eCQM Title | Heart Failure (HF): Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD) |
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eCQM Identifier (Measure Authoring Tool) | 144 | eCQM Version number | 7.1.000 |
NQF Number | 0083 | GUID | 8439f671-2932-4d4c-88ca-ea5faeacc89a |
Measurement Period | January 1, 20XX through December 31, 20XX | ||
Measure Steward | PCPI(R) Foundation (PCPI[R]) | ||
Measure Developer | American Medical Association (AMA) | ||
Measure Developer | PCPI(R) Foundation (PCPI[R]) | ||
Endorsed By | National Quality Forum | ||
Description | |||
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Disclaimer | |||
Measure Scoring | Proportion | ||
Measure Type | Process | ||
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Risk Adjustment | |||
Rate Aggregation | |||
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Definition | |||
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Initial Population | |||
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Supplemental Data Elements |
exists ( ["Patient Characteristic Birthdate"] BirthDate where Global."CalendarAgeInYearsAt"(BirthDate.birthDatetime, start of "Measurement Period")>= 18 ) and Count("Qualifying Encounter")>= 2 and exists "Heart Failure Outpatient Encounter"
"Initial Population 1" and exists "Heart Failure Outpatient Encounter with Moderate or Severe LVSD"
exists "Beta Blocker Therapy for LVSD Ordered Outpatient" or exists "Currently Taking Beta Blocker Therapy for LVSD Outpatient"
exists "Consecutive Heart Rates Less Than 50 Outpatient" or exists "Medical Patient or System Reason for Not Ordering Beta Blocker for LVSD Outpatient" or exists "Arrhythmia Diagnosis Outpatient" or exists "Hypotension Diagnosis Outpatient" or exists "Asthma Diagnosis Outpatient" or exists "Diagnosis of Allergy to Beta Blocker Therapy Outpatient" or exists "Diagnosis of Intolerance to Beta Blocker Therapy Outpatient" or exists "Bradycardia Diagnosis Outpatient" or exists "Allergy or Intolerance to Beta Blocker Therapy Ingredient Outpatient" or "Atrioventricular Block Without Cardiac Pacer Outpatient"
exists ( ["Patient Characteristic Birthdate"] BirthDate where Global."CalendarAgeInYearsAt"(BirthDate.birthDatetime, start of "Measurement Period")>= 18 ) and exists "Heart Failure Inpatient Encounter"
"Initial Population 2" and exists "Heart Failure Inpatient Encounter with Moderate or Severe LVSD"
exists "Beta Blocker Therapy for LVSD Ordered Inpatient" or exists "Currently Taking Beta Blocker Therapy for LVSD Inpatient"
exists "Consecutive Heart Rates Less Than 50 Inpatient" or exists "Medical Patient or System Reason for Not Ordering Beta Blocker for LVSD Inpatient" or exists "Arrhythmia Diagnosis Inpatient" or exists "Hypotension Diagnosis Inpatient" or exists "Asthma Diagnosis Inpatient" or exists "Diagnosis of Allergy to Beta Blocker Therapy Inpatient" or exists "Diagnosis of Intolerance to Beta Blocker Therapy Inpatient" or exists "Bradycardia Diagnosis Inpatient" or exists "Allergy or Intolerance to Beta Blocker Therapy Ingredient Inpatient" or "Atrioventricular Block Without Cardiac Pacer Inpatient"
["Allergy/Intolerance": "Beta Blocker Therapy Ingredient"] BetaBlockerAllergyIntolerance with "Heart Failure Inpatient Encounter with Moderate or Severe LVSD" ModerateOrSevereLVSDHFInpatientEncounter such that BetaBlockerAllergyIntolerance.prevalencePeriod overlaps after ModerateOrSevereLVSDHFInpatientEncounter.relevantPeriod
["Allergy/Intolerance": "Beta Blocker Therapy Ingredient"] BetaBlockerAllergyIntolerance with "Heart Failure Outpatient Encounter with Moderate or Severe LVSD" ModerateOrSevereLVSDHFOutpatientEncounter such that BetaBlockerAllergyIntolerance.prevalencePeriod overlaps after ModerateOrSevereLVSDHFOutpatientEncounter.relevantPeriod
["Diagnosis": "Arrhythmia"] Arrhythmia with "Heart Failure Inpatient Encounter with Moderate or Severe LVSD" ModerateOrSevereLVSDHFInpatientEncounter such that Arrhythmia.prevalencePeriod overlaps ModerateOrSevereLVSDHFInpatientEncounter.relevantPeriod
["Diagnosis": "Arrhythmia"] Arrhythmia with "Heart Failure Outpatient Encounter with Moderate or Severe LVSD" ModerateOrSevereLVSDHFOutpatientEncounter such that Arrhythmia.prevalencePeriod overlaps ModerateOrSevereLVSDHFOutpatientEncounter.relevantPeriod
["Diagnosis": "Asthma"] Asthma with "Heart Failure Inpatient Encounter with Moderate or Severe LVSD" ModerateOrSevereLVSDHFInpatientEncounter such that Asthma.prevalencePeriod overlaps ModerateOrSevereLVSDHFInpatientEncounter.relevantPeriod
["Diagnosis": "Asthma"] Asthma with "Heart Failure Outpatient Encounter with Moderate or Severe LVSD" ModerateOrSevereLVSDHFOutpatientEncounter such that Asthma.prevalencePeriod overlaps ModerateOrSevereLVSDHFOutpatientEncounter.relevantPeriod
["Diagnosis": "Atrioventricular Block"] AtrioventricularBlock with "Heart Failure Inpatient Encounter with Moderate or Severe LVSD" ModerateOrSevereLVSDHFInpatientEncounter such that AtrioventricularBlock.prevalencePeriod overlaps ModerateOrSevereLVSDHFInpatientEncounter.relevantPeriod
["Diagnosis": "Atrioventricular Block"] AtrioventricularBlock with "Heart Failure Outpatient Encounter with Moderate or Severe LVSD" ModerateOrSevereLVSDHFOutpatientEncounter such that AtrioventricularBlock.prevalencePeriod overlaps ModerateOrSevereLVSDHFOutpatientEncounter.relevantPeriod
exists "Atrioventricular Block Diagnosis Inpatient" and not exists "Diagnosis of Cardiac Pacer in Situ Inpatient" and not exists "Cardiac Pacer Device Implanted Inpatient"
exists "Atrioventricular Block Diagnosis Outpatient" and not exists "Diagnosis of Cardiac Pacer in Situ Outpatient" and not exists "Cardiac Pacer Device Implanted Outpatient"
["Medication, Order": "Beta Blocker Therapy for LVSD"] BetaBlockerOrdered with "Heart Failure Inpatient Encounter with Moderate or Severe LVSD" ModerateOrSevereLVSDHFInpatientEncounter such that BetaBlockerOrdered.authorDatetime during ModerateOrSevereLVSDHFInpatientEncounter.relevantPeriod
["Medication, Order": "Beta Blocker Therapy for LVSD"] BetaBlockerOrdered with "Heart Failure Outpatient Encounter with Moderate or Severe LVSD" ModerateOrSevereLVSDHFOutpatientEncounter such that BetaBlockerOrdered.authorDatetime during ModerateOrSevereLVSDHFOutpatientEncounter.relevantPeriod
["Diagnosis": "Bradycardia"] Bradycardia with "Heart Failure Inpatient Encounter with Moderate or Severe LVSD" ModerateOrSevereLVSDHFInpatientEncounter such that Bradycardia.prevalencePeriod overlaps ModerateOrSevereLVSDHFInpatientEncounter.relevantPeriod
["Diagnosis": "Bradycardia"] Bradycardia with "Heart Failure Outpatient Encounter with Moderate or Severe LVSD" ModerateOrSevereLVSDHFOutpatientEncounter such that Bradycardia.prevalencePeriod overlaps ModerateOrSevereLVSDHFOutpatientEncounter.relevantPeriod
["Device, Applied": "Cardiac Pacer"] ImplantedCardiacPacer with "Heart Failure Inpatient Encounter with Moderate or Severe LVSD" ModerateOrSevereLVSDHFInpatientEncounter such that ImplantedCardiacPacer.relevantPeriod overlaps after ModerateOrSevereLVSDHFInpatientEncounter.relevantPeriod
["Device, Applied": "Cardiac Pacer"] ImplantedCardiacPacer with "Heart Failure Outpatient Encounter with Moderate or Severe LVSD" ModerateOrSevereLVSDHFOutpatientEncounter such that ImplantedCardiacPacer.relevantPeriod overlaps after ModerateOrSevereLVSDHFOutpatientEncounter.relevantPeriod
from ["Physical Exam, Performed": "Heart rate"] HeartRate, "Heart Failure Inpatient Encounter with Moderate or Severe LVSD" ModerateOrSevereLVSDHFInpatientEncounter let PriorHeartRate: Last(["Physical Exam, Performed": "Heart rate"] MostRecentPriorHeartRate where MostRecentPriorHeartRate.relevantPeriod during ModerateOrSevereLVSDHFInpatientEncounter.relevantPeriod and MostRecentPriorHeartRate.relevantPeriod starts before start of HeartRate.relevantPeriod sort by start of relevantPeriod ) where HeartRate.relevantPeriod during ModerateOrSevereLVSDHFInpatientEncounter.relevantPeriod and HeartRate.result < 50 '{Beats}/min' and PriorHeartRate.result < 50 '{Beats}/min'
from ["Physical Exam, Performed": "Heart rate"] HeartRate, "Heart Failure Outpatient Encounter with Moderate or Severe LVSD" ModerateOrSevereLVSDHFOutpatientEncounter let PriorHeartRate: Last(["Physical Exam, Performed": "Heart rate"] MostRecentPriorHeartRate where MostRecentPriorHeartRate.relevantPeriod during ModerateOrSevereLVSDHFOutpatientEncounter.relevantPeriod and MostRecentPriorHeartRate.relevantPeriod starts before start of HeartRate.relevantPeriod sort by start of relevantPeriod ) where HeartRate.relevantPeriod during ModerateOrSevereLVSDHFOutpatientEncounter.relevantPeriod and HeartRate.result < 50 '{Beats}/min' and PriorHeartRate.result < 50 '{Beats}/min'
["Medication, Active": "Beta Blocker Therapy for LVSD"] ActiveBetaBlocker with "Heart Failure Inpatient Encounter with Moderate or Severe LVSD" ModerateOrSevereLVSDHFInpatientEncounter such that ActiveBetaBlocker.relevantPeriod overlaps after ModerateOrSevereLVSDHFInpatientEncounter.relevantPeriod
["Medication, Active": "Beta Blocker Therapy for LVSD"] ActiveBetaBlocker with "Heart Failure Outpatient Encounter with Moderate or Severe LVSD" ModerateOrSevereLVSDHFOutpatientEncounter such that ActiveBetaBlocker.relevantPeriod overlaps after ModerateOrSevereLVSDHFOutpatientEncounter.relevantPeriod
"Initial Population 1" and exists "Heart Failure Outpatient Encounter with Moderate or Severe LVSD"
"Initial Population 2" and exists "Heart Failure Inpatient Encounter with Moderate or Severe LVSD"
exists "Consecutive Heart Rates Less Than 50 Outpatient" or exists "Medical Patient or System Reason for Not Ordering Beta Blocker for LVSD Outpatient" or exists "Arrhythmia Diagnosis Outpatient" or exists "Hypotension Diagnosis Outpatient" or exists "Asthma Diagnosis Outpatient" or exists "Diagnosis of Allergy to Beta Blocker Therapy Outpatient" or exists "Diagnosis of Intolerance to Beta Blocker Therapy Outpatient" or exists "Bradycardia Diagnosis Outpatient" or exists "Allergy or Intolerance to Beta Blocker Therapy Ingredient Outpatient" or "Atrioventricular Block Without Cardiac Pacer Outpatient"
exists "Consecutive Heart Rates Less Than 50 Inpatient" or exists "Medical Patient or System Reason for Not Ordering Beta Blocker for LVSD Inpatient" or exists "Arrhythmia Diagnosis Inpatient" or exists "Hypotension Diagnosis Inpatient" or exists "Asthma Diagnosis Inpatient" or exists "Diagnosis of Allergy to Beta Blocker Therapy Inpatient" or exists "Diagnosis of Intolerance to Beta Blocker Therapy Inpatient" or exists "Bradycardia Diagnosis Inpatient" or exists "Allergy or Intolerance to Beta Blocker Therapy Ingredient Inpatient" or "Atrioventricular Block Without Cardiac Pacer Inpatient"
["Diagnosis": "Allergy to Beta Blocker Therapy"] BetaBlockerAllergyDiagnosis with "Heart Failure Inpatient Encounter with Moderate or Severe LVSD" ModerateOrSevereLVSDHFInpatientEncounter such that BetaBlockerAllergyDiagnosis.prevalencePeriod overlaps after ModerateOrSevereLVSDHFInpatientEncounter.relevantPeriod
["Diagnosis": "Allergy to Beta Blocker Therapy"] BetaBlockerAllergyDiagnosis with "Heart Failure Outpatient Encounter with Moderate or Severe LVSD" ModerateOrSevereLVSDHFOutpatientEncounter such that BetaBlockerAllergyDiagnosis.prevalencePeriod overlaps after ModerateOrSevereLVSDHFOutpatientEncounter.relevantPeriod
["Diagnosis": "Cardiac Pacer in Situ"] CardiacPacerDiagnosis with "Heart Failure Inpatient Encounter with Moderate or Severe LVSD" ModerateOrSevereLVSDHFInpatientEncounter such that CardiacPacerDiagnosis.prevalencePeriod starts before end of ModerateOrSevereLVSDHFInpatientEncounter.relevantPeriod
["Diagnosis": "Cardiac Pacer in Situ"] CardiacPacerDiagnosis with "Heart Failure Outpatient Encounter with Moderate or Severe LVSD" ModerateOrSevereLVSDHFOutpatientEncounter such that CardiacPacerDiagnosis.prevalencePeriod starts before end of ModerateOrSevereLVSDHFOutpatientEncounter.relevantPeriod
["Diagnosis": "Intolerance to Beta Blocker Therapy"] BetaBlockerIntoleranceDiagnosis with "Heart Failure Inpatient Encounter with Moderate or Severe LVSD" ModerateOrSevereLVSDHFInpatientEncounter such that BetaBlockerIntoleranceDiagnosis.prevalencePeriod overlaps after ModerateOrSevereLVSDHFInpatientEncounter.relevantPeriod
["Diagnosis": "Intolerance to Beta Blocker Therapy"] BetaBlockerIntoleranceDiagnosis with "Heart Failure Outpatient Encounter with Moderate or Severe LVSD" ModerateOrSevereLVSDHFOutpatientEncounter such that BetaBlockerIntoleranceDiagnosis.prevalencePeriod overlaps after ModerateOrSevereLVSDHFOutpatientEncounter.relevantPeriod
( ["Encounter, Performed": "Care Services in Long-Term Residential Facility"] union ["Encounter, Performed": "Home Healthcare Services"] union ["Encounter, Performed": "Nursing Facility Visit"] union ["Encounter, Performed": "Office Visit"] union ["Encounter, Performed": "Outpatient Consultation"] ) FaceToFaceEncounter where FaceToFaceEncounter.relevantPeriod during "Measurement Period"
"Inpatient Discharge During Measurement Period" InpatientEncounter with ["Diagnosis": "Heart Failure"] HeartFailure such that HeartFailure.prevalencePeriod overlaps InpatientEncounter.relevantPeriod
"Heart Failure Inpatient Encounter" HFInpatientEncounter with "Moderate or Severe LVSD Findings" InpatientLVSDFindings such that InpatientLVSDFindings.prevalencePeriod starts before end of HFInpatientEncounter.relevantPeriod or InpatientLVSDFindings.relevantPeriod starts before end of HFInpatientEncounter.relevantPeriod
"Face to Face Encounter During Measurement Period" FaceToFaceEncounter with ["Diagnosis": "Heart Failure"] HeartFailure such that HeartFailure.prevalencePeriod overlaps FaceToFaceEncounter.relevantPeriod
"Heart Failure Outpatient Encounter" HFOutpatientEncounter with "Moderate or Severe LVSD Findings" OutpatientLVSDFindings such that OutpatientLVSDFindings.prevalencePeriod starts before end of HFOutpatientEncounter.relevantPeriod or OutpatientLVSDFindings.relevantPeriod starts before end of HFOutpatientEncounter.relevantPeriod
["Diagnosis": "Hypotension"] Hypotension with "Heart Failure Inpatient Encounter with Moderate or Severe LVSD" ModerateOrSevereLVSDHFInpatientEncounter such that Hypotension.prevalencePeriod overlaps ModerateOrSevereLVSDHFInpatientEncounter.relevantPeriod
["Diagnosis": "Hypotension"] Hypotension with "Heart Failure Outpatient Encounter with Moderate or Severe LVSD" ModerateOrSevereLVSDHFOutpatientEncounter such that Hypotension.prevalencePeriod overlaps ModerateOrSevereLVSDHFOutpatientEncounter.relevantPeriod
exists ( ["Patient Characteristic Birthdate"] BirthDate where Global."CalendarAgeInYearsAt"(BirthDate.birthDatetime, start of "Measurement Period")>= 18 ) and Count("Qualifying Encounter")>= 2 and exists "Heart Failure Outpatient Encounter"
exists ( ["Patient Characteristic Birthdate"] BirthDate where Global."CalendarAgeInYearsAt"(BirthDate.birthDatetime, start of "Measurement Period")>= 18 ) and exists "Heart Failure Inpatient Encounter"
["Encounter, Performed": "Discharge Services - Hospital Inpatient"] InpatientEncounter where InpatientEncounter.relevantPeriod during "Measurement Period"
["Medication, Not Ordered": "Beta Blocker Therapy for LVSD"] NoBetaBlockerOrdered with "Heart Failure Inpatient Encounter with Moderate or Severe LVSD" ModerateOrSevereLVSDHFInpatientEncounter such that NoBetaBlockerOrdered.authorDatetime during ModerateOrSevereLVSDHFInpatientEncounter.relevantPeriod and ( NoBetaBlockerOrdered.negationRationale in "Medical Reason" or NoBetaBlockerOrdered.negationRationale in "Patient Reason" or NoBetaBlockerOrdered.negationRationale in "System Reason" )
["Medication, Not Ordered": "Beta Blocker Therapy for LVSD"] NoBetaBlockerOrdered with "Heart Failure Outpatient Encounter with Moderate or Severe LVSD" ModerateOrSevereLVSDHFOutpatientEncounter such that NoBetaBlockerOrdered.authorDatetime during ModerateOrSevereLVSDHFOutpatientEncounter.relevantPeriod and ( NoBetaBlockerOrdered.negationRationale in "Medical Reason" or NoBetaBlockerOrdered.negationRationale in "Patient Reason" or NoBetaBlockerOrdered.negationRationale in "System Reason" )
( ["Diagnostic Study, Performed": "Ejection Fraction"] EjectionFraction where EjectionFraction.result < 40 '%' ) union ["Diagnosis": "Moderate or Severe LVSD"] union ( ["Diagnosis": "Left Ventricular Systolic Dysfunction"] LVSD where LVSD.severity in "Moderate or Severe" )
exists "Beta Blocker Therapy for LVSD Ordered Outpatient" or exists "Currently Taking Beta Blocker Therapy for LVSD Outpatient"
exists "Beta Blocker Therapy for LVSD Ordered Inpatient" or exists "Currently Taking Beta Blocker Therapy for LVSD Inpatient"
( ["Encounter, Performed": "Care Services in Long-Term Residential Facility"] union ["Encounter, Performed": "Home Healthcare Services"] union ["Encounter, Performed": "Nursing Facility Visit"] union ["Encounter, Performed": "Office Visit"] union ["Encounter, Performed": "Outpatient Consultation"] union ["Encounter, Performed": "Patient Provider Interaction"] ) ValidEncounter where ValidEncounter.relevantPeriod during "Measurement Period"
["Patient Characteristic Ethnicity": "Ethnicity"]
["Patient Characteristic Payer": "Payer"]
["Patient Characteristic Race": "Race"]
["Patient Characteristic Sex": "ONC Administrative Sex"]
years between ToDate(BirthDateTime)and ToDate(AsOf)
DateTime(year from Value, month from Value, day from Value, 0, 0, 0, 0, timezone from Value)
["Patient Characteristic Ethnicity": "Ethnicity"]
["Patient Characteristic Payer": "Payer"]
["Patient Characteristic Race": "Race"]
["Patient Characteristic Sex": "ONC Administrative Sex"]
Measure Set |