Clarification on intent and logic of high risk medications

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    • Type: EC eCQMs - Eligible Clinicians
    • Resolution: Answered
    • Priority: Minor
    • Component/s: Measure
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      The numerator should include only the high risk medications ordered by the EP reporting the measure. This is an overuse measure and as such the intent of the measure is to hold only the ordering physician accountable for the use of the high risk medication. We understand the HQMF and program constraints do not allow us to express this explicitly in the eMeasure. Because of the community aspect of a medical record and the program constraints, all physicians using the same EHR may inadvertently be held accountable for prescriptions ordered. If the prescription was written by someone that does not have access to the EHR, the order for that prescription will not be in the EHR, and the providers using the EHR will not be accountable for the prescription.
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      The numerator should include only the high risk medications ordered by the EP reporting the measure. This is an overuse measure and as such the intent of the measure is to hold only the ordering physician accountable for the use of the high risk medication. We understand the HQMF and program constraints do not allow us to express this explicitly in the eMeasure. Because of the community aspect of a medical record and the program constraints, all physicians using the same EHR may inadvertently be held accountable for prescriptions ordered. If the prescription was written by someone that does not have access to the EHR, the order for that prescription will not be in the EHR, and the providers using the EHR will not be accountable for the prescription.
    • CMS156v3/NQF0022

      Seeking clarification on whether all high risk medications should be included in the numerator logic for this measure. It seems the intent is to monitor how often patients are being prescribed high risk medications and in order to fully monitor this you would need to capture all medications reported as active and those prescribed during the visit. However, the measure logic seems to point to only including those medications that were prescribed by that physician in the numerator.

      Should the numerator include patients who have high risk medications currently reported as being prescribed to them (even by another provider) or only include them if they were prescribed a high risk medication by that particular EP?

            Assignee:
            Mathematica EC eCQM Team (Inactive)
            Reporter:
            Erin Ward (Inactive)
            Erin Ward (Inactive)
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