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  1. eCQM Issue Tracker
  2. CQM-7563

Conflicts with units of measure for CMS529, CMS832, CMS844

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      Thank you for your inquiry regarding CMS832v1, Hospital Harm – Acute Kidney Injury. Specific to the 4 risk factor variables included in the measure (FirstBodyTemperature; FirstHeartRate; FirstRespiratoryRate; FirstSystolicBloodPressure), in both the 2024 (CMS832v1) and 2025 (CMS832v2) implementations of the eCQM specification, readings must be captured using decimals (numeric value) rather than quantities (numeric values with units). Specific to casting, CMS832v1 should capture “results as Decimal”, whereas CMS844v4 and CMS529v4 capture “results as Quantity”. The measure developer for CMS832 will consider updating the vital sign data in a future Annual Update.
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      Thank you for your inquiry regarding CMS832v1, Hospital Harm – Acute Kidney Injury. Specific to the 4 risk factor variables included in the measure (FirstBodyTemperature; FirstHeartRate; FirstRespiratoryRate; FirstSystolicBloodPressure), in both the 2024 (CMS832v1) and 2025 (CMS832v2) implementations of the eCQM specification, readings must be captured using decimals (numeric value) rather than quantities (numeric values with units). Specific to casting, CMS832v1 should capture “results as Decimal”, whereas CMS844v4 and CMS529v4 capture “results as Quantity”. The measure developer for CMS832 will consider updating the vital sign data in a future Annual Update.
    • CMS0529v4, CMS0832v1, CMS0844v4
    • A system reporting on CMS832, CMS529 and CMS844 may need to report (in QRDA I) the same data elements (e.g., ["Physical Exam, Performed": "Heart rate”]) differently for CMS832 as it would for CMS529 and CMS844.

      The logic for CMS832 is looking for the heart rate as a unitless decimal. The logic for CMS529 and CMS844 is looking for the heart rate as a quantity with a recommended unit of

      {Beats}

      /min. This also impacts the blood pressure readings, body temperature and respiratory rate.

      Its likely one would need to report a heart rate like this for CMS529 and CMS844

      <entry>
  <observation classCode="OBS" moodCode="EVN" >
    <!-- Procedure Activity Procedure (Consolidation) template -->
    <templateId root="2.16.840.1.113883.10.20.22.4.13" extension="2014-06-09"/>
    <!-- Physical Exam, Performed template -->
    <templateId root="2.16.840.1.113883.10.20.24.3.59" extension="2021-08-01"/>
    <id root="1.3.6.1.4.1.115" extension="6489ecccf9a010b4926a572f"/>
    <!-- QDM Attribute: Code -->
      <code code="8867-4" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
    <text></text>
    <statusCode code="completed"/>
    <effectiveTime value='20220615050000'/>
    <!-- QDM Attribute: Result -->
    <value xsi:type="PQ" value="65" unit="\{Beats}/min"/>
  </observation>
</entry>

      Its likely one would need to report a heart rate like this for CMS832

      <entry>
  <observation classCode="OBS" moodCode="EVN" >
    <!-- Procedure Activity Procedure (Consolidation) template -->
    <templateId root="2.16.840.1.113883.10.20.22.4.13" extension="2014-06-09"/>
    <!-- Physical Exam, Performed template -->
    <templateId root="2.16.840.1.113883.10.20.24.3.59" extension="2021-08-01"/>
    <id root="1.3.6.1.4.1.115" extension="6489ecccf9a010b4926a572f"/>
    <!-- QDM Attribute: Code -->
      <code code="8867-4" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
    <text></text>
    <statusCode code="completed"/>
    <effectiveTime value='20220615050000'/>
    <!-- QDM Attribute: Result -->
    <value xsi:type="REAL" value="65"/>
  </observation>
</entry>

      Note that there is no default conversion of a quantity to decimal in CQL. A decimal can be converted to a unitless quantity.

      Should the 3 eCQMs use the same casting, either "result as Decimal" or "result as Quantity?"

            aweber Mathematica EH eCQM Team
            dczulada David Czulada
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