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["Medication, Administered": "Low Dose Unfractionated Heparin for VTE Prophylaxis"]

eCQM Data Element

Performance/Reporting Period
2020
Value Set Description from VSAC
Clinical Focus: This value set contains concepts that represent unfractionated heparin medications with strengths that could reasonably be used for venous thromboembolism (VTE) prophylaxis.
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 on low-dose unfractionated heparin as VTE prophylaxis.
Inclusion Criteria: Includes only relevant concepts associated with injectable products that could reasonably be used to achieve a dose of at least 5000 units when administered subcutaneously.
Exclusion Criteria: Excludes concentrations less than 250 units/mL.

Constrained to codes in the Medication, Administered: Low Dose Unfractionated Heparin for VTE Prophylaxis value set (2.16.840.1.113762.1.4.1045.39)

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.

QDM Attributes

authorDateTime

The time the data element was entered into the clinical software. Note, some datatypes include both Relevant Time and Author dateTime attributes. The purpose is to accommodate Author dateTime if the actual start and stop times are not available when evaluating for feasibility, and also to allow specification of a time for Negation Rationale.

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.

relevantPeriod

Relevant Period addresses the time between the start of an action to the end of an action. Each datatype using relevant period defines specific definitions for the start and stop time for the action listed.

route

Refers to the path by which the medication or substance should be taken into the body system, such as intradermally, intrathecally, intramuscularly, intranasally, intravenously, orally, rectally, subcutaneously, sublingually, topically, or vaginally.
Last Updated: Jul 08, 2021