| Measure Information | 2021 Performance Period |
|---|---|
| CMS Measure ID | CMS349v3 |
| NQF Number | Not Applicable |
| Measure Description |
Percentage of patients aged 15-65 at the start of the measurement period who were between 15-65 years old when tested for HIV |
| Initial Population | Patients 15 to 65 years of age at the start of the measurement period AND who had at least one outpatient visit during the measurement period |
| Denominator Statement |
Equals Initial Population |
| Denominator Exclusions |
Patients diagnosed with HIV prior to the start of the measurement period |
| Numerator Statement |
Patients with documentation of an HIV test performed on or after their 15th birthday and before their 66th birthday |
| Numerator Exclusions |
Not Applicable |
| Denominator Exceptions |
None |
| Measure Steward | Centers for Disease Control and Prevention (CDC) |
| Domain | Community/Population Health |
| Measure Scoring | Proportion measure |
| Measure Type | Process measure |
| Improvement Notation |
Higher score indicates better quality |
| Guidance |
This measure evaluates the proportion of patients aged 15 to 65 at the start of the measurement period who have documentation of having received an HIV test at least once on or after their 15th birthday and before their 66th birthday. In order to satisfy the measure, the reporting provider must have documentation of the administration of the laboratory test present in the patient's medical record. In cases where the HIV test was performed elsewhere, providers cannot rely on patient attestation or self-report to meet the measure requirements, as previous research has shown that patient self-report is an unreliable indicator of previous HIV testing history. Rather, providers must request documentation of those test results. If such documentation is not available, the patient should be considered still eligible for HIV screening. If such documentation is available, but cannot be provided in a standardized, structured format (such that the lab test and results can be readily incorporated as structured data within the EHR), providers should enter the information into their EHR as a laboratory test in a manner consistent with the EHR in use. If the specific Human Immunodeficiency Virus (HIV) Laboratory Test LOINC code of the test is not known, the entry should use the more generic code LOINC panel code [75622-1]. This eCQM is a patient-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. |
| MIPS Quality ID | 475 |
| Meaningful Measure | Preventive Care |
| Telehealth Eligible | Yes |
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Data Element Repository
Header
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Updated eCQM Version Number.
Measure Section: eCQM Version Number
Source of Change: Standards Update
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Updated Measure Developer name from 'Mathematica Policy Research' to 'Mathematica'.
Measure Section: Measure Developer
Source of Change: Measure Lead
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Updated copyright.
Measure Section: Copyright
Source of Change: Annual Update
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Updated rationale with newer studies and data.
Measure Section: Rationale
Source of Change: Measure Lead
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Updated the clinical recommendation statement with newer studies and data.
Measure Section: Clinical Recommendation Statement
Source of Change: Measure Lead
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Updated references.
Measure Section: Reference
Source of Change: Standards Update
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Added text to identify the Quality Data Model (QDM) version used in the measure specification.
Measure Section: Guidance
Source of Change: Standards Update
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Added text to indicate whether the measure is patient-based or episode-based.
Measure Section: Guidance
Source of Change: Standards Update
Logic
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Streamlined the logic by using an interval for age instead of two inequalities.
Measure Section: Initial Population
Source of Change: Measure Lead
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Updated the logic to refer to HIV Indicators to align with the value set change 'Indicators of Human Immunodeficiency Disease (HIV)'.
Measure Section: Denominator Exclusions
Source of Change: Measure Lead
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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
Source of Change: Standards Update
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Updated Clinical Quality Language (CQL) expression to conform with the HL7 Standard: Clinical Quality Language Specification, Release 1 STU 4 (CQL 1.4).
Measure Section: Multiple Sections
Source of Change: Standards Update
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Updated the names of CQL definitions, functions, and/or aliases for clarification and to align with the CQL Style Guide.
Measure Section: Multiple Sections
Source of Change: Standards Update
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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.
Measure Section: Multiple Sections
Source of Change: Standards Update
Value Set
The VSAC is the source of truth for the value set content, please visit the VSAC for downloads of current value sets.
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Value set (2.16.840.1.113762.1.4.1056.54): Renamed grouping value set to Indicators of Human Immunodeficiency Virus (HIV) to clarify purpose of the value set and better align with value set content. Renamed extensional value sets (2.16.840.1.113762.1.4.1056.51, 2.16.840.1.113762.1.4.1056.52, and 2.16.840.1.113762.1.4.1056.53) within the grouping value set to clarify purpose of the value sets and better align with value set content.
Measure Section: Terminology
Source of Change: Measure Lead
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Value set Indicators of Human Immunodeficiency Virus (HIV) (2.16.840.1.113762.1.4.1056.54): Deleted 11 SNOMED CT codes (103406000, 103407009, 103408004, 103411003, 103412005, 103413000, 103414006, 165816005, 103409007, 103410002, 698703002) based on new or changed coding guidelines. Added 1 ICD-9-CM code (176.9) based on expert review and/or public feedback.
Measure Section: Terminology
Source of Change: Annual Update