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  2. CQM-6858

CMS 506 Safe Use of Opioids - Patient left AMA

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      Thank you for your question regarding CMS506v6: Safe Use of Opioids - Concurrent Prescribing.

      Patients who left against medical advice are currently included in the measure. As currently specified, the measure only excludes “[p]atients: [that] have cancer that begins prior to or during the encounter or are ordered or are receiving palliative or hospice care (including comfort measures, terminal care, and dying care) during the hospitalization or in an emergency department encounter or observation stay immediately prior to hospitalization, patients discharged to another inpatient care facility, and patients who expire during the inpatient stay”. We understand there are some situations where a clinician may not be able to reconcile medications upon discharge. We will bring this scenario to the attention of our subject matter experts to evaluate if this merits future revisions to the measure.
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      Thank you for your question regarding CMS506v6: Safe Use of Opioids - Concurrent Prescribing. Patients who left against medical advice are currently included in the measure. As currently specified, the measure only excludes “[p]atients: [that] have cancer that begins prior to or during the encounter or are ordered or are receiving palliative or hospice care (including comfort measures, terminal care, and dying care) during the hospitalization or in an emergency department encounter or observation stay immediately prior to hospitalization, patients discharged to another inpatient care facility, and patients who expire during the inpatient stay”. We understand there are some situations where a clinician may not be able to reconcile medications upon discharge. We will bring this scenario to the attention of our subject matter experts to evaluate if this merits future revisions to the measure.
    • CMS0506v6
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      Patient leaving against medical advice (AMA) are not excluded from the eCQM CMS 506. Should they be?
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      Patient leaving against medical advice (AMA) are not excluded from the eCQM CMS 506. Should they be?

      We have noticed that patients may decided to leave against medical advice (AMA) and fall out for this measure. This is because clinically discharge med reconciliation is not done for a patient that leaves AMA. 
      After investigating this with our EHR vendor, we found in this scenario, the eCQM reports looks at the patient's home medication list upon admission when discharge med reconciliation is not done. 

      Our quality department is monitoring this measure and believe a patient who leaves AMA should be excluded. Why are AMA patients not considered an exclusion for this measure? 

            JLeflore Mathematica EH eCQM Team
            u18320 Kourtney Kouns
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