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cds.ahrq.gov/sites/default/files/cds/artifact/106/AMIA_presentation.pptx
January 01, 2012 - something” to help with obesity management in primary care
Recognition of weight status and screening laboratory … status but actual documentation rates are 21% (overweight) and 64% (obese)
85% report ordering screening laboratory … evaluation but only 50% of patients had screening laboratory evaluation ordered
4
Next Step:
Plan … Targets were recognition of obesity and appropriate screening laboratory evaluation derived from the
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cds.ahrq.gov/sites/default/files/workgroups/226/mar-2017-cholesterol-wg-notes.docx
January 01, 2017 - detecting the target phenotype; consider other avenues to identify patient population, including marker laboratory … provide flexibility, when possible, to minimize issues with local data capture/workflow practices.
· Laboratory … test results:
· Consider any laboratory test result, if status isn’t flagged as “cancelled” or “entered
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cds.ahrq.gov/sites/default/files/cds/artifact/106/Poster_AMIA_mid_atlantic_HWI_jm.pptx
February 09, 2018 - at a visit or as a problem list entry for patients with a BMI above the 95th percentile
Appropriate laboratory … streamlining evaluation and management
increasing documentation of weight status
facilitating ordering laboratory … to educational materials
1
2
3
4
Clinician documentation of overweight/obesity status
Appropriate laboratory … providers reported starting screening labs before 10 years
Actual EHR documentation rates:
Disorder (laboratory
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cds.ahrq.gov/sites/default/files/cds/artifact/106/HWI_2017.pptx
January 01, 2017 - Management guidelines include documentation of weight status and laboratory screening for co-morbidities … * CDS provided laboratory ordering and diagnosis support
Discussion
Financial incentives and automation
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cds.ahrq.gov/sites/default/files/cds/artifact/18/Enhanced%20CDS%20Artifact%20Based%20on%20Pilot%20Implementation_Final.docx
October 01, 2017 - Integration Development and Testing 6
3.2.1 Conditions 6
3.2.2 Procedures 8
3.2.3 Medications 8
3.2.4 Laboratory … Laboratory Tests
Laboratory tests have numerous dates and times associated with them (e.g., order date … The label that each distinct EHR and laboratory system assigns to these dates and times can vary widely … , making generalized attribute definition very challenging.
· LDL-C Laboratory Test
Initial Definition … · HDL-C Laboratory Test
Initial Definition
CQL code looked for the “effectiveDateTime” (i.e.,
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cds.ahrq.gov/sites/default/files/cds/artifact/111/implementation-checklist_1.docx
November 06, 2020 - type matches the organization’s workflow
Skills
Someone who can check mapping medications, laboratory
-
cds.ahrq.gov/sites/default/files/cds/artifact/1061/2024_Data_Requirements_T2DM_Part_One.xlsx
January 01, 2024 - valueset-observation-status.html)
valueQuantity with 'mg/dL' or 'mmol/L' units Single VS 2.16.840.1.113762.1.4.1032.94
HgA1C laboratory … valueset-observation-status.html)
valueQuantity with 'mg/dL' or 'mmol/L' units Single VS 2.16.840.1.113762.1.4.1032.94
HgA1C laboratory
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cds.ahrq.gov/sites/default/files/cds/artifact/1066/2024_Data_Requirements_T2DM_Part_Two_0.xlsx
January 01, 2024 - valueset-observation-status.html)
valueQuantity with 'mg/dL' or 'mmol/L' units Two LOINC Codes LOINC: 1518-0 LOINC: 14995-5
HgA1C laboratory … valueset-observation-status.html)
valueQuantity with 'mg/dL' or 'mmol/L' units Two LOINC Codes LOINC: 1518-0 LOINC: 14995-5
HgA1C laboratory
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cds.ahrq.gov/sites/default/files/workgroups/221/feb-2017-cholesterol-wg-notes.docx
January 01, 2017 - .
· Discussion on LDL-c laboratory results to consider in the artifacts:
· Considerations for timing … availability of LCL-c results:
· The WG members agreed on a lookback period of 6 years for the LDL-c laboratory
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cds.ahrq.gov/sites/default/files/cds/artifact/21/Implementation%20Guide_Statin%20Therapy%20for%20the%20Prevention%20and%20Treatment%20of%20CVD%20eCQM_Final.docx
October 01, 2017 - Individuals ≥ 21 years who have ever had a laboratory result of LDL-c ≥190 mg/dL, or who have a previous … Patients aged >= 21 years at the beginning of the measurement period who have ever had a fasting or direct laboratory … Type 2 diabetes and with an LDL-C result of 70-189 mg/dL recorded as the highest fasting or direct laboratory … Patients with diabetes who have the most recent fasting or direct LDL-C laboratory test result < 70 mg … Denominator exception
"...who have the most recent fasting or direct LDL-C laboratory test result <
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cds.ahrq.gov/sites/default/files/cds/artifact/1061/CDS%20Connect_Year%203%20Pilot%20Report_Final.pdf
September 01, 2019 - the b.well platform comes from a variety of sources, including one or more EHRs,
claims, reference laboratories … • Modifying the error returned by CQL Services when invalid units of measurement appear in
laboratory … • Laboratory test results: More than 85 percent of lab results did not contain LOINC
codes, the … freely available standard terminology used for identifying health
measurements such as laboratory results … Because
most of b.well’s lab result data originated directly from reference laboratories, it was
surprising
-
cds.ahrq.gov/sites/default/files/cds/artifact/1056/CDS%20Connect_Year%203%20Pilot%20Report_Final.pdf
September 01, 2019 - the b.well platform comes from a variety of sources, including one or more EHRs,
claims, reference laboratories … • Modifying the error returned by CQL Services when invalid units of measurement appear in
laboratory … • Laboratory test results: More than 85 percent of lab results did not contain LOINC
codes, the … freely available standard terminology used for identifying health
measurements such as laboratory results … Because
most of b.well’s lab result data originated directly from reference laboratories, it was
surprising
-
cds.ahrq.gov/sites/default/files/cds/artifact/1066/CDS%20Connect_Year%203%20Pilot%20Report_Final.pdf
September 01, 2019 - the b.well platform comes from a variety of sources, including one or more EHRs,
claims, reference laboratories … • Modifying the error returned by CQL Services when invalid units of measurement appear in
laboratory … • Laboratory test results: More than 85 percent of lab results did not contain LOINC
codes, the … freely available standard terminology used for identifying health
measurements such as laboratory results … Because
most of b.well’s lab result data originated directly from reference laboratories, it was
surprising
-
cds.ahrq.gov/sites/default/files/cds/artifact/1071/CDS%20Connect_Year%203%20Pilot%20Report_Final.pdf
September 01, 2019 - the b.well platform comes from a variety of sources, including one or more EHRs,
claims, reference laboratories … • Modifying the error returned by CQL Services when invalid units of measurement appear in
laboratory … • Laboratory test results: More than 85 percent of lab results did not contain LOINC
codes, the … freely available standard terminology used for identifying health
measurements such as laboratory results … Because
most of b.well’s lab result data originated directly from reference laboratories, it was
surprising
-
cds.ahrq.gov/sites/default/files/cds/artifact/71/CDS%20Connect_Year%203%20Pilot%20Report_Final.pdf
September 01, 2019 - the b.well platform comes from a variety of sources, including one or more EHRs,
claims, reference laboratories … • Modifying the error returned by CQL Services when invalid units of measurement appear in
laboratory … • Laboratory test results: More than 85 percent of lab results did not contain LOINC
codes, the … freely available standard terminology used for identifying health
measurements such as laboratory results … Because
most of b.well’s lab result data originated directly from reference laboratories, it was
surprising
-
cds.ahrq.gov/sites/default/files/cds/artifact/1061/2019%20CDS%20Connect_Year%203%20Pilot%20Report_Final.pdf
January 01, 2019 - the b.well platform comes from a variety of sources, including one or more EHRs,
claims, reference laboratories … • Modifying the error returned by CQL Services when invalid units of measurement appear in
laboratory … • Laboratory test results: More than 85 percent of lab results did not contain LOINC
codes, the … freely available standard terminology used for identifying health
measurements such as laboratory results … Because
most of b.well’s lab result data originated directly from reference laboratories, it was
surprising
-
cds.ahrq.gov/sites/default/files/cds/artifact/106/Guide%20to%20the%20Healthy%20Weight%20Care%20Assistant.docx
February 15, 2018 - Use of the HWCA drove change in identification of weight status AND appropriate laboratory investigations
-
cds.ahrq.gov/sites/default/files/cds/artifact/21/2024_CDS_Connect_IG_Statin_Therapy_CVD_eCQM.pdf
January 01, 2024 - Individuals 20 to 75 years of age who have ever had a laboratory result of LDL ≥190 mg/dL,
or who have … procedure
• Patients aged 20 to 75 years at the beginning of the measurement period who have ever had a laboratory
-
cds.ahrq.gov/sites/default/files/cds/artifact/1071/2024_CDS_Connect_IG_Healthy_Diet_Physical_Activity.pdf
January 01, 2024 - HDL-
C is defined as the union of two value sets, HDL-C Laboratory Test and High Density Lipoprotein … Inclusions
(metabolic
syndrome
criteria)
“Triglyceride lab
result ≥150 mg/dL”
Triglyceride laboratory
-
cds.ahrq.gov/sites/default/files/cds/artifact/18/Pilot%20Report_Final_0.docx
March 01, 2018 - Hypercholesterolemia, and Hypertension).
2) Medications (i.e., Low, Moderate, and High Intensity Statins).
3) Laboratory