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  1. eCQM Issue Tracker
  2. CQM-3624

1 hour calculation in the IPP for the ED-1 measure

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    • Icon: EH/CAH eCQMs - Eligible Hospitals/Critical Access Hospitals EH/CAH eCQMs - Eligible Hospitals/Critical Access Hospitals
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      Thank you for your question related to timing phrases. The CQL expression 'ends 1 hour or less on or before start of' is used to identify the end of an emergency department visit 1 hour or less prior to or on the start of an inpatient encounter. In the CQL expression, the 'one hour or less on or before' is evaluated using an interval calculation for a time comparison, which is calculated to 60 minutes or less, per the measure intent. In CQL duration is a different timing operation and represents a change from the previous QDM logic in which an 'hour' may have included a duration of 1 hour and 59 minutes. For more information on this topic, please see the Cooking with CQL examples 06-27-2019 located here:
      https://github.com/esacinc/CQL-Formatting-and-Usage-Wiki/wiki/Cooking-with-CQL-Examples
      Show
      Thank you for your question related to timing phrases. The CQL expression 'ends 1 hour or less on or before start of' is used to identify the end of an emergency department visit 1 hour or less prior to or on the start of an inpatient encounter. In the CQL expression, the 'one hour or less on or before' is evaluated using an interval calculation for a time comparison, which is calculated to 60 minutes or less, per the measure intent. In CQL duration is a different timing operation and represents a change from the previous QDM logic in which an 'hour' may have included a duration of 1 hour and 59 minutes. For more information on this topic, please see the Cooking with CQL examples 06-27-2019 located here: https://github.com/esacinc/CQL-Formatting-and-Usage-Wiki/wiki/Cooking-with-CQL-Examples
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      Potential for inaccurately including or excluding patients in the population for ED measures and other measures that check if there is an ED encounter than ends within one hour before the start of the inpatient encounter

      Details of the question are provided in the attached document.
      Show
      Potential for inaccurately including or excluding patients in the population for ED measures and other measures that check if there is an ED encounter than ends within one hour before the start of the inpatient encounter Details of the question are provided in the attached document.

      Reference https://github.com/esacinc/CQL-Formatting-and-Usage-Wiki/wiki/Authoring-Measures-in-CQL#calculating-duration-in-hours

      We have a question to verify the expectation about the calculation of duration in hours in the example provided below which is used in any Eligible Hospital eCQM where an ED visit is being evaluated.

       

       Example

      ED End Date/Time = 2019-03-01 03:10:00

      Inp Admission Start Date/Time = 2019-03-01 05:09:00

      The duration calculation as per above example would return 1 hour while in minutes this would be 119 minutes (or 1 hour and 59 minutes).

       

      Would you expect this patient to meet the condition specified in the ED-1 Initial Population logic below-  

      Outcome 1 - If you go by minutes then the ED visit end date/time is not within 1 hour or less before or on start of inpatient encounter, so this condition should return false and patient should not meet the IPP

      Outcome 2 - But if you go by the hour calculation above, after truncation it returns 1 hour, and therefore the condition ends 1 hour or less before or on start of inpatient encounter would return true and patient would be included in the encounter.

      Could you help verify which outcome is expected?

      Thanks in advance for our review and guidance.

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            JLeflore Joelencia Leflore
            mparekhji Manish Parekhji
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