Updated JSON and XML files, containing patched ELM (including change notations) have been included in updated measure package zip files published on the eCQI site here: https://ecqi.healthit.gov/ecqm/ep/2020/cms146v8.
eCQM Impacted – CMS146v8 (Appropriate Testing for Children with Pharyngitis)
Issue – An issue has been identified in the published Expression Logical Model (ELM) file content for this measure, which is contained within each measure package zip file. ELM is a machine-readable representation of an eCQM’s logic that allows implementers to directly incorporate measure logic into their systems. For certain timing phrases, the ELM representation of the CQL logic does not correctly reflect the semantics when the date/time values are not present in the data being evaluated.
This issue only impacts implementer systems that directly consume ELM files to evaluate eCQMs.
There are 2 definition expressions in this measure that could result in erroneous calculation when no value is present for authorDatetime or the start of a relevant period.
"Encounter With Antibiotic Ordered Within Three Days"
"Qualifying Encounter" EDOrAmbulatoryVisit
with ["Medication, Order": "Antibiotic Medications for Pharyngitis"] AntibioticOrdered
such that ( EDOrAmbulatoryVisit.relevantPeriod starts 3 days or less on or before AntibioticOrdered.authorDatetime )
where EDOrAmbulatoryVisit.relevantPeriod during "Measurement Period"
"Competing Diagnosis for Upper Respiratory Infection"
"Encounter With Pharyngitis or Tonsillitis" EncounterWithPharyngitis
with ["Diagnosis": "Competing Conditions for Respiratory Conditions"] CompetingCondition
such that EncounterWithPharyngitis.AcutePharyngitisTonsillitis !~ CompetingCondition
and CompetingCondition.prevalencePeriod starts 3 days or less after start of EncounterWithPharyngitis.AcutePharyngitisTonsillitis.prevalencePeriod