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CMS Measure ID: CMS156v13    Performance/Reporting Period: 2025    NQF Number: Not Applicable
Description:

Percentage of patients 65 years of age and older who were ordered at least two high-risk medications from the same drug class. Three rates are reported.

1. Percentage of patients 65 years of age and older who were ordered at least two high-risk medications from the same drug class.

2. Percentage of patients 65 years of age and older who were ordered at least two high-risk medications from the same drug class, except for appropriate diagnoses.

3. Total rate (the sum of the two numerators divided by the denominator, deduplicating for patients in both numerators).

Data Elements and coded QDM Attributes contained within the eCQM

+ Expand all

Direct Reference Code

Constrained to 'Functional Assessment of Chronic Illness Therapy - Palliative Care Questionnaire (FACIT-Pal)' LOINC code

QDM Datatype and Definition

"Assessment, Performed"

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.

Direct Reference Code

Constrained to 'Hospice care [Minimum Data Set]' LOINC code

QDM Datatype and Definition

"Assessment, Performed"

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.

Value Set Description from VSAC
Clinical Focus: The purpose of this value set is to represent concepts for a diagnosis of alcohol withdrawal.
Data Element Scope: This value set may use a model element related to Diagnosis.
Inclusion Criteria: Includes concepts that represent a diagnosis of alcohol withdrawal or alcohol dependence with withdrawal.
Exclusion Criteria: No exclusions.

Constrained to codes in the Alcohol Withdrawal value set (2.16.840.1.113883.3.464.1003.105.12.1209)

QDM Datatype and Definition

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

Value Set Description from VSAC
Clinical Focus: The purpose of this value set is to represent concepts for a diagnosis of benzodiazepine withdrawal.
Data Element Scope: This value set may use a model element related to Diagnosis.
Inclusion Criteria: Includes concepts that represent a diagnosis of benzodiazepine withdrawal; sedative, hypnotic or anxiolytic withdrawal; or sedative, hypnotic, or anxiolytic dependence with withdrawal.
Exclusion Criteria: No exclusions.

Constrained to codes in the Benzodiazepine Withdrawal value set (2.16.840.1.113883.3.464.1003.105.12.1208)

QDM Datatype and Definition

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

Value Set Description from VSAC
Clinical Focus: The purpose of this value set is to represent concepts for diagnoses related to bipolar disorder.
Data Element Scope: This value set may use a model element related to Diagnosis.
Inclusion Criteria: Includes concepts that represent a diagnosis of bipolar disorder.
Exclusion Criteria: No exclusions.

Constrained to codes in the Bipolar Disorder value set (2.16.840.1.113883.3.67.1.101.1.128)

QDM Datatype and Definition

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

Value Set Description from VSAC
Clinical Focus: The purpose of this value set is to represent concepts for a diagnosis of generalized anxiety disorder.
Data Element Scope: This value set may use a model element related to Diagnosis.
Inclusion Criteria: Includes concepts that represent a diagnosis of generalized anxiety disorder, panic disorder or other anxiety disorders.
Exclusion Criteria: Excludes concepts that represent a diagnosis of phobic anxiety disorders.

Constrained to codes in the Generalized Anxiety Disorder value set (2.16.840.1.113883.3.464.1003.105.12.1210)

QDM Datatype and Definition

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

Value Set Description from VSAC
Clinical Focus: The purpose of this value set is to represent concepts that indicate a patient is receiving hospice care or services.
Data Element Scope: This value set may use a model element related to Diagnosis.
Inclusion Criteria: Includes concepts that represent hospice care or services.
Exclusion Criteria: No exclusions.

Constrained to codes in the Hospice Diagnosis value set (2.16.840.1.113883.3.464.1003.1165)

QDM Datatype and Definition

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

Value Set Description from VSAC
Clinical Focus: The purpose of this value set is to represent concepts that indicate a patient is receiving palliative care or services.
Data Element Scope: This value set may use a model element related to Diagnosis.
Inclusion Criteria: Includes concepts that represent palliative care or services.
Exclusion Criteria: No exclusions.

Constrained to codes in the Palliative Care Diagnosis value set (2.16.840.1.113883.3.464.1003.1167)

QDM Datatype and Definition

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

Value Set Description from VSAC
Clinical Focus: The purpose of this value set is to represent concepts for a diagnosis of rapid eye movement (REM) sleep behavior disorder.
Data Element Scope: This value set may use a model element related to Diagnosis.
Inclusion Criteria: Includes concepts that represent a diagnosis of REM sleep behavior disorder.
Exclusion Criteria: No exclusions.

Constrained to codes in the REM Sleep Behavior Disorder value set (2.16.840.1.113883.3.464.1003.105.12.1207)

QDM Datatype and Definition

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

Value Set Description from VSAC
Clinical Focus: The purpose of this value set is to represent concepts for a diagnosis of schizophrenia.
Data Element Scope: This value set may use a model element related to Diagnosis.
Inclusion Criteria: Includes concepts that represent a diagnosis of schizophrenia or schizoaffective disorder.
Exclusion Criteria: No exclusions.

Constrained to codes in the Schizophrenia value set (2.16.840.1.113883.3.464.1003.105.12.1205)

QDM Datatype and Definition

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

Value Set Description from VSAC
Clinical Focus: The purpose of this value set is to represent concepts for a diagnosis of a seizure disorder.
Data Element Scope: This value set may use a model element related to Diagnosis.
Inclusion Criteria: Includes concepts that represent a diagnosis of epilepsy or recurrent seizures.
Exclusion Criteria: No exclusions.

Constrained to codes in the Seizure Disorder value set (2.16.840.1.113883.3.464.1003.105.12.1206)

QDM Datatype and Definition

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

Value Set Description from VSAC
Clinical Focus: The purpose of this value set is to represent concepts for encounters for annual wellness visits.
Data Element Scope: This value set may use a model element related to Encounter.
Inclusion Criteria: Includes concepts that represent an encounter for a Medicare annual wellness visit.
Exclusion Criteria: No exclusions.

Constrained to codes in the Annual Wellness Visit value set (2.16.840.1.113883.3.526.3.1240)

QDM Datatype and Definition

"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.

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.
Value Set Description from VSAC
Clinical Focus: The purpose of this value set is to represent concepts for encounters for patients living in assisted living, domiciliary care or rest homes.
Data Element Scope: This value set may use a model element related to Encounter.
Inclusion Criteria: Includes concepts that represent an encounter for services provided to new and established patients living in assisted living, domiciliary care or rest home who have had an interaction with a member of their medical team.
Exclusion Criteria: Excludes concepts that represent an encounter for settings other than assisted living, domiciliary care, or rest homes.

Constrained to codes in the Care Services in Long Term Residential Facility value set (2.16.840.1.113883.3.464.1003.101.12.1014)

QDM Datatype and Definition

"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.

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.
Value Set Description from VSAC
Clinical Focus: The purpose of this value set is to represent concepts for encounters for discharges from a nursing facility.
Data Element Scope: This value set may use a model element related to Encounter.
Inclusion Criteria: Includes concepts that represent an encounter for nursing facility discharge.
Exclusion Criteria: Excludes concepts that represent discharges from settings other than a nursing facility.

Constrained to codes in the Discharge Services Nursing Facility value set (2.16.840.1.113883.3.464.1003.101.12.1013)

QDM Datatype and Definition

"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.

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.
Value Set Description from VSAC
Clinical Focus: The purpose of this value set is to represent concepts of inpatient hospitalization encounters.
Data Element Scope: This value set may use a model element related to Encounter.
Inclusion Criteria: Includes concepts that represent an encounter for inpatient hospitalizations.
Exclusion Criteria: No exclusions.

Constrained to codes in the Encounter Inpatient value set (2.16.840.1.113883.3.666.5.307)

QDM Datatype and Definition

"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.

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.
Value Set Description from VSAC
Clinical Focus: The purpose of this value set is to represent concepts for encounters for home health visits.
Data Element Scope: This value set may use a model element related to Encounter.
Inclusion Criteria: Includes concepts that represent an encounter for a home health visit for the evaluation and management of a new or established patient.
Exclusion Criteria: No exclusions.

Constrained to codes in the Home Healthcare Services value set (2.16.840.1.113883.3.464.1003.101.12.1016)

QDM Datatype and Definition

"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.

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.
Value Set Description from VSAC
Clinical Focus: The purpose of this value set is to represent concepts for encounters for hospice care services.
Data Element Scope: This value set may use a model element related to Encounter.
Inclusion Criteria: Includes concepts that represent hospice services in a hospice, home or inpatient setting.
Exclusion Criteria: Excludes concepts that represent palliative care or comfort measures.

Constrained to codes in the Hospice Encounter value set (2.16.840.1.113883.3.464.1003.1003)

QDM Datatype and Definition

"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.

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.
Value Set Description from VSAC
Clinical Focus: The purpose of this value set is to represent concepts for encounters in a nursing facility.
Data Element Scope: This value set may use a model element related to Encounter.
Inclusion Criteria: Includes concepts that represent an encounter specific to a nursing facility, including skilled, intermediate and long term care facilities.
Exclusion Criteria: Excludes concepts that represent an encounter other than a nursing facility visits.

Constrained to codes in the Nursing Facility Visit value set (2.16.840.1.113883.3.464.1003.101.12.1012)

QDM Datatype and Definition

"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.

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.
Direct Reference Code

Constrained to 'Office or other outpatient visit for the evaluation and management of an established patient that may not require the presence of a physician or other qualified health care professional' CPT code

QDM Datatype and Definition

"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.

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.
Value Set Description from VSAC
Clinical Focus: The purpose of this value set is to represent concepts for encounters for an outpatient visit.
Data Element Scope: This value set may use a model element related to Encounter.
Inclusion Criteria: Includes concepts that represent an encounter for the comprehensive history, evaluation, and management of a patient presenting with minor to high severity problems.
Exclusion Criteria: No exclusions.

Constrained to codes in the Office Visit value set (2.16.840.1.113883.3.464.1003.101.12.1001)

QDM Datatype and Definition

"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.

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.
Value Set Description from VSAC
Clinical Focus: The purpose of this value set is to represent concepts of encounters for ophthalmological visits.
Data Element Scope: This value set may use a model element related to Encounter.
Inclusion Criteria: Includes concepts that represent an encounter for a visit with an eye care professional.
Exclusion Criteria: No exclusions.

Constrained to codes in the Ophthalmological Services value set (2.16.840.1.113883.3.526.3.1285)

QDM Datatype and Definition

"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.

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.
Value Set Description from VSAC
Clinical Focus: The purpose of this value set is to represent concepts for encounters for palliative care services.
Data Element Scope: This value set may use a model element related to Encounter.
Inclusion Criteria: Includes concepts that represent an encounter for admission and management for palliative care services.
Exclusion Criteria: Excludes concepts that represent encounters for hospice and a referral to palliative care.

Constrained to codes in the Palliative Care Encounter value set (2.16.840.1.113883.3.464.1003.101.12.1090)

QDM Datatype and Definition

"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.

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.
Value Set Description from VSAC
Clinical Focus: The purpose of this value set is to represent concepts for encounters for preventive care.
Data Element Scope: This value set may use a model element related to Encounter.
Inclusion Criteria: Includes concepts that represent an encounter for comprehensive preventive medicine reevaluation and management of an established patient 18 years of age or over.
Exclusion Criteria: Excludes initial visits for new patients.

Constrained to codes in the Preventive Care Services Established Office Visit, 18 and Up value set (2.16.840.1.113883.3.464.1003.101.12.1025)

QDM Datatype and Definition

"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.

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.
Value Set Description from VSAC
Clinical Focus: The purpose of this value set is to represent concepts for encounters for preventive care.
Data Element Scope: This value set may use a model element related to Encounter.
Inclusion Criteria: Includes concepts that represent an encounter for comprehensive preventive medicine reevaluation and management of a new patient 18 years or over.
Exclusion Criteria: Excludes visits for established patients.

Constrained to codes in the Preventive Care Services Initial Office Visit, 18 and Up value set (2.16.840.1.113883.3.464.1003.101.12.1023)

QDM Datatype and Definition

"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.

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.
Value Set Description from VSAC
Clinical Focus: The purpose of this value set is to represent concepts for encounters for telephone visits.
Data Element Scope: This value set may use a model element related to Encounter.
Inclusion Criteria: Includes concepts that represent an encounter for assessment, evaluation and management services to a patient by telephone.
Exclusion Criteria: Excludes concepts that represent an encounter for telephone assessment, evaluation and management services that last for less than five minutes.

Constrained to codes in the Telephone Visits value set (2.16.840.1.113883.3.464.1003.101.12.1080)

QDM Datatype and Definition

"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.

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.
Value Set Description from VSAC
Clinical Focus: Includes concepts that represent an encounter using online modalities.
Data Element Scope: This value set may use a model element related to Encounter.
Inclusion Criteria: Includes concepts that represent an encounter using online modalities.
Exclusion Criteria: Excludes concepts that represent encounters other than online.

Constrained to codes in the Virtual Encounter value set (2.16.840.1.113883.3.464.1003.101.12.1089)

QDM Datatype and Definition

"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.

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.
Value Set Description from VSAC
Clinical Focus: The purpose of this value set is to represent concepts of interventions to identify patients receiving hospice care outside of a hospital or long term care facility.
Data Element Scope: This value set may use a model element related to Procedure or Intervention.
Inclusion Criteria: Includes concepts that represent a procedure or intervention for hospice care.
Exclusion Criteria: Excludes concepts that represent palliative care or comfort measures.

Constrained to codes in the Hospice Care Ambulatory value set (2.16.840.1.113883.3.526.3.1584)

QDM Datatype and Definition

"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.

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.

Value Set Description from VSAC
Clinical Focus: The purpose of this value set is to represent concepts of interventions to identify patients receiving hospice care outside of a hospital or long term care facility.
Data Element Scope: This value set may use a model element related to Procedure or Intervention.
Inclusion Criteria: Includes concepts that represent a procedure or intervention for hospice care.
Exclusion Criteria: Excludes concepts that represent palliative care or comfort measures.

Constrained to codes in the Hospice Care Ambulatory value set (2.16.840.1.113883.3.526.3.1584)

QDM Datatype and Definition

"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:

  • 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.
Value Set Description from VSAC
Clinical Focus: The purpose of this value set is to represent concepts for palliative care interventions.
Data Element Scope: This value set may use a model element related to Intervention.
Inclusion Criteria: Includes concepts that represent palliative care interventions, including procedures and regime/therapy provided as part of palliative care services.
Exclusion Criteria: Excludes concepts that represent an intervention for hospice.

Constrained to codes in the Palliative Care Intervention value set (2.16.840.1.113883.3.464.1003.198.12.1135)

QDM Datatype and Definition

"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:

  • 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.
Value Set Description from VSAC
Clinical Focus: The purpose of this value set is to represent concepts for desiccated thyroid medications.
Data Element Scope: This value set may use a model element related to Medication.
Inclusion Criteria: Includes concepts that represent generic, human use and prescribable medications.
Exclusion Criteria: Excludes concepts that represent non-prescribable or branded drugs and excludes concepts that represent components or ingredients.

Constrained to codes in the Desiccated Thyroid Medications value set (2.16.840.1.113883.3.464.1003.1060)

QDM Datatype and Definition

"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:

  • 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 4.1.16 for scenarios to consider in calculating cumulative medication duration.

Value Set Description from VSAC
Clinical Focus: The purpose of this value set is to represent concepts for digoxin medications.
Data Element Scope: This value set may use a model element related to Medication.
Inclusion Criteria: Includes concepts that represent generic, human use and prescribable medications.
Exclusion Criteria: Excludes concepts that represent non-prescribable or branded drugs and excludes concepts that represent components or ingredients.

Constrained to codes in the Digoxin Medications value set (2.16.840.1.113883.3.464.1003.1065)

QDM Datatype and Definition

"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:

  • 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 4.1.16 for scenarios to consider in calculating cumulative medication duration.

Value Set Description from VSAC
Clinical Focus: The purpose of this value set is to represent concepts for antithrombotic medications.
Data Element Scope: This value set may use a model element related to Medication.
Inclusion Criteria: Includes dipyridamole (oral, excluding extended release). Includes concepts that represent generic, human use and prescribable medications.
Exclusion Criteria: Excludes concepts that represent non-prescribable or branded drugs and excludes concepts that represent components or ingredients.

Constrained to codes in the Dipyridamole Medications value set (2.16.840.1.113883.3.464.1003.1051)

QDM Datatype and Definition

"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:

  • 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 4.1.16 for scenarios to consider in calculating cumulative medication duration.

Value Set Description from VSAC
Clinical Focus: The purpose of this value set is to represent concepts for doxepin medications.
Data Element Scope: This value set may use a model element related to Medication.
Inclusion Criteria: Includes concepts that represent generic, human use and prescribable medications.
Exclusion Criteria: Excludes concepts that represent non-prescribable or branded drugs and excludes concepts that represent components or ingredients.

Constrained to codes in the Doxepin Medications value set (2.16.840.1.113883.3.464.1003.1067)

QDM Datatype and Definition

"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:

  • 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 4.1.16 for scenarios to consider in calculating cumulative medication duration.

Direct Reference Code

Constrained to ergoloid mesylates, USP 1 MG Oral Tablet RXNORM code

QDM Datatype and Definition

"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:

  • 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 4.1.16 for scenarios to consider in calculating cumulative medication duration.

Value Set Description from VSAC
Clinical Focus: The purpose of this value set is to represent concepts for guanfacine medications.
Data Element Scope: This value set may use a model element related to Medication.
Inclusion Criteria: Includes concepts that represent generic, human use, prescribable guanfacine and guanfacine in combination with other medications.
Exclusion Criteria: Excludes concepts that represent non-prescribable, branded drugs and excludes concepts that represent components or ingredients.

Constrained to codes in the Guanfacine Medications value set (2.16.840.1.113883.3.464.1003.196.11.1252)

QDM Datatype and Definition

"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:

  • 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 4.1.16 for scenarios to consider in calculating cumulative medication duration.

Value Set Description from VSAC
Clinical Focus: The purpose of this value set is to represent concepts for megestrol medications.
Data Element Scope: This value set may use a model element related to Medication.
Inclusion Criteria: Includes concepts that represent generic, human use, prescribable megestrol and megestrol in combination with other medications.
Exclusion Criteria: Excludes concepts that represent non-prescribable, branded drugs and excludes concepts that represent components or ingredients.

Constrained to codes in the Megestrol Medications value set (2.16.840.1.113883.3.464.1003.1247)

QDM Datatype and Definition

"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:

  • 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 4.1.16 for scenarios to consider in calculating cumulative medication duration.

Value Set Description from VSAC
Clinical Focus: The purpose of this value set is to represent concepts for meperidine medications.
Data Element Scope: This value set may use a model element related to Medication.
Inclusion Criteria: Includes concepts that represent generic, human use and prescribable nonbenzodiazepine hypnotic medication.
Exclusion Criteria: Excludes concepts that represent non-prescribable or branded drugs and concepts that represent components or ingredients.

Constrained to codes in the Meperidine Medications value set (2.16.840.1.113883.3.464.1003.1248)

QDM Datatype and Definition

"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:

  • 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 4.1.16 for scenarios to consider in calculating cumulative medication duration.

Value Set Description from VSAC
Clinical Focus: The purpose of this value set is to represent concepts for meprobamate medications.
Data Element Scope: This value set may use a model element related to Medication.
Inclusion Criteria: Includes concepts that represent generic, human use and prescribable medications.
Exclusion Criteria: Excludes concepts that represent non-prescribable or branded drugs and excludes concepts that represent components or ingredients.

Constrained to codes in the Meprobamate Medications value set (2.16.840.1.113883.3.464.1003.1057)

QDM Datatype and Definition

"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:

  • 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 4.1.16 for scenarios to consider in calculating cumulative medication duration.

Value Set Description from VSAC
Clinical Focus: The purpose of this value set is to represent concepts for disopyramide and nifedipine (excluding extended release) medications.
Data Element Scope: This value set may use a model element related to Medication.
Inclusion Criteria: Includes concepts that represent generic, human use and prescribable medications.
Exclusion Criteria: Excludes concepts that represent non-prescribable or branded drugs and excludes concepts that represent components or ingredients.

Constrained to codes in the Nifedipine Medications value set (2.16.840.1.113883.3.464.1003.1053)

QDM Datatype and Definition

"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:

  • 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 4.1.16 for scenarios to consider in calculating cumulative medication duration.

Value Set Description from VSAC
Clinical Focus: The purpose of this value set is to represent concepts for potentially harmful antidepressants for older adults as described in the 2023 American Geriatrics Society BEERS criteria
Data Element Scope: This value set may use a model element related to Medication.
Inclusion Criteria: Includes Amoxapine, Amitriptyline Hydrochloride, Desipramine, Nortriptyline, Clomipramine, Paroxetine, Imipramine. Includes concepts that represent generic, human use and prescribable medications. Imipramine
Exclusion Criteria: Excludes concepts that represent non-prescribable or branded drugs and excludes concepts that represent components or ingredients.

Constrained to codes in the Potentially Harmful Antidepressants for Older Adults value set (2.16.840.1.113883.3.464.1003.1054)

QDM Datatype and Definition

"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:

  • 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 4.1.16 for scenarios to consider in calculating cumulative medication duration.

Value Set Description from VSAC
Clinical Focus: The purpose of this value set is to represent concepts for potentially harmful antihistamines for older adults as described in the 2023 American Geriatrics Society BEERS criteria
Data Element Scope: This value set may use a model element related to Medication.
Inclusion Criteria: Includes concepts that represent generic, human use and prescribable medications. Includes Diphenhydramine, Hydroxyzine, Chlorpheniramine, Promethazine, Triprolidine, Cyproheptadine, Dimenhydrinate, Meclizine, Brompheniramine, Doxylamine.
Exclusion Criteria: Excludes concepts that represent non-prescribable or branded drugs and excludes concepts that represent components or ingredients.

Constrained to codes in the Potentially Harmful Antihistamines for Older Adults value set (2.16.840.1.113883.3.464.1003.1043)

QDM Datatype and Definition

"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:

  • 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 4.1.16 for scenarios to consider in calculating cumulative medication duration.

Value Set Description from VSAC
Clinical Focus: The purpose of this value set is to represent concepts for potentially harmful ant infectives for older adults as described in the 2023 American Geriatrics Society BEERS criteria.
Data Element Scope: This value set may use a model element related to Medication.
Inclusion Criteria: Includes concepts that represent generic, human use, prescribable nitrofurantoin and nitrofurantoin in combination with other medications.
Exclusion Criteria: Excludes concepts that represent non-prescribable, branded drugs and excludes concepts that represent components or ingredients.

Constrained to codes in the Potentially Harmful Antiinfectives for Older Adults value set (2.16.840.1.113883.3.464.1003.196.12.1481)

QDM Datatype and Definition

"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:

  • 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 4.1.16 for scenarios to consider in calculating cumulative medication duration.

Value Set Description from VSAC
Clinical Focus: The purpose of this value set is to represent concepts for potentially harmful antiparkinsonian agents for older adults as described in the 2023 American Geriatrics Society BEERS criteria
Data Element Scope: This value set may use a model element related to Medication.
Inclusion Criteria: Includes concepts that represent generic, human use and prescribable medications. Includes Benztripine and Trihexyphenidyl medications.
Exclusion Criteria: Excludes concepts that represent non-prescribable or branded drugs and excludes concepts that represent components or ingredients.

Constrained to codes in the Potentially Harmful Antiparkinsonian Agents for Older Adults value set (2.16.840.1.113883.3.464.1003.1049)

QDM Datatype and Definition

"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:

  • 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 4.1.16 for scenarios to consider in calculating cumulative medication duration.

Value Set Description from VSAC
Clinical Focus: The purpose of this value set is to represent concepts for potentially harmful antipsychotics for older adults as described in the 2023 American Geriatrics Society BEERS criteria.
Data Element Scope: This value set may use a model element related to Medication.
Inclusion Criteria: Includes concepts that represent generic, human use and prescribable antipsychotic medications.
Exclusion Criteria: Excludes concepts that represent non-prescribable or branded drugs and excludes concepts that represent components or ingredients.

Constrained to codes in the Potentially Harmful Antipsychotics for Older Adults value set (2.16.840.1.113883.3.464.1003.196.12.1523)

QDM Datatype and Definition

"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:

  • 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 4.1.16 for scenarios to consider in calculating cumulative medication duration.

Value Set Description from VSAC
Clinical Focus: The purpose of this value set is to represent concepts for potentially harmful barbituates for older adults as described in the 2023 American Geriatrics Society BEERS criteria.
Data Element Scope: This value set may use a model element related to Medication.
Inclusion Criteria: Includes butalbital, phenobarbital and Primidone. Includes concepts that represent generic, human use and prescribable medications.
Exclusion Criteria: Excludes concepts that represent non-prescribable or branded drugs and excludes concepts that represent components or ingredients.

Constrained to codes in the Potentially Harmful Barbiturates for Older Adults value set (2.16.840.1.113883.3.464.1003.1055)

QDM Datatype and Definition

"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:

  • 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 4.1.16 for scenarios to consider in calculating cumulative medication duration.

Value Set Description from VSAC
Clinical Focus: The purpose of this value set is to represent concepts for potentially harmful benzodiazepines for older adults as described in the 2023 American Geriatrics Society BEERS criteria.
Data Element Scope: This value set may use a model element related to Medication.
Inclusion Criteria: Includes concepts that represent generic, human use and prescribable benzodiazepine medications.
Exclusion Criteria: Excludes concepts that represent non-prescribable or branded drugs and excludes concepts that represent components or ingredients.

Constrained to codes in the Potentially Harmful Benzodiazepines for Older Adults value set (2.16.840.1.113883.3.464.1003.196.12.1522)

QDM Datatype and Definition

"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:

  • 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 4.1.16 for scenarios to consider in calculating cumulative medication duration.

Value Set Description from VSAC
Clinical Focus: The purpose of this value set is to represent concepts for potentially harmful estrogens for older adults as described in the 2023 American Geriatrics Society BEERS criteria.
Data Element Scope: This value set may use a model element related to Medication.
Inclusion Criteria: Includes concepts that represent generic, human use and prescribable medications. Includes only oral and topical patch products. Includes Esterified Estrogens, Estradiol, Estropipate and Conjugated Estrogens
Exclusion Criteria: Excludes concepts that represent non-prescribable or branded drugs and excludes concepts that represent components or ingredients. Excludes implant and injection medications.

Constrained to codes in the Potentially Harmful Estrogens for Older Adults value set (2.16.840.1.113883.3.464.1003.1058)

QDM Datatype and Definition

"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:

  • 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 4.1.16 for scenarios to consider in calculating cumulative medication duration.

Value Set Description from VSAC
Clinical Focus: The purpose of this value set is to represent concepts for potentially harmful Gastrointestinal Antispasmodics for older adults as described in the 2023 American Geriatrics Society BEERS criteria.
Data Element Scope: This value set may use a model element related to Medication.
Inclusion Criteria: Includes atropine, chlordiazepoxide-clidinium, dicyclomine, hyoscyamine, and scopolamine. Includes concepts that represent generic, human use and prescribable medications.
Exclusion Criteria: Excludes concepts that represent non-prescribable or branded drugs and excludes concepts that represent components or ingredients. Excludes ophthalmic routes.

Constrained to codes in the Potentially Harmful Gastrointestinal Antispasmodics for Older Adults value set (2.16.840.1.113883.3.464.1003.1050)

QDM Datatype and Definition

"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:

  • 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 4.1.16 for scenarios to consider in calculating cumulative medication duration.

Value Set Description from VSAC
Clinical Focus: The purpose of this value set is to represent concepts for potentially harmful Nonbenzodiazepine Hypnotics for older adults as described in the 2023 American Geriatrics Society BEERS criteria.
Data Element Scope: This value set may use a model element related to Medication.
Inclusion Criteria: Includes concepts that represent generic, human use and prescribable nonbenzodiazepine hypnotic medication.
Exclusion Criteria: Excludes concepts that represent non-prescribable or branded drugs and concepts that represent components or ingredients.

Constrained to codes in the Potentially Harmful Nonbenzodiazepine Hypnotics for Older Adults value set (2.16.840.1.113883.3.464.1003.196.12.1480)

QDM Datatype and Definition

"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:

  • 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 4.1.16 for scenarios to consider in calculating cumulative medication duration.

Value Set Description from VSAC
Clinical Focus: The purpose of this value set is to represent concepts for potentially harmful pain medications for older adults as described in the 2023 American Geriatrics Society BEERS criteria.
Data Element Scope: This value set may use a model element related to Medication.
Inclusion Criteria: Includes concepts that represent generic, human use and prescribable medications. Includes Indomethacin and Ketorolac Tromethamine.
Exclusion Criteria: Excludes concepts that represent non-prescribable or branded drugs and excludes concepts that represent components or ingredients.

Constrained to codes in the Potentially Harmful Pain Medications for Older Adults value set (2.16.840.1.113883.3.464.1003.1063)

QDM Datatype and Definition

"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:

  • 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 4.1.16 for scenarios to consider in calculating cumulative medication duration.

Value Set Description from VSAC
Clinical Focus: The purpose of this value set is to represent concepts for potentially harmful Skeletal Muscle Relaxants for older adults as described in the 2023 American Geriatrics Society BEERS criteria.
Data Element Scope: This value set may use a model element related to Medication.
Inclusion Criteria: Includes concepts that represent generic, human use and prescribable medications. Includes Carisoprodol, Metaxalone, Chlorzoxazone , Cyclobenzaprine Hydrochloride, Methocarbamol and Orphenadrine.
Exclusion Criteria: Excludes concepts that represent non-prescribable or branded drugs and excludes concepts that represent components or ingredients.

Constrained to codes in the Potentially Harmful Skeletal Muscle Relaxants for Older Adults value set (2.16.840.1.113883.3.464.1003.1062)

QDM Datatype and Definition

"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:

  • 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 4.1.16 for scenarios to consider in calculating cumulative medication duration.

Value Set Description from VSAC
Clinical Focus: The purpose of this value set is to represent concepts for potentially harmful Sulfonylureas for older adults as described in the 2023 American Geriatrics Society BEERS criteria.
Data Element Scope: This value set may use a model element related to Medication.
Inclusion Criteria: Includes concepts that represent generic, human use and prescribable medications. Includes glimepiride and glyburide.
Exclusion Criteria: Excludes concepts that represent non-prescribable or branded drugs and excludes concepts that represent components or ingredients.

Constrained to codes in the Potentially Harmful Sulfonylureas for Older Adults value set (2.16.840.1.113883.3.464.1003.1059)

QDM Datatype and Definition

"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:

  • 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 4.1.16 for scenarios to consider in calculating cumulative medication duration.

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 Ethnicity value set (2.16.840.1.114222.4.11.837)

QDM Datatype and Definition

"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 payer 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 Payer Type value set (2.16.840.1.114222.4.11.3591)

QDM Datatype and Definition

"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 relevantPeriod 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 Race value set (2.16.840.1.114222.4.11.836)

QDM Datatype and Definition

"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 ONC Administrative Sex value set (2.16.840.1.113762.1.4.1)

QDM Datatype and Definition

"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.