Telehealth Services Or Telephone Management Encounter Union

Data elements that meet criteria using this datatype should document that the medication indicated by the QDM category and its corresponding value set is being taken by the patient. Keep in mind that when this datatype is used with timing relationships, the criterion is looking for a medication being taken for the time frame indicated by the timing relationships.

A QDM Known Issue has been identified related to this datatype. To see this QDM known Issue, please click here.  

Timing: The Relevant Period addresses:

• startTime - when the medication is first known to be used (generally the time of entry on the medication list),
• stopTime - when the medication is discontinued (generally, the time discontinuation is recorded on the medication list)

Data elements that meet criteria using this datatype should document that a prescription for the medication indicated by the QDM category and its corresponding value set has been dispensed and provided to the patient or patient proxy. In the ambulatory setting, medications are primarily taken directly by patients and not directly observed. Hence, dispensed, or fulfillment, information is the closest health provider documentation of medication compliance. In settings where patients attest to taking medications in electronic format (perhaps a Personal Health Record), patient attestation of medication taken may be available. The QDM datatype, Medication, Administered addresses medication taken; to address the source of the information, a measure addressing such patient attestation would require use of the dataflow attribute, source.

Timing: The time the medication dispensing event occurs; the Author dateTime.

[For Reference: in QDM 5.5 Guidance Update and QDM 5.6, the time the dispensing occurs is referenced as a new “Medication, Dispensed” attribute: relevant dateTime which references the dateTime the prescription dispensing event occurred. The timing corresponds to the HL7® FHIR® MedicationDispense.whenHandedOver, i.e., the time the prescription was handed over to the patient or patient’s representative. In QDM 5.5 Guidance Update and QDM 5.6 the “Medication, Dispensed” author dateTime is reserved for use only for documentation of negationRationale, the reason the dispensing event did not happen.]

Timing: The Relevant Period addresses:

• startTime - when the first administration of the medication is expected. If not specified. the startTime defaults to the Author dateTime (the time the medication dispensing event occurs).
• stopTime - when the medication supply provided by the dispensing event is expected to be completed.
• [For Reference: in QDM 5.5 Guidance Update and QDM 5.6, the “Medication, Dispense” relevantPeriod addresses the time referenced in the dosage instruction indicating when the medication administration should start and end. The timing corresponds to the HL7® FHIR® MedicationDispense.dosageInstruction.timing.]

Note that when calculating cumulative medication duration, the medication dispensed stopTime may be present directly in the fulfillment record. If the stopTime is not available, the duration in days is the difference between the Relevant Period start and stop times. The record may indicate which of the available refills the fulfillment represents but each dispensing event is unique. Therefore, the measure developer should use CQL logic to address multiple dispensing events over a period of time.

Data elements that meet criteria using this datatype should document that the encounter indicated by the QDM category and its corresponding value set is in progress or has been completed.

A QDM Known Issue has been identified related to this datatype. To see this QDM known Issue, please click here.

Timing: The Relevant Period addresses:

• startTime – the time the encounter began (admission time)
• stopTime – the time the encounter ended (discharge time)

The Author dateTime addresses when an Encounter is documented. Documentation can occur at the beginning, during, at the end or subsequent to the end of an Encounter. The Author dateTime should be used only if the Relevant Period cannot be obtained.

The Location Period is an attribute of the attribute facility location addresses:

• startTime -the time the patient arrived at the location;
• stopTime -the time the patient departed from the location

Data elements that meet criteria using this datatype should document that the encounter indicated by the QDM category and its corresponding value set is in progress or has been completed.

A QDM Known Issue has been identified related to this datatype. To see this QDM known Issue, please click here.

Timing: The Relevant Period addresses:

• startTime – the time the encounter began (admission time)
• stopTime – the time the encounter ended (discharge time)

The Author dateTime addresses when an Encounter is documented. Documentation can occur at the beginning, during, at the end or subsequent to the end of an Encounter. The Author dateTime should be used only if the Relevant Period cannot be obtained.

The Location Period is an attribute of the attribute facility location addresses:

• startTime -the time the patient arrived at the location;
• stopTime -the time the patient departed from the location