Where is information on negation in the QDM?

Negation has several aspects: (a) assurance a certain condition does not exist (e.g., no known allergies); (b) lack of evidence a condition exists (e.g., no information is available in the electronic health record about allergies); and (c) a measured entity intentionally did not perform an action, with or without a reason (e.g., the clinician did not prescribe the medication due to interaction with other medications a patient is taking). The QDM negation rationale attribute addresses only the third definition, sometimes called action negation. The QDM includes this concept as negation rationale as an attribute of the QDM datatypes. Its inclusion allows an eCQM developer to express an eCQM criterion or exception if the clinician expressed a reason for not performing the action expected. The QDM documentation on the eCQI Resource Center describes how an eCQM developer can use negation rationale. Negation rationale is part of QDM version 5.6 for the 2023 and 2024 reporting/performance periods.