During the 2016 annual update, we encountered an issue with the value sets used in this measure. There were duplicate codes in the two encounter value sets. We further determined that the psychotherapy encounters represent not only the encounter, but treatment as well. As a result, the psychotherapy encounter codes were removed from the BH Outpatient Encounter value set and added to a new BH Psychotherapy Encounter value set (to address the duplicate code issue) and the logic was updated to accommodate the treatment aspect of this encounter type. However, we did not account for the possibility that a patient could have only psychotherapy encounters, where one of those psychotherapy encounters could represent a qualifying index encounter. Since the prior logic only identified BH Outpatient Encounters as index encounters, this patient would be excluded from the measure. To prevent the unintended exclusion of qualifying patients with only psychotherapy encounter, the logic will need to be updated.
https://ecqi.healthit.gov/ep/ecqms-2017-performance-period/bipolar-disorder-and-major-depression-appraisal-alcohol-or-chemical
The current logic may inadvertently omit qualifying patients from the IP who had only outpatient psychotherapy encounters.
Current Logic:
•Initial Population =
◦AND: Age>= 18 year(s) at: "Measurement Period"
◦AND: Union of:
◾$Treatments
◾"Encounter, Performed: BH Outpatient Psychotherapy"
◾<= 42 day(s) starts after start of Occurrence A of $BHEncounter
Solution:
Modify the IP logic to include qualifying index psychotherapy encounters:
◦AND: Union of:
◾$Treatments
◾"Encounter, Performed: BH Outpatient Psychotherapy"
◾<= 42 day(s) starts after start of Union of:
◾Occurrence A of $BHEncounter
◾Occurrence A of $BHOutptPsychotherapy
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Moderate Mathematica EC eCQM Team (Inactive)