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  2. CQM-6176

CMS819v2: Query for IPP and Numerator

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      ​Hello and thank you for your inquiry about to CMS819v2 Hospital Harm - Opioid-Related Adverse Events. In response to query 1, only operating room/suite locations that occur during the qualifying inpatient encounter are considered for the initial population. The initial population includes patients given an opioid while not in the operating room/suite.

      The logic referenced in the numerator in query 2, captures an opioid administration that began during the hospitalization. The "Global."NormalizeInterval" function allows the opioid administration start to be identified as either a relevantDatetime, the time the medication is administered if it was given or taken at a single point in time, or relevantPeriod, the start and stop time for a single medication administration if the administration event occurred over a time interval. The opioid administration must also start during the hospitalization. As in the initial population, the hospitalization period includes the Global."HospitalizationWithObservation" function which includes time in the emergency department and observation when the transition between these encounters (if they exist) and the inpatient encounter are within an hour or less of each other.

      We hope this helps.
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      ​Hello and thank you for your inquiry about to CMS819v2 Hospital Harm - Opioid-Related Adverse Events. In response to query 1, only operating room/suite locations that occur during the qualifying inpatient encounter are considered for the initial population. The initial population includes patients given an opioid while not in the operating room/suite. The logic referenced in the numerator in query 2, captures an opioid administration that began during the hospitalization. The "Global."NormalizeInterval" function allows the opioid administration start to be identified as either a relevantDatetime, the time the medication is administered if it was given or taken at a single point in time, or relevantPeriod, the start and stop time for a single medication administration if the administration event occurred over a time interval. The opioid administration must also start during the hospitalization. As in the initial population, the hospitalization period includes the Global."HospitalizationWithObservation" function which includes time in the emergency department and observation when the transition between these encounters (if they exist) and the inpatient encounter are within an hour or less of each other. We hope this helps.
    • CMS0819v2

      Hi Team,

       

      Consider the below part from IPP:

       

      Encounter with Opioid Administration Outside of Operating Room :
      "Qualifying Encounter" InpatientEncounter
        with "Opioid Administration" OpioidGiven
          such that Global."NormalizeInterval" ( OpioidGiven.relevantDatetime, OpioidGiven.relevantPeriod ) starts during Global."HospitalizationWithObservation" ( InpatientEncounter )
            and not exists ( InpatientEncounter.facilityLocations EncounterLocation
                where EncounterLocation.code ~ "Operating Room/Suite"
                  and Global."NormalizeInterval" ( OpioidGiven.relevantDatetime, OpioidGiven.relevantPeriod ) starts during EncounterLocation.locationPeriod
            )

      Query 1:

      From the above statement, we understand that the operating room/ suite should be during Inpatient encounter ( IPadmit to IPdischarge). Kindly confirm our understanding.

       

      Consider the below part from Numerator:

      Encounter with Non-Enteral Opioid Antagonist Administration Outside of Operating Room and within 12 Hrs After Opioid 

      //Opioids administered before opioid antagonist AND excludes opioid antagonist administered in operating room AND limits opioid antagonist to non-enteral routes

      from ["Medication, Administered": "Opioid Antagonist"] OpioidAntagonistGiven,

        "Opioid Administration" OpioidGiven,

        "Denominator" EncounterWithQualifyingAge

        where not exists ( EncounterWithQualifyingAge.facilityLocations EncounterLocation

            where EncounterLocation.code ~ "Operating Room/Suite"

              and Global."NormalizeInterval" ( OpioidAntagonistGiven.relevantDatetime, OpioidAntagonistGiven.relevantPeriod )

      starts during EncounterLocation.locationPeriod )  

      and ( Global."NormalizeInterval" ( OpioidAntagonistGiven.relevantDatetime, OpioidAntagonistGiven.relevantPeriod )

      starts during Global."HospitalizationWithObservation" ( EncounterWithQualifyingAge )

              and Global."NormalizeInterval" ( OpioidGiven.relevantDatetime, OpioidGiven.relevantPeriod )

      starts during Global."HospitalizationWithObservation" ( EncounterWithQualifyingAge )

              and Global."NormalizeInterval" ( OpioidGiven.relevantDatetime, OpioidGiven.relevantPeriod )

      ends 12 hours or less before start of Global."NormalizeInterval" ( OpioidAntagonistGiven.relevantDatetime, OpioidAntagonistGiven.relevantPeriod )

              and OpioidAntagonistGiven.route in "Routes of Administration for Opioid Antagonists"

          )

        return EncounterWithQualifyingAge

       

      Query 2:

       

      Also, we would like to understand the use of the statement "Global."NormalizeInterval" ( OpioidGiven.relevantDatetime, OpioidGiven.relevantPeriod )starts during Global."HospitalizationWithObservation" ( EncounterWithQualifyingAge )" in the numerator as it was part of IPP too. Also, do we need to consider it in numerator logic configuration?

       

      Request you to provide us with the resolution urgently as our client deliverables are dependent on it.

       

       

            JLeflore Mathematica EH eCQM Team
            SimranM2 Simran Motwani (Inactive)
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