CMS60v5 - Temporal logic operator is inconsistent.

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    • Type: Hosp Inpt eCQMs - Hospital Inpatient eCQMs
    • Resolution: Done
    • Priority: Minor
    • Component/s: Guidance, Measure
    • None
    • 412-338-0366 x 622
    • Premier Inc.
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      The clause in question for AMI-8a (CMS53) was updated in version 5 to replace the ‘starts after start of’ with ‘starts during’ because there were no boundaries associated with the ECG. Therefore, by using ‘starts after start of’ an ECG could occur years later and still be considered valid. By changing to the ‘starts during’ operator, the start and end date/time of the ECG must occur completely within the encounter (i.e., begin after or equal to the start date/time of the encounter and before or equal to the end date/time of the same encounter).

       

      Unfortunately, this was overlooked in the 2016 Annual Updates for the AMI-7a (CMS60) measure. However, the Fiscal Year 2017 IPPS Final Rule removed CMS60 from the program effective 1/1/2017, and as such, the measure will no longer be updated.
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      The clause in question for AMI-8a (CMS53) was updated in version 5 to replace the ‘starts after start of’ with ‘starts during’ because there were no boundaries associated with the ECG. Therefore, by using ‘starts after start of’ an ECG could occur years later and still be considered valid. By changing to the ‘starts during’ operator, the start and end date/time of the ECG must occur completely within the encounter (i.e., begin after or equal to the start date/time of the encounter and before or equal to the end date/time of the same encounter).   Unfortunately, this was overlooked in the 2016 Annual Updates for the AMI-7a (CMS60) measure. However, the Fiscal Year 2017 IPPS Final Rule removed CMS60 from the program effective 1/1/2017, and as such, the measure will no longer be updated.
    • CMS53v5/NQF0163, CMS60v5/NQFna
    • There is a discrepancy in the measure logic that is impacting how the criteria is implemented.

      We came across a potential inconsistency when looking at the 2016 EH eCQM specifications. Last year, both CMS53v4 and CMS60v4 used the same temporal operators in 2nd AND statement of the Denominator Criteria. This year, the operators were updated “starts after start” to “starts during” but it does not appear like the change was made everywhere.

      The difference occurs in the second “AND” clause of the second “OR” clause of the second “AND” clause of the denominator logic of each measure (the part that talks about defining “Occurrence A of Diagnostic Study, Performed: Electrocardiogram (ECG)” when there are no relevant Emergency Department visits).

      In the second OR clause, measure CMS53 states the following:
      • OR: First: "Occurrence A of Diagnostic Study, Performed: Electrocardiogram (ECG)" starts during Occurrence A of $EncounterInpatient

      while measure CMS60 states the following (again, emphasis mine):
      • OR: First: "Occurrence A of Diagnostic Study, Performed: Electrocardiogram (ECG)" starts after start of Occurrence A of $EncounterInpatient

      All other areas of CMS60 were updated to use "starts during" (as was CMS53) but it appears last year's operator is still in-use in this one clause, which does not align with the rest of CMS60 or CMS53.

      Change the temporal logic operator in the last line of the second "AND" clause of the CMS60v5 Denominator (second AND of the second OR of the second AND) from "Starts after start" to "starts during" to be consistent with other locations in the measure and so it matches CMS53v5.

            Assignee:
            Joelencia Leflore
            Reporter:
            Patrick Gillie (Inactive)
            Greta Kessler (Inactive), Patrick Gillie (Inactive)
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              Created:
              Updated:
              Resolved: