Leave this window open while you follow the steps below and maneuver through the ASH portion of the Myelodysplastic Syndromes (MDS) Practice Improvement Module(PIM).

1) Review Measures for MDS

The ASH Pay for Performance Task Force has developed a list of eight measures for MDS that will be the focus of this PIM. This list is not meant to be all inclusive, but rather identifies specific areas in practice that the Task Force has selected to focus on. By way of the chart abstraction tool, your compliance with these eight measures will be tested. Please print and review these measures.

2) Select Your Patient Sample

Patients can be included in this module if:

• They have been seen by the practice within the past 12 months; and
• Management decisions regarding care are made primarily by providers in the practice.

Select 10 of your MDS patients for review based on the following:

238.72	Include	Low grade myelodysplastic syndrome lesions Refractory anemia (RA) Refractory anemia with excess blasts-1 (RAEB-1) Refractory anemia with ringed sideroblasts (RARS) Refractory cytopenia with multilineage dysplasia (RCMD) Refractory cytopenia with multilineage dysplasia and ringed sideroblasts (RCMD-RS)
238.73	Include	High grade myelodysplastic syndrome lesions Refractory anemia with excess blasts-2 (RAEB-2) High grade myelodysplastic syndrome with 5q deletion
238.74	Include	Myelodysplastic syndrome with 5q deletion 5q minus syndrome NOS
238.75	Include	Myelodysplastic syndrome, unspecified
238.71	Exclude	Essential thrombocythemia Essential hemorrhagic thrombocythemia Essential thrombocytosis Idiopathic (hemorrhagic) thrombocythemia Primary thrombocytosis
238.76	Exclude	Myelofibrosis with myeloid metaplasia Agnogenic myeloid metaplasia Idiopathic myelofibrosis (chronic) Myelosclerosis with myeloid metaplasia Primary myelofibrosis
238.77	Exclude	Post-transplant lymphoproliferative disorder (PTLD)
238.79	Exclude	Other lymphatic and hematopoietic tissues Lymphoproliferative disease (chronic) NOS Megakaryocytic myelosclerosis Myeloproliferative disease (chronic) NOS Panmyelosis (acute)
284.2	Exclude	Myelophthisis Leukoerythroblastic anemia Myelophthisic anemia
289.83	Exclude	Myelofibrosis NOS Secondary myelofibrosis
758.39	Exclude	Constitutional 5q deletion

3) Begin the MDS PIM

Use the chart abstraction tool to evaluate your patient cases.

4) Add Another Patient

Return to the chart abstraction tool to add chart information on another patient. You must enter information for a total of 10 patients before obtaining your personal results report.

5) Obtain Your Personal Results Report

After you have entered data for 10 patients, follow the instructions below to obtain your personal results report.

1. Visit the View Summarypage. This page includes compiled data for allMyelodysplactic Syndromes PIM users.
2. Click the Filter Responses button on the top right of the page.
3. Check the Filter by Responses box on the top left of the page.
4. Click the New Response Filter button.

5. Click the pull down after 1. Show responses of people who answered question and select Your pseudonym (unique identifier).

6. In the box that follows "with text," enter your name exactly as you entered it in the Your pseudonym question.
7. Select all words from the adjacent drop down box.
8. Click the SaveChanges button (top right of report). This will filter out all but your results for viewing.
9. You will now be able to view your personal results. Print the final report.

If you wish to change the "Your pseudonym" identifier, or if you were interrupted while completing the survey and need to eliminate incomplete responses,send your request to cme@hematology.org.

6) Enter Performance Data

When you have obtained your personal results report and are ready to proceed, return to the ABIM Website (http://www.abim.org) and log in using your candidate number or social security number and password to access the ABIM Self-Directed PIM*. You will be asked to choose a single measure from your personal results and to develop an action plan to improve performance for your selected measure.

Please note that a sample size of 10 or more is required for Part IV credit - do not select a measure for your improvement plan if you reported on fewer than 10 patients for that measure.

*Only board-certified physicians enrolled in ABIM's Maintenance of Certification (MOC) program will be able to access and complete the ABIM Self-Directed HCT PIM. If you would like more information about becoming board certified in or enrolling in the MOC program, please visit the ABIM Website.

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