In validating our hospitals’ results for the eCQM STEMI measure OP-40, it was clear that the measure logic placed patients into the Initial Patient Population who did not have a STEMI in the Emergency Department. For example, a patient who had a STEMI on an inpatient unit several days after admission was included in the IPP due to a diagnosis of STEMI from the later event. The measure requires that the patient receive treatment within a short time after arrival in the ED This patient was inappropriate for the IPP and did not receive the treatment in the required time window as there was no need for treatment in the ED.
The chart abstracted measures that the eCQM measure replaced such as OP-02 required an “Initial ECG Interpretation.” If this was missing, the case was rejected. Wouldn’t it be appropriate to include an initial ECG interpretation in the Emergency Department as a criteria for including patients in the Initial Patient Population for OP-40?