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  1. MADiE Issue Tracker
  2. MADIE-1536

CMS156v12 - Numerator 1 Prolonged Duration Clarification

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    • Icon: Question Question
    • Resolution: Answered
    • Icon: Major Major
    • Measure Calculation
    • None
    • BONNIE
    • Use of High-Risk Medications in Older Adults
    • CMS156v12
    • Yes

      Need to get clarification  2024 CMS156v12 on Numerator1 criteria for "Two High Risk Medications with Prolonged Duration" 

      Two High Risk Medications with Prolonged Duration
      Sum(("More Than One Order"(["Medication, Order": "Anti Infectives, other"]))AntiInfectives
      let DaysSupply: Coalesce(AntiInfectives.daysSupplied, AntiInfectives.supply.value /(AntiInfectives.dosage.value * CMD.ToDaily(AntiInfectives.frequency)))*(1 +
      Coalesce(AntiInfectives.refills, 0))
      return all DaysSupply
      )> 90More 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

      Currently for below scenario patient is meeting numerator in bonnie, if patient has 3 medication orders out of which 2 medication orders starts on same day and 1 medication on different day. 

      Medication order 1: author date= 7/24/2023 and start date = 7/24/2023 daysSupplied = 25 days
      Medication order 2: author date = 7/24/2023 and start date = 7/24/2023 daysSupplied = 25 days
      Medication order 3: author date = 7/24/2023 and start date = 8/24/2023 daysSupplied = 41 days

      Total CMD = 91 days

      According to "more than one order function" start date of more than one order should be different so above scenario should not meet numerator 1 requirement. But in bonnie patient is meeting numerator, screen shot attached. 

        1. Prolonged Dur 1.png
          93 kB
          Ashish Trivedy
        2. Prolonged Dur 2.png
          117 kB
          Ashish Trivedy
        3. Prolonged Dur 3.png
          77 kB
          Ashish Trivedy

            cbartleman@telligen.com Chandra Bartleman
            ashishtrivedy Ashish Trivedy
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              Created:
              Updated:
              Resolved: