We were told by our Oracle vendor, that their architects built this measure to only look at the first opioid ever given, and then look to see if there was an opioid antagonist administered with in 12 hours of that first opioid. From how the measure specifications read, it states, "Medication Administered": "OPIOIDS ALL". The Numerator of the measure states, " Inpatient hospitalizations where an opioid antagonist was administered outside of the operating room and within 12 hours following administration of an opioid medication. The route of administration of the opioid antagonist must be by intranasal spray, inhalation, intramuscular, subcutaneous, or intravenous injection." It states, "an" opioid, not the "first" opioid. Clinically it makes no sense for the measure if the only the first opioid is ever looked at. Clinically thinking through this, it would seem that the measure is trying to capture any instance that an opioid antagonist is given, which would mean anytime during the patient's hospital course, not just looking at the first opioid given and if the patient received an opioid antagonist based off of that first opioid, and looking at no other opioids given after if the first opioid never required an opioid antagonist. Is my assumption correct, that the measure should be looking at all opioids and if there was ever an opioid antagonist given throughout the patient's hospital stay? Thanks!