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EC eCQMs
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Resolution: Answered
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Moderate
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None
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We plan to move forward with the proposed change during this annual update.
Brief Description of Measure:
CMS146: Appropriate Testing for Pharyngitis:
The percentage of episodes for patients 3 years and older with a diagnosis of pharyngitis that resulted in an antibiotic dispensing event and a group A streptococcus (strep) test
Description of Issue:
In the previous 2021 measure version, the In operator used the day precision. This made the +/- 3 days consistent and easy to understand.
For the 2022 measure version, the In operator does not use the day precision. This makes the +/- 3 days inconsistent and not easy to understand. To correct this and improve implementers' understanding of intent, the measure developer proposes adding a day precision to the encounter which will specify whether or not a lab on the 3rd day prior or after counts depends on its precision. If the encounter has a more precise precision, the timing of the lab matters, which aligns with the measure intent. For example, if your encounter ends at 3pm, then a lab at 2pm 3 days prior does not count.
Proposed Solution:
Current logic:
from
"Group A Streptococcus Lab Test With Result" GroupAStreptococcusTest,
"Encounter With Pharyngitis or Tonsillitis With Antibiotic" EncounterWithPharyngitis
where ( Global."NormalizeInterval" ( GroupAStreptococcusTest.relevantDatetime, GroupAStreptococcusTest.relevantPeriod ) starts within 3 days of
end of EncounterWithPharyngitis.relevantPeriod )
return EncounterWithPharyngitis
Proposed logic:
from
"Group A Streptococcus Lab Test With Result" GroupAStreptococcusTest,
"Encounter With Pharyngitis or Tonsillitis With Antibiotic" EncounterWithPharyngitis
where ( Global."NormalizeInterval" ( GroupAStreptococcusTest.relevantDatetime, GroupAStreptococcusTest.relevantPeriod )
starts during day of Interval[( end of EncounterWithPharyngitis.relevantPeriod) - 3 days, ( end of EncounterWithPharyngitis.relevantPeriod) + 3 days] )
return EncounterWithPharyngitis
Rationale for Change:
Adding "day of" to look for the lab any time within the encounter with pharyngitis and correcting the timing should provide clarity for implementers.