We are planning to certify the measure – “Home Management Plan of Care (HMPC) Document Given to Patient/Caregiver” – CMS26v2 from the April 2014 eCQM Update. Our product – Meaningful Use Quality Manager – is currently already certified to 22 of the 29 Stage 2 measures.

When creating a test with this measure, Cypress generates 4 QRDA test files (attached)

Issue

What we have noticed is that 2 test files each share the same encounter/id/extension.

3_Danny_Santiago.xml and 0_Ryan_Graham have the same encounter id – “544e2ea84556411678380000” for their inpatient encounter. See Attachment 1 from the QRDA CAT I file for Ryan_Graham. This exact same id is used for the encounter for Danny_Santiago as well, although they are 2 separate patients and separate encounters.

Similarly, 1_Curtis_Payne.xml and 2_Glen_Porter also share the same ID encounter id (544e2ea84556411678330000).

My understanding is that this encounter id should be unique for each encounter. Our system uses this encounter id as the unique id to identify an encounter. Our system also updates an encounter if it is submitted multiple times.

Because of the above, when we upload the 4 files, our system sees these as only 2 encounters (because there are only 2 unique encounter identifiers) and so gets an initial population for this measure as 2 (instead of 4 as expected by Cypress - please see Attachment 2). This discrepancy would cause us to fail the certification test since we will not match the expected results in Cypress.

How can this issue be resolved?

Why would Cypress not generate unique identifiers for each separate encounter? During our certification (Sept 2013) for the previous measures we did not run into this issue. I wonder if there has been a change to how Cypress generates the encounter ids.

I would appreciate any assistance with this issue. If you have any further questions, I will be happy to meet with you as per your convenience.

Thanks in advance for your assistance.