Hello JIRA,

My question involves the two Hybrid Measures - CMS 529v4 and CMS 844v4. The IQR requirements state that we need to meet a 90% threshold (or more) for vital signs and laboratory test results on both measures.

We use Epic EMR with lab results interfaced from the SoftLab system. The Epic EMR QRDA engine logic was pulling the first lab result (numeric or text), so the following value could return:

• Cancelled
• Hemolyzed

The CMS specifications cause our EHR to pick up the text lab value as non-null and they will be counted as missing towards the CMS 90% threshold.

Although numeric values are available in the relevant timeframes, we are unsure how to configure our Epic EMR QRDA engine (built strictly per eCQM criteria, see below) to populate and submit those values to CMS.

// First lab tests

  FirstHematocritLab: "FirstLabTestWithEncounterId"(["Laboratory Test, Performed": "Hematocrit lab test"]),

  FirstWhiteBloodCellCount: "FirstLabTestWithEncounterId"(["Laboratory Test, Performed": "White blood cells count lab test"]),

  FirstPotassiumLab: "FirstLabTestWithEncounterId"(["Laboratory Test, Performed": "Potassium lab test"]),

  FirstSodiumLab: "FirstLabTestWithEncounterId"(["Laboratory Test, Performed": "Sodium lab test"]),

  FirstBicarbonateLab: "FirstLabTestWithEncounterId"(["Laboratory Test, Performed": "Bicarbonate lab test"]),

  FirstCreatinineLab: "FirstLabTestWithEncounterId"(["Laboratory Test, Performed": "Creatinine lab test"]),

  FirstGlucoseLab: "FirstLabTestWithEncounterId"(["Laboratory Test, Performed": "Glucose lab test"])

}

Thank you,

Elaine Chen