[CYPRESS-243] Cypress calculating NQF 0041 denominator incorrectly Created: 10/11/13 Updated: 06/20/18 Resolved: 11/05/13 |
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Status: | Closed |
Project: | CYPRESS Issue Tracker |
Component/s: | None |
Type: | Question | Priority: | Minor |
Reporter: | Eric Gunther (Inactive) | Assignee: | Renee Rookwood (Inactive) |
Resolution: | Answered | Votes: | 0 |
Labels: | None |
Issue Links: |
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Solution: | This issue is due to the way the measure is written which results in a time window on January 1 that will cause encounters to not qualify for the measure. This issue will be addressed for the next measure annual update by updating the patient. Interim guidance recommended by the Cypress team to ONC was to allow both results for the measure in the meantime. Official guidance is pending from ONC. | ||||
Previous Issue Type: | Logic affecting more than 1 eCQM |
Description |
There's an email chain on the Cypress listserv with the subject "Possible Issue with Cypress Measure Calculation NQF 0041" that describes this in a bit more detail. Here's the summary though: Cypress is showing that patient “A, Diabetes_Peds” should only be in the NQF 0041 IPP, but we are returning the patient in the denominator as well. Looking at the patient’s encounter history, they have a 99381 encounter on 1/1/2012, which I believe meets the denominator criteria for this measure. This is preventing us from certifying against this measure right now. |
Comments |
Comment by Sharon Sebastian (Inactive) [ 10/01/14 ] |
The encounter date in question was changed from January 1st to January 5th in the 2014 test bundle to alleviate this issue. |
Comment by Howard Bregman [ 02/03/14 ] |
Sam- Thanks for that. Just the response we were looking for. |
Comment by Samuel Sayer (Inactive) [ 02/03/14 ] |
Howard, It is a little unclear from the solution text (which I have just updated), but we plan on updating the patient test deck to move the encounter to another time. We plan on updating the patients by late Spring, though we are trying to move that time frame up. The interim guidance recommended by the Cypress team to ONC last Friday was to allow both results for the measure in the meantime. Official guidance is pending from ONC. |
Comment by Howard Bregman [ 02/03/14 ] |
The response to this issue is plainly absurd. The fact that the measure is specified in this way is clearly a typo on the part of the measure authors, something that is a by-product of the complexity of the QDM. There is no benefit to anyone, not to the measure authors, to the vendors, to CMS, to publc health, to provide a test patient which exploits this typo. This test patient only makes sense to a mathematician, which regretably is the case for a number of other test patients as well. |
Comment by Debbie Mobley [ 01/16/14 ] |
Clinigence is having this issue as well. Is there guidance for this issue for the ATL's? |
Comment by Robert Dingwell (Inactive) [ 11/05/13 ] |
Measure definition error being tracked in |
Comment by Eric Gunther (Inactive) [ 11/05/13 ] |
Created a ticket in the CQM tracker: |
Comment by Samuel Sayer (Inactive) [ 11/05/13 ] |
The best way to raise this issue with the measure developers is to post an issue on the CQM JIRA (http://oncprojecttracking.org/browse/CQM) with the relevant information. |
Comment by Eric Gunther (Inactive) [ 10/29/13 ] |
Looking to follow up on this - what's the best way to raise this issue with the measure developers? Again, we understand that Cypress is calculating it correctly per the measure spec, but we feel this measure warrants a modification to the specifications. |
Comment by Eric Gunther (Inactive) [ 10/23/13 ] |
Hi Robert, We understand your hands are tied. Sounds like this issue belongs in the CQM tracker - is that the correct place to raise issues like this to the measure developers? If so then I'd recommend this ticket be moved to that project since, as you've noted, it's not a problem with Cypress. |
Comment by Robert Dingwell (Inactive) [ 10/23/13 ] |
Eric, You need to understand that we cannot modify any of the measures. All modifications must come from the measure developers and released through CMS. I understand your concerns with the way it is coded presently but there is nothing that we can do about that we must use the measures as published from CMS. |
Comment by Eric Gunther (Inactive) [ 10/22/13 ] |
I agree with Adam that, while this may not occur frequently with real data, it's definitely a problem with the measure specification and it would be great if this could be addressed in the next set of measure updates. I wonder if we could also consider some kind of exception for vendors who are failing this measure on this specific corner case. Clearly the intent of the measure is to include patients with an encounter only on January 1 - the USHIK site describes the denominator as "Equals Initial Patient Population and seen for a visit between October 1 and March 31". I understand the need to follow the spec but I think this scenario warrants an exception until the specification is altered. |
Comment by Adam Plotts (Inactive) [ 10/21/13 ] |
Hi Robert, Thanks, Adam |
Comment by Robert Dingwell (Inactive) [ 10/18/13 ] |
There is a slight issue with the temporal constraints in the Denominator that cause the patient to not be included. Specifically these to constraints. In order for something to match it must either start after the start of the Measurement period or before the start of the measurement period. The encounter in question on the record starts at the exact same time as the measurement period. As it starts at the exact same time it does not start before or after the start of the measurement period. |