{ "_id": "59cbe36b942c6d4064001bf3", "bundle_id": "578565956c5d1c3d49000007", "category": "Miscellaneous", "cms_id": "CMS107v6", "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": "Encounter With Discharge Status of Discharge To Home Or Police Custody", "complexity": 1 }, { "name": "Intervention Comfort Measures", "complexity": 1 }, { "name": "Comfort Measures During Hospitalization", "complexity": 1 }, { "name": "Denominator", "complexity": 1 }, { "name": "Denominator Exclusions", "complexity": 1 }, { "name": "Initial Population", "complexity": 1 }, { "name": "Written Information Not Given", "complexity": 1 }, { "name": "Written Information Not Done During IP", "complexity": 1 }, { "name": "Numerator", "complexity": 1 }, { "name": "Patient", "complexity": 1 }, { "name": "ToDate", "complexity": 1 }, { "name": "CalendarAgeInYearsAt", "complexity": 1 }, { "name": "CalendarAgeInMonthsAt", "complexity": 1 }, { "name": "CalendarAgeInDaysAt", "complexity": 1 }, { "name": "CalendarAgeInYears", "complexity": 1 }, { "name": "CalendarAgeInMonths", "complexity": 1 }, { "name": "CalendarAgeInDays", "complexity": 1 }, { "name": "TotalLengthOfStay", "complexity": 1 }, { "name": "Hospitalization", "complexity": 0 }, { "name": "LengthInDays", "complexity": 1 }, { "name": "Patient", "complexity": 1 }, { "name": "Non Elective Inpatient Encounter", "complexity": 2 }, { "name": "Encounter with Principal Diagnosis of Hemorrhagic or Ischemic Stroke", "complexity": 2 }, { "name": "Encounter with Principal Diagnosis and Age", "complexity": 1 }, { "name": "Encounter with Principal Diagnosis of Ischemic Stroke", "complexity": 1 }, { "name": "Inpatient Encounter", "complexity": 2 }, { "name": "Ischemic Stroke Encounters with Discharge Status and Comfort Measure Exclusions", "complexity": 1 } ] }, "continuous_variable": false, "cql": [ "library StrokeEducation version '6.1.011'\r\n\r\nusing QDM version '5.3'\r\n\r\ninclude TJC_Overall version '7.0.000' called TJC\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 \"Activation of Emergency Medical System Education\": 'urn:oid:2.16.840.1.113883.3.117.1.7.1.377'\r\nvalueset \"Comfort Measures\": 'urn:oid:1.3.6.1.4.1.33895.1.3.0.45'\r\nvalueset \"Discharge To Home Or Police Custody\": 'urn:oid:2.16.840.1.113883.3.117.1.7.1.82'\r\nvalueset \"Instructions for Follow Up After Discharge\": 'urn:oid:2.16.840.1.113883.3.117.1.7.1.378'\r\nvalueset \"Patient Refusal\": 'urn:oid:2.16.840.1.113883.3.117.1.7.1.93'\r\nvalueset \"Prescribed Medications Education\": 'urn:oid:2.16.840.1.113883.3.117.1.7.1.379'\r\nvalueset \"Risk Factors Education\": 'urn:oid:2.16.840.1.113883.3.117.1.7.1.380'\r\nvalueset \"Warning Signs and Symptoms Education\": 'urn:oid:2.16.840.1.113883.3.117.1.7.1.381'\r\nvalueset \"Written Information Given\": 'urn:oid:2.16.840.1.113883.3.117.1.7.1.415'\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 \"Comfort Measures During Hospitalization\":\r\n\t\"Encounter With Discharge Status of Discharge To Home Or Police Custody\" A\r\n\t\twith \"Intervention Comfort Measures\" B\r\n\t\t\tsuch that Coalesce(start of B.relevantPeriod, B.authorDatetime)during Global.\"Hospitalization\"(A)\r\n\r\ndefine \"Denominator\":\r\n\t\"Encounter With Discharge Status of Discharge To Home Or Police Custody\"\r\n\r\ndefine \"Denominator Exclusions\":\r\n\t\"Comfort Measures During Hospitalization\"\r\n\r\ndefine \"Encounter With Discharge Status of Discharge To Home Or Police Custody\":\r\n\tTJC.\"Encounter with Principal Diagnosis and Age\" A\r\n\t\twhere A.dischargeDisposition in \"Discharge To Home Or Police Custody\"\r\n\r\ndefine \"Initial Population\":\r\n\tTJC.\"Encounter with Principal Diagnosis and Age\"\r\n\r\ndefine \"Intervention Comfort Measures\":\r\n\t[\"Intervention, Order\": \"Comfort Measures\"]\r\n\t\tunion [\"Intervention, Performed\": \"Comfort Measures\"]\r\n\r\ndefine \"Numerator\":\r\n\tdistinct((((\"Encounter With Discharge Status of Discharge To Home Or Police Custody\" A\r\n\t\t\t\t\t\twith [\"Communication: From Provider To Patient\": \"Activation of Emergency Medical System Education\"] B\r\n\t\t\t\t\t\t\tsuch that B.authorDatetime during A.relevantPeriod\r\n\t\t\t\t)\r\n\t\t\t\t\tintersect(\"Encounter With Discharge Status of Discharge To Home Or Police Custody\" A\r\n\t\t\t\t\t\t\twith [\"Communication: From Provider To Patient\": \"Instructions for Follow Up After Discharge\"] C\r\n\t\t\t\t\t\t\t\tsuch that C.authorDatetime during A.relevantPeriod\r\n\t\t\t\t\t)\r\n\t\t\t\t\tintersect(\"Encounter With Discharge Status of Discharge To Home Or Police Custody\" A\r\n\t\t\t\t\t\t\twith [\"Communication: From Provider To Patient\": \"Prescribed Medications Education\"] D\r\n\t\t\t\t\t\t\t\tsuch that D.authorDatetime during A.relevantPeriod\r\n\t\t\t\t\t)\r\n\t\t\t\t\tintersect(\"Encounter With Discharge Status of Discharge To Home Or Police Custody\" A\r\n\t\t\t\t\t\t\twith [\"Communication: From Provider To Patient\": \"Risk Factors Education\"] E\r\n\t\t\t\t\t\t\t\tsuch that E.authorDatetime during A.relevantPeriod\r\n\t\t\t\t\t)\r\n\t\t\t\t\tintersect(\"Encounter With Discharge Status of Discharge To Home Or Police Custody\" A\r\n\t\t\t\t\t\t\twith [\"Communication: From Provider To Patient\": \"Warning Signs and Symptoms Education\"] F\r\n\t\t\t\t\t\t\t\tsuch that F.authorDatetime during A.relevantPeriod\r\n\t\t\t\t\t)\r\n\t\t\t\t\tintersect(\"Encounter With Discharge Status of Discharge To Home Or Police Custody\" A\r\n\t\t\t\t\t\t\twith [\"Communication: From Provider To Patient\": \"Written Information Given\"] G\r\n\t\t\t\t\t\t\t\tsuch that G.authorDatetime during A.relevantPeriod\r\n\t\t\t\t\t)\r\n\t\t\t\t\tunion(\"Written Information Not Done During IP\")\r\n\t\t\t)\r\n\t\t)\r\n\t)\r\n\r\ndefine \"Written Information Not Done During IP\":\r\n\t\"Encounter With Discharge Status of Discharge To Home Or Police Custody\" E\r\n\t\twith \"Written Information Not Given\" W\r\n\t\t\tsuch that W.authorDatetime during E.relevantPeriod\r\n\r\ndefine \"Written Information Not Given\":\r\n\t[\"Communication: From Provider To Patient, Not Done\": \"Written Information Given\"] W\r\n\t\twhere W.negationRationale in \"Patient Refusal\"\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\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\n\n/*CalendarAgeInYearsAt calculates the calendar age (meaning the age without\nconsidering 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/*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/*CalendarAgeInDaysAt calculates the calendar age (meaning the age without\nconsidering 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/*CalendarAgeInYears calculates the calendar age (meaning the age without\nconsidering time components) in years as of today.*/\r\n\r\ndefine function \"CalendarAgeInYears\"(BirthDateTime DateTime):\r\n\tCalendarAgeInYearsAt(BirthDateTime, Today())\n\n/*CalendarAgeInMonths calculates the calendar age (meaning the age without\nconsidering time components) in months as of today.*/\r\n\r\ndefine function \"CalendarAgeInMonths\"(BirthDateTime DateTime):\r\n\tCalendarAgeInMonthsAt(BirthDateTime, Today())\n\n/*CalendarAgeInDays calculates the calendar age (meaning the age without\nconsidering time components) in days as of today.*/\r\n\r\ndefine function \"CalendarAgeInDays\"(BirthDateTime DateTime):\r\n\tCalendarAgeInDaysAt(BirthDateTime, Today())\n\n/*TotalLengthOfStay calculates the difference in calendar days between the\nstart and end of the given stay interval.*/\r\n\r\ndefine function \"TotalLengthOfStay\"(Stay Interval):\r\n\tdifference in days between start of Stay and end of Stay\n\n/*Hospitalization returns the total interval for admission to discharge for\nthe given encounter, or for the admission of any immediately prior emergency \ndepartment 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/*ToDate takes a given DateTime value and returns a DateTime with the time components \"zeroed\", and the timezone of the input value. For example,\ngiven the DateTime @2012-01-01T06:30:00.0Z, this function will return\n@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/*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\r\n", "library TJC_Overall version '7.0.000'\r\n\r\nusing QDM version '5.3'\r\n\r\ninclude MATGlobalCommonFunctions version '2.0.000' called global\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 \"Encounter Inpatient\": 'urn:oid:2.16.840.1.113883.3.666.5.307'\r\nvalueset \"Non-Elective Inpatient Encounter\": 'urn:oid:2.16.840.1.113883.3.117.1.7.1.424'\r\nvalueset \"Ischemic Stroke\": 'urn:oid:2.16.840.1.113883.3.117.1.7.1.247'\r\nvalueset \"Hemorrhagic Stroke\": 'urn:oid:2.16.840.1.113883.3.117.1.7.1.212'\r\nvalueset \"Comfort Measures\": 'urn:oid:1.3.6.1.4.1.33895.1.3.0.45'\r\nvalueset \"Emergency Department Visit\": 'urn:oid:2.16.840.1.113883.3.117.1.7.1.292'\r\nvalueset \"Left Against Medical Advice\": 'urn:oid:2.16.840.1.113883.3.117.1.7.1.308'\r\nvalueset \"Discharged to Health Care Facility for Hospice Care\": 'urn:oid:2.16.840.1.113883.3.117.1.7.1.207'\r\nvalueset \"Patient Expired\": 'urn:oid:2.16.840.1.113883.3.117.1.7.1.309'\r\nvalueset \"Discharge To Acute Care Facility\": 'urn:oid:2.16.840.1.113883.3.117.1.7.1.87'\r\nvalueset \"Discharged to Home for Hospice Care\": 'urn:oid:2.16.840.1.113883.3.117.1.7.1.209'\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 with Principal Diagnosis and Age\":\r\n\t\"Encounter with Principal Diagnosis of Hemorrhagic or Ischemic Stroke\" NonElectiveEncounter\r\n\t\twith [\"Patient Characteristic Birthdate\"] P\r\n\t\t\tsuch that global.\"CalendarAgeInYearsAt\"(P.birthDatetime, start of NonElectiveEncounter.relevantPeriod)>= 18\r\n\r\ndefine \"Encounter with Principal Diagnosis of Hemorrhagic or Ischemic Stroke\":\r\n\t\"Non Elective Inpatient Encounter\" NonElectiveEncounter\r\n\t\twhere NonElectiveEncounter.principalDiagnosis in \"Hemorrhagic Stroke\"\r\n\t\t\tor NonElectiveEncounter.principalDiagnosis in \"Ischemic Stroke\"\r\n\r\ndefine \"Encounter with Principal Diagnosis of Ischemic Stroke\":\r\n\t\"Encounter with Principal Diagnosis and Age\" NonElectiveEncounter\r\n\t\twhere NonElectiveEncounter.principalDiagnosis in \"Ischemic Stroke\"\r\n\r\ndefine \"Inpatient Encounter\":\r\n\t[\"Encounter, Performed\": \"Encounter Inpatient\"] Encounter\r\n\t\twhere Encounter.lengthOfStay <= 120 days\r\n\t\t\tand Encounter.relevantPeriod ends during \"Measurement Period\"\r\n\r\ndefine \"Ischemic Stroke Encounters with Discharge Status and Comfort Measure Exclusions\":\r\n\tdistinct((\"Encounter with Principal Diagnosis of Ischemic Stroke\" Encounter\r\n\t\t\t\twhere Encounter.dischargeDisposition in \"Discharge To Acute Care Facility\"\r\n\t\t\t\t\tor Encounter.dischargeDisposition in \"Left Against Medical Advice\"\r\n\t\t\t\t\tor Encounter.dischargeDisposition in \"Patient Expired\"\r\n\t\t\t\t\tor Encounter.dischargeDisposition in \"Discharged to Home for Hospice Care\"\r\n\t\t\t\t\tor Encounter.dischargeDisposition in \"Discharged to Health Care Facility for Hospice Care\"\r\n\t\t)\r\n\t)\r\n\r\ndefine \"Non Elective Inpatient Encounter\":\r\n\t[\"Encounter, Performed\": \"Non-Elective Inpatient Encounter\"] NonElectiveEncounter\r\n\t\twhere NonElectiveEncounter.lengthOfStay <= 120 days\r\n\t\t\tand NonElectiveEncounter.relevantPeriod ends during \"Measurement Period\"\r\n" ], "cql_statement_dependencies": { "StrokeEducation": { "Patient": [ ], "SDE Ethnicity": [ ], "SDE Payer": [ ], "SDE Race": [ ], "SDE Sex": [ ], "Encounter With Discharge Status of Discharge To Home Or Police Custody": [ { "library_name": "TJC_Overall", "statement_name": "Encounter with Principal Diagnosis and Age" } ], "Intervention Comfort Measures": [ ], "Comfort Measures During Hospitalization": [ { "library_name": "StrokeEducation", "statement_name": "Encounter With Discharge Status of Discharge To Home Or Police Custody" }, { "library_name": "StrokeEducation", "statement_name": "Intervention Comfort Measures" }, { "library_name": "MATGlobalCommonFunctions", "statement_name": "Hospitalization" } ], "Denominator": [ { "library_name": "StrokeEducation", "statement_name": "Encounter With Discharge Status of Discharge To Home Or Police Custody" } ], "Denominator Exclusions": [ { "library_name": "StrokeEducation", "statement_name": "Comfort Measures During Hospitalization" } ], "Initial Population": [ { "library_name": "TJC_Overall", "statement_name": "Encounter with Principal Diagnosis and Age" } ], "Written Information Not Given": [ ], "Written Information Not Done During IP": [ { "library_name": "StrokeEducation", "statement_name": "Encounter With Discharge Status of Discharge To Home Or Police Custody" }, { "library_name": "StrokeEducation", "statement_name": "Written Information Not Given" } ], "Numerator": [ { "library_name": "StrokeEducation", "statement_name": "Encounter With Discharge Status of Discharge To Home Or Police Custody" }, { "library_name": "StrokeEducation", "statement_name": "Encounter With Discharge Status of Discharge To Home Or Police Custody" }, { "library_name": "StrokeEducation", "statement_name": "Encounter With Discharge Status of Discharge To Home Or Police Custody" }, { "library_name": "StrokeEducation", "statement_name": "Encounter With Discharge Status of Discharge To Home Or Police Custody" }, { "library_name": "StrokeEducation", "statement_name": "Encounter With Discharge Status of Discharge To Home Or Police Custody" }, { "library_name": "StrokeEducation", "statement_name": "Encounter With Discharge Status of Discharge To Home Or Police Custody" }, { "library_name": "StrokeEducation", "statement_name": "Written Information Not Done During IP" } ] }, "TJC_Overall": { "Encounter with Principal Diagnosis and Age": [ { "library_name": "TJC_Overall", "statement_name": "Encounter with Principal Diagnosis of Hemorrhagic or Ischemic Stroke" }, { "library_name": "MATGlobalCommonFunctions", "statement_name": "CalendarAgeInYearsAt" } ], "Encounter with Principal Diagnosis of Hemorrhagic or Ischemic Stroke": [ { "library_name": "TJC_Overall", "statement_name": "Non Elective Inpatient Encounter" } ], "Non Elective Inpatient Encounter": [ ] }, "MATGlobalCommonFunctions": { "CalendarAgeInYearsAt": [ { "library_name": "MATGlobalCommonFunctions", "statement_name": "ToDate" } ], "ToDate": [ ], "Hospitalization": [ ] } }, "created_at": "2017-09-27T17:44:11.667Z", "data_criteria": { "Payer_PatientCharacteristicPayer_8ce679de_3e80_4562_98c5_63e763763d68": { "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_8ce679de_3e80_4562_98c5_63e763763d68_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", "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", "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", "4", "41", "42", "43", "44", "5", "51", "511", "512", "513", "514", "515", "516", "519", "52", "521", "522", "523", "529", "53", "54", "55", "56", "561", "562", "59", "6", "61", "611", "612", "613", "619", "62", "63", "64", "69", "7", "71", "72", "73", "79", "8", "81", "82", "821", "822", "823", "83", "84", "85", "89", "9", "91", "92", "93", "94", "95", "951", "953", "954", "959", "96", "97", "98", "99", "9999" ] } }, "ComfortMeasures_InterventionOrder_e1698114_9f7d_44ee_8fad_7c0d3c137ee8": { "title": "ComfortMeasures", "description": "Intervention, Order: ComfortMeasures", "code_list_id": "1.3.6.1.4.1.33895.1.3.0.45", "type": "interventions", "definition": "intervention", "status": "ordered", "hard_status": true, "negation": false, "source_data_criteria": "ComfortMeasures_InterventionOrder_e1698114_9f7d_44ee_8fad_7c0d3c137ee8_source", "variable": false }, "ComfortMeasures_InterventionPerformed_e1698114_9f7d_44ee_8fad_7c0d3c137ee8": { "title": "ComfortMeasures", "description": "Intervention, Performed: ComfortMeasures", "code_list_id": "1.3.6.1.4.1.33895.1.3.0.45", "type": "interventions", "definition": "intervention", "status": "performed", "hard_status": false, "negation": false, "source_data_criteria": "ComfortMeasures_InterventionPerformed_e1698114_9f7d_44ee_8fad_7c0d3c137ee8_source", "variable": false }, "InstructionsforFollowUpAfterDischarge_Communication_FromProviderToPatient_40280381_3d61_56a7_013d_8477cebe701d": { "title": "InstructionsforFollowUpAfterDischarge", "description": "Communication: From Provider To Patient: InstructionsforFollowUpAfterDischarge", "code_list_id": "2.16.840.1.113883.3.117.1.7.1.378", "type": "communications", "definition": "communication", "status": "performed", "hard_status": false, "negation": false, "source_data_criteria": "InstructionsforFollowUpAfterDischarge_Communication_FromProviderToPatient_40280381_3d61_56a7_013d_8477cebe701d_source", "variable": false }, "WarningSignsandSymptomsEducation_Communication_FromProviderToPatient_40280381_3d61_56a7_013d_8477cebe7020": { "title": "WarningSignsandSymptomsEducation", "description": "Communication: From Provider To Patient: WarningSignsandSymptomsEducation", "code_list_id": "2.16.840.1.113883.3.117.1.7.1.381", "type": "communications", "definition": "communication", "status": "performed", "hard_status": false, "negation": false, "source_data_criteria": "WarningSignsandSymptomsEducation_Communication_FromProviderToPatient_40280381_3d61_56a7_013d_8477cebe7020_source", "variable": false }, "ONCAdministrativeSex_PatientCharacteristicSex_ea68ab18_3541_4f3f_b577_94cf2031655f": { "title": "ONCAdministrativeSex", "description": "Patient Characteristic Sex: 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"children": [ { "text": "where " } ] }, { "children": [ { "children": [ { "children": [ { "children": [ { "children": [ { "children": [ { "children": [ { "children": [ { "text": "Encounter" } ] } ], "ref_id": "88" }, { "children": [ { "text": "." } ] }, { "children": [ { "children": [ { "text": "dischargeDisposition" } ] } ], "ref_id": "89" } ], "ref_id": "89" }, { "children": [ { "text": " in " } ] }, { "children": [ { "children": [ { "text": "\"Discharge To Acute Care Facility\"" } ] } ], "ref_id": "90" } ], "node_type": "InValueSet", "ref_id": "91" }, { "children": [ { "text": " \n\t\t\t\t\tor " } ] }, { "children": [ { "children": [ { "children": [ { "children": [ { "text": "Encounter" } ] } ], "ref_id": "92" }, { "children": [ { "text": "." } ] }, { "children": [ { "children": [ { "text": "dischargeDisposition" } ] } ], "ref_id": "93" } ], "ref_id": "93" }, { "children": [ { "text": " in " } ] }, { "children": [ { "children": [ { "text": "\"Left Against Medical Advice\"" } ] } ], "ref_id": "94" } ], "node_type": "InValueSet", "ref_id": "95" } ], "node_type": "Or", "ref_id": "96" }, { "children": [ { "text": " \n\t\t\t\t\tor " } ] }, { "children": [ { "children": [ { "children": [ { "children": [ { "text": "Encounter" } ] } ], "ref_id": "97" }, { "children": [ { "text": "." } ] }, { "children": [ { "children": [ { "text": "dischargeDisposition" } ] } ], "ref_id": "98" } ], "ref_id": "98" }, { "children": [ { "text": " in " } ] }, { "children": [ { "children": [ { "text": "\"Patient Expired\"" } ] } ], "ref_id": "99" } ], "node_type": "InValueSet", "ref_id": "100" } ], "node_type": "Or", "ref_id": "101" }, { "children": [ { "text": " \n\t\t\t\t\tor " } ] }, { "children": [ { "children": [ { "children": [ { "children": [ { "text": "Encounter" } ] } ], "ref_id": "102" }, { "children": [ { "text": "." } ] }, { "children": [ { "children": [ { "text": "dischargeDisposition" } ] } ], "ref_id": "103" } ], "ref_id": "103" }, { "children": [ { "text": " in " } ] }, { "children": [ { "children": [ { "text": "\"Discharged to Home for Hospice Care\"" } ] } ], "ref_id": "104" } ], "node_type": "InValueSet", "ref_id": "105" } ], "node_type": "Or", "ref_id": "106" }, { "children": [ { "text": " \n\t\t\t\t\tor " } ] }, { "children": [ { "children": [ { "children": [ { "children": [ { "text": "Encounter" } ] } ], "ref_id": "107" }, { "children": [ { "text": "." } ] }, { "children": [ { "children": [ { "text": "dischargeDisposition" } ] } ], "ref_id": "108" } ], "ref_id": "108" }, { "children": [ { "text": " in " } ] }, { "children": [ { "children": [ { "text": "\"Discharged to Health Care Facility for Hospice Care\"" } ] } ], "ref_id": "109" } ], "node_type": "InValueSet", "ref_id": "110" } ], "ref_id": "111" } ], "ref_id": "111" } ], "node_type": "Query", "ref_id": "112" }, { "children": [ { "text": " \n\t\t)" } ] } ], "node_type": "Query", "ref_id": "112" }, { "children": [ { "text": " \n\t)" } ] } ], "node_type": "Distinct", "ref_id": "113" } ], "ref_id": "114" } ], "define_name": "Ischemic Stroke Encounters with Discharge Status and Comfort Measure Exclusions" } ], "identifier": { "id": "TJC_Overall", "version": "7.0.000" } } }, "episode_ids": null, "episode_of_care": true, "hqmf_id": "40280582-5C5B-CF39-015C-A1FB846814BE", "hqmf_set_id": "217FDF0D-3D64-4720-9116-D5E5AFA27F2C", "hqmf_version_number": 6, "id": "59cbe36b942c6d4064001bf3", "main_cql_library": "StrokeEducation", "measure_attributes": [ { "code": "OTH", "value": "107", "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": "107", "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\nLOINC(R) is a registered trademark of the Regenstrief Institute.\n\nThis material contains SNOMED Clinical Terms (R) (SNOMED CT[C]) copyright 2004-2016 International Health Terminology Standards Development Organization. All rights reserved.", "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\nLOINC(R) is a registered trademark of the Regenstrief Institute.\n\nThis material contains SNOMED Clinical Terms (R) (SNOMED CT[C]) copyright 2004-2016 International Health Terminology Standards Development Organization. All rights reserved.", "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.", "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.", "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": "There are many examples of how patient education programs for specific chronic conditions have increased healthful behaviors, improved health status, and/or decreased health care costs of their participants. Clinical practice guidelines include recommendations for patient and family education during hospitalization as well as information about resources for social support services. Some clinical trials have shown measurable benefits in patient and caregiver outcomes with the application of education and support strategies. The type of stroke experienced and the resulting outcomes will play a large role in determining not only the course of treatment but also what education will be required. Patient education should include information about the event (eg, cause, treatment, and risk factors), the role of various medications or strategies, as well as desirable lifestyle modifications to reduce risk or improve outcomes. Family/caregivers will also need guidance in planning effective and realistic care strategies appropriate to the patient's prognosis and potential for rehabilitation.", "name": "Rationale", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "RAT", "title": "Rationale" }, "value_obj": { "type": "ED", "value": "There are many examples of how patient education programs for specific chronic conditions have increased healthful behaviors, improved health status, and/or decreased health care costs of their participants. Clinical practice guidelines include recommendations for patient and family education during hospitalization as well as information about resources for social support services. Some clinical trials have shown measurable benefits in patient and caregiver outcomes with the application of education and support strategies. The type of stroke experienced and the resulting outcomes will play a large role in determining not only the course of treatment but also what education will be required. Patient education should include information about the event (eg, cause, treatment, and risk factors), the role of various medications or strategies, as well as desirable lifestyle modifications to reduce risk or improve outcomes. Family/caregivers will also need guidance in planning effective and realistic care strategies appropriate to the patient's prognosis and potential for rehabilitation.", "media_type": "text/plain" } }, { "code": "CRS", "value": "Some clinical trials have shown measurable benefits in patient and caregiver outcomes with the application of education and support strategies. Patient education should include information about the event (eg, cause, treatment, and risk factors), the role of various medications or strategies, as well as desirable lifestyle modifications to reduce risk or improve outcomes. Family/caregivers will also need guidance in planning effective and realistic care strategies appropriate to the patient's prognosis and potential for rehabilitation.", "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": "Some clinical trials have shown measurable benefits in patient and caregiver outcomes with the application of education and support strategies. Patient education should include information about the event (eg, cause, treatment, and risk factors), the role of various medications or strategies, as well as desirable lifestyle modifications to reduce risk or improve outcomes. Family/caregivers will also need guidance in planning effective and realistic care strategies appropriate to the patient's prognosis and potential for rehabilitation.", "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": "Eames, S., T. Hoffmann, L. Worrall, and S. Read. \"Stroke Patients' and Carers' Perception of Barriers to Accessing Stroke Information.\" [In eng]. Top Stroke Rehabil 17, no. 2 (Mar-Apr 2010): 69-78.", "name": "Reference", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "REF", "title": "Reference" }, "value_obj": { "type": "ED", "value": "Eames, S., T. Hoffmann, L. Worrall, and S. Read. \"Stroke Patients' and Carers' Perception of Barriers to Accessing Stroke Information.\" [In eng]. Top Stroke Rehabil 17, no. 2 (Mar-Apr 2010): 69-78.", "media_type": "text/plain" } }, { "code": "REF", "value": "Furie, K. L., S. E. Kasner, R. J. Adams, G. W. Albers, R. L. Bush, S. C. Fagan, J. L. Halperin, et al. \"Guidelines for the Prevention of Stroke in Patients with Stroke or Transient Ischemic Attack: A Guideline for Healthcare Professionals from the American Heart Association/American Stroke Association.\" [In eng]. Stroke 42, no. 1 (Jan 2011): 227-76.", "name": "Reference", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "REF", "title": "Reference" }, "value_obj": { "type": "ED", "value": "Furie, K. L., S. E. Kasner, R. J. Adams, G. W. Albers, R. L. Bush, S. C. Fagan, J. L. Halperin, et al. \"Guidelines for the Prevention of Stroke in Patients with Stroke or Transient Ischemic Attack: A Guideline for Healthcare Professionals from the American Heart Association/American Stroke Association.\" [In eng]. Stroke 42, no. 1 (Jan 2011): 227-76.", "media_type": "text/plain" } }, { "code": "REF", "value": "Goldstein, L. B., C. D. Bushnell, R. J. Adams, L. J. Appel, L. T. Braun, S. Chaturvedi, M. A. Creager, et al. \"Guidelines for the Primary Prevention of Stroke: A Guideline for Healthcare Professionals from the American Heart Association/American Stroke Association.\" [In eng]. Stroke 42, no. 2 (Feb 2011): 517-84.", "name": "Reference", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "REF", "title": "Reference" }, "value_obj": { "type": "ED", "value": "Goldstein, L. B., C. D. Bushnell, R. J. Adams, L. J. Appel, L. T. Braun, S. Chaturvedi, M. A. Creager, et al. \"Guidelines for the Primary Prevention of Stroke: A Guideline for Healthcare Professionals from the American Heart Association/American Stroke Association.\" [In eng]. Stroke 42, no. 2 (Feb 2011): 517-84.", "media_type": "text/plain" } }, { "code": "REF", "value": "Hafsteinsdottir, T. B., M. Vergunst, E. Lindeman, and M. Schuurmans. \"Educational Needs of Patients with a Stroke and Their Caregivers: A Systematic Review of the Literature.\" [In eng]. Patient Educ Couns 85, no. 1 (Oct 2011): 14-25", "name": "Reference", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "REF", "title": "Reference" }, "value_obj": { "type": "ED", "value": "Hafsteinsdottir, T. B., M. Vergunst, E. Lindeman, and M. Schuurmans. \"Educational Needs of Patients with a Stroke and Their Caregivers: A Systematic Review of the Literature.\" [In eng]. Patient Educ Couns 85, no. 1 (Oct 2011): 14-25", "media_type": "text/plain" } }, { "code": "REF", "value": "Jauch, E. C., J. L. Saver, H. P. Adams, Jr., A. Bruno, J. J. Connors, B. M. Demaerschalk, P. Khatri, et al. \"Guidelines for the Early Management of Patients with Acute Ischemic Stroke: A Guideline for Healthcare Professionals from the American Heart Association/American Stroke Association.\" [In Eng]. Stroke (Jan 31 2013).", "name": "Reference", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "REF", "title": "Reference" }, "value_obj": { "type": "ED", "value": "Jauch, E. C., J. L. Saver, H. P. Adams, Jr., A. Bruno, J. J. Connors, B. M. Demaerschalk, P. Khatri, et al. \"Guidelines for the Early Management of Patients with Acute Ischemic Stroke: A Guideline for Healthcare Professionals from the American Heart Association/American Stroke Association.\" [In Eng]. Stroke (Jan 31 2013).", "media_type": "text/plain" } }, { "code": "REF", "value": "Lorig, K. R., D. S. Sobel, A. L. Stewart, B. W. Brown, Jr., A. Bandura, P. Ritter, V. M. Gonzalez, D. D. Laurent, and H. R. Holman. \"Evidence Suggesting That a Chronic Disease Self-Management Program Can Improve Health Status While Reducing Hospitalization: A Randomized Trial.\" [In eng]. Med Care 37, no. 1 (Jan 1999): 5-14.", "name": "Reference", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "REF", "title": "Reference" }, "value_obj": { "type": "ED", "value": "Lorig, K. R., D. S. Sobel, A. L. Stewart, B. W. Brown, Jr., A. Bandura, P. Ritter, V. M. Gonzalez, D. D. Laurent, and H. R. Holman. \"Evidence Suggesting That a Chronic Disease Self-Management Program Can Improve Health Status While Reducing Hospitalization: A Randomized Trial.\" [In eng]. Med Care 37, no. 1 (Jan 1999): 5-14.", "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": "Written information given to the patient is required to address each and every one of the educational components. These components are modeled in the population criteria and data criteria as communication from provider to patient :activation of emergency medical system, follow-up after discharge, medications prescribed at discharge, risk factors and signs and symptoms, and are intended to be specific to stroke.\n\nThe \"Non-elective admissions\" value set intends to capture all non-scheduled hospitalizations. This value set is a subset of the \"Inpatient encounter\" value set, excluding concepts that specifically refer to elective hospital admissions. Non-elective admissions include emergency, urgent and unplanned admissions.", "name": "Guidance", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "GUIDE", "title": "Guidance" }, "value_obj": { "type": "ED", "value": "Written information given to the patient is required to address each and every one of the educational components. These components are modeled in the population criteria and data criteria as communication from provider to patient :activation of emergency medical system, follow-up after discharge, medications prescribed at discharge, risk factors and signs and symptoms, and are intended to be specific to stroke.\n\nThe \"Non-elective admissions\" value set intends to capture all non-scheduled hospitalizations. This value set is a subset of the \"Inpatient encounter\" value set, excluding concepts that specifically refer to elective hospital admissions. Non-elective admissions include emergency, urgent and unplanned admissions.", "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 discharged from inpatient care (non-elective admissions) with a principal diagnosis of ischemic or hemorrhagic stroke and a length of stay less than or equal to 120 days that ends 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 discharged from inpatient care (non-elective admissions) with a principal diagnosis of ischemic or hemorrhagic stroke and a length of stay less than or equal to 120 days that ends during the measurement period", "media_type": "text/plain" } }, { "code": "DENOM", "value": "Ischemic stroke or hemorrhagic stroke patients discharged to home, home care, or court/law enforcement", "name": "Denominator", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "DENOM", "title": "Denominator" }, "value_obj": { "type": "ED", "value": "Ischemic stroke or hemorrhagic stroke patients discharged to home, home care, or court/law enforcement", "media_type": "text/plain" } }, { "code": "DENEX", "value": "Patients with comfort measures documented", "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 with comfort measures documented", "media_type": "text/plain" } }, { "code": "NUMER", "value": "Ischemic or hemorrhagic stroke patients with written documentation that they or their caregivers were given educational material addressing all of the following:\n1. Activation of emergency medical system \n2. Follow-up after discharge\n3. Medications prescribed at discharge\n4. Risk factors for stroke\n5. Warning signs and symptoms of stroke", "name": "Numerator", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "NUMER", "title": "Numerator" }, "value_obj": { "type": "ED", "value": "Ischemic or hemorrhagic stroke patients with written documentation that they or their caregivers were given educational material addressing all of the following:\n1. Activation of emergency medical system \n2. Follow-up after discharge\n3. Medications prescribed at discharge\n4. Risk factors for stroke\n5. Warning signs and symptoms of stroke", "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": "None", "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": "None", "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 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