Start of Hospitalization

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    • Type: Hosp Inpt eCQMs - Hospital Inpatient eCQMs
    • Resolution: Answered
    • Priority: Moderate
    • Component/s: None
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      Thank you for your question regarding Venous Thromboembolism Prophylaxis (CMS0108v13), Intensive Care Unit Venous Thromboembolism Prophylaxis (CMS190v13). The function of FromDayOfStartOfHospitalizationToDayAfterAdmission(Encounter "Encounter, Performed") includes another function named Global."HospitalizationWithObservation", where the logic expresses how ED and/or Observation Service are counted along with inpatient. See the function detail below. If ED within 1 hour Observation Service start time, and/or within 1 hour prior to inpatient admission time, the start of hospitalization would be the start of ED or Observation start time.

      Global.HospitalizationWithObservation(Encounter "Encounter, Performed")
      Encounter Visit
      let ObsVisit: Last(["Encounter, Performed": "Observation Services"] LastObs
      where LastObs.relevantPeriod ends 1 hour or less on or before start of Visit.relevantPeriod
      sort by
      end of relevantPeriod
      ),
      VisitStart: Coalesce(start of ObsVisit.relevantPeriod, start of Visit.relevantPeriod),
      EDVisit: Last(["Encounter, Performed": "Emergency Department Visit"] LastED
      where LastED.relevantPeriod ends 1 hour or less on or before VisitStart
      sort by
      end of relevantPeriod
      )
      return Interval[Coalesce(start of EDVisit.relevantPeriod, VisitStart),
      end of Visit.relevantPeriod]

      Therefore, if the patient was admitted to inpatient through the ED, with an ED discharge time within 1 hour before the inpatient admission time, and no VTE prophylaxis was documented during the ED, this could satisfy the numerator condition.
      Show
      Thank you for your question regarding Venous Thromboembolism Prophylaxis (CMS0108v13), Intensive Care Unit Venous Thromboembolism Prophylaxis (CMS190v13). The function of FromDayOfStartOfHospitalizationToDayAfterAdmission(Encounter "Encounter, Performed") includes another function named Global."HospitalizationWithObservation", where the logic expresses how ED and/or Observation Service are counted along with inpatient. See the function detail below. If ED within 1 hour Observation Service start time, and/or within 1 hour prior to inpatient admission time, the start of hospitalization would be the start of ED or Observation start time. Global.HospitalizationWithObservation(Encounter "Encounter, Performed") Encounter Visit let ObsVisit: Last(["Encounter, Performed": "Observation Services"] LastObs where LastObs.relevantPeriod ends 1 hour or less on or before start of Visit.relevantPeriod sort by end of relevantPeriod ), VisitStart: Coalesce(start of ObsVisit.relevantPeriod, start of Visit.relevantPeriod), EDVisit: Last(["Encounter, Performed": "Emergency Department Visit"] LastED where LastED.relevantPeriod ends 1 hour or less on or before VisitStart sort by end of relevantPeriod ) return Interval[Coalesce(start of EDVisit.relevantPeriod, VisitStart), end of Visit.relevantPeriod] Therefore, if the patient was admitted to inpatient through the ED, with an ED discharge time within 1 hour before the inpatient admission time, and no VTE prophylaxis was documented during the ED, this could satisfy the numerator condition.
    • CMS0108v13
    • VTE-1 and VTE-2 numerator calculation question

      The specifications for the two VTE eCQM measures state that the numerator includes documentation of a reason why no VTE prophylaxis was given between arrival and hospital admission. The CQL appears to use "FromDayOfStartOfHospitalizationToDayAfterAdmission" but it is unclear how this CQL statement relates to patients that are seen in the ED and/or admitted to Observation prior to Acute Care hospitalization Admission Date? Does "FromDayOfStartOfHospitalizationToDayAfterAdmission" include the presence of a reason for no VTE prophylaxis found when a patient is in the Emergency Department and/or during an Observation Encounter prior to Acute Care Inpatient Admission?

            Assignee:
            Mathematica EH eCQM Team
            Reporter:
            Beth Sahlmann
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              Created:
              Updated:
              Resolved:
              Solution Posted On: