Most of the CQMs consider certain data elements which are effective before the patient was admitted.
E.g. :-
STK 2
"Occurrence A of Intervention, Order: Palliative Care" starts before or during "Occurrence A of Encounter, Performed: Inpatient Encounter"

STK 3
"Procedure, Performed: Atrial Ablation" starts before start of "Occurrence A of Encounter, Performed: Inpatient Encounter"

and there are other such examples.

Does CMS expect hospitals to consider only those elements which were captured during the patient's prior encounters with the same hospital, or from prior encounters belonging to other hospitals as well? The only place they might capture labs and meds done prior to admission from MD office or other hospital might be in scanned documents from other provider or potentially in free text note from MD or an answer provided by the patient. In those cases, it is very difficult to capture the exact code and dates and represent them in the QRDA Category I.

During the certification, will a vendor receive patient data from Cypress which will mandate such 'prior-to-admission' data entry? If an EHR is not able to capture these concepts, will it be regarded as a failure?