Brief Description of Measure:

​CMS117: Childhood Immunization Status:
Percentage of children 2 years of age who had four diphtheria, tetanus and acellular pertussis (DTaP); three polio (IPV), one measles, mumps and rubella (MMR); three or four H influenza type B (Hib); three hepatitis B (Hep B); one chicken pox (VZV); four pneumococcal conjugate (PCV); one hepatitis A (Hep A); two or three rotavirus (RV); and two influenza (flu) vaccines by their second birthday

Description of Issue:

​The value set Hib Vaccine (3 dose schedule) grouping OID (2.16.840.1.113883.3.464.1003.110.12.1083) contains one member OID (2.16.840.1.113883.3.464.1003.110.11.115) which consists of a single code.
This does not align with best practices for value set and direct reference code (DRC) management; therefore, we plan to replace this value set with the indicated DRC directly within the logic and terminology section of the eCQM.

Proposed Solution:

​Remove value set Hib Vaccine (3 dose schedule) grouping OID (2.16.840.1.113883.3.464.1003.110.12.1083). Replace this with direct reference code: 
CVX 49 - Haemophilus influenzae type b vaccine, PRP-OMP conjugate. 
Before:
//Terminology
valueset "Hib Vaccine (3 dose schedule)" (2.16.840.1.113883.3.464.1003.110.12.1083)
 
//Logic definition
define "Hib 3 Dose Immunizations or Procedures"
 ( ( ["Immunization, Administered": "Hib Vaccine (3 dose schedule)"] 
    union ["Procedure, Performed": "Hib Vaccine (3 dose schedule) Administered"] ) ThreeDoseHib
    where ThreeDoseHib.relevantDatetime during "Vaccine Administration Interval - 42 Days up to 2 Years Old")

After:
//Terminology
code "Haemophilus influenzae type b vaccine, PRP-OMP conjugate": "49" from "CVX" display 'Haemophilus influenzae type b vaccine, PRP-OMP conjugate'
 
//Logic definition
define "Hib 3 Dose Immunizations or Procedures"
( ( ["Immunization, Administered": "Haemophilus influenzae type b vaccine, PRP-OMP conjugate"] 
    union ["Procedure, Performed": "Hib Vaccine (3 dose schedule) Administered"] ) ThreeDoseHib
    where ThreeDoseHib.relevantDatetime during "Vaccine Administration Interval - 42 Days up to 2 Years Old"
)

Rationale for Change:

​​To align with value set best practices, we replaced a single-code value set ("Hib Vaccine (3 dose schedule)") with a direct reference code.