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  1. eCQM Issue Tracker
  2. CQM-6636

Clarification needed for CQL logic regarding Encounter Performed

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    • Resolution: Answered
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    • CMS0996v4
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      Historical STEMI diagnoses cause the data for this measure to be inaccurate. There is no way to filter out the historical diagnosis of a STEMI. Using a Clinical Impression that flows to the Problem List for a particular encounter would eliminate historical STEMIs that are still in "Active" status from including a patient in the IPP. There are also STEMIs qualifying the patient when they occur after admission. The Clinical Impression is only used in the ED.
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      Historical STEMI diagnoses cause the data for this measure to be inaccurate. There is no way to filter out the historical diagnosis of a STEMI. Using a Clinical Impression that flows to the Problem List for a particular encounter would eliminate historical STEMIs that are still in "Active" status from including a patient in the IPP. There are also STEMIs qualifying the patient when they occur after admission. The Clinical Impression is only used in the ED.

      In the logic of the STEMI measure, a STEMI encounter is defined as 

      • /The below instance of "Emergency Department Visit" corresponds to OID 2.16.840.1.113883.3.464.1003.101.12.1010 and this OID should be used where this definition is used/
        ["Encounter, Performed": "Emergency Department Visit (1010)"] EDEncounter
        with EDEncounter.diagnoses EncounterDiagnosis
        such that EncounterDiagnosis.code in "STEMI"
        and EDEncounter.relevantPeriod during "Measurement Period"

      We would like to clarify if an Encounter Diagnosis must be used or can a Clinical Impression in the ED be used. This would filter out historical STEMIs from this measure which makes the data inaccurate. In other words, would a clinical impression qualify for an Encounter diagnosis? The Clinical Impression is only used in the ED, so we would like to use this instead of an Encounter Diagnosis to avoid patients qualifying erroneously.  

            cmaffry Cathy Maffry
            kmclaughlin@medisolv.com Karen McLaughlin
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