Brief Description of Measure:

​CMS108/VTE-1: Venous Thromboembolism Prophylaxis
This measure assesses the number of patients who received VTE prophylaxis or have documentation why no VTE prophylaxis was given between the day of arrival to the day after hospital admission or surgery end date for surgeries that start the day of or the day after hospital admission
 
CMS190/VTE-2: Intensive Care Unit Venous Thromboembolism Prophylaxis
This measure assesses the number of patients who received VTE prophylaxis or have documentation why no VTE prophylaxis was given the day of or the day after the initial admission (or transfer) to the Intensive Care Unit (ICU) or surgery end date for surgeries that start the day of or the day after ICU admission (or transfer)
 Description of Issue:

​The datatype "Device, Applied" is retired from Quality Data Model (QDM) v5.6, the version of the standard to be used for this annual update. Therefore, this datatype will be replaced with "Procedure, Performed" for the sequential Compression Devices (SCDs) used in the VTE measures.
 
The proposed solution originally presented in CRP received feedback that expressed concerns. Note: This type of structure changes are proposed for multiple measures (see the positive feedback for other measures CQM-4826). Below is the original proposal:
 
1. Create a new value set named "Device Application" (OID: 2.16.840.1.113762.1.4.1110.48) with a SNOMED code under the procedure category.​
2.Change the definition "VTE Prophylaxis by Medication Administered or Device Applied" from:
  .......
  union ["Device, Applied": "Intermittent pneumatic compression devices (IPC)"]
  union ["Device, Applied": "Venous foot pumps (VFP)"]
  union ["Device, Applied": "Graduated compression stockings (GCS)"]
TO:
.......
  ["Procedure, Performed": "Device Application"] DeviceApplied
      where DeviceApplied.result in "Intermittent pneumatic compression devices (IPC)"
               or DeviceApplied.result in "Venous foot pumps (VFP)"
               or DeviceApplied.result in "Graduated compression stockings (GCS)"
 
Based upon the feedback, the measure developer has considered an alternate way to modify the measures, based on the change to the QDM.

Proposed Solution:

REVISED PROPOSAL

1.   Create 3 new value sets with Procedure codes –
     - Application of intermittent pneumatic compression device
     - Application of graduated compression garment
     - Application of Venous foot pumps (VFP)
 
2.      Update definitions as follows: 

"VTE Prophylaxis by Medication Administered or Device Applied”
                ….
               union ["Procedure, Performed":"Application for Intermittent pneumatic compression devices (IPC )"]
               union ["Procedure, Performed ": " Application of graduated compression garment"]
               union ["Procedure, Performed ": " Application of Venous foot pumps (VFP)"]
“No VTE Prophylaxis Device Applied or Ordered”
          ["Procedure, Not Performed":"Application for Intermittent pneumatic compression devices (IPC )"]
               union ["Procedure, Not Performed ": " Application of graduated compression garment"]
               union ["Procedure, Not Performed ": " Application of Venous foot pumps (VFP)"]
                union ......
 
The measure developer is still in the process of assessing which is a more appropriate way to model this in the measures and will discuss with standards experts.                            

Rationale for Change:

​The datatype "Device, Applied" is retired from QDM v5.6 and is recommended to be replaced with "Procedure, Performed".