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

Timing:

• relevant dateTime references timing for an assessment that occurs at a single point in time.
• relevant Period references a start and stop time for an assessment that occurs over a time interval
• author dateTime references the time the action was recorded.
• Refer to the eCQM expression to determine allowable timings to meet measure criterion.

Note: negation rationale 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 and must not use relevantPeriod.

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

Timing:

• relevant dateTime references timing for an assessment that occurs at a single point in time.
• relevant Period references a start and stop time for an assessment that occurs over a time interval
• author dateTime references the time the action was recorded.
• Refer to the eCQM expression to determine allowable timings to meet measure criterion.

Note: negation rationale 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 and must not use relevantPeriod.

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 prevalencePeriod references the time from the onset date to the abatement date.

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 prevalencePeriod references the time from the onset date to the abatement date.

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 prevalencePeriod references the time from the onset date to the abatement date.

Data elements that meet criteria using this datatype should document a request by a clinician or appropriately licensed care provider to an appropriate provider or organization to perform the diagnostic study indicated by the QDM category and its corresponding value set. The request may be in the form of a consultation or a direct order to the organization that performs the diagnostic study. Diagnostic studies are those that are not performed in the clinical laboratory. Such studies include, but are not limited to, imaging studies, cardiology studies (electrocardiogram, treadmill stress testing), pulmonary function testing, and vascular laboratory testing.

Timing: The time the order is signed; author dateTime.

Note: negation rationale 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 and must not use relevantPeriod.

Data elements that meet criteria using this datatype should document a request by a clinician or appropriately licensed care provider to an appropriate provider or organization to perform the diagnostic study indicated by the QDM category and its corresponding value set. The request may be in the form of a consultation or a direct order to the organization that performs the diagnostic study. Diagnostic studies are those that are not performed in the clinical laboratory. Such studies include, but are not limited to, imaging studies, cardiology studies (electrocardiogram, treadmill stress testing), pulmonary function testing, and vascular laboratory testing.

Timing: The time the order is signed; author dateTime.

Note: negation rationale 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 and must not use relevantPeriod.

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.

The "Encounter, Performed" participant references the primary participant.

Previous versions of QDM included an attribute principal diagnosis, defined as the condition that, after study, was determined to be the principal cause of the admission. QDM version 5.6 addresses that concept using the diagnosis rank=1.

Timing:

• The relevantPeriod addresses:
  • startTime - The time the encounter began (admission time).
  • stopTime - The time the encounter ended (discharge time).
• author dateTime references the time the action was recorded.
• Refer to the eCQM expression to determine allowable timings to meet measure criteria.

Notes:

• negation rationale 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 and must not use relevantPeriod.
• The locationPeriod is an attribute of the attribute facility location that addresses:
  • startTime - the time the patient arrived at the location. The time the encounter began (admission time).
  • stopTime - the time the patient departed from the location.

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.

The "Encounter, Performed" participant references the primary participant.

Previous versions of QDM included an attribute principal diagnosis, defined as the condition that, after study, was determined to be the principal cause of the admission. QDM version 5.6 addresses that concept using the diagnosis rank=1.

Timing:

• The relevantPeriod addresses:
  • startTime - The time the encounter began (admission time).
  • stopTime - The time the encounter ended (discharge time).
• author dateTime references the time the action was recorded.
• Refer to the eCQM expression to determine allowable timings to meet measure criteria.

Notes:

• negation rationale 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 and must not use relevantPeriod.
• The locationPeriod is an attribute of the attribute facility location that addresses:
  • startTime - the time the patient arrived at the location. The time the encounter began (admission time).
  • stopTime - the time the patient departed from the location.

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.

The "Encounter, Performed" participant references the primary participant.

Previous versions of QDM included an attribute principal diagnosis, defined as the condition that, after study, was determined to be the principal cause of the admission. QDM version 5.6 addresses that concept using the diagnosis rank=1.

Timing:

• The relevantPeriod addresses:
  • startTime - The time the encounter began (admission time).
  • stopTime - The time the encounter ended (discharge time).
• author dateTime references the time the action was recorded.
• Refer to the eCQM expression to determine allowable timings to meet measure criteria.

Notes:

• negation rationale 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 and must not use relevantPeriod.
• The locationPeriod is an attribute of the attribute facility location that addresses:
  • startTime - the time the patient arrived at the location. The time the encounter began (admission time).
  • stopTime - the time the patient departed from the location.

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.

The "Encounter, Performed" participant references the primary participant.

Previous versions of QDM included an attribute principal diagnosis, defined as the condition that, after study, was determined to be the principal cause of the admission. QDM version 5.6 addresses that concept using the diagnosis rank=1.

Timing:

• The relevantPeriod addresses:
  • startTime - The time the encounter began (admission time).
  • stopTime - The time the encounter ended (discharge time).
• author dateTime references the time the action was recorded.
• Refer to the eCQM expression to determine allowable timings to meet measure criteria.

Notes:

• negation rationale 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 and must not use relevantPeriod.
• The locationPeriod is an attribute of the attribute facility location that addresses:
  • startTime - the time the patient arrived at the location. The time the encounter began (admission time).
  • stopTime - the time the patient departed from the location.

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.

The "Encounter, Performed" participant references the primary participant.

Previous versions of QDM included an attribute principal diagnosis, defined as the condition that, after study, was determined to be the principal cause of the admission. QDM version 5.6 addresses that concept using the diagnosis rank=1.

Timing:

• The relevantPeriod addresses:
  • startTime - The time the encounter began (admission time).
  • stopTime - The time the encounter ended (discharge time).
• author dateTime references the time the action was recorded.
• Refer to the eCQM expression to determine allowable timings to meet measure criteria.

Notes:

• negation rationale 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 and must not use relevantPeriod.
• The locationPeriod is an attribute of the attribute facility location that addresses:
  • startTime - the time the patient arrived at the location. The time the encounter began (admission time).
  • stopTime - the time the patient departed from the location.

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.

The "Encounter, Performed" participant references the primary participant.

Previous versions of QDM included an attribute principal diagnosis, defined as the condition that, after study, was determined to be the principal cause of the admission. QDM version 5.6 addresses that concept using the diagnosis rank=1.

Timing:

• The relevantPeriod addresses:
  • startTime - The time the encounter began (admission time).
  • stopTime - The time the encounter ended (discharge time).
• author dateTime references the time the action was recorded.
• Refer to the eCQM expression to determine allowable timings to meet measure criteria.

Notes:

• negation rationale 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 and must not use relevantPeriod.
• The locationPeriod is an attribute of the attribute facility location that addresses:
  • startTime - the time the patient arrived at the location. The time the encounter began (admission time).
  • stopTime - the time the patient departed from the location.

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.

The "Encounter, Performed" participant references the primary participant.

Previous versions of QDM included an attribute principal diagnosis, defined as the condition that, after study, was determined to be the principal cause of the admission. QDM version 5.6 addresses that concept using the diagnosis rank=1.

Timing:

• The relevantPeriod addresses:
  • startTime - The time the encounter began (admission time).
  • stopTime - The time the encounter ended (discharge time).
• author dateTime references the time the action was recorded.
• Refer to the eCQM expression to determine allowable timings to meet measure criteria.

Notes:

• negation rationale 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 and must not use relevantPeriod.
• The locationPeriod is an attribute of the attribute facility location that addresses:
  • startTime - the time the patient arrived at the location. The time the encounter began (admission time).
  • stopTime - the time the patient departed from the location.

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.

The "Encounter, Performed" participant references the primary participant.

Previous versions of QDM included an attribute principal diagnosis, defined as the condition that, after study, was determined to be the principal cause of the admission. QDM version 5.6 addresses that concept using the diagnosis rank=1.

Timing:

• The relevantPeriod addresses:
  • startTime - The time the encounter began (admission time).
  • stopTime - The time the encounter ended (discharge time).
• author dateTime references the time the action was recorded.
• Refer to the eCQM expression to determine allowable timings to meet measure criteria.

Notes:

• negation rationale 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 and must not use relevantPeriod.
• The locationPeriod is an attribute of the attribute facility location that addresses:
  • startTime - the time the patient arrived at the location. The time the encounter began (admission time).
  • stopTime - the time the patient departed from the location.

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.

The "Encounter, Performed" participant references the primary participant.

Previous versions of QDM included an attribute principal diagnosis, defined as the condition that, after study, was determined to be the principal cause of the admission. QDM version 5.6 addresses that concept using the diagnosis rank=1.

Timing:

• The relevantPeriod addresses:
  • startTime - The time the encounter began (admission time).
  • stopTime - The time the encounter ended (discharge time).
• author dateTime references the time the action was recorded.
• Refer to the eCQM expression to determine allowable timings to meet measure criteria.

Notes:

• negation rationale 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 and must not use relevantPeriod.
• The locationPeriod is an attribute of the attribute facility location that addresses:
  • startTime - the time the patient arrived at the location. The time the encounter began (admission time).
  • stopTime - the time the patient departed from the location.

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.

The "Encounter, Performed" participant references the primary participant.

Previous versions of QDM included an attribute principal diagnosis, defined as the condition that, after study, was determined to be the principal cause of the admission. QDM version 5.6 addresses that concept using the diagnosis rank=1.

Timing:

• The relevantPeriod addresses:
  • startTime - The time the encounter began (admission time).
  • stopTime - The time the encounter ended (discharge time).
• author dateTime references the time the action was recorded.
• Refer to the eCQM expression to determine allowable timings to meet measure criteria.

Notes:

• negation rationale 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 and must not use relevantPeriod.
• The locationPeriod is an attribute of the attribute facility location that addresses:
  • startTime - the time the patient arrived at the location. The time the encounter began (admission time).
  • stopTime - the time the patient departed from the location.

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.

Note: negation rationale 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 and must not use relevantPeriod.

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:

• relevant dateTime references the time the intervention is performed when the intervention occurs at a single point in time.
• relevantPeriod references a start and stop time for an intervention that occurs over a time interval. relevantPeriod addresses:
  • startTime - The time the intervention begins.
  • stopTime - The time the intervention ends.
• author dateTime references the time the action was recorded.
• Refer to the eCQM expression to determine allowable timings to meet measure criterion.

Notes:

• 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.
• negation rationale 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 and must not use relevantPeriod.

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

Timing: The time the order is signed; author dateTime.

Note: negation rationale 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 and must not use relevantPeriod.

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

Timing: The time the order is signed; author dateTime.

Note: negation rationale 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 and must not use relevantPeriod.

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

Timing: The time the order is signed; author dateTime.

Note: negation rationale 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 and must not use relevantPeriod.

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

Timing: The time the order is signed; author dateTime.

Note: negation rationale 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 and must not use relevantPeriod.

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.

Timing:

• relevant dateTime references the time the laboratory test is performed when the laboratory test occurs at a single point in time.
• relevantPeriod references a start and stop time for a laboratory test that occurs over a time interval. relevantPeriod addresses:
  • startTime - The time the laboratory test begins.
  • stopTime - The time the laboratory test ends.
• author dateTime references the time the action was recorded.
• Refer to the eCQM expression to determine allowable timings to meet measure criterion.

Examples:

• Initiation of a venipuncture for a fasting blood glucose to the time venipuncture for the fasting blood glucose is completed – use relevant dateTime to reference this 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 – use relevantPeriod to reference the start to stop time for this event.

Notes:

• The time that the result report is available is a separate attribute than the time of the study (specimen collection).
• negation rationale 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 and must not use relevantPeriod.

Data elements that meet criteria using this datatype should document that the medication indicated by the QDM category and its corresponding value set is being taken by the patient. Keep in mind that when this datatype is used with timing relationships, the criterion is looking for a medication being taken for the time frame indicated by the timing relationships.

Timing:

• relevant dateTime references the time the medication is active on the medication record if it was given or taken at a single point in time.
• relevantPeriod references a start and stop time for an active medication on the medication record that is given or taken over a time interval:
• The relevantPeriod addresses:
  • startTime = when the medication is first known to be used (generally the time of entry on the medication list).
  • stopTime = when the medication is no longer active.

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:

• relevantPeriod addresses the time referenced in the dosage instruction indicating when the medication administration should start and end.
• author dateTime references the date and time the medication order (prescription) is authored.

Notes:

• The medication order (prescription) is unlikely to indicate a relevantPeriod, the time period for which the ordered supply is to be administered/taken including all refills. Therefore, to determine the number of days covered by a single dispensing event, use the daysSupplied attribute and the relevant dateTime of the event to determine when the ordered medication will run out. If daysSupplied is not available, derive it from the supply (quantity of medication ordered) divided by the dosage (amount of medication to be taken at a single administration) times the frequency (number of units per time period – e.g., per day):
  daysSupplied = supply / (dosage x frequency)
  And multiply the daysSupplied per dispensing event multiplied by one plus the number of refills to determine the total daysSupplied ordered.
  daysSupplied x (1 + #refills)
  Starting with the relevant dateTime add the total daysSupplied (including refills) to determine when the ordered medication quantity will run out.
• negation rationale 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 and must not use relevantPeriod.

Refer to Special Cases in Section 5.7 for scenarios to consider in calculating cumulative medication duration.

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:

• relevantPeriod addresses the time referenced in the dosage instruction indicating when the medication administration should start and end.
• author dateTime references the date and time the medication order (prescription) is authored.

Notes:

• The medication order (prescription) is unlikely to indicate a relevantPeriod, the time period for which the ordered supply is to be administered/taken including all refills. Therefore, to determine the number of days covered by a single dispensing event, use the daysSupplied attribute and the relevant dateTime of the event to determine when the ordered medication will run out. If daysSupplied is not available, derive it from the supply (quantity of medication ordered) divided by the dosage (amount of medication to be taken at a single administration) times the frequency (number of units per time period – e.g., per day):
  daysSupplied = supply / (dosage x frequency)
  And multiply the daysSupplied per dispensing event multiplied by one plus the number of refills to determine the total daysSupplied ordered.
  daysSupplied x (1 + #refills)
  Starting with the relevant dateTime add the total daysSupplied (including refills) to determine when the ordered medication quantity will run out.
• negation rationale 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 and must not use relevantPeriod.

Refer to Special Cases in Section 5.7 for scenarios to consider in calculating cumulative medication duration.

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.

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 relevantPeriod addresses:

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

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.

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.

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.

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.

Timing:

• relevant dateTime references the time the procedure is performed when the procedure occurs at a single point in time.
• relevantPeriod references a start and stop time for a procedure that occurs over a time interval. relevantPeriod addresses:
  • startTime - The time the procedure begins.
  • stopTime - The time the procedure ends.
• author dateTime references the time the action was recorded.
• Refer to the eCQM expression to determine allowable timings to meet measure criterion.

Notes: 

• 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.
• The incision dateTime is a single point in time available from the Operating Room and/or Anesthesia Record.
• negation rationale 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 and must not use relevantPeriod.
• See section 6.4 for guidance about differentiating between successful and unsuccessful procedures.