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  1. eCQM Issue Tracker
  2. CQM-795

Dispensed requirement affects data validity and is not consistent with measure description

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    • Icon: Intent/Governance affecting more than 1 eCQM Intent/Governance affecting more than 1 eCQM
    • Resolution: Answered
    • Icon: Major Major
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      NCQA has tried to use the following policy for its eCQMs - for overuse measures, we use "Medication, prescribed" because the act of prescribing the medication is the action that providers should be avoiding. For measures where we need to know if the patient is actually on the medication, we use "Medication, dispensed." We understand that some systems will not have dispensing information available.
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      NCQA has tried to use the following policy for its eCQMs - for overuse measures, we use "Medication, prescribed" because the act of prescribing the medication is the action that providers should be avoiding. For measures where we need to know if the patient is actually on the medication, we use "Medication, dispensed." We understand that some systems will not have dispensing information available.
    • To add some context to this issue, we are probably going to elect not to certify this measure because of this issue and the difficulty it will cause for providers.

      The measure description is "Percentage of patients 5-64 years of age who were identified as having persistent asthma and were appropriately prescribed medication during the measurement period." But the specifications require that the medication be dispensed, a more stringent criteria than prescribed. Dispense information will in many cases not be available in the EHR, and the patient will be out of the numerator even though the provider took the correct action according to the intent of the measure, a false negative. Also, in almost all other measures that look at medication intervention, the required action is prescribed, not dispense.

            rtallapragada Ramya Tallapragada (Inactive)
            pbasch1 Peter Basch
            Cindy Cullen, Minet Javellana (Inactive)
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