Percentage of episodes for patients 3 months of age and older with a diagnosis of upper respiratory infection (URI) that did not result in an antibiotic dispensing event.
Outpatient visits, telephone visits, online assessments, observation stays or emergency department visits with a diagnosis of URI during the measurement period among patients 3 months of age and older.
Equals Initial Population
Exclude URI episodes when the patient had a competing comorbid condition during the 12 months prior to or on the episode date.
Exclude URI episodes when the patient had a new or refill prescription of antibiotics in the 30 days prior to or on the episode date.
Exclude URI episodes when the patient had competing diagnosis on or three days after the episode date.
Exclude URI episodes when the patient had hospice care overlapping with the measurement period.
URI episodes without a prescription for antibiotic medication on or 3 days after the outpatient visit, telephone visit, online assessment, observation stay or emergency department visit for an upper respiratory infection
Not Applicable
None
Higher score indicates better quality
This is an episode of care measure that examines all eligible episodes for the patient during the measurement period.
This eCQM is a episode-based measure.
This version of the eCQM uses QDM version 5.5. Please refer to the eCQI resource center for more information on the QDM.
The Compare function compares two years of the measure specifications found in the header of the measure's HTML. It does not include a comparison of any information in the body of the HTML, e.g., population criteria, Clinical Quality Language, or value sets.
Strikethrough text highlighted in red indicates information changed from the previous version. Text highlighted in green indicates information updated in the new eCQM version.
Percentage of episodes for patients 3 months of age and older with a diagnosis of upper respiratory infection (URI) that did not result in an antibiotic order
Outpatient visits, telephone visits, online assessments (i.e. e-visit or virtual check-in), observation stays or emergency department visits with a diagnosis of URI during the measurement period among patients 3 months of age and older.
Outpatient visits, telephone visits, online assessments (i.e. e-visit or virtual check-in), observation stays or emergency department visits with a diagnosis of URI during the measurement period among patients 3 months of age and older
This eCQM is an episode-based measure. An episode is defined as each eligible encounter for patients aged 3 months of age and older with a diagnosis of upper respiratory infection during the measurement period.
This version of the eCQM uses QDM version 5.6. Please refer to the QDM page for more information on the QDM.
Increased the age range age to 3 months and older, from 3 months to 18 years, to address the increasing alarm regarding antibiotic overuse among all age ranges.
Measure Section: eCQM Title
Source of Change: Measure Lead
Updated eCQM Version Number.
Measure Section: eCQM Version Number
Source of Change: Standards Update
Measure Section: Description
Updated the description and numerator statements to be episode based for better alignment with the measure intent.
Updated copyright.
Measure Section: Copyright
Source of Change: Annual Update
Updated references.
Measure Section: Reference
Added text to identify the Quality Data Model (QDM) version used in the measure specification.
Measure Section: Guidance
Added text to indicate whether the measure is patient-based or episode-based.
Measure Section: Initial Population
Updated denominator exclusions for upper respiratory infection (URI) to clarify language regarding eligible encounter types and add an exclusion for competing comorbid condition during the 12 months prior to or on the episode date.
Measure Section: Denominator Exclusions
Measure Section: Numerator
Added 'on or' to the 'Encounter with Competing Diagnosis for Upper Respiratory Infection' definition to allow for same day competing diagnosis.
Measure Section: Definitions
Source of Change: ONC Project Tracking System (Jira): CQM-3789
QDM v5.5 standards update: Added 'relevantDatetime' attribute to QDM datatypes. 'RelevantDatetime' indicates when the action occurred whereas 'authorDatetime' indicates when the action was recorded.
Measure Section: Multiple Sections
Updated Clinical Quality Language (CQL) expression to conform with the HL7 Standard: Clinical Quality Language Specification, Release 1 STU 4 (CQL 1.4).
Updated the names of CQL definitions, functions, and/or aliases for clarification and to align with the CQL Style Guide.
Updated version number of the Measure Authoring Tool (MAT) Global Common Functions Library (MATGlobalCommonFunctions-5.0.000). Updated definitions and functions in the MAT Global Common Functions Library to align with standards changes, CQL Style Guide, and to include one new function related to calculating length of hospital stays with observation stays.
CQL Library version update: Updated version number of the Hospice Library (Hospice-2.2.000).
The VSAC is the source of truth for the value set content, please visit the VSAC for downloads of current value sets.
Value set Antibiotic Medications for Pharyngitis (2.16.840.1.113883.3.464.1003.196.12.1001): Deleted 9 RxNorm codes (1148107, 199497, 199620, 199710, 199802, 245240, 245837, 245838, 761979) based on terminology update.
Measure Section: Terminology
Value set Competing Conditions for Respiratory Conditions (2.16.840.1.113883.3.464.1003.102.12.1017): Deleted 29 SNOMED CT codes based on terminology update.
Value sets Preventive Care Services - Established Office Visit, 18 and Up (2.16.840.1.113883.3.464.1003.101.12.1025); Preventive Care Services - Initial Office Visit, 18 and Up (2.16.840.1.113883.3.464.1003.101.12.1023); Telephone Visits (2.16.840.1.113883.3.464.1003.101.12.1080) added to accommodate the expanded age range of the initial population.
Value set Comorbid Conditions for Respiratory Conditions (2.16.840.1.113883.3.464.1003.102.12.1025): Added Comorbid Conditions for Respiratory Conditions based on change in measure requirements/measure specification.