Stroke 2 medications

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    • Type: Hosp Inpt eCQMs - Hospital Inpatient eCQMs
    • Resolution: Answered
    • Priority: Moderate
    • Component/s: None
    • None
    • Rupinder Gill
    • South Miami Hospital
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      Thank you for your inquiry regarding CMS104v13 (Discharged on Antithrombotic Therapy). The logic utilizes the "Medication, Discharge" data type to refer to the discharge medication list. This data type is intended to express medications ordered for post-discharge use. Information on this data type is available in the QDM v5.6 publication (https://ecqi.healthit.gov/sites/default/files/QDM-v5.6-508.pdf), which is located on the eCQI Resource Center. The timing of this data criteria refers to the time the discharge medication list on the discharge instruction form is authored.

      Specific to the numerator logic, the logic first pulls in the ‘Ischemic Stroke Encounter’ from the denominator, then looks for datatype ‘Medication, Discharge’ order found within the ‘Antithrombotic Therapy for Ischemic Stroke’ value set. Further, this medication must be documented using a timestamp, or ‘DischargeAntithrombotic.authorDatetime’, which occurs during the ischemic stroke encounter, or during IschemicStrokeEncounter.relevantPeriod’

      CMS104v13/STK-2 Numerator

      TJC."Ischemic Stroke Encounter" IschemicStrokeEncounter

       with ["Medication, Discharge": "Antithrombotic Therapy for Ischemic Stroke"] DischargeAntithrombotic

       such that DischargeAntithrombotic.authorDatetime during IschemicStrokeEncounter.relevantPeriod

      Regarding your examples, if the medications were on the discharge medication list, and the discharge medication list was completed during the inpatient encounter, then the patients would meet the numerator.
      Show
      Thank you for your inquiry regarding CMS104v13 (Discharged on Antithrombotic Therapy). The logic utilizes the "Medication, Discharge" data type to refer to the discharge medication list. This data type is intended to express medications ordered for post-discharge use. Information on this data type is available in the QDM v5.6 publication ( https://ecqi.healthit.gov/sites/default/files/QDM-v5.6-508.pdf), which is located on the eCQI Resource Center. The timing of this data criteria refers to the time the discharge medication list on the discharge instruction form is authored. Specific to the numerator logic, the logic first pulls in the ‘Ischemic Stroke Encounter’ from the denominator, then looks for datatype ‘Medication, Discharge’ order found within the ‘Antithrombotic Therapy for Ischemic Stroke’ value set. Further, this medication must be documented using a timestamp, or ‘DischargeAntithrombotic.authorDatetime’, which occurs during the ischemic stroke encounter, or during IschemicStrokeEncounter.relevantPeriod’ CMS104v13/STK-2 Numerator TJC."Ischemic Stroke Encounter" IschemicStrokeEncounter  with ["Medication, Discharge": "Antithrombotic Therapy for Ischemic Stroke"] DischargeAntithrombotic  such that DischargeAntithrombotic.authorDatetime during IschemicStrokeEncounter.relevantPeriod Regarding your examples, if the medications were on the discharge medication list, and the discharge medication list was completed during the inpatient encounter, then the patients would meet the numerator.
    • CMS0104v13
    • Medications on the discharge list but ordered during observation period is resulting in fallouts and lower performance rates for eStroke-2 measure.

      Aspirin and Plavix is on the discharge list under inpatient status but ordered during the observation time period for discharge, resulting in fallouts. Preparing the patients for discharge begins on admission. Providers are ordering the medications for discharge. All cases should pass if the medication is on the discharge list and the patient is inpatient status. The timing of the ordering of medication should not be the only factor being looked at when assessing this measure. Quality care is being provided. The method of capturing the information needs to be revisited and revised. This is not a change in practice that physicians should undertake to meet this measure. It should be that they continue to order medications when needed and the discharge reconciliation list is captured under inpatient status, not the time the medications were ordered. Please consider looking into this measure and thank you.

            Assignee:
            Augustine Weber
            Reporter:
            Rupinder Gill
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              Created:
              Updated:
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