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  2. CQM-5701

CRP: Revised timing to 'day of' specificity to align with measure intent

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    • Other
    • Resolution: Resolved
    • Moderate
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      Brief description of measure
      CMS646: Intravesical Bacillus-Calmette-Guerin for non-muscle invasive bladder cancer:
      Percentage of patients initially diagnosed with non-muscle invasive bladder cancer and who received intravesical Bacillus-Calmette-Guerin (BCG) within 6 months of bladder cancer staging.

      CMS771: Urinary Symptom Score Change 6-12 Months After Diagnosis of Benign Prostatic Hyperplasia:
      Percentage of patients with an office visit within the measurement period and with a new diagnosis of clinically significant Benign Prostatic Hyperplasia who have International Prostate Symptoms Score (IPSS) or American Urological Association (AUA) Symptom Index (SI) documented at time of diagnosis and again 6-12 months later with an improvement of 3 points.

      Description of issue
      Measurement Period should be updated to "day of Measurement Period" to harmonize with other measures and as a consideration for the transition to FHIR.

      Goal of review
      Obtain technical feedback
      Show
      Brief description of measure CMS646: Intravesical Bacillus-Calmette-Guerin for non-muscle invasive bladder cancer: Percentage of patients initially diagnosed with non-muscle invasive bladder cancer and who received intravesical Bacillus-Calmette-Guerin (BCG) within 6 months of bladder cancer staging. CMS771: Urinary Symptom Score Change 6-12 Months After Diagnosis of Benign Prostatic Hyperplasia: Percentage of patients with an office visit within the measurement period and with a new diagnosis of clinically significant Benign Prostatic Hyperplasia who have International Prostate Symptoms Score (IPSS) or American Urological Association (AUA) Symptom Index (SI) documented at time of diagnosis and again 6-12 months later with an improvement of 3 points. Description of issue Measurement Period should be updated to "day of Measurement Period" to harmonize with other measures and as a consideration for the transition to FHIR. Goal of review Obtain technical feedback
    • Hide
      Proposed solution
      ​Revise logic to include "day of Measurement Period" instead of "Measurement Period".

      CMS646
      CURRENT LOGIC:
      define "Has Qualifying Encounter"
        exists ["Encounter, Performed": "Office Visit"] ValidEncounter
          where ValidEncounter.relevantPeriod during "Measurement Period"
            and ValidEncounter.class !~ "virtual"

      PROPOSED LOGIC:
      define "Has Qualifying Encounter"
        exists ["Encounter, Performed": "Office Visit"] ValidEncounter
           where ValidEncounter.relevantPeriod during day of "Measurement Period"
             and ValidEncounter.class !~ "virtual"

      CMS771:
      CURRENT LOGIC:
      define "BMI Exam Result Greater Than or Equal To 40 During Measurement Period and On or Before Follow Up USS Assessment"
         exists[...]
                 and Global.EarliestOf(BMIExam.relevantDatetime, BMIExam.relevantPeriod)during "Measurement Period"
                 and Global.EarliestOf(BMIExam.relevantDatetime, BMIExam.relevantPeriod)on or before FollowUpUSSAssessment.assessmentDatetime
             return Global.EarliestOf(BMIExam.relevantDatetime, BMIExam.relevantPeriod))

      define "Has Qualifying Encounter"
        exists ["Encounter, Performed": "Office Visit"] ValidEncounter
          where ValidEncounter.relevantPeriod during "Measurement Period"
            and ValidEncounter.class !~ "virtual"

      PROPOSED LOGIC:  
      define "BMI Exam Result Greater Than or Equal To 40 During Measurement Period and On or Before Follow Up USS Assessment"
         exists[...]
              and Global.EarliestOf(BMIExam.relevantDatetime, BMIExam.relevantPeriod)during day of "Measurement Period"
              and Global.EarliestOf(BMIExam.relevantDatetime, BMIExam.relevantPeriod)on or before FollowUpUSSAssessment.assessmentDatetime
          return Global.EarliestOf(BMIExam.relevantDatetime, BMIExam.relevantPeriod))

      define "Has Qualifying Encounter"
         exists ["Encounter, Performed": "Office Visit"] ValidEncounter
             where ValidEncounter.relevantPeriod during day of "Measurement Period"
               and ValidEncounter.class !~ "virtual"

      Rationale for change
      ​Revising the timing harmonizes with the approach across measures, and aligns with the measure intent.
      Show
      Proposed solution ​Revise logic to include "day of Measurement Period" instead of "Measurement Period". CMS646 CURRENT LOGIC: define "Has Qualifying Encounter"   exists ["Encounter, Performed": "Office Visit"] ValidEncounter     where ValidEncounter.relevantPeriod during "Measurement Period"       and ValidEncounter.class !~ "virtual" PROPOSED LOGIC: define "Has Qualifying Encounter"   exists ["Encounter, Performed": "Office Visit"] ValidEncounter      where ValidEncounter.relevantPeriod during day of "Measurement Period"        and ValidEncounter.class !~ "virtual" CMS771: CURRENT LOGIC: define "BMI Exam Result Greater Than or Equal To 40 During Measurement Period and On or Before Follow Up USS Assessment"    exists[...]            and Global.EarliestOf(BMIExam.relevantDatetime, BMIExam.relevantPeriod)during "Measurement Period"            and Global.EarliestOf(BMIExam.relevantDatetime, BMIExam.relevantPeriod)on or before FollowUpUSSAssessment.assessmentDatetime        return Global.EarliestOf(BMIExam.relevantDatetime, BMIExam.relevantPeriod)) define "Has Qualifying Encounter"   exists ["Encounter, Performed": "Office Visit"] ValidEncounter     where ValidEncounter.relevantPeriod during "Measurement Period"       and ValidEncounter.class !~ "virtual" PROPOSED LOGIC:   define "BMI Exam Result Greater Than or Equal To 40 During Measurement Period and On or Before Follow Up USS Assessment"    exists[...]         and Global.EarliestOf(BMIExam.relevantDatetime, BMIExam.relevantPeriod)during day of "Measurement Period"         and Global.EarliestOf(BMIExam.relevantDatetime, BMIExam.relevantPeriod)on or before FollowUpUSSAssessment.assessmentDatetime     return Global.EarliestOf(BMIExam.relevantDatetime, BMIExam.relevantPeriod)) define "Has Qualifying Encounter"    exists ["Encounter, Performed": "Office Visit"] ValidEncounter        where ValidEncounter.relevantPeriod during day of "Measurement Period"          and ValidEncounter.class !~ "virtual" Rationale for change ​Revising the timing harmonizes with the approach across measures, and aligns with the measure intent.

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          edave Mathematica EC eCQM Team
          edave Mathematica EC eCQM Team
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            Updated:
            Resolved: