A Mathematica research team is collaborating with a Client to specify and test an eCQM that assesses perinatal hypertension and we have a specific question about what the logic will allow.

Ideally, we’d like to specify a patient-level measure that assesses blood pressures at multiple outpatient encounters and determines whether these BPs met a certain threshold at each encounter. The denominator would focus on all pregnant patients with at least two encounters with the clinician group. Ideally for the numerator we would assess all BPs that occurred at outpatient visits (or select one BP from each visit) within a certain timeframe of gestation. Is this possible in the eCQM logic while keeping this a patient-level measure? We have received feedback from some eCQM experts that examining more than one BP (from various visits) in the numerator would essentially be defining the numerator as visit-level while the denominator is patient-level. Is that accurate or would it be possible to generate a ratio measure where the denominator is patient-level and the numerator is encounter-level?

Thank you for your help and clarification.