IHS Diabetic Audit Report (IDA)


IHS Diabetic Audit Report (IDA)

The IDA (IHS Diabetic Audit) Report extracts audit data from the NextGen Healthcare database to assess diabetes care and health outcomes for American Indians and Alaskan Natives with diagnosed diabetes.

The IHS Diabetic Audit Report for CY2023 Reporting is now available for download.


The Product User Guide helps to explain the purpose of the utility and how to use it successfully. The user guide can be found by clicking on the Resources / Training tab on this webpage.

To purchase IHS Diabetes Care and Outcome Report, please submit a NextGen Healthcare Success Community request and we will provide a quote.

If you have purchased IHS Diabetic Audit Report and have not received a license key, please submit a NextGen Healthcare Success Community request and we will provide a license key as soon as possible.

To download and install the latest version on your machine, first uninstall any previous version of the DART application then click the INSTALL link below to download.

Download Latest Version:  v10.5 SP1
v10.5 SP1
March 28, 2024
Team R&D
10.5 SP1
March 28, 2024
  • Bugfix: The measure eGFR was updated with missing LOINC codes
March 5, 2024
  • Updates for CY2023 Specification
  • Over 25+ updated features, defects resolved, and enhancements!
10.4 SP3
June 20, 2023
  • Version details to come.
10.4 SP2
March 16, 2023
  • Bugfix: An exception could occur while IDA generates report data. The bug was occurring in a private method of a class responsible for loading IDA result data into a collection, run some data cleanup and analysis on it, then return the data back to the visible data grid. The private method was not handling null values in a context where nulls were very likely.
  • Bugfix: The measure eGFR was not capturing on the visible grid.
  • Bugfix: While generating report data, an eGFR lab result value that exceeded 30 characters would cause an exception which would not allow IDA to complete its data collection process.
  • Bugfix: The interaction between the "Generate", "View", "Clear", "Export" command buttons and the grid filtering checkboxes (Output, Warning, Error) were not behaving according to specification and needed some adjustment.
10.4 SP1
March 1, 2023
  • Update: Added configuration for tracking registered dieticians for reporting purposes.
  • Update: Added additional logic for detecting nutrition education to align with IHS's requirement for this measure (2022 Diabetes Audit User Addendum Section A.28)
  • Update: A1C Lab results: IHS does not accept non numeric values for this measure. Stripping off all '<' and '>' symbols where they appear on the left side of the lab value. All other text values found within the result field for this measure will be removed from the report data.
  • Update: The SQL tables used by IDA to reference nutrition education have been exposed allowing a user to add custom education items.
  • Update: The measure value for TBScreen = 2 (Neg) requires a TB screen test date. In some instances, IDA was allowing the value of 2 to be assigned without the presence of a TB test / result date. This has been corrected.
  • Update: The measure TBTESTDATE IDA in some instances was utilizing a TB screening that occurred after the reporting end date. These screenings for reporting purposes must be filtered by the reporting end date with the latest screening being used for the measure. This is now occurring as expected.
February 2, 2023
  • Updates for CY2022 Specification
  • Over 40+ updated features, defects resolved, and enhancements!
February 4, 2022
  • Updates for CY2021 Specification
  • Added ICD check for CVD detection
  • Numerous issues, defects, UI changes, and updates
March 2, 2021
  • Updates to specification of current year vs previous year
August 7, 2020
  • Updates to LOINC codes for eFGR
  • Updates for DM patient list eligible location and eligible encounter
  • Updates to specification of current year vs previous year
  • Updates for hepatitis b series complete
  • Updates for nutritional information
  • Updates to allow documentation of diabetes, educational, nutritional education by staff other than providers only as long as rendering is specified.
  • Corrections to foot exam reporting to only report if Monofilament exam and one of either Dorsalis or Posterior exam is done. Previous reporting only considered All Normal checkbox.
  • New version number scheme to align with our software release process.
  • Updates to licensing
December 13, 2019
  • Corrected an error that prevented all American Indian/Alaska Natives with DM from always showing in the cohort list. This made it impossible to remove persons who are now ineligible, and prevented it from showing newly eligible persons in the cohort list.
July 25, 2019
  • Metformin was only being detected if METFORMIN was being prescribed. However, Metformin is a component of MANY other medications also prescribed for diabetic patients. The RxNorm codes that detect Metformin have been updated to include all brand names, all product combinations, and all common forms and doses. This should give more accurate Metformin statistics in the future.
  • The RxNorm codes for Insulin have been updated to recognize more forms of the medication. This should improve detection of Insulin medications amongst Report Populations.
  • eGFR LOINC codes have been adjusted to exclude estimated values for African American persons, and estimates specifically for MALE or FEMALE readings. IHS is only interested in the basic value, and does not want the value corrected for gender or race.
July 24, 2019
  • TB Testing: A list of medical codes that detect a TB Screening were being interpreted as if they indicated a positive TB Test results. This has been corrected. It is recommended that the TB Statistics be tested by users before being accepted.
  • The list of medical codes indicating eGFR included some invalid LOINC values. This has been corrected. In addition, items indicating eGFR measurements for African-American individuals have been removed from the LOINC list for eGFR, since IDA only looks for tests from Native American and Alaska Native persons, not African-American persons.
July 16, 2019
  • SNOMED Codes related to TB Skin Test added
  • Additional index on Social History to improve performance
  • Identified code lists that aren't being used. Will remove in a future version of IDA.
  • Modified acceptable list of LOINC codes for identifying Lab Component values for UACR. IDA was using value for [Albumin] as if it were [Albumin/Creatinine] (i.e. a Ratio value). IDA no longer identifies 14957-5 and 2161-8 for UACR use.
  • TB Screening required significant correction. The IHS Diabetic WebAudit data is checking for TB SCREENINGS that have ever occurred. IDA reports a current TB Diagnosis as a screening as of the date of diagnosis. In all other respects, IDA only checks for Skin (PPD) or Blood (QFT-GIT or T-SPOT) screening results. It now checks for TB Screening events using ICD, CPT, LOINC, and SNOMED codes. It now checks KBM Tuberculin Skin Test, Completed events from ORDERS, Events from Patient Diagnosis, and results from Lab Components.
  • ICD Codes for detecting TB Skin Test events changed to detect ICD-10 codes (in addition to ICD-9, which should be discontinued now)
  • Cohort Definition: If a new patient appears in the database after the cohort for the current year is defined, IDA would not show the new patient, meaning they could not be added to the cohort. A fix has been attempted for this.
  • An additional technique has been added to identify Eye Exams using the Clinical Guidelines panel.
  • A new staging table was created to collect results from other staging tables related to TB Skin and Blood screening events. Makes it easy to determine the most recent screening, the type of screen (blood or skin), and the result.
  • IDA used to present TB Screen information using four fields: [TB Skin Test], [TB Blood Test], [TB Result], [TB Test Date]. It now combines some information to present only two fields: [TB Screen] (Skin or Blood, and the date of the most recent exam), and [TB Test Result] (POS or NEG).
  • The KBM Tuberculin Skin Test panel for EHR 5.8/8.3 and earlier has a bug that erases the diagnosis (POS or NEG) when entering values in the DETAILS text field. IDA now uses Patient Age and HIV Status to auto-determine POS or NEG for all TB Skin Test readings, to overcome the bug in v5.8/8.3 KBM.
  • IDA can use the ORDERS panel for EHR 5.8/8.3 can be used to identify TB Skin Test Diagnosis information, even though the location of relevant information has changed over the different EHR versions. IDA now uses Patient Age and HIV Status to auto-determine POS or NEG for all TB Skin Test readings from ORDERS, when readings make this possible.
  • The KBM Tuberculin Skin Test panel has changed over the EHR versions. Test results exist in multiple fields depending on version year. IDA is now able to read the data from all these fields, extract the meaning, and make a determination for test results.
July 1, 2019
  • Updated list of CPT codes involved in detecting DENTAL EXAM. Previously accepted CPT codes D0120, D0150. Now accepts CPT codes D0120, D0140, D0145, D0150, D0160, D0180, D0191, D0190, D0191.
June 21, 2019
  • An error in the build process prevented script changes from being added to the build. This has been corrected.
June 19, 2019
  • Lab Results for eGFR now accept the following LOINC codes (in addition to all previous codes): 88294-4, 88293-6, 2160-0
  • When collecting Patient data from PATIENT_DIAGNOSIS using CPT codes, a Patient with DM Type 2 was being collected and reported as having DM Type 1. This has been corrected.
  • If VAPING SCREENING has been completed, but no VAPING STATUS occurs, the VAPING STATUS will be set to 3 - NOT DOCUMENTED.
June 13, 2019
  • Dental Exam, Eye Exam, and Foot Exam now include records from PATIENT_PROCEDURE, using specific CPT codes.
  • Bug in final script preventing application from working correctly. Fixed.
June 7, 2019
  • Diabetes Education: Included a KBM Document (Diabetes Self Management Education) in the list of documents indicating Diabetes Education
  • UACR was allowing LOINC codes 14957-5 (Albumin) and 2161-8 (Creatinine) to count as if they were Microalbumin/Creatinine Ratio Panel. This is incorrect and has been fixed.
  • Amputations were not including "History of Amputation of Lesser Toe". Added ICD and SNOMED code to the appropriate lists to start capturing this data.
  • Pneumococcal Vaccine: IHS wants to know if it was EVER GIVEN, while IDA was only including the data if given during the REPORT PERIOD. Fixed.
May 28, 2019
  • Minor changes to queries to improve join speed. Medications joining on GCN_NUMBER to be more correct.
April 4, 2019
  • Changed query timeout to 20 minutes per command. Was set to 2 by default.
  • Changed code to show more of the error information when exceptions occur. Meant to help in troubleshooting unknown errors on some systems.
  • Updated SQL Scripts so that IDA LIST tables are deleted once every day (the first time the script runs on that day), and when the product is upgraded. This makes sure that changes to List Data takes effect during the product upgrade that introduces the change, and at least once per day.
April 4, 2019
  • Spelling error in a script causing failure. Fixed.
April 3, 2019
  • IDA was incorrectly requiring HEIGHT to be taken during the Reporting Period, though the report only expects the last ever recorded value. Fixed. Metformin codes were incorrect and have been adjusted.
April 3, 2019
  • The DIABETIC FOOT EXAM update code was removed by accident. It has been restored, meaning Foot Exam data will now be correct.
April 2, 2019
  • Key medications were being tested to see if they were being used AT ANY POINT in the Report Period. IHS indicated that the patient must STILL BE USING a prescribed medication through the end of the report period. Affected checks for INSULIN, METFORMIN, SULFONYLUREA, DPP4 INHIBITOR, INJECTABLE GLP-1, SGLT2 INHIBITOR, PIOGLITAZONE, ACARBOSE, REPAGLINIDE, AMYLIN, BROMOCRYPTINE, COLESEVELAM, ACE INHIBITOR, ASPIRIN, and STATINS.
  • EYE EXAM: Was counting eye exams labeled "EYE EXAM", but not exams labeled "DILATED EYE EXAM". Fixed.
  • DEPRESSION DIAGNOSIS: Was missing the diagnosis entirely thanks to an invalid NULL check on a date. Fixed.
  • eGFR: Some Lab services return a numeric value for eGFR, and some return a text string indicating the range. One client has results of ">60" instead of a number. IDA has been changed to ignore invalid values for eGFR, and to attempt to calculate it using Age, Sex, and Serum Creatinine (if available). Fixed.
  • Most Recent Eligible Location: IDA attempts to find the most recent visit to an Eligible Location. It was not properly excluding invalid records, which caused some persons to be incorrectly excluded if the last Location they had an Encounter was an ineligible location (according to IHS). This has been fixed.
April 1, 2019
  • Added an additional code to the list of Eligible Provider Specialties to include DIETICIAN (29) along with NUTRITIONIST (07) and TRIBAL/CONTRACT NUTRITIONIST (34).
March 29, 2019
  • IDA was not including enough codes to recognize "Registered Dietician" and "Registered Nutritionist". Fixed.
March 28, 2019
  • Fixed default values for when there is no data were incorrect for: Hep B Vaccine, Hep C Diagnosis, Depression Screening, Tobacco Counseling. Also: It is possible for a patient to have a Hep C Diagnosis, but no screening records in EHR (because they were done long ago for example). IDA now automatically sets Hep C Screen to TRUE if a HEP C Diagnosis is found.
March 27, 2019
  • Fixed calculation errors for EGFR that was preventing report from calculating fully.
  • Fixed calculation and output errors for TB Test Result indicator, Tobacco Screening, Tobacco Counseling, and Weight.
March 26, 2019
  • Certain data fields were being stored in the temp tables in the wrong format, preventing them from being read and from appearing in the final IHS Diabetic WebAudit file. This included AGE, EGFRVALUE, and CREATVALUE. This has been fixed.
March 25, 2019
  • An issue was preventing the IHS Diabetic WebAudit file from generating. Fixed.
  • Export to Excel CSV now works
March 23, 2019
  • DM Report Data computed with REFRESH is now persisted across sessions. Choosing a YEAR will automatically load the saved data about each Person in the list, and remember the User's INCLUDE or EXCLUDE setting for each one.
  • Selecting the YEAR will automatically load the information that was SAVED for persons in that year. If there is no saved data, a message is shown indicating that the user needs to click REFRESH to make the IDA check all Users again and build data to be saved.
  • When creating the DM List for a new report year, IDA will use the patient selections from the previous report year's DM List in the new DM list by default when choosing REFRESH. This is intended to save time when choosing the DM List members of the new Report Year, assuming they are similar to the previous year's selections.
  • Saving the DM Patient List will clear all generated Report Data, forcing the User to click GENERATE when they make changes.
  • The year specified in the Ending Date controls which DM Patient List is used when reporting.
  • The IDA will only generate report results for Patients that have been "included" on the DM Patient List.
  • The DM Patient List shows all Native American/Alaska Native persons with a DM diagnosis. The User can then choose which ones to include or exclude from reporting during the year.
March 20, 2019
  • IDA now allows the User to create a COHORT for a given reporting year. This makes sure IDA will report on the same persons throughout the reporting period.
March 11, 2019
  • Supports file export in the correct format for 2019 WebAudit. The application is stable. The SQL queries work, but it is unclear if they are completely accurate. Testing is ongoing.
January 24, 2019
  • Initial Release of IDA 2019.124 (released January 24, 2019)
May 2, 2018
  • Included 2018 headers.
March 6, 2018
  • Export by ASUFAC or all locations
February 22, 2018
  • Improved foot exam results
February 16, 2018
  • Updated foot exam support
February 13, 2018
  • Added support for CPT4 cod 2022f from patient procedures.
February 8, 2018
  • Added wider support race support.
February 7, 2018
  • Race ID filtering resolved.
January 29, 2018
  • Added support for 2018 reporting deadline. Improved race filter. Added option to color code columns for easier viewing.
January 16, 2018
  • Corrected filter update issue.
January 12, 2018
  • Removed unused code.
January 11, 2018
  • Updated export DM group by location to work with previous version.
January 10, 2018
  • Supports default ASUFAC and ASUFACs by location.
January 4, 2018
  • Included documents in the help menu.
December 13, 2017
  • UI improvements.
  • Performance improvements.
  • Include missing patients.
May 23, 2017
  • Updated Depression screening to check the chk data present indicator for the depression short form
April 25, 2017
  • Update to some measures for current version
February 9, 2017
  • Update to the appearance of audit form
February 8, 2017
  • Visual update to audit form
February 3, 2017
  • Correct form in application
January 31, 2017
  • Update to 2017 Audit

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