Atopic Dermatitis Data Collection

Please complete the data collection form below by the 5th of each month for the previous month. Include:

  • Patients with eczema as a chief compliant/previous diagnosis
  • At least 10 charts per month or all patients with eczema as a chief compliant/previous diagnosis seen in that month, whichever is smaller, per physician seeking MOC credit
    • For example: 2 physicians, 20 charts

Resources to assist in your implementation of the project:

If you have questions or comments on this data collection tool or your practice data, please contact Hayley Southworth at hsouthworth@ohioaap.org.

Atopic Dermatitis Data Collection Form
Was this the first quality of life screening documented for this patient?
Was there a change in the quality of life screening results for this patient compared to previous screenings?