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  2. CQM-981

Harmonization is needed for (a) defining denominator populations for preventive care and screening measures, (b) definition (value sets) of tests and conditions across measures. Examples provided

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      Lack of harmonization in definition (value sets and logic) will cause significant confusion and excess work effort in (a) defining new measures or HeD rules, and (b) implementing such measures and rules, and (c) comparing performance results among EPs and EHs. Specifically, in writing rules for the QIR HeD project, choosing among conflicting value sets is causing rework as clinical SME's are confused about which (if any) existing logic to reuse.
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      Lack of harmonization in definition (value sets and logic) will cause significant confusion and excess work effort in (a) defining new measures or HeD rules, and (b) implementing such measures and rules, and (c) comparing performance results among EPs and EHs. Specifically, in writing rules for the QIR HeD project, choosing among conflicting value sets is causing rework as clinical SME's are confused about which (if any) existing logic to reuse.

      1) Inconsistency with definition of (a) encounters used to specify an encounter that qualifies a patient for a measure denominator is exclusively one preventive care visit in some measures and either one preventive care visit or two "non-preventive" care visits in other measures. The SMEs (CDC) question why there is no standard method across all eCQMs
      2) Inconsistent definition of data elements with competing value sets (see attached Excel Spreadsheet for a listing of value sets with competing and at least non-harmonized content. The spreadsheet was developed as part of a new eCQM and HeD development project for ONC:
      (a) Definition of an ambulatory encounter (value sets) differ among measures - NCQA and AMA-PCPI are often similar but have identical value sets with different OIDS. QIP and Behavioral Health measure steward use their own value sets which are different from the first two stewards.
      (b) HIV tests - one value set is HIV load only, one include many SNOMED-CT and a few LOINC codes, LOINC has many codes that apply and is the preferred terminology for lab testing. SNOMED-CT is not preferred to describe the observable entity, but only the result.
      (c) STI - sexually transmitted infection value sets are incomplete or conflicting

        1. Value Sets HIV Screening Measures - Proposal 26Dec2013.xls
          1.06 MB

            edave Mathematica EC eCQM Team
            FEisenberg Floyd Eisenberg
            Floyd Eisenberg
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