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Enhancement
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Resolution: Done
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Moderate
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None
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If there is limited or no ability to retrieve information from the EHR to calculate an eCQM, the feasibility will be significantly limited without adding additional provider burden to enter such information with limited clinical usefulness.
17 QDM datatypes include the attribute "method" (5 for the context "Performed", the rest for "order" or "recommended")---
• Assessment, Performed
• Assessment, Recommended
• Diagnostic Study, Order
• Laboratory Test, Order
• Physical Exam, Order
• Procedure, Order
• Diagnostic Study, Recommended
• Laboratory Test, Recommended
• Physical Exam, Recommended
• Procedure, Recommended
• Substance, Recommended
• Diagnostic Study, Performed
• Laboratory Test, Performed
• Physical Exam, Performed
• Procedure, Performed
• Medication, Order
• Substance, Order
To assess the likelihood that a QDM data element can be retrieved from an existing EHR clinical record, each of the QDM datatypes and attributes has been mapped to the comparable HL7 FHIR resources (http://wiki.hl7.org/index.php?title=Harmonization_of_Health_Quality_Information_models). The Recommended- or Order- related QDM datatypes all map to either ProcedureRequest, ReferralRequest or MedicationRequest. None of the FHIR "request" resources include a metadata element "method". Method is reserved for actions that have occurred, such as an observation, a procedure, or the like. The QDM attribute "method" has not been used in eCQMs because most measure developers wishing to specify a method for a procedure or action do so by choosing a pre-coordinated concept from one of the existing code systems (LOINC, SNOMED, etc.).
This proposal requests removal of the "method" attribute from all QDM datatypes referencing Recommended or Order contexts.