In the numerator of VTE2, there exists the following code:

■OR:
■OR: "Device, Applied not done: Patient Refusal" for "Graduated compression stockings (GCS) SNOMED-CT Value Set"
■OR: "Device, Applied not done: Patient Refusal" for "Venous foot pumps (VFP) SNOMED-CT Value Set"
■OR: "Device, Applied not done: Patient Refusal" for "Intermittent pneumatic compression devices (IPC) SNOMED-CT Value Set"
■starts after start of "Occurrence A of Encounter, Performed: Inpatient Encounter"

Since this is starts after start of the encounter, with no end limiter, there could be a problem if the patient had two encounters

Encounter 1 from 10/1/13 to 10/5/13, has no VTE prophylaxis and no reason for not having one
Encounter 2 from 10/10/13 to 10/15/13 has a patient refusal for
"Intermittent pneumatic compression devices (IPC) SNOMED-CT Value Set" on 10/11/13

If Encounter 1 is run through the logic above on any day after 10/11/13, the result of the logic above would be a true, because 10/11/13 is after 10/1/13, even though during encounter 1 the patient was never given VTE Prophylaxis.

This code would work better if it was looking for "starts during" encounter instead of starts after start of encounter