eCQM Title | Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care |
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eCQM Identifier (Measure Authoring Tool) | 142 | eCQM Version number | 8.1.000 |
NQF Number | 0089e | GUID | 53d6d7c3-43fb-4d24-8099-17e74c022c05 |
Measurement Period | January 1, 20XX through December 31, 20XX | ||
Measure Steward | PCPI(R) Foundation (PCPI[R]) | ||
Measure Developer | American Medical Association (AMA) | ||
Measure Developer | PCPI(R) Foundation (PCPI[R]) | ||
Endorsed By | National Quality Forum | ||
Description | |||
Copyright | |||
Disclaimer | |||
Measure Scoring | Proportion | ||
Measure Type | Process | ||
Stratification | |||
Risk Adjustment | |||
Rate Aggregation | |||
Rationale | |||
Clinical Recommendation Statement | |||
Improvement Notation | |||
Reference | |||
Definition | |||
Guidance | |||
Transmission Format | |||
Initial Population | |||
Denominator | |||
Denominator Exclusions | |||
Numerator | |||
Numerator Exclusions | |||
Denominator Exceptions | |||
Supplemental Data Elements |
exists ( ["Patient Characteristic Birthdate": "Birth date"] BirthDate where Global."CalendarAgeInYearsAt"(BirthDate.birthDatetime, start of "Measurement Period")>= 18 ) and exists "Diabetic Retinopathy Encounter"
"Initial Population" and exists "Macular Exam Performed"
"Results of Dilated Macular or Fundus Exam Communicated"
exists "Medical or Patient Reason for Not Communicating Level of Severity of Retinopathy" or exists "Medical or Patient Reason for Not Communicating Absence of Macular Edema" or exists "Medical or Patient Reason for Not Communicating Presence of Macular Edema"
"Initial Population" and exists "Macular Exam Performed"
exists "Medical or Patient Reason for Not Communicating Level of Severity of Retinopathy" or exists "Medical or Patient Reason for Not Communicating Absence of Macular Edema" or exists "Medical or Patient Reason for Not Communicating Presence of Macular Edema"
"Face to Face Encounter During Measurement Period" ValidFaceToFaceEncounter with ["Diagnosis": "Diabetic Retinopathy"] DiabeticRetinopathy such that DiabeticRetinopathy.prevalencePeriod overlaps ValidFaceToFaceEncounter.relevantPeriod
( ["Encounter, Performed": "Office Visit"] union ["Encounter, Performed": "Ophthalmological Services"] union ["Encounter, Performed": "Outpatient Consultation"] union ["Encounter, Performed": "Care Services in Long-Term Residential Facility"] union ["Encounter, Performed": "Nursing Facility Visit"] ) FaceToFaceEncounter where FaceToFaceEncounter.relevantPeriod during "Measurement Period"
exists ( ["Patient Characteristic Birthdate": "Birth date"] BirthDate where Global."CalendarAgeInYearsAt"(BirthDate.birthDatetime, start of "Measurement Period")>= 18 ) and exists "Diabetic Retinopathy Encounter"
["Communication, Performed": "Level of Severity of Retinopathy Findings"] LevelOfSeverityCommunicated with "Diabetic Retinopathy Encounter" EncounterDiabeticRetinopathy such that LevelOfSeverityCommunicated.authorDatetime after start of EncounterDiabeticRetinopathy.relevantPeriod and ( LevelOfSeverityCommunicated.sender ~ "Healthcare professional (occupation)" or LevelOfSeverityCommunicated.sender ~ "Ophthalmologist (occupation)" or LevelOfSeverityCommunicated.sender ~ "Optometrist (occupation)" ) and ( LevelOfSeverityCommunicated.recipient ~ "Physician (occupation)" or LevelOfSeverityCommunicated.recipient ~ "Healthcare professional (occupation)" or LevelOfSeverityCommunicated.recipient ~ "Medical practitioner (occupation)" )
["Communication, Performed": "Macular edema absent (situation)"] MacularEdemaAbsentCommunicated with "Diabetic Retinopathy Encounter" EncounterDiabeticRetinopathy such that MacularEdemaAbsentCommunicated.authorDatetime after start of EncounterDiabeticRetinopathy.relevantPeriod and ( MacularEdemaAbsentCommunicated.sender ~ "Healthcare professional (occupation)" or MacularEdemaAbsentCommunicated.sender ~ "Ophthalmologist (occupation)" or MacularEdemaAbsentCommunicated.sender ~ "Optometrist (occupation)" ) and ( MacularEdemaAbsentCommunicated.recipient ~ "Physician (occupation)" or MacularEdemaAbsentCommunicated.recipient ~ "Healthcare professional (occupation)" or MacularEdemaAbsentCommunicated.recipient ~ "Medical practitioner (occupation)" )
["Communication, Performed": "Macular Edema Findings Present"] MacularEdemaPresentCommunicated with "Diabetic Retinopathy Encounter" EncounterDiabeticRetinopathy such that MacularEdemaPresentCommunicated.authorDatetime after start of EncounterDiabeticRetinopathy.relevantPeriod and ( MacularEdemaPresentCommunicated.sender ~ "Healthcare professional (occupation)" or MacularEdemaPresentCommunicated.sender ~ "Ophthalmologist (occupation)" or MacularEdemaPresentCommunicated.sender ~ "Optometrist (occupation)" ) and ( MacularEdemaPresentCommunicated.recipient ~ "Physician (occupation)" or MacularEdemaPresentCommunicated.recipient ~ "Healthcare professional (occupation)" or MacularEdemaPresentCommunicated.recipient ~ "Medical practitioner (occupation)" )
["Diagnostic Study, Performed": "Macular Exam"] MacularExam with "Diabetic Retinopathy Encounter" EncounterDiabeticRetinopathy such that MacularExam.relevantPeriod during EncounterDiabeticRetinopathy.relevantPeriod where MacularExam.result is not null
["Communication, Not Performed": "Macular edema absent (situation)"] MacularEdemaAbsentNotCommunicated with "Diabetic Retinopathy Encounter" EncounterDiabeticRetinopathy such that MacularEdemaAbsentNotCommunicated.authorDatetime during EncounterDiabeticRetinopathy.relevantPeriod where ( MacularEdemaAbsentNotCommunicated.negationRationale in "Medical Reason" or MacularEdemaAbsentNotCommunicated.negationRationale in "Patient Reason" )
["Communication, Not Performed": "Level of Severity of Retinopathy Findings"] LevelOfSeverityNotCommunicated with "Diabetic Retinopathy Encounter" EncounterDiabeticRetinopathy such that LevelOfSeverityNotCommunicated.authorDatetime during EncounterDiabeticRetinopathy.relevantPeriod where ( LevelOfSeverityNotCommunicated.negationRationale in "Medical Reason" or LevelOfSeverityNotCommunicated.negationRationale in "Patient Reason" )
["Communication, Not Performed": "Macular Edema Findings Present"] MacularEdemaPresentNotCommunicated with "Diabetic Retinopathy Encounter" EncounterDiabeticRetinopathy such that MacularEdemaPresentNotCommunicated.authorDatetime during EncounterDiabeticRetinopathy.relevantPeriod where ( MacularEdemaPresentNotCommunicated.negationRationale in "Medical Reason" or MacularEdemaPresentNotCommunicated.negationRationale in "Patient Reason" )
"Results of Dilated Macular or Fundus Exam Communicated"
exists "Level of Severity of Retinopathy Findings Communicated" and ( exists "Macular Edema Absence Communicated" or exists "Macular Edema Presence Communicated" )
["Patient Characteristic Ethnicity": "Ethnicity"]
["Patient Characteristic Payer": "Payer"]
["Patient Characteristic Race": "Race"]
["Patient Characteristic Sex": "ONC Administrative Sex"]
years between ToDate(BirthDateTime)and ToDate(AsOf)
DateTime(year from Value, month from Value, day from Value, 0, 0, 0, 0, timezone from Value)
["Patient Characteristic Ethnicity": "Ethnicity"]
["Patient Characteristic Payer": "Payer"]
["Patient Characteristic Race": "Race"]
["Patient Characteristic Sex": "ONC Administrative Sex"]
Measure Set |