I've done some reasearch on the references used in this measure, and I can't figure out the logic surrounding the exclusion of prolonged QT interval, specfically that it start within 24 hours after the start of the admission. The measure is only interested in excluding patients who did not have prolonged QT on admission, and then developed it within the first day of admission only? There is no reference anywhere else in the meausure regarding the reason for this exclusion, and the specification itself is so impractical as to make the exclusion meaningless, since it basically requires that it be recorded somewhere in a time sensitive way only on the first day. Some clarification from the measure steward on the intent here would be helpful to all.