Use of High-Risk Medications in the Elderly

eCQM / NQF #: CMS156v7 / 0022
Measure: Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are reported:

A. Percentage of patients who were ordered at least one high-risk medication. B. Percentage of patients who were ordered at least two of the same high-risk medications.

Numerator 1: Patients with an order for at least one high-risk medication during the measurement period
Numerator 2: Patients with at least two orders for the same high-risk medication during the measurement period
Denominator: Patients 65 years and older who had a visit during the measurement period
Denominator Exclusion: Exclude patients who were in hospice care during the measurement year
Domain: Patient Safety

In ChartMaker Clinical:

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

Required Data Elements for the Denominator:

Denominator Exclusion:

Required Data Elements for Numerator 1:

One of the following:

Required Data Elements for Numerator 2:

One of the following:

ADDITIONAL INFORMATION:

•  The patient must be 65 years of age or older prior to the start of the measurement period.

• The intent of Numerator 1 of the measure is to assess if the patient has been prescribed at least one high-risk medication.

• The intent of Numerator 2 of the measure is to assess if the patient has been prescribed at least two of the same high-risk medications.

•  The days supply of greater than 90 is determined using CUMULATIVE MEDICATION DURATION.  This is an individual’s total number of medication days over a specific period (the measurement period); the period counts multiple prescriptions with gaps in between, but does not count the gaps during which a medication was not dispensed.
To determine the cumulative medication duration, determine first the number of the Medication Days for each prescription in the period: the number of doses divided by the dose frequency per day. Then add the Medication Days for each prescription without counting any days between the prescriptions.

•  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.