​​We plan to move forward with the proposed change during this annual update. Additionally, we will not add "'before or on day of "LastTimeOfDelivery"(Encounter)' to trigger day precision per commenter's recommendation as the clinical intent is for the assessment of gestational age to be performed prior to delivery. Timing is sensitive to date/time of delivery.

Brief description of measure CMS334/PC-02: Cesarean Birth: Nulliparous women with a term, singleton baby in a vertex position delivered by cesarean birth. CMS1028/PC-07: Severe Obstetric Complications: Patients with severe obstetric complications which occur during the inpatient delivery hospitalization. Description of issue Currently, the Estimated Delivery Date (EDD) is reported as date only, but uses the "TruncateTime" function to convert date only to date and time (where time is populated as 0000) in the Quality Data Model. This logic was used to avoid manual conversion of a date only data element to a date/time data element. The measure developer has learned the "as dateTime" function when added to the PCMaternal.LastEstimated DeliveryDate function allows date only to be submitted. With this addition, hospitals can submit a date only or a date/time and the data will process appropriately. ​In the current version of the measure, the PCMaternal Library houses the following functions to support this approach: PCMaternal.FormattedLastEstimatedDeliveryDate(Encounter "Encounter, Performed") If "LastEstimatedDeliveryDate"(Encounter)is not null then TJC."TruncateTime" ( "LastEstimatedDeliveryDate"(Encounter)) else null TJC.TruncateTime(Value DateTime) DateTime(year from Value, month from Value, day from Value, 0, 0, 0, 0, timezoneoffset from Value) Goal of review Obtain technical feedback

Proposed solution The measure developer proposes to: ​1.  Delete TJC.TruncateTime function from the measure. 2.  Add "as DateTime" to PCMaternal.LastEstimatedDeliveryDate function. PCMaternal.LastEstimatedDeliveryDate(Encounter "Encounter, Performed") //This function identifies the last time the Estimated Delivery Date was assessed 42 weeks or less prior to or on delivery and stores the result of that assessment.   Last(["Assessment, Performed": "Delivery date Estimated"] EstimatedDateOfDelivery     where Global."EarliestOf"(EstimatedDateOfDelivery.relevantDatetime, EstimatedDateOfDelivery.relevantPeriod)42 weeks or less before or on "LastTimeOfDelivery"(Encounter)       and EstimatedDateOfDelivery.result is not null     sort by Global."EarliestOf"(relevantDatetime, relevantPeriod) ).result as DateTime 3. Delete PCMaternal.FormattedLastEstimatedDeliveryDate function. 4.  Remove "Formatted" from PCMaternal.CalculatedGestationalAge function.  In other words, call the "LastEstimatedDeliveryDate" function instead of the "FormattedLastEstimatedDeliveryDate" function. Rationale for change This change will ​​simplify the logic to allow hospitals to submit date and time or date only.