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  1. eCQM Issue Tracker
  2. CQM-6042

ePC-07 White Blood Cell (WBC) count fails to pull into report

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    • Icon: EH/CAH eCQMs EH/CAH eCQMs
    • Resolution: Answered
    • Icon: Moderate Moderate
    • None
    • None
    • Jennifer Harlos
    • 907-729-2226
    • Alaska Native Medical Center
    • Hide
      Thank you for your inquiry specific to CMS1028v1 (Severe Obstetric Complications). This measure uses a Function “FirstLabTestWithEncounterId” to incorporate the initial lab tests from your OB Triage encounter. See the initial population logic included below:

      FirstLabTestWithEncounterId(LabList List<QDM.PositiveLaboratoryTestPerformed>)
      "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" Encounter
        let FirstLab: First(LabList Lab
      //(first resulted value 24 hours prior to start of encounter and before time of delivery)
            where Lab.resultDatetime during Interval[start of PCMaternal."HospitalizationWithEDOBTriageObservation"(Encounter)- 1440 minutes, PCMaternal."LastTimeOfDelivery"(Encounter))
            sort by resultDatetime
        )
        return {
          EncounterId: Encounter.id,
          FirstResult: FirstLab.result as Quantity,
          Timing: FirstLab.resultDatetime
        }

      The measure logic is looking for the first resulted value in the interval beginning 24 hours prior to the start of the encounter, all the way up to the time of delivery. Please note, your OB triage encounter should be included in the inpatient encounter ("HospitalizationWithEDOBTriageObservation").
      In the scenario where you mention that WBC counts are obtained after admission AND before delivery, these values should be pulled into the measure. We encourage you to work with your EMR vendor as this lab value collected within 24 hours prior to admission during OB Triage and prior to delivery should fulfill the measure logic to incorporate the lab value.

      Please let us know if you have additional questions. Thank you.
      Show
      Thank you for your inquiry specific to CMS1028v1 (Severe Obstetric Complications). This measure uses a Function “FirstLabTestWithEncounterId” to incorporate the initial lab tests from your OB Triage encounter. See the initial population logic included below: FirstLabTestWithEncounterId(LabList List<QDM.PositiveLaboratoryTestPerformed>) "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" Encounter   let FirstLab: First(LabList Lab //(first resulted value 24 hours prior to start of encounter and before time of delivery)       where Lab.resultDatetime during Interval[start of PCMaternal."HospitalizationWithEDOBTriageObservation"(Encounter)- 1440 minutes, PCMaternal."LastTimeOfDelivery"(Encounter))       sort by resultDatetime   )   return {     EncounterId: Encounter.id,     FirstResult: FirstLab.result as Quantity,     Timing: FirstLab.resultDatetime   } The measure logic is looking for the first resulted value in the interval beginning 24 hours prior to the start of the encounter, all the way up to the time of delivery. Please note, your OB triage encounter should be included in the inpatient encounter ("HospitalizationWithEDOBTriageObservation"). In the scenario where you mention that WBC counts are obtained after admission AND before delivery, these values should be pulled into the measure. We encourage you to work with your EMR vendor as this lab value collected within 24 hours prior to admission during OB Triage and prior to delivery should fulfill the measure logic to incorporate the lab value. Please let us know if you have additional questions. Thank you.
    • CMS1028v1
    • Risk adjustment isn't considered for missing values.

      On our business objects reports for the ePC-07 measure we are seeing 100% of our cases not pulling in white blood cell count.  In speaking with our vendor, the rationale provided was that the documentation of WBC laboratory values did not occur in the 24 hours prior to the inpatient encounter.  We have cases of WBC counts being obtained after admission AND before delivery yet it's still not captured. Our vendor states again that the labs must be obtained in the 24 hours prior to admission, even though labs are confirmed prior to delivery.  Is this the way that it should be working? From a clinical perspective, our workflow is such that the patient is admitted, labs are obtained, and then the patient delivers and so these labs should pull in.

       

      In this same measure, heart rate and systolic blood pressure are pulling into our reports appropriately. In these cases, heart rate and systolic blood pressure are generally obtained prior to admission while in OB Triage.  Is it the intent of the measure that WBC should only be pulled in if drawn before the start of the inpatient admission? Please see the attached screenshot of specification. 

        1. epc-07 spec.PNG
          epc-07 spec.PNG
          103 kB

            JLeflore Mathematica EH eCQM Team
            jlharlos Jennifer Harlos
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