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  1. eCQM Issue Tracker
  2. CQM-1296

Difference in logic for Comfort Measures Only in AMI-2 and AMI-10

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    • Icon: EH/CAH eCQMs - Eligible Hospitals/Critical Access Hospitals EH/CAH eCQMs - Eligible Hospitals/Critical Access Hospitals
    • Resolution: Resolved
    • Icon: Minor Minor
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    • None
    • Carla McCorkle
    • 520-750-4177
    • Midas+
    • Yes
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      "Soution noted in CQM-1090 The logic will be modified to add an additional logic statement: AND: “Occurrence A of Encounter, Performed: Emergency Department Visit” <= 1 hour(s) ends before start of “Occurrence A of Encounter, Performed: Encounter Inpatient”
      • AND: “Occurrence A of Intervention, Performed: Comfort Measures” starts after start of “Occurrence A of Encounter, Performed: Emergency Department Visit”
      • AND: “Occurrence A of Intervention, Performed: Comfort Measures” starts before or during “Occurrence A of Encounter, Performed: Encounter Inpatient”

      This logic change compliments the fix proposed in ticket CQM-1090 and satisfies the scenarios for patients with an ED encounter. This leads to an inpatient encounter where Comfort Measure documentation may occur in the ED and inpatient setting, and patients with only an inpatient encounter where Comfort Measure documentation occurs during the inpatient encounter. This solution satisfies the questions raised in CQM-1089 and CQM-1090.
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      "Soution noted in CQM-1090 The logic will be modified to add an additional logic statement: AND: “Occurrence A of Encounter, Performed: Emergency Department Visit” <= 1 hour(s) ends before start of “Occurrence A of Encounter, Performed: Encounter Inpatient” • AND: “Occurrence A of Intervention, Performed: Comfort Measures” starts after start of “Occurrence A of Encounter, Performed: Emergency Department Visit” • AND: “Occurrence A of Intervention, Performed: Comfort Measures” starts before or during “Occurrence A of Encounter, Performed: Encounter Inpatient” This logic change compliments the fix proposed in ticket CQM-1090 and satisfies the scenarios for patients with an ED encounter. This leads to an inpatient encounter where Comfort Measure documentation may occur in the ED and inpatient setting, and patients with only an inpatient encounter where Comfort Measure documentation occurs during the inpatient encounter. This solution satisfies the questions raised in CQM-1089 and CQM-1090 .
    • CMS100v3/NQF142, CMS30v4/NQF0639
    • Cases with Comfort Measures Only documented during Inpatient Stay will not be excluded.

      We appreciate the update to the Comfort Measure Only(CMO) logic to include CMO documented during the ED visit. However, there is a discrepancy in how the logic is written for AMI-2 and how it is written for AMI-10.

      As written for AMI-2, the logic makes sense and will calculate correctly. However, for AMI-10, we believe there are conflicting statements in the ED Visit logic (additional AND statement for Encounter Inpatient). Below is how the statements appear in each:

      AMI-2
       OR:
       AND: "Occurrence A of Encounter, Performed: Emergency Department Visit" <= 1 hour(s) ends before start of "Occurrence A of Encounter, Performed: Encounter Inpatient"
       AND: "Occurrence A of Intervention, Performed: Comfort Measures" starts after start of "Occurrence A of Encounter, Performed: Emergency Department Visit"

      AMI-10
       OR:
       AND: "Occurrence A of Encounter, Performed: Emergency Department Visit" <= 1 hour(s) ends before start of "Occurrence A of Encounter, Performed: Encounter Inpatient"
       AND: "Occurrence A of Intervention, Performed: Comfort Measures" starts after start of "Occurrence A of Encounter, Performed: Emergency Department Visit"
       AND: "Occurrence A of Intervention, Performed: Comfort Measures" starts before or during "Occurrence A of Encounter, Performed: Encounter Inpatient"

      Is the intent that CMO is documented in both the ED and during the IP encounter as written in AMI-10? We suspect that the intent is to capture only CMO which starts after the start of the ED visit, as written in AMI-2. The additional logic statements will capture CMO documented during the IP encounter.

      Screenshots attached for further clarification.

        1. AMI10_CMO_Logic.png
          AMI10_CMO_Logic.png
          41 kB
        2. AMI2_CMO_Logic.png
          AMI2_CMO_Logic.png
          34 kB

            cindy.cullen Cindy Cullen
            cmccorkle Carla McCorkle (Inactive)
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