[CYPRESS-524] CMS 179v3 requirements for calculation Created: 02/10/15  Updated: 05/06/18  Resolved: 07/24/15

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

Type: Bug/Issue Priority: Minor
Reporter: Matthew Dugal Assignee: David Czulada
Resolution: Delivered Votes: 0
Labels: None

Issue Links:
Duplicate
duplicates CQM-899 CMS179v2/ADE_TTR: Require Understandi... Closed
Relates
relates to CQM-1462 CMS 179v3 requirements for calculation Closed
Previous Issue Type: Implementation Problem

 Description   

I am having some difficulty understanding the requirements for calculating measure 179. I am finding conflicting information and having difficulty calculating this measure.

The measure guidance states: "A Valid INR Interval is defined as a pair of INR start dates that are less than or equal to 56 days apart. Patients without 2 such intervals will be excluded from the calculation of the providers’ Average PctTTR later on."

This is found in both of the following documents:
"Electronic Clinical Quality Measure Logic and Implementation Guidance and Technical Release Notes"
which references file
"CMS179v2_UserGuide_SQL_Logic_Reference Jun 2013.pdf"

But neither of the two Cypress patients (both A, Heart_Adult) have a valid INR Interval. All of the dates of the results are > 56 days apart. This should result in the patient from being "excluded from the calculation of the providers’ Average PctTTR later on".

Additionally, according to JIRA CQM issue #899, "There is nothing in the logic definition that states 56 days. It may say something in the description about it but unless the measure authors actually place it in the logic it will not get picked up and will not be implemented. All of the measures are based strictly off of the coded logic sections in the HQMF. If anything this is an error in the measure definition in that the developers did not actually implement in the logic what they described in the description. We can certainly open an issue based around that."

https://jira.oncprojectracking.org/browse/CQM-899

But the measure as written in the XML does not appear to be something that can be calculated.

What is going on here?



 Comments   
Comment by David Czulada [ 07/24/15 ]

This has been addressed in Cypress 2.7.0 released yesterday for use with the 2015 CMS measures. It can be downloaded by following the link below.

https://github.com/projectcypress/cypress/wiki/Cypress-2.7.0-Install-Instructions

-Dave Czulada

Comment by David Czulada [ 02/12/15 ]

Matthew

Currently, the Cypress is only validating against the stated measure logic in the HQMF document (AND: Count >= 3 of:"Laboratory Test, Result: INR" during "Measurement Period") and not the logic specified in the SQL Logic Reference. This is why you see the two Cypress patients falling into the Measure Population with invalid INR Intervals. We are currently working on more complete procedure for testing this measure with Cypress. We will keep you posted.

-Dave Czulada

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