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Reviewing our results, we realized that lab values that return with a non-numeric value like "see comment" are captured as "missing" by the measure. The comments are either because the specimen was hemolyzed or clotted. However, a new specimen is collected within the measure's acceptable timeframe and resulted with an actual quantity value. My question is, why if a new specimen is collected and has a quantity value within the allowed timeframe, the measure logic is not allowing for those values to be used? I recently sent a comment via Qnet and below is their answer. However, unless there are changes made to the logic our EHR vendor could not make the changes to bypass the non-numeric value and use the first quantity result available within the timeframe so this issue will continue.
"Your case, CS1954444, has been marked as resolved.
Please view the close notes below before clicking the corresponding option at the bottom of this page to confirm or reject your case resolution.
Case Status: Resolved
Short Description: HWR - hemolyzed lab
Close notes: Hello, and thank you for your question. Please accept our apology for the delayed response.
To confirm: yes, if data from the original capture of the laboratory test CCDE values are not available to your hospital (e.g., due to results being hemolyzed) your hospital should submit the first available lab results collected within the appropriate time frames at your hospital (24 hours before the inpatient admission to 24 hours after the start of the inpatient admission).
We appreciate the opportunity to assist you.
Thank you,
QualityNet Service Center"
Second Qnet question sent:
"The resolution for your case, CS2008094, has been approved and the case is now closed. Please review the details below for more information about this case.
Case Status: Closed
Program: QualityNet Q&A
Topic: Hybrid Measures
Subject: Hybrid readmission - lab value/hemolyzed
Question Submitted:
I wanted to follow up as I have not received an answer regarding ticket CS1954444. I appreciate your help.
Description: If the first lab value drawn comes back as “hemolyzed” – should the next available actual lab value be captured if is within the specified timeframe?
Example:
Admission time 06:30
First Potassium at 07:00 – “hemolyzed”
Second Potassium at 08:05 – resulted at 4.0
Resolution:
Hello, and thank you for your question. Please accept our apology for the delayed response.
To confirm: yes, if data from the original capture of the laboratory test CCDE values are not available to your hospital (e.g., due to results being hemolyzed) your hospital should submit the first available lab results collected within the appropriate time frames at your hospital (24 hours before the inpatient admission to 24 hours after the start of the inpatient admission)"
Thank you!
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Reviewing our results, we realized that lab values that return with a non-numeric value like "see comment" are captured as "missing" by the measure. The comments are either because the specimen was hemolyzed or clotted. However, a new specimen is collected within the measure's acceptable timeframe and resulted with an actual quantity value. My question is, why if a new specimen is collected and has a quantity value within the allowed timeframe, the measure logic is not allowing for those values to be used? I recently sent a comment via Qnet and below is their answer. However, unless there are changes made to the logic our EHR vendor could not make the changes to bypass the non-numeric value and use the first quantity result available within the timeframe so this issue will continue.
"Your case, CS1954444, has been marked as resolved.
Please view the close notes below before clicking the corresponding option at the bottom of this page to confirm or reject your case resolution.
Case Status: Resolved
Short Description: HWR - hemolyzed lab
Close notes: Hello, and thank you for your question. Please accept our apology for the delayed response.
To confirm: yes, if data from the original capture of the laboratory test CCDE values are not available to your hospital (e.g., due to results being hemolyzed) your hospital should submit the first available lab results collected within the appropriate time frames at your hospital (24 hours before the inpatient admission to 24 hours after the start of the inpatient admission).
We appreciate the opportunity to assist you.
Thank you,
QualityNet Service Center"
Second Qnet question sent:
"The resolution for your case, CS2008094, has been approved and the case is now closed. Please review the details below for more information about this case.
Case Status: Closed
Program: QualityNet Q&A
Topic: Hybrid Measures
Subject: Hybrid readmission - lab value/hemolyzed
Question Submitted:
I wanted to follow up as I have not received an answer regarding ticket CS1954444. I appreciate your help.
Description: If the first lab value drawn comes back as “hemolyzed” – should the next available actual lab value be captured if is within the specified timeframe?
Example:
Admission time 06:30
First Potassium at 07:00 – “hemolyzed”
Second Potassium at 08:05 – resulted at 4.0
Resolution:
Hello, and thank you for your question. Please accept our apology for the delayed response.
To confirm: yes, if data from the original capture of the laboratory test CCDE values are not available to your hospital (e.g., due to results being hemolyzed) your hospital should submit the first available lab results collected within the appropriate time frames at your hospital (24 hours before the inpatient admission to 24 hours after the start of the inpatient admission)"
Thank you!