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  1. eCQM Issue Tracker
  2. CQM-693

Device, Applied not done "During" encounter, effective datetimes?

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    • Icon: Annual Update Annual Update
    • Resolution: Fixed
    • Icon: Minor Minor
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    • Tamara Bailey
    • 520.750.4324
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      Thank you for your question. Your comment regarding the NQF data type is correct. In the current QDM specification, the "Device Applied" datatype only includes “Start Time” and “Removal Time” attributes; it does not include an “End Time” attribute to indicate a device application end time. This concern will be forwarded to NQF to determine if the concept is necessary for clinical quality measurement context and update the QDM datatype for “Device Applied" accordingly.

      To more accurately represent the intent of “During” in the measure, "Starts During" replaced "During" in the specifications for the April 2014 annual update.

      For the mentioned VTE measures containing "Device, Applied not done: . . . ", the intent is to identify the "device application was not performed during an encounter", which is applicable in the VTE measures.

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      Thank you for your question. Your comment regarding the NQF data type is correct. In the current QDM specification, the "Device Applied" datatype only includes “Start Time” and “Removal Time” attributes; it does not include an “End Time” attribute to indicate a device application end time. This concern will be forwarded to NQF to determine if the concept is necessary for clinical quality measurement context and update the QDM datatype for “Device Applied" accordingly. To more accurately represent the intent of “During” in the measure, "Starts During" replaced "During" in the specifications for the April 2014 annual update. For the mentioned VTE measures containing "Device, Applied not done: . . . ", the intent is to identify the "device application was not performed during an encounter", which is applicable in the VTE measures.

      In multiple places in the VTE measures it looks for Device, Applied not done "during" an encounter. For example:

      OR:
      OR: "Device, Applied not done: Medical Reason" for "Intermittent pneumatic compression devices (IPC) SNOMED-CT Value Set"
      OR: "Device, Applied not done: Medical Reason" for "Venous foot pumps (VFP) SNOMED-CT Value Set"
      OR: "Device, Applied not done: Medical Reason" for "Graduated compression stockings (GCS) SNOMED-CT Value Set"
      during "Occurrence A of Encounter, Performed: Emergency Department Visit"

      The Device, Applied datatype shows a "start datetime" attribute, but no "end datetime" attribute. There is a "removal datetime" attribute, but I do not believe the end date of a device application is the same as it's removal date. For example, when applying a pacemaker, the actual application isn't instantaneous, you start applying the pacemaker, and some minutes later you're done applying the pacemaker. The pacemaker isn't removed or it's removal at least isn't the end time of the application.

      So, 1) you have a gap in the QDM where you're missing an end datetime for the device application
      or 2) you can't look for Device, Applied not done "during" an encounter.

            abt.associate Abt Associate (Inactive)
            tamarabailey Tamara Bailey (Inactive)
            Balu Balasubramanyam (Inactive), Yan Heras
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