Brief description of measure: Multiple EC eCQMs Description of issue: The measure developer received feedback from the QDM User Group that a diagnosis datatype would be important to include in the Hospice Care library which is applied to multiple measures to capture patients receiving Hospice Care, as there may be cases where receipt of hospice care is only captured on the patient problem list. These instances are not accounted for in the current specification. The measure developer recommends adding a "Diagnosis" QDM datatype referencing 3 SNOMED-CT finding codes, which currently reside in the "Hospice Care Ambulatory" value set (OID: 2.16.840.1.113883.3.526.3.1584) and map to "Intervention, Performed" and "Intervention, Order" datatypes.  Goal of review: Obtain clinical and technical feedback

Proposed solution: ​"Has Hospice Services" before: exists ( ["Encounter, Performed": "Encounter Inpatient"] InpatientEncounter     where ( InpatientEncounter.dischargeDisposition ~ "Discharge to home for hospice care (procedure)"         or InpatientEncounter.dischargeDisposition ~ "Discharge to healthcare facility for hospice care (procedure)"    )       and InpatientEncounter.relevantPeriod ends during day of "Measurement Period")   or exists ( ["Encounter, Performed": "Hospice Encounter"] HospiceEncounter       where HospiceEncounter.relevantPeriod overlaps "Measurement Period"  )   or exists ( ["Assessment, Performed": "Hospice care [Minimum Data Set]"] HospiceAssessment       where HospiceAssessment.result ~ "Yes (qualifier value)"         and Global."NormalizeInterval" ( HospiceAssessment.relevantDatetime, HospiceAssessment.relevantPeriod ) overlaps "Measurement Period"  )   or exists ( ["Intervention, Order": "Hospice Care Ambulatory"] HospiceOrder       where HospiceOrder.authorDatetime during day of "Measurement Period"  )   or exists ( ["Intervention, Performed": "Hospice Care Ambulatory"] HospicePerformed       where Global."NormalizeInterval" ( HospicePerformed.relevantDatetime, HospicePerformed.relevantPeriod ) overlaps "Measurement Period"  ) "Has Hospice Services" after: exists ( ["Encounter, Performed": "Encounter Inpatient"] InpatientEncounter     where ( InpatientEncounter.dischargeDisposition ~ "Discharge to home for hospice care (procedure)"         or InpatientEncounter.dischargeDisposition ~ "Discharge to healthcare facility for hospice care (procedure)"    )       and InpatientEncounter.relevantPeriod ends during day of "Measurement Period")   or exists ( ["Encounter, Performed": "Hospice Encounter"] HospiceEncounter       where HospiceEncounter.relevantPeriod overlaps "Measurement Period"  )   or exists ( ["Assessment, Performed": "Hospice care [Minimum Data Set]"] HospiceAssessment       where HospiceAssessment.result ~ "Yes (qualifier value)"         and Global."NormalizeInterval" ( HospiceAssessment.relevantDatetime, HospiceAssessment.relevantPeriod ) overlaps "Measurement Period"  )   or exists ( ["Intervention, Order": "Hospice Care Ambulatory"] HospiceOrder       where HospiceOrder.authorDatetime during day of "Measurement Period"  )   or exists ( ["Intervention, Performed": "Hospice Care Ambulatory"] HospicePerformed       where Global."NormalizeInterval" ( HospicePerformed.relevantDatetime, HospicePerformed.relevantPeriod ) overlaps "Measurement Period"  ) or exists ( ["Diagnosis": "Hospice Diagnosis"] HospiceCareDiagnosis       where HospiceCareDiagnosis.prevalencePeriod overlaps "Measurement Period"   ) Value Set/Codes before:  •value set "Hospice Care Ambulatory" (2.16.840.1.113883.3.526.3.1584)  Value Set/Codes after:  •value set "Hospice Care Ambulatory" (2.16.840.1.113883.3.526.3.1584)  ///Remove codes 170935008 Full care by hospice (finding), 170936009 Shared care - hospice and general practitioner (finding), 305911006 Seen in hospice (finding) •value set "Hospice Diagnosis" (2.16.840.1.113883.3.464.1003.1165) ///Add codes 170935008 Full care by hospice (finding), 170936009 Shared care - hospice and general practitioner (finding), 305911006 Seen in hospice (finding) Rationale for change: Based on QDM User Group feedback, we will add in the "Diagnosis" datatype and reference a new value set containing existing SNOMED-CT finding codes that indicate receipt of hospice care. This will provide a method to identify patients who have hospice care documented in their problem list.