HIV/AIDS: RNA Control for Patients with HIV

eMeasure Title	HIV/AIDS: RNA Control for Patients with HIV
eMeasure Identifier (Measure Authoring Tool)	77	eMeasure Version number	3
NQF Number	Not Applicable	GUID	e0a07809-7b74-473f-bcc4-1891be506aaa
Measurement Period	January 1, 20xx through December 31, 20xx
Measure Steward	Centers for Medicare & Medicaid Services
Measure Developer	National Committee for Quality Assurance
Endorsed By	None
Description	Percentage of patients aged 13 years and older with a diagnosis of HIV/AIDS, with at least two visits during the measurement year, with at least 90 days between each visit, whose most recent HIV RNA level is <200 copies/mL.
Copyright	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. CPT(R) contained in the Measure specifications is copyright 2004-2013 American Medical Association. LOINC(R) copyright 2004-2013 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2013 International Health Terminology Standards Development Organisation. ICD-10 copyright 2013 World Health Organization. All Rights Reserved.
Disclaimer	These performance Measures are not clinical guidelines and do not establish a standard of medical care, and have not been tested for all potential applications. THE MEASURES 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].
Measure Scoring	Proportion
Measure Type	Outcome
Stratification	None
Risk Adjustment	None
Rate Aggregation	Not Applicable
Rationale	TBD
Clinical Recommendation Statement	TBD
Improvement Notation	A higher score indicates better quality
Reference	None
Definition	None
Guidance	None
Transmission Format	TBD
Initial Patient Population	All patients aged 13 years and older with a diagnosis of HIV/AIDS with at least two visits during the measurement year, with at least 90 days between each visit.
Denominator	Equals initial patient population
Denominator Exclusions	Not Applicable
Numerator	Patients whose most recent HIV RNA level is <200 copies/mL.
Numerator Exclusions	Not Applicable
Denominator Exceptions	None
Measure Population	Not Applicable
Measure Observations	Not Applicable
Supplemental Data Elements	For every patient evaluated by this measure also identify payer, race, ethnicity and sex.

Population criteria
Data criteria (QDM Data Elements)
Reporting Stratification
Supplemental Data Elements

Population criteria

Initial Patient Population =
- AND: "Patient Characteristic Birthdate: birth date" >= 13 year(s) starts before start of "Measurement Period"
- AND: "Occurrence A of Encounter, Performed: HIV Visit" during "Measurement Period"
- AND: "Occurrence B of Encounter, Performed: HIV Visit" during "Measurement Period"
- AND: "Diagnosis, Active: HIV" starts before or during "Measurement Period"
- AND: "Occurrence B of Encounter, Performed: HIV Visit" >= 90 day(s) starts after end of "Occurrence A of Encounter, Performed: HIV Visit"
Denominator =
- AND: "Initial Patient Population"
Denominator Exclusions =
- None
Numerator =
- AND: MOST RECENT: "Occurrence A of Laboratory Test, Result: HIV Viral Load (result)" during "Measurement Period"
- AND: "Occurrence A of Laboratory Test, Result: HIV Viral Load (result < 200 copies/mL)"
Denominator Exceptions =
- None

Data criteria (QDM Data Elements)

"Diagnosis, Active: HIV" using "HIV Grouping Value Set (2.16.840.1.113883.3.464.1003.120.12.1003)"
"Encounter, Performed: HIV Visit" using "HIV Visit Grouping Value Set (2.16.840.1.113883.3.464.1003.101.12.1047)"
"Laboratory Test, Result: HIV Viral Load" using "HIV Viral Load Grouping Value Set (2.16.840.1.113883.3.464.1003.120.12.1002)"
"Patient Characteristic Birthdate: birth date" using "birth date LOINC Value Set (2.16.840.1.113883.3.560.100.4)"

Reporting Stratification

None

Supplemental Data Elements

"Patient Characteristic Ethnicity: Ethnicity" using "Ethnicity CDCREC Value Set (2.16.840.1.114222.4.11.837)"
"Patient Characteristic Payer: Payer" using "Payer SOP Value Set (2.16.840.1.114222.4.11.3591)"
"Patient Characteristic Race: Race" using "Race CDCREC Value Set (2.16.840.1.114222.4.11.836)"
"Patient Characteristic Sex: ONC Administrative Sex" using "ONC Administrative Sex AdministrativeSex Value Set (2.16.840.1.113762.1.4.1)"

Measure Set

Not Applicable

Table of Contents

Population criteria

Data criteria (QDM Data Elements)

Reporting Stratification

Supplemental Data Elements