Diabetes: Hemoglobin A1c (HbA1c) Poor Control (> 9%)

• • AdultOutpatientEncounters.Qualifying Encounters

    • • ( ["Encounter, Performed": "Office Visit"]
        	union ["Encounter, Performed": "Annual Wellness Visit"]
        	union ["Encounter, Performed": "Preventive Care Services - Established Office Visit, 18 and Up"]
        	union ["Encounter, Performed": "Preventive Care Services-Initial Office Visit, 18 and Up"]
        	union ["Encounter, Performed": "Home Healthcare Services"] ) ValidEncounter
        	where ValidEncounter.relevantPeriod during "Measurement Period"

       

  • FrailtyLTI.Advanced Illness and Frailty Exclusion Not Including Over Age 80

    • • //If the measure does NOT include populations age 80 and older, then use this logic:
        exists ( ["Patient Characteristic Birthdate": "Birth date"] BirthDate
            where Global."CalendarAgeInYearsAt" ( BirthDate.birthDatetime, start of "Measurement Period" ) >= 65
              and "Has Criteria Indicating Frailty"
              and ( Count("Outpatient Encounters with Advanced Illness")>= 2
                  or exists ( "Inpatient Encounter with Advanced Illness" )
                  or exists "Dementia Medications In Year Before or During Measurement Period"
              )
        )

       

  • FrailtyLTI.Dementia Medications In Year Before or During Measurement Period

    • • ["Medication, Active": "Dementia Medications"] DementiaMed
        	where DementiaMed.relevantPeriod overlaps Interval[( start of "Measurement Period" - 1 year ), 
        	end of "Measurement Period"]

       

  • FrailtyLTI.Has Criteria Indicating Frailty

    • • exists ( ["Device, Order": "Frailty Device"] FrailtyDeviceOrder
        		where FrailtyDeviceOrder.authorDatetime during "Measurement Period"
        )
        	or exists ( ["Device, Applied": "Frailty Device"] FrailtyDeviceApplied
        			where FrailtyDeviceApplied.relevantPeriod overlaps "Measurement Period"
        	)
        	or exists ( ["Diagnosis": "Frailty Diagnosis"] FrailtyDiagnosis
        			where FrailtyDiagnosis.prevalencePeriod overlaps "Measurement Period"
        	)
        	or exists ( ["Encounter, Performed": "Frailty Encounter"] FrailtyEncounter
        			where FrailtyEncounter.relevantPeriod overlaps "Measurement Period"
        	)
        	or exists ( ["Symptom": "Frailty Symptom"] FrailtySymptom
        			where FrailtySymptom.prevalencePeriod overlaps "Measurement Period"
        	)

       

  • FrailtyLTI.Inpatient Encounter with Advanced Illness

    • • ["Encounter, Performed": "Acute Inpatient"] InpatientEncounter
          where exists ( InpatientEncounter.diagnoses Diagnosis
              where Diagnosis.code in "Advanced Illness"
          )
            and InpatientEncounter.relevantPeriod starts 2 years or less on or before 
            end of "Measurement Period"

       

  • FrailtyLTI.Long Term Care Periods During Measurement Period

    • • ( ["Encounter, Performed": "Care Services in Long-Term Residential Facility"]
        	union ["Encounter, Performed": "Nursing Facility Visit"] ) LongTermFacilityEncounter
        	where LongTermFacilityEncounter.relevantPeriod overlaps "Measurement Period"
        	return LongTermFacilityEncounter.relevantPeriod
        		intersect "Measurement Period"

       

  • FrailtyLTI.Long Term Care Periods Longer Than 90 Consecutive Days

    • • exists ( "Long Term Care Periods During Measurement Period" LongTermCareDuringMP
            where duration in days of LongTermCareDuringMP > 90
        )

       

  • FrailtyLTI.Outpatient Encounters with Advanced Illness

    • • ( ["Encounter, Performed": "Outpatient"]
          union ["Encounter, Performed": "Observation"]
          union ["Encounter, Performed": "ED"]
          union ["Encounter, Performed": "Nonacute Inpatient"] ) OutpatientEncounter
          where exists ( OutpatientEncounter.diagnoses Diagnosis
              where Diagnosis.code in "Advanced Illness"
          )
            and OutpatientEncounter.relevantPeriod starts 2 years or less on or before 
            end of "Measurement Period"

       

  • Denominator

    • • "Initial Population"

       

  • Denominator Exclusions

    • • Hospice."Has Hospice"
          or FrailtyLTI."Advanced Illness and Frailty Exclusion Not Including Over Age 80"
          or ( exists ["Patient Characteristic Birthdate": "Birth date"] BirthDate
              where ( Global."CalendarAgeInYearsAt" ( BirthDate.birthDatetime, start of "Measurement Period" ) >= 65 )
                and FrailtyLTI."Long Term Care Periods Longer Than 90 Consecutive Days"
          )

       

  • Has Most Recent Elevated HbA1c

    • • "Most Recent HbA1c".result > 9 '%'

       

  • Has Most Recent HbA1c Without Result

    • • "Most Recent HbA1c" is not null
          and "Most Recent HbA1c".result is null

       

  • Has No Record Of HbA1c

    • • not exists ( ["Laboratory Test, Performed": "HbA1c Laboratory Test"] NoHbA1c
            where NoHbA1c.relevantDatetime during "Measurement Period"
        )

       

  • Hospice.Has Hospice

    • • exists ( ["Encounter, Performed": "Encounter Inpatient"] DischargeHospice
            where ( DischargeHospice.dischargeDisposition ~ "Discharge to home for hospice care (procedure)"
                or DischargeHospice.dischargeDisposition ~ "Discharge to healthcare facility for hospice care (procedure)"
            )
              and DischargeHospice.relevantPeriod ends during "Measurement Period"
        )
          or exists ( ["Intervention, Order": "Hospice care ambulatory"] HospiceOrder
              where HospiceOrder.authorDatetime during "Measurement Period"
          )
          or exists ( ["Intervention, Performed": "Hospice care ambulatory"] HospicePerformed
              where HospicePerformed.relevantPeriod overlaps "Measurement Period"
          )

       

  • Initial Population

    • • exists ( ["Patient Characteristic Birthdate": "Birth date"] BirthDate
            where Global."CalendarAgeInYearsAt" ( BirthDate.birthDatetime, start of "Measurement Period" ) in Interval[18, 75 )
        )
          and exists ( AdultOutpatientEncounters."Qualifying Encounters" )
          and exists ( ["Diagnosis": "Diabetes"] Diabetes
              where Diabetes.prevalencePeriod overlaps "Measurement Period"
          )

       

  • Most Recent HbA1c

    • • Last(["Laboratory Test, Performed": "HbA1c Laboratory Test"] RecentHbA1c
            where RecentHbA1c.relevantDatetime during "Measurement Period"
            sort by relevantDatetime
        )

       

  • Numerator

    • • "Has Most Recent HbA1c Without Result"
          or "Has Most Recent Elevated HbA1c"
          or "Has No Record Of HbA1c"

       

  • SDE Ethnicity

    • • ["Patient Characteristic Ethnicity": "Ethnicity"]

       

  • SDE Payer

    • • ["Patient Characteristic Payer": "Payer"]

       

  • SDE Race

    • • ["Patient Characteristic Race": "Race"]

       

  • SDE Sex

    • • ["Patient Characteristic Sex": "ONC Administrative Sex"]

       

Functions

None