TOB-1: The temporal comparison operator for Diagnosis, Active: Cognitive and Psychiatric Disorders Indicative of Impaired Cognition can be reduced to "starts before or concurrent with end of Occurence A of $EncounterInpatient."

TOB-2 and TOB-3: The differentiation of light versus heavy tobacco users in the Numerator sections does not account for multi-form tobacco users. A Risk Category Assessment for tobacco users could indicate that an individual is a light cigarette smoker (2 cigarettes/day) and a heavy cigar smoker (smokes tobacco daily). In such a situation, the individual would pass the numerator logic as a light tobacco user and would not required the documentation of cessation medication as necessitated for heavy tobacco users. In order to indicate that an individual is a light tobacco user, the logic must indicate that they are a light tobacco user AND NOT a heavy tobacco user.

All TOB: The value set for “Risk Category Assessment: Frequency of Tobacco Use” has not yet been posted on the Value Set Authority Center. Since this data element should be only documented in relation with pipe and cigar tobacco usage, can the name of the value set be changed to reflect this dependency? For example, changing the name to “Risk Category Assessment: Frequency of Cigars/Pipe Tobacco Use”.