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  2. CQM-3498

CMS156v7 Numerator Query for Population Criteria 2

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      Thank you for your question. The numerator statement in the header section of the html document for CMS156v7, Use of High-Risk Medications in the Elderly (https://ecqi.healthit.gov/system/files/ecqm/measures/CMS156v7.html), indicates there needs to be at least two orders for the same high-risk medication during the measurement period. The numerator logic indicates this can be more than one of the same medication from the "Medication List", or more than one antiifective with a cumulative duration of >= 90 days, or more than one nonbenzodiazepine hypnotics with a cumulative duration of >= 90 days during the measurement period.
       
      The guidance statement in the header section of the html document explains and provides an example of how to determine cumulative medication duration, which is an individual's total number of medication days over a specific period. The cumulative medication duration is based on the total duration of sequentially ordered medications.
       
      It is difficult to provide a response to your question based on the way the information is provided, which is limited, and appears to be test cases. For us to provide more meaningful responses, it would be helpful to limit the question to the area of primary concern or interest within the logic itself, instead of providing pieces of scenarios that may be prone to misinterpretation outside of the context of the full measure. For example, instead of asking please confirm which scenario(s) will qualify, it might be better to ask how the criteria for numerator are met. Then the focus of our responses could be on the relevant logic instead of testing cases, which may differ in other key parameters and result in different answers. We hope this helps with any future questions.
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      Thank you for your question. The numerator statement in the header section of the html document for CMS156v7, Use of High-Risk Medications in the Elderly ( https://ecqi.healthit.gov/system/files/ecqm/measures/CMS156v7.html), indicates there needs to be at least two orders for the same high-risk medication during the measurement period. The numerator logic indicates this can be more than one of the same medication from the "Medication List", or more than one antiifective with a cumulative duration of >= 90 days, or more than one nonbenzodiazepine hypnotics with a cumulative duration of >= 90 days during the measurement period.   The guidance statement in the header section of the html document explains and provides an example of how to determine cumulative medication duration, which is an individual's total number of medication days over a specific period. The cumulative medication duration is based on the total duration of sequentially ordered medications.   It is difficult to provide a response to your question based on the way the information is provided, which is limited, and appears to be test cases. For us to provide more meaningful responses, it would be helpful to limit the question to the area of primary concern or interest within the logic itself, instead of providing pieces of scenarios that may be prone to misinterpretation outside of the context of the full measure. For example, instead of asking please confirm which scenario(s) will qualify, it might be better to ask how the criteria for numerator are met. Then the focus of our responses could be on the relevant logic instead of testing cases, which may differ in other key parameters and result in different answers. We hope this helps with any future questions.
    • EP
    •  Use of High-Risk Medications in the Elderly

      Hi Team,

      We have a query regarding Numerator Query for Population Criteria 2:

      Numerator
      exists ( "Medication List" )
      or ( "Two High Risk Medications With Prolonged Duration" )

      *Two High Risk Medications With Prolonged Duration *
      ( "Cumulative Medication Duration"("AntiInfectives During Measurement Period")>= 90
      and "AntiInfectives"
      )
      or ( "Cumulative Medication Duration"("Hypnotics During Measurement Period")>= 90
      and "Nonbenzodiazepine_Hypnotics")

      AntiInfectives
      //Anti Infectives, other
      exists ( "More than 1 Of"(["Medication, Order": "Anti Infectives, other"]))

      *AntiInfectives During Measurement Period *
      ["Medication, Order": "Anti Infectives, other"] AntiInfectives
      where AntiInfectives.relevantPeriod during "Measurement Period"

      *Cumulative Medication Duration(Medication List<"Medication, Order">) *
      Sum((collapse(Medication.relevantPeriod))CumulativeDosages
      return all duration in days of CumulativeDosages)

      Please consider below scenario:

      Scenario 1:
      Measurement Period : 01-01-2019 to 12-31-2019
      Patient Age > 65
      Has Qualifying encounter during measurement period
      Has antinfectives 1 from 01-01-2019 to 01-31-2019
      Has antinfectives 2 from 01-31-2019 to 04-01-2019

      Scenario 2:
      Measurement Period : 01-01-2019 to 12-31-2019
      Patient Age > 65
      Has Qualifying encounter during measurement period
      Has antinfectives 1 from 01-01-2019 to 02-15-2019
      Has antinfectives 2 from 01-01-2019 to 02-15-2019

      Scenario 3:
      Measurement Period : 01-01-2019 to 12-31-2019
      Patient Age > 65
      Has Qualifying encounter during measurement period
      Has antinfectives 1 from 01-01-2019 to 01-31-2019
      Has antinfectives 2 from 02-01-2019 to 04-02-2019

      Please confirm which scenario will qualify

            edave Mathematica EC eCQM Team
            vinaykumarp Vinay (Inactive)
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