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CMS Measure ID: CMS72v8    Performance/Reporting Period: 2020    Version: 8    NQF Number: Not Applicable
Description:

Ischemic stroke patients administered antithrombotic therapy by the end of hospital day 2

Data Elements and coded QDM Attributes contained within the eCQM

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Value Set Description from VSAC
Clinical Focus: This value set contains concepts that represent diagnosis codes for intravenous or intra-arterial thrombolytic (t-PA) therapy administered within 24 hours prior to admission.
Data Element Scope: This value set may use Quality Data Model (QDM) category related to Diagnosis. The intent of this data element is to identify administration intravenous or intra-arterial thrombolytic (t-PA) therapy within 24 hours prior to admission.
Inclusion Criteria: Includes only relevant concepts associated with administration of intravenous or intra-arterial thrombolytic (t-PA) therapy of within 24 hours prior to admission.
Exclusion Criteria: No exclusions.

Constrained to codes in the Diagnoses: Intravenous Or Intra Arterial Thrombolytic (TPA) Therapy Prior To Arrival value set (2.16.840.1.113762.1.4.1110.21)

QDM Attribute and Definition (QDM Version 5.4)

diagnoses

Coded diagnoses/problems addressed during the encounter. The diagnoses attribute is intended to capture ALL diagnoses, including principal diagnosis. Use of the Encounter, Performed: diagnoses attribute and the Diagnosis datatype is redundant for relating the diagnosis to the Encounter, Performed. The Encounter, Performed: diagnoses syntax is preferred. Referencing the same diagnosis using Encounter, Performed (diagnoses attribute) and Diagnosis (datatype) should only occur if the measure must define a specified length of a prevalence period, e.g., the measure must assure that the diagnoses have been present for at least some defined time period before the encounter, and were addressed during the Encounter.
Value Set Description from VSAC
Clinical Focus: This value set contains concepts that represent diagnosis codes for intravenous or intra-arterial thrombolytic (t-PA) therapy administered within 24 hours prior to admission.
Data Element Scope: This value set may use Quality Data Model (QDM) category related to Diagnosis. The intent of this data element is to identify administration intravenous or intra-arterial thrombolytic (t-PA) therapy within 24 hours prior to admission.
Inclusion Criteria: Includes only relevant concepts associated with administration of intravenous or intra-arterial thrombolytic (t-PA) therapy of within 24 hours prior to admission.
Exclusion Criteria: No exclusions.

Constrained to codes in the Diagnosis: Intravenous or Intra arterial Thrombolytic (tPA) Therapy Prior to Arrival value set (2.16.840.1.113762.1.4.1110.21)

QDM Datatype and Definition (QDM Version 5.4)

"Diagnosis"

Data elements that meet criteria using this datatype should document the Condition/Diagnosis/Problem and its corresponding value set. The onset dateTime corresponds to the implicit start dateTime of the datatype and the abatement dateTime corresponds to the implicit stop dateTime of the datatype. If the abatement dateTime is not present, then the diagnosis is considered to still be active. When this datatype is used with timing relationships, the criterion is looking for an active diagnosis for the time frame indicated by the timing relationships.

Timing: The Prevalence Period references the time from the onset date to the abatement date.

Value Set Description from VSAC
Clinical Focus: This value set contains concepts that represent procedures representing an emergency department encounter.
Data Element Scope: This value set may use the Quality Data Model (QDM) category related to Encounter. The intent of this data element is to identify patients who have had an emergency department encounter.
Inclusion Criteria: Includes only relevant concepts associated with an emergency department visit encounter using the SNOMED CT code system.
Exclusion Criteria: No exclusions.

Constrained to codes in the Encounter, Performed: Emergency Department Visit 1 value set (2.16.840.1.113883.3.117.1.7.1.292)

QDM Datatype and Definition (QDM Version 5.4)

"Encounter, Performed"

Data elements that meet criteria using this datatype should document that the encounter indicated by the QDM category and its corresponding value set is in progress or has been completed.

A QDM Known Issue has been identified related to this datatype. To see this QDM known Issue, please click here.

Timing: The Relevant Period addresses:

  • startTime – the time the encounter began (admission time)
  • stopTime – the time the encounter ended (discharge time)

The Author dateTime addresses when an Encounter is documented. Documentation can occur at the beginning, during, at the end or subsequent to the end of an Encounter. The Author dateTime should be used only if the Relevant Period cannot be obtained.

The Location Period is an attribute of the attribute facility location addresses:

  • startTime -the time the patient arrived at the location;
  • stopTime -the time the patient departed from the location
Value Set Description from VSAC
Clinical Focus: This value set contains concepts that represent procedures for non-elective inpatient encounters.
Data Element Scope: This value set may use the Quality Data Model (QDM) category related to Encounter. The intent of this data element is to identify non-elective inpatient encounters.
Inclusion Criteria: Includes only relevant concepts associated with SNOMED CT codes representing non-elective inpatient encounters.
Exclusion Criteria: No exclusions.

Constrained to codes in the Encounter, Performed: Non-Elective Inpatient Encounter value set (2.16.840.1.113883.3.117.1.7.1.424)

QDM Datatype and Definition (QDM Version 5.4)

"Encounter, Performed"

Data elements that meet criteria using this datatype should document that the encounter indicated by the QDM category and its corresponding value set is in progress or has been completed.

A QDM Known Issue has been identified related to this datatype. To see this QDM known Issue, please click here.

Timing: The Relevant Period addresses:

  • startTime – the time the encounter began (admission time)
  • stopTime – the time the encounter ended (discharge time)

The Author dateTime addresses when an Encounter is documented. Documentation can occur at the beginning, during, at the end or subsequent to the end of an Encounter. The Author dateTime should be used only if the Relevant Period cannot be obtained.

The Location Period is an attribute of the attribute facility location addresses:

  • startTime -the time the patient arrived at the location;
  • stopTime -the time the patient departed from the location
Value Set Description from VSAC
Clinical Focus: This value set contains concepts that represent observation encounter types.
Data Element Scope: This value set may use the Quality Data Model (QDM) category related to Encounter. The intent of this data element is to identify patients who have had an observation encounter.
Inclusion Criteria: Includes only relevant concepts associated with SNOMED CT codes representing inpatient encounter.
Exclusion Criteria: No exclusions.

Constrained to codes in the Encounter, Performed: Observation Services value set (2.16.840.1.113762.1.4.1111.143)

QDM Datatype and Definition (QDM Version 5.4)

"Encounter, Performed"

Data elements that meet criteria using this datatype should document that the encounter indicated by the QDM category and its corresponding value set is in progress or has been completed.

A QDM Known Issue has been identified related to this datatype. To see this QDM known Issue, please click here.

Timing: The Relevant Period addresses:

  • startTime – the time the encounter began (admission time)
  • stopTime – the time the encounter ended (discharge time)

The Author dateTime addresses when an Encounter is documented. Documentation can occur at the beginning, during, at the end or subsequent to the end of an Encounter. The Author dateTime should be used only if the Relevant Period cannot be obtained.

The Location Period is an attribute of the attribute facility location addresses:

  • startTime -the time the patient arrived at the location;
  • stopTime -the time the patient departed from the location
Value Set Description from VSAC
Clinical Focus: This value set contains concepts that represent care regimes used to define comfort measure care.
Data Element Scope: This value set may use the Quality Data Model (QDM) category related to Intervention. The intent of this data element is to identify patients receiving comfort measure care.
Inclusion Criteria: Includes only relevant concepts associated with SNOMED CT regime and therapy codes for comfort measures, terminal care, dying care and hospice care.
Exclusion Criteria: Palliative Care.

Constrained to codes in the Intervention, Order: Comfort Measures value set (1.3.6.1.4.1.33895.1.3.0.45)

QDM Datatype and Definition (QDM Version 5.4)

"Intervention, Order"

Data elements that meet criteria using this datatype should document a request to perform the intervention indicated by the QDM category and its corresponding value set.

Timing: The time the order is signed; Author dateTime

Value Set Description from VSAC
Clinical Focus: This value set contains concepts that represent care regimes used to define comfort measure care.
Data Element Scope: This value set may use the Quality Data Model (QDM) category related to Intervention. The intent of this data element is to identify patients receiving comfort measure care.
Inclusion Criteria: Includes only relevant concepts associated with SNOMED CT regime and therapy codes for comfort measures, terminal care, dying care and hospice care.
Exclusion Criteria: Palliative Care.

Constrained to codes in the Intervention, Performed: Comfort Measures value set (1.3.6.1.4.1.33895.1.3.0.45)

QDM Datatype and Definition (QDM Version 5.4)

"Intervention, Performed"

Data elements that meet criteria using this datatype should document the completion of the intervention indicated by the QDM category and its corresponding value set.

Timing: The Relevant Period addresses:

  • startTime – the time the intervention begins
  • stopTime – the time the intervention ends

NOTE - timing refers to a single instance of an intervention. If a measure seeks to evaluate multiple interventions over a period of time, the measure developer should use CQL logic to represent the query request.

Value Set Description from VSAC
Clinical Focus: This value set contains concepts that represent codes for laboratory test for INR, or international normalized ratio.
Data Element Scope: This value set may use the Quality Data Model (QDM) category related to Laboratory Test. The intent of this data element is to identify INR laboratory tests.
Inclusion Criteria: Includes only relevant concepts associated with a laboratory test of INR (International Normalized Ratio). These are LOINC codes.
Exclusion Criteria: No exclusions.

Constrained to codes in the Laboratory Test, Performed: INR value set (2.16.840.1.113883.3.117.1.7.1.213)

QDM Datatype and Definition (QDM Version 5.4)

"Laboratory Test, Performed"

Data elements that meet criteria using this datatype should document the laboratory test indicated by the QDM category and its corresponding value set was performed.

A QDM Known Issue has been identified related to this datatype. To see this QDM known Issue, please click here.

Timing: The Relevant Period addresses:

  • startTime – when the laboratory test is initiated (i.e., the time the specimen collection begins)
  • stopTime – when the laboratory test is completed (i.e., the time the specimen collection ends)

Examples:

  • Initiation of a venipuncture for a fasting blood glucose to the time venipuncture for the fasting blood glucose is completed – basically a single point in time for many specimen collections
  • Initiation of a 24-hour urine collection for measured creatinine clearance until completion of the 24-hour urine collection

Note – the time that the result report is available is a separate attribute than the time of the study (specimen collection).

Value Set Description from VSAC
Clinical Focus: This value set contains concepts that represent anticoagulant and antiplatelet medications used to reduce stroke mortality and morbidity.
Data Element Scope: This value set may use the Quality Data Model (QDM) category related to Medication. The intent of this data element is to identify patients who receive antithrombotic therapy following stroke.
Inclusion Criteria: Includes only relevant concepts associated with single and multi-ingredient drugs. Oral, rectal, and injectable dose forms should be included. Antithrombotic medications includes only relevant concepts associated with anticoagulants and antiplatelet drugs.
Exclusion Criteria: Excludes codes for enoxaparin and heparin generally given for VTE prophylaxis.

Constrained to codes in the Medication, Administered: Antithrombotic Therapy value set (2.16.840.1.113883.3.117.1.7.1.201)

QDM Datatype and Definition (QDM Version 5.4)

"Medication, Administered"

Data elements that meet criteria using this datatype should document that the medication indicated by the QDM category and its corresponding value set was actually administered to the patient.

Timing: The Relevant Period addresses:

  • startTime - when a single medication administration event starts (e.g., the initiation of an intravenous infusion, or administering a pill or IM injection to a patient),
  • stopTime - when a single medication administration event ends (e.g., the end time of the intravenous infusion, or the administration of a pill or IM injection is completed - for pills and IM injections, the start and stop times are the same)

NOTE – Measure developers should address multiple administrations over a period of time using CQL logic.

Value Set Description from VSAC
Clinical Focus: This value set contains concepts that represent medications that are prescribed for thrombolytic (t-PA) therapy for treatment of ischemic stroke.
Data Element Scope: This value set may use the Quality Data Model (QDM) category related to Medication. The intent of this data element is to identify patients who are administered appropriate thrombolytic (t-PA) therapy for stroke.
Inclusion Criteria: Includes only relevant concepts associated with RxNorm thrombolytic medications appropriate for stroke treatment consistent with administration by intravenous (IV) route.
Exclusion Criteria: No exclusions.

Constrained to codes in the Medication, Administered: Thrombolytic (t-PA) Therapy value set (2.16.840.1.113883.3.117.1.7.1.226)

QDM Datatype and Definition (QDM Version 5.4)

"Medication, Administered"

Data elements that meet criteria using this datatype should document that the medication indicated by the QDM category and its corresponding value set was actually administered to the patient.

Timing: The Relevant Period addresses:

  • startTime - when a single medication administration event starts (e.g., the initiation of an intravenous infusion, or administering a pill or IM injection to a patient),
  • stopTime - when a single medication administration event ends (e.g., the end time of the intravenous infusion, or the administration of a pill or IM injection is completed - for pills and IM injections, the start and stop times are the same)

NOTE – Measure developers should address multiple administrations over a period of time using CQL logic.

Value Set Description from VSAC
Clinical Focus: This value set contains concepts that represent Ticagrelor therapy used to reduce stroke mortality and morbidity.
Data Element Scope: This value set may use Quality Data Model (QDM) category related to Medication. The intent of this data element is to identify patients who receive Ticagrelor therapy.
Inclusion Criteria: Includes only relevant concepts associated with Ticagrelor therapy.
Exclusion Criteria: No exclusions.

Constrained to codes in the Medication, Administered: Ticagrelor Therapy value set (2.16.840.1.113762.1.4.1110.39)

QDM Datatype and Definition (QDM Version 5.4)

"Medication, Administered"

Data elements that meet criteria using this datatype should document that the medication indicated by the QDM category and its corresponding value set was actually administered to the patient.

Timing: The Relevant Period addresses:

  • startTime - when a single medication administration event starts (e.g., the initiation of an intravenous infusion, or administering a pill or IM injection to a patient),
  • stopTime - when a single medication administration event ends (e.g., the end time of the intravenous infusion, or the administration of a pill or IM injection is completed - for pills and IM injections, the start and stop times are the same)

NOTE – Measure developers should address multiple administrations over a period of time using CQL logic.

Value Set Description from VSAC
Clinical Focus: This value set contains concepts that represent anticoagulant and antiplatelet medications used to reduce stroke mortality and morbidity.
Data Element Scope: This value set may use the Quality Data Model (QDM) category related to Medication. The intent of this data element is to identify patients who receive antithrombotic therapy following stroke.
Inclusion Criteria: Includes only relevant concepts associated with single and multi-ingredient drugs. Oral, rectal, and injectable dose forms should be included. Antithrombotic medications includes only relevant concepts associated with anticoagulants and antiplatelet drugs.
Exclusion Criteria: Excludes codes for enoxaparin and heparin generally given for VTE prophylaxis.

Constrained to codes in the Medication, Discharge: Antithrombotic Therapy value set (2.16.840.1.113883.3.117.1.7.1.201)

QDM Datatype and Definition (QDM Version 5.4)

"Medication, Discharge"

Data elements that meet criteria using this datatype should document that the medications indicated by the QDM category and its corresponding value set should be taken by or given to the patient after being discharged from an inpatient encounter.

Timing: The time the discharge medication list on the discharge instruction form is authored.

Value Set Description from VSAC
Clinical Focus: This value set contains concepts that represent anticoagulant and antiplatelet medications used to reduce stroke mortality and morbidity.
Data Element Scope: This value set may use the Quality Data Model (QDM) category related to Medication. The intent of this data element is to identify patients who receive antithrombotic therapy following stroke.
Inclusion Criteria: Includes only relevant concepts associated with single and multi-ingredient drugs. Oral, rectal, and injectable dose forms should be included. Antithrombotic medications includes only relevant concepts associated with anticoagulants and antiplatelet drugs.
Exclusion Criteria: Excludes codes for enoxaparin and heparin generally given for VTE prophylaxis.

Constrained to codes in the Medication, Order: Antithrombotic Therapy value set (2.16.840.1.113883.3.117.1.7.1.201)

QDM Datatype and Definition (QDM Version 5.4)

"Medication, Order"

Data elements that meet criteria using this datatype should document a request to a pharmacy to provide the medication indicated by the QDM category and its corresponding value set.

Timing: The Author dateTime is the time the order is signed.

Timing: The Relevant Period addresses:

  • startTime - when the first administration of the medication is expected. The first administration may be expected at the time of the order or at a specified future date (i.e., the active time for the order); such information should be identified in the medication order. If the startTime is not specified in the order, the startTime defaults to the Author dateTime (the time the order is signed).
  • stopTime - when the medication supply provided by the medication order is expected to be completed, including all fulfillments covered by the number of refills.

Note that when calculating cumulative medication duration, the stopTime may be present directly in the medication order. If the stopTime is not available, the duration in days is the difference between the Relevant Period start and stop times multiplied by (1 + the number of refills).

Value Set Description from VSAC
Clinical Focus: This value set contains concepts that represent situations that represent medical reasons for not providing treatment.
Data Element Scope: This value set may use the Quality Data Model (QDM) attribute related to Negation Rationale or Reason. The intent of this data element is to identify medical reasons for not providing treatment.
Inclusion Criteria: Includes only relevant concepts associated with SNOMED CT codes representing medical reasons for not providing treatment should be included.
Exclusion Criteria: No exclusions.

Constrained to codes in the Negation Rationale: Medical Reason 1 value set (2.16.840.1.113883.3.117.1.7.1.473)

QDM Attribute and Definition (QDM Version 5.4)

negationRationale

The QDM attribute, negation rationale indicates the reason that an action was not performed. Only QDM datatypes that represent actions (e.g., performed, recommended, communication, order, dispensed) allow the 'negation rationale' attribute. The intent is to indicate a justification that such action did not happen as expected. This attribute specifically does not address the presence or absence of information in a clinical record (e.g., documented absence of allergies versus lack of documentation about allergies). QDM assumes that any information expected will be in a clinical record. The situation is different when something that normally would be expected to be done is specifically not done because of a valid clinical reason (such as the patient is allergic, they are suffering from a complication, or some other rationale. In this case, the 'thing not done' is rarely documented, especially as a code, in the patient record. To express such lack of evidence, an eCQM author should use a CQL 'not exists' expression noted in the examples, and they must also capture the Negation rationale to capture a reason for the absence, i.e., the reason must be included to qualify as a negation rationale type expression. The syntax in the human readable HQMF is described in CQL examples and in the MAT User Guide. Prior versions of QDM used the syntax, 'Procedure, Performed not done.' QDM 5.5 uses the syntax, 'Procedure, not Performed' and this is then associated with either a DRC or a value set used to identify 'the expected thing,' that in this case was not done. Negation Rationale attribute value indicates a one-time documentation of a reason an activity is not performed. Negation of QDM datatype-related actions for a reason always use the author dateTime attribute to reference timing.

A QDM Known Issue has been identified related to this attribute. To see this QDM known Issue, please click here.

Value Set Description from VSAC
Clinical Focus: This value set contains concepts that represent situations representing a patient's refusal for treatment.
Data Element Scope: This value set may use the Quality Data Model (QDM) attribute related to Reason. The intent of this data element is to identify reasons a patient refuses treatment.
Inclusion Criteria: Includes only relevant concepts associated with identifying refusal of any intervention (including procedures, treatment, medication, counseling, screening).
Exclusion Criteria: No exclusions.

Constrained to codes in the Negation Rationale: Patient Refusal value set (2.16.840.1.113883.3.117.1.7.1.93)

QDM Attribute and Definition (QDM Version 5.4)

negationRationale

The QDM attribute, negation rationale indicates the reason that an action was not performed. Only QDM datatypes that represent actions (e.g., performed, recommended, communication, order, dispensed) allow the 'negation rationale' attribute. The intent is to indicate a justification that such action did not happen as expected. This attribute specifically does not address the presence or absence of information in a clinical record (e.g., documented absence of allergies versus lack of documentation about allergies). QDM assumes that any information expected will be in a clinical record. The situation is different when something that normally would be expected to be done is specifically not done because of a valid clinical reason (such as the patient is allergic, they are suffering from a complication, or some other rationale. In this case, the 'thing not done' is rarely documented, especially as a code, in the patient record. To express such lack of evidence, an eCQM author should use a CQL 'not exists' expression noted in the examples, and they must also capture the Negation rationale to capture a reason for the absence, i.e., the reason must be included to qualify as a negation rationale type expression. The syntax in the human readable HQMF is described in CQL examples and in the MAT User Guide. Prior versions of QDM used the syntax, 'Procedure, Performed not done.' QDM 5.5 uses the syntax, 'Procedure, not Performed' and this is then associated with either a DRC or a value set used to identify 'the expected thing,' that in this case was not done. Negation Rationale attribute value indicates a one-time documentation of a reason an activity is not performed. Negation of QDM datatype-related actions for a reason always use the author dateTime attribute to reference timing.

A QDM Known Issue has been identified related to this attribute. To see this QDM known Issue, please click here.

Direct Reference Code

Constrained to 'Birth date' LOINC code

QDM Datatype and Definition (QDM Version 5.4)

"Patient Characteristic Birthdate"

The Patient Characteristic Birthdate data element should document the patient’s date of birth. Timing: The Patient Characteristic, Birthdate is a single point in time representing the date and time of birth. It does not have a start and stop time. Note: Patient Characteristic Birthdate is fixed to LOINC code 21112-8 (Birth date) and therefore cannot be further qualified with a value set.

Value Set Description from VSAC
Clinical Focus: n/a Data Element Scope: n/a Inclusion Criteria: n/a Exclusion Criteria: n/a

Constrained to codes in the Patient Characteristic, Ethnicity: Ethnicity value set (2.16.840.1.114222.4.11.837)

QDM Datatype and Definition (QDM Version 5.4)

"Patient Characteristic Ethnicity"

Data elements that meet criteria using this datatype should document that the patient has one or more of the ethnicities indicated by the QDM category and its corresponding value set.

Timing: Ethnicity does not have a specific timing. Measures using Patient Characteristic, Ethnicity should address the most recent entry in the clinical record.

Value Set Description from VSAC
Clinical Focus: Categories of types of health care payor entities as defined by the US Public Health Data Consortium SOP code system
Data Element Scope: @code in CCDA r2.1 template Planned Coverage [act: identifier urn:oid:2.16.840.1.113883.10.20.22.4.129 (open)] DYNAMIC
Inclusion Criteria: All codes in the code system
Exclusion Criteria: none

Constrained to codes in the Patient Characteristic, Payer: Payer value set (2.16.840.1.114222.4.11.3591)

QDM Datatype and Definition (QDM Version 5.4)

"Patient Characteristic Payer"

Data elements that meet criteria using this datatype should document that the patient has one or more of the payers indicated by the QDM category and its corresponding value set.

Timing: The Relevant Period addresses:

  • startTime – the first day of insurance coverage with the referenced payer
  • stopTime – the last day of insurance coverage with the referenced payer

 

Value Set Description from VSAC
Clinical Focus: n/a Data Element Scope: n/a Inclusion Criteria: n/a Exclusion Criteria: n/a

Constrained to codes in the Patient Characteristic, Race: Race value set (2.16.840.1.114222.4.11.836)

QDM Datatype and Definition (QDM Version 5.4)

"Patient Characteristic Race"

Data elements that meet criteria using this datatype should document the patient’s race.

Timing: Race does not have a specific timing. Measures using Patient Characteristic, Race should address the most recent entry in the clinical record.

Value Set Description from VSAC
Clinical Focus: Gender identity restricted to only Male and Female used in administrative situations requiring a restriction to these two categories.
Data Element Scope: Gender
Inclusion Criteria: Male and Female only.
Exclusion Criteria: Any gender identity that is not male or female.

Constrained to codes in the Patient Characteristic, Sex: ONC Administrative Sex value set (2.16.840.1.113762.1.4.1)

QDM Datatype and Definition (QDM Version 5.4)

"Patient Characteristic Sex"

Data elements that meet criteria using this datatype should document that the patient's sex matches the QDM category and its corresponding value set.

Timing: Birth (administrative) sex does not have a specific timing.

Value Set Description from VSAC
Clinical Focus: This value set grouping contains concepts that represent patients who have had a hemorrhagic stroke, or stroke caused by hemorrhage.
Data Element Scope: This value set may use the Quality Data Model (QDM) attribute related to Principal Diagnosis. The intent of this data element is to identify patients who have a diagnosis of hemorrhagic stroke, or stroke caused by a hemorrhage.
Inclusion Criteria: Includes only relevant concepts associated with a diagnosis of hemorrhagic stroke, or stroke caused by hemorrhage. This is a grouping of ICD-10-CM and SNOMED CT codes.
Exclusion Criteria: No exclusions.

Constrained to codes in the Principal Diagnosis: Hemorrhagic Stroke value set (2.16.840.1.113883.3.117.1.7.1.212)

QDM Attribute and Definition (QDM Version 5.4)

principalDiagnosis

The coded diagnosis/problem established after study to be chiefly responsible for occasioning the admission of the patient to the hospital for care.
Value Set Description from VSAC
Clinical Focus: This value set grouping contains concepts that represent patients who have had a stroke caused by ischemia, where the blood supply is restricted to an area of the brain by something like thrombosis or an embolism.
Data Element Scope: This value set may use the Quality Data Model (QDM) category or attribute related to Diagnosis. The intent of this data element is to identify patients who have a diagnosis of ischemic stroke, or stroke caused by ischemia.
Inclusion Criteria: Includes only relevant concepts associated with a diagnosis of ischemic stroke, or stroke caused by ischemia. This is a grouping of ICD-10-CM and SNOMED CT codes and concepts.
Exclusion Criteria: No exclusions.

Constrained to codes in the Principal Diagnosis: Ischemic Stroke value set (2.16.840.1.113883.3.117.1.7.1.247)

QDM Attribute and Definition (QDM Version 5.4)

principalDiagnosis

The coded diagnosis/problem established after study to be chiefly responsible for occasioning the admission of the patient to the hospital for care.
Value Set Description from VSAC
Clinical Focus: This value set grouping contains concepts that represent intravenous or intra-arterial thrombolytic (t-PA) therapy procedures.
Data Element Scope: This value set may use the Quality Data Model (QDM) category related to Procedure. The intent of this data element is to identify intravenous or intra-arterial thrombolytic (t-PA) therapy procedures.
Inclusion Criteria: Includes only relevant concepts associated with identifying intravenous or intra-arterial thrombolytic (t-PA) therapy procedures.
Exclusion Criteria: No exclusions.

Constrained to codes in the Procedure, Performed: Intravenous or Intra-arterial Thrombolytic (t-PA) Therapy value set (2.16.840.1.113762.1.4.1045.21)

QDM Datatype and Definition (QDM Version 5.4)

"Procedure, Performed"

Data elements that meet criteria using this datatype should document the completion of the procedure indicated by the QDM category and its corresponding value set.

A QDM Known Issue has been identified related to this datatype. To see this QDM known Issue, please click here.

Timing: The Relevant Period addresses:

  • startTime -the time the procedure begins,
  • stopTime -the time the procedure is completed

NOTE:

  1. Timing refers to a single instance of a procedure. If a measure seeks to evaluate multiple procedures over a period of time, the measure developer should use CQL logic to represent the query request.
  2. The Incision dateTime is a single point in time available from the Operating Room and/or Anesthesia Record.