Brief description of measure CMS996: Appropriate Treatment for ST-Segment Elevation Myocardial Infarction (STEMI) Patients in the Emergency Department (ED) Percentage of emergency department (ED) encounters for patients 18 years and older with a diagnosis of ST-segment elevation myocardial infarction (STEMI) that received appropriate treatment, defined as fibrinolytic therapy within 30 minutes of ED arrival, percutaneous coronary intervention (PCI) within 90 minutes of ED arrival, or transfer within 45 minutes of ED arrival Description of issue ​The STEMI eCQM currently requires the duration of the relevant encounter occur during the measurement period (i.e., Encounter.relevantPeriod during "Measurement Period"). However, the measure developer received a question asking whether modifying the timing to only look for encounters that began during the measurement period would be more appropriate (i.e., Encounter.relevantPeriod starts during "Measurement Period") throughout the logic. Goal of review Obtain technical feedback

Proposed solution The measure developer proposes revising the measure logic to indicate that Encounter.RelevantPeriod starts during the Measurement Period instead of Encounter.RelevantPeriod during the Measurement Period. CURRENT LOGIC: define "ED Encounter with Diagnosis of STEMI" ["Encounter, Performed": "ED"] EDEncounter   with ["Diagnosis": "STEMI"] DxSTEMI     such that ( DxSTEMI.prevalencePeriod starts during EDEncounter.relevantPeriod )       and EDEncounter.relevantPeriod during "Measurement Period"   define "ED Encounter with Encounter Diagnosis of STEMI" ["Encounter, Performed": "ED"] EDEncounter   with EDEncounter.diagnoses EncounterDiagnosis     such that EncounterDiagnosis.code in "STEMI"       and EDEncounter.relevantPeriod during "Measurement Period" PROPOSED LOGIC: define "ED Encounter with Diagnosis of STEMI" ["Encounter, Performed": "ED"] EDEncounter   with ["Diagnosis": "STEMI"] DxSTEMI     such that ( DxSTEMI.prevalencePeriod starts during EDEncounter.relevantPeriod )       and EDEncounter.relevantPeriod starts during "Measurement Period"   define "ED Encounter with Encounter Diagnosis of STEMI" ["Encounter, Performed": "ED"] EDEncounter   with EDEncounter.diagnoses EncounterDiagnosis     such that EncounterDiagnosis.code in "STEMI"       and EDEncounter.relevantPeriod starts during "Measurement Period" Rationale for change ​The intent of the measure is to capture ED visits that begin (but may not end) during the Measurement Period.