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  1. QDM Issue Tracker
  2. QDM-49

Enhance the relationships within the eMeasure specification standards to enable linking of two data elements based on one of their components (patient ID, referral number, etc.)

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    • Communication: From Provider to Provider, Intervention, Order
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      This impacts a current MU-3 measure under development (MUCD-21) entitled "Closing the Referral Loop - Specialist Report Sent to Primary Care Physician". This measure is important and represents an underrepresented domain (care coordination). This measure will likely require workflow changes as well as changes to vendor systems. The draft description of this measure is "Percentage of referrals received for which the receiving provider sent a consultant report back to the referring provider."

      It also impacts MUCD-20 entitled "Closing the Referral Loop - Critical Information Communicated with Request for Referral".
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      This impacts a current MU-3 measure under development (MUCD-21) entitled "Closing the Referral Loop - Specialist Report Sent to Primary Care Physician". This measure is important and represents an underrepresented domain (care coordination). This measure will likely require workflow changes as well as changes to vendor systems. The draft description of this measure is "Percentage of referrals received for which the receiving provider sent a consultant report back to the referring provider." It also impacts MUCD-20 entitled "Closing the Referral Loop - Critical Information Communicated with Request for Referral".

      The eMeasure specification standards do not provide the ability to link the referral request that is received to the report that is subsequently generated.

      We can implement a temporary workaround by indicating in the guidance that the report generated for the numerator should be linked to the referral in the denominator.

      Solution:

      The MAT currently supports several "general relationship" operators (e.g., "causes"), although they are not defined in the QDM specification. Rather than introduce a brand new concept (like the "has relation" operator originally brought to the User Group), it makes better sense to remain consistent with what is already in place. This honors the intent of the originally proposed solution while providing a more efficient and consistent path forward.

      As a result, we'd recommend adding a new fulfills general relationship operator:

      "Communication: Provider to Provider: Consult Note" fulfills "Intervention, Order: Referral"

      QDM should document the fulfills operator in version 4.1 As a separate topic (QDM-69), we should review the existing general relationship operators supported in MAT and determine what other operators should be retained and documented.

      Previous Solution:

      The following solution was discussed in the User Group, but recent discoveries have led to the new (but very similar) solution noted above.

      While we've been talking specifically about relating consult notes to referrals, we'd like to provide a more general solution that supports other relationships (and other datatypes) as well. With that in mind, we propose a solution that looks like this:

      "Communication: Provider to Provider: Consult Note" has relation "FLFS" to "Intervention, Order: Referral"

      The new has relation operator takes a code from the HL7 ActRelationshipType value set. This value set offers other codes that might be useful to developers (e.g., "CAUS"). The QDM specification would indicate a subset of codes that are supported.

      Although many timing relations are in the value set (e.g., "SBS"), QDM would not allow them in this context since QDM's native timing operators should be used.

        1. QDM-49_Summary.pdf
          477 kB

            chris.moesel Chris Moesel (Inactive)
            jeff.mccartney Jeff McCartney (Inactive)
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