CMS347-need specifics in statin measures

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    • Type: None
    • Resolution: Answered
    • Priority: Moderate
    • Component/s: None
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    • respond to concerns about medication value sets
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      Thank you for your inquiry on CMS347 Statin Therapy for the Prevention and Treatment of Cardiovascular Disease. The statin therapy value sets use generalized drug concepts (e.g., semantic clinical drug (SCD) RxNorm). It is expected that health IT vendors or providers will report the drug entities in patient data using the generalized drug concepts included in the defined value sets. Please work with your EHR vendor to map the specific drug entities found in patient records to those found in the value sets provided:

      "Low Intensity Statin Therapy" (2.16.840.1.113883.3.526.3.1574)
      "Moderate Intensity Statin Therapy" (2.16.840.1.113883.3.526.3.1575)
      "High Intensity Statin Therapy" (2.16.840.1.113883.3.526.3.1572)


      For more information, please refer to section 4.5 in Electronic Clinical Quality Measure Logic and Implementation Guidancev6 (https://ecqi.healthit.gov/sites/default/files/eCQM-Logic-and-Guidance-v6.pdf). The guidance supports mapping for generalized drug concepts.
      Show
      Thank you for your inquiry on CMS347 Statin Therapy for the Prevention and Treatment of Cardiovascular Disease. The statin therapy value sets use generalized drug concepts (e.g., semantic clinical drug (SCD) RxNorm). It is expected that health IT vendors or providers will report the drug entities in patient data using the generalized drug concepts included in the defined value sets. Please work with your EHR vendor to map the specific drug entities found in patient records to those found in the value sets provided: "Low Intensity Statin Therapy" (2.16.840.1.113883.3.526.3.1574) "Moderate Intensity Statin Therapy" (2.16.840.1.113883.3.526.3.1575) "High Intensity Statin Therapy" (2.16.840.1.113883.3.526.3.1572) For more information, please refer to section 4.5 in Electronic Clinical Quality Measure Logic and Implementation Guidancev6 ( https://ecqi.healthit.gov/sites/default/files/eCQM-Logic-and-Guidance-v6.pdf ). The guidance supports mapping for generalized drug concepts.
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      We work diligently to ensure that our patients are receiving the care they deserve as well as meeting the required metrics set by CMS, but these reports could reflect poorly on our care for our patients. When in actuality, they are receiving the correct that is necessary.
      Show
      We work diligently to ensure that our patients are receiving the care they deserve as well as meeting the required metrics set by CMS, but these reports could reflect poorly on our care for our patients. When in actuality, they are receiving the correct that is necessary.

      We are pulling reports for MIPS measures and our EMR is only pulling data for Rule CMS347 (Statin therapy for the prevention and treatment of cardiovascular disease) for patients taking generic statins, not brand name.  We have some patients that are on brand name Crestor, Lipitor etc. but the reports are showing that those patients are not on therapy.  We requested that our EMR update the report to capture those patients based on the Crestor and Lipitor as well, but they said that CMS ONLY wants generic statins included in this measure.  That didn't seem right to me. They said that we needed to take this up with CMS.  Is this true information? Do we need to switch these patients to generic drugs to meet requirements?  

            Assignee:
            Mathematica EC eCQM Team (Inactive)
            Reporter:
            ALEXANDRA M LONGO (Inactive)
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