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  2. CQM-5465

CMS156v11 - Average Daily Dose(MedicationOrder "Medication, Order")

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      Thank you for your inquiry regarding CMS156v11, Use of High-Risk Medications in Older Adults (2023 Performance Period).

      1. In this function, "Order.supply" anticipates the number of tablets or pills (no specific unit is required), or volume of medication (in mL). The "supply" attribute is more formally defined in QDM v5.6 as "The quantity (amount) of therapeutic agent provided to a patient per dispensing event (i.e., number of doses, number of tablets or pills, volume of medication) indicated to be given during a procedure, diagnostic test, or medication, or substance administration.". For more information, you may refer to QDM v5.6 Table 29 QDM Attribute Definitions (https://ecqi.healthit.gov/sites/default/files/QDM-v5.6-508.pdf#page=82) or direct questions to the QDM Issue Tracker.

      2. For an example calculation of average daily dose, please refer to the following statement available in the Guidance section of the CMS156v11 header (https://ecqi.healthit.gov/sites/default/files/ecqm/measures/CMS156v11-v2.html).

      "Calculate average daily dose for each prescription event. To calculate average daily dose, multiply the quantity of pills prescribed by the dose of each pill and divide by the days supply. For example, a prescription for the 30-days supply of digoxin containing 15 pills, 0.25 mg each pill, has an average daily dose of 0.125 mg. To calculate average daily dose for elixirs and concentrates, multiply the volume prescribed by daily dose and divide by the days supply. Do not round when calculating average daily dose."
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      Thank you for your inquiry regarding CMS156v11, Use of High-Risk Medications in Older Adults (2023 Performance Period). 1. In this function, "Order.supply" anticipates the number of tablets or pills (no specific unit is required), or volume of medication (in mL). The "supply" attribute is more formally defined in QDM v5.6 as "The quantity (amount) of therapeutic agent provided to a patient per dispensing event (i.e., number of doses, number of tablets or pills, volume of medication) indicated to be given during a procedure, diagnostic test, or medication, or substance administration.". For more information, you may refer to QDM v5.6 Table 29 QDM Attribute Definitions ( https://ecqi.healthit.gov/sites/default/files/QDM-v5.6-508.pdf#page=82 ) or direct questions to the QDM Issue Tracker. 2. For an example calculation of average daily dose, please refer to the following statement available in the Guidance section of the CMS156v11 header ( https://ecqi.healthit.gov/sites/default/files/ecqm/measures/CMS156v11-v2.html ). "Calculate average daily dose for each prescription event. To calculate average daily dose, multiply the quantity of pills prescribed by the dose of each pill and divide by the days supply. For example, a prescription for the 30-days supply of digoxin containing 15 pills, 0.25 mg each pill, has an average daily dose of 0.125 mg. To calculate average daily dose for elixirs and concentrates, multiply the volume prescribed by daily dose and divide by the days supply. Do not round when calculating average daily dose."
    • CMS0156v11

      Hi Team,

      Consider below statements from CMS156v11 measure :

      Average Daily Dose(MedicationOrder "Medication, Order")

      MedicationOrder Order

        let MedicationStrength: "MedicationStrengthPerUnit"(Order.code),

        DaysSupplied: Coalesce(Order.daysSupplied, Order.supply.value /(Order.dosage.value * CMD.ToDaily(Order.frequency)))

        return if DaysSupplied is not null

          and ( MedicationStrength.unit = 'mg'

              or ( MedicationStrength.unit = 'mg/mL'

                  and Order.supply.unit = 'mL'

              )

          ) then ( ( Order.supply * MedicationStrength ) / Quantity { value: DaysSupplied, unit: 'd' } )

          else null

      Query :

      What is order.supply in the above formula of average daily dose?

      We have examples for CMD calculation(days supplied) in QDM v5.6. Similarly can you provide an example of Average daily dose calculation for better understanding.

      Kindly assist us on the above query urgently as client deliverables are dependent upon it.

            edave Mathematica EC eCQM Team
            AkashP Akash Pawar
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