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  1. eCQM Issue Tracker
  2. CQM-4826

Replace QDM datatype of Device, Applied with Assessment, Performed to capture frailty device

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Details

    • EP/EC eCQMs
    • Status: Open
    • Moderate
    • Resolution: Unresolved
    • None

    Description

      Brief Description of Measure:

      CMS122: Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)

      Percentage of patients 18-75 years of age with diabetes who had hemoglobin A1c > 9.0% during the measurement period

      CMS125: Breast Cancer Screening

      Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer in the 27 months prior to the end of the Measurement Period

      CMS130: Colorectal Cancer Screening

      Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer

      CMS131: Diabetes: Eye Exam

      Percentage of patients 18-75 years of age with diabetes and an active diagnosis of retinopathy in any part of the measurement period who had a retinal or dilated eye exam by an eye care professional during the measurement period or diabetics with no diagnosis of retinopathy in any part of the measurement period who had a retinal or dilated eye exam by an eye care professional during the measurement period or in the 12 months prior to the measurement period

      CMS134: Diabetes: Medical Attention for Nephropathy

      The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period

      CMS165: Controlling High Blood Pressure

      Percentage of patients 18-85 years of age who had a diagnosis of essential hypertension starting before and continuing into, or starting during the first six months of the measurement period, and whose most recent blood pressure was adequately controlled (<140/90mmHg) during the measurement period

      Description of Issue:

      ​QDM datatype Device, Applied will be retired in QDM v5.6. Since QDM v5.6 Section 6.1 (https://ecqi.healthit.gov/sites/default/files/QDM-v5.6-508.pdf) recommends "Assessment, Performed" as a replacement option for referencing an observation about device usage, stability, and presence.

      Below is the current specification:

      //Terminology
      value set "Frailty Device" (2.16.840.1.113883.3.464.1003.118.12.1300)
      value set "Frailty Diagnosis" (2.16.840.1.113883.3.464.1003.113.12.1074)
      value set "Frailty Encounter" (2.16.840.1.113883.3.464.1003.101.12.1088)
      value set "Frailty Symptom" (2.16.840.1.113883.3.464.1003.113.12.1075)

      //Logic
      define "Has Criteria Indicating Frailty":
      exists ( ["Device, Order": "Frailty Device"] FrailtyDeviceOrder
      where FrailtyDeviceOrder.authorDatetime during "Measurement Period" )
      or exists ( ["Device, Applied": "Frailty Device"] FrailtyDeviceApplied
      where Global."NormalizeInterval" ( FrailtyDeviceApplied.relevantDatetime, FrailtyDeviceApplied.relevantPeriod ) overlaps "Measurement Period" )
      or exists ( ["Diagnosis": "Frailty Diagnosis"] FrailtyDiagnosis
      where FrailtyDiagnosis.prevalencePeriod overlaps "Measurement Period" )
      or exists ( ["Encounter, Performed": "Frailty Encounter"] FrailtyEncounter
      where FrailtyEncounter.relevantPeriod overlaps "Measurement Period" )
      or exists ( ["Symptom": "Frailty Symptom"] FrailtySymptom
      where FrailtySymptom.prevalencePeriod overlaps "Measurement Period" )

      Proposed Solution:

      ​The proposed logic replaces ["Device, Applied": "Frailty Device"] with ["Assessment, Performed": "Medical equipment used"] requiring a result of "Frailty Device". Since recency is an important aspect for frailty device usage, assessments are restricted to those completed during the measurement period.

      Please note that LOINC code 98181-1 "Medical equipment used" (https://loinc.org/98181-1/) is not yet released in VSAC as of 8/19/2021, but will be required to implement this change.

      Below is the proposed specification:

      //Terminology
      code "Medical equipment used": '98181-1' from "LOINC" display 'Medical equipment used'
      value set "Frailty Device" (2.16.840.1.113883.3.464.1003.118.12.1300)
      value set "Frailty Diagnosis" (2.16.840.1.113883.3.464.1003.113.12.1074)
      value set "Frailty Encounter" (2.16.840.1.113883.3.464.1003.101.12.1088)
      value set "Frailty Symptom" (2.16.840.1.113883.3.464.1003.113.12.1075)

      //Logic
      define "Has Criteria Indicating Frailty":
      exists ( ["Device, Order": "Frailty Device"] FrailtyDeviceOrder
      where FrailtyDeviceOrder.authorDatetime during "Measurement Period" )
      or exists ( ["Assessment, Performed": "Medical equipment used"] EquipmentUse
      where EquipmentUse.result in "Frailty Device"
      and Global."NormalizeInterval" ( EquipmentUse.relevantDatetime, EquipmentUse.relevantPeriod ) ends during "Measurement Period" )
      or exists ( ["Diagnosis": "Frailty Diagnosis"] FrailtyDiagnosis
      where FrailtyDiagnosis.prevalencePeriod overlaps "Measurement Period" )
      or exists ( ["Encounter, Performed": "Frailty Encounter"] FrailtyEncounter
      where FrailtyEncounter.relevantPeriod overlaps "Measurement Period" )
      or exists ( ["Symptom": "Frailty Symptom"] FrailtySymptom
      where FrailtySymptom.prevalencePeriod overlaps "Measurement Period" )

      Rationale for Change:

      The proposed changes provide a new approach for identifying frailty device usage as replacement of the retiring QDM datatype.

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            khancock Mathematica EC eCQM Team
            khancock Mathematica EC eCQM Team
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            Dates

              Created:
              Updated: