Use of HAR incorrectly includes patients with a STEMI that did not occur in ED

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    • Type: Hosp Outpt eCQMs - Hospital Outpatient eCQMs
    • Resolution: Answered
    • Priority: Moderate
    • Component/s: None
    • None
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      Thank you for your inquiry regarding CMS996v5, Appropriate Treatment for ST-Segment Elevation Myocardial Infarction (STEMI) Patients in the Emergency Department (ED). We recommend working with your EHR vendor to document the ED encounter and the inpatient encounter separately, and map the ED encounter to the “Encounter, Performed”: “Emergency Department Evaluation and Management Visit” QDM datatype, and the inpatient encounter to the “Encounter, Performed”: “Encounter Inpatient” QDM datatype. Documentation of both of these encounters separately will help ensure that diagnoses occurring during the inpatient encounter are not erroneously pulled into the ED encounter.
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      Thank you for your inquiry regarding CMS996v5, Appropriate Treatment for ST-Segment Elevation Myocardial Infarction (STEMI) Patients in the Emergency Department (ED). We recommend working with your EHR vendor to document the ED encounter and the inpatient encounter separately, and map the ED encounter to the “Encounter, Performed”: “Emergency Department Evaluation and Management Visit” QDM datatype, and the inpatient encounter to the “Encounter, Performed”: “Encounter Inpatient” QDM datatype. Documentation of both of these encounters separately will help ensure that diagnoses occurring during the inpatient encounter are not erroneously pulled into the ED encounter.
    • CMS0996v5
    • Patients are incorrectly being pulled into the measure population denominator

      The STEMI eCQM measure uses the Hospital Account Record (HAR) to identify patients who had a STEMI in the ED. However, since the HAR is shared between the inpatient are and the emergency department, this leads to an evaluation error when a STEMI occurs after the ED visit is complete. If a STEMI happens after the patient leaves the ED, the patient is incorrectly included in the denominator and should not be part of the population. How are other hospitals correcting this issue?

            Assignee:
            Mathematica EH eCQM Team
            Reporter:
            Loraine Phomsopha (Inactive)
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              Created:
              Updated:
              Resolved: