Thank you for your question. VTE Prophylaxis was administered during observation, a status prior to admission, will not be counted in the numerator. We also understand that it would be important not to order additional consults to meet the measures. The Change Review Process evaluated potential solutions to address capturing this data and concluded that limitations to the standards used to define the measures, including the Quality Data Model and eCQM expression language, prevent efficient representation for these types of care. Plans to address this continue to be under discussion.​​

If a patient is admitted to the hospital in "observation" or "outpatient in bed" status but is later changed to inpatient status, do the interventions that were ordered, implemented, and documented for VTE-1 prophylaxis during "observation" or "outpatient in bed" status count towards fulfilling the core measure? For example, if the reason for no pharmacological prophylaxis or the anti-embolism device was applied and documented during the "observation" or "outpatient in bed" status prior to the patient transition to "inpatient" status, should the eCQM report logic start when the patient is admitted to the hospital regardless of status or when the patient is classified as an inpatient? Thank you.