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  2. CQM-7586

eCQM CMS506 Confusing New Logic with Medication and Intervention for Treatment of Opioid Use Disorders

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    • Icon: EH/CAH eCQMs - Eligible Hospitals/Critical Access Hospitals EH/CAH eCQMs - Eligible Hospitals/Critical Access Hospitals
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      Thank you for your question regarding CMS506v7 Safe Use of Opioids - Concurrent Prescribing. The coalesce operator returns the first value that is not null. The use in these patterns are to help to find the first non-null datetime value associated with the "Treatment for Opioid Use Disorders" definition in the first example and the medication treatment in the second, whether the data is collected using a datetime or period. Yes, that is correct that the author datetime is referring to the medication treatment, not the MAT Intervention seen in the second pattern example. The ‘with’ clause allows relationships between the primary source and other clinical information to be used to filter the result. The query, or definition, starts with a primary source of medication treatment and uses the ‘with’ clause to filter those also receiving "Opioid Medication Assisted Treatment (MAT)" where the medication treatment’s applicable timings collected occur during the day of the MAT intervention’s applicable timings collected. Your interpretation is correct. There is a helpful video to support you in understanding the use of coalesce, navigate to the teach me video series and review the recording found on this page - https://ecqi.healthit.gov/new-resources-available-teach-me-clinical-quality-language-cql-video-series.

      For questions and issues related to the development and implementation of the CQL standard, please submit a ticket to the CQL Issue Tracker: https://oncprojectracking.healthit.gov/support/projects/CQLIT.
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      Thank you for your question regarding CMS506v7 Safe Use of Opioids - Concurrent Prescribing. The coalesce operator returns the first value that is not null. The use in these patterns are to help to find the first non-null datetime value associated with the "Treatment for Opioid Use Disorders" definition in the first example and the medication treatment in the second, whether the data is collected using a datetime or period. Yes, that is correct that the author datetime is referring to the medication treatment, not the MAT Intervention seen in the second pattern example. The ‘with’ clause allows relationships between the primary source and other clinical information to be used to filter the result. The query, or definition, starts with a primary source of medication treatment and uses the ‘with’ clause to filter those also receiving "Opioid Medication Assisted Treatment (MAT)" where the medication treatment’s applicable timings collected occur during the day of the MAT intervention’s applicable timings collected. Your interpretation is correct. There is a helpful video to support you in understanding the use of coalesce, navigate to the teach me video series and review the recording found on this page - https://ecqi.healthit.gov/new-resources-available-teach-me-clinical-quality-language-cql-video-series . For questions and issues related to the development and implementation of the CQL standard, please submit a ticket to the CQL Issue Tracker: https://oncprojectracking.healthit.gov/support/projects/CQLIT .
    • CMS0506v7
    • Need Clarification of Coalesce and WITH statements for these Denominator Exclusions

      This logic in Denominator Exclusions, because it refers to another definition for both a Medication and an Intervention, seems to be applying the Coalesce timing to both the Medication and the Intervention.
      *or exists ( "Treatment for Opioid Use Disorders" OUDTreatment
      where Coalesce(start of Global."NormalizeInterval"(OUDTreatment.relevantDatetime, OUDTreatment.relevantPeriod), OUDTreatment.authorDatetime) during day of InpatientEncounter.relevantPeriod*

      Here is the further definition and timing for Treatment for Opioid Use Disorders, where Author date time is not included in the Intervention. Is that correct?

      ["Medication, Active": "Medications for Opioid Use Disorder (MOUD)"]
      union ["Medication, Order": "Medications for Opioid Use Disorder (MOUD)"] ) MedicationTreatment
      with ["Intervention, Performed": "Opioid Medication Assisted Treatment (MAT)"] MAT
      such that Coalesce(start of Global."NormalizeInterval"(MedicationTreatment.relevantDatetime, MedicationTreatment.relevantPeriod), MedicationTreatment.authorDatetime) during day of Global."NormalizeInterval" ( MAT.relevantDatetime, MAT.relevantPeriod )
      and Coalesce(start of Global."NormalizeInterval"(MedicationTreatment.relevantDatetime, MedicationTreatment.relevantPeriod), MedicationTreatment.authorDatetime) during day of "Measurement Period"+*

      What is the meaning of the "with "Intervention, Performed" clause in the middle of the Medication definition? Is it saying that the medication Relevant date/time, Relevant period or Author Date/Time has to be during a day of the Intervention/Treatment Relevant Date/Time, Relevant period?

            aweber Mathematica EH eCQM Team
            megbutler Margaret Butler
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