eCQM Title | Controlling High Blood Pressure |
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eCQM Identifier (Measure Authoring Tool) | 165 | eCQM Version Number | 12.0.000 |
NQF Number | Not Applicable | GUID | abdc37cc-bac6-4156-9b91-d1be2c8b7268 |
Measurement Period | January 1, 20XX through December 31, 20XX | ||
Measure Steward | National Committee for Quality Assurance | ||
Measure Developer | National Committee for Quality Assurance | ||
Endorsed By | None | ||
Description |
Percentage of patients 18-85 years of age who had a diagnosis of essential hypertension starting before and continuing into, or starting during the first six months of the measurement period, and whose most recent blood pressure was adequately controlled (<140/90 mmHg) during the measurement period |
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Copyright |
This Physician Performance Measure (Measure) and related data specifications are owned and were developed 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. (C) 2012-2022 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 2022. American Medical Association. All rights reserved. CPT is a trademark of the American Medical Association. No fee schedules, basic units, relative values or related listings are included in CPT. The AMA assumes no liability for the data contained herein. Applicable FARS/DFARS restrictions apply to government use. LOINC(R) copyright 2004-2022 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2022 International Health Terminology Standards Development Organisation. ICD-10 copyright 2022 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 | Intermediate Clinical Outcome | ||
Stratification |
None |
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Risk Adjustment |
None |
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Rate Aggregation |
None |
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Rationale |
High blood pressure (HBP), also known as hypertension, is when the pressure in blood vessels is higher than normal (Centers for Disease Control and Prevention [CDC], 2021). The causes of hypertension are multiple and multifaceted and can be based on genetic predisposition, environmental risk factors, being overweight and obese, sodium intake, potassium intake, physical activity, and alcohol use. High blood pressure is common; according to the American Heart Association, between 2013-2016, approximately 121.5 million US adults >= 20 years of age had HBP and the prevalence of hypertension among US adults 65 and older was 77.0 percent (Virani et al., 2021). In an analysis of adults with hypertension in NHANES, the estimated age-adjusted proportion with controlled BP increased from 31.8 percent in 1999 to 53.8 percent in 2014. However, that proportion declined to 43.7 percent in 2017 to 2018 (Tsao et al., 2022). HBP, known as the “silent killer,” increases risks of heart disease and stroke which are two of the leading causes of death in the US; a person who has HBP is four times more likely to die from a stroke and three times more likely to die from heart disease (CDC, 2012). The National Center for Health Statistics reported that in 2020 there were over 670,000 deaths with HBP as a primary or contributing cause (CDC, 2022). Between 2009 and 2019 the number of deaths due to HBP rose by 65.3 percent (Tsao et al., 2022). Managing and treating HBP would reduce cardiovascular disease mortality for males and females by 30.4 percent and 38.0 percent, respectively (Patel et al., 2015). Age-adjusted death rates attributable to HBP in 2019 were more than twice as high in non-Hispanic Black males (56.7 percent) when compared to rates for non-Hispanic White males (25.7 percent) (Tsao et al., 2022). HBP costs the U.S. approximately 131 billion dollars each year, averaged over 12 years from 2003 to 2014 (Kirkland et al., 2018). A study on cost-effectiveness on treating hypertension found that controlling HBP in patients with cardiovascular disease and systolic blood pressures (SBP) of >= 160 mmHg could be effective and cost-saving (Moran, 2015). Many studies have shown that controlling high blood pressure reduces cardiovascular events and mortality. The Systolic Blood Pressure Intervention Trial (SPRINT) investigated the impact of obtaining a SBP goal of <120 mmHg compared to a SBP goal of <140 mmHg among patients 50 and older with established cardiovascular disease and found that the patients with the former goal had reduced cardiovascular events and mortality (SPRINT Research Group et al., 2015). Controlling HBP will significantly reduce the risks of cardiovascular disease mortality and lead to better health outcomes like reduction of heart attacks, stroke, and kidney disease (James et al., 2014). Thus, the relationship between the measure (control of hypertension) and the long-term clinical outcomes listed is well established. |
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Clinical Recommendation Statement |
U.S. Preventive Services Task Force (USPSTF) (2021): - The USPSTF recommends screening for hypertension in adults 18 years or older with office blood pressure measurement (OBPM). The USPSTF recommends obtaining blood pressure measurements outside of the clinical setting for diagnostic confirmation before starting treatment. This is a grade A recommendation. American College of Cardiology/American Heart Association (2017): - For adults with confirmed hypertension and known CVD or 10-year ASCVD event risk of 10 percent or higher, a blood pressure target of less than 130/80 mmHg is recommended (Level of evidence: B-R (for systolic blood pressures), Level of evidence: C-EO (for diastolic blood pressure)) - For adults with confirmed hypertension, without additional markers of increased CVD risk, a blood pressure target of less than 130/80 mmHg may be reasonable (Note: clinical trial evidence is strongest for a target blood pressure of 140/90 mmHg in this population. However, observational studies suggest that these individuals often have a high lifetime risk and would benefit from blood pressure control earlier in life) (Level of evidence: B-NR (for systolic blood pressure), Level of evidence: C-EO (for diastolic blood pressure)). American College of Physicians and the American Academy of Family Physicians (2017): - Initiate or intensify pharmacologic treatment in some adults aged 60 years or older at high cardiovascular risk, based on individualized assessment, to achieve a target systolic blood pressure of less than 140 mmHg (Grade: weak recommendation, Quality of evidence: low) - Initiate or intensify pharmacologic treatment in adults aged 60 years or older with a history of stroke or transient ischemic attack to achieve a target systolic blood pressure of less than 140 mmHg to reduce the risk of recurrent stroke (Grade: weak recommendation, Quality of evidence: moderate) American Diabetes Association (2021): - For individuals with diabetes and hypertension at higher cardiovascular risk (existing atherosclerotic cardiovascular disease or 10-year atherosclerotic cardiovascular disease risk >=15 percent), a blood pressure target of <130/80 mmHg may be appropriate, if it can be safely attained (Level of evidence: C) - For individuals with diabetes and hypertension at lower risk for cardiovascular disease (10-year atherosclerotic cardiovascular disease risk <15 percent), treat to a blood pressure target of <140/90 mmHg (Level of evidence: A) |
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Improvement Notation |
Higher score indicates better quality |
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Reference |
Reference Type: CITATION Reference Text: 'American Diabetes Association. (2021). 10. Cardiovascular disease and risk management: Standards of medical care in diabetes—2021. Diabetes Care 2021, 44(Suppl. 1), S125-S150. https://doi.org/10.2337/dc21-S010' |
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Reference |
Reference Type: CITATION Reference Text: 'Centers for Disease Control and Prevention. (2012). Vital signs: Getting blood pressure under control. Retrieved from https://www.cdc.gov/vitalsigns/hypertension/index.html' |
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Reference |
Reference Type: CITATION Reference Text: 'Centers for Disease Control and Prevention. (2021). Facts About Hypertension. Retrieved from https://www.cdc.gov/bloodpressure/facts.htm' |
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Reference |
Reference Type: CITATION Reference Text: 'Centers for Disease Control and Prevention, National Center for Health Statistics. About Multiple Cause of Death, 1999–2020. CDC WONDER Online Database website. Atlanta, GA: Centers for Disease Control and Prevention; 2022. Available from http://www.cdc.gov/nchs/data_access/Vitalstatsonline.htm#Mortality_Multiple' |
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Reference |
Reference Type: CITATION Reference Text: 'James, P.A., Oparil, S., Carter, B.L., et al. (2014). 2014 Evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2014 Feb 5;311(5):507-20. doi: 10.1001/jama.2013.284427. Erratum in: JAMA. 2014 May 7;311(17):1809. PMID: 24352797.' |
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Reference |
Reference Type: CITATION Reference Text: 'Kirkland, E. B., Heincelman, M., Bishu, K. G., Schumann, S. O., Schreiner, A., Axon, R. N., Mauldin, P. D., & Moran, W. P. (2018). Trends in Healthcare Expenditures Among US Adults With Hypertension: National Estimates, 2003–2014. Journal of the American Heart Association, 7(11), e008731. https://doi.org/10.1161/JAHA.118.008731' |
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Reference |
Reference Type: CITATION Reference Text: 'Moran, A. E., Odden, M. C., Thanataveerat, A., et al. (2015). Cost-effectiveness of hypertension therapy according to 2014 guidelines. [published correction appears in N Engl J. Med. 2015;372:1677]. New England Journal of Medicine. 2015 ;372, 447-455. doi: 10.1056/NEJMsa1406751. [published correction appears on page 1677]' |
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Reference |
Reference Type: CITATION Reference Text: 'Patel, S. A., Winkel, M., Ali, M. K., et al. (2015). Cardiovascular mortality associated with 5 leading risk factors: National and state preventable fractions estimated from survey data. Annals of Internal Medicine, 163(4), 245-253. doi: 10.7326/M14-1753' |
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Reference |
Reference Type: CITATION Reference Text: 'Qaseem, A., Wilt, T. J., Rich, R., et al. (2017). Pharmacologic treatment of hypertension in adults aged 60 years or older to higher versus lower blood pressure targets: A clinical practice guideline from the American College of Physicians and the American Academy of Family Physicians. Annals of Internal Medicine, 166(6), 430-437. Retrieved from https://annals.org/aim/fullarticle/2598413/pharmacologic-treatment-hypertension-adults-aged-60-years-older-higher-versus' |
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Reference |
Reference Type: CITATION Reference Text: 'SPRINT Research Group, Wright, J. T., Jr., Williamson, J. D., et al. (2015). A randomized trial of intensive versus standard blood-pressure control. New England Journal of Medicine, 373(22), 2103–2116.' |
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Reference |
Reference Type: CITATION Reference Text: 'Tsao, C. W., Aday, A. W., Almarzooq, Z. I., Alonso, A., Beaton, A. Z., Bittencourt, M. S., Boehme, A. K., Buxton, A. E., Carson, A. P., Commodore-Mensah, Y., Elkind, M. S. V., Evenson, K. R., Eze-Nliam, C., Ferguson, J. F., Generoso, G., Ho, J. E., Kalani, R., Khan, S. S., Kissela, B. M., et al. (2022). Heart Disease and Stroke Statistics—2022 Update: A Report From the American Heart Association. Circulation, 145(8), e153–e639. https://doi.org/10.1161/CIR.0000000000001052' |
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Reference |
Reference Type: CITATION Reference Text: 'U.S. Preventive Services Task Force. (2015). Screening for high blood pressure in adults: U.S. Preventive Services Task Force recommendation statement. Annals of Internal Medicine, 163(10), 778-787. Retrieved from https://annals.org/aim/fullarticle/2456129/screening-high-blood-pressure-adults-u-s-preventive-services-task' |
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Reference |
Reference Type: CITATION Reference Text: 'Virani, S.S., Alonso, A., Aparicio, H.J., et al.; on behalf of the American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee. (2021). Heart disease and stroke statistics—2021 update: a report from the American Heart Association. Circulation. 2021;143:e254–e743. doi: 10.1161/CIR.0000000000000950' |
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Reference |
Reference Type: CITATION Reference Text: 'Whelton, P. K., Carey, R. M., Aronow, W. S., et al. (2017). Guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Journal of the American College of Cardiology. https://doi.org/10.1161/HYP.0000000000000065' |
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Definition |
None |
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Guidance |
In reference to the numerator element, only blood pressure readings performed by a clinician or an automated blood pressure monitor or device are acceptable for numerator compliance with this measure. This includes blood pressures taken in person by a clinician and blood pressures measured remotely by electronic monitoring devices capable of transmitting the blood pressure data to the clinician. Blood pressure readings taken by an automated blood pressure monitor or device and conveyed by the patient to the clinician are also acceptable. It is the clinician’s responsibility and discretion to confirm the automated blood pressure monitor or device used to obtain the blood pressure is considered acceptable and reliable and whether the blood pressure reading is considered accurate before documenting it in the patient’s medical record. Do not include BP readings taken during an acute inpatient stay or an ED visit. If no blood pressure is recorded during the measurement period, the patient's blood pressure is assumed "not controlled". If there are multiple blood pressure readings on the same day, use the lowest systolic and the lowest diastolic reading as the most recent blood pressure reading. Ranges and thresholds do not meet criteria for this measure. A distinct numeric result for both the systolic and diastolic BP reading is required for numerator compliance. 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 18-85 years of age by the end of the measurement period who had a visit during the measurement period and diagnosis of essential hypertension starting before and continuing into, or starting during the first six months of the measurement period |
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Denominator |
Equals Initial Population |
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Denominator Exclusions |
Patients with evidence of end stage renal disease (ESRD), dialysis or renal transplant before or during the measurement period. Also exclude patients with a diagnosis of pregnancy during the measurement period. Exclude patients who are in hospice care for any part of the measurement period. Exclude patients 66 and older by the end of the measurement period who are living long term in a nursing home any time on or before the end of the measurement period. Exclude patients 66-80 by the end of the measurement period with an indication of frailty for any part of the measurement period who also meet any of the following advanced illness criteria: - Advanced illness with two outpatient encounters during the measurement period or the year prior - OR advanced illness with one inpatient encounter during the measurement period or the year prior - OR taking dementia medications during the measurement period or the year prior Exclude patients 81 and older by the end of the measurement period with an indication of frailty for any part of the measurement period. Exclude patients receiving palliative care for any part of the measurement period. |
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Numerator |
Patients whose most recent blood pressure is adequately controlled (systolic blood pressure < 140 mmHg and diastolic blood pressure < 90 mmHg) during 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 end of "Measurement Period" )in Interval[18, 85] and exists "Essential Hypertension Diagnosis" and exists AdultOutpatientEncounters."Qualifying Encounters"
"Initial Population"
Hospice."Has Hospice Services" or exists ( "Pregnancy or Renal Diagnosis" ) or exists ( "End Stage Renal Disease Procedures" ) or exists ( "End Stage Renal Disease Encounter" ) or AIFrailLTCF."Is Age 66 to 80 with Advanced Illness and Frailty or Is Age 81 or Older with Frailty" or AIFrailLTCF."Is Age 66 or Older Living Long Term in a Nursing Home" or PalliativeCare."Has Palliative Care in the Measurement Period"
"Has Systolic Blood Pressure Less Than 140" and "Has Diastolic Blood Pressure Less Than 90"
None
None
None
( ["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": "Online Assessments"] union ["Encounter, Performed": "Telephone Visits"] ) ValidEncounter where ValidEncounter.relevantPeriod during day of "Measurement Period"
exists ( ["Device, Order": "Frailty Device"] FrailtyDeviceOrder where FrailtyDeviceOrder.authorDatetime during day of "Measurement Period" ) or exists ( ["Assessment, Performed": "Medical equipment used"] EquipmentUsed where EquipmentUsed.result in "Frailty Device" and Global."NormalizeInterval" ( EquipmentUsed.relevantDatetime, EquipmentUsed.relevantPeriod ) ends during day of "Measurement Period" ) or exists ( ["Diagnosis": "Frailty Diagnosis"] FrailtyDiagnosis where FrailtyDiagnosis.prevalencePeriod overlaps "Measurement Period" ) or exists ( ["Encounter, Performed": "Frailty Encounter"] FrailtyEncounter where FrailtyEncounter.relevantPeriod overlaps "Measurement Period" ) or exists ( ["Symptom": "Frailty Symptom"] FrailtySymptom where FrailtySymptom.prevalencePeriod overlaps "Measurement Period" )
exists (["Medication, Active": "Dementia Medications"] DementiaMedication where Global."NormalizeInterval" ( DementiaMedication.relevantDatetime, DementiaMedication.relevantPeriod ) overlaps Interval[start of "Measurement Period" - 1 year, end of "Measurement Period"])
exists( ["Encounter, Performed": "Acute Inpatient"] InpatientEncounter where exists ( InpatientEncounter.diagnoses Diagnosis where Diagnosis.code in "Advanced Illness" ) and InpatientEncounter.relevantPeriod starts during day of Interval[start of "Measurement Period" - 1 year, end of "Measurement Period"])
exists ( from "Outpatient Encounters with Advanced Illness" OutpatientEncounter1, "Outpatient Encounters with Advanced Illness" OutpatientEncounter2 where OutpatientEncounter2.relevantPeriod ends 1 day or more after day of end of OutpatientEncounter1.relevantPeriod return OutpatientEncounter1 )
( AgeInYearsAt(date from end of "Measurement Period" )>= 66 ) and ( ( Last(["Assessment, Performed": "Housing status"] HousingStatus where Global."NormalizeInterval"(HousingStatus.relevantDatetime, HousingStatus.relevantPeriod)ends on or before end of "Measurement Period" sort by end of Global."NormalizeInterval"(relevantDatetime, relevantPeriod)asc )) LastHousingStatus where LastHousingStatus.result ~ "Lives in a nursing home (finding)" ) is not null
( AgeInYearsAt(date from end of "Measurement Period" )in Interval[66, 80] and "Has Criteria Indicating Frailty" and ( "Has Two Outpatient Encounters with Advanced Illness on Different Dates of Service" or "Has Inpatient Encounter with Advanced Illness" or "Has Dementia Medications in Year Before or During Measurement Period" ) ) or ( AgeInYearsAt(date from end of "Measurement Period" )>= 81 and "Has Criteria Indicating Frailty" )
( ["Encounter, Performed": "Outpatient"] union ["Encounter, Performed": "Observation"] union ["Encounter, Performed": "Emergency Department Evaluation and Management Visit"] union ["Encounter, Performed": "Nonacute Inpatient"] ) OutpatientEncounter where exists ( OutpatientEncounter.diagnoses Diagnosis where Diagnosis.code in "Advanced Illness" ) and OutpatientEncounter.relevantPeriod starts during day of Interval[start of "Measurement Period" - 1 year, end of "Measurement Period"]
( "Qualifying Diastolic Blood Pressure Reading" DBPExam return date from Global."LatestOf" ( DBPExam.relevantDatetime, DBPExam.relevantPeriod ) ) intersect ( "Qualifying Systolic Blood Pressure Reading" SBPExam return date from Global."LatestOf" ( SBPExam.relevantDatetime, SBPExam.relevantPeriod ) )
"Initial Population"
Hospice."Has Hospice Services" or exists ( "Pregnancy or Renal Diagnosis" ) or exists ( "End Stage Renal Disease Procedures" ) or exists ( "End Stage Renal Disease Encounter" ) or AIFrailLTCF."Is Age 66 to 80 with Advanced Illness and Frailty or Is Age 81 or Older with Frailty" or AIFrailLTCF."Is Age 66 or Older Living Long Term in a Nursing Home" or PalliativeCare."Has Palliative Care in the Measurement Period"
["Encounter, Performed": "ESRD Monthly Outpatient Services"] ESRDEncounter where ESRDEncounter.relevantPeriod starts on or before end of "Measurement Period"
( ["Procedure, Performed": "Kidney Transplant"] union ["Procedure, Performed": "Dialysis Services"] ) ESRDProcedure where end of Global."NormalizeInterval" ( ESRDProcedure.relevantDatetime, ESRDProcedure.relevantPeriod ) on or before end of "Measurement Period"
["Diagnosis": "Essential Hypertension"] Hypertension where Hypertension.prevalencePeriod overlaps Interval[start of "Measurement Period", start of "Measurement Period" + 6 months )
"Lowest Diastolic Reading on Most Recent Blood Pressure Day".result < 90 'mm[Hg]'
"Lowest Systolic Reading on Most Recent Blood Pressure Day".result < 140 'mm[Hg]'
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 end of "Measurement Period" )in Interval[18, 85] and exists "Essential Hypertension Diagnosis" and exists AdultOutpatientEncounters."Qualifying Encounters"
First("Qualifying Diastolic Blood Pressure Reading" DBPReading where Global."LatestOf"(DBPReading.relevantDatetime, DBPReading.relevantPeriod)same day as "Most Recent Blood Pressure Day" sort by(result as Quantity) )
First("Qualifying Systolic Blood Pressure Reading" SBPReading where Global."LatestOf"(SBPReading.relevantDatetime, SBPReading.relevantPeriod)same day as "Most Recent Blood Pressure Day" sort by(result as Quantity) )
Last("Blood Pressure Days" BPDays sort asc )
"Has Systolic Blood Pressure Less Than 140" and "Has Diastolic Blood Pressure Less Than 90"
exists ( ["Assessment, Performed": "Functional Assessment of Chronic Illness Therapy - Palliative Care Questionnaire (FACIT-Pal)"] PalliativeAssessment where Global."NormalizeInterval" ( PalliativeAssessment.relevantDatetime, PalliativeAssessment.relevantPeriod ) overlaps day of "Measurement Period" ) or exists ( ["Diagnosis": "Palliative Care Diagnosis"] PalliativeDiagnosis where PalliativeDiagnosis.prevalencePeriod overlaps day of "Measurement Period" ) or exists ( ["Encounter, Performed": "Palliative Care Encounter"] PalliativeEncounter where PalliativeEncounter.relevantPeriod overlaps day of "Measurement Period" ) or exists ( ["Intervention, Performed": "Palliative Care Intervention"] PalliativeIntervention where Global."NormalizeInterval" ( PalliativeIntervention.relevantDatetime, PalliativeIntervention.relevantPeriod ) overlaps day of "Measurement Period" )
( ["Diagnosis": "Pregnancy"] union ["Diagnosis": "End Stage Renal Disease"] union ["Diagnosis": "Kidney Transplant Recipient"] union ["Diagnosis": "Chronic Kidney Disease, Stage 5"] ) PregnancyESRDDiagnosis where PregnancyESRDDiagnosis.prevalencePeriod overlaps "Measurement Period"
["Physical Exam, Performed": "Diastolic blood pressure"] DiastolicBP without ( ["Encounter, Performed": "Encounter Inpatient"] union ["Encounter, Performed": "Emergency Department Evaluation and Management Visit"] ) DisqualifyingEncounter such that Global."LatestOf" ( DiastolicBP.relevantDatetime, DiastolicBP.relevantPeriod ) during day of DisqualifyingEncounter.relevantPeriod where DiastolicBP.result.unit = 'mm[Hg]' and Global."LatestOf" ( DiastolicBP.relevantDatetime, DiastolicBP.relevantPeriod ) during day of "Measurement Period"
["Physical Exam, Performed": "Systolic blood pressure"] SystolicBP without ( ["Encounter, Performed": "Encounter Inpatient"] union ["Encounter, Performed": "Emergency Department Evaluation and Management Visit"] ) DisqualifyingEncounter such that Global."LatestOf" ( SystolicBP.relevantDatetime, SystolicBP.relevantPeriod ) during day of DisqualifyingEncounter.relevantPeriod where SystolicBP.result.unit = 'mm[Hg]' and Global."LatestOf" ( SystolicBP.relevantDatetime, SystolicBP.relevantPeriod ) during day of "Measurement Period"
["Patient Characteristic Ethnicity": "Ethnicity"]
["Patient Characteristic Payer": "Payer"]
["Patient Characteristic Race": "Race"]
["Patient Characteristic Sex": "ONC Administrative Sex"]
not ( end of period is null or end of period = maximum DateTime )
if ( HasEnd(period)) then end of period else start of period
Latest(NormalizeInterval(pointInTime, period))
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"]
["Patient Characteristic Race": "Race"]
["Patient Characteristic Sex": "ONC Administrative Sex"]
Measure Set |
None |
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