HH-ORAE CMS819v3 OR Start Time during ED Encounter

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    • Type: Hosp Inpt eCQMs - Hospital Inpatient eCQMs
    • Resolution: Answered
    • Priority: Moderate
    • Component/s: None
    • None
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      Thank you for your feedback regarding CMS819v3, Hospital Harm - Opioid-Related Adverse Events. Patients who are administered an opioid medication outside of the operating room and are subsequently administered a non-enteral opioid antagonist outside of the operating room within 12 hours are included in this measure. Opioids and opioid antagonists administered in the operating room should not count towards the measure. The measure team will consider updating the logic to account for operating room encounters occurring during the entire hospitalization period.
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      Thank you for your feedback regarding CMS819v3, Hospital Harm - Opioid-Related Adverse Events. Patients who are administered an opioid medication outside of the operating room and are subsequently administered a non-enteral opioid antagonist outside of the operating room within 12 hours are included in this measure. Opioids and opioid antagonists administered in the operating room should not count towards the measure. The measure team will consider updating the logic to account for operating room encounters occurring during the entire hospitalization period.
    • CMS0819v3
    • Affect measure outcome, potential false numerator when case had OR time within 12 hours.

      We had a patient who went to the OR during ED encounter for emergent need and when had another case where their encounter started as "Same Day Surgery" an outpatient encounter. The measure did not show their OR start time since it occurred before the inpatient start time. According to the measure logic, the Operating room encounter location is during the inpatient encounter. 

      This logic has a potential of missing OR start & end times when occur outside the inpatient encounter when the measure looks for Narcan administration throughout the encounter (ED or SDS- observation -inpatient)

      • "Qualifying Encounter" InpatientEncounter
        with "Opioid Administration" OpioidGiven
        such that Global."NormalizeInterval" ( OpioidGiven.relevantDatetime, OpioidGiven.relevantPeriod ) starts during Global."HospitalizationWithObservation" ( InpatientEncounter )
        and not exists ( InpatientEncounter.facilityLocations EncounterLocation
        where EncounterLocation.code ~ "Operating Room/Suite"
        and Global."NormalizeInterval" ( OpioidGiven.relevantDatetime, OpioidGiven.relevantPeriod ) starts during EncounterLocation.locationPeriod
        )

      Desired outcome recovered from Solution field:

      Suggest adding a global encounter time for operating room start & end times. 

            Assignee:
            Mathematica EH eCQM Team
            Reporter:
            Emily Solomon
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              Updated:
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