{ "_id": { "$oid": "5abba995b848461de62cb080" }, "bundle_id": "582c7dca6c5d1c1cf10006e6", "calculate_sdes": null, "category": "Miscellaneous", "cms_id": "CMS53v7", "complexity": { "variables": [ { "name": "Patient", "complexity": 1 }, { "name": "SDE Ethnicity", "complexity": 1 }, { "name": "SDE Payer", "complexity": 1 }, { "name": "SDE Race", "complexity": 1 }, { "name": "SDE Sex", "complexity": 1 }, { "name": "Exception Procedures", "complexity": 1 }, { "name": "Inpatient Encounters", "complexity": 2 }, { "name": "Procedure Exceptions Within 90 Minutes of Arrival", "complexity": 1 }, { "name": "Diagnosis Exception", "complexity": 1 }, { "name": "Denominator Exceptions", "complexity": 1 }, { "name": "Diagnostic Electrocardiogram", "complexity": 1 }, { "name": "Fibrinolytic", "complexity": 1 }, { "name": "PCI Procedure", "complexity": 1 }, { "name": "AMI Encounter", "complexity": 1 }, { "name": "Initial Population", "complexity": 1 }, { "name": "Denominator", "complexity": 3 }, { "name": "Denominator Exclusions", "complexity": 4 }, { "name": "Numerator", "complexity": 1 }, { "name": "Patient", "complexity": 1 }, { "name": "Encounter", "complexity": 1 }, { "name": "LengthInDays", "complexity": 1 }, { "name": "Inpatient Encounter", "complexity": 2 }, { "name": "ToDate", "complexity": 1 }, { "name": "CalendarAgeInDaysAt", "complexity": 1 }, { "name": "CalendarAgeInDays", "complexity": 1 }, { "name": "CalendarAgeInMonthsAt", "complexity": 1 }, { "name": "CalendarAgeInMonths", "complexity": 1 }, { "name": "CalendarAgeInYearsAt", "complexity": 1 }, { "name": "CalendarAgeInYears", "complexity": 1 }, { "name": "Hospitalization", "complexity": 0 }, { "name": "Hospitalization Locations", "complexity": 0 }, { "name": "Hospitalization Length of Stay", "complexity": 1 }, { "name": "Hospital Admission Time", "complexity": 1 }, { "name": "Hospital Discharge Time", "complexity": 1 }, { "name": "Hospital Arrival Time", "complexity": 1 }, { "name": "Hospital Departure Time", "complexity": 1 }, { "name": "Emergency Department Arrival Time", "complexity": 1 }, { "name": "First Inpatient Intensive Care Unit", "complexity": 1 } ] }, "continuous_variable": false, "cql": [ "library PrimaryPCIReceivedWithin90MinutesofHospitalArrival version '7.1.000'\r\n\r\nusing QDM version '5.3'\r\n\r\ninclude MATGlobalCommonFunctions version '2.0.000' called Global\r\n\r\nvalueset \"ONC Administrative Sex\": 'urn:oid:2.16.840.1.113762.1.4.1'\r\nvalueset \"Race\": 'urn:oid:2.16.840.1.114222.4.11.836'\r\nvalueset \"Ethnicity\": 'urn:oid:2.16.840.1.114222.4.11.837'\r\nvalueset \"Payer\": 'urn:oid:2.16.840.1.114222.4.11.3591'\r\nvalueset \"Acute or Evolving MI\": 'urn:oid:2.16.840.1.113883.3.666.5.3022'\r\nvalueset \"Ambulatory surgical center\": 'urn:oid:2.16.840.1.113883.3.666.5.687'\r\nvalueset \"Aortic balloon pump insertion\": 'urn:oid:2.16.840.1.113883.3.666.5.1151'\r\nvalueset \"Cardiopulmonary arrest\": 'urn:oid:2.16.840.1.113883.3.666.5.748'\r\nvalueset \"Encounter Inpatient\": 'urn:oid:2.16.840.1.113883.3.666.5.307'\r\nvalueset \"Endotracheal Intubation\": 'urn:oid:2.16.840.1.113762.1.4.1045.69'\r\nvalueset \"Fibrinolytic Therapy\": 'urn:oid:2.16.840.1.113883.3.666.5.736'\r\nvalueset \"Transfer From Emergency Department (ED) Locations\": 'urn:oid:2.16.840.1.113883.3.666.5.3006'\r\nvalueset \"Transfer From Inpatient\": 'urn:oid:2.16.840.1.113883.3.666.5.3013'\r\nvalueset \"Transfer From Outpatient\": 'urn:oid:2.16.840.1.113883.3.67.1.101.950'\r\nvalueset \"Ventricular Assist Device placement\": 'urn:oid:2.16.840.1.113883.3.666.5.3015'\r\nvalueset \"PCI\": 'urn:oid:2.16.840.1.113762.1.4.1045.67'\r\nvalueset \"Electrocardiogram (ECG)\": 'urn:oid:2.16.840.1.113883.3.666.5.735'\r\n\r\nparameter \"Measurement Period\" Interval\r\n\r\ncontext Patient\r\n\r\ndefine \"SDE Ethnicity\":\r\n\t[\"Patient Characteristic Ethnicity\": \"Ethnicity\"]\r\n\r\ndefine \"SDE Payer\":\r\n\t[\"Patient Characteristic Payer\": \"Payer\"]\r\n\r\ndefine \"SDE Race\":\r\n\t[\"Patient Characteristic Race\": \"Race\"]\r\n\r\ndefine \"SDE Sex\":\r\n\t[\"Patient Characteristic Sex\": \"ONC Administrative Sex\"]\r\n\r\ndefine \"Exception Procedures\":\r\n\t( [\"Procedure, Performed\": \"Endotracheal Intubation\"]\r\n\t\t\tunion [\"Procedure, Performed\": \"Aortic balloon pump insertion\"]\r\n\t\t\tunion [\"Procedure, Performed\": \"Ventricular Assist Device placement\"]\r\n\t)\r\n\r\ndefine \"Denominator Exceptions\":\r\n\t( \"Procedure Exceptions Within 90 Minutes of Arrival\"\r\n\t\t\tunion \"Diagnosis Exception\"\r\n\t)\r\n\r\ndefine \"Diagnostic Electrocardiogram\":\r\n\t[\"Diagnostic Study, Performed\": \"Electrocardiogram (ECG)\"]\r\n\r\ndefine \"Fibrinolytic\":\r\n\t[\"Medication, Administered\": \"Fibrinolytic Therapy\"]\r\n\r\ndefine \"PCI Procedure\":\r\n\t[\"Procedure, Performed\": \"PCI\"]\r\n\r\ndefine \"Denominator Exclusions\":\r\n\t\"Denominator\" DenominatorEncounter\r\n\t\twhere DenominatorEncounter.admissionSource in \"Ambulatory surgical center\"\r\n\t\t\tor DenominatorEncounter.admissionSource in \"Transfer From Outpatient\"\r\n\t\t\tor DenominatorEncounter.admissionSource in \"Transfer From Emergency Department (ED) Locations\"\r\n\t\t\tor DenominatorEncounter.admissionSource in \"Transfer From Inpatient\"\r\n\r\ndefine \"AMI Encounter\":\r\n\t[\"Encounter, Performed\": \"Encounter Inpatient\"] Encounter\r\n\t\twith [\"Patient Characteristic Birthdate\"] BirthDate\r\n\t\t\tsuch that Global.CalendarAgeInYearsAt(BirthDate.birthDatetime, start of Encounter.relevantPeriod)>= 18\r\n\t\t\t\tand Encounter.principalDiagnosis in \"Acute or Evolving MI\"\r\n\r\ndefine \"Inpatient Encounters\":\r\n\t[\"Encounter, Performed\": \"Encounter Inpatient\"] Encounter\r\n\t\twhere Global.\"LengthInDays\"(Encounter.relevantPeriod)<= 120\r\n\t\t\tand Encounter.relevantPeriod ends during \"Measurement Period\"\r\n\r\ndefine \"Diagnosis Exception\":\r\n\t\"Inpatient Encounters\" Encounter\r\n\t\twith [\"Diagnosis\": \"Cardiopulmonary arrest\"] CardiacArrest\r\n\t\t\tsuch that CardiacArrest.prevalencePeriod starts 90 minutes or less on or after start of Global.Hospitalization(Encounter)\r\n\r\ndefine \"Initial Population\":\r\n\t\"Inpatient Encounters\"\r\n\t\tintersect \"AMI Encounter\"\r\n\r\ndefine \"Numerator\":\r\n\t\"Initial Population\" QualifyingEncounter\r\n\t\twith \"PCI Procedure\" PCI\r\n\t\t\tsuch that PCI.relevantPeriod starts 90 minutes or less on or after Global.\"Hospital Arrival Time\"(QualifyingEncounter)\r\n\r\ndefine \"Procedure Exceptions Within 90 Minutes of Arrival\":\r\n\t\"Inpatient Encounters\" Encounter\r\n\t\twith \"Exception Procedures\" ExceptionProcedures\r\n\t\t\tsuch that ExceptionProcedures.relevantPeriod starts 90 minutes or less on or after Global.\"Hospital Arrival Time\"(Encounter)\r\n\r\ndefine \"Denominator\":\r\n\t\"Initial Population\" QualifyingEncounter\r\n\t\tlet FirstPCI: First(\"PCI Procedure\" FirstPCI\r\n\t\t\t\twhere FirstPCI.relevantPeriod starts on or after Global.\"Hospital Arrival Time\"(QualifyingEncounter)\r\n\t\t\t\tsort by start of relevantPeriod\r\n\t\t)\r\n\t\twith \"Diagnostic Electrocardiogram\" ECG\r\n\t\t\tsuch that ECG.relevantPeriod starts during Global.\"Hospitalization\"(QualifyingEncounter)\r\n\t\t\t\tor ECG.relevantPeriod starts 1 hour or less on or before Global.\"Hospital Arrival Time\"(QualifyingEncounter)\r\n\t\twhere FirstPCI.relevantPeriod starts 1440 minutes or less on or after Global.\"Hospital Arrival Time\"(QualifyingEncounter)\r\n\t\t\tand not exists ( \"Fibrinolytic\" FibrinolyticTherapy\r\n\t\t\t\t\twhere FibrinolyticTherapy.relevantPeriod starts after Global.\"Hospital Arrival Time\"(QualifyingEncounter)\r\n\t\t\t\t\t\tand FibrinolyticTherapy.relevantPeriod starts before start of FirstPCI.relevantPeriod\r\n\t\t\t)\r\n", "library MATGlobalCommonFunctions version '2.0.000'\r\n\r\nusing QDM version '5.3'\r\n\r\ncodesystem \"LOINC:2.46\": 'urn:oid:2.16.840.1.113883.6.1' version 'urn:hl7:version:2.46'\r\ncodesystem \"SNOMEDCT:2016-03\": 'urn:oid:2.16.840.1.113883.6.96' version 'urn:hl7:version:2016-03'\r\n\r\nvalueset \"Emergency Department Visit\": 'urn:oid:2.16.840.1.113883.3.117.1.7.1.292'\r\nvalueset \"Encounter Inpatient\": 'urn:oid:2.16.840.1.113883.3.666.5.307'\r\nvalueset \"Intensive Care Unit\": 'urn:oid:2.16.840.1.113762.1.4.1110.23'\r\n\r\ncode \"Birthdate\": '21112-8' from \"LOINC:2.46\" display 'Birth date'\r\ncode \"Dead\": '419099009' from \"SNOMEDCT:2016-03\" display 'Dead'\r\n\r\nparameter \"Measurement Period\" Interval\r\n\r\ncontext Patient\r\n\r\ndefine \"Encounter\":\r\n\t[\"Encounter, Performed\": \"Emergency Department Visit\"]\r\n\r\ndefine \"Inpatient Encounter\":\r\n\t[\"Encounter, Performed\": \"Encounter Inpatient\"] EncounterInpatient\r\n\t\twhere \"LengthInDays\"(EncounterInpatient.relevantPeriod)<= 120\r\n\t\t\tand EncounterInpatient.relevantPeriod ends during \"Measurement Period\"\n\n/*ToDate takes a given DateTime value and returns a DateTime with the time components \"zeroed\", and the timezone of the input value, for example, given the DateTime @2012-01-01T06:30:00.0Z, this function will return @2012-01-01T00:00:00.0Z.*/\r\n\r\ndefine function \"ToDate\"(Value DateTime):\r\n\tDateTime(year from Value, month from Value, day from Value, 0, 0, 0, 0, timezone from Value)\n\n/*CalendarAgeInDaysAt calculates the calendar age (meaning the age without considering time components) in days.*/\r\n\r\ndefine function \"CalendarAgeInDaysAt\"(BirthDateTime DateTime, AsOf DateTime):\r\n\tdays between ToDate(BirthDateTime)and ToDate(AsOf)\n\n/*CalendarAgeInDays calculates the calendar age (meaning the age without considering time components) in days as of today*/\r\n\r\ndefine function \"CalendarAgeInDays\"(BirthDateTime DateTime):\r\n\tCalendarAgeInDaysAt(BirthDateTime, Today())\n\n/*CalendarAgeInMonthsAt calculates the calendar age (meaning the age without considering time components) in months.*/\r\n\r\ndefine function \"CalendarAgeInMonthsAt\"(BirthDateTime DateTime, AsOf DateTime):\r\n\tmonths between ToDate(BirthDateTime)and ToDate(AsOf)\n\n/*CalendarAgeInMonths calculates the calendar age (meaning the age without considering time components) in months as of today.*/\r\n\r\ndefine function \"CalendarAgeInMonths\"(BirthDateTime DateTime):\r\n\tCalendarAgeInMonthsAt(BirthDateTime, Today())\n\n/*CalendarAgeInYearsAt calculates the calendar age (meaning the age without considering time components) in years.*/\r\n\r\ndefine function \"CalendarAgeInYearsAt\"(BirthDateTime DateTime, AsOf DateTime):\r\n\tyears between ToDate(BirthDateTime)and ToDate(AsOf)\n\n/*CalendarAgeInYears calculates the calendar age (meaning the age without considering time components) in years as of today.*/\r\n\r\ndefine function \"CalendarAgeInYears\"(BirthDateTime DateTime):\r\n\tCalendarAgeInYearsAt(BirthDateTime, Today())\n\n/*Hospitalization returns the total interval for admission to discharge for the given encounter, or for the admission of any immediately prior emergency department visit to the discharge of the given encounter.*/\r\n\r\ndefine function \"Hospitalization\"(Encounter \"Encounter, Performed\"):\r\n\t( singleton from ( [\"Encounter, Performed\": \"Emergency Department Visit\"] EDVisit\r\n\t\t\twhere EDVisit.relevantPeriod ends 1 hour or less on or before start of Encounter.relevantPeriod\r\n\t) ) X\r\n\t\treturn if X is null then Encounter.relevantPeriod else Interval[start of X.relevantPeriod, end of Encounter.relevantPeriod]\n\n/*calculates the difference in calendar days between the start and end of the given interval.*/\r\n\r\ndefine function \"LengthInDays\"(Value Interval):\r\n\tdifference in days between start of Value and end of Value\n\n/* returns list of all locations within an encounter, including locations for immediately prior ED visit. If data contains many encounters within 1 hour before the start of encounter error will occur indicating the hospitalization cannot be determined*/\r\n\r\ndefine function \"Hospitalization Locations\"(Encounter \"Encounter, Performed\"):\r\n\t( singleton from ( [\"Encounter, Performed\": \"Emergency Department Visit\"] EDVisit\r\n\t\t\twhere EDVisit.relevantPeriod ends 1 hour or less on or before start of Encounter.relevantPeriod\r\n\t) ) EDEncounter\r\n\t\treturn if EDEncounter is null then Encounter.facilityLocations else flatten { EDEncounter.facilityLocations, Encounter.facilityLocations }\n\n/*Returns the length of stay in days (i.e. the number of days between admission and discharge) for the given encounter, or from the admission of any immediately prior emergency department visit to the discharge of the encounter*/\r\n\r\ndefine function \"Hospitalization Length of Stay\"(Encounter \"Encounter, Performed\"):\r\n\tLengthInDays(\"Hospitalization\"(Encounter))\n\n/*Returns admission time for an encounter or for immediately prior emergency department visit. If the data contain many encounters within 1 hour before the start of the encounter an error indicating hospitalization cannot be determined\n*/\r\n\r\ndefine function \"Hospital Admission Time\"(Encounter \"Encounter, Performed\"):\r\n\tstart of \"Hospitalization\"(Encounter)\n\n/*Hospital Discharge Time returns the discharge time for an encounter*/\r\n\r\ndefine function \"Hospital Discharge Time\"(Encounter \"Encounter, Performed\"):\r\n\tend of Encounter.relevantPeriod\n\n/*Returns earliest arrival time for an encounter including any prior ED visit. If the data contain multiple encounters within 1 hour before the start of the encounter, an error will occur indicating it cannot be unambiguously determined\n*/\r\n\r\ndefine function \"Hospital Arrival Time\"(Encounter \"Encounter, Performed\"):\r\n\tstart of First((\"Hospitalization Locations\"(Encounter))HospitalLocation\r\n\t\t\tsort by start of locationPeriod\r\n\t).locationPeriod\n\n/*Returns the latest departure time for encounter including any prior ED visit. If the data contain multiple encounters within 1 hour before the start of the encounter, an error will occur indicating it cannot be unambiguously determined*/\r\n\r\ndefine function \"Hospital Departure Time\"(Encounter \"Encounter, Performed\"):\r\n\tend of Last((\"Hospitalization Locations\"(Encounter))HospitalLocation\r\n\t\t\tsort by start of locationPeriod\r\n\t).locationPeriod\n\n/*Returns the arrival time in the ED for the encounter. If the data contain multiple encounters within 1 hour before the start of the encounter or multiple ED locations an error will occur indicating it cannot be determined\n*/\r\n\r\ndefine function \"Emergency Department Arrival Time\"(Encounter \"Encounter, Performed\"):\r\n\tstart of ( singleton from ( ( \"Hospitalization Locations\"(Encounter)) HospitalLocation\r\n\t\t\t\twhere HospitalLocation.code in \"Emergency Department Visit\"\r\n\t\t)\r\n\t).locationPeriod\n\n/*First Inpatient Intensive Care Unit returns the first intensive care unit for\nthe given encounter, without considering any immediately prior emergency\ndepartment visit.*/\r\n\r\ndefine function \"First Inpatient Intensive Care Unit\"(Encounter \"Encounter, Performed\"):\r\n\tFirst((Encounter.facilityLocations)HospitalLocation\r\n\t\t\twhere HospitalLocation.code in \"Intensive Care Unit\"\r\n\t\t\t\tand HospitalLocation.locationPeriod during Encounter.relevantPeriod\r\n\t\t\tsort by start of locationPeriod\r\n\t)\r\n" ], "cql_statement_dependencies": { "PrimaryPCIReceivedWithin90MinutesofHospitalArrival": { "Patient": [ ], "SDE Ethnicity": [ ], "SDE Payer": [ ], "SDE Race": [ ], "SDE Sex": [ ], "Exception Procedures": [ ], "Inpatient Encounters": [ { "library_name": "MATGlobalCommonFunctions", "statement_name": "LengthInDays" } ], "Procedure Exceptions Within 90 Minutes of Arrival": [ { "library_name": "PrimaryPCIReceivedWithin90MinutesofHospitalArrival", "statement_name": "Inpatient Encounters" }, { "library_name": "PrimaryPCIReceivedWithin90MinutesofHospitalArrival", "statement_name": "Exception Procedures" }, { "library_name": "MATGlobalCommonFunctions", "statement_name": "Hospital Arrival Time" }, { "library_name": "MATGlobalCommonFunctions", "statement_name": "Hospital Arrival Time" } ], "Diagnosis Exception": [ { "library_name": "PrimaryPCIReceivedWithin90MinutesofHospitalArrival", "statement_name": "Inpatient Encounters" }, { "library_name": "MATGlobalCommonFunctions", "statement_name": "Hospitalization" }, { "library_name": "MATGlobalCommonFunctions", "statement_name": "Hospitalization" } ], "Denominator Exceptions": [ { "library_name": "PrimaryPCIReceivedWithin90MinutesofHospitalArrival", "statement_name": "Procedure Exceptions Within 90 Minutes of Arrival" }, { "library_name": "PrimaryPCIReceivedWithin90MinutesofHospitalArrival", "statement_name": "Diagnosis Exception" } ], "Diagnostic Electrocardiogram": [ ], "Fibrinolytic": [ ], "PCI Procedure": [ ], "AMI Encounter": [ { "library_name": "MATGlobalCommonFunctions", "statement_name": "CalendarAgeInYearsAt" } ], "Initial Population": [ { "library_name": "PrimaryPCIReceivedWithin90MinutesofHospitalArrival", "statement_name": "Inpatient Encounters" }, { "library_name": "PrimaryPCIReceivedWithin90MinutesofHospitalArrival", "statement_name": "AMI Encounter" } ], "Denominator": [ { "library_name": "PrimaryPCIReceivedWithin90MinutesofHospitalArrival", "statement_name": "Initial Population" }, { "library_name": "PrimaryPCIReceivedWithin90MinutesofHospitalArrival", "statement_name": "PCI Procedure" }, { "library_name": "MATGlobalCommonFunctions", "statement_name": "Hospital Arrival Time" }, { "library_name": "PrimaryPCIReceivedWithin90MinutesofHospitalArrival", "statement_name": "Diagnostic Electrocardiogram" }, { "library_name": "MATGlobalCommonFunctions", "statement_name": "Hospitalization" }, { "library_name": "MATGlobalCommonFunctions", "statement_name": "Hospital Arrival Time" }, { "library_name": "MATGlobalCommonFunctions", "statement_name": "Hospital Arrival Time" }, { "library_name": "MATGlobalCommonFunctions", "statement_name": "Hospital Arrival Time" }, { "library_name": "MATGlobalCommonFunctions", "statement_name": "Hospital Arrival Time" }, { "library_name": "PrimaryPCIReceivedWithin90MinutesofHospitalArrival", "statement_name": "Fibrinolytic" }, { "library_name": "MATGlobalCommonFunctions", "statement_name": "Hospital Arrival Time" } ], "Denominator Exclusions": [ { "library_name": "PrimaryPCIReceivedWithin90MinutesofHospitalArrival", "statement_name": "Denominator" } ], "Numerator": [ { "library_name": "PrimaryPCIReceivedWithin90MinutesofHospitalArrival", "statement_name": "Initial Population" }, { "library_name": "PrimaryPCIReceivedWithin90MinutesofHospitalArrival", "statement_name": "PCI Procedure" }, { "library_name": "MATGlobalCommonFunctions", "statement_name": "Hospital Arrival Time" }, { "library_name": "MATGlobalCommonFunctions", "statement_name": "Hospital Arrival Time" } ] }, "MATGlobalCommonFunctions": { "LengthInDays": [ ], "Hospital Arrival Time": [ { "library_name": "MATGlobalCommonFunctions", "statement_name": "Hospitalization Locations" } ], "Hospitalization Locations": [ ], "Hospitalization": [ ], "CalendarAgeInYearsAt": [ { "library_name": "MATGlobalCommonFunctions", "statement_name": "ToDate" } ], "ToDate": [ ] } }, "created_at": "2018-03-28T14:41:25.906Z", "data_criteria": { "EncounterInpatient_EncounterPerformed_8ee8cc7d_b1d8_4e88_b02c_6be2f448bbd7": { "title": "EncounterInpatient", "description": "Encounter, Performed: EncounterInpatient", "code_list_id": "2.16.840.1.113883.3.666.5.307", "type": "encounters", "definition": "encounter", "status": "performed", "hard_status": false, "negation": false, "source_data_criteria": "EncounterInpatient_EncounterPerformed_8ee8cc7d_b1d8_4e88_b02c_6be2f448bbd7_source", "variable": false }, "Payer_PatientCharacteristicPayer_ac8a015a_4827_4bd8_a4f2_450a5f462258": { "title": "Payer", "description": "Patient Characteristic Payer: Payer", "code_list_id": "2.16.840.1.114222.4.11.3591", "property": "payer", "type": "characteristic", "definition": "patient_characteristic_payer", "hard_status": false, "negation": false, "source_data_criteria": "Payer_PatientCharacteristicPayer_ac8a015a_4827_4bd8_a4f2_450a5f462258_source", "variable": false, "inline_code_list": { "Source of Payment Typology": [ "1", "11", "111", "112", "113", "119", "12", "121", "122", "123", "129", "13", "14", "19", "191", "2", "21", "211", "212", "213", "219", "22", "23", "24", "25", "26", "29", "291", "299", "3", "31", "311", "3111", "3112", "3113", "3114", "3115", "3116", "3119", "312", "3121", "3122", "3123", "313", "32", "321", "3211", "3212", "32121", "32122", "32123", "32124", "32125", "32126", "32127", "32128", "322", "3221", "3222", "3223", "3229", "33", "331", "332", "333", "334", "34", "341", "342", "343", "349", "35", "36", "361", "362", "369", "37", "371", "3711", "3712", "3713", "372", "379", "38", "381", "3811", "3812", "3813", "3819", "382", "389", "39", "391", "4", "41", "42", "43", "44", "5", "51", "511", "512", "513", "514", "515", "516", "517", "519", "52", "521", "522", "523", "524", "529", "53", "54", "55", "56", "561", "562", "59", "6", "61", "611", "612", "613", "614", "619", "62", "621", "622", "623", "629", "7", "71", "72", "73", "79", "8", "81", "82", "821", "822", "823", "83", "84", "85", "89", "9", "91", "92", 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"ref_id": "33" }, { "children": [ { "text": "\n union " } ] }, { "children": [ { "children": [ { "text": "[\"Procedure, Performed\": " } ] }, { "children": [ { "children": [ { "text": "\"Ventricular Assist Device placement\"" } ] } ] }, { "children": [ { "text": "]" } ] } ], "node_type": "Retrieve", "ref_id": "34" } ], "node_type": "Union", "ref_id": "35" }, { "children": [ { "text": "\n )" } ] } ], "node_type": "Union", "ref_id": "35" } ], "ref_id": "36" } ], "define_name": "Exception Procedures" }, { "children": [ { "children": [ { "children": [ { "text": "define \"Inpatient Encounters\":\n " } ] }, { "children": [ { "children": [ { "children": [ { "children": [ { "children": [ { "children": [ { "text": "[\"Encounter, Performed\": " } ] }, { "children": [ { "children": [ { "text": "\"Encounter Inpatient\"" } ] } ] }, { "children": [ { "text": "]" } ] } ], "node_type": "Retrieve", "ref_id": "37" } ], "node_type": "Retrieve", "ref_id": "37" }, { "children": [ { "text": " Encounter" } ] } ], "ref_id": "38" } ] }, { "children": [ { "text": "\n " } ] }, { "children": [ { "children": [ { "text": "where " } ] }, { "children": [ { "children": [ { "children": [ { "children": [ { "children": [ { "text": "Global" } ] } ], "ref_id": "39" }, { "children": [ { "text": "." } ] }, { "children": [ { "children": [ { "text": "\"LengthInDays\"(" } ] }, { "children": [ { "children": [ { "children": [ { "text": "Encounter" } ] } ], "ref_id": "40" }, { "children": [ { "text": "." } ] }, { "children": [ { "children": [ { "text": "relevantPeriod" } ] } ], "node_type": "Property", "ref_id": "41" } ], "node_type": "Property", "ref_id": "41" }, { "children": [ { "text": ")" } ] } ], "node_type": "FunctionRef", "ref_id": "42" } ], "node_type": "FunctionRef", "ref_id": "42" }, { "children": [ { "text": "<= 120" } ] } ], "node_type": "LessOrEqual", "ref_id": "44" }, { "children": [ { "text": "\n and " } ] }, { "children": [ { "children": [ { "children": [ { "children": [ { "text": "Encounter" } ] } ], "ref_id": "45" }, { "children": [ { "text": "." } ] }, { "children": [ { "children": [ { "text": "relevantPeriod" } ] } ], "node_type": "Property", "ref_id": "46" } ], "node_type": "Property", "ref_id": "46" }, { "children": [ { "text": " ends during " } ] }, { "children": [ { "children": [ { "text": "\"Measurement Period\"" } ] } ], "node_type": "ParameterRef", "ref_id": "47" } ], "node_type": "In", "ref_id": "48" } ], "ref_id": "49" } ], "ref_id": "49" } ], "node_type": "Query", "ref_id": "50" } ], "ref_id": "51" } ], "define_name": "Inpatient Encounters" }, { "children": [ { "children": [ { "children": [ { "text": "define \"Procedure Exceptions Within 90 Minutes of Arrival\":\n " } ] }, { "children": [ { "children": [ { "children": [ { "children": [ { "children": [ { "children": [ { "text": "\"Inpatient Encounters\"" } ] } ] } ], "node_type": "ExpressionRef", "ref_id": "52" }, { "children": [ { "text": " Encounter" } ] } ], "ref_id": "53" } ] }, { "children": [ { "text": "\n " } ] }, { "children": [ { "children": [ { "text": "with " } ] }, { "children": [ { "children": [ { "children": [ { "children": [ { "text": "\"Exception Procedures\"" } ] } ] } ], "node_type": "ExpressionRef", "ref_id": "54" }, { "children": [ { "text": " ExceptionProcedures" } ] } ], "ref_id": "55" }, { "children": [ { "text": "\n such that " } ] }, { "children": [ { "children": [ { "children": [ { "children": [ { "text": "ExceptionProcedures" } ] } ], "ref_id": "56" }, { "children": [ { "text": "." } ] }, { "children": [ { "children": [ { "text": "relevantPeriod" } ] } ], "node_type": "Property", "ref_id": "57" } ], "node_type": "Property", "ref_id": "57" }, { "children": [ { "text": " " } ] }, { "children": [ { "children": [ { "text": "starts " } ] }, { "children": [ { "children": [ { "text": "90 minutes" } ] } ], "node_type": "Quantity", "ref_id": "61" }, { "children": [ { "text": " or less on or after" } ] } ], "node_type": "In", "ref_id": "62" }, { "children": [ { "text": " " } ] }, { "children": [ { "children": [ { "children": [ { "text": "Global" } ] } ], "ref_id": "58" }, { "children": [ { "text": "." } ] }, { "children": [ { "children": [ { "text": "\"Hospital Arrival Time\"(" } ] }, { "children": [ { "children": [ { "text": "Encounter" } ] } ], "node_type": "AliasRef", "ref_id": "59" }, { "children": [ { "text": ")" } ] } ], "node_type": "FunctionRef", "ref_id": "60" } ], "node_type": "FunctionRef", "ref_id": "60" } ], "node_type": "In", "ref_id": "62" } ], "ref_id": "63" } ], "node_type": "Query", "ref_id": "64" } ], "ref_id": "65" } ], "define_name": "Procedure Exceptions Within 90 Minutes of Arrival" }, { "children": [ { "children": [ { "children": [ { "text": "define \"Diagnosis Exception\":\n " } ] }, { "children": [ { "children": [ { "children": [ { "children": [ { "children": [ { "children": [ { "text": "\"Inpatient Encounters\"" } ] } ] } ], "node_type": "ExpressionRef", "ref_id": "67" }, { "children": [ { "text": " Encounter" } ] } ], "ref_id": "68" } ] }, { "children": [ { "text": "\n " } ] }, { "children": [ { "children": [ { "text": "with " } ] }, { "children": [ { "children": [ { "children": [ { "children": [ { "text": "[\"Diagnosis\": " } ] }, { "children": [ { "children": [ { "text": "\"Cardiopulmonary arrest\"" } ] } ] }, { "children": [ { "text": "]" } ] } ], "node_type": "Retrieve", "ref_id": "69" } ], "node_type": "Retrieve", "ref_id": "69" }, { "children": [ { "text": " CardiacArrest" } ] } ], "ref_id": "70" }, { "children": [ { "text": "\n such that " } ] }, { "children": [ { "children": [ { "children": [ { "children": [ { "text": "CardiacArrest" } ] } ], "ref_id": "71" }, { "children": [ { "text": "." } ] }, { "children": [ { "children": [ { "text": "prevalencePeriod" } ] } ], "node_type": "Property", "ref_id": "72" } ], "node_type": "Property", "ref_id": "72" }, { "children": [ { "text": " " } ] }, { "children": [ { "children": [ { "text": "starts " } ] }, { "children": [ { "children": [ { "text": "90 minutes" } ] } ], "node_type": "Quantity", "ref_id": "77" }, { "children": [ { "text": " or less on or after" } ] } ], "node_type": "In", "ref_id": "78" }, { "children": [ { "text": " " } ] }, { "children": [ { "children": [ { "text": "start of " } ] }, { "children": [ { "children": [ { "children": [ { "text": "Global" } ] } ], "ref_id": "73" }, { "children": [ { "text": "." } ] }, { "children": [ { "children": [ { "text": "Hospitalization(" } ] }, { "children": [ { "children": [ { "text": "Encounter" } ] } ], "node_type": "AliasRef", "ref_id": "74" }, { "children": [ { "text": ")" } ] } ], "node_type": "FunctionRef", "ref_id": "75" } ], "node_type": "FunctionRef", "ref_id": "75" } ], "node_type": "Start", "ref_id": "76" } ], "node_type": "In", "ref_id": "78" } ], "ref_id": "79" } ], "node_type": "Query", "ref_id": "80" } ], "ref_id": "81" } ], "define_name": "Diagnosis Exception" }, { "children": [ { "children": [ { "children": [ { "text": "define \"Denominator Exceptions\":\n " } ] }, { "children": [ { "children": [ { "text": "( " } ] }, { "children": [ { "children": [ { "children": [ { "text": "\"Procedure Exceptions Within 90 Minutes of Arrival\"" } ] } ], "node_type": "ExpressionRef", "ref_id": "66" }, { "children": [ { "text": "\n union " } ] }, { "children": [ { "children": [ { "text": "\"Diagnosis Exception\"" } ] } ], "node_type": "ExpressionRef", "ref_id": "82" } ], "node_type": "Union", "ref_id": "83" }, { "children": [ { "text": "\n )" } ] } ], "node_type": "Union", "ref_id": "83" } ], "ref_id": "84" } ], "define_name": "Denominator Exceptions" }, { "children": [ { "children": [ { "children": [ { "text": "define \"Diagnostic Electrocardiogram\":\n " } ] }, { "children": [ { "children": [ { "text": "[\"Diagnostic Study, Performed\": " } ] }, { "children": [ { "children": [ { "text": "\"Electrocardiogram (ECG)\"" } ] } ] }, { "children": [ { "text": "]" } ] } ], "node_type": "Retrieve", "ref_id": "85" } ], "ref_id": "86" } ], "define_name": "Diagnostic 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"children": [ { "children": [ { "text": "BirthDate" } ] } ], "ref_id": "97" }, { "children": [ { "text": "." } ] }, { "children": [ { "children": [ { "text": "birthDatetime" } ] } ], "node_type": "Property", "ref_id": "98" } ], "node_type": "Property", "ref_id": "98" }, { "children": [ { "text": ", " } ] }, { "children": [ { "children": [ { "text": "start of " } ] }, { "children": [ { "children": [ { "children": [ { "text": "Encounter" } ] } ], "ref_id": "99" }, { "children": [ { "text": "." } ] }, { "children": [ { "children": [ { "text": "relevantPeriod" } ] } ], "node_type": "Property", "ref_id": "100" } ], "node_type": "Property", "ref_id": "100" } ], "node_type": "Start", "ref_id": "101" }, { "children": [ { "text": ")" } ] } ], "node_type": "FunctionRef", "ref_id": "102" } ], "node_type": "FunctionRef", "ref_id": "102" }, { "children": [ { "text": ">= 18" } ] } ], "node_type": "GreaterOrEqual", "ref_id": "104" }, { "children": [ { "text": "\n and " } ] }, { "children": [ { "children": [ { "children": [ { "children": [ { "text": "Encounter" } ] } ], "ref_id": "105" }, { "children": [ { "text": "." } ] }, { "children": [ { "children": [ { "text": "principalDiagnosis" } ] } ], "ref_id": "106" } ], "ref_id": "106" }, { "children": [ { "text": " in " } ] }, { "children": [ { "children": [ { "text": "\"Acute or Evolving MI\"" } ] } ], "ref_id": "107" } ], "node_type": "InValueSet", "ref_id": "108" } ], "node_type": "And", "ref_id": "109" } ], "ref_id": "110" } ], "node_type": "Query", "ref_id": "111" } ], "ref_id": "112" } ], "define_name": "AMI Encounter" }, { "children": [ { "children": [ { "children": [ { "text": "define \"Initial Population\":\n " } ] }, { "children": [ { "children": [ { "children": [ { "text": "\"Inpatient Encounters\"" } ] } ], "node_type": "ExpressionRef", "ref_id": "91" }, { "children": [ { "text": "\n intersect " } ] }, { "children": [ { "children": [ { "text": "\"AMI Encounter\"" } ] } ], "node_type": "ExpressionRef", "ref_id": "113" } ], "node_type": "Intersect", "ref_id": "114" } ], "ref_id": "115" } ], "define_name": "Initial Population" }, { "children": [ { "children": [ { "children": [ { "text": "define \"Denominator\":\n " } ] }, { "children": [ { "children": [ { "children": [ { "children": [ { "children": [ { "children": [ { "text": "\"Initial Population\"" } ] } ] } ], "node_type": "ExpressionRef", "ref_id": "116" }, { "children": [ { "text": " QualifyingEncounter" } ] } ], "ref_id": "117" } ] }, { "children": [ { "text": "\n " } ] }, { "children": [ { "children": [ { "text": "let " } ] }, { "children": [ { "children": [ { "text": "FirstPCI: " } ] }, { "children": [ { "children": [ { "text": "First(" } ] }, { "children": [ { "children": [ { "children": [ { "children": [ { "children": [ { "children": [ { "text": "\"PCI Procedure\"" } ] } ] } ], "node_type": "ExpressionRef", "ref_id": "118" }, { "children": [ { "text": " FirstPCI" } ] } ], "ref_id": "119" } ] }, { "children": [ { "text": "\n " } ] }, { "children": [ { "children": [ { "text": "where " } ] }, { "children": [ { "children": [ { "children": [ { "children": [ { "text": "FirstPCI" } ] } ], "ref_id": "120" }, { "children": [ { "text": "." } ] }, { "children": [ { "children": [ { "text": "relevantPeriod" } ] } ], "node_type": "Property", "ref_id": "121" } ], "node_type": "Property", "ref_id": "121" }, { "children": [ { "text": " starts on or after " } ] }, { "children": [ { "children": [ { "children": [ { "text": "Global" } ] } ], "ref_id": "122" }, { "children": [ { "text": "." } ] }, { "children": [ { "children": [ { "text": "\"Hospital Arrival Time\"(" } ] }, { "children": [ { "children": [ { "text": "QualifyingEncounter" } ] } ], "node_type": "AliasRef", "ref_id": "123" }, { "children": [ { "text": ")" } ] } ], "node_type": "FunctionRef", "ref_id": "124" } ], "node_type": "FunctionRef", "ref_id": "124" } ], "ref_id": "125" } ], "ref_id": "125" }, { "children": [ { "text": "\n " } ] }, { "children": [ { "children": [ { 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"value": "53", "name": "eCQM Identifier (Measure Authoring Tool)", "code_obj": { "type": "CD", "null_flavor": "OTH", "original_text": "eCQM Identifier (Measure Authoring Tool)" }, "value_obj": { "type": "ED", "value": "53", "media_type": "text/plain" } }, { "code": "OTH", "value": "Not Applicable", "name": "NQF Number", "code_obj": { "type": "CD", "null_flavor": "OTH", "original_text": "NQF Number" }, "value_obj": { "type": "ED", "value": "Not Applicable", "media_type": "text/plain" } }, { "code": "COPY", "value": "Measure specifications are in the Public Domain.\n\nThis material contains SNOMED Clinical Terms (R) (SNOMED CT(C)) copyright 2004-2017 International Health Terminology Standards Development Organization. All rights reserved.\n\nLOINC (R) is a registered trademark of the Regenstrief Institute.", "name": "Copyright", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "COPY", "title": "Copyright" }, "value_obj": { "type": "ED", "value": "Measure specifications are in the Public Domain.\n\nThis material contains SNOMED Clinical Terms (R) (SNOMED CT(C)) copyright 2004-2017 International Health Terminology Standards Development Organization. All rights reserved.\n\nLOINC (R) is a registered trademark of the Regenstrief Institute.", "media_type": "text/plain" } }, { "code": "DISC", "value": "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 without warranty. CMS has contracted with Mathematica Policy Research and its subcontractors, Lantana and Telligen, for the continued maintenance of this electronic measure.", "name": "Disclaimer", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "DISC", "title": "Disclaimer" }, "value_obj": { "type": "ED", "value": "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 without warranty. CMS has contracted with Mathematica Policy Research and its subcontractors, Lantana and Telligen, for the continued maintenance of this electronic measure.", "media_type": "text/plain" } }, { "code": "MSRSCORE", "name": "Measure Scoring", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "MSRSCORE", "title": "Measure Scoring" }, "value_obj": { "type": "CD", "system": "2.16.840.1.113883.1.11.20367", "code": "PROPOR", "title": "Proportion" } }, { "code": "MSRTYPE", "name": "Measure Type", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "MSRTYPE", "title": "Measure Type" }, "value_obj": { "type": "CD", "system": "2.16.840.1.113883.1.11.20368", "code": "PROCESS", "title": "PROCESS" } }, { "code": "STRAT", "value": "None", "name": "Stratification", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "STRAT", "title": "Stratification" }, "value_obj": { "type": "ED", "value": "None", "media_type": "text/plain" } }, { "code": "MSRADJ", "value": "None", "name": "Risk Adjustment", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "MSRADJ", "title": "Risk Adjustment" }, "value_obj": { "type": "ED", "value": "None", "media_type": "text/plain" } }, { "code": "MSRAGG", "value": "None", "name": "Rate Aggregation", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "MSRAGG", "title": "Rate Aggregation" }, "value_obj": { "type": "ED", "value": "None", "media_type": "text/plain" } }, { "code": "RAT", "value": "The early use of primary angioplasty in patients with ST-segment myocardial infarction (STEMI) results in a significant reduction in mortality and morbidity. The earlier primary coronary intervention is provided, the more effective it is (Brodie, 1998 and DeLuca, 2004). National guidelines recommend the prompt initiation of PCI in patients presenting with ST-elevation myocardial infarction (O'Gara, 2013; and Levine 2011).", "name": "Rationale", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "RAT", "title": "Rationale" }, "value_obj": { "type": "ED", "value": "The early use of primary angioplasty in patients with ST-segment myocardial infarction (STEMI) results in a significant reduction in mortality and morbidity. The earlier primary coronary intervention is provided, the more effective it is (Brodie, 1998 and DeLuca, 2004). National guidelines recommend the prompt initiation of PCI in patients presenting with ST-elevation myocardial infarction (O'Gara, 2013; and Levine 2011).", "media_type": "text/plain" } }, { "code": "CRS", "value": "National guidelines recommend the prompt initiation of PCI in patients presenting with ST-elevation myocardial infarction", "name": "Clinical Recommendation Statement", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "CRS", "title": "Clinical Recommendation Statement" }, "value_obj": { "type": "ED", "value": "National guidelines recommend the prompt initiation of PCI in patients presenting with ST-elevation myocardial infarction", "media_type": "text/plain" } }, { "code": "IDUR", "value": "Improvement noted as an increase in rate", "name": "Improvement Notation", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "IDUR", "title": "Improvement Notation" }, "value_obj": { "type": "ED", "value": "Improvement noted as an increase in rate", "media_type": "text/plain" } }, { "code": "REF", "value": "Brodie BR, Stuckey TD, Wall TC, Kissling G, Hansen CJ, Muncy DB, et al. Importance of time to reperfusion for 30-day and late survival and recovery of left ventricular function after primary angioplasty for acute myocardial infarction. J Am Coll Cardiol. 1998;32:1312-9.", "name": "Reference", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "REF", "title": "Reference" }, "value_obj": { "type": "ED", "value": "Brodie BR, Stuckey TD, Wall TC, Kissling G, Hansen CJ, Muncy DB, et al. Importance of time to reperfusion for 30-day and late survival and recovery of left ventricular function after primary angioplasty for acute myocardial infarction. J Am Coll Cardiol. 1998;32:1312-9.", "media_type": "text/plain" } }, { "code": "REF", "value": "DeLuca G, Suryapranata H, Ottervanger JP, Antman EM. Time delay to treatment and mortality in primary angioplasty for acute myocardial infarction: every minute of delay counts. Circulation 2004;109(10):1223-1225.", "name": "Reference", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "REF", "title": "Reference" }, "value_obj": { "type": "ED", "value": "DeLuca G, Suryapranata H, Ottervanger JP, Antman EM. Time delay to treatment and mortality in primary angioplasty for acute myocardial infarction: every minute of delay counts. Circulation 2004;109(10):1223-1225.", "media_type": "text/plain" } }, { "code": "REF", "value": "Krumholz HM, Anderson JL, Bachelder BL, Fesmire FM, Fihn SD, Foody JM, et al. ACC/AHA 2008 performance measures for adults with ST-elevation and non-ST-elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Performance Measures (Writing Committee to Develop Performance Measures for ST-Elevation and Non-ST-Elevation Myocardial Infarction). J Am Coll Cardiol. 2008;52:2046-99.", "name": "Reference", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "REF", "title": "Reference" }, "value_obj": { "type": "ED", "value": "Krumholz HM, Anderson JL, Bachelder BL, Fesmire FM, Fihn SD, Foody JM, et al. ACC/AHA 2008 performance measures for adults with ST-elevation and non-ST-elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Performance Measures (Writing Committee to Develop Performance Measures for ST-Elevation and Non-ST-Elevation Myocardial Infarction). J Am Coll Cardiol. 2008;52:2046-99.", "media_type": "text/plain" } }, { "code": "REF", "value": "Levine GN, Bates ER, Blankenship JC, Bailey SR, Bittl JA, Cercek B, et al. 2011 ACCF/AHA/SCAI guideline for percutaneous coronary intervention: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions. J Am Coll Cardiol. 2011;58:e44-122.", "name": "Reference", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "REF", "title": "Reference" }, "value_obj": { "type": "ED", "value": "Levine GN, Bates ER, Blankenship JC, Bailey SR, Bittl JA, Cercek B, et al. 2011 ACCF/AHA/SCAI guideline for percutaneous coronary intervention: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions. J Am Coll Cardiol. 2011;58:e44-122.", "media_type": "text/plain" } }, { "code": "REF", "value": "O'Gara PT, Kushner FG, Ascheim DD, Casey DE, Jr, Chung MK, de Lemos JA, et al. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2013;61:485-510.", "name": "Reference", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "REF", "title": "Reference" }, "value_obj": { "type": "ED", "value": "O'Gara PT, Kushner FG, Ascheim DD, Casey DE, Jr, Chung MK, de Lemos JA, et al. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2013;61:485-510.", "media_type": "text/plain" } }, { "code": "DEF", "value": "None", "name": "Definition", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "DEF", "title": "Definition" }, "value_obj": { "type": "ED", "value": "None", "media_type": "text/plain" } }, { "code": "GUIDE", "value": "To identify the ECG closest to hospital arrival, the denominator will identify the most recent ECG performed that starts less than 1 hour prior to the emergency department (ED) or inpatient encounter OR the first ECG performed starts after the ED or inpatient encounter started.\n\nPCI procedures analyzed in this measure must be primary procedures. Primary includes emergent or urgent PCI procedures and not those described by the physician/APN/PA anywhere in the record as elective, not emergent, not immediate, not primary, not urgent, or secondary.\n\nFrom a clinical standpoint, Primary PCI is loosely defined as percutaneous coronary intervention performed in the acute setting in patients with ST-segment elevation MI which is intended to restore perfusion in the infarct-related artery.", "name": "Guidance", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "GUIDE", "title": "Guidance" }, "value_obj": { "type": "ED", "value": "To identify the ECG closest to hospital arrival, the denominator will identify the most recent ECG performed that starts less than 1 hour prior to the emergency department (ED) or inpatient encounter OR the first ECG performed starts after the ED or inpatient encounter started.\n\nPCI procedures analyzed in this measure must be primary procedures. Primary includes emergent or urgent PCI procedures and not those described by the physician/APN/PA anywhere in the record as elective, not emergent, not immediate, not primary, not urgent, or secondary.\n\nFrom a clinical standpoint, Primary PCI is loosely defined as percutaneous coronary intervention performed in the acute setting in patients with ST-segment elevation MI which is intended to restore perfusion in the infarct-related artery.", "media_type": "text/plain" } }, { "code": "TRANF", "value": "TBD", "name": "Transmission Format", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "TRANF", "title": "Transmission Format" }, "value_obj": { "type": "ED", "value": "TBD", "media_type": "text/plain" } }, { "code": "IPOP", "value": "Patients age 18 and older at the time of hospital admission with a principal diagnosis of an Acute or Evolving Myocardial Infarction (ST-segment elevation MI) with hospital stays <= 120 days during the measurement period", "name": "Initial Population", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "IPOP", "title": "Initial Population" }, "value_obj": { "type": "ED", "value": "Patients age 18 and older at the time of hospital admission with a principal diagnosis of an Acute or Evolving Myocardial Infarction (ST-segment elevation MI) with hospital stays <= 120 days during the measurement period", "media_type": "text/plain" } }, { "code": "DENOM", "value": "Initial population with an ECG performed and a primary PCI procedure closest to the inpatient admission that does not start after fibrinolytic therapy", "name": "Denominator", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "DENOM", "title": "Denominator" }, "value_obj": { "type": "ED", "value": "Initial population with an ECG performed and a primary PCI procedure closest to the inpatient admission that does not start after fibrinolytic therapy", "media_type": "text/plain" } }, { "code": "DENEX", "value": "Patients who transferred from another hospital's inpatient, outpatient, or emergency department and ambulatory surgery center facilities are excluded", "name": "Denominator Exclusions", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "DENEX", "title": "Denominator Exclusions" }, "value_obj": { "type": "ED", "value": "Patients who transferred from another hospital's inpatient, outpatient, or emergency department and ambulatory surgery center facilities are excluded", "media_type": "text/plain" } }, { "code": "NUMER", "value": "Initial population whose time from hospital arrival to primary PCI is 90 minutes or less", "name": "Numerator", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "NUMER", "title": "Numerator" }, "value_obj": { "type": "ED", "value": "Initial population whose time from hospital arrival to primary PCI is 90 minutes or less", "media_type": "text/plain" } }, { "code": "NUMEX", "value": "Not applicable", "name": "Numerator Exclusions", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "NUMEX", "title": "Numerator Exclusions" }, "value_obj": { "type": "ED", "value": "Not applicable", "media_type": "text/plain" } }, { "code": "DENEXCEP", "value": "Patients who did not receive PCI within 90 minutes and have a documented reason. Documented reasons include:\n\"Diagnosis: Cardiopulmonary arrest\"\n\"Procedure, Performed: Endotracheal Intubation\"\n\"Procedure, Performed: Aortic balloon pump insertion\"\n\"Procedure, Performed: Ventricular Assist Device placement\"", "name": "Denominator Exceptions", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "DENEXCEP", "title": "Denominator Exceptions" }, "value_obj": { "type": "ED", "value": "Patients who did not receive PCI within 90 minutes and have a documented reason. Documented reasons include:\n\"Diagnosis: Cardiopulmonary arrest\"\n\"Procedure, Performed: Endotracheal Intubation\"\n\"Procedure, Performed: Aortic balloon pump insertion\"\n\"Procedure, Performed: Ventricular Assist Device placement\"", "media_type": "text/plain" } }, { "code": "SDE", "value": "For every patient evaluated by this measure also identify payer, race, ethnicity, and sex", "name": "Supplemental Data Elements", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "SDE", "title": "Supplemental Data Elements" }, "value_obj": { "type": "ED", "value": "For every patient evaluated by this measure also identify payer, race, ethnicity, and sex", "media_type": "text/plain" } } ], "measure_id": "40280382-610B-E7A4-0161-BE5CF659426C", "measure_period": { "type": "IVL_TS", "low": { "type": "TS", "value": "201201010000", "inclusive?": true, "derived?": false }, "high": { "type": "TS", "value": "201212312359", "inclusive?": true, "derived?": false }, "width": { "type": "PQ", "unit": "a", "value": "1", "inclusive?": true, "derived?": false } }, "needs_finalize": false, "observations": [ ], "population_criteria": { "IPP": { "conjunction?": true, "type": "IPP", "hqmf_id": "EAF94835-9BC5-467F-B055-40C923D82F7C", "preconditions": [ { "id": 2, "preconditions": [ { "id": 1, "reference": "PrimaryPCIReceivedWithin90MinutesofHospitalArrival__Initial_Population__77D9529E_CE08_41CE_85A6_5186E1E5D7D2" } ], "conjunction_code": "allTrue" } ] }, "DENOM": { "conjunction?": true, "type": "DENOM", "hqmf_id": "6E0F1E96-06BA-4BC2-885F-2FB247B41E8B", "preconditions": [ { "id": 4, "preconditions": [ { "id": 3, "reference": "PrimaryPCIReceivedWithin90MinutesofHospitalArrival__Denominator__77D9529E_CE08_41CE_85A6_5186E1E5D7D2" } ], "conjunction_code": "allTrue" } ] }, "NUMER": { "conjunction?": true, "type": "NUMER", "hqmf_id": "4681B8EB-4083-47AC-A7DE-9102482BACFD", "preconditions": [ { "id": 6, "preconditions": [ { "id": 5, "reference": "PrimaryPCIReceivedWithin90MinutesofHospitalArrival__Numerator__77D9529E_CE08_41CE_85A6_5186E1E5D7D2" } ], "conjunction_code": "allTrue" } ] }, "DENEXCEP": { "conjunction?": true, "type": "DENEXCEP", "hqmf_id": "4698D4AA-4E2E-4910-AB68-1C889690FEBE", "preconditions": [ { "id": 8, "preconditions": [ { "id": 7, "reference": "PrimaryPCIReceivedWithin90MinutesofHospitalArrival__Denominator_Exceptions__77D9529E_CE08_41CE_85A6_5186E1E5D7D2" } ], "conjunction_code": "atLeastOneTrue" } ] }, "DENEX": { "conjunction?": true, "type": "DENEX", "hqmf_id": "BC6ABA5A-EF35-4ED9-A6FB-2A7B0AB77C2E", "preconditions": [ { "id": 10, "preconditions": [ { "id": 9, "reference": "PrimaryPCIReceivedWithin90MinutesofHospitalArrival__Denominator_Exclusions__77D9529E_CE08_41CE_85A6_5186E1E5D7D2" } ], "conjunction_code": "atLeastOneTrue" } ] } }, "populations": [ { "IPP": "IPP", "DENOM": "DENOM", "NUMER": "NUMER", "DENEXCEP": "DENEXCEP", "DENEX": "DENEX", "id": "PopulationCriteria1", "title": "Population Criteria Section" } ], "populations_cql_map": { "IPP": [ "Initial Population" ], "DENOM": [ "Denominator" ], "DENEX": [ "Denominator Exclusions" ], "DENEXCEP": [ "Denominator Exceptions" ], "NUMER": [ "Numerator" ] }, "publish_date": null, "published": null, "record_ids": [ ], "source_data_criteria": { "EncounterInpatient_EncounterPerformed_8ee8cc7d_b1d8_4e88_b02c_6be2f448bbd7_source": { "title": "EncounterInpatient", "description": "Encounter, Performed: EncounterInpatient", "code_list_id": "2.16.840.1.113883.3.666.5.307", "type": "encounters", "definition": "encounter", "status": "performed", "hard_status": false, "negation": false, "source_data_criteria": "EncounterInpatient_EncounterPerformed_8ee8cc7d_b1d8_4e88_b02c_6be2f448bbd7_source", "variable": false }, "Payer_PatientCharacteristicPayer_ac8a015a_4827_4bd8_a4f2_450a5f462258_source": { "title": "Payer", "description": "Patient Characteristic Payer: Payer", "code_list_id": "2.16.840.1.114222.4.11.3591", "property": "payer", "type": "characteristic", "definition": "patient_characteristic_payer", "hard_status": false, "negation": false, "source_data_criteria": "Payer_PatientCharacteristicPayer_ac8a015a_4827_4bd8_a4f2_450a5f462258_source", "variable": false, "inline_code_list": { "Source of Payment Typology": [ "1", "11", "111", "112", "113", "119", "12", "121", "122", "123", "129", "13", "14", "19", "191", "2", "21", "211", "212", "213", "219", "22", "23", "24", "25", "26", "29", "291", "299", "3", "31", "311", "3111", "3112", "3113", "3114", "3115", "3116", "3119", "312", "3121", "3122", "3123", "313", "32", "321", "3211", "3212", "32121", "32122", "32123", "32124", "32125", "32126", "32127", "32128", "322", "3221", "3222", "3223", "3229", "33", "331", "332", "333", "334", "34", "341", "342", "343", "349", "35", "36", "361", "362", "369", "37", "371", "3711", "3712", "3713", "372", "379", "38", "381", "3811", "3812", "3813", "3819", "382", "389", "39", "391", "4", "41", "42", "43", "44", "5", "51", "511", "512", 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