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  2. CQM-5704

CRP: Create unique value set for antibiotics for Upper Respiratory Infection

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    • Icon: Other Other
    • Resolution: Resolved
    • Icon: Moderate Moderate
    • None
    • ​​We plan to move forward with the proposed change during this Annual Update​
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      Brief description of measure
      CMS154: Appropriate Treatment for Upper Respiratory Infection (URI):
      Percentage of episodes for patients 3 months of age and older with a diagnosis of upper respiratory infection (URI) that did not result in an antibiotic order.

      Description of issue
      ​​CMS146 (Appropriate Testing for Pharyngitis) and CMS154 (Appropriate Treatment for Upper Respiratory Infection) currently use the same value set for antibiotic medications. The measure developer would like to ​maintain separate antibiotic medication value sets for CMS146 and CMS154 as the measures are constructed differently and are intended to have a different set of appropriate antibiotic medications.

      Goal of review
      Obtain clinical feedback
      Show
      Brief description of measure CMS154: Appropriate Treatment for Upper Respiratory Infection (URI): Percentage of episodes for patients 3 months of age and older with a diagnosis of upper respiratory infection (URI) that did not result in an antibiotic order. Description of issue ​​CMS146 (Appropriate Testing for Pharyngitis) and CMS154 (Appropriate Treatment for Upper Respiratory Infection) currently use the same value set for antibiotic medications. The measure developer would like to ​maintain separate antibiotic medication value sets for CMS146 and CMS154 as the measures are constructed differently and are intended to have a different set of appropriate antibiotic medications. Goal of review Obtain clinical feedback
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      Proposed solution
      ​Replace value set "Antibiotic Medications for Pharyngitis" (OID: 2.16.840.1.113883.3.464.1003.196.12.1001)
      with value set “Antibiotic Medications for Upper Respiratory Infection” (OID: 2.16.840.1.113883.3.464.1003.1190)

      //Logic - before

      define "Numerator":
        "Encounter with Upper Respiratory Infection" EncounterWithURI
          without ["Medication, Order": "Antibiotic Medications for Pharyngitis"] OrderedAntibiotic
            such that [...]

      define "Encounter with Upper Respiratory Infection and Antibiotics Active 30 Days Prior Or The First Day of the Encounter":
        "Encounter with Upper Respiratory Infection" EncounterWithURI
          with ["Medication, Active": "Antibiotic Medications for Pharyngitis"] ActiveAntibiotic
            such that [...]

      //Logic - after

      define "Numerator":
        "Encounter with Upper Respiratory Infection" EncounterWithURI
          without ["Medication, Order": "Antibiotic Medications for Upper Respiratory Infection"] OrderedAntibiotic
            such that [...]

      define "Encounter with Upper Respiratory Infection and Antibiotics Active 30 Days Prior Or The First Day of the Encounter":
        "Encounter with Upper Respiratory Infection" EncounterWithURI
          with ["Medication, Active": "Antibiotic Medications for Upper Respiratory Infection"] ActiveAntibiotic
            such that [...]

      Rationale for change
      This change will align with the measure intent to create specific value sets of antibiotics based on the condition and apply to respective measures.
      Show
      Proposed solution ​Replace value set "Antibiotic Medications for Pharyngitis" (OID: 2.16.840.1.113883.3.464.1003.196.12.1001) with value set “Antibiotic Medications for Upper Respiratory Infection” (OID: 2.16.840.1.113883.3.464.1003.1190) //Logic - before define "Numerator":   "Encounter with Upper Respiratory Infection" EncounterWithURI     without ["Medication, Order": "Antibiotic Medications for Pharyngitis"] OrderedAntibiotic       such that [...] define "Encounter with Upper Respiratory Infection and Antibiotics Active 30 Days Prior Or The First Day of the Encounter":   "Encounter with Upper Respiratory Infection" EncounterWithURI     with ["Medication, Active": "Antibiotic Medications for Pharyngitis"] ActiveAntibiotic       such that [...] //Logic - after define "Numerator":   "Encounter with Upper Respiratory Infection" EncounterWithURI     without ["Medication, Order": "Antibiotic Medications for Upper Respiratory Infection"] OrderedAntibiotic       such that [...] define "Encounter with Upper Respiratory Infection and Antibiotics Active 30 Days Prior Or The First Day of the Encounter":   "Encounter with Upper Respiratory Infection" EncounterWithURI     with ["Medication, Active": "Antibiotic Medications for Upper Respiratory Infection"] ActiveAntibiotic       such that [...] Rationale for change This change will align with the measure intent to create specific value sets of antibiotics based on the condition and apply to respective measures.

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