Brief Description of Measure:

Multiple EC eCQMs

Description of Issue:

​​The measure logic currently compares a date time to an interval of dates. In such instance, the CQL converts an interval of dates to an interval of date times with local timezone, which may introduce timezone offsets that result in patients falling out of the timeframe unexpectedly. This behavior does not align with the measure intent. After reviewing, the measure developer found this to be a cross-cutting issue that impacts multiple measures and definitions stewarded by NCQA. ** 

Proposed Solution:

​Here are a few examples from CMS 131 in which we are applying the "day of" comparison to get day level precision. Please note, this same pattern is being applied to multiple measures that NCQA stewards.

Current definition:
Qualifying Encounters:

( ["Encounter, Performed": "Office Visit"]
  union ["Encounter, Performed": "Annual Wellness Visit"]
  union ["Encounter, Performed": "Preventive Care Services - Established Office Visit, 18 and Up"]
  union ["Encounter, Performed": "Preventive Care Services-Initial Office Visit, 18 and Up"]
  union ["Encounter, Performed": "Home Healthcare Services"]
  union ["Encounter, Performed": "Ophthalmological Services"]
  union ["Encounter, Performed": "Telephone Visits"] ) ValidEncounter
  where ValidEncounter.relevantPeriod during "Measurement Period"

Proposed change:
Qualifying Encounters

( ["Encounter, Performed": "Office Visit"]
union ["Encounter, Performed": "Annual Wellness Visit"]
union ["Encounter, Performed": "Preventive Care Services - Established Office Visit, 18 and Up"]
union ["Encounter, Performed": "Preventive Care Services-Initial Office Visit, 18 and Up"]
union ["Encounter, Performed": "Home Healthcare Services"]
union ["Encounter, Performed": "Ophthalmological Services"]
union ["Encounter, Performed": "Telephone Visits"] ) ValidEncounter 

where ValidEncounter.relevantPeriod during day of "Measurement Period" 

Current definition: 

Retinal Exam in Measurement Period:

["Physical Exam, Performed": "Retinal or Dilated Eye Exam"] RetinalExam

where Global."NormalizeInterval" ( RetinalExam.relevantDatetime, RetinalExam.relevantPeriod ) during day of "Measurement Period"

Proposed change:
Retinal Exam in Measurement Period:
["Physical Exam, Performed": "Retinal or Dilated Eye Exam"] RetinalExam

where Global."NormalizeInterval" ( RetinalExam.relevantDatetime, RetinalExam.relevantPeriod ) during day of Interval[start of "Measurement Period" - 1 year,
  end of "Measurement Period"]
Rationale for Change:
​​NCQA would like to add date level precision to the logic - using the "day of" operator for comparison - where an interval of dates is being compared to align with the measure intent of capturing date level specificity.