Back to top
Top

Core Clinical Data Elements for the Hybrid Hospital-Wide Readmission (HWR) Measure with Claims and Electronic Health Record Data

Specifications
Attachment Size
CMS529v1.html 49.41 KB
CMS529v1.zip 61.85 KB
CMS529v1-TRN.xlsx 25.5 KB
Release Notes

Header

  • Updated eCQM Version Number.

    Measure Section: eCQM Version Number

    Source of Change: Standards Update

  • Added National Quality Forum (NQF) number: 2879e.

    Measure Section: NQF Number

    Source of Change: Measure Lead

  • Updated the measurement period.

    Measure Section: Measurement Period

    Source of Change: Measure Lead

  • Updated measure scoring to 'cohort' to better align with measure intent.

    Measure Section: Measure Scoring

    Source of Change: Measure Lead

  • Added text to identify the Quality Data Model (QDM) version used in the measure specification.

    Measure Section: Guidance

    Source of Change: Standards Update

  • Updated header language to clarify which version of the specifications should be used for the reporting period.

    Measure Section: Guidance

    Source of Change: Measure Lead

  • Added additional timing clarification to guidance for extraction of first lab results and vital signs to better align with specification logic.

    Measure Section: Guidance

    Source of Change: Measure Lead

  • Updated header language to clarify the intent is to report encounters discharged during the measurement period.

    Measure Section: Initial Population

    Source of Change: ONC Project Tracking System (Jira): CHM-11

  • Updated header language to clarify the measure includes encounters where the patient is 65 years or older at the start of the inpatient admission.

    Measure Section: Initial Population

    Source of Change: Measure Lead

  • Updated header language to clarify Medicare can be the primary, secondary, or tertiary payer.

    Measure Section: Initial Population

    Source of Change: ONC Project Tracking System (Jira): CHM-16

  • Updated header language to clarify the result timestamp.

    Measure Section: Multiple Sections

    Source of Change: ONC Project Tracking System (Jira): CHM-15

  • Updated header language to better reflect measure intent.

    Measure Section: Multiple Sections

    Source of Change: Expert Work Group Review

Logic

  • Updated measure logic from QDM-based logic to Clinical Quality Language (CQL)-based logic. Information on CQL can be found at the eCQI Resource center (https://ecqi.healthit.gov/cql). Information about specific versions of the new standards in use for CMS reporting periods can be found at the eCQI Resource Center (https://ecqi.healthit.gov/ecqm-tools-key-resources). Switching from QDM to CQL brings with it many changes, as well as enhanced expression capability, but only those changes with significant impact will be outlined in technical release notes. For example, in the case of timing operators, changes may only be summarized if those changes impact the measure calculation.

    Measure Section: Multiple Sections

    Source of Change: Standards Update

  • Updated Global Common Library function to 'Hospitalization with Observation Length of Stay' to better align with measure intent to capture lab results and vital signs from Observation stays and Emergency Department visits.

    Measure Section: Measure Population

    Source of Change: Standards Update

  • Updated QDM timing attribute for 'Physical Exam, Performed' to 'relevantDatetime' to better align with measure intent.

    Measure Section: Functions

    Source of Change: Standards Update

  • Updated all functions logic to return a tuple - Encounter ID, lab/vital signs results, and timing of results, to assist with returning the intended data for measure calculation.

    Measure Section: Functions

    Source of Change: Expert Work Group Review

  • Updated version number of the Measure Authoring Tool (MAT) Global Common Functions Library (MATGlobalCommonFunctions-5.0.000).

    Measure Section: Multiple Sections

    Source of Change: Standards Update

  • Updated definitions and functions in the MAT Global Common Functions Library to align with standards changes, CQL Style Guide, and to include one new function related to calculating length of hospital stays with observation stays.

    Measure Section: Multiple Sections

    Source of Change: Standards Update

  • Updated the names of CQL definitions, functions, and/or aliases for clarification and to align with the CQL Style Guide.

    Measure Section: Multiple Sections

    Source of Change: Standards Update

  • Updated QDM datatype from 'Patient Characteristic Payer' to 'Participant' data element; Updated the ‘Participant’ timing logic to not include periods that start and end before the encounter.

    Measure Section: Multiple Sections

    Source of Change: Measure Lead

  • Updated measure library name for brevity.

    Measure Section: Multiple Sections

    Source of Change: Measure Lead

  • Updated Initial Population to be defined by ‘Inpatient Encounters’.

    Measure Section: Multiple Sections

    Source of Change: Measure Lead

Value Set

The VSAC is the source of truth for the value set content, please visit the VSAC for downloads of current value sets.

  • Replaced value set Heart Rate LOINC (2.16.840.1.113762.1.4.1045.149) with direct reference code LOINC code (8867-4) based on interoperability standards.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Replaced value set Oxygen Saturation in Arterial Blood by Pulse Oximetry (2.16.840.1.113762.1.4.1045.151) with direct reference code LOINC code (59408-5) based on interoperability standards.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Replaced value set Respiratory Rate LOINC (2.16.840.1.113762.1.4.1045.130) with direct reference code LOINC code (9279-1) based on interoperability standards.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Replaced value set Systolic Blood Pressure LOINC (2.16.840.1.113762.1.4.1045.163) with direct reference code LOINC code (8480-6) based on interoperability standards.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Value set Observation Services (2.16.840.1.113762.1.4.1111.143): Added Observation Services to align with updated measure specifications.

    Measure Section: Terminology

    Source of Change: Standards Update

  • Value set 2.16.840.1.113762.1.4.1045.152: Renamed to Body temperature to better align with value set naming conventions.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Value set 2.16.840.1.113762.1.4.1045.119: Renamed to Sodium lab test to better align with value set naming conventions.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Replaced value set Bicarbonate Lab Test (2.16.840.1.113762.1.4.1045.138) with value set Bicarbonate lab test (2.16.840.1.113762.1.4.1045.139) to better support this updated clinical concept.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Value set Bicarbonate lab test (2.16.840.1.113762.1.4.1045.139): Added 8 LOINC codes (19223-7, 2026-3, 2027-1, 20565-8, 77143-6, 19232-8, 19233-6, 1963-8) based on expert input on common codes for these tests.

    Measure Section: Terminology

    Source of Change: Expert Work Group Review

  • Value set White blood cells count lab test (2.16.840.1.113762.1.4.1045.129): added 1 LOINC code (33256-9) based on feedback on common codes for these tests.

    Measure Section: Terminology

    Source of Change: Expert Work Group Review

  • Value set Glucose lab test (2.16.840.1.113762.1.4.1045.134): Added 16 LOINC codes based on feedback on common codes for these tests.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Value set Medicare payer (2.16.840.1.113762.1.4.1104.10): Deleted 7 SOP codes (11, 111, 112, 113, 119, 19, 523) and added 1 SOP code (14) based on clinical input on codes used for Medicare fee-for-service.

    Measure Section: Terminology

    Source of Change: ONC Project Tracking System (Jira): CHM-10

  • Added direct reference code for Birth date (LOINC Code (21112-8)) to align with other eCQMs.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Replaced value set Acute care hospital Inpatient Encounter (2.16.840.1.113883.3.666.5.2289) with value set Encounter Inpatient (2.16.840.1.113883.3.666.5.307) to better harmonize with other eCQMs.

    Measure Section: Terminology

    Source of Change: ONC Project Tracking System (Jira): CHM-20

Last Updated: Jun 24, 2020