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  2. CQM-4950

Apply 'day of' precision timing to accurately capture qualifying risk factor diagnoses

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

    Description

      Brief Description of Measure:
      ​CMS249: Appropriate Use of DXA Scans in Women Under 65 Years Who Do Not Meet the Risk Factor Profile for Osteoporotic Fracture:
      Percentage of female patients 50 to 64 years of age without select risk factors for osteoporotic fracture who received an order for a dual-energy x-ray absorptiometry (DXA) scan during the measurement period

      Description of Issue:
      ​The current specification excludes any qualifying diagnosis that occurs any time before the end of the "Measurement Period" (i.e., any time in history through 12/31 11:58PM). However, this timing does not does not exclude qualifying diagnoses that occur during the last minute of the measurement period (i.e., 12/31 11:59PM). 
      The measure developer proposes to revise the logic from "starts before end..." to "starts on or before day of end of..." to improve the timing precision and further align with the measure intent of excluding qualifying diagnoses any time on or before the end of the measurement period, including 12/31 11:59PM.

      Proposed Solution:
      ​//Before
      define "Has Independent Risk Factors Applicable Any Time":
        exists ( ["Diagnosis": "Type 1 Diabetes"]
          union ["Diagnosis": "End Stage Renal Disease"]
          union ["Diagnosis": "Osteogenesis Imperfecta"]
          union ["Diagnosis": "Ankylosing Spondylitis"]
          union ["Diagnosis": "Psoriatic Arthritis"]
          union ["Diagnosis": "Ehlers Danlos Syndrome"]
          union ["Diagnosis": "Cushings Syndrome"]
          union ["Diagnosis": "Marfan's Syndrome"]
          union ["Diagnosis": "Hyperparathyroidism"]
          union ["Diagnosis": "Lupus"] ) IndependentRiskDiagnosis
          where IndependentRiskDiagnosis.prevalencePeriod starts before
          end "Measurement Period"

      //After
      ... exists ( "DiagnosisInPatientHistory"(  ...
                union ["Diagnosis": "Type 1 Diabetes"]
                union ["Diagnosis": "End Stage Renal Disease"]
                union ["Diagnosis": "Osteogenesis Imperfecta"]
                union ["Diagnosis": "Ankylosing Spondylitis"]
                union ["Diagnosis": "Psoriatic Arthritis"]
                union ["Diagnosis": "Ehlers Danlos Syndrome"]
                union ["Diagnosis": "Cushings Syndrome"]
                union ["Diagnosis": "Hyperparathyroidism"]
                union ["Diagnosis": "Marfan's Syndrome"]
                union ["Diagnosis": "Lupus"] ...
            ))

      define function "DiagnosisInPatientHistory"(Diagnosis List<"Diagnosis"> ):
        Diagnosis Dx
          where Dx.prevalencePeriod starts on or before day of
          end of "Measurement Period"

      Rationale for Change:
      The measure developer proposes to revise the logic to increase alignment with the measure intent of excluding qualifying diagnoses any time on or before the end of the measurement period. This change will also increase the precision of the measure's timing. 

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            khancock Mathematica EC eCQM Team
            khancock Mathematica EC eCQM Team
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            Dates

              Created:
              Updated: