[CQM-7604] [CMS50v12]Handling multiple FIRST referrals with same date and time Created: 01/21/25  Updated: 02/18/25  Resolved: 02/18/25

Status: Closed
Project: eCQM Issue Tracker
Component/s: None

Type: EC eCQMs - Eligible Clinicians Priority: Moderate
Reporter: Amesh (Inactive) Assignee: AIR EC eCQM Team
Resolution: Answered Votes: 0
Labels: None

Attachments: PNG File First referral.png     PNG File Sort.png    
Contact Name: Amesh
Contact Email: aamesh@athenahealth.com
Solution: Thank you for your question related to CMS50v13. If two or more referrals have the same time stamp and are being captured in the denominator as first referral, the referral that meets the numerator criteria may be used for the measure. If none of the referrals meet the numerator criteria, then any of the referrals may be used in the measure. We are working to evaluate potential logic modifications to the measure that may resolve these issues in the future.
Solution Posted On:
2025 Performance Period EC eCQMs:
CMS0050v13
2024 Performance Period EC eCQMs:
CMS0050v12

 Description   

I needed clarification in handling a particular scenario,

  • The patient has two referrals (e.g., dermatologist and cardiologist).
  • Both referrals share the same authoredon timestamp
  • Only one referral (cardiologist) has a consultant report tied to it.

Under such cases if the referral without consultant report is picked as FIRST it results in measure dissatisfaction.
Which referral is to be considered? And how is the cql handling this for the measure?

As per our understanding:
The image below is the CQL which tells us about the logic to choose the FIRST referral

According to the CQL HL7 authors guide when there are duplicates in sorting value (in our example multiple referrals with same referral having dateintervention ascending) the order of duplicate is unspecified.

Ref: https://cql.hl7.org/STU4/02-authorsguide.html#sorting
Hence there is a 1/2 probability of choosing a referral with consult note in case of 2 referrals being performed at same time.

Could you further give us clarification to handle this scenario.

 Comments   
Comment by AIR EC eCQM Team [ 02/07/25 ]

We apologize for the delay in providing a response for your question. We continue to investigate the issue noted in your ticket and will provide a response as soon as we are able. Thank you for your continued patience.

Comment by AIR EC eCQM Team [ 01/30/25 ]

We continue to investigate the issue noted in your ticket and will provide a response as soon as we are able. Thank you for your patience.

Comment by AIR EC eCQM Team [ 01/24/25 ]

Thank you for submitting your question. We will review your ticket and provide a response as soon as possible. 

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