Thank you for your inquiry regarding CMS996: Appropriate Treatment for ST-Segment Elevation Myocardial Infarction (STEMI) Patients in the Emergency Department (ED). We understand the intent of your question is to determine the EHR documentation needed to indicate the end of an ED encounter for measure inclusion in a specific reporting period. As mentioned by the inquirer, the measure denominator captures ED encounters with a STEMI diagnosis among patients aged 18 years or older during a one-year measurement period. The denominator is calculated using the QDM datatype “Encounter, Performed”: “Emergency Department Evaluation and Management Visit” relevantPeriod attribute which is the period from the ED encounter startTime – or the time the ED encounter began (admission time) to the ED encounter stopTime – or the time the ED encounter ended (discharge time). Therefore, the relevantPeriod stopTime, indicating the end of the ED encounter, should be documented in the EHR using an ED discharge disposition. Since the measure only captures ED encounters and not inpatient encounters, the end of an ED encounter is defined by ED discharge, not physical discharge from the hospital following an inpatient encounter. We recommend working with your EHR vendor to ensure proper documentation of the end of an ED encounter even if a patient receives inpatient care following the ED encounter. In the scenario depicted by the inquirer, the patient would be assigned to the quarter based on the ED encounter end date (March 28th) rather than the hospital discharge date (April 5th).

Clarifying the measurement period and quarter assignment is crucial for accurate data reporting and compliance. Without this clarification, there is uncertainty in tracking patient encounters, which could lead to incorrect quarter-based reporting and affect performance assessments.