ecqm.measure

CMS113v7 - Elective Delivery (PC-01)

Rationale:

Elective Delivery (PC-01). For almost 3 decades, the American College of Obstetricians and Gynecologists (ACOG) and the American Academy of Pediatrics (AAP) have had in place a standard requiring 39 completed weeks gestation prior to ELECTIVE delivery, either vaginal or operative (ACOG, 1996). A survey conducted in 2007 of almost 20,000 births in HCA hospitals throughout the U.S. carried out in conjunction with the March of Dimes at the request of ACOG revealed that almost 1/3 of all babies delivered in the United States are electively delivered with 5% of all deliveries in the U.S. delivered in a manner violating ACOG/AAP guidelines. Most of these are for convenience, and result in significant short term neonatal morbidity (neonatal intensive care unit admission rates of 13- 21%) (Clark et al., 2009). According to Glantz (2005), compared to spontaneous labor, elective inductions result in more cesarean births and longer maternal length of stay. The American Academy of Family Physicians (2000) also notes that elective induction doubles the cesarean delivery rate. Repeat elective cesarean births before 39 weeks gestation also result in higher rates of adverse respiratory outcomes, mechanical ventilation, sepsis and hypoglycemia for the newborns (Tita et al., 2009).

Data Elements

EstimatedGestationalAgeAtDeliveryPerformed

Clinical Focus: This set of values contains 'observable entities' that represent the estimated gestational age at delivery.

Data Element Scope: The intent of this data element is to identify the fetus's estimated length of gestation at delivery. Using the Quality Data Model, this particular element will map to the 'Assessment' category.

Inclusion Criteria: Include SNOMED CT codes that identify the estimated gestational age at delivery.

Exclusion Criteria: None

Subject constrained to the Estimated Gestational Age at Delivery

AssessmentPerformed: Data elements that meet criteria using this datatype should document completion of the assessment indicated by the QDM category and its corresponding value set. Timing: The time the assessment is completed; Author dateTime.

DataType

Cardinality

EstimatedGestationalAgeAtDeliveryPerformed

0..*

TimeOfDeliveryPerformed

Clinical Focus: This set of values that represent the time of delivery.

Data Element Scope: The intent of this data element is to identify the time of delivery. Using the Quality Data Model, this particular element will map to the 'Assessment' category.

Inclusion Criteria: Include SNOMED CT codes that identify time of delivery.

Exclusion Criteria: None

Subject constrained to the Time of Delivery

AssessmentPerformed: Data elements that meet criteria using this datatype should document completion of the assessment indicated by the QDM category and its corresponding value set. Timing: The time the assessment is completed; Author dateTime.

DataType

Cardinality

TimeOfDeliveryPerformed

0..*

LaborPerformed

Clinical Focus: This set of values represent the concept of labor.

Data Element Scope: The intent of this data element is to identify that a patient is in labor. Using the Quality Data Model, this particular element will map to the 'Physical Exam' category.

Inclusion Criteria: Include SNOMED CT codes that identify onset and establishment of labor.

Exclusion Criteria: Exclude codes describing later stages of labor and latent labor.

Subject constrained to the Labor

AssessmentPerformed: Data elements that meet criteria using this datatype should document completion of the assessment indicated by the QDM category and its corresponding value set. Timing: The time the assessment is completed; Author dateTime.

DataType

Cardinality

LaborPerformed

0..*

CornualEctopicPregnancyDiagnosis

Clinical Focus: This set of values contains diagnosis that represent a cornual ectopic pregnancy

Data Element Scope: The intent of this data element is to identify a cornual ectopic pregnancy.

Inclusion Criteria: Includes codes representing cornual ectopic pregancy

Exclusion Criteria: Excludes codes representing ectopic pregnancies other than cornual ectopic pregnancies, such as tubal ectopic pregnancies.

ResultValue constrained to codes in the Cornual Ectopic Pregnancy valueset (2.16.840.1.113762.1.4.1110.12)

Diagnosis: Condition/Diagnosis/Problem represents a practitioner’s identification of a patient’s disease, illness, injury, or condition. This category contains a single datatype to represent all of these concepts: Diagnosis. A practitioner determines the diagnosis by means of examination, diagnostic test results, patient history, and/or family history. Diagnoses are usually considered unfavorable, but may also represent neutral or favorable conditions that affect a patient’s plan of care (e.g., pregnancy). The QDM does not prescribe the source of diagnosis data in the EHR. Diagnoses may be found in a patient’s problem list, encounter diagnosis list, claims data, or other sources within the EHR. The preferred terminology for diagnoses is SNOMED-CT, but diagnoses may also be encoded using ICD-9/10. The Diagnosis datatype should not be used for differential diagnoses or rule-out diagnoses (neither of which are currently supported by the QDM).

DataType

Cardinality

CornualEctopicPregnancyDiagnosis

0..*

PerforationOfUterusDiagnosis

Clinical Focus: This set of values contains diagnoses that represent perforation of the uterus.

Data Element Scope: The intent of this data element is to identify perforation of the uterus.

Inclusion Criteria: Includes codes that identify perforation of the uterus.

Exclusion Criteria: Excludes codes indentifying perforation to body structures other than the uterus.

ResultValue constrained to codes in the Perforation of Uterus valueset (2.16.840.1.113762.1.4.1110.14)

Diagnosis: Condition/Diagnosis/Problem represents a practitioner’s identification of a patient’s disease, illness, injury, or condition. This category contains a single datatype to represent all of these concepts: Diagnosis. A practitioner determines the diagnosis by means of examination, diagnostic test results, patient history, and/or family history. Diagnoses are usually considered unfavorable, but may also represent neutral or favorable conditions that affect a patient’s plan of care (e.g., pregnancy). The QDM does not prescribe the source of diagnosis data in the EHR. Diagnoses may be found in a patient’s problem list, encounter diagnosis list, claims data, or other sources within the EHR. The preferred terminology for diagnoses is SNOMED-CT, but diagnoses may also be encoded using ICD-9/10. The Diagnosis datatype should not be used for differential diagnoses or rule-out diagnoses (neither of which are currently supported by the QDM).

DataType

Cardinality

PerforationOfUterusDiagnosis

0..*

UterineRuptureDiagnosis

Clinical Focus: This set of values contains diagnoses that represent a uterine rupture

Data Element Scope: The intent of this data element is to identify a uterine rupture.

Inclusion Criteria: Include codes that identify a uterine rupture.

Exclusion Criteria: None

ResultValue constrained to codes in the Uterine Rupture valueset (2.16.840.1.113762.1.4.1110.16)

Diagnosis: Condition/Diagnosis/Problem represents a practitioner’s identification of a patient’s disease, illness, injury, or condition. This category contains a single datatype to represent all of these concepts: Diagnosis. A practitioner determines the diagnosis by means of examination, diagnostic test results, patient history, and/or family history. Diagnoses are usually considered unfavorable, but may also represent neutral or favorable conditions that affect a patient’s plan of care (e.g., pregnancy). The QDM does not prescribe the source of diagnosis data in the EHR. Diagnoses may be found in a patient’s problem list, encounter diagnosis list, claims data, or other sources within the EHR. The preferred terminology for diagnoses is SNOMED-CT, but diagnoses may also be encoded using ICD-9/10. The Diagnosis datatype should not be used for differential diagnoses or rule-out diagnoses (neither of which are currently supported by the QDM).

DataType

Cardinality

UterineRuptureDiagnosis

0..*

UterineWindowDiagnosis

Clinical Focus: This set of values contains diagnoses that represent a uterine window.

Data Element Scope: The intent of this data element is to identify a uterine window. Using the Quality Data Model, this particular element will map to the 'Diagnosis' category.

Inclusion Criteria: Include SNOMED CT codes that identify a uterine window.

Exclusion Criteria: None

ResultValue constrained to codes in the Uterine Window valueset (2.16.840.1.113883.3.117.1.7.1.137)

Diagnosis: Condition/Diagnosis/Problem represents a practitioner’s identification of a patient’s disease, illness, injury, or condition. This category contains a single datatype to represent all of these concepts: Diagnosis. A practitioner determines the diagnosis by means of examination, diagnostic test results, patient history, and/or family history. Diagnoses are usually considered unfavorable, but may also represent neutral or favorable conditions that affect a patient’s plan of care (e.g., pregnancy). The QDM does not prescribe the source of diagnosis data in the EHR. Diagnoses may be found in a patient’s problem list, encounter diagnosis list, claims data, or other sources within the EHR. The preferred terminology for diagnoses is SNOMED-CT, but diagnoses may also be encoded using ICD-9/10. The Diagnosis datatype should not be used for differential diagnoses or rule-out diagnoses (neither of which are currently supported by the QDM).

DataType

Cardinality

UterineWindowDiagnosis

0..*

ConditionsPossiblyJustifyingElectiveDeliveryPriorTo39WeeksGestationDiagnosis

Clinical Focus: This set of values contains diagnoses that represent conditions possibly justifying elective delivery prior to 39 weeks gestation.

Data Element Scope: The intent of this data element is to identify conditions possibly justifying elective delivery prior to 39 weeks gestation. Using the Quality Data Model, this particular element will map to the 'Diagnosis' category.

Inclusion Criteria: Include ICD 10 CM and SNOMED CT codes that identify conditions possibly justifying elective delivery prior to 39 weeks gestation.

Exclusion Criteria: None.

ResultValue constrained to codes in the Conditions Possibly Justifying Elective Delivery Prior to 39 Weeks Gestation valueset (2.16.840.1.113883.3.117.1.7.1.286)

Diagnosis: Condition/Diagnosis/Problem represents a practitioner’s identification of a patient’s disease, illness, injury, or condition. This category contains a single datatype to represent all of these concepts: Diagnosis. A practitioner determines the diagnosis by means of examination, diagnostic test results, patient history, and/or family history. Diagnoses are usually considered unfavorable, but may also represent neutral or favorable conditions that affect a patient’s plan of care (e.g., pregnancy). The QDM does not prescribe the source of diagnosis data in the EHR. Diagnoses may be found in a patient’s problem list, encounter diagnosis list, claims data, or other sources within the EHR. The preferred terminology for diagnoses is SNOMED-CT, but diagnoses may also be encoded using ICD-9/10. The Diagnosis datatype should not be used for differential diagnoses or rule-out diagnoses (neither of which are currently supported by the QDM).

DataType

Cardinality

ConditionsPossiblyJustifyingElectiveDeliveryPriorTo39WeeksGestationDiagnosis

0..*

ConditionsPossiblyJustifyingElectiveDeliveryPriorTo39WeeksGestationDiagnoses

Clinical Focus: This set of values contains diagnoses that represent conditions possibly justifying elective delivery prior to 39 weeks gestation.

Data Element Scope: The intent of this data element is to identify conditions possibly justifying elective delivery prior to 39 weeks gestation. Using the Quality Data Model, this particular element will map to the 'Diagnosis' category.

Inclusion Criteria: Include ICD 10 CM and SNOMED CT codes that identify conditions possibly justifying elective delivery prior to 39 weeks gestation.

Exclusion Criteria: None.

Diagnoses: Coded diagnoses/problems addressed during the encounter. The diagnoses attribute is intended to capture ALL diagnoses, including principal diagnosis. Use of the Encounter, Performed: diagnoses attribute and the Diagnosis datatype is redundant for relating the diagnosis to the Encounter, Performed. The Encounter, Performed: diagnoses syntax is preferred. Referencing the same diagnosis using Encounter, Performed (diagnoses attribute) and Diagnosis (datatype) should only occur if the measure must define a specified length of a prevalence period, e.g., The measure must assure that the diagnoseis have been present for at least some defined time period before the encounter, and were addressed during the Encounter

DataType

Cardinality

ConditionsPossiblyJustifyingElectiveDeliveryPriorTo39WeeksGestationDiagnoses

0..*

EncounterInpatientPerformed

Clinical Focus: This set of values identify the most common inpatient encounter types.

Data Element Scope: The intent of this data element is to identify patients who have had an inpatient encounter. Using the Quality Data Model, this particular element will map to the 'encounter' category.

Inclusion Criteria: Only SNOMED CT codes representing inpatient encounter should be included.

Exclusion Criteria: None.

Subject constrained to the Encounter Inpatient

EncounterPerformed: Data elements that meet criteria using this datatype should document that the encounter indicated by the QDM category and its corresponding value set is in progress or has been completed. Timing: The Relevant Period addresses: startTime – The time the encounter began (admission time) stopTime – The time the encounter ended (discharge time). The Author dateTime addresses when an Encounter is documented. Documentation can occur at the beginning, during, at the end or subsequent to the end of an Encounter. The Author dateTime should be used only if the Relevant Period cannot be obtained. The Location Period is an attribute of the attribute facility location addresses: startTime = the time the patient arrived at the location; stopTime = the time the patient departed from the location

DataType

Cardinality

EncounterInpatientPerformed

0..*

OxytocinAdministered

Clinical Focus: This set of values contains medications that represent Oxytocin.

Data Element Scope: The intent of this data element is to identify medications that represent Oxytocin. Using the Quality Data Model, this particular element will map to the 'Medication' category.

Inclusion Criteria: Include RxNorm codes that identify medications that represent Oxytocin as a single ingredient, administered in an injectable form.

Exclusion Criteria: Exclude drugs that have multiple ingredients. In addition, drugs with dose forms not consistent with injectable administration should not be included. The codes should be limited to those which are for human use and which are able to be prescribed in the US.

Subject constrained to the Oxytocin

MedicationAdministered: Data elements that meet criteria using this datatype should document that the medication indicated by the QDM category and its corresponding value set was actually administered to the patient. Timing: The Relevant Period addresses: startTime = when a single medication administration event starts (e.g., the initiation of an intravenous infusion, or administering a pill or IM injection to a patient); stopTime = when a single medication administration event ends (e.g., the end time of the intravenous infusion, or the administration of a pill or IM injection is completed - for pills and IM injections, the start and stop times are the same) NOTE – Measure developers should address multiple administrations over a period of time using CQL logic. Refer to Special Cases in Appendix A (Section A.3) for scenarios to consider in calculating cumulative medication duration.

DataType

Cardinality

OxytocinAdministered

0..*

DinoprostoneAdministered

Clinical Focus: This set of values contains medications that represent Dinoprostone, commonly used in the delivery setting for induction of labor.

Data Element Scope: The intent of this data element is to identify patients who receive dinoprostone for the purpose of inducing labor. Using the Quality Data Model, this particular element will map to the 'Medication' category.

Inclusion Criteria: Include RxNorm codes that identify medications that contain Dinoprostone as the single ingredient. Drug forms consistent with vaginal administration should be included.

Exclusion Criteria: Medications that have multiple ingredients should be excluded. Drug forms that are not consistent with vaginal administration should not be included. The codes should be limited to those which are for human use and which are able to be prescribed in the US.

Subject constrained to the Dinoprostone

MedicationAdministered: Data elements that meet criteria using this datatype should document that the medication indicated by the QDM category and its corresponding value set was actually administered to the patient. Timing: The Relevant Period addresses: startTime = when a single medication administration event starts (e.g., the initiation of an intravenous infusion, or administering a pill or IM injection to a patient); stopTime = when a single medication administration event ends (e.g., the end time of the intravenous infusion, or the administration of a pill or IM injection is completed - for pills and IM injections, the start and stop times are the same) NOTE – Measure developers should address multiple administrations over a period of time using CQL logic. Refer to Special Cases in Appendix A (Section A.3) for scenarios to consider in calculating cumulative medication duration.

DataType

Cardinality

DinoprostoneAdministered

0..*

EthnicityPatientCharacteristicEthnicity

Clinical Focus:

Data Element Scope:

Inclusion Criteria:

Exclusion Criteria:

ResultValue constrained to codes in the Ethnicity valueset (2.16.840.1.114222.4.11.837)

PatientCharacteristicEthnicity: Data elements that meet criteria using this datatype should document that the patient has one or more of the ethnicities indicated by the QDM category and its corresponding value set. Timing: Ethnicity does not have a specific timing. Measures using Patient Characteristic, Ethnicity should address the most recent entry in the clinical record.

DataType

Cardinality

EthnicityPatientCharacteristicEthnicity

0..*

OncAdministrativeSexPatientCharacteristicGender

Clinical Focus: Gender identity restricted to only Male and Female used in administrative situations requiring a restriction to these two categories.

Data Element Scope: Gender

Inclusion Criteria: Male and Female only.

Exclusion Criteria: Any gender identity that is not male or female.

ResultValue constrained to codes in the ONC Administrative Sex valueset (2.16.840.1.113762.1.4.1)

PatientCharacteristicGender: Data elements that meet criteria using this datatype should document that the patient's sex matches the QDM category and its corresponding value set. Timing: Birth (administrative) sex does not have a specific timing.

DataType

Cardinality

OncAdministrativeSexPatientCharacteristicGender

0..*

PayerPatientCharacteristicPayer

Clinical Focus: Categories of types of health care payor entities as defined by the US Public Health Data Consortium SOP code system

Data Element Scope: @code in CCDA r2.1 template Planned Coverage [act: identifier urn:oid:2.16.840.1.113883.10.20.22.4.129 (open)] DYNAMIC

Inclusion Criteria: All codes in the code system

Exclusion Criteria: none

ResultValue constrained to codes in the Payer valueset (2.16.840.1.114222.4.11.3591)

PatientCharacteristicPayer: Data elements that meet criteria using this datatype should document that the patient has one or more of the payers indicated by the QDM category and its corresponding value set. Timing: The Relevant Period addresses: startTime – The first day of insurance coverage with the referenced payer stopTime – The last day of insurance coverage with the referenced payer

DataType

Cardinality

PayerPatientCharacteristicPayer

0..*

RacePatientCharacteristicRace

Clinical Focus:

Data Element Scope:

Inclusion Criteria:

Exclusion Criteria:

ResultValue constrained to codes in the Race valueset (2.16.840.1.114222.4.11.836)

PatientCharacteristicRace: Data elements that meet criteria using this datatype should document the patient’s race. Timing: Race does not have a specific timing. Measures using Patient Characteristic, Race should address the most recent entry in the clinical record.

DataType

Cardinality

RacePatientCharacteristicRace

0..*

ArtificialRuptureOfMembranesPerformed

Clinical Focus: This set of values contains procedures that represent the artificial rupture of membranes.

Data Element Scope: The intent of this data element is to identify artificial rupture of membranes as a mechanism to induce labor. Using the Quality Data Model, this particular element will map to the 'procedure' category.

Inclusion Criteria: Include SNOMED CT codes that identify artificial rupture of membranes.

Exclusion Criteria: None

Subject constrained to the Artificial Rupture of Membranes

ProcedurePerformed: Data elements that meet criteria using this datatype should document the completion of the procedure indicated by the QDM category and its corresponding value set. Timing: The Relevant Period addresses: StartTime = the time the procedure begins; StopTime = the time the procedure is completed NOTE: 1) Timing refers to a single instance of a procedure. If a measure seeks to evaluate multiple procedures over a period of time, the measure developer should use CQL logic to represent the query request. 2) The Incision dateTime is a single point in time available from the Operating Room and/or Anesthesia Record.

DataType

Cardinality

ArtificialRuptureOfMembranesPerformed

0..*

DeliveryProceduresPerformed

Clinical Focus: This group of value sets contain procedures that represent delivery procedures.

Data Element Scope: The intent of this data element is to identify delivery procedures. Using the Quality Data Model, this particular element will map to the 'Procedure' category.

Inclusion Criteria: Include codes that identify delivery procedures.

Exclusion Criteria: None.

Subject constrained to the Delivery Procedures

ProcedurePerformed: Data elements that meet criteria using this datatype should document the completion of the procedure indicated by the QDM category and its corresponding value set. Timing: The Relevant Period addresses: StartTime = the time the procedure begins; StopTime = the time the procedure is completed NOTE: 1) Timing refers to a single instance of a procedure. If a measure seeks to evaluate multiple procedures over a period of time, the measure developer should use CQL logic to represent the query request. 2) The Incision dateTime is a single point in time available from the Operating Room and/or Anesthesia Record.

DataType

Cardinality

DeliveryProceduresPerformed

0..*

TransabdominalCerclagePerformed

Clinical Focus: This set of values contains cervical cerclage procedures performed by the abdominal approach.

Data Element Scope: The intent of this value set is to identify patients who have had a transabdominal cerclage.

Inclusion Criteria: Cervical cerclage procedures performed by the abdominal approach should be included.

Exclusion Criteria: None

Subject constrained to the Transabdominal Cerclage

ProcedurePerformed: Data elements that meet criteria using this datatype should document the completion of the procedure indicated by the QDM category and its corresponding value set. Timing: The Relevant Period addresses: StartTime = the time the procedure begins; StopTime = the time the procedure is completed NOTE: 1) Timing refers to a single instance of a procedure. If a measure seeks to evaluate multiple procedures over a period of time, the measure developer should use CQL logic to represent the query request. 2) The Incision dateTime is a single point in time available from the Operating Room and/or Anesthesia Record.

DataType

Cardinality

TransabdominalCerclagePerformed

0..*

UterineHornPerformed

Clinical Focus: This set of values contains excision of the uterine horn procedures performed.

Data Element Scope: The intent of this value set is to identify patients who have had an excision of the uterine horn procedure.

Inclusion Criteria: Excision of the uterine horn procedures by any approach are included.

Exclusion Criteria: All other procedures.

Subject constrained to the Uterine Horn

ProcedurePerformed: Data elements that meet criteria using this datatype should document the completion of the procedure indicated by the QDM category and its corresponding value set. Timing: The Relevant Period addresses: StartTime = the time the procedure begins; StopTime = the time the procedure is completed NOTE: 1) Timing refers to a single instance of a procedure. If a measure seeks to evaluate multiple procedures over a period of time, the measure developer should use CQL logic to represent the query request. 2) The Incision dateTime is a single point in time available from the Operating Room and/or Anesthesia Record.

DataType

Cardinality

UterineHornPerformed

0..*

MetroplastyPerformed

Clinical Focus: This set of values contains repair of the uterus procedures performed by any approach.

Data Element Scope: The intent of this value set is to identify patients who have had a metroplasty, uteroplasty, hysteroplasty, or repair of the uterus procedure.

Inclusion Criteria: Metroplasty, uteroplasty, hysteroplasty, and repair of uterus procedures by any approach are included.

Exclusion Criteria: All other procedures.

Subject constrained to the Metroplasty

ProcedurePerformed: Data elements that meet criteria using this datatype should document the completion of the procedure indicated by the QDM category and its corresponding value set. Timing: The Relevant Period addresses: StartTime = the time the procedure begins; StopTime = the time the procedure is completed NOTE: 1) Timing refers to a single instance of a procedure. If a measure seeks to evaluate multiple procedures over a period of time, the measure developer should use CQL logic to represent the query request. 2) The Incision dateTime is a single point in time available from the Operating Room and/or Anesthesia Record.

DataType

Cardinality

MetroplastyPerformed

0..*

CesareanBirthPerformed

Clinical Focus: This grouping of value sets contain procedures that represent a cesarean section.

Data Element Scope: The intent of this data element is to identify cesarean section. Using the Quality Data Model, this particular element will map to the 'Procedure' category.

Inclusion Criteria: Include ICD 9 CM, ICD 10 CM, and SNOMED CT codes that identify cesarean section.

Exclusion Criteria: None

Subject constrained to the Cesarean Birth

ProcedurePerformed: Data elements that meet criteria using this datatype should document the completion of the procedure indicated by the QDM category and its corresponding value set. Timing: The Relevant Period addresses: StartTime = the time the procedure begins; StopTime = the time the procedure is completed NOTE: 1) Timing refers to a single instance of a procedure. If a measure seeks to evaluate multiple procedures over a period of time, the measure developer should use CQL logic to represent the query request. 2) The Incision dateTime is a single point in time available from the Operating Room and/or Anesthesia Record.

DataType

Cardinality

CesareanBirthPerformed

0..*

MedicalInductionOfLaborPerformed

Clinical Focus: This set of values contains procedures that represent the medical induction of labor.

Data Element Scope: The intent of this data element is to identify medical induction of labor. Using the Quality Data Model, this particular element will map to the 'Procedure' category.

Inclusion Criteria: Include ICD 9 CM and SNOMED CT codes that identify the medical induction of labor.

Exclusion Criteria: None.

Subject constrained to the Medical Induction of Labor

ProcedurePerformed: Data elements that meet criteria using this datatype should document the completion of the procedure indicated by the QDM category and its corresponding value set. Timing: The Relevant Period addresses: StartTime = the time the procedure begins; StopTime = the time the procedure is completed NOTE: 1) Timing refers to a single instance of a procedure. If a measure seeks to evaluate multiple procedures over a period of time, the measure developer should use CQL logic to represent the query request. 2) The Incision dateTime is a single point in time available from the Operating Room and/or Anesthesia Record.

DataType

Cardinality

MedicalInductionOfLaborPerformed

0..*

ClassicalCesareanBirthPerformed

Clinical Focus: This grouping of value sets contain procedures that represent cesarean section.

Data Element Scope: The intent of this data element is to identify classical cesarean section. Using the Quality Data Model, this particular element will map to the 'Procedure' category.

Inclusion Criteria: Include ICD 10 PCS, and SNOMED CT codes that identify the classical cesarean section.

Exclusion Criteria: None

Subject constrained to the Classical Cesarean Birth

ProcedurePerformed: Data elements that meet criteria using this datatype should document the completion of the procedure indicated by the QDM category and its corresponding value set. Timing: The Relevant Period addresses: StartTime = the time the procedure begins; StopTime = the time the procedure is completed NOTE: 1) Timing refers to a single instance of a procedure. If a measure seeks to evaluate multiple procedures over a period of time, the measure developer should use CQL logic to represent the query request. 2) The Incision dateTime is a single point in time available from the Operating Room and/or Anesthesia Record.

DataType

Cardinality

ClassicalCesareanBirthPerformed

0..*

MyomectomyPerformed

Clinical Focus: This set of values contains procedures that represent a myomectomy.

Data Element Scope: The intent of this data element is to identify a myomectomy. Using the Quality Data Model, this particular element will map to the 'Procedure' category.

Inclusion Criteria: Include SNOMED CT codes that identify a myomectomy.

Exclusion Criteria: None

Subject constrained to the Myomectomy

ProcedurePerformed: Data elements that meet criteria using this datatype should document the completion of the procedure indicated by the QDM category and its corresponding value set. Timing: The Relevant Period addresses: StartTime = the time the procedure begins; StopTime = the time the procedure is completed NOTE: 1) Timing refers to a single instance of a procedure. If a measure seeks to evaluate multiple procedures over a period of time, the measure developer should use CQL logic to represent the query request. 2) The Incision dateTime is a single point in time available from the Operating Room and/or Anesthesia Record.

DataType

Cardinality

MyomectomyPerformed

0..*