Updating Medication Value Sets for Prophylaxis for VTE

XMLWordPrintable

    • Type: Annual Update
    • Resolution: Answered
    • Priority: Major
    • Component/s: ValueSet
    • None
    • Hide
      All value sets will be reviewed for the next measure update for EH to be published on April 1 2014.

      For the time being, CMS is bound by statute to updating value set content no more often than once a year, with that update being published at least 6 months prior to the next reporting period start. Furthermore, the updates are limited to content changes that do not change the fundamental intent of the measure to begin with. Therefore, the inclusion of new medications is limited to the annual update window and would require review by the steward to ensure that the change wouldn't alter the original clinical intent.

      In the future, CMS and ONC plan to consider decoupling value set updates from the annual update publication to facilitate more frequent opportunities to change and improve measure data elements.
      Show
      All value sets will be reviewed for the next measure update for EH to be published on April 1 2014. For the time being, CMS is bound by statute to updating value set content no more often than once a year, with that update being published at least 6 months prior to the next reporting period start. Furthermore, the updates are limited to content changes that do not change the fundamental intent of the measure to begin with. Therefore, the inclusion of new medications is limited to the annual update window and would require review by the steward to ensure that the change wouldn't alter the original clinical intent. In the future, CMS and ONC plan to consider decoupling value set updates from the annual update publication to facilitate more frequent opportunities to change and improve measure data elements.

      The medication value sets are missing medications that have been approved by the Federal Drug Administration for VTE prophylaxis. In addition, these medications are either considered appropriate prophylaxis by Core Measures or an allowable "Reason for Not" ordering prophylaxis. Both of these scenarios place the patient in the Numerator population for the applicable measure.

      This contradiction of rules creates a situation where providers and clinicians struggle "to do the right thing for the patient" and meet irreconcilable reporting requirements. If the intent is truly to align the Clinical Quality Measures and Core Measures, for a side-by-side comparison, consistency in medication tables is critical.

      VTE prophylaxis accepted for Core Measures but not for the involved CQMs
      Oral Factor Xa Inhibitor:
      • Xarelto/Rivaroxaban (Only for a current finding or history of the following)
      o Hip/Knee Replacement
      o Atrial Fib/Flutter
      o VTE Treatment

      Allowable Reasons for Not Administering VTE Prophylaxis for Core Measures but not for involved CQMs
      If administered on the day of day after ICU admission:
      • Continuous IV Heparin
      • Anticoagulant therapy, including Apixaban, Xarelto, and others

      1.)What measures will be taken to ensure efficient and effective processes around the inclusion of medications that are newly approved or expanded by the Federal Drug Administration (FDA)?

        1. EHandEPcodesystem_udpatesMarch2013.docx
          16 kB

            Assignee:
            Julia Skapik (Inactive)
            Reporter:
            Kimberly M. Bodine (Inactive)
            Kimberly Schwartz (Inactive), Minet Javellana (Inactive), Rob McClure
            Votes:
            0 Vote for this issue
            Watchers:
            5 Start watching this issue

              Created:
              Updated:
              Resolved: