[MADIE-415] Bonnie doeas not appear to be processing numerator logic appropriately Created: 01/10/18  Updated: 05/11/18  Resolved: 01/23/18

Status: Closed
Project: MADiE Issue Tracker
Component/s: Measure Calculation
Affects Version/s: None
Fix Version/s: None

Type: Bug/Issue Priority: Blocker
Reporter: Mike Shoemaker (Inactive) Assignee: Lizzie Charbonneau
Resolution: Fixed Votes: 0
Labels: CQL
Remaining Estimate: Not Specified
Time Spent: Not Specified
Original Estimate: Not Specified

Attachments: Zip Archive CMS156_v5_4_Artifacts.zip    
Measure/Library Title: Use of High-Risk Medications in the Elderly
CBE Number: CMS 156
Test Case Name(s):  NUMERPop2Pass AmoxapineX2, plus others
Impact: Unable to determine if the logic is valid.

 Description   

There appears to be 2 issues:
1) We believe the Population 1 Numerator should be met if Population 2 Numerator is met, see test case - NUMERPop2Pass Hyos/Meth/Mblue/Biphosx2 where this patient has 2 medication orders for 'Hyoscyamine / Methenamine / Mblue / Sodium Biphosphate' - this same medication (code) is also in the High Risk Medications for the Elderly value set used in the logic for Population 1 Numerator. The only way to get this patient to be included in Population 1 Numerator is to add a 'Medication: Order: High Risk Medications for the Elderly' data element.

2) However, this brings up the second issue, see test case - NUMERPop2Pass AmoxapineX2 where this patient meets the Population 2 numerator, but even having the High Risk Medications for the Elderly data element added to the History, the patient is still not passing in spite of adding 19 eligible codes. Other codes will work, but it is apparent not all codes are recognized.

 Comments   
Comment by Mike Shoemaker (Inactive) [ 03/23/18 ]

Thanks Lizzie. We'll take a look!!

Comment by Lizzie Charbonneau [ 01/23/18 ]

Mike confirmed that this issue is addressed.

Comment by Mike Shoemaker (Inactive) [ 01/23/18 ]

Based on preliminary testing, both issues appear to have been addressed.

Comment by Mike Shoemaker (Inactive) [ 01/18/18 ]

Thanks Lizzie. We'll take a look!!

Comment by Lizzie Charbonneau [ 01/18/18 ]

Hi Mike,

This issue has been addressed in the v2.0.3 release of Bonnie on 1/18.

Please note that there are several failures. These are related to codes not being present in the "High Risk Medications" value set.

Please let us know if this addresses your concerns.

Thank you,
Lizzie

Comment by Lizzie Charbonneau [ 01/10/18 ]

Hi Mike,

I apologize - I see that this is a different issue.

We will look into this.

Thanks,
Lizzie

Comment by Lizzie Charbonneau [ 01/10/18 ]

Hi Mike,

When we did the original patient move, we did a preliminary analysis to see why there was a decline in pass rates for population 2. It appeared that, for at least some of the patients, the medication was not listed in the new CQL logic that had previously been listed in the old CQL logic. For example, one medication combination that appeared to be missing was "Acetaminophen / Dextromethorphan / Doxylamine / Pseudoephedrine".

This discovery was included in the spreadsheet we sent out after performing the patient transfer and referenced in the email, so it's possible you've already addressed this. Can you confirm if this has been addressed? If not, it may be the cause of the issues you're currently seeing.

Thank you,
Lizzie

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