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  1. eCQM Issue Tracker
  2. CQM-4885

Add day of precision to encounter

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Details

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

    Description

      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.

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            khancock Mathematica EC eCQM Team
            sgearhart Mathematica EH eCQM Team
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            Dates

              Created:
              Updated: