eCQM Title | Coronary Artery Disease (CAD): Beta-Blocker Therapy-Prior Myocardial Infarction (MI) or Left Ventricular Systolic Dysfunction (LVEF <40%) |
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eCQM Identifier (Measure Authoring Tool) | 145 | eCQM Version number | 7.2.000 |
NQF Number | 0070 | GUID | 80744ae2-de81-4b16-a71d-69522eb865c5 |
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 | |||
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Measure Scoring | Proportion | ||
Measure Type | Process | ||
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Risk Adjustment | |||
Rate Aggregation | |||
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Definition | |||
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Initial Population | |||
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Supplemental Data Elements |
exists ( ["Patient Characteristic Birthdate"] BirthDate where Global."CalendarAgeInYearsAt"(BirthDate.birthDatetime, start of "Measurement Period")>= 18 ) and Count("Qualifying Encounter")>= 2 and ( exists "Qualifying CAD Encounter" )
"Initial Population" and exists "Qualifying CAD Encounter and Moderate or Severe LVSD"
exists "Beta Blocker Therapy for LVSD Ordered" or exists "Currently Taking Beta Blocker Therapy for LVSD"
exists "Arrhythmia with Qualifying CAD Encounter and Moderate or Severe LVSD" or exists "Asthma with Qualifying CAD Encounter and Moderate or Severe LVSD" or exists "Bradycardia with Qualifying CAD Encounter and Moderate or Severe LVSD" or exists "Hypotension with Qualifying CAD Encounter and Moderate or Severe LVSD" or exists "Consecutive Heart Rates Less Than 50 with Qualifying CAD Encounter and Moderate or Severe LVSD" or exists "Allergy or Intolerance to Beta Blocker Therapy Ingredient with Qualifying CAD Encounter and Moderate or Severe LVSD" or exists "Diagnosis of Allergy to Beta Blocker Therapy with Qualifying CAD Encounter and Moderate or Severe LVSD" or exists "Diagnosis of Intolerance to Beta Blocker Therapy with Qualifying CAD Encounter and Moderate or Severe LVSD" or exists "Medical Patient or System Reason for Not Ordering Beta Blocker for LVSD" or "Atrioventricular Block with Qualifying CAD Encounter and Moderate or Severe LVSD Without Cardiac Pacer"
exists ( ["Patient Characteristic Birthdate"] BirthDate where Global."CalendarAgeInYearsAt"(BirthDate.birthDatetime, start of "Measurement Period")>= 18 ) and Count("Qualifying Encounter")>= 2 and ( exists "Qualifying CAD Encounter" )
"Initial Population" and exists "Qualifying CAD Encounter and Prior MI"
exists "Beta Blocker Therapy Ordered" or exists "Currently Taking Beta Blocker Therapy"
exists "Arrhythmia with Qualifying CAD Encounter and Prior MI" or exists "Asthma with Qualifying CAD Encounter and Prior MI" or exists "Bradycardia with Qualifying CAD Encounter and Prior MI" or exists "Hypotension with Qualifying CAD Encounter and Prior MI" or exists "Consecutive Heart Rates Less Than 50 with Qualifying CAD Encounter and Prior MI" or exists "Allergy or Intolerance to Beta Blocker Therapy Ingredient with Qualifying CAD Encounter and Prior MI" or exists "Diagnosis of Allergy to Beta Blocker Therapy with Qualifying CAD Encounter and Prior MI" or exists "Diagnosis of Intolerance to Beta Blocker Therapy with Qualifying CAD Encounter and Prior MI" or exists "Medical Patient or System Reason for Not Ordering Beta Blocker Therapy" or "Atrioventricular Block with Qualifying CAD Encounter and Prior MI Without Cardiac Pacer"
["Allergy/Intolerance": "Beta Blocker Therapy Ingredient"] BetaBlockerAllergyIntolerance with "Qualifying CAD Encounter and Moderate or Severe LVSD" CADEncounterModerateOrSevereLVSD such that BetaBlockerAllergyIntolerance.prevalencePeriod overlaps after CADEncounterModerateOrSevereLVSD.relevantPeriod
["Allergy/Intolerance": "Beta Blocker Therapy Ingredient"] BetaBlockerAllergyIntolerance with "Qualifying CAD Encounter and Prior MI" CADEncounterMI such that BetaBlockerAllergyIntolerance.prevalencePeriod overlaps after CADEncounterMI.relevantPeriod
["Diagnosis": "Arrhythmia"] Arrhythmia with "Qualifying CAD Encounter and Moderate or Severe LVSD" CADEncounterModerateOrSevereLVSD such that Arrhythmia.prevalencePeriod overlaps CADEncounterModerateOrSevereLVSD.relevantPeriod
["Diagnosis": "Arrhythmia"] Arrhythmia with "Qualifying CAD Encounter and Prior MI" CADEncounterMI such that Arrhythmia.prevalencePeriod overlaps CADEncounterMI.relevantPeriod
["Diagnosis": "Asthma"] Asthma with "Qualifying CAD Encounter and Moderate or Severe LVSD" CADEncounterModerateOrSevereLVSD such that Asthma.prevalencePeriod overlaps CADEncounterModerateOrSevereLVSD.relevantPeriod
["Diagnosis": "Asthma"] Asthma with "Qualifying CAD Encounter and Prior MI" CADEncounterMI such that Asthma.prevalencePeriod overlaps CADEncounterMI.relevantPeriod
["Diagnosis": "Atrioventricular Block"] AtrioventricularBlock with "Qualifying CAD Encounter and Moderate or Severe LVSD" CADEncounterModerateOrSevereLVSD such that AtrioventricularBlock.prevalencePeriod overlaps CADEncounterModerateOrSevereLVSD.relevantPeriod
exists "Atrioventricular Block with Qualifying CAD Encounter and Moderate or Severe LVSD" and not exists "Diagnosis of Cardiac Pacer in Situ with Qualifying CAD Encounter and Moderate or Severe LVSD" and not exists "Cardiac Pacer Device Implanted with Qualifying CAD Encounter and Moderate or Severe LVSD"
["Diagnosis": "Atrioventricular Block"] AtrioventricularBlock with "Qualifying CAD Encounter and Prior MI" CADEncounterMI such that AtrioventricularBlock.prevalencePeriod overlaps CADEncounterMI.relevantPeriod
exists "Atrioventricular Block with Qualifying CAD Encounter and Prior MI" and not exists "Diagnosis of Cardiac Pacer in Situ with Qualifying CAD Encounter and Prior MI" and not exists "Cardiac Pacer Device Implanted with Qualifying CAD Encounter and Prior MI"
["Medication, Order": "Beta Blocker Therapy for LVSD"] BetaBlockerForLVSDOrdered with "Qualifying CAD Encounter and Moderate or Severe LVSD" CADEncounterModerateOrSevereLVSD such that BetaBlockerForLVSDOrdered.authorDatetime during CADEncounterModerateOrSevereLVSD.relevantPeriod
["Medication, Order": "Beta Blocker Therapy"] BetaBlockerOrdered with "Qualifying CAD Encounter and Prior MI" CADEncounterMI such that BetaBlockerOrdered.authorDatetime during CADEncounterMI.relevantPeriod
["Diagnosis": "Bradycardia"] Bradycardia with "Qualifying CAD Encounter and Moderate or Severe LVSD" CADEncounterModerateOrSevereLVSD such that Bradycardia.prevalencePeriod overlaps CADEncounterModerateOrSevereLVSD.relevantPeriod
["Diagnosis": "Bradycardia"] Bradycardia with "Qualifying CAD Encounter and Prior MI" CADEncounterMI such that Bradycardia.prevalencePeriod overlaps CADEncounterMI.relevantPeriod
["Device, Applied": "Cardiac Pacer"] ImplantedCardiacPacer with "Qualifying CAD Encounter and Moderate or Severe LVSD" CADEncounterModerateOrSevereLVSD such that ImplantedCardiacPacer.relevantPeriod overlaps after CADEncounterModerateOrSevereLVSD.relevantPeriod
["Device, Applied": "Cardiac Pacer"] ImplantedCardiacPacer with "Qualifying CAD Encounter and Prior MI" CADEncounterMI such that ImplantedCardiacPacer.relevantPeriod overlaps after CADEncounterMI.relevantPeriod
from ["Physical Exam, Performed": "Heart rate"] HeartRate, "Qualifying CAD Encounter and Moderate or Severe LVSD" CADEncounterModerateOrSevereLVSD let PriorHeartRate: Last(["Physical Exam, Performed": "Heart rate"] MostRecentPriorHeartRate where MostRecentPriorHeartRate.relevantPeriod during CADEncounterModerateOrSevereLVSD.relevantPeriod and MostRecentPriorHeartRate.relevantPeriod starts before start of HeartRate.relevantPeriod sort by start of relevantPeriod ) where HeartRate.relevantPeriod during CADEncounterModerateOrSevereLVSD.relevantPeriod and HeartRate.result < 50 '{Beats}/min' and PriorHeartRate.result < 50 '{Beats}/min'
from ["Physical Exam, Performed": "Heart rate"] HeartRate, "Qualifying CAD Encounter and Prior MI" CADEncounterMI let PriorHeartRate: Last(["Physical Exam, Performed": "Heart rate"] MostRecentPriorHeartRate where MostRecentPriorHeartRate.relevantPeriod during CADEncounterMI.relevantPeriod and MostRecentPriorHeartRate.relevantPeriod starts before start of HeartRate.relevantPeriod sort by start of relevantPeriod ) where HeartRate.relevantPeriod during CADEncounterMI.relevantPeriod and HeartRate.result < 50 '{Beats}/min' and PriorHeartRate.result < 50 '{Beats}/min'
"Face to Face Encounter During Measurement Period" FaceToFaceEncounter with ["Diagnosis": "Coronary Artery Disease No MI"] CoronaryArteryDisease such that CoronaryArteryDisease.prevalencePeriod overlaps FaceToFaceEncounter.relevantPeriod
["Medication, Active": "Beta Blocker Therapy"] ActiveBetaBlocker with "Qualifying CAD Encounter and Prior MI" CADEncounterMI such that ActiveBetaBlocker.relevantPeriod overlaps after CADEncounterMI.relevantPeriod
["Medication, Active": "Beta Blocker Therapy for LVSD"] ActiveBetaBlockerForLVSD with "Qualifying CAD Encounter and Moderate or Severe LVSD" CADEncounterModerateOrSevereLVSD such that ActiveBetaBlockerForLVSD.relevantPeriod overlaps after CADEncounterModerateOrSevereLVSD.relevantPeriod
"Initial Population" and exists "Qualifying CAD Encounter and Moderate or Severe LVSD"
"Initial Population" and exists "Qualifying CAD Encounter and Prior MI"
exists "Arrhythmia with Qualifying CAD Encounter and Moderate or Severe LVSD" or exists "Asthma with Qualifying CAD Encounter and Moderate or Severe LVSD" or exists "Bradycardia with Qualifying CAD Encounter and Moderate or Severe LVSD" or exists "Hypotension with Qualifying CAD Encounter and Moderate or Severe LVSD" or exists "Consecutive Heart Rates Less Than 50 with Qualifying CAD Encounter and Moderate or Severe LVSD" or exists "Allergy or Intolerance to Beta Blocker Therapy Ingredient with Qualifying CAD Encounter and Moderate or Severe LVSD" or exists "Diagnosis of Allergy to Beta Blocker Therapy with Qualifying CAD Encounter and Moderate or Severe LVSD" or exists "Diagnosis of Intolerance to Beta Blocker Therapy with Qualifying CAD Encounter and Moderate or Severe LVSD" or exists "Medical Patient or System Reason for Not Ordering Beta Blocker for LVSD" or "Atrioventricular Block with Qualifying CAD Encounter and Moderate or Severe LVSD Without Cardiac Pacer"
exists "Arrhythmia with Qualifying CAD Encounter and Prior MI" or exists "Asthma with Qualifying CAD Encounter and Prior MI" or exists "Bradycardia with Qualifying CAD Encounter and Prior MI" or exists "Hypotension with Qualifying CAD Encounter and Prior MI" or exists "Consecutive Heart Rates Less Than 50 with Qualifying CAD Encounter and Prior MI" or exists "Allergy or Intolerance to Beta Blocker Therapy Ingredient with Qualifying CAD Encounter and Prior MI" or exists "Diagnosis of Allergy to Beta Blocker Therapy with Qualifying CAD Encounter and Prior MI" or exists "Diagnosis of Intolerance to Beta Blocker Therapy with Qualifying CAD Encounter and Prior MI" or exists "Medical Patient or System Reason for Not Ordering Beta Blocker Therapy" or "Atrioventricular Block with Qualifying CAD Encounter and Prior MI Without Cardiac Pacer"
["Diagnosis": "Allergy to Beta Blocker Therapy"] BetaBlockerAllergyDiagnosis with "Qualifying CAD Encounter and Moderate or Severe LVSD" CADEncounterModerateOrSevereLVSD such that BetaBlockerAllergyDiagnosis.prevalencePeriod overlaps after CADEncounterModerateOrSevereLVSD.relevantPeriod
["Diagnosis": "Allergy to Beta Blocker Therapy"] BetaBlockerAllergyDiagnosis with "Qualifying CAD Encounter and Prior MI" CADEncounterMI such that BetaBlockerAllergyDiagnosis.prevalencePeriod overlaps after CADEncounterMI.relevantPeriod
["Diagnosis": "Cardiac Pacer in Situ"] CardiacPacerDiagnosis with "Qualifying CAD Encounter and Moderate or Severe LVSD" CADEncounterModerateOrSevereLVSD such that CardiacPacerDiagnosis.prevalencePeriod overlaps after CADEncounterModerateOrSevereLVSD.relevantPeriod
["Diagnosis": "Cardiac Pacer in Situ"] CardiacPacerDiagnosis with "Qualifying CAD Encounter and Prior MI" CADEncounterMI such that CardiacPacerDiagnosis.prevalencePeriod overlaps after CADEncounterMI.relevantPeriod
["Diagnosis": "Intolerance to Beta Blocker Therapy"] BetaBlockerIntoleranceDiagnosis with "Qualifying CAD Encounter and Moderate or Severe LVSD" CADEncounterModerateOrSevereLVSD such that BetaBlockerIntoleranceDiagnosis.prevalencePeriod overlaps after CADEncounterModerateOrSevereLVSD.relevantPeriod
["Diagnosis": "Intolerance to Beta Blocker Therapy"] BetaBlockerIntoleranceDiagnosis with "Qualifying CAD Encounter and Prior MI" CADEncounterMI such that BetaBlockerIntoleranceDiagnosis.prevalencePeriod overlaps after CADEncounterMI.relevantPeriod
( ["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": "Nursing Facility Visit"] ) FaceToFaceEncounter where FaceToFaceEncounter.relevantPeriod during "Measurement Period"
"Face to Face Encounter During Measurement Period" FaceToFaceEncounter with ["Procedure, Performed": "Cardiac Surgery"] CardiacSurgery such that CardiacSurgery.relevantPeriod starts before end of FaceToFaceEncounter.relevantPeriod
["Diagnosis": "Hypotension"] Hypotension with "Qualifying CAD Encounter and Moderate or Severe LVSD" CADEncounterModerateOrSevereLVSD such that Hypotension.prevalencePeriod overlaps CADEncounterModerateOrSevereLVSD.relevantPeriod
["Diagnosis": "Hypotension"] Hypotension with "Qualifying CAD Encounter and Prior MI" CADEncounterMI such that Hypotension.prevalencePeriod overlaps CADEncounterMI.relevantPeriod
exists ( ["Patient Characteristic Birthdate"] BirthDate where Global."CalendarAgeInYearsAt"(BirthDate.birthDatetime, start of "Measurement Period")>= 18 ) and Count("Qualifying Encounter")>= 2 and ( exists "Qualifying CAD Encounter" )
["Medication, Not Ordered": "Beta Blocker Therapy for LVSD"] NoBetaBlockerForLVSDOrdered with "Qualifying CAD Encounter and Moderate or Severe LVSD" CADEncounterModerateOrSevereLVSD such that NoBetaBlockerForLVSDOrdered.authorDatetime during CADEncounterModerateOrSevereLVSD.relevantPeriod and ( NoBetaBlockerForLVSDOrdered.negationRationale in "Medical Reason" or NoBetaBlockerForLVSDOrdered.negationRationale in "Patient Reason" or NoBetaBlockerForLVSDOrdered.negationRationale in "System Reason" )
["Medication, Not Ordered": "Beta Blocker Therapy"] NoBetaBlockerOrdered with "Qualifying CAD Encounter and Prior MI" CADEncounterMI such that NoBetaBlockerOrdered.authorDatetime during CADEncounterMI.relevantPeriod and ( NoBetaBlockerOrdered.negationRationale in "Medical Reason" or NoBetaBlockerOrdered.negationRationale in "Patient Reason" or NoBetaBlockerOrdered.negationRationale in "System Reason" )
exists "Beta Blocker Therapy for LVSD Ordered" or exists "Currently Taking Beta Blocker Therapy for LVSD"
exists "Beta Blocker Therapy Ordered" or exists "Currently Taking Beta Blocker Therapy"
"Coronary Artery Disease Encounter" union "History of Cardiac Surgery"
"Qualifying CAD Encounter" EncounterWithCADProxy with ( ( ["Diagnostic Study, Performed": "Ejection Fraction"] EjectionFraction where EjectionFraction.result < 40 '%' ) union ["Diagnosis": "Moderate or Severe LVSD"] union ( ["Diagnosis": "Left Ventricular Systolic Dysfunction"] LVSD where LVSD.severity in "Moderate or Severe" ) ) LVSDFindings such that LVSDFindings.prevalencePeriod starts before end of EncounterWithCADProxy.relevantPeriod or LVSDFindings.relevantPeriod starts before end of EncounterWithCADProxy.relevantPeriod
"Qualifying CAD Encounter" EncounterWithCADProxy with ["Diagnosis": "Myocardial Infarction"] MyocardialInfarction such that MyocardialInfarction.prevalencePeriod ends 3 years or less before day of start of EncounterWithCADProxy.relevantPeriod
( ["Encounter, Performed": "Office Visit"] union ["Encounter, Performed": "Outpatient Consultation"] union ["Encounter, Performed": "Nursing Facility Visit"] union ["Encounter, Performed": "Care Services in Long-Term Residential Facility"] union ["Encounter, Performed": "Home Healthcare Services"] union ["Encounter, Performed": "Patient Provider Interaction"] ) ValidEncounter where ValidEncounter.relevantPeriod during "Measurement Period"
["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 |