OP-40 STEMI diagnosis timing clarification

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    • Type: Hosp Outpt eCQMs - Hospital Outpatient eCQMs
    • Resolution: Answered
    • Priority: Moderate
    • Component/s: None
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      Thank you for your inquiry regarding CMS996v4 and CMS996v5, Appropriate Treatment for ST-Segment Elevation Myocardial Infarction (STEMI) Patients in the Emergency Department (ED). We understand your question intends to determine if a STEMI diagnosis may be captured by an automated time-stamp of the entered diagnosis or a manually entered date/time. We recommend working with your EHR vendor to ensure that the time period attributes are populated in the EHR and mapped to the appropriate QDM data element. The measure uses two time period attributes to capture a STEMI diagnosis: prevalencePeriod and relevantPeriod. PrevalencePeriod is an attribute of the “Diagnosis” datatype and signifies the onset dateTime to the abatement dateTime of the STEMI diagnosis. RelevantPeriod is an attribute of the “Encounter, Performed” datatype and signifies the startTime that the encounter began (admission time) to the stopTime that the encounter ended (discharge time). For an ED encounter with a STEMI diagnosis to be captured in the measure denominator, the STEMI diagnosis prevalencePeriod must start during the ED encounter relevantPeriod, and the ED encounter must occur during the measurement period. For more information regarding these attributes, please reference the QDM v5.6 [https://ecqi.healthit.gov/sites/default/files/QDM-v5.6-508.pdf].
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      Thank you for your inquiry regarding CMS996v4 and CMS996v5, Appropriate Treatment for ST-Segment Elevation Myocardial Infarction (STEMI) Patients in the Emergency Department (ED). We understand your question intends to determine if a STEMI diagnosis may be captured by an automated time-stamp of the entered diagnosis or a manually entered date/time. We recommend working with your EHR vendor to ensure that the time period attributes are populated in the EHR and mapped to the appropriate QDM data element. The measure uses two time period attributes to capture a STEMI diagnosis: prevalencePeriod and relevantPeriod. PrevalencePeriod is an attribute of the “Diagnosis” datatype and signifies the onset dateTime to the abatement dateTime of the STEMI diagnosis. RelevantPeriod is an attribute of the “Encounter, Performed” datatype and signifies the startTime that the encounter began (admission time) to the stopTime that the encounter ended (discharge time). For an ED encounter with a STEMI diagnosis to be captured in the measure denominator, the STEMI diagnosis prevalencePeriod must start during the ED encounter relevantPeriod, and the ED encounter must occur during the measurement period. For more information regarding these attributes, please reference the QDM v5.6 [ https://ecqi.healthit.gov/sites/default/files/QDM-v5.6-508.pdf ].
    • CMS0996v5
    • CMS0996v4
    • Low IPP and Denominator volumes

      For timing of STEMI diagnosis during the ED encounter, should the timing be from the date/time of the observation (such as an automated time-stamp of the entered diagnosis), or can the date/time of the STEMI diagnosis be from a manually entered date/time? Hypothetical example scenario: ED provider diagnoses patient with STEMI at 13:30 and immediately begins treatment, but the observation is not physically documented in an EHR mappable data point until 15:45, after the patient's ED encounter has ended with a discharge/transfer. Would this patient visit qualify for the IPP, since the diagnosis is documented with a start time during the ED encounter, regardless of when the documentation actually occurred?

            Assignee:
            Augustine Weber
            Reporter:
            Kimberly Kreitzer
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            1 Vote for this issue
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              Created:
              Updated:
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