FHIR Server FHIR Server Version n/a

Resource Measure/FHIR Server from package example.fhir.uv.mycontentig#current (297 ms)

Package

example.fhir.uv.mycontentig

Type

Measure

FHIR Version

Source

http://somewhere.org/fhir/uv/mycontentig/https://build.fhir.org/ig/cqframework/sample-content-ig/Measure-HybridHospitalWideMortalityFHIRExample.html

Url

http://somewhere.org/fhir/uv/mycontentig/Measure/HybridHospitalWideMortalityFHIRExample

Version

0.4.4

Status

draft

Date

2024-05-06T01:40:05+00:00

Name

HybridHospitalWideMortalityFHIRExample

Title

Core Clinical Data Elements for the Hybrid Hospital-Wide (All-Condition, All-Procedure) Risk-Standardized Mortality Measure (HWM) FHIR Example

Experimental

False

Realm

Authority

hl7

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

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.

Resources that use this resource

No resources found

Resources that this resource uses

No resources found

Narrative

Note: links and images are rebased to the (stated) source

Title: Core Clinical Data Elements for the Hybrid Hospital-Wide (All-Condition, All-Procedure) Risk-Standardized Mortality Measure (HWM) FHIR Example

Id: HybridHospitalWideMortalityFHIRExample

Version: 0.4.4

Url: Core Clinical Data Elements for the Hybrid Hospital-Wide (All-Condition, All-Procedure) Risk-Standardized Mortality Measure (HWM) FHIR Example

short-name identifier:

CMS844FHIR

version-independent identifier:

urn:uuid:965255e9-dfeb-42d0-8416-2c4b7ecc5109

version-specific identifier:

urn:uuid:2c92808482113ece0182c5d4fc662f1a

endorser (NQF) identifier:

3502

publisher (CMS) identifier:

844FHIR

Effective Period: 2024-07-01..2025-06-30

Status: draft

Publisher: HL7 International - [Some] Work Group

Author: Mathematica, Yale New Haven Health Service Corporation/ Center for Outcomes Research and Evaluation

Description:

Jurisdiction: 001

Purpose:

UNKNOWN

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.

Disclaimer:

These performance specifications 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 “AS IS” WITHOUT WARRANTY OF ANY KIND.

Due to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM].

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.

Guidance (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.

Population Criteria:

6385011c4ba3d47c885c02aa

Initial Population:

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.

Supplemental Data Elements:

Results

SDE Ethnicity

SDE Payer

SDE Race

SDE Sex

Supplemental Data Guidance :

Libraries:

Hybrid Hospital-Wide Mortality FHIR Example

Terminology and Other Dependencies: Supplemental Data Elements Example

http://hl7.org/fhir/Library/FHIRHelpers|4.0.1

CQM Common Example

QICore Common Example

ActCode

Encounter Inpatient

Medicare payer

Observation Services

Emergency Department Visit

Heart Rate

Systolic Blood Pressure

Body temperature

Oxygen Saturation by Pulse Oximetry

Hematocrit lab test

Platelet count lab test

White blood cells count lab test

Sodium lab test

Bicarbonate lab test

Creatinine lab test

Payer

Parameters:

name

use

min

max

type

Measurement Period

Period

SDE Sex

Out

Coding

Results

Out

string

SDE Payer

Out

Resource

Initial Population

Out

Resource

SDE Ethnicity

Out

Resource

SDE Race

Out

Resource

DataRequirements:

Resource Type

Resource Elements

Valueset Name

Valueset

Patient(QICore Patient)

url extension

Encounter(QICore Encounter)

type status status.value period id id.value

Observation Services

Encounter(QICore Encounter)

type status status.value period id id.value

Emergency Department Visit

Encounter(QICore Encounter)

type status status.value class period id id.value

Encounter Inpatient

Coverage(QICore Coverage)

type

Medicare payer

Coverage(QICore Coverage)

type period

Payer Type

Payer

Observation(QICore Observation)