eCQM Title | Preventive Care and Screening: Influenza Immunization |
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eCQM Identifier (Measure Authoring Tool) | 147 | eCQM Version Number | 11.0.000 |
NQF Number | 0041e | GUID | a244aa29-7d11-4616-888a-86e376bfcc6f |
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 | National Quality Forum | ||
Description |
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization |
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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 PCPI’s and AMA’s significant past efforts and contributions to the development and updating of the measure are acknowledged. (C) 2012-2020 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) contained in the Measure specifications is copyright 2004-2020 American Medical Association. LOINC(R) copyright 2004-2020 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2020 International Health Terminology Standards Development Organisation. ICD-10 copyright 2020 World Health Organization. All Rights Reserved. |
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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 |
Influenza vaccination is the most effective protection against influenza virus infection (Centers for Disease Control and Prevention [CDC], 2019). Influenza may lead to serious complications including hospitalization or death (CDC, 2019). Influenza vaccine is recommended for all persons aged >=6 months who do not have contraindications to vaccination. However, data indicate that less than half of all eligible individuals receive an influenza vaccination (CDC, 2019). This measure promotes annual influenza vaccination for all persons aged >= 6 months. |
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Clinical Recommendation Statement |
Routine annual influenza vaccination is recommended for all persons aged >= 6 months who do not have contraindications. Optimally, vaccination should occur before onset of influenza activity in the community. Although vaccination by the end of October is recommended, vaccine administered in December or later, even if influenza activity has already begun, is likely to be beneficial in the majority of influenza seasons (CDC/Advisory Committee on Immunization Practices [ACIP], 2020). |
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Improvement Notation |
Higher score indicates better quality |
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Reference |
Reference Type: CITATION Reference Text: 'Centers for Disease Control and Prevention. (2019, September 5). About Flu. Retrieved from https://www.cdc.gov/flu/about/index.html' |
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Reference |
Reference Type: CITATION Reference Text: 'Centers for Disease Control and Prevention. (2019, September 26). Flu Vaccination Coverage: United States, 2018-19 Influenza Season. Retrieved from https://www.cdc.gov/flu/fluvaxview/coverage-1819estimates.htm' |
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Reference |
Reference Type: CITATION Reference Text: 'Grohskopf, L.A., Alyanak, E., Broder, K. R., Blanton, L. H. , Fry, A. M., Jernigan, D. B, Atmar, R. L. (2020). Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices — United States, 2020–21 Influenza Season. MMWR Recommendations and Reports; 69(No. RR-8):1–24. DOI: http://dx.doi.org/10.15585/mmwr.rr6908a1.' |
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Definition |
Previous Receipt - receipt of the current season's influenza immunization from another provider OR from same provider prior to the visit to which the measure is applied (typically, prior vaccination would include influenza vaccine given since August 1st) |
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Guidance |
The timeframe for the visit during the "Encounter, Performed": "Encounter-Influenza" or "Procedure, Performed": "Peritoneal Dialysis" or "Procedure, Performed": "Hemodialysis" in the Population Criteria-Denominator, refers to the influenza season defined by the measure: October through March (October 1 for the year prior to the start of the reporting period through March 31 during the reporting period). The "Encounter-Influenza" Grouping OID detailed in the data criteria section below is comprised of several individual OIDs of different encounter types. The individual OIDs are included in the value set and should be reviewed to determine that an applicable visit occurred during the timeframe for "Encounter, Performed": "Encounter-Influenza" as specified in the denominator. To enable reporting of this measure at the close of the reporting period, this measure will only assess the influenza season that ends in March of the reporting period. The subsequent influenza season (ending March of the following year) will be measured and reported in the following year. Due to the changing stance of the CDC/ACIP recommendations regarding the live attenuated influenza vaccine (LAIV) for a particular flu season, this measure will not include the administration of this specific formulation of the flu vaccination. Given the variance of the timeframes for the annual update cycles, program implementation, and publication of revised recommendations from the CDC/ACIP, it has been determined that the coding for this measure will specifically exclude this formulation, so as not to inappropriately include this form of the vaccine for flu seasons when CDC/ACIP explicitly advise against it. However, it is recommended that all eligible professionals or eligible clinicians to review the guidelines for each flu season to determine appropriateness of the LAIV and other formulations of the flu vaccine. Should the LAIV be recommended for administration for a particular flu season, eligible professional or clinician may consider one of the following options: 1) satisfy the numerator by reporting either previous receipt or using the CVX 88 for unspecified formulation, 2) report a denominator exception, either as a patient reason (e.g., for patient preference) or a system reason (e.g., the institution only carries LAIV). Patient self-report for procedures as well as immunizations should be recorded in 'Procedure, Performed' template or 'Immunization, Administered' template in QRDA-1. This eCQM is a patient-based measure. This version of the eCQM uses QDM version 5.5. 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 |
All patients aged 6 months and older seen for a visit during the measurement period |
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Denominator |
Equals Initial Population and seen for a visit between October 1 and March 31 |
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Denominator Exclusions |
None |
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Numerator |
Patients who received an influenza immunization OR who reported previous receipt of an influenza immunization |
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Numerator Exclusions |
Not Applicable |
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Denominator Exceptions |
Documentation of medical reason(s) for not receiving influenza immunization (e.g., patient allergy, other medical reasons). Documentation of patient reason(s) for not receiving influenza immunization (e.g., patient declined, other patient reasons). Documentation of system reason(s) for not receiving influenza immunization (e.g., vaccine not available, other system reasons). |
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Supplemental Data Elements |
For every patient evaluated by this measure also identify payer, race, ethnicity and sex |
exists ( ["Patient Characteristic Birthdate": "Birth date"] BirthDate where Global."CalendarAgeInMonthsAt" ( BirthDate.birthDatetime, start of "Measurement Period" ) >= 6 ) and ( exists "Qualifying Encounter During Measurement Period" or exists "Hemodialysis During Measurement Period" or exists "Peritoneal Dialysis During Measurement Period" )
"Initial Population" and ( exists "Encounter During Influenza Season" or exists "Hemodialysis During Influenza Season" or exists "Peritoneal Dialysis During Influenza Season" )
None
exists "Influenza Vaccination Procedure" or exists "Influenza Immunization Administered"
None
exists "Medical Patient or System Reason for Not Performing Influenza Vaccination" or exists "Medical Patient or System Reason for Not Administering Influenza Vaccine" or exists "Diagnosis of Allergy to Egg" or exists "Egg Substance Allergy" or exists "Diagnosis of Allergy to Influenza Vaccine" or exists "Diagnosis of Intolerance to Influenza Vaccine" or exists "Intolerance of Influenza Vaccination Procedure" or exists "Allergy or Intolerance to Influenza Vaccine"
None
["Allergy/Intolerance": "Influenza Vaccine"] FluVaccineAllergyIntolerance where FluVaccineAllergyIntolerance.prevalencePeriod overlaps after "Influenza Season"
"Initial Population" and ( exists "Encounter During Influenza Season" or exists "Hemodialysis During Influenza Season" or exists "Peritoneal Dialysis During Influenza Season" )
exists "Medical Patient or System Reason for Not Performing Influenza Vaccination" or exists "Medical Patient or System Reason for Not Administering Influenza Vaccine" or exists "Diagnosis of Allergy to Egg" or exists "Egg Substance Allergy" or exists "Diagnosis of Allergy to Influenza Vaccine" or exists "Diagnosis of Intolerance to Influenza Vaccine" or exists "Intolerance of Influenza Vaccination Procedure" or exists "Allergy or Intolerance to Influenza Vaccine"
["Diagnosis": "Allergy to Eggs"] EggAllergy where EggAllergy.prevalencePeriod overlaps after "Influenza Season"
["Diagnosis": "Allergy to Influenza Vaccine"] FluVaccineAllergyDiagnosis where FluVaccineAllergyDiagnosis.prevalencePeriod overlaps after "Influenza Season"
["Diagnosis": "Intolerance to Influenza Vaccine"] FluVaccineIntoleranceDiagnosis where FluVaccineIntoleranceDiagnosis.prevalencePeriod overlaps after "Influenza Season"
["Allergy/Intolerance": "Egg Substance"] AllergyEggSubstance where AllergyEggSubstance.prevalencePeriod overlaps after "Influenza Season"
["Encounter, Performed": "Encounter-Influenza"] FluEncounter where FluEncounter.relevantPeriod starts during "Influenza Season"
["Procedure, Performed": "Hemodialysis"] FluSeasonHemodialysis where Global."NormalizeInterval" ( FluSeasonHemodialysis.relevantDatetime, FluSeasonHemodialysis.relevantPeriod ) overlaps "Influenza Season"
["Procedure, Performed": "Hemodialysis"] Hemodialysis where Global."NormalizeInterval" ( Hemodialysis.relevantDatetime, Hemodialysis.relevantPeriod ) overlaps "Measurement Period"
["Immunization, Administered": "Influenza Vaccine"] AdministeredFluVaccine where AdministeredFluVaccine.relevantDatetime during "Influenza Season Including August and September of the Prior Year"
Interval[start of "Measurement Period" - 3 months, start of "Measurement Period" + 3 months )
Interval[start of "Measurement Period" - 5 months, start of "Measurement Period" + 3 months )
["Procedure, Performed": "Influenza Vaccination"] FluVaccination where Global."NormalizeInterval" ( FluVaccination.relevantDatetime, FluVaccination.relevantPeriod ) during "Influenza Season Including August and September of the Prior Year"
exists ( ["Patient Characteristic Birthdate": "Birth date"] BirthDate where Global."CalendarAgeInMonthsAt" ( BirthDate.birthDatetime, start of "Measurement Period" ) >= 6 ) and ( exists "Qualifying Encounter During Measurement Period" or exists "Hemodialysis During Measurement Period" or exists "Peritoneal Dialysis During Measurement Period" )
["Allergy/Intolerance": "Influenza Vaccination"] FluVaccinationIntolerance where FluVaccinationIntolerance.prevalencePeriod overlaps after "Influenza Season"
["Immunization, Not Administered": "Influenza Vaccine"] NoFluVaccine where NoFluVaccine.authorDatetime during "Influenza Season Including August and September of the Prior Year" and ( NoFluVaccine.negationRationale in "Medical Reason" or NoFluVaccine.negationRationale in "Patient Reason" or NoFluVaccine.negationRationale in "System Reason" or NoFluVaccine.negationRationale in "Influenza Vaccination Declined" )
["Procedure, Not Performed": "Influenza Vaccination"] NoFluVaccination where NoFluVaccination.authorDatetime during "Influenza Season Including August and September of the Prior Year" and ( NoFluVaccination.negationRationale in "Medical Reason" or NoFluVaccination.negationRationale in "Patient Reason" or NoFluVaccination.negationRationale in "System Reason" or NoFluVaccination.negationRationale in "Influenza Vaccination Declined" )
exists "Influenza Vaccination Procedure" or exists "Influenza Immunization Administered"
["Procedure, Performed": "Peritoneal Dialysis"] FluSeasonPeritonealDialysis where Global."NormalizeInterval" ( FluSeasonPeritonealDialysis.relevantDatetime, FluSeasonPeritonealDialysis.relevantPeriod ) overlaps "Influenza Season"
["Procedure, Performed": "Peritoneal Dialysis"] PeritonealDialysis where Global."NormalizeInterval" ( PeritonealDialysis.relevantDatetime, PeritonealDialysis.relevantPeriod ) overlaps "Measurement Period"
( ["Encounter, Performed": "Office Visit"] union ["Encounter, Performed": "Outpatient Consultation"] union ["Encounter, Performed": "Care Services in Long-Term Residential Facility"] union ["Encounter, Performed": "Home Healthcare Services"] union ["Encounter, Performed": "Patient Provider Interaction"] union ["Encounter, Performed": "Preventive Care Services, Initial Office Visit, 0 to 17"] union ["Encounter, Performed": "Preventive Care Services-Initial Office Visit, 18 and Up"] union ["Encounter, Performed": "Preventive Care Services-Individual Counseling"] union ["Encounter, Performed": "Preventive Care Services - Group Counseling"] union ["Encounter, Performed": "Preventive Care Services - Other"] union ["Encounter, Performed": "Discharge Services - Nursing Facility"] union ["Encounter, Performed": "Nursing Facility Visit"] union ["Encounter, Performed": "Annual Wellness Visit"] union ["Encounter, Performed": "Preventive Care, Established Office Visit, 0 to 17"] union ["Encounter, Performed": "Preventive Care Services - Established Office Visit, 18 and Up"] union ["Encounter, Performed": "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. Usually, the presenting problem(s) are minimal."] union ["Encounter, Performed": "Online Assessments"] union ["Encounter, Performed": "Telephone Visits"] ) QualifyingEncounter where QualifyingEncounter.relevantPeriod during "Measurement Period"
["Patient Characteristic Ethnicity": "Ethnicity"]
["Patient Characteristic Payer": "Payer"]
["Patient Characteristic Race": "Race"]
["Patient Characteristic Sex": "ONC Administrative Sex"]
months between ToDate(BirthDateTime)and ToDate(AsOf)
if pointInTime is not null then Interval[pointInTime, pointInTime] else if period is not null then period else null as Interval<DateTime>
DateTime(year from Value, month from Value, day from Value, 0, 0, 0, 0, timezoneoffset from Value)
["Patient Characteristic Ethnicity": "Ethnicity"]
["Patient Characteristic Payer": "Payer"]
["Patient Characteristic Race": "Race"]
["Patient Characteristic Sex": "ONC Administrative Sex"]
Measure Set |
None |
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