eCQM Title | Falls: Screening for Future Fall Risk |
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eCQM Identifier (Measure Authoring Tool) | 139 | eCQM Version Number | 13.1.000 |
CBE Number | Not Applicable | GUID | bc5b4a57-b964-4399-9d40-667c896f31ea |
Measurement Period | January 1, 20XX through December 31, 20XX | ||
Measure Steward | National Committee for Quality Assurance | ||
Measure Developer | National Committee for Quality Assurance | ||
Measure Developer | American Medical Association (AMA) | ||
Measure Developer | PCPI(R) Foundation (PCPI[R]) | ||
Endorsed By | None | ||
Description |
Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period |
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Copyright |
This Physician Performance Measure (Measure) and related data specifications are owned by the National Committee for Quality Assurance (NCQA). NCQA is not responsible for any use of the Measure. NCQA makes no representations, warranties, or endorsement about the quality of any organization or physician that uses or reports performance measures and NCQA has no liability to anyone who relies on such measures or specifications. NCQA holds a copyright in the Measure. The Measure can be reproduced and distributed, without modification, for noncommercial purposes (e.g., use by healthcare providers in connection with their practices) without obtaining approval from NCQA. Commercial use is defined as the sale, licensing, or distribution of the Measure for commercial gain, or incorporation of the Measure into a product or service that is sold, licensed or distributed for commercial gain. All commercial uses or requests for modification must be approved by NCQA and are subject to a license at the discretion of NCQA. The Physician Consortium for Performance Improvement’s (PCPI) and American Medical Association’s (AMA) significant past efforts and contributions to the development and updating of the measure are acknowledged. (C) 2012-2024 National Committee for Quality Assurance. All Rights Reserved. Limited proprietary coding is contained in the Measure specifications for user convenience. Users of proprietary code sets should obtain all necessary licenses from the owners of the code sets. NCQA disclaims all liability for use or accuracy of any third-party codes contained in the specifications. CPT(R) codes, descriptions and other data are copyright 2024. American Medical Association. All rights reserved. CPT is a trademark of the American Medical Association. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein. Some measure specifications contain coding from LOINC(R) (http://loinc.org). The LOINC table, LOINC codes, LOINC panels and form file, LOINC linguistic variants file, LOINC/RSNA Radiology Playbook, and LOINC/IEEE Medical Device Code Mapping Table are copyright 2004-2024 Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee, and are available at no cost under the license at http://loinc.org/terms-of-use. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2023 International Health Terminology Standards Development Organisation. ICD-10 copyright 2024 World Health Organization. All Rights Reserved. Some measures use RxNorm, a standardized nomenclature and coding for clinical drugs and drug delivery devices, which is made publicly available courtesy of the U.S. National Library of Medicine (NLM), National Institutes of Health, Department of Health and Human Services. NLM is not responsible for the measures and does not endorse or recommend this or any other product. “HL7” is the registered trademark of Health Level Seven International. |
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Disclaimer |
The performance Measure is not a clinical guideline and does not establish a standard of medical care, and has not been tested for all potential applications. THE MEASURE AND SPECIFICATIONS ARE PROVIDED "AS IS" WITHOUT WARRANTY OF ANY KIND. Due to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM]. |
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Measure Scoring | Proportion | ||
Measure Type | Process | ||
Stratification |
None |
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Risk Adjustment |
None |
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Rate Aggregation |
None |
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Rationale |
As the leading cause of both fatal and nonfatal injuries for older adults, falls are one of the most common and significant health issues facing people aged 65 years or older (Schneider, Shubert, & Harmon, 2010). Moreover, the rate of falls increases with age (Dykes et al., 2010). Older adults are five times more likely to be hospitalized for fall-related injuries than any other cause-related injury. It is estimated that one in every four adults over 65 will fall each year (Centers for Disease Control and Prevention, 2023). In those over age 80, the rate of falls increases to fifty percent (Doherty et al., 2009). Falls are also associated with substantial cost and resource use, approaching $30,000 per fall hospitalization (Woolcott et al., 2011). Identifying at-risk patients is the most important part of management, as applying preventive measures in this vulnerable population can have a profound effect on public health (al-Aama, 2011). Family physicians have a pivotal role in screening older patients for risk of falls, and applying preventive strategies for patients at risk (al-Aama, 2011). |
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Clinical Recommendation Statement |
All older persons who are under the care of a heath professional (or their caregivers) should be asked at least once a year about falls. (American Geriatrics Society/British Geriatric Society/American Academy of Orthopaedic Surgeons (AGS/BGS/AAOS), 2010) Older persons who present for medical attention because of a fall, report recurrent falls in the past year, or demonstrate abnormalities of gait and/or balance should have a fall evaluation performed. This evaluation should be performed by a clinician with appropriate skills and experience, which may necessitate referral to a specialist (e.g., geriatrician). (AGS/BGS/AAOS, 2010) |
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Improvement Notation |
A higher score indicates better quality |
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Reference |
Reference Type: CITATION Reference Text: 'al-Aama, T. (2011). Falls in the elderly: spectrum and prevention. Can Fam Physician 57(7),771-6. Retrieved from https://pubmed.ncbi.nlm.nih.gov/21753098/' |
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Reference |
Reference Type: CITATION Reference Text: 'American Geriatrics Society and British Geriatrics Society. (2010). Prevention of Falls in Older Persons AGS BGS Clinical Practice Guideline 2010. Accessed December 8. 2023. Available at https://geriatricscareonline.org/toc/updated-american-geriatrics-societybritish-geriatrics-society-clinical-practice-guideline-for-prevention-of-falls-in-older-persons-and-recommendations/CL014/' |
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Reference |
Reference Type: CITATION Reference Text: 'Centers for Disease Control and Prevention. (2023). "Facts about Falls" (May 12, 2023) https://www.cdc.gov/falls/facts.html' |
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Reference |
Reference Type: CITATION Reference Text: 'Doherty, M., and J. Crossen-Sills. (2009). Fall Risk: Keep your Patients in Balance. The Nurse Practitioner: The American Journal of Primary Health Care 34(12),46-51.' |
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Reference |
Reference Type: CITATION Reference Text: 'Dykes, P.C., Carrollf, D.L., Hurley, A., et al. (2010). Fall Prevention in Acute Care Hospitals: A Randomized Trial. JAMA, 304(17), 1912-1918.' |
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Reference |
Reference Type: CITATION Reference Text: 'Schneider, E.C., Shubert, T.E., & Harmon, K.J. (2010). Addressing the Escalating Public Health Issue of Falls Among Older Adults. NC Med J, 71(6), 547-52.' |
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Reference |
Reference Type: CITATION Reference Text: 'Woolcott, J.C., Khan, K.M., Mitrovic, S., et al. (2011). The Cost of Fall Related Presentations to the ED: A Prospective, In-Person, Patient-Tracking Analysis of Health Resource Utilization. Osteporos Int [Epub ahead of print].' |
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Definition |
Screening for Future Fall Risk: Assessment of whether an individual has experienced a fall or problems with gait or balance. A specific screening tool is not required for this measure, however potential screening tools include the Morse Fall Scale and the timed Get-Up-And-Go test. Fall: A sudden, unintentional change in position causing an individual to land at a lower level, on an object, the floor, or the ground, other than as a consequence of sudden onset of paralysis, epileptic seizure, or overwhelming external force. |
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Guidance |
This eCQM is a patient-based measure. This version of the eCQM uses QDM version 5.6. Please refer to the eCQI resource center (https://ecqi.healthit.gov/qdm) for more information on the QDM. |
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Transmission Format |
TBD |
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Initial Population |
Patients aged 65 years and older at the start of the measurement period with a visit during the measurement period |
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Denominator |
Equals Initial Population |
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Denominator Exclusions |
Exclude patients who are in hospice care for any part of the measurement period |
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Numerator |
Patients who were screened for future fall risk at least once within the measurement period |
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Numerator Exclusions |
Not Applicable |
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Denominator Exceptions |
None |
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Supplemental Data Elements |
For every patient evaluated by this measure also identify payer, race, ethnicity and sex |
AgeInYearsAt(date from start of "Measurement Period") >= 65 and exists "Qualifying Encounter"
"Initial Population"
Hospice."Has Hospice Services"
exists ( ["Assessment, Performed": "Falls Screening"] FallsScreening where Global."NormalizeInterval" ( FallsScreening.relevantDatetime, FallsScreening.relevantPeriod ) during day of "Measurement Period" )
None
None
None
"Initial Population"
Hospice."Has Hospice Services"
exists ( ["Encounter, Performed": "Encounter Inpatient"] InpatientEncounter where ( InpatientEncounter.dischargeDisposition ~ "Discharge to home for hospice care (procedure)" or InpatientEncounter.dischargeDisposition ~ "Discharge to healthcare facility for hospice care (procedure)" ) and InpatientEncounter.relevantPeriod ends during day of "Measurement Period" ) or exists ( ["Encounter, Performed": "Hospice Encounter"] HospiceEncounter where HospiceEncounter.relevantPeriod overlaps day of "Measurement Period" ) or exists ( ["Assessment, Performed": "Hospice care [Minimum Data Set]"] HospiceAssessment where HospiceAssessment.result ~ "Yes (qualifier value)" and Global."NormalizeInterval" ( HospiceAssessment.relevantDatetime, HospiceAssessment.relevantPeriod ) overlaps day of "Measurement Period" ) or exists ( ["Intervention, Order": "Hospice Care Ambulatory"] HospiceOrder where HospiceOrder.authorDatetime during day of "Measurement Period" ) or exists ( ["Intervention, Performed": "Hospice Care Ambulatory"] HospicePerformed where Global."NormalizeInterval" ( HospicePerformed.relevantDatetime, HospicePerformed.relevantPeriod ) overlaps day of "Measurement Period" ) or exists ( ["Diagnosis": "Hospice Diagnosis"] HospiceCareDiagnosis where HospiceCareDiagnosis.prevalencePeriod overlaps day of "Measurement Period" )
AgeInYearsAt(date from start of "Measurement Period") >= 65 and exists "Qualifying Encounter"
exists ( ["Assessment, Performed": "Falls Screening"] FallsScreening where Global."NormalizeInterval" ( FallsScreening.relevantDatetime, FallsScreening.relevantPeriod ) during day of "Measurement Period" )
( ["Encounter, Performed": "Office Visit"] union ["Encounter, Performed": "Annual Wellness Visit"] union ["Encounter, Performed": "Preventive Care Services Established Office Visit, 18 and Up"] union ["Encounter, Performed": "Preventive Care Services Initial Office Visit, 18 and Up"] union ["Encounter, Performed": "Home Healthcare Services"] union ["Encounter, Performed": "Ophthalmological Services"] union ["Encounter, Performed": "Preventive Care Services Individual Counseling"] union ["Encounter, Performed": "Discharge Services Nursing Facility"] union ["Encounter, Performed": "Nursing Facility Visit"] union ["Encounter, Performed": "Care Services in Long Term Residential Facility"] union ["Encounter, Performed": "Audiology Visit"] union ["Encounter, Performed": "Telephone Visits"] union ["Encounter, Performed": "Virtual Encounter"] union ["Encounter, Performed": "Physical Therapy Evaluation"] union ["Encounter, Performed": "Occupational Therapy Evaluation"] ) ValidEncounters where ValidEncounters.relevantPeriod during day of "Measurement Period"
["Patient Characteristic Ethnicity": "Ethnicity"]
["Patient Characteristic Payer": "Payer Type"]
["Patient Characteristic Race": "Race"]
["Patient Characteristic Sex": "ONC Administrative Sex"]
if pointInTime is not null then Interval[pointInTime, pointInTime] else if period is not null then period else null as Interval<DateTime>
["Patient Characteristic Ethnicity": "Ethnicity"]
["Patient Characteristic Payer": "Payer Type"]
["Patient Characteristic Race": "Race"]
["Patient Characteristic Sex": "ONC Administrative Sex"]
Measure Set |
None |
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