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  1. eCQM Issue Tracker
  2. CQM-3658

Timing calculation for Comfort measures in VTE-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 follow-up question.

      Yes, you are correct that the timing calculation here uses “interval” operator. However, a key word “day of” is applied in the “1 day or less on or after day of start”, where it is counting the calendar by day not by hour. Therefore, the = Interval [global.”ToDate”(04/05/2019 10:00 AM), global.”ToDate”( (04/05/2019 10:00 AM + 2 day)), means the Comfort measures starts from any time on the day of admission (including prior to admission time) to 1 day after admission datetime and will qualify for the condition.
      Your example should return True as Bonnie shows.
      Show
      Thank you for your follow-up question. Yes, you are correct that the timing calculation here uses “interval” operator. However, a key word “day of” is applied in the “1 day or less on or after day of start”, where it is counting the calendar by day not by hour. Therefore, the = Interval [global.”ToDate”(04/05/2019 10:00 AM), global.”ToDate”( (04/05/2019 10:00 AM + 2 day)), means the Comfort measures starts from any time on the day of admission (including prior to admission time) to 1 day after admission datetime and will qualify for the condition. Your example should return True as Bonnie shows.
    • Potential for inaccurate calculations due to lack of specific and clear guidance for the timing calculation method

      This is a follow up to the following - https://oncprojectracking.healthit.gov/support/browse/CQM-3624 where your response provides the calculation method for the ED visit end and inpatient encounter start.

      It seems however the eCQMs may not be using the same method of timing calculations in different timing comparison elements within the measures.

      Could you help explain what would be the result for the following logic in the example provided below?

      VTE-1

      Intervention Comfort Measures on Day of or Day After Start of Hospitalization

              "Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter

                     with "Intervention Comfort Measures" ComfortMeasures

                                    such that Coalesce(start of ComfortMeasures.relevantPeriod, ComfortMeasures.authorDatetime)1 day or less on or after day of start of Global."Hospitalization"(QualifyingEncounter)

       __ 

      Inpatient start: 04/05/2019 10:00 AM
      Comfort measures start: 04/05/2019 4:00 AM (comfort measures starts before inpatient start)

       If you apply the interval calculation as you have described above, I would think it would evaluate to

      = Interval [04/05/2019 10:00 AM, (04/05/2019 10:00 AM *+ 1*)]

      = Interval [04/05/2019 10:00 AM, (04/*06*/2019 10:00 AM)]

      Which means if the Comfort Measures starts on or after 04/05/2019 10:00 AM and on or before 04/06/2019 10:00 AM then this logic should return true.

      However, in this example the Comfort Measure Start is not in this range, so it should return false.

      The Bonnie tool returns true. That would mean that it is not following the interval calculation method described above for this logic. In which case it would mean that different logic elements are expecting different ways of calculating the timing but no specific guidance is provided for calculation of each one.

      What is the expectation for this type of calculation? How will TJC and CMS (QualityNet) calculate this? And if there is an implicit assumption for different calculation methods for timing statements in different logic elements how can the community know what those assumptions are? This could lead to a lot of confusion.

      Thanks in advance for your review.

        1. HIQR_Jan2015_v4_4a_ZIP(1).pdf
          104 kB
          Manish Parekhji

            JLeflore Joelencia Leflore
            mparekhji Manish Parekhji
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