation of pharmacies to improve patient outcomes. We believe a community pharmacy should have a star rating or measurement system developed for evaluating pharmacies using measures designed for community pharmacies.

Our core values are listed below and represent who we are and what we do for pharmacy practice, healthcare quality, and patient care. We want to help pharmacists be pharmacists and ensure the right patient gets the right drug at the right dose through the right route at the right time for the right reason. Everything we do focuses on helping pharmacies optimize patient care and improve outcomes.

Core Values of Seguridad, Inc

Safety

Advance patient safety in pharmacy practice.

Education

Anyone will be able to understand why pharmacy quality is essential and how to use the information.

Improvement

Pharmacies will improve the quality of care delivered through measurement science.

Entrusted

A trusted source of pharmacy quality for decision-makers.

Empowered

Pharmacies will be able to demonstrate a role in high-quality healthcare.

Well-Being

Healthy through fiscal accountability and a culture of excellence

We look forward to helping you become a “Five-Star Pharmacy.” Feel free to contact us at healthequity@espha.net if you have any questions or if we can help you in any way.

Chapter 2: Implementation

Implementation

There are currently eleven (11) Seguridad Health Measures® as part of the Choose My Pharmacy® measurement system summarized in chapter 3. The full measure specifications may be found in chapter 4.

A measurement system is a report card, or star rating, evaluating the performance of the stakeholder – in this case, community pharmacies. The pharmacy is encouraged to implement a myriad of diverse services to improve patient outcomes and lower healthcare cost. Choose My Pharmacy® is how well the pharmacy performs in these goals.

Every pharmacy that participates in Choose My Pharmacy® shares standard, de-identified data to Seguridad, Inc. Seguridad, Inc uses proprietary calculations and analytics to produce a customized report card for the pharmacy. Each pharmacy receives a calendar year score, reported with four quarterly report cards. Overtime, pharmacies will be able to track progress year-over-year on Seguridad Health Measures® - from the current core set to future measures in development.

Seguridad leverages a HIPAA-Secure survey platform, JotForm, to help collect pharmacy information. Each pharmacy pharmacist-in-charge (PIC) will:

Receive a Business Associate Agreement (BAA) between the pharmacy and Seguridad. This form will be pre-populated with pharmacy specific details and a digital signature is requested.
The PIC will receive the Seguridad PIC On-Boarding Survey after execution of the BAA.
The PIC will receive the Seguridad Data Request after the PIC On-Boarding Survey is complete.
a. This will be requested on a quarterly basis to update measure results.
The PIC will receive a link for the Employee Survey. This is to be completed by each individual involved with the fill and dispensing of medications.
Once all data is collected, Seguridad will provide a Choose My Pharmacy® Health Measures Report Card to the pharmacy.

Chapter 3: Choose My Pharmacy® Core Measure Set

Seguridad Health Measures®

Title	Description	Performance
Assessment of Renal Function in Older Adults	Percent of patients aged 65 years and older with a serum creatine on file at the pharmacy during the measurement year	A higher rate is better
Assessment of Weights in Pediatrics	Percent of pediatric patients (17 years and less) with an updated weight during the measurement year	A higher rate is better
Known Allergy Status	Percent of patient records with documented allergy status, including ‘no known drug allergies’.	A higher rate is better
Medication Indication	Percent of electronic prescriptions with prescriber-reported indication based on International Classification of Disease – 10	This is a reporting measure only
Electronic Care Plan Accessibility	Possession of e-care plan with appropriate training	A higher rate is better
Point of Care Testing Structure	Possession of a CLIA-waiver in the pharmacy.	A higher rate is better
Employee Vaccination Rate	Percent of employees in a pharmacy that are vaccinated for influenza and COVID-19.	A higher rate is better
Advanced Pharmacy Technicians	Percent of pharmacy technicians with advance training	A higher rate is better
Improving Pain Management Safety	Percent of households at risk for opioid adverse event with naloxone available	A higher rate is better
Improving Diabetes Safety	Percent of patients with high-risk diabetes with glucagon available.	A higher rate is better
Identify Social Determinants of Health	Percent of patients with documented demographic information.	A higher rate is better

Chapter 4: Choose My Pharmacy® Measure Specifications

Assessment of Renal Function in Older Adults

Title	Assessment of Renal Function in Older Adults
Description	Percent of patients aged 65 years and older with a serum creatine on file at the pharmacy during the measurement year A higher score is better
Rationale	Older adults have diminished renal function and many medications need to be adjusted based on renal excretion. This measure assesses whether the pharmacy has collected the laboratory information required to assess renal function.
Logic Model	This measure ensures the pharmacy has the salient information (serum creatine) to ensure patient specific dosing.
Level of Analysis	Pharmacy (Patient)
Data Source	Pharmacy Data
Denominator Statement	All patients aged 65 years or older that received a medication during the measurement year.
Denominator Calculation	1. 1. All individuals in the pharmacy 2. 2. All individuals aged 65 or older at the beginning of the measurement year 3. 3. Must have received a medication during the measurement year 4. 4. Remove an individual with exclusion criteria
Denominator Exclusions	Any patient only receiving an immunization at the pharmacy Any non-human patients (e.g., cats, dogs, clinics, office-use, etc)
Denominator Exclusion Rationale	Many pharmacies may host immunization clinics and only interact with a patient during these visits. As immunizations do not need to be renally adjusted, assessment of renal function is not a required (valid) assessment. Pharmacies may provide care to pets or other veterinarian needs, or for office-use. This patient profiles should be excluded from the measure calculation.
Numerator Statement	Individuals from the denominator with a serum creatine drawn during the measurement year
Numerator Calculation	1. 1. Identify number of individuals with serum creatine recorded 2. 2. Identify number of individuals with serum creatine updated during the measurement year
Seguridad Measure Specification Process
Data Stratification	The measure rate will be reported as a percent of patients within a single pharmacy. If available and feasible, measure rate will be reported by type of pharmacy (e.g., health-system, community, specialty, mail-order, long-term care). If available and feasible, measure rate will be reported by line of business (pharmacy Medicare rate, pharmacy Medicaid rate, pharmacy Commercial rate, and pharmacy uninsured rate). Risk adjustment will be applied when available.
Value Sets	The value set Seguridad - CMP Immunizations will be used to support the exclusion criteria.
Future Iterations	Many pharmacy measures are designed as structure or process. Future goals of this concept include measures focused on appropriate dosing based on renal function and assessment of all patients.
Harmonization¹	Payors: N/A Providers: N/A

1. Measures that have either the same target populations (denominator) or the same measure focus (numerators) may be considered related, whereas measures that have the same targeted population (denominator) and same measure focus (numerator), are considered competing measures. Measures being developed should be harmonized, where feasible, to previously established measures to decrease measure burden. Choose My Pharmacy measures are developed for pharmacy evaluation, which is a novel area for measurement science, no current measure evaluates this level of analysis. Choose My Pharmacy measures will be harmonized to the extent possible, recognizing different levels of analysis have different data elements, and instead the focus will be to vertically integrate the Choose My Pharmacy measures with other measurement systems and measures.

Chapter 4: Choose My Pharmacy® Measure Specifications

Assessment of Weights in Pediatrics

Title	Assessment of Weights in Pediatrics
Description	Percent of pediatric patients (17 years and less) with an updated weight during the measurement year A higher score is better
Rationale	Most pediatric prescriptions are weight-based and the pharmacy should be checking the dose prior to dispensing.
Logic Model	This measure ensures the pharmacy has the salient information (weight) to ensure patient specific dosing.
Level of Analysis	Pharmacy (Patient)
Data Source	Pharmacy Data
Denominator Statement	All patients 17 years and less that received a medication at the pharmacy during the measurement year
Denominator Calculation	1. 1. All patients in the pharmacy 2. 2. All patients age 17 or less during the measurement year 3. 3. Apply exclusion criteria
Denominator Exclusions	Any patient only receiving an immunization at the pharmacy Any non-human patients (e.g., cats, dogs, clinics, office-use, etc)
Denominator Exclusion Rationale	Many pharmacies may host immunization clinics and only interact with a patient during these visits. As immunizations do not need to be weight-based, assessment of weight is not a required (valid) assessment. Pharmacies may provide care to pets or other veterinarian needs, or for office-use. This patient profiles should be excluded from the measure calculation.
Numerator Statement	Individuals from the denominator with a weight (pounds) during the measurement year
Numerator Calculation	1. Identify number of individuals with a weight recorded in the pharmacy record.
Seguridad Measure Specification Process
Data Stratification	The measure rate will be reported as percent of patients within a single pharmacy. If available and feasible, measure rate will be reported by type of pharmacy (e.g., health-system, community, specialty, mail-order, long-term care). If available and feasible, measure rate will be reported by line of business (pharmacy Medicare rate, pharmacy Medicaid rate, pharmacy Commercial rate, and pharmacy uninsured rate). Risk adjustment will be applied when available.
Value Sets	The value set Seguridad - CMP Immunizations will be used to support the exclusion criteria.
Future Iterations	Many pharmacy measures are designed as structure or process. Future goals of this concept include measures focused on appropriate dosing based on weight and assessment of all patients.
Harmonization¹	Payors: N/A Providers: N/A

Chapter 4: Choose My Pharmacy® Measure Specifications

Known Allergy Status

Title	Known Allergy Status
Description	Percent of patient records with documented allergy status, including ‘no known drug allergies’. A higher rate is better.
Rationale	Community pharmacies are the last step prior to a patient receiving a medication and last chance to verify drug allergies.
Logic Model	This measure ensures the pharmacy has the salient information (allergy history) to ensure patient specific dosing.
Level of Analysis	Pharmacy (Patient)
Data Source	Pharmacy Data
Denominator Statement	All individuals dispensed a prescription from the pharmacy during a measurement year
Denominator Calculation	1. 1. Identify all prescriptions in a measurement year 2. 2. Identify all unique patients from the prescriptions 3. 3. Apply exclusions
Denominator Exclusions	Any non-human patients (e.g., cats, dogs, clinics, office-use, etc)
Denominator Exclusion Rationale	Pharmacies may provide care to pets or other veterinarian needs, or for office-use. This patient profiles should be excluded from the measure calculation.
Numerator Statement	Individuals from the denominator with documented allergy status on record
Numerator Calculation	1. Number of individuals from the denominator with documented allergy
Seguridad Measure Specification Process
Data Stratification	The measure rate will be reported as percent of patients within a single pharmacy. If available and feasible, measure rate will be reported by type of pharmacy (e.g., health-system, community, specialty, mail-order, long-term care). If available and feasible, measure rate will be reported by line of business (pharmacy Medicare rate, pharmacy Medicaid rate, pharmacy Commercial rate, and pharmacy uninsured rate). Risk adjustment will be applied when available.
Value Sets	No value set is required for the calculation of this measure.
Future Iterations	Many pharmacy measures are designed as structure or process. Future goals of this concept include measures focused on updating the allergy status on an annual basis.
Harmonization¹	Payors: N/A Providers: N/A

Chapter 4: Choose My Pharmacy® Measure Specifications

Medication Indication

Title	Medication Indication
Description	Percent of electronic prescriptions with prescriber-reported indication based on International Classification of Disease – 10 This is a reporting measure only
Rationale	Pharmacies ensure the right patient gets the right drug at the right time for the right reason. This measure will help to evaluate the right reason. Caveats: This measure is not for performance evaluation. Pharmacists may not diagnosis patients (by entering patient-reported diagnosis in the pharmacy system). This measure will evolve over time to ensure every prescription has an indication and said indication is correct.
Logic Model	This measure is establishing the need pharmacies have for an indication on every prescription. Currently, regulatory barriers exist that prevents the measure from being ‘Every Medication Has an Indication’ however, this measure is headed in that direction.
Level of Analysis	Pharmacy (Prescription)
Data Source	Pharmacy Data
Denominator Statement	All prescriptions electronically submitted to the pharmacy during a measurement year
Denominator Calculation	1. 1. Identify all prescriptions in a pharmacy 2. 2. Identify all new prescriptions denoted as refill number 0 3. 3. Identify all new prescriptions with source field (NCPDP = electronic) 4. 4. Apply exclusion criteria
Denominator Exclusions	Any electronic prescription that was canceled by the prescriber. Any non-human patients (e.g., cats, dogs, clinics, office-use, etc)
Denominator Exclusion Rationale	Canceled prescriptions were never filled and confirmed to not be valid prescriptions Pharmacies may provide care to pets or other veterinarian needs, or for office-use. This patient profiles should be excluded from the measure calculation.
Numerator Statement	Percent of electronic prescriptions with prescriber reported ICD-10
Numerator Calculation	1. Number of prescriptions with supplied ICD-10
Seguridad Measure Specification Process
Data Stratification	The measure rate will be reported as pharmacy. If available and feasible, measure rate will be reported by type of pharmacy (e.g., health-system, community, specialty, mail-order, long-term care). If available and feasible, measure rate will be reported by line of business (pharmacy Medicare rate, pharmacy Medicaid rate, pharmacy Commercial rate, and pharmacy uninsured rate). Risk adjustment will be applied when available.
Value Sets	No value set is required for the calculation of this measure.
Future Iterations	Many pharmacy measures are designed as structure or process. Future goals of this concept include measures focused ensuring all prescriptions have an indication and that the indication and medication are appropriate.
Harmonization¹	Payors: N/A Providers: This measure is similar to the CMS SNF measure ensuring all medications have an indication.

Chapter 4: Choose My Pharmacy® Measure Specifications

Electronic Care Plan Accessibility

Title	Electronic Care Plan Accessibility
Description	Possession of e-care plan with appropriate training A higher score is better
Rationale	Clinical documentation is required to validate actions occurred and provide patient care notes from one provider to another.
Logic Model	This measure ensures clinical documentation of patient encounters at the pharmacy. If it isn’t document, it didn’t happen. The E-Care Plan Accessibility measure creates the structure for future process, outcome, and patient-reported measures.
Level of Analysis	Pharmacy (Nominal and Structure)
Data Source	Survey
Denominator Statement	This measure is a structure-based measure evaluate a nominal endpoint. The denominator is the pharmacy.
Denominator Calculation	1. The pharmacy
Denominator Exclusions	No exclusions
Denominator Exclusion Rationale	N/A
Numerator Statement	Accessibility of e-care plan by all members of the pharmacy
Numerator Calculation	Nominal endpoint determined by survey results
Seguridad Measure Specification Process
Data Stratification	The measure rate will be reported as pharmacy. If available and feasible, measure rate will be reported by type of pharmacy (e.g., health-system, community, specialty, mail-order, long-term care). If available and feasible, measure rate will be reported by line of business (pharmacy Medicare rate, pharmacy Medicaid rate, pharmacy Commercial rate, and pharmacy uninsured rate). Risk adjustment will be applied when available.
Value Sets	No value set is required for the calculation of this measure.
Future Iterations	Many pharmacy measures are designed as structure or process. Future goals of this concept include evaluating the outcomes from E-Care Plan submissions, type of data within E-Care Plans, and other aspects of safety/quality.
Harmonization¹	Payors: N/A Providers: N/A

Chapter 4: Choose My Pharmacy® Measure Specifications

Point of Care Testing Structure

Title	Point of Care Testing Structure
Description	Possess of a CLIA-waiver in the pharmacy. A higher score is better
Rationale	Point-of-care testing (POCT) requires a CLIA-waiver. Pharmacies that offer point-of-care testing may be able to optimize care through patient monitoring (blood glucose, HbA1c, HIV, influenza, COVID-19, pharmacogenomics, lipids, and others).
Logic Model	This measure evaluates the pharmacy’s readiness to provide advance services and address gaps in care, healthcare accessibility, and monitoring.
Level of Analysis	Pharmacy (Nominal and Structure)
Data Source	Survey
Denominator Statement	This measure is a structure-based measure evaluate a nominal endpoint. The denominator is the pharmacy.
Denominator Calculation	1. The pharmacy
Denominator Exclusions	No exclusions
Denominator Exclusion Rationale	N/A
Numerator Statement	Possession of a CLIA-waiver at the pharmacy
Numerator Calculation	Nominal endpoint determined by survey results
Seguridad Measure Specification Process
Data Stratification	The measure rate will be reported as pharmacy. If available and feasible, measure rate will be reported by type of pharmacy (e.g., health-system, community, specialty, mail-order, long-term care). If available and feasible, measure rate will be reported by line of business (pharmacy Medicare rate, pharmacy Medicaid rate, pharmacy Commercial rate, and pharmacy uninsured rate). Risk adjustment will be applied when available.
Value Sets	No value set is required for the calculation of this measure.
Future Iterations	Many pharmacy measures are designed as structure or process. Future goals of this concept include evaluating the outcomes from CLIA-waived tests, the types of tests, patient-reported outcomes, and other aspects of the quality and safety of POCT.
Harmonization¹	Payors: Some payors are evaluated on collection of clinical data, like hemoglobin A1c. This measure will help pharmacies align with those measures. Providers: N/A

Chapter 4: Choose My Pharmacy® Measure Specifications

Employee Vaccination Rate

Title	Employee Vaccination Rate
Description	Percent of employees in a pharmacy that are vaccinated for influenza and COVID-19. A higher rate is better.
Rationale	Similar to health systems, pharmacies are frontline workers during pandemics. Ensuring pharmacies are not hot spots of disease will help prevent pandemics.
Logic Model	This measure evaluates the pharmacy’s role in public health and mitigated infectious diseases. As healthcare providers, pharmacy teams should be immunized as soon as possible to protect themselves, their families, and the public.
Level of Analysis	Pharmacy (Employee)
Data Source	Survey
Denominator Statement	Number of employees (full or part time) at the pharmacy during a measurement year
Denominator Calculation	1. 1. Number of part-time employees 2. 2. Number of full-time employees
Denominator Exclusions	Exclude any employee <18 years old; any employee that works ≤6 months.
Denominator Exclusion Rationale	Minors may need parental permission. All employees are encouraged to receive immunizations. Data show that to reach herd immunity (often defined as 70% immunized), individuals 17 years old and younger will need to be vaccinated. However, most pharmacies will not have ≥30% of staff ≤17 years old. Employees working ≤6 months may not be employed during the annual influenza immunization period.
Numerator Statement	Number of employees vaccinated with influenza and COVID-19 immunizations
Numerator Calculation	1. Count the number of individuals that have received the COVID-19 and influenza vaccines
Seguridad Measure Specification Process
Data Stratification	The measure rate will be reported as pharmacy. If available and feasible, measure rate will be reported by type of pharmacy (e.g., health-system, community, specialty, mail-order, long-term care). If available and feasible, measure rate will be reported by line of business (pharmacy Medicare rate, pharmacy Medicaid rate, pharmacy Commercial rate, and pharmacy uninsured rate). Risk adjustment will be applied when available.
Value Sets	No value set is required for the calculation of this measure.
Future Iterations	If other pandemics or required vaccines are authorized/approved, this measure would be updated.
Harmonization¹	Payors: N/A Providers: This measure is similar to the CMS Hospital Compare Employee Vaccination rate measure.

Chapter 4: Choose My Pharmacy® Measure Specifications

Advanced Pharmacy Technicians

Title	Advanced Pharmacy Technicians
Description	Percent of pharmacy technicians with advance training
Rationale	Pharmacy technicians are able to expand scope of practice through certifications and credentials. The elevated pharmacy technician provides higher quality care and allows the pharmacy staff to focus on non-dispensing clinical activities.
Logic Model	This measure evaluates the training and credentialing of a pharmacy technician. When pharmacy technicians are able to advance scope of practice, like product verification, pharmacists are able to advance their role towards medication optimization.
Level of Analysis	Pharmacy (Employee)
Data Source	Survey
Denominator Statement	Number of pharmacy technicians (full or part time) at the pharmacy during a measurement year
Denominator Calculation	1. 1. Number of part-time pharmacy technicians 2. 2. Number of full-time pharmacy technicians
Denominator Exclusions	Exclude any employee ≤17 years old, less than 6 months employment, or ≤1 year as a pharmacy technician
Denominator Exclusion Rationale	Minors may need parental permission, other technicians may not be eligible for technician exam
Numerator Statement	Number of pharmacy technicians with advance credentials and training
Numerator Calculation	• Count the number of individuals that have advanced training.
Seguridad Measure Specification Process
Data Stratification	The measure rate will be reported as pharmacy. If available and feasible, measure rate will be reported by type of pharmacy (e.g., health-system, community, specialty, mail-order, long-term care). If available and feasible, measure rate will be reported by line of business (pharmacy Medicare rate, pharmacy Medicaid rate, pharmacy Commercial rate, and pharmacy uninsured rate). Risk adjustment will be applied when available.
Value Sets	No value set is required for the calculation of this measure.
Future Iterations	As additional training programs and certificates are authorized for pharmacy technicians, the numerator will be updated.
Harmonization¹	Payors: N/A Providers: N/A

Chapter 4: Choose My Pharmacy® Measure Specifications

Improving Pain Management Safety

Title	Improving Pain Management Safety
Description	Percent of households where at least one individual is at risk for adverse opioid event, like overdose or respiratory depression, with naloxone available. A higher score is better
Rationale	Many individuals are at increased risk for adverse events associated with opioid use. Additionally, many states have implemented standing protocols for naloxone dispensing without prescription to patients or caregivers of patients at risk for adverse opioid events. This measure ensures, at a household level, naloxone is available to any patient.
Logic Model	This measure ensures any household at risk for adverse opioid events is evaluated and provided treatment.
Level of Analysis	Pharmacy (Patient)
Data Source	Pharmacy Data
Denominator Statement	Any household with a patient at risk for adverse opioid event defined as patients prescribed opioids and any of the following: · ≥50 morphine milligram equivalents per day · Concomitant use of sedating medications, like benzodiazepines
Denominator Calculation	1. 1. All individuals in the pharmacy 2. 2. All individuals prescribed an opioid 3. 3. All individuals with risk factor (≥50 MME or benzodiazepine) 4. 4. Exclude non-human patients 5. 5. Identify each unique household
Denominator Exclusions	Any non-human patients (e.g., cats, dogs, clinics, office-use, etc)
Denominator Exclusion Rationale	Pharmacies may provide care to pets or other veterinarian needs, or for office-use. This patient profiles should be excluded from the measure calculation.
Numerator Statement	Household from the denominator with a naloxone dispensed during the measurement year
Numerator Calculation	1. 1. Identify all naloxone prescriptions dispensed from the pharmacy 2. 2. Identify each household with a naloxone prescription 3. 3. Households that have a match in the denominator are in the numerator.
Seguridad Measure Specification Process
Data Stratification	The measure rate will be reported as a percent of patients within a single pharmacy. If available and feasible, measure rate will be reported by type of pharmacy (e.g., health-system, community, specialty, mail-order, long-term care). If available and feasible, measure rate will be reported by line of business (pharmacy Medicare rate, pharmacy Medicaid rate, pharmacy Commercial rate, and pharmacy uninsured rate). Risk adjustment will be applied when available.
Value Sets	The value set Seguridad – Opioids and Seguridad – Opioid Risk Medications will be used to support the exclusion criteria.
Future Iterations	Many pharmacy measures are designed as structure or process. Future goals of this concept include measures focused on appropriate dosing based on renal function and assessment of all patients.
Harmonization¹	Payors: PQA’s Opioid Measure Set Providers: PQA’s Opioid Measure Set

Chapter 4: Choose My Pharmacy® Measure Specifications

Improving Diabetes Safety

Title	Improving Diabetes Safety
Description	Percent of patients at risk for glycemia receiving bolus insulin receive glucagon. A higher score is better
Rationale	Many patients with diabetes are at risk for hypoglycemia, which can cause hospitalizations or death. Individuals using insulin, particularly meal-time, or bolus, are at increased risk for hypoglycemia.
Logic Model	This measure ensures patients at increased risk for hypoglycemia have appropriate treatment available.
Level of Analysis	Pharmacy (Patient)
Data Source	Pharmacy Data
Denominator Statement	Patient at risk for hypoglycemia due to bolus insulin use.
Denominator Calculation	1. 1. All individuals in the pharmacy 2. 2. All individuals prescribed a bolus insulin 3. 3. Exclude non-human patients.
Denominator Exclusions	Any non-human patients (e.g., cats, dogs, clinics, office-use, etc)
Denominator Exclusion Rationale	Pharmacies may provide care to pets or other veterinarian needs, or for office-use. This patient profiles should be excluded from the measure calculation.
Numerator Statement	Patients from the denominator with glucagon.
Numerator Calculation	1. Identify individuals from the denominator with a prescription for glucagon
Seguridad Measure Specification Process
Data Stratification	The measure rate will be reported as a percent of patients within a single pharmacy. If available and feasible, measure rate will be reported by type of pharmacy (e.g., health-system, community, specialty, mail-order, long-term care). If available and feasible, measure rate will be reported by line of business (pharmacy Medicare rate, pharmacy Medicaid rate, pharmacy Commercial rate, and pharmacy uninsured rate). Risk adjustment will be applied when available.
Value Sets	The value set Seguridad – Basal Insulin will be used to support the exclusion criteria.
Future Iterations	Many pharmacy measures are designed as structure or process. Future goals of this concept include measures will include other high-risk diabetes medications.
Harmonization¹	Payors: N/A Providers: N/A

Chapter 4: Choose My Pharmacy® Measure Specifications

Identifying Social Determinants of Health

Title	Identifying Social Determinants of Health
Description	Percent of patients in the pharmacy that have documented SDOH data elements. A higher score is better
Rationale	Pharmacies are often identifying and resolving social determinant of health barriers for patients. However, documentation is vital to showing progress on care. This measure evaluates if a pharmacy is collecting SDOH identifiers at the pharmacy. Once patients are identified, pharmacies will be able to make interventions and bill for these services.
Logic Model	This measure ensures pharmacies are documenting and collecting the data required for SDOH clinical services.
Level of Analysis	Pharmacy (Patient)
Data Source	Pharmacy Data
Denominator Statement	All patients within a pharmacy
Denominator Calculation	1. 1. Identify all prescriptions in a measurement year 2. 2. Identify all unique patients from the prescriptions 3. 3. Apply exclusions
Denominator Exclusions	Any non-human patients (e.g., cats, dogs, clinics, office-use, etc)
Denominator Exclusion Rationale	Pharmacies may provide care to pets or other veterinarian needs, or for office-use. This patient profiles should be excluded from the measure calculation.
Numerator Statement	Patients from the denominator with documented SDOH data elements, including: Insurance Status, Education level, Race, Ethnicity, Zip Code
Numerator Calculation	1. Identify individuals from the denominator with a documented SDOH data element (composite)
Seguridad Measure Specification Process
Data Stratification	The measure rate will be reported as a percent of patients within a single pharmacy. If available and feasible, measure rate will be reported by type of pharmacy (e.g., health-system, community, specialty, mail-order, long-term care). If available and feasible, measure rate will be reported by line of business (pharmacy Medicare rate, pharmacy Medicaid rate, pharmacy Commercial rate, and pharmacy uninsured rate). Risk adjustment will be applied when available.
Value Sets	No value set is required for this measure.
Future Iterations	Many pharmacy measures are designed as structure or process. Future goals of this measure will be to track additional SDOH data elements, like housing or food insecurity, for eventual Z-code billing and interventions.
Harmonization¹	Payors: N/A Providers: N/A

Chapter 5: Choose My Pharmacy® PMS Support

PioneerRx

Prescription Report

1. Go to the Rx tab

2. Select the binocular icon in the Data Entry section

3. In the Completed Between line, enter the date range

4. Press Search (F12) to generate the report

Once the report has been generated, create a new report design layout.

1. In the drop-down box next to View, select Expanded with Comments

2. Select the Field Chooser icon on the left side of the screen

3. Check the boxes of the data fields you want to report

PioneerRx

Date Filled

Days Supply

Dispensed Item Name

Dispensed Item NDC

Dispensed Item Strength

Dispensed Quantity

Origin

Patient Age

Patient Ethnicity

Patient Gender

Patient Paid Amount

Patient Primary Address

Patient Primary Zip Code

Patient Race

Patient Serial Number

Pharmacy NCPDP

Primary ICD10 Code

Primary ICD10 Code Description

Refill Number

Rx Number

Sig Code

4. Select the blue plus sign next to the View drop-down box

5. Name the layout

6. Press Search (F12) to regenerate the report with new data fields

Export the report to an excel file.

2. Choose Export to Excel

3. Name and save Excel document

Patient Weight & Allergy Report

1. Go to Patient tab

2. Select the binocular icon in the Patient section

3. In the Activity Between, enter the same date range used to generate the prescription report

4. Press Search (F12) to generate the report

Once the report has been generated, use the steps to create a new report design layout from above that includes Serial Number, Weight, and Patient Active Allergy List and regenerate the report.

Export, name, and save the report as an Excel document.

Patient Serum Creatinine Report

**If your pharmacy does not collect serum creatinine, there is no need to submit a report**

Create a patient category.

1. Go to the System tab

2. Select the Category icon

3. In the Category Scope drop-down box, select Patient

4. Press the green plus sign on the right side to create a new category

5. Provide a name and description for the category

6. Choose Auto in the Type drop-down

7. In box B (Any of These), press the green plus sign

8. Choose Any Lab Greater Than as a filter

9. Choose Comprehensive Metabolic Panel – Creatinine, Serum (SCr) as the lab

E. Enter 0 in the Greater Than box

P. Press Save (F12)

1.. Make sure the status of the category is active and press Save (F12)

You must process the category for it to immediately work, or it will not become active until the next day.

.1. Select the Actions drop in the top right

2. Choose Process Category Auto Filter Rules and follow the prompts

Use the patient category to generate a patient report

... Go to Patient tab

2. Select the binocular icon in the Patient section

3. In the Activity Between line, enter the same date range used to generate the prescription report

4. From the Category drop-down, select the patient category.

5. Press Search (F12)

This will generate a report of all the patients in your system with a SCr value on file. Choose or create a layout that includes the Serial Number. Export the report to an Excel document.

Chapter 5: Choose My Pharmacy® PMS Support

ComputerRx

1. Create a view for your data.

a) You’ll first want to create a “view” including all of the data-points you want, and none of the data-points you don’t want. Run a very limited dispense report (like filled today) by navigating to Reports>Dispensing Report>Detailed Dispensing.

i. ComputerRx will pull up your dispense report with your default view.

ii. In the top right of the screen, Press the blue + sign next to the view dropdown to create a new “view” - name it something like “Seguridad”

iii. Customize the view to match the data request, generally as follows:

1. Include columns (these are the specific data element names in ComputerRx):

Patient Record (please be sure you are selecting Patient Record and not Patient ID, as they are different)
Date
Drug
NDC
Patient Age
Diag. Code 1
Rx Origin
Day Supply
Quan.
Sig
Patient Address
Patient Zip
Sex
Race
Ethnicity

2. Additional data elements that may not be available for download. Please find the closest match if possible:

1. Patient Allergies

2. Patient Serum Creatinine

3. Species

4. Patient Weight

5. ICD-10 Description

3. You may need a few more or a few less columns depending on the specific data request.

iv. Save the “view” as you have it set by clicking the Save button (floppy disk).

2. Pull the data requested

a) Put in filters for the specific request. For example:

i. In Start Date, put 1/1/2021, and End Date put 3/30/2021. (Quarterly results aid in data pull)

ii. The report will build (it may take some time).

b) Once the report has loaded and been filtered, press export at the bottom middle left of the screen to generate an excel file.

c) Name the excel appropriately per the work order, for example “Seguridad NABP DATE”.

Chapter 5: Choose My Pharmacy® PMS Support

Liberty

Generating Reports for Liberty

Select “Reporting” on the top
Select “Rx Data”
Right Click Top Row on the pop up box
Select "Column Chooser”
Add requested Seguridad Data Elements

Customer ID
Date Dispensed
Drug Name
Drug NDC
Customer Age
ICD Code
ICD10 Description
Origin Code
Customer Allergies
Customer Weight
Customer SrCr
Day Supply
Qty
Sigs
Customer Address
Customer Zip
Customer Species
Customer Gender
Customer Race
Customer Ethnicity

Use ‘Advance’ to update the time range
Save As Excel on Desktop

Chapter 5: Choose My Pharmacy® PMS Support

Rx30

General Field Name	Rx30 Field Name
Date Dispensed	FILLDATE
Patient Date of Birth	PATDOB
Directions	DIRECTION 1
Directions	DIRECTION 2
Directions	DIRECTION 3
Directions	DIRECTION 4
Directions	DIRECTION 5
Gender	GENDER
Patient Address/Household	PATADD1
Patient Address/Household	PATADD2
Insurance Status	PAYTYPE
Medication Days Supply	DS
Medication Indication ICD10	RXDIAG 1
Medication Name	DRUG NAME
Medication Origin	RXORIGIN
NDC	NDC
Patient ID	PATKEY
Prescription Number	RXNBR
Quantity Dispensed	QTY DSP
Patient Zip Code	PATZIP

Chapter 5: Choose My Pharmacy® PMS Support

QS/1

QS/1 support is currently unavailable at this time. Please submit your data as best you can using the following generic terms to guide you. Depending on the pharmacy management system, reports may be a single file with all data elements or may be multiple files. Please generate your Seguridad Data Reports from the pharmacy management system and submit the data as xls, xlsx, or csv.

De-identified Patient ID (patient serial number, customer ID, patient record)
Date Dispensed
Drug Name
Drug NDC
Customer Age (patient age)
ICD-10 Code
ICD-10 Description
Origin Code (prescription origin status, walk-in, electronic, telephone)
Patient Allergies
Patient Weight
Patient Serum Creatinine
Days Supply
Quantity Dispensed
Sig/Directions
Patient Address
Patient Zip Code
Patient Species (Human, Cat, Dog)
Gender
Race (White, Black, Asian, etc)
Ethnicity (Hispanic, Non-hispanic)

If you are unable to pull a specific data field - that is ok. Some pharmacy management systems do not report or save all data elements. Pharmacy performance may be lower in some measures, but Seguridad will work with the pharmacy management system to make this a reportable data element in the future.

Once you have submitted your data, please reach out to support@choosemypharmacy.com stating your pharmacy's NCPDP number and which PMS you submitted data from. A member of our team will reach back out to your with further information.

Chapter 5: Choose My Pharmacy® PMS Support

MicroMerchant

MicroMerchant support is currently unavailable at this time. Please submit your data as best you can using the following generic terms to guide you. Depending on the pharmacy management system, reports may be a single file with all data elements or may be multiple files. Please generate your Seguridad Data Reports from the pharmacy management system and submit the data as xls, xlsx, or csv.

De-identified Patient ID (patient serial number, customer ID, patient record)
Date Dispensed
Drug Name
Drug NDC
Customer Age (patient age)
ICD-10 Code
ICD-10 Description
Origin Code (prescription origin status, walk-in, electronic, telephone)
Patient Allergies
Patient Weight
Patient Serum Creatinine
Days Supply
Quantity Dispensed
Sig/Directions
Patient Address
Patient Zip Code
Patient Species (Human, Cat, Dog)
Gender
Race (White, Black, Asian, etc)
Ethnicity (Hispanic, Non-hispanic)

Chapter 5: Choose My Pharmacy® PMS Support

BestRx

BestRx support is currently unavailable at this time. Please submit your data as best you can using the following generic terms to guide you. Depending on the pharmacy management system, reports may be a single file with all data elements or may be multiple files. Please generate your Seguridad Data Reports from the pharmacy management system and submit the data as xls, xlsx, or csv.

De-identified Patient ID (patient serial number, customer ID, patient record)
Date Dispensed
Drug Name
Drug NDC
Customer Age (patient age)
ICD-10 Code
ICD-10 Description
Origin Code (prescription origin status, walk-in, electronic, telephone)
Patient Allergies
Patient Weight
Patient Serum Creatinine
Days Supply
Quantity Dispensed
Sig/Directions
Patient Address
Patient Zip Code
Patient Species (Human, Cat, Dog)
Gender
Race (White, Black, Asian, etc)
Ethnicity (Hispanic, Non-hispanic)

Chapter 5: Choose My Pharmacy® PMS Support

FSI Foundation Systems

FSI Foundation Systems support is currently unavailable at this time. Please submit your data as best you can using the following generic terms to guide you. Depending on the pharmacy management system, reports may be a single file with all data elements or may be multiple files. Please generate your Seguridad Data Reports from the pharmacy management system and submit the data as xls, xlsx, or csv.

De-identified Patient ID (patient serial number, customer ID, patient record)
Date Dispensed
Drug Name
Drug NDC
Customer Age (patient age)
ICD-10 Code
ICD-10 Description
Origin Code (prescription origin status, walk-in, electronic, telephone)
Patient Allergies
Patient Weight
Patient Serum Creatinine
Days Supply
Quantity Dispensed
Sig/Directions
Patient Address
Patient Zip Code
Patient Species (Human, Cat, Dog)
Gender
Race (White, Black, Asian, etc)
Ethnicity (Hispanic, Non-hispanic)

Chapter 6: Choose My Pharmacy® Report Card FAQs

I submitted my data! When can I expect my report card?

Approximately six weeks after the quarterly data request emails are sent out (these are sent on the 1st of the month or first business day at the start of a new quarter). The time between the email being sent out and you receiving your report is spent gathering data from as many of our participating pharmacies as possible as well as engaging in quality assurance to make sure the data is accurate.

I am going through the onboarding process and submitted my data but never received my Employee Survey. What happen?

This likely means there was an issue with processing your data submission. If someone from our support team has not reached out to you already, please email support@choosemypharmacy.com and include your pharmacy's NCPDP.

I have a measure rating that says N/A. How can I fix this to 'meet the requirements'?

N/A, or not applicable, means that the data provided does not allow for a denominator to be calculated for the specified measure. The reasoning can vary from measure to measure. For example, if a pharmacy does not have any patients <18 years old, the Assessment of Weights in Pediatrics score would be N/A.

My entire report card has N/D listed for all measures. What does this mean?

This means there was most likely an issue with processing your data submission. Be it missing required fields or a formatting error or a technical bug on our end. Please email support@choosemypharmacy.com with your pharmacy's NCPDP and our team will be able to identify the error and possibly have you resubmit data to resolve the issue.

How are each of these metrics measured? How do I go about improving my score?

For a detailed explanation of how we calculate our metrics, click to view our Measure Specifications Guide. We have also provided a chart below that shows which collected data points go into the calculation of each measure.

My overall score in my report card is blank. Why is it missing?

Given that our company is still in the early stages of collecting and analyzing data from all of our participating pharmacies, it is difficult to calculate a grade that accurately reflects overall performance at this time. As we gather more data and are able to compare it to previous quarters, we will be able to create an accurate system for calculating grades. Until such a time, we have decided to leave the overall scores blank to avoid confusion.

My rating for Known Allergy Status seems unusually low even though we ask our customers for any allergies. What is causing this?

The numerator for the measure is calculated by the documentation of any allergies OR no known allergies. Leaving the field blank rather than recording it as "no known allergies" negatively impacts the pharmacy's score. We recommend filling out the allergy status field every time to improve this measure rating.

Why is Employee Vaccination Rate is reading N/A even though our pharmacy completed the employee surveys?

As of right now, our engineering team is working through a bug in the calculation that provides an accurate rating for this measurement.