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Chronic Disease Management
Chronic Disease Management
Helping you utilize the dashboard for CCM and how you can use this to help your clinic and identify CCM in patients.
Updated over a week ago

To load a patient profile, you need to click on the Patient table and click on the analytics eye:

If you do not have the eye, you must request this from your system administrator. 

Once the eye is clicked, it will bring up a dashboard with many different insights.

Total Unsigned Encounters:
This is the total encounters unsigned created by the provider or from the providers schedule. If you click on the number it will display a list of all unsigned encounters. You can navigate to the

Unsigned Encounters:
This lists different details on the total unsigned encounters. Each column can be sorted by clicking the column header.

Within this view, you can also go directly to the Patients Chart by clicking the three little dots next to the value either the Patient Link or Visit Link column.

Enrolled Patients:
This displays the number of patients that are enrolled with the Primary Practitioner or the provider. . If you click on this it will display a list of all the patients. 

1 CCM Problem:
Patients with one CCM problem (HTN, DM, CAD,CHF, Asthma, COPD).
2 CCM Problems:  
Patients with two CCM problems.
3 CCM Problems:
Patients with three or more CCM problems. 

Missing Enrollment Date:
Patients enrolled missing an enrollment date.

Not Enrolled and Seen in the Last Year:
This is the number of patients seen within the last year that have the provider as the Primary Practitioner and are not enrolled. 

Enrolled Deceased:
The number of patients that are enrolled and deceased. These patients should be de-enrolled. 

Possible Hypertension, Diabetes, CAD, CHF, Asthma, and COPD:
This shows the number of patients seen within the last year with a billing code for a chronic disease. Providers should review these patients and add Active Problems. If you click on the number it will bring up the list of patients. You should review each patient starting from the top to the bottom. 

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