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  2. QRDA-1081

CMS156v11- CMD.ToDaily Function

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    • Resolution: Answered
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      ​Thank you for your inquiry for CMS156v11 (2023 performance period).

      *Query 1 - Please note that among the three functions listed, "CMD.ToDaily" is the only function that is specified directly in the measure logic. This function calculates daily frequency based on the given input, either a quantity (numeric value) or a code. If the input is quantity, quantity is used to calculate daily frequency, else code is used to calculate daily frequency. Therefore, if a quantity input is available, code input is not necessary.

      Query 2 - In the context of CMS156v11, frequency can be interpreted as the medication order (prescription) frequency, e.g., number of units per day that should be taken by the patient. The function "CMD.QuantityToDaily" converts a frequency quantity to a daily frequency (as a decimal) and considers both the value and unit of the given frequency. For example, a frequency of 12 'h' will result in a daily frequency of 2.0, and a frequency of 30 'min' will result in a daily frequency of 48.0.

      Additional descriptions and guidance for these functions can be found in the CQL file named "CumulativeMedicationDuration-v1-0-000-QDM-5-6.cql" available at "https://ecqi.healthit.gov/sites/default/files/ecqm/measures/CMS156v11-v2.zip".
      Show
      ​Thank you for your inquiry for CMS156v11 (2023 performance period). *Query 1 - Please note that among the three functions listed, "CMD.ToDaily" is the only function that is specified directly in the measure logic. This function calculates daily frequency based on the given input, either a quantity (numeric value) or a code. If the input is quantity, quantity is used to calculate daily frequency, else code is used to calculate daily frequency. Therefore, if a quantity input is available, code input is not necessary. Query 2 - In the context of CMS156v11, frequency can be interpreted as the medication order (prescription) frequency, e.g., number of units per day that should be taken by the patient. The function "CMD.QuantityToDaily" converts a frequency quantity to a daily frequency (as a decimal) and considers both the value and unit of the given frequency. For example, a frequency of 12 'h' will result in a daily frequency of 2.0, and a frequency of 30 'min' will result in a daily frequency of 48.0. Additional descriptions and guidance for these functions can be found in the CQL file named "CumulativeMedicationDuration-v1-0-000- QDM-5 -6.cql" available at " https://ecqi.healthit.gov/sites/default/files/ecqm/measures/CMS156v11-v2.zip ".

    Description

      Hi Team,

      Below mentioned are functions from CMS156v11:

      CMD.CodeToDaily(Frequency Code)
      case
        when Frequency ~ "Once daily (qualifier value)" then 1.0
        when Frequency ~ "Twice a day (qualifier value)" then 2.0
        when Frequency ~ "Three times daily (qualifier value)" then 3.0
        when Frequency ~ "Four times daily (qualifier value)" then 4.0
        when Frequency ~ "Every twenty four hours (qualifier value)" then 1.0
        when Frequency ~ "Every twelve hours (qualifier value)" then 2.0
        when Frequency ~ "Every thirty six hours (qualifier value)" then 0.67
        when Frequency ~ "Every eight hours (qualifier value)" then 3.0
        when Frequency ~ "Every four hours (qualifier value)" then 6.0
        when Frequency ~ "Every six hours (qualifier value)" then 4.0
        when Frequency ~ "Every seventy two hours (qualifier value)" then 0.34
        when Frequency ~ "Every forty eight hours (qualifier value)" then 0.5
        when Frequency ~ "Every eight to twelve hours (qualifier value)" then 2.0
        when Frequency ~ "Every six to eight hours (qualifier value)" then 3.0
        when Frequency ~ "Every three to four hours (qualifier value)" then 6.0
        when Frequency ~ "Every three to six hours (qualifier value)" then 4.0
        when Frequency ~ "Every two to four hours (qualifier value)" then 6.0
        when Frequency ~ "One to four times a day (qualifier value)" then 4.0
        when Frequency ~ "One to three times a day (qualifier value)" then 3.0
        when Frequency ~ "One to two times a day (qualifier value)" then 2.0
        when Frequency ~ "Two to four times a day (qualifier value)" then 4.0
        else null
      end

      CMD.QuantityToDaily(Frequency Quantity)
      case Frequency.unit
          when 'h' then (24.0 / Frequency.value)
          when 'min' then (24.0 / Frequency.value) * 60
          when 's' then (24.0 / Frequency.value) * 60 * 60
          when 'd' then (24.0 / Frequency.value) / 24
          when 'wk' then (24.0 / Frequency.value) / (24 * 7)
          when 'mo' then (24.0 / Frequency.value) / (24 * 30) /* assuming 30 days in month */
          when 'a' then (24.0 / Frequency.value) / (24 * 365) /* assuming 365 days in year */
          when 'hour' then (24.0 / Frequency.value)
          when 'minute' then (24.0 / Frequency.value) * 60
          when 'second' then (24.0 / Frequency.value) * 60 * 60
          when 'day' then (24.0 / Frequency.value) / 24
          when 'week' then (24.0 / Frequency.value) / (24 * 7)
          when 'month' then (24.0 / Frequency.value) / (24 * 30) /* assuming 30 days in month */
          when 'year' then (24.0 / Frequency.value) / (24 * 365) /* assuming 365 days in year */
          when 'hours' then (24.0 / Frequency.value)
          when 'minutes' then (24.0 / Frequency.value) * 60
          when 'seconds' then (24.0 / Frequency.value) * 60 * 60
          when 'days' then (24.0 / Frequency.value) / 24
          when 'weeks' then (24.0 / Frequency.value) / (24 * 7)
          when 'months' then (24.0 / Frequency.value) / (24 * 30) /* assuming 30 days in month */
          when 'years' then (24.0 / Frequency.value) / (24 * 365) /* assuming 365 days in year */
          else null
        end

      CMD.ToDaily(Frequency Choice<Quantity, Code>)
      case
        when Frequency is Quantity then QuantityToDaily(Frequency as Quantity)
        else CodeToDaily(Frequency as Code)
      end

      Query 1:

      For CMD.CodeToDaily(Frequency Code):
      For example: 
      when Frequency ~ "Once daily (qualifier value)" then 1.0  
      code "Once daily (qualifier value)" ("SNOMEDCT Code (229797004)")

      If we are getting a numeric value for frequency from client, is it necessary to use the above mentioned SNOMEDCT code ?

      Query 2:

      CMD.QuantityToDaily(Frequency Quantity)

      Need more understanding of this functionality.
      For example:  
      when 'h' then (24.0 / Frequency.value)

      How to interpret this. How to calculate Frequency.value here?

      Request you to provide us with the resolution urgently as our client deliverables are dependent on it.

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            yanheras Yan Heras
            AkashP Akash Pawar
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