Your User Friendly Name for MyContentIG Here
0.4.6 - CI Build
Your User Friendly Name for MyContentIG Here, published by HL7 International - [Some] Work Group. This guide is not an authorized publication; it is the continuous build for version 0.4.6 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/cqframework/sample-content-ig/ and changes regularly. See the Directory of published versions
Official URL: http://somewhere.org/fhir/uv/mycontentig/Measure/HybridHospitalWideMortalityFHIRExample | Version: 0.4.6 | |||
Draft as of 2024-05-06 | Computable Name: HybridHospitalWideMortalityFHIRExample | |||
Other Identifiers: Short Name (use: usual, ), UUID:965255e9-dfeb-42d0-8416-2c4b7ecc5109 (use: official, ), UUID:2c92808482113ece0182c5d4fc662f1a (use: official, ), Endorser (use: official, ), Publisher (use: official, ) | ||||
Copyright/Legal: Limited proprietary coding is contained in these specifications for user convenience. Users of proprietary code sets should obtain all necessary licenses from the owners of the code sets. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2021 International Health Terminology Standards Development Organisation. All rights reserved. LOINC(R) copyright 2004-2021 Regenstrief Institute, Inc. |
This logic is intended to extract electronic clinical data. This is not an electronic clinical quality measure and this logic will not produce measure results. Instead, it will produce a file containing the data that CMS will link with administrative claims to risk adjust the Hybrid HWM outcome measure. It is designed to extract the first resulted set of vital signs and basic laboratory results obtained from encounters for adult Medicare Fee-For-Service patients admitted to acute care short stay hospitals.
UNKNOWN
Knowledge Artifact Metadata | |
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Name (machine-readable) | HybridHospitalWideMortalityFHIRExample |
Title (human-readable) | Core Clinical Data Elements for the Hybrid Hospital-Wide (All-Condition, All-Procedure) Risk-Standardized Mortality Measure (HWM) FHIR Example |
Status | Draft |
Experimental | false |
Description | This logic is intended to extract electronic clinical data. This is not an electronic clinical quality measure and this logic will not produce measure results. Instead, it will produce a file containing the data that CMS will link with administrative claims to risk adjust the Hybrid HWM outcome measure. It is designed to extract the first resulted set of vital signs and basic laboratory results obtained from encounters for adult Medicare Fee-For-Service patients admitted to acute care short stay hospitals. |
Purpose | UNKNOWN |
Clinical Usage | This FHIR-based measure has been derived from the QDM-based measure: CMS844v3.1 (QDM 5.6). Please refer to the HL7 QI-Core Implementation Guide (http://hl7.org/fhir/us/qicore/index.html) for more information on QI-Core and mapping recommendations from QDM to QI-Core 4.1.1 (http://hl7.org/fhir/us/qicore/qdm-to-qicore.html). These specifications are for use for data with discharges that occur between July 1, 2023 and June 30, 2024. This logic guides the user to extract the FIRST resulted HWM-specific core clinical data elements for all Medicare Fee-For-Service encounters for patients age 65 to 94 (Initial Population) directly admitted to the hospital or admitted to the same facility after being treated in another area, such as the emergency department or hospital outpatient location. The logic supports extraction of the FIRST set of HWM-specific core clinical data elements in two different ways, depending on if the patient was a direct admission, meaning that the patient was admitted directly to an inpatient unit without first receiving care in the emergency department or other hospital outpatient locations within the same admitting facility: 1. If the patient was a direct admission, the logic supports extraction of the FIRST resulted vital signs within 2 hours (120 minutes) after the start of the inpatient admission, and the FIRST resulted laboratory tests within 24 hours (1440 minutes) after the start of the inpatient admission. 2. If the patient has values captured prior to admission, for example from the emergency department, pre-operative, or other outpatient area within the hospital, the logic supports extraction of the FIRST resulted vital signs and laboratory tests within 24 hours (1440 minutes) PRIOR to the start of the inpatient admission. All clinical systems used in inpatient and outpatient locations within the hospital facility should be queried when looking for core clinical data element values related to a patient who is subsequently admitted. Value sets for the laboratory tests represent the LOINC codes currently available for these tests. If the institution is using local codes to capture and store relevant laboratory test data, those sites should map that information to the LOINC code for reporting of the core clinical data elements. NOTE: Do not report ALL values on an encounter during their entire admission. Only report the FIRST resulted value for EACH core clinical data element collected in the appropriate timeframe, if available. For each core clinical data element, please report values using one of the appropriate units of measurement listed below, which represent valid UCUM codes: Core Clinical Data Element UCUM Unit Bicarbonate-----------------------------------meq/L mmol/L Creatinine-------------------------------------mg/dL umol/L Heart rate------------------------------------{Beats}/min Hematocrit -----------------------------------% Oxygen saturation (by pulse oximetry)-----%{Oxygen} Platelet----------------------------------------10*3/uL 10*9/L /mm3 Sodium----------------------------------------meq/L mmol/L Systolic blood pressure----------------------mm[Hg] Temperature----------------------------------Cel [degF] White blood cell count ----------------------{Cells}/uL 10*3/uL 10*9/L /mm3 For each encounter please also submit the following Linking Variables: CMS Certification Number; Health Insurance Claim Number (HICN) or Medicare Beneficiary Identifier (MBI); Date of Birth; Sex; Inpatient Admission Date; and, Discharge Date. The initial population includes patients with inpatient hospitalizations and patients from Acute Hospital Care at Home programs, who are treated and billed as inpatients but receive care in their home. |
Approval Date | 2023-08-14 |
Effective Period | 2024-07-01..2025-06-30 |
Measure Developer | Mathematica: https://www.mathematica.org/ |
Measure Developer | Yale New Haven Health Service Corporation/ Center for Outcomes Research and Evaluation: https://medicine.yale.edu/core/ |
Measure Steward | HL7 International - [Some] Work Group |
Steward Contact Details | http://hl7.org/Special/committees/[something] |
Copyright | Limited proprietary coding is contained in these specifications for user convenience. Users of proprietary code sets should obtain all necessary licenses from the owners of the code sets. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2021 International Health Terminology Standards Development Organisation. All rights reserved. LOINC(R) copyright 2004-2021 Regenstrief Institute, Inc. |
Measure Metadata | |
Short Name Identifier | CMS844FHIR |
Version Independent Identifier | urn:uuid:965255e9-dfeb-42d0-8416-2c4b7ecc5109 |
Version Specific Identifier | urn:uuid:2c92808482113ece0182c5d4fc662f1a |
Publisher (CMS) Identifier | 844FHIR |
Identifier | Endorser/3502 (use: official, ) |
Version Number | 0.4.6 |
Rationale | The intent of this logic is to extract the FIRST set of clinical data elements from hospital electronic health records (EHRs) for all qualifying encounters. The data will be linked with administrative claims to risk adjust the Hybrid HWM outcome measure. This work addresses stakeholder concerns that clinical data garnered from patients, and used by clinicians to guide diagnostic decisions and treatment, are preferable to administrative claims data when profiling hospitals’ case mix. We are calling the list of data elements for extraction the "HWM-specific core clinical data elements". The core clinical data elements are the first set of vital signs and basic laboratory tests resulted from encounters for adult Medicare Fee-For-Service patients, age 65 to 94 (Initial Population), after they arrive at the hospital to which they are subsequently admitted. For example, this first set of data values are often captured in the emergency department or in the pre-operative area, sometimes hours before a patient is admitted to that same facility. Encounters over the age of 94 are not included to avoid holding hospitals responsible for the survival of the oldest elderly patients, who may be less likely to have survival as a primary goal. While we acknowledge that many elderly patients do have survival beyond 30 days as a primary goal for their hospitalization, with input from our Technical Expert Panel and work groups, we decided to only include encounters between 65 and 94 years of age. These core clinical data elements were selected because they: 1. reflect patients' clinical status when they first present to the hospital; 2. are clinically and statistically relevant to patient outcomes; 3. are consistently obtained on adult inpatient encounters based on current clinical practice; 4. are captured with a standard definition and recorded in a standard format across providers; and 5. are entered in structured fields that are feasibly retrieved from current EHR systems (YNHHSC/CORE, 2015). Additional data called Linking Variables are used to link EHR data files with administrative claims data for CMS to calculate results for the Hybrid HWM measure, which are: CMS Certification Number; Health Insurance Claim Number (HICN) or Medicare Beneficiary Identifier (MBI); date of birth; sex; admission date; and discharge date. |
Clinical Recommendation Statement | The logic is not meant to guide or alter the care patients receive. The purpose of this core clinical data elements logic is to extract clinical data that are already routinely captured in EHRs from encounters for hospitalized adult patients. It is not intended to require that clinical staff perform additional measurements or tests that are not needed for diagnostic assessment or treatment of patients. |
Measure Population Criteria (ID: 6385011c4ba3d47c885c02aa) | |
Initial Population |
ID: 24BB5BA9-820F-4958-B8AA-AA8962E9E398
Description: All Medicare Fee-For-Service encounters age 65 to 94 years at the start of an inpatient admission, who are discharged during the measurement period (length of stay <365 days). NOTE: All Medicare Fee-For-Service encounters meeting the above criteria should be included, regardless if Medicare Fee-For-Service is the primary, secondary, or tertiary payer. Logic Definition: Initial Population |
Population Basis | Encounter |
Scoring | Cohort |
Type | Outcome |
Supplemental Data Elements | |
Supplemental Data Element |
ID: results
Usage Code: Supplemental Data Description: Results Logic Definition: Results |
Supplemental Data Element |
ID: sde-ethnicity
Usage Code: Supplemental Data Description: SDE Ethnicity Logic Definition: SDE Ethnicity |
Supplemental Data Element |
ID: sde-payer
Usage Code: Supplemental Data Description: SDE Payer Logic Definition: SDE Payer |
Supplemental Data Element |
ID: sde-race
Usage Code: Supplemental Data Description: SDE Race Logic Definition: SDE Race |
Supplemental Data Element |
ID: sde-sex
Usage Code: Supplemental Data Description: SDE Sex Logic Definition: SDE Sex |
Measure Logic | |
Primary Library | Hybrid Hospital-Wide Mortality FHIR Example |
Dependency |
Description: Library SDE
Resource: Supplemental Data Elements Example Canonical URL: http://somewhere.org/fhir/uv/mycontentig/Library/SupplementalDataElementsExample |
Dependency |
Description: Library FHIRHelpers
Resource: http://hl7.org/fhir/Library/FHIRHelpers|4.0.1
Canonical URL: http://hl7.org/fhir/Library/FHIRHelpers|4.0.1 |
Dependency |
Description: Library CQMCommon
Resource: CQM Common Example Canonical URL: http://somewhere.org/fhir/uv/mycontentig/Library/CQMCommonExample |
Dependency |
Description: Library QICoreCommon
Resource: QICore Common Example Canonical URL: http://somewhere.org/fhir/uv/mycontentig/Library/QICoreCommonExample |
Dependency |
Description: Code system ActCode
Resource: ActCode Canonical URL: http://terminology.hl7.org/CodeSystem/v3-ActCode |
Dependency |
Description: Value set Encounter Inpatient
Resource: Encounter Inpatient Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307 |
Dependency |
Description: Value set Medicare payer
Resource: Medicare payer Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1104.10 |
Dependency |
Description: Value set Observation Services
Resource: Observation Services Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.143 |
Dependency |
Description: Value set Emergency Department Visit
Resource: Emergency Department Visit Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292 |
Dependency |
Description: Value set Heart Rate
Resource: Heart Rate Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.149 |
Dependency |
Description: Value set Systolic Blood Pressure
Resource: Systolic Blood Pressure Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.163 |
Dependency |
Description: Value set Body temperature
Resource: Body temperature Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.152 |
Dependency |
Description: Value set Oxygen Saturation by Pulse Oximetry
Resource: Oxygen Saturation by Pulse Oximetry Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.151 |
Dependency |
Description: Value set Hematocrit lab test
Resource: Hematocrit lab test Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.114 |
Dependency |
Description: Value set Platelet count lab test
Resource: Platelet count lab test Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.127 |
Dependency |
Description: Value set White blood cells count lab test
Resource: White blood cells count lab test Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.129 |
Dependency |
Description: Value set Sodium lab test
Resource: Sodium lab test Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.119 |
Dependency |
Description: Value set Bicarbonate lab test
Resource: Bicarbonate lab test Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.139 |
Dependency |
Description: Value set Creatinine lab test
Resource: Creatinine lab test Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.2363 |
Dependency |
Description: Value set Payer Type
Resource: Payer Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591 |
Direct Reference Code |
Display: Inpatient
Code: IMP System: http://terminology.hl7.org/CodeSystem/v3-ActCode |
Direct Reference Code |
Display: Acute
Code: ACUTE System: http://terminology.hl7.org/CodeSystem/v3-ActCode |
Direct Reference Code |
Display: Nonacute
Code: NONAC System: http://terminology.hl7.org/CodeSystem/v3-ActCode |
Direct Reference Code |
Display: Observation Encounter
Code: OBSENC System: http://terminology.hl7.org/CodeSystem/v3-ActCode |
Parameter |
Name: Measurement Period
Use: In Min Cardinality: 0 Max Cardinality: 1 Type: Period |
Parameter |
Name: SDE Sex
Use: Out Min Cardinality: 0 Max Cardinality: 1 Type: Coding |
Parameter |
Name: Results
Use: Out Min Cardinality: 0 Max Cardinality: * Type: string |
Parameter |
Name: SDE Payer
Use: Out Min Cardinality: 0 Max Cardinality: * Type: Resource |
Parameter |
Name: Initial Population
Use: Out Min Cardinality: 0 Max Cardinality: * Type: Resource |
Parameter |
Name: SDE Ethnicity
Use: Out Min Cardinality: 0 Max Cardinality: 1 Type: Resource |
Parameter |
Name: SDE Race
Use: Out Min Cardinality: 0 Max Cardinality: 1 Type: Resource |
Measure Logic Data Requirements | |
Data Requirement |
Type: Patient
Profile(s): QICore Patient Must Support Elements: url, extension |
Data Requirement |
Type: Encounter
Profile(s): QICore Encounter Must Support Elements: type, status, status.value, period, id, id.value Code Filter(s): Path: type ValueSet: Observation Services |
Data Requirement |
Type: Encounter
Profile(s): QICore Encounter Must Support Elements: type, status, status.value, period, id, id.value Code Filter(s): Path: type ValueSet: Emergency Department Visit |
Data Requirement |
Type: Encounter
Profile(s): QICore Encounter Must Support Elements: type, status, status.value, class, period, id, id.value Code Filter(s): Path: type ValueSet: Encounter Inpatient |
Data Requirement |
Type: Coverage
Profile(s): QICore Coverage Must Support Elements: type Code Filter(s): Path: type ValueSet: Medicare payer |
Data Requirement |
Type: Coverage
Profile(s): QICore Coverage Must Support Elements: type, period Code Filter(s): Path: type ValueSet: Payer |
Data Requirement |
Type: Observation
Profile(s): QICore Observation Must Support Elements: code, effective, status, status.value, value, issued, issued.value Code Filter(s): Path: code ValueSet: Heart Rate |
Data Requirement |
Type: Observation
Profile(s): QICore Observation Must Support Elements: code, effective, status, status.value, value, issued, issued.value Code Filter(s): Path: code ValueSet: Systolic Blood Pressure |
Data Requirement |
Type: Observation
Profile(s): QICore Observation Must Support Elements: code, effective, status, status.value, value, issued, issued.value Code Filter(s): Path: code ValueSet: Body temperature |
Data Requirement |
Type: Observation
Profile(s): QICore Observation Must Support Elements: code, effective, status, status.value, value, issued, issued.value Code Filter(s): Path: code ValueSet: Oxygen Saturation by Pulse Oximetry |
Data Requirement |
Type: Observation
Profile(s): QICore Observation Must Support Elements: code, effective, status, status.value, value, issued, issued.value Code Filter(s): Path: code ValueSet: Hematocrit lab test |
Data Requirement |
Type: Observation
Profile(s): QICore Observation Must Support Elements: code, effective, status, status.value, value, issued, issued.value Code Filter(s): Path: code ValueSet: Platelet count lab test |
Data Requirement |
Type: Observation
Profile(s): QICore Observation Must Support Elements: code, effective, status, status.value, value, issued, issued.value Code Filter(s): Path: code ValueSet: White blood cells count lab test |
Data Requirement |
Type: Observation
Profile(s): QICore Observation Must Support Elements: code, effective, status, status.value, value, issued, issued.value Code Filter(s): Path: code ValueSet: Sodium lab test |
Data Requirement |
Type: Observation
Profile(s): QICore Observation Must Support Elements: code, effective, status, status.value, value, issued, issued.value Code Filter(s): Path: code ValueSet: Bicarbonate lab test |
Data Requirement |
Type: Observation
Profile(s): QICore Observation Must Support Elements: code, effective, status, status.value, value, issued, issued.value Code Filter(s): Path: code ValueSet: Creatinine lab test |
Measure Logic Definitions | |
Logic Definition | Library Name: SupplementalDataElementsExample |
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Logic Definition | Library Name: HybridHospitalWideMortalityFHIRExample |
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Logic Definition | Library Name: HybridHospitalWideMortalityFHIRExample |
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Logic Definition | Library Name: HybridHospitalWideMortalityFHIRExample |
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Logic Definition | Library Name: SupplementalDataElementsExample |
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Logic Definition | Library Name: HybridHospitalWideMortalityFHIRExample |
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Logic Definition | Library Name: HybridHospitalWideMortalityFHIRExample |
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Logic Definition | Library Name: SupplementalDataElementsExample |
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Logic Definition | Library Name: HybridHospitalWideMortalityFHIRExample |
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Logic Definition | Library Name: SupplementalDataElementsExample |
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Logic Definition | Library Name: HybridHospitalWideMortalityFHIRExample |
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Logic Definition | Library Name: HybridHospitalWideMortalityFHIRExample |
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Logic Definition | Library Name: CQMCommonExample |
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Logic Definition | Library Name: CQMCommonExample |
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Logic Definition | Library Name: CQMCommonExample |
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Logic Definition | Library Name: QICoreCommonExample |
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Logic Definition | Library Name: HybridHospitalWideMortalityFHIRExample |
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Logic Definition | Library Name: FHIRHelpers |
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Logic Definition | Library Name: FHIRHelpers |
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