Thank you for your inquiry. Please refer to the measure specification to interpret data requirements:
https://ecqi.healthit.gov/sites/default/files/ecqm/measures/CMS156v13.html. Numerator 1a and 1b evaluate different medications. In your example, RxNorm 314267 is included in the value set Desiccated Thyroid Medications (2.16.840.1.113883.3.464.1003.1060) used for calculating Numerator 1a but not for Numerator 1b. Below are relevant logic.
If you have questions about reading the measure specification or understanding data requirements, please refer to the "Guide for Reading eCQMs" for additional guidance. Resources can be found in the eCQI Resource Center:
https://ecqi.healthit.gov/ep-ec?qt-tabs_ep=ecqm-resources&global_measure_group=eCQMs.
Numerator
exists ( "Same High Risk Medications Ordered on Different Days" )
or ( "Two High Risk Medications with Prolonged Duration" )
or ( "High Risk Medications with Average Daily Dose Criteria" )
Same High Risk Medications Ordered on Different Days
"More Than One Order"(["Medication, Order": "Potentially Harmful Antihistamines for Older Adults"])
union "More Than One Order"(["Medication, Order": "Potentially Harmful Antiparkinsonian Agents for Older Adults"])
union "More Than One Order"(["Medication, Order": "Potentially Harmful Gastrointestinal Antispasmodics for Older Adults"])
union "More Than One Order"(["Medication, Order": "Dipyridamole Medications"])
union "More Than One Order"(["Medication, Order": "Guanfacine Medications"])
union "More Than One Order"(["Medication, Order": "Nifedipine Medications"])
union "More Than One Order"(["Medication, Order": "Potentially Harmful Antidepressants for Older Adults"])
union "More Than One Order"(["Medication, Order": "Potentially Harmful Barbiturates for Older Adults"])
union "More Than One Order"(["Medication, Order": "ergoloid mesylates, USP 1 MG Oral Tablet"])
union "More Than One Order"(["Medication, Order": "Meprobamate Medications"])
union "More Than One Order"(["Medication, Order": "Potentially Harmful Estrogens for Older Adults"])
union "More Than One Order"(["Medication, Order": "Potentially Harmful Sulfonylureas for Older Adults"])
union "More Than One Order"(["Medication, Order": "Desiccated Thyroid Medications"])
union "More Than One Order"(["Medication, Order": "Potentially Harmful Nonbenzodiazepine Hypnotics for Older Adults"])
union "More Than One Order"(["Medication, Order": "Potentially Harmful Skeletal Muscle Relaxants for Older Adults"])
union "More Than One Order"(["Medication, Order": "Potentially Harmful Pain Medications for Older Adults"])
union "More Than One Order"(["Medication, Order": "Megestrol Medications"])
union "More Than One Order"(["Medication, Order": "Meperidine Medications"])
Two High Risk Medications with Prolonged Duration
Sum(("More Than One Order"(["Medication, Order": "Potentially Harmful Antiinfectives for Older Adults"])) AntiInfectives
let DaysSupply: Coalesce(AntiInfectives.daysSupplied, AntiInfectives.supply.value /(AntiInfectives.dosage.value * CMD.ToDaily(AntiInfectives.frequency))) *(1 + Coalesce(AntiInfectives.refills, 0))
return all DaysSupply
) > 90
More Than One Order(Medication List<"Medication, Order">)
"Medication" OrderMedication1
with "Medication" OrderMedication2
such that ( OrderMedication1.authorDatetime during "Measurement Period"
and OrderMedication1.refills >= 1
)
or ( date from OrderMedication1.authorDatetime !~ date from OrderMedication2.authorDatetime
and OrderMedication1.authorDatetime during "Measurement Period"
and OrderMedication2.authorDatetime during "Measurement Period"
)
or ( date from OrderMedication1.authorDatetime ~ date from OrderMedication2.authorDatetime
and OrderMedication1.authorDatetime during "Measurement Period"
and date from start of OrderMedication1.relevantPeriod !~ date from start of OrderMedication2.relevantPeriod
and start of OrderMedication1.relevantPeriod during "Measurement Period"
and start of OrderMedication2.relevantPeriod during "Measurement Period"
)
return OrderMedication1
EC eCQMs - Eligible Clinicians
Moderate