Brief Description of Measure: CMS314: HIV Viral Suppression Percentage of patients, regardless of age, diagnosed with HIV prior to or during the first 90 days of the measurement period, with an eligible encounter in the first 240 days of the measurement period, whose last HIV viral load test result was less than 200 copies/mL during the measurement period Description of Issue: Based on feedback received via ONC Jira, some measure reporters are submitting viral load values as log values, rather than numeric values. Reporters noted uncertainty about how they should handle log values for viral load.

Proposed Solution: The measure steward recommends updating the guidance statement in the measure to provide additional clarity. Existing language: "This eCQM is a patient-based measure. HIV viral load data should be captured either as a numeric value or as a character/text value, depending on whether a given viral load result falls above or below the lab’s lower limit of detection. For viral loads at or above the lower limit of detection, the viral load should be captured as a numeric value (expressed as the number of copies/mL). For viral loads below the lower limit of detection, the viral load should be populated with a character/text value equivalent to "Below lower limit of detection." The EHR need not record this character value using this exact wording (for example, the character value could be recorded as "<20 copies/mL" or "not detected"), but values below the lower limit of detection should be documented to allow the submitter to accurately map them to a value of "Below lower limit of detection" for reporting purposes. This version of the eCQM uses QDM version 5.6. Please refer to the eCQI resource center ( https://ecqi.healthit.gov/qdm ) for more information on the QDM." Revised language (updated text in asterisks): "This eCQM is a patient-based measure. HIV viral load data should be captured either as a numeric value or as a character/text value, depending on whether a given viral load result falls above or below the lab’s lower limit of detection. For viral loads at or above the lower limit of detection, the viral load should be captured as a numeric value (expressed as the number of copies/mL). For viral loads below the lower limit of detection, the viral load should be populated with a character/text value equivalent to "Below lower limit of detection." The EHR need not record this character value using this exact wording (for example, the character value could be recorded as "<20 copies/mL" or "not detected"), but values below the lower limit of detection should be documented to allow the submitter to accurately map them to a value of "Below lower limit of detection" for reporting purposes. *HIV viral load test results may be expressed as log values (log copies/mL). For this eCQM, please convert the log value to copies/mL.* This version of the eCQM uses QDM version 5.6. Please refer to the eCQI resource center ( https://ecqi.healthit.gov/qdm ) for more information on the QDM." Rationale for Change: The revised guidance provides clarification on the approach to log values in the measure. This guidance update aligns with measure intent and measure logic.