Appropriate Treatment for Children with Upper Respiratory Infection (URI)

eCQM / NQF #: CMS154v7 / 0069
Measure: Percentage of children 3 months-18 years of age who were diagnosed with upper respiratory infection (URI) and were not dispensed an antibiotic prescription on or three days after the episode.
Numerator: Children without a prescription for antibiotic medication on or 3 days after the outpatient or ED visit for an upper respiratory infection.
Denominator: Children age 3 months to 18 years who had an outpatient or emergency department (ED) visit with a diagnosis of upper respiratory infection (URI) during the measurement period.
Denominator Exclusions: Exclude children who are taking antibiotics in the 30 days prior to the date of the encounter during which the diagnosis was established. Exclude children who had an encounter with a competing diagnosis within three days after the initial diagnosis of URI. Exclude patients who were in hospice care during the measurement year.
Domain: Efficiency and Cost Reduction

In ChartMaker Clinical:

In order to qualify for this measure, the provider must have seen the patient, aged 3 months to 18 years, at least once during the reporting period and have the appropriate information documented in the chart:

Required Data Elements for the Denominator:

Required Data Elements for the Numerator:

EXCLUSION DETAILS: 

Children who are taking antibiotics in the 30 days prior to the date of the encounter during which the diagnosis was established and children who had an encounter with a competing diagnosis within three days after the initial diagnosis of URI are excluded from this measure.  In order to meet the requirements for this exclusion, the appropriate information must be documented in the chart:

ADDITIONAL INFORMATION:

•  The patient must be at least 3 months of age and up to 18 years of age prior to the start of the measurement period.

•  This is an episode of care measure that examines all eligible episodes for the patient during the measurement period. If the patient has more than one episode, include all episodes in the measure.

•  The only data used to determine the denominator is data from the ChartMaker Clinical Module. If a patient encounter was not entered into the ChartMaker Clinical Module, that encounter is not included in the denominator for the statistical calculations on the Meaningful Use Dashboard. Please add these additional patients to the denominator and recalculate the percentage for Attestation purposes.