Diabetes: Medical Attention for Nephropathy

• • Active ACE or ARB Medications

    • • ["Medication, Active": "ACE Inhibitor or ARB or ARNI"] ACEorARBMedication
          where ACEorARBMedication.relevantPeriod overlaps "Measurement Period"

       

  • 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"
          )

       

  • End Stage Renal Disease Encounter

    • • ["Encounter, Performed": "ESRD Monthly Outpatient Services"]

       

  • 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"
          )

       

  • Nephropathy Diagnoses

    • • ( ["Diagnosis": "Hypertensive Chronic Kidney Disease"]
          union ["Diagnosis": "Kidney Failure"]
          union ["Diagnosis": "Glomerulonephritis and Nephrotic Syndrome"]
          union ["Diagnosis": "Diabetic Nephropathy"]
          union ["Diagnosis": "Proteinuria"] ) NephropathyDiagnoses
          where NephropathyDiagnoses.prevalencePeriod overlaps "Measurement Period"

       

  • Nephropathy Screenings

    • • ( "Renal Procedures"
          union "Renal Interventions"
          union "End Stage Renal Disease Encounter"
          union "Protein Urea Lab Test" ) ScreeningNephropathy
          where ScreeningNephropathy.relevantPeriod during "Measurement Period"

       

  • Numerator

    • • exists ( "Active ACE or ARB Medications" )
          or exists ( "Nephropathy Diagnoses" )
          or exists ( "Nephropathy Screenings" )

       

  • Protein Urea Lab Test

    • • ["Laboratory Test, Performed": "Urine Protein Tests"] ProteinUreaResult
          where ProteinUreaResult.result is not null

       

  • Renal Interventions

    • • ["Intervention, Performed": "Other Services Related to Dialysis"]
          union ["Intervention, Performed": "Dialysis Education"]

       

  • Renal Procedures

    • • ( ["Procedure, Performed": "Kidney Transplant"]
            union ["Procedure, Performed": "Vascular Access for Dialysis"]
            union ["Procedure, Performed": "Dialysis Services"]
        )

       

  • 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