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  1. QDM Issue Tracker
  2. QDM-135

Medication, Administered datatype lacks granularity to capture IV Continuous infusions

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    • Icon: Defect Defect
    • Resolution: Deferred
    • Icon: Minor Minor
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    • Medication, Administered
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      VTE-1, VTE-2: Patients who are receiving heparin by a method other than continuous infusion (ie IV Push to clean lines and ports) are inappropriately being excluded under logic that is intended to exclude patients receiving heparin for anticoagulation. Thus, fewer patients are evaluated for the measure's target intervention.

      VTE-4: Patients who are receiving heparin by a method other than continuous infusion (ie IV Push to clean a port) are inappropriately being included in the numerator as having received appropriate anticoagulation. For these patients, opportunities to provide appropriate anticoagulation may be missed.
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      VTE-1, VTE-2: Patients who are receiving heparin by a method other than continuous infusion (ie IV Push to clean lines and ports) are inappropriately being excluded under logic that is intended to exclude patients receiving heparin for anticoagulation. Thus, fewer patients are evaluated for the measure's target intervention. VTE-4: Patients who are receiving heparin by a method other than continuous infusion (ie IV Push to clean a port) are inappropriately being included in the numerator as having received appropriate anticoagulation. For these patients, opportunities to provide appropriate anticoagulation may be missed.

      In 3 Joint Commission measures, we seek to include or exclude patients based on administration of a continuous infusion of heparin. Capturing continuous infusion requires two attributes- route (IV), and method (Continuous). Currently, the QDM attribute of "Method" is present on the "Medication, Order" datatype, but not for "Medication, Administered." We recommend adding the Method Attribute to Medication, Administered. Without a way to specify the Method, our logic currently includes or excludes patients who are receiving heparin by a method that does not meet the intent of the measure.

      Note: The same RXNORM code for heparin may be used via multiple methods, so logic in addition to value sets is needed to achieve the appropriate granularity.

            FEisenberg Floyd Eisenberg
            mdardis Michelle Dardis (Inactive)
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