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  1. eCQM Issue Tracker
  2. CQM-5191

VTE1 and VTE2 Population Scenario

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    • Icon: EH/CAH eCQMs EH/CAH eCQMs
    • Resolution: Answered
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    • Brian Summerville
    • 816-201-3660
    • Cerner Corporation
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      ​​Thank you for your inquiry. Yes, the scenario of "I have seen several clients who transfer patients to the ICU prior to placing the admit to Inpatient PSO order" will impact measure qualification for VTE measures and yield an unexpected result. In eCQM, ICU is identified by location code and used to determine if the case qualifies for VTE-2 measure. We need to learn more about your provided scenario on why patient was in ICU before inpatient admission. Was patient in ICU as outpatient observation before admitting to inpatient or just a temporary stay as direct admit? In eCQM logic, ICU stay is included in inpatient hospital stay so ICU admission time should be as early as inpatient admission time.
      Therefore, if the patient was in ICU as outpatient stay, that ICU should be mapped to outpatient observation. If the patient was directly admitted to inpatient from a temporary ICU stay, the inpatient admission datetime should be rolled back to the time ICU starts.
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      ​​Thank you for your inquiry. Yes, the scenario of "I have seen several clients who transfer patients to the ICU prior to placing the admit to Inpatient PSO order" will impact measure qualification for VTE measures and yield an unexpected result. In eCQM, ICU is identified by location code and used to determine if the case qualifies for VTE-2 measure. We need to learn more about your provided scenario on why patient was in ICU before inpatient admission. Was patient in ICU as outpatient observation before admitting to inpatient or just a temporary stay as direct admit? In eCQM logic, ICU stay is included in inpatient hospital stay so ICU admission time should be as early as inpatient admission time. Therefore, if the patient was in ICU as outpatient stay, that ICU should be mapped to outpatient observation. If the patient was directly admitted to inpatient from a temporary ICU stay, the inpatient admission datetime should be rolled back to the time ICU starts.
    • CMS0108v10, CMS0190v10
    • The eCQM report appears to be inaccurate.

      The Cerner VTE1 and VTE2 eCQM reports use the Inpatient Admit Date and Time field as the inpatient start date and time. The inpatient start date and time clinical event is created when the Admit to Inpatient PSO order is placed. The eCQM uses the date and time a patient is transferred to an ICU location as the ICU start date and time. I have seen several clients who transfer patients to the ICU prior to placing the admit to Inpatient PSO order. When this scenario occurs, patients who would normally qualify for the Denominator of the VTE2 report are instead qualifying for the Denominator of the VTE1 report. Do you have any guidance around this scenario? If a front end workflow is not being followed, can the VTE1 and VTE2 reports still be used? Is it ok for clients to choose VTE1 and VTE2 as eCQM' s for submission if this scenario is occurring? What would be the outcome in the event of an audit?

            JLeflore Mathematica EH eCQM Team
            brian.summerville@cerner.com Brian Summerville
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