{ "calculate_sdes": null, "calculation_method": "EPISODE_OF_CARE", "cms_id": "CMS177v6", "component": false, "component_hqmf_set_ids": [ ], "composite": false, "composite_hqmf_set_id": null, "cql_libraries": [ { "cql": "library ChildandAdolescentMajorDepressiveDisorderMDDSuicideRiskAssessment version '6.0.002'\r\n\r\nusing QDM version '5.3'\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 \"Face-to-Face Interaction\": 'urn:oid:2.16.840.1.113883.3.464.1003.101.12.1048'\r\nvalueset \"Group Psychotherapy\": 'urn:oid:2.16.840.1.113883.3.526.3.1187'\r\nvalueset \"Major Depressive Disorder-Active\": 'urn:oid:2.16.840.1.113883.3.526.3.1491'\r\nvalueset \"Office Visit\": 'urn:oid:2.16.840.1.113883.3.464.1003.101.12.1001'\r\nvalueset \"Outpatient Consultation\": 'urn:oid:2.16.840.1.113883.3.464.1003.101.12.1008'\r\nvalueset \"Psych Visit - Diagnostic Evaluation\": 'urn:oid:2.16.840.1.113883.3.526.3.1492'\r\nvalueset \"Psych Visit - Family Psychotherapy\": 'urn:oid:2.16.840.1.113883.3.526.3.1018'\r\nvalueset \"Psych Visit - Psychotherapy\": 'urn:oid:2.16.840.1.113883.3.526.3.1496'\r\nvalueset \"Psychoanalysis\": 'urn:oid:2.16.840.1.113883.3.526.3.1141'\r\nvalueset \"Suicide Risk Assessment\": 'urn:oid:2.16.840.1.113883.3.526.3.1484'\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 \"Denominator\":\r\n\t\"Initial Population\"\r\n\r\ndefine \"Numerator\":\r\n\t\"Encounter with Major Depressive Disorder Diagnosis\" Enc\r\n\t\twith [\"Intervention, Performed\": \"Suicide Risk Assessment\"] Intervention\r\n\t\t\tsuch that Intervention.relevantPeriod during Enc.relevantPeriod\r\n\r\ndefine \"Encounter with Major Depressive Disorder Diagnosis\":\r\n\t( [\"Encounter, Performed\": \"Office Visit\"]\r\n\t\tunion [\"Encounter, Performed\": \"Outpatient Consultation\"]\r\n\t\tunion [\"Encounter, Performed\": \"Face-to-Face Interaction\"]\r\n\t\tunion [\"Encounter, Performed\": \"Psych Visit - Diagnostic Evaluation\"]\r\n\t\tunion [\"Encounter, Performed\": \"Psych Visit - Family Psychotherapy\"]\r\n\t\tunion [\"Encounter, Performed\": \"Psych Visit - Psychotherapy\"]\r\n\t\tunion [\"Encounter, Performed\": \"Psychoanalysis\"]\r\n\t\tunion [\"Encounter, Performed\": \"Group Psychotherapy\"] ) Enc\r\n\t\twhere exists ( Enc.diagnoses Diagnosis\r\n\t\t\t\twhere Diagnosis in \"Major Depressive Disorder-Active\"\r\n\t\t)\r\n\t\t\tand Enc.relevantPeriod during \"Measurement Period\"\r\n\r\ndefine \"Initial Population\":\r\n\t\"Encounter with Major Depressive Disorder Diagnosis\" Enc\r\n\t\twhere AgeInYearsAt(start of \"Measurement Period\")>= 6\r\n\t\t\tand AgeInYearsAt(start of \"Measurement Period\")< 17\r\n", "elm": { "library": { "identifier": { "id": "ChildandAdolescentMajorDepressiveDisorderMDDSuicideRiskAssessment", "version": "6.0.002" }, "schemaIdentifier": { "id": "urn:hl7-org:elm", "version": "r1" }, "usings": { "def": [ { "localIdentifier": "System", "uri": "urn:hl7-org:elm-types:r1" }, { "localId": "1", "locator": "3:1-3:23", "localIdentifier": "QDM", "uri": "urn:healthit-gov:qdm:v5_3", "version": "5.3" } ] }, "parameters": { "def": [ { "localId": "18", "locator": "22:1-22:49", "name": "Measurement Period", "accessLevel": "Public", "parameterTypeSpecifier": { "localId": "17", "locator": "22:32-22:49", "type": "IntervalTypeSpecifier", "pointType": { "localId": "16", "locator": "22:41-22:48", "name": "{urn:hl7-org:elm-types:r1}DateTime", "type": "NamedTypeSpecifier" } } } ] }, "valueSets": { "def": [ { "localId": "2", "locator": "6:1-6:68", "name": "ONC Administrative Sex", "id": "2.16.840.1.113762.1.4.1", "accessLevel": "Public" }, { "localId": "3", "locator": "7:1-7:53", "name": "Race", "id": "2.16.840.1.114222.4.11.836", "accessLevel": "Public" }, { "localId": "4", "locator": "8:1-8:58", "name": "Ethnicity", "id": "2.16.840.1.114222.4.11.837", "accessLevel": "Public" }, { "localId": "5", "locator": "9:1-9:55", "name": "Payer", "id": "2.16.840.1.114222.4.11.3591", "accessLevel": "Public" }, { "localId": "6", "locator": "10:1-10:87", "name": "Face-to-Face Interaction", "id": "2.16.840.1.113883.3.464.1003.101.12.1048", "accessLevel": "Public" }, { "localId": "7", "locator": "11:1-11:72", "name": "Group Psychotherapy", "id": "2.16.840.1.113883.3.526.3.1187", "accessLevel": "Public" }, { "localId": "8", "locator": "12:1-12:85", "name": "Major Depressive Disorder-Active", "id": "2.16.840.1.113883.3.526.3.1491", "accessLevel": "Public" }, { "localId": "9", "locator": "13:1-13:75", "name": "Office Visit", "id": "2.16.840.1.113883.3.464.1003.101.12.1001", "accessLevel": "Public" }, { "localId": "10", "locator": "14:1-14:86", "name": "Outpatient Consultation", "id": "2.16.840.1.113883.3.464.1003.101.12.1008", "accessLevel": "Public" }, { "localId": "11", "locator": "15:1-15:88", "name": "Psych Visit - Diagnostic Evaluation", "id": "2.16.840.1.113883.3.526.3.1492", "accessLevel": "Public" }, { "localId": "12", "locator": "16:1-16:87", "name": "Psych Visit - Family Psychotherapy", "id": "2.16.840.1.113883.3.526.3.1018", "accessLevel": "Public" }, { "localId": "13", "locator": "17:1-17:80", "name": "Psych Visit - Psychotherapy", "id": "2.16.840.1.113883.3.526.3.1496", "accessLevel": "Public" }, { "localId": "14", "locator": "18:1-18:67", "name": "Psychoanalysis", "id": "2.16.840.1.113883.3.526.3.1141", "accessLevel": "Public" }, { "localId": "15", "locator": "19:1-19:76", "name": "Suicide Risk Assessment", "id": "2.16.840.1.113883.3.526.3.1484", "accessLevel": "Public" } ] }, "statements": { "def": [ { "locator": "24:1-24:15", "name": "Patient", "context": "Patient", "expression": { "type": "SingletonFrom", "operand": { "locator": "24:1-24:15", "dataType": "{urn:healthit-gov:qdm:v5_3}Patient", "templateId": "Patient", "type": "Retrieve" } } }, { "localId": "20", "locator": "26:1-27:50", "name": "SDE Ethnicity", "context": "Patient", "accessLevel": "Public", "annotation": [ { "type": "Annotation", "s": { "r": "20", "s": [ { "value": [ "define ", "\"SDE Ethnicity\"", ":\n\t" ] }, { "r": "19", "s": [ { "value": [ "[", "\"Patient Characteristic Ethnicity\"", ": " ] }, { "s": [ { "value": [ "\"Ethnicity\"" ] } ] }, { "value": [ "]" ] } ] } ] } } ], "expression": { "localId": "19", "locator": "27:2-27:50", "dataType": "{urn:healthit-gov:qdm:v5_3}PatientCharacteristicEthnicity", "codeProperty": "code", "type": "Retrieve", "codes": { "name": "Ethnicity", "type": "ValueSetRef" } } }, { "localId": "22", "locator": "29:1-30:42", "name": "SDE Payer", "context": "Patient", "accessLevel": "Public", "annotation": [ { "type": "Annotation", "s": { "r": "22", "s": [ { "value": [ "define ", "\"SDE Payer\"", ":\n\t" ] }, { "r": "21", "s": [ { "value": [ "[", "\"Patient Characteristic Payer\"", ": " ] }, { "s": [ { "value": [ "\"Payer\"" ] } ] }, { "value": [ "]" ] } ] } ] } } ], "expression": { "localId": "21", "locator": "30:2-30:42", "dataType": "{urn:healthit-gov:qdm:v5_3}PatientCharacteristicPayer", "codeProperty": "code", "type": "Retrieve", "codes": { "name": "Payer", "type": "ValueSetRef" } } }, { "localId": "24", "locator": "32:1-33:40", "name": "SDE Race", "context": "Patient", "accessLevel": "Public", "annotation": [ { "type": "Annotation", "s": { "r": "24", "s": [ { "value": [ "define ", "\"SDE Race\"", ":\n\t" ] }, { "r": "23", "s": [ { "value": [ "[", "\"Patient Characteristic Race\"", ": " ] }, { "s": [ { "value": [ "\"Race\"" ] } ] }, { "value": [ "]" ] } ] } ] } } ], "expression": { "localId": "23", "locator": "33:2-33:40", "dataType": "{urn:healthit-gov:qdm:v5_3}PatientCharacteristicRace", "codeProperty": "code", "type": "Retrieve", "codes": { "name": "Race", "type": "ValueSetRef" } } }, { "localId": "26", "locator": "35:1-36:57", "name": "SDE Sex", "context": "Patient", "accessLevel": "Public", "annotation": [ { "type": "Annotation", "s": { "r": "26", "s": [ { "value": [ "define ", "\"SDE Sex\"", ":\n\t" ] }, { "r": "25", "s": [ { "value": [ "[", "\"Patient Characteristic Sex\"", ": " ] }, { "s": [ { "value": [ "\"ONC Administrative Sex\"" ] } ] }, { "value": [ "]" ] } ] } ] } } ], "expression": { "localId": "25", "locator": "36:2-36:57", "dataType": "{urn:healthit-gov:qdm:v5_3}PatientCharacteristicSex", "codeProperty": "code", "type": "Retrieve", "codes": { "name": "ONC Administrative Sex", "type": "ValueSetRef" } } }, { "localId": "56", "locator": "46:1-58:53", "name": "Encounter with Major 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risk", "hqmf_id": "40280382-5FA6-FE85-0160-0498BA791EE8", "hqmf_set_id": "848D09DE-7E6B-43C4-BEDD-5A2957CCFFE3", "hqmf_version_number": "0", "main_cql_library": "ChildandAdolescentMajorDepressiveDisorderMDDSuicideRiskAssessment", "measure_attributes": [ { "code": "OTH", "value": "177", "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": "177", "media_type": "text/plain" } }, { "code": "OTH", "value": "1365", "name": "NQF Number", "code_obj": { "type": "CD", "null_flavor": "OTH", "original_text": "NQF Number" }, "value_obj": { "type": "ED", "value": "1365", "media_type": "text/plain" } }, { "code": "COPY", "value": "Copyright 2017 PCPI(R) Foundation and American Medical Association. 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": "Copyright 2017 PCPI(R) Foundation and American Medical Association. All Rights Reserved.", "media_type": "text/plain" } }, { "code": "DISC", "value": "The Measures are not clinical guidelines, do not establish a standard of medical care, and have not been tested for all potential applications. \n\nThe Measures, while copyrighted, can be reproduced and distributed, without modification, for noncommercial purposes, eg, use by health care providers in connection with their practices. Commercial use is defined as the sale, license, or distribution of the Measures for commercial gain, or incorporation of the Measures into a product or service that is sold, licensed or distributed for commercial gain. \n\nCommercial uses of the Measures require a license agreement between the user and the PCPI(R) Foundation (PCPI[R]) or the American Medical Association (AMA). Neither the American Medical Association (AMA), nor the AMA-convened Physician Consortium for Performance Improvement(R) (AMA-PCPI), nor PCPI, nor their members shall be responsible for any use of the Measures.\n\nAMA and PCPI encourage use of the Measures by other health care professionals, where appropriate.\n\nTHE MEASURES AND SPECIFICATIONS ARE PROVIDED \"AS IS\" WITHOUT WARRANTY OF ANY KIND.\n\nLimited proprietary coding is contained in the Measure specifications for convenience. Users of the proprietary code sets should obtain all necessary licenses from the owners of these code sets. The AMA, the PCPI and its members and former members of the AMA-PCPI disclaim all liability for use or accuracy of any Current Procedural Terminology (CPT[R]) or other coding contained in the specifications. \n\nCPT(R) contained in the Measure specifications is copyright 2004-2016 American Medical Association. LOINC(R) is copyright 2004-2016 Regenstrief Institute, Inc. This material contains SNOMED CLINICAL TERMS (SNOMED CT[R]) copyright 2004-2016 International Health Terminology Standards Development Organisation (IHTSDO). ICD-10 is copyright 2016 World Health Organization. All Rights Reserved.\n\nDue to technical limitations, registered trademarks are indicated by (R) or [R].", "name": "Disclaimer", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "DISC", "title": "Disclaimer" }, "value_obj": { "type": "ED", "value": "The Measures are not clinical guidelines, do not establish a standard of medical care, and have not been tested for all potential applications. \n\nThe Measures, while copyrighted, can be reproduced and distributed, without modification, for noncommercial purposes, eg, use by health care providers in connection with their practices. Commercial use is defined as the sale, license, or distribution of the Measures for commercial gain, or incorporation of the Measures into a product or service that is sold, licensed or distributed for commercial gain. \n\nCommercial uses of the Measures require a license agreement between the user and the PCPI(R) Foundation (PCPI[R]) or the American Medical Association (AMA). Neither the American Medical Association (AMA), nor the AMA-convened Physician Consortium for Performance Improvement(R) (AMA-PCPI), nor PCPI, nor their members shall be responsible for any use of the Measures.\n\nAMA and PCPI encourage use of the Measures by other health care professionals, where appropriate.\n\nTHE MEASURES AND SPECIFICATIONS ARE PROVIDED \"AS IS\" WITHOUT WARRANTY OF ANY KIND.\n\nLimited proprietary coding is contained in the Measure specifications for convenience. Users of the proprietary code sets should obtain all necessary licenses from the owners of these code sets. The AMA, the PCPI and its members and former members of the AMA-PCPI disclaim all liability for use or accuracy of any Current Procedural Terminology (CPT[R]) or other coding contained in the specifications. \n\nCPT(R) contained in the Measure specifications is copyright 2004-2016 American Medical Association. LOINC(R) is copyright 2004-2016 Regenstrief Institute, Inc. This material contains SNOMED CLINICAL TERMS (SNOMED CT[R]) copyright 2004-2016 International Health Terminology Standards Development Organisation (IHTSDO). ICD-10 is copyright 2016 World Health Organization. All Rights Reserved.\n\nDue to technical limitations, registered trademarks are indicated by (R) or [R].", "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": "Research has shown that patients with major depressive disorder are at a high risk for suicide, which makes this assessment an important aspect of care that should be assessed at each visit. According to a study analyzing the quality of health care in the United States, only about 25.8% of patients with depression had documentation of the presence or absence of suicidal ideation during the first or second diagnostic visit. 76.11% of those patients who have suicidality were asked if they have specific plans to carry out suicide. A 2003 study reviewed medical records to assess the degree to which providers adhered to depression guidelines in a VA primary care setting. Providers documented exploration for suicidal ideation in 57% of the records.", "name": "Rationale", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "RAT", "title": "Rationale" }, "value_obj": { "type": "ED", "value": "Research has shown that patients with major depressive disorder are at a high risk for suicide, which makes this assessment an important aspect of care that should be assessed at each visit. According to a study analyzing the quality of health care in the United States, only about 25.8% of patients with depression had documentation of the presence or absence of suicidal ideation during the first or second diagnostic visit. 76.11% of those patients who have suicidality were asked if they have specific plans to carry out suicide. A 2003 study reviewed medical records to assess the degree to which providers adhered to depression guidelines in a VA primary care setting. Providers documented exploration for suicidal ideation in 57% of the records.", "media_type": "text/plain" } }, { "code": "CRS", "value": "The evaluation must include assessment for the presence of harm to self or others (MS). (AACAP, 2007)\n\nSuicidal behavior exists along a continuum from passive thoughts of death to a clearly developed plan and intent to carry out that plan. Because depression is closely associated with suicidal thoughts and behavior, it is imperative to evaluate these symptoms at the initial and subsequent assessments. For this purpose, low burden tools to track suicidal ideation and behavior such as the Columbia-Suicidal Severity Rating Scale can be used. Also, it is crucial to evaluate the risk (eg, age, sex, stressors, comorbid conditions, hopelessness, impulsivity) and protective factors (eg, religious belief, concern not to hurt family) that might influence the desire to attempt suicide. The risk for suicidal behavior increases if there is a history of suicide attempts, comorbid psychiatric disorders (eg, disruptive disorders, substance abuse), impulsivity and aggression, availability of lethal agents (eg, firearms), exposure to negative events (eg, physical or sexual abuse, violence), and a family history of suicidal behavior. (AACAP, 2007)\n\nA careful and ongoing evaluation of suicide risk is necessary for all patients with major depressive disorder (Category I). Such an assessment includes specific inquiry about suicidal thoughts, intent, plans, means, and behaviors; identification of specific psychiatric symptoms (eg, psychosis, severe anxiety, substance use) or general medical conditions that may increase the likelihood of acting on suicidal ideas; assessment of past and, particularly, recent suicidal behavior; delineation of current stressors and potential protective factors (eg, positive reasons for living, strong social support); and identification of any family history of suicide or mental illness (Category I). (APA, 2010)", "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": "The evaluation must include assessment for the presence of harm to self or others (MS). (AACAP, 2007)\n\nSuicidal behavior exists along a continuum from passive thoughts of death to a clearly developed plan and intent to carry out that plan. Because depression is closely associated with suicidal thoughts and behavior, it is imperative to evaluate these symptoms at the initial and subsequent assessments. For this purpose, low burden tools to track suicidal ideation and behavior such as the Columbia-Suicidal Severity Rating Scale can be used. Also, it is crucial to evaluate the risk (eg, age, sex, stressors, comorbid conditions, hopelessness, impulsivity) and protective factors (eg, religious belief, concern not to hurt family) that might influence the desire to attempt suicide. The risk for suicidal behavior increases if there is a history of suicide attempts, comorbid psychiatric disorders (eg, disruptive disorders, substance abuse), impulsivity and aggression, availability of lethal agents (eg, firearms), exposure to negative events (eg, physical or sexual abuse, violence), and a family history of suicidal behavior. (AACAP, 2007)\n\nA careful and ongoing evaluation of suicide risk is necessary for all patients with major depressive disorder (Category I). Such an assessment includes specific inquiry about suicidal thoughts, intent, plans, means, and behaviors; identification of specific psychiatric symptoms (eg, psychosis, severe anxiety, substance use) or general medical conditions that may increase the likelihood of acting on suicidal ideas; assessment of past and, particularly, recent suicidal behavior; delineation of current stressors and potential protective factors (eg, positive reasons for living, strong social support); and identification of any family history of suicide or mental illness (Category I). (APA, 2010)", "media_type": "text/plain" } }, { "code": "IDUR", "value": "Higher score indicates better quality", "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": "Higher score indicates better quality", "media_type": "text/plain" } }, { "code": "REF", "value": "American Academy of Child and Adolescent Psychiatry (AACAP). Practice parameters for the assessment and treatment of children and adolescents with depressive disorders. J. Am. Acad. Child Adolesc. Psychiatry, 2007;\n46(11):1503-1526. Available at: \nhttp://www.aacap.org/App_Themes/AACAP/docs/practice_parameters/depressive_disorders_practice_parameter.pdf", "name": "Reference", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "REF", "title": "Reference" }, "value_obj": { "type": "ED", "value": "American Academy of Child and Adolescent Psychiatry (AACAP). Practice parameters for the assessment and treatment of children and adolescents with depressive disorders. J. Am. Acad. Child Adolesc. Psychiatry, 2007;\n46(11):1503-1526. Available at: \nhttp://www.aacap.org/App_Themes/AACAP/docs/practice_parameters/depressive_disorders_practice_parameter.pdf", "media_type": "text/plain" } }, { "code": "REF", "value": "Gelenberg AJ, Freeman MP, Markowitz JC, et al; American Psychiatric Association Work Group on Major Depressive Disorder. Practice guideline for the treatment of patients with major depressive disorder. 3rd ed. http://www.psychiatryonline.com/pracGuide/pracGuideTopic_7.aspx. Published October 2010. Accessed November 24, 2010.", "name": "Reference", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "REF", "title": "Reference" }, "value_obj": { "type": "ED", "value": "Gelenberg AJ, Freeman MP, Markowitz JC, et al; American Psychiatric Association Work Group on Major Depressive Disorder. Practice guideline for the treatment of patients with major depressive disorder. 3rd ed. http://www.psychiatryonline.com/pracGuide/pracGuideTopic_7.aspx. Published October 2010. Accessed November 24, 2010.", "media_type": "text/plain" } }, { "code": "REF", "value": "Zimmerman M, Galione J. Psychiatrists' and Nonpsychiatrist Physicians' Reported Use of the DSM-IV Criteria for Major Depressive Disorder. J Clin Psychiatry. 2010;71:235-238.", "name": "Reference", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "REF", "title": "Reference" }, "value_obj": { "type": "ED", "value": "Zimmerman M, Galione J. Psychiatrists' and Nonpsychiatrist Physicians' Reported Use of the DSM-IV Criteria for Major Depressive Disorder. J Clin Psychiatry. 2010;71:235-238.", "media_type": "text/plain" } }, { "code": "REF", "value": "Dobscha SK, Gerrity MS, Corson K, Bahr A, Cuilwik NM. Measuring adherence to depression treatment guidelines in a VA primary care clinic. Gen Hosp Psychiatry. 2003;25:230-7.", "name": "Reference", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "REF", "title": "Reference" }, "value_obj": { "type": "ED", "value": "Dobscha SK, Gerrity MS, Corson K, Bahr A, Cuilwik NM. Measuring adherence to depression treatment guidelines in a VA primary care clinic. Gen Hosp Psychiatry. 2003;25:230-7.", "media_type": "text/plain" } }, { "code": "REF", "value": "McGlynn EA, Asch SM, Adams J, Keesey J, Hicks J, DeCristofaro A, Kerr EA. The quality of health care delivered to adults in the United States. New England Journal of Medicine. 2003;348(26):2635-2645.", "name": "Reference", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "REF", "title": "Reference" }, "value_obj": { "type": "ED", "value": "McGlynn EA, Asch SM, Adams J, Keesey J, Hicks J, DeCristofaro A, Kerr EA. The quality of health care delivered to adults in the United States. New England Journal of Medicine. 2003;348(26):2635-2645.", "media_type": "text/plain" } }, { "code": "DEF", "value": "Numerator Definition: The specific type and magnitude of the suicide risk assessment is intended to be at the discretion of the individual clinician and should be specific to the needs of the patient. At a minimum, suicide risk assessment should evaluate:\n1. Risk (eg, age, sex, stressors, comorbid conditions, hopelessness, impulsivity) and protective factors (eg, religious belief, concern not to hurt family) that may influence the desire to attempt suicide.\n2. Current severity of suicidality.\n3. Most severe point of suicidality in episode and lifetime.\n \nLow burden tools to track suicidal ideation and behavior such as the Columbia-Suicidal Severity Rating Scale can also be used.", "name": "Definition", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "DEF", "title": "Definition" }, "value_obj": { "type": "ED", "value": "Numerator Definition: The specific type and magnitude of the suicide risk assessment is intended to be at the discretion of the individual clinician and should be specific to the needs of the patient. At a minimum, suicide risk assessment should evaluate:\n1. Risk (eg, age, sex, stressors, comorbid conditions, hopelessness, impulsivity) and protective factors (eg, religious belief, concern not to hurt family) that may influence the desire to attempt suicide.\n2. Current severity of suicidality.\n3. Most severe point of suicidality in episode and lifetime.\n \nLow burden tools to track suicidal ideation and behavior such as the Columbia-Suicidal Severity Rating Scale can also be used.", "media_type": "text/plain" } }, { "code": "GUIDE", "value": "A suicide risk assessment should be performed at every visit for major depressive disorder during the measurement period. \n\nThis measure is an episode-of-care measure; the level of analysis for this measure is every visit for major depressive disorder during the measurement period. For example, at every visit for MDD, the patient should have a suicide risk assessment.\n\nUse of a standardized tool or instrument to assess suicide risk will meet numerator performance. Standardized tools can be mapped to the concept \"Intervention, Performed: Suicide Risk Assessment\" included in the numerator logic below.", "name": "Guidance", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "GUIDE", "title": "Guidance" }, "value_obj": { "type": "ED", "value": "A suicide risk assessment should be performed at every visit for major depressive disorder during the measurement period. \n\nThis measure is an episode-of-care measure; the level of analysis for this measure is every visit for major depressive disorder during the measurement period. For example, at every visit for MDD, the patient should have a suicide risk assessment.\n\nUse of a standardized tool or instrument to assess suicide risk will meet numerator performance. Standardized tools can be mapped to the concept \"Intervention, Performed: Suicide Risk Assessment\" included in the numerator logic below.", "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": "All patient visits for those patients aged 6 through 17 years with a diagnosis of major depressive disorder", "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": "All patient visits for those patients aged 6 through 17 years with a diagnosis of major depressive disorder", "media_type": "text/plain" } }, { "code": "DENOM", "value": "Equals Initial Population", "name": "Denominator", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "DENOM", "title": "Denominator" }, "value_obj": { "type": "ED", "value": "Equals Initial Population", "media_type": "text/plain" } }, { "code": "DENEX", "value": "None", "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": "None", "media_type": "text/plain" } }, { "code": "NUMER", "value": "Patient visits with an assessment for suicide risk", "name": "Numerator", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "NUMER", "title": "Numerator" }, "value_obj": { "type": "ED", "value": "Patient visits with an assessment for suicide risk", "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 payer, race, ethnicity and sex", "media_type": "text/plain" } } ], "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 } }, "measure_scoring": "PROPORTION", "population_criteria": { "IPP": { "conjunction?": true, "type": "IPP", "hqmf_id": "814DC710-4366-4E53-8747-EA68A1D82146", "preconditions": [ { "id": 2, "preconditions": [ { "id": 1, "reference": "ChildandAdolescentMajorDepressiveDisorderMDDSuicideRiskAssessment__Initial_Population__1544087D_9E0F_4F91_9366_A9163A4B55D6" } ], "conjunction_code": "allTrue" } ] }, "DENOM": { "conjunction?": true, "type": "DENOM", "hqmf_id": "FB9470CF-9D17-4D21-A56C-DD50333C41DB", "preconditions": [ { "id": 4, "preconditions": [ { "id": 3, "reference": "ChildandAdolescentMajorDepressiveDisorderMDDSuicideRiskAssessment__Denominator__1544087D_9E0F_4F91_9366_A9163A4B55D6" } ], "conjunction_code": "allTrue" } ] }, "NUMER": { "conjunction?": true, "type": "NUMER", "hqmf_id": "487BEADB-29B5-43D7-8E33-F0E40184E27B", "preconditions": [ { "id": 6, "preconditions": [ { "id": 5, "reference": "ChildandAdolescentMajorDepressiveDisorderMDDSuicideRiskAssessment__Numerator__1544087D_9E0F_4F91_9366_A9163A4B55D6" } ], "conjunction_code": "allTrue" } ] } }, "population_sets": [ { "population_set_id": "PopulationCriteria1", "populations": { "DENOM": { "hqmf_id": "FB9470CF-9D17-4D21-A56C-DD50333C41DB", "library_name": "ChildandAdolescentMajorDepressiveDisorderMDDSuicideRiskAssessment", "statement_name": "Denominator" }, "IPP": { "hqmf_id": "814DC710-4366-4E53-8747-EA68A1D82146", "library_name": "ChildandAdolescentMajorDepressiveDisorderMDDSuicideRiskAssessment", "statement_name": "Initial Population" }, "NUMER": { "hqmf_id": "487BEADB-29B5-43D7-8E33-F0E40184E27B", "library_name": "ChildandAdolescentMajorDepressiveDisorderMDDSuicideRiskAssessment", "statement_name": "Numerator" }, "_type": "CQM::ProportionPopulationMap" }, "title": "Population Criteria Section" } ], "source_data_criteria": [ { "admissionSource": null, "authorDatetime": null, "codeListId": "2.16.840.1.113883.3.464.1003.101.12.1048", "dataElementCodes": [ ], "description": "Encounter, Performed: Face-to-FaceInteraction", "diagnoses": null, "dischargeDisposition": null, "facilityLocations": [ ], "hqmfOid": "2.16.840.1.113883.10.20.28.4.5", "id": "5d289cc931fe5f8b72e2a30b", "lengthOfStay": null, "negationRationale": null, "participant": null, "priority": null, "qdmCategory": "encounter", "qdmStatus": "performed", "qdmTitle": "Encounter, Performed", "qdmVersion": "5.5", "relevantPeriod": null, "_type": "QDM::EncounterPerformed" }, { "codeListId": "2.16.840.1.114222.4.11.3591", "dataElementCodes": [ ], "description": "Patient Characteristic Payer: Payer", "hqmfOid": "2.16.840.1.113883.10.20.28.4.58", "id": "5d289cc931fe5f8b72e2a30c", "qdmCategory": "patient_characteristic", "qdmStatus": "payer", "qdmTitle": "Patient Characteristic Payer", "qdmVersion": "5.5", "relevantPeriod": null, "_type": "QDM::PatientCharacteristicPayer" }, { "codeListId": "2.16.840.1.113762.1.4.1", 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null, "codeListId": "2.16.840.1.113883.3.526.3.1492", "dataElementCodes": [ ], "description": "Encounter, Performed: PsychVisit-DiagnosticEvaluation", "diagnoses": null, "dischargeDisposition": null, "facilityLocations": [ ], "hqmfOid": "2.16.840.1.113883.10.20.28.4.5", "id": "5d289cc931fe5f8b72e2a30f", "lengthOfStay": null, "negationRationale": null, "participant": null, "priority": null, "qdmCategory": "encounter", "qdmStatus": "performed", "qdmTitle": "Encounter, Performed", "qdmVersion": "5.5", "relevantPeriod": null, "_type": "QDM::EncounterPerformed" }, { "admissionSource": null, "authorDatetime": null, "codeListId": "2.16.840.1.113883.3.526.3.1496", "dataElementCodes": [ ], "description": "Encounter, Performed: PsychVisit-Psychotherapy", "diagnoses": null, "dischargeDisposition": null, "facilityLocations": [ ], "hqmfOid": "2.16.840.1.113883.10.20.28.4.5", "id": "5d289cc931fe5f8b72e2a310", "lengthOfStay": null, "negationRationale": null, "participant": null, "priority": null, 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"dischargeDisposition": null, "facilityLocations": [ ], "hqmfOid": "2.16.840.1.113883.10.20.28.4.5", "id": "5d289cc931fe5f8b72e2a314", "lengthOfStay": null, "negationRationale": null, "participant": null, "priority": null, "qdmCategory": "encounter", "qdmStatus": "performed", "qdmTitle": "Encounter, Performed", "qdmVersion": "5.5", "relevantPeriod": null, "_type": "QDM::EncounterPerformed" }, { "codeListId": "2.16.840.1.114222.4.11.836", "dataElementCodes": [ ], "description": "Patient Characteristic Race: Race", "hqmfOid": "2.16.840.1.113883.10.20.28.4.59", "id": "5d289cc931fe5f8b72e2a315", "qdmCategory": "patient_characteristic", "qdmStatus": "race", "qdmTitle": "Patient Characteristic Race", "qdmVersion": "5.5", "_type": "QDM::PatientCharacteristicRace" }, { "authorDatetime": null, "codeListId": "2.16.840.1.113883.3.526.3.1484", "dataElementCodes": [ ], "description": "Intervention, Performed: SuicideRiskAssessment", "hqmfOid": "2.16.840.1.113883.10.20.28.4.36", "id": "5d289cc931fe5f8b72e2a316", "negationRationale": null, "performer": null, "qdmCategory": "intervention", "qdmStatus": "performed", "qdmTitle": "Intervention, Performed", "qdmVersion": "5.5", "reason": null, "relevantDatetime": null, "relevantPeriod": null, "result": null, "status": null, "_type": "QDM::InterventionPerformed" }, { "admissionSource": null, "authorDatetime": null, "codeListId": "2.16.840.1.113883.3.464.1003.101.12.1001", "dataElementCodes": [ ], "description": "Encounter, Performed: OfficeVisit", "diagnoses": null, "dischargeDisposition": null, "facilityLocations": [ ], "hqmfOid": "2.16.840.1.113883.10.20.28.4.5", "id": "5d289cc931fe5f8b72e2a317", "lengthOfStay": null, "negationRationale": null, "participant": null, "priority": null, "qdmCategory": "encounter", "qdmStatus": "performed", "qdmTitle": "Encounter, Performed", "qdmVersion": "5.5", "relevantPeriod": null, "_type": "QDM::EncounterPerformed" } ], "title": "Child and Adolescent Major Depressive Disorder (MDD): 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