OP:40 STEMI

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    • Type: Hosp Outpt eCQMs - Hospital Outpatient eCQMs
    • Resolution: Answered
    • Priority: Moderate
    • Component/s: None
    • None
    • Ashley Lindberg
    • 7013208034
    • Hennepin Healthcare
    • Hide
      Thank you for your inquiry regarding CMS996: Appropriate Treatment for ST-Segment Elevation Myocardial Infarction (STEMI) Patients in the Emergency Department (ED). The measure defines ED arrival time using the following function found in the measure’s HTML file posted on the eCQI Resource Center [https://ecqi.healthit.gov/sites/default/files/ecqm/measures/CMS996-v6.3.000-QDM.html].

      Global.EmergencyDepartmentArrivalTime(Encounter "Encounter, Performed")

                     start of First(("HospitalizationLocations"(Encounter))HospitalLocation

                                     where HospitalLocation.code in "Emergency Department Visit"

                                     sort by start of locationPeriod

                     ).locationPeriod

      This function defines ED arrival time as the time of the patient’s arrival to their first location in the ED. The function uses the locationPeriod attribute which defines the startTime as the time the patient arrived at the location and the time the encounter began (admission time). We agree with your current mapping of ED arrival time to the time the patient arrived at the front desk at the ED before they are roomed.
      Show
      Thank you for your inquiry regarding CMS996: Appropriate Treatment for ST-Segment Elevation Myocardial Infarction (STEMI) Patients in the Emergency Department (ED). The measure defines ED arrival time using the following function found in the measure’s HTML file posted on the eCQI Resource Center [ https://ecqi.healthit.gov/sites/default/files/ecqm/measures/CMS996-v6.3.000-QDM.html ]. Global.EmergencyDepartmentArrivalTime(Encounter "Encounter, Performed")                start of First(("HospitalizationLocations"(Encounter))HospitalLocation                                where HospitalLocation.code in "Emergency Department Visit"                                sort by start of locationPeriod                ).locationPeriod This function defines ED arrival time as the time of the patient’s arrival to their first location in the ED. The function uses the locationPeriod attribute which defines the startTime as the time the patient arrived at the location and the time the encounter began (admission time). We agree with your current mapping of ED arrival time to the time the patient arrived at the front desk at the ED before they are roomed.
    • CMS0996v6
    • CMS0996v5
    • CMS0996v4
    • Many cases are ending up in the Denominator because the times from ED Arrival to ED Admission (roomed) are a couple minute difference that puts PCI time >90minutes, resulting in a fail to the measure.

      The OP STEMI measure logic states that the relevant period start time is the arrival time and time the encounter began (admission time). When looking at the numerator definition for this measure, it is written as "time from ED arrival" but when reading under the rationale to the measure, "guidelines recommend initiation of PCI within 120minutes from first medical contact." This is impacting our performance with this measure greatly as our current mapping is to the ED arrival time, which is when the ED clicks arrived at the front desk at our facility, and then will click Admit date/time to the ED once roomed and being evaluated. On many cases we are failing by just a few minutes because of this time difference. With the numerator definition wording using "ED arrival" and the logic definition using the "ed encounter time begins (admission time). Which ED time should be mapped from EHR to calculate this performance? ED arrival (not roomed yet) or ED admission (pt is roomed)?

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          image-2025-07-02-15-56-19-835.png
          17 kB

            Assignee:
            Mathematica EH eCQM Team
            Reporter:
            Ashley Lindberg
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              Created:
              Updated:
              Resolved: