CMS FHIR Prototype Measure Calculation Tool IG
0.1.0 - CI Build

CMS FHIR Prototype Measure Calculation Tool IG, published by HL7 International - [Some] Work Group. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/cqframework/mct-ig/ and changes regularly. See the Directory of published versions

## Measure: Discharged on Antithrombotic Therapy QICore

Official URL: http://cms.gov/fhir/mct/Measure/DischargedonAntithromboticTherapyQICore4 | Version: 0.1.0
Draft as of 2022-07-05 | Computable Name: DischargedonAntithromboticTherapyQICore4
Other Identifiers: http://hl7.org/fhir/cqi/ecqm/Measure/Identifier/guid#755216b2-5fa4-474d-bb29-ae8eaa209460 (use: official, ), http://hl7.org/fhir/cqi/ecqm/Measure/Identifier/cms#1095FHIR (use: official, )
Copyright/Legal: Measure specifications are in the Public Domain LOINC(R) copyright 2004-2020 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2020 International Health Terminology Standards Development Organisation. All Rights Reserved.

Ischemic stroke patients prescribed or continuing to take antithrombotic therapy at hospital discharge

The effectiveness of antithrombotic agents in reducing stroke mortality, stroke-related morbidity and recurrence rates has been studied in several large clinical trials. While the use of these agents for patients with acute ischemic stroke and transient ischemic attacks continues to be the subject of study, substantial evidence is available from completed studies. Data at this time suggest that antithrombotic therapy should be prescribed at discharge following acute ischemic stroke to reduce stroke mortality and morbidity as long as no contraindications exist. For patients with a stroke due to a cardioembolic source (e.g. atrial fibrillation, mechanical heart valve), warfarin is recommended unless contraindicated. In recent years, novel oral anticoagulant agents (NOACs) have been developed and approved by the U.S. Food and Drug Administration (FDA) for stroke prevention, and may be considered as an alternative to warfarin for select patients. Anticoagulation therapy is not generally recommended for secondary stroke prevention in patients presumed to have a non-cardioembolic stroke. Anticoagulants at doses to prevent venous thromboembolism are insufficient antithrombotic therapy to prevent recurrent ischemic stroke or TIA.

Id: | DischargedonAntithromboticTherapyQICore4
Url: | Discharged on Antithrombotic Therapy QICore
Version: | 0.1.0
Identifier: | value: 755216b2-5fa4-474d-bb29-ae8eaa209460
Identifier: | value: 1095FHIR
Name: | DischargedonAntithromboticTherapyQICore4
Title: | Discharged on Antithrombotic Therapy QICore
Status: | draft
Experimental: | false
Scoring: | system: http://terminology.hl7.org/CodeSystem/measure-scoring code: proportion display: Proportion
Improvement Notation: | system: http://terminology.hl7.org/CodeSystem/measure-improvement-notation code: increase
Type: | system: http://terminology.hl7.org/CodeSystem/measure-type code: process
Date: | 2022-07-05 20:34:35-0600
Publisher: | HL7 International - [Some] Work Group
Description: | Ischemic stroke patients prescribed or continuing to take antithrombotic therapy at hospital discharge
Populations: |
Group | Population | Description
--- | --- | ---
| Initial Population | Inpatient hospitalizations for patients age 18 and older, discharged from inpatient care (non-elective admissions) with a principal diagnosis of ischemic or hemorrhagic stroke and a length of stay less than or equal to 120 days that ends during the measurement period
| Denominator | Inpatient hospitalizations for patients with a principal diagnosis of Ischemic stroke
| Denominator Exclusion | Inpatient hospitalizations for patients admitted for elective carotid intervention. This exclusion is implicitly modeled by only including non-elective hospitalizations. Inpatient hospitalizations for patients discharged to another hospital Inpatient hospitalizations for patients who left against medical advice Inpatient hospitalizations for patients who expired Inpatient hospitalizations for patients discharged to home for hospice care Inpatient hospitalizations for patients discharged to a health care facility for hospice care Inpatient hospitalizations for patients with comfort measures documented
| Denominator Exception | Inpatient hospitalizations for patients with a documented reason for not prescribing antithrombotic therapy at discharge. Inpatient hospitalizations for patients who receive Ticagrelor or Prasugrel as an antithrombotic therapy at discharge.
| Numerator | Inpatient hospitalizations for patients prescribed or continuing to take antithrombotic therapy at hospital discharge

Supplemental Data:

expression | system
--- | ---
SDE Sex | http://terminology.hl7.org/CodeSystem/measure-data-usage
SDE Ethnicity | http://terminology.hl7.org/CodeSystem/measure-data-usage
SDE Payer | http://terminology.hl7.org/CodeSystem/measure-data-usage

Jurisdiction: US
Purpose:

The effectiveness of antithrombotic agents in reducing stroke mortality, stroke-related morbidity and recurrence rates has been studied in several large clinical trials. While the use of these agents for patients with acute ischemic stroke and transient ischemic attacks continues to be the subject of study, substantial evidence is available from completed studies. Data at this time suggest that antithrombotic therapy should be prescribed at discharge following acute ischemic stroke to reduce stroke mortality and morbidity as long as no contraindications exist. For patients with a stroke due to a cardioembolic source (e.g. atrial fibrillation, mechanical heart valve), warfarin is recommended unless contraindicated. In recent years, novel oral anticoagulant agents (NOACs) have been developed and approved by the U.S. Food and Drug Administration (FDA) for stroke prevention, and may be considered as an alternative to warfarin for select patients. Anticoagulation therapy is not generally recommended for secondary stroke prevention in patients presumed to have a non-cardioembolic stroke. Anticoagulants at doses to prevent venous thromboembolism are insufficient antithrombotic therapy to prevent recurrent ischemic stroke or TIA.

Copyright:

Measure specifications are in the Public Domain

LOINC(R) copyright 2004-2020 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2020 International Health Terminology Standards Development Organisation. All Rights Reserved.

Disclaimer:

These performance measures are not clinical guidelines and do not establish a standard of medical care, and have not been tested for all potential applications. The measures and specifications are provided without warranty.

Effective Period: 2022-01-01..2022-12-31
Logic Definitions:

Group | Scoring | Population Criteria | Expression
--- | --- | --- | ---
| Measure scoring: proportion
|  | Initial Population |
    Initial Population
|  | Denominator |
    Denominator
|  | Denominator Exclusion |
    Denominator Exclusions
|  | Denominator Exception |
    Denominator Exceptions
|  | Numerator |
    Numerator