Care Gap Report Walkthrough

This walkthrough builds on the Quality Measure Evaluation Walkthrough, using the same patient:

denom-cms124-stu3

And the same CCS Measure Evaluation Result:

CCS Measure Evaluation

Consider another Preventive Care and Screening Measure:

Breast Cancer Screening

Here again, the Measure resource identifies CQL expressions that define the population criteria for the measure:

Initial Population

Denominator

Numerator

In this measure, the numerator is looking for a mammography procedure. Again, the measure uses a value set to identify known codes identifying mammography procedures. Note the use of a "grouping" value set here:

Mammography Valueset

It is a best-practice in value set development to draw codes from a single code system, rather than multiple code systems, and then use a "grouping" value set to bring multiple code systems together.

The query for Procedure for this patient in the Mammography value set returns no results:

Procedure in Mammography

As a result, the patient is not in the numerator, as shown in the result of the BCS evaluation:

BCS Measure Evaluation

Both of these measures, BCS and CCS, are "Preventive Care and Screening" measures, as indicated with the "topic" element in each Measure. We can search for all measures in this category:

Preventive Care and Screening Measures

Which is what the $care-gaps operation does:

Care Gaps Operation

The result of this operation is a document containing an entry for each Measure where the patient is, according to the improvement notation for the measure, outside of the measure. In this case, the improvement notation for both measures is positive, so if the patient is not in the numerator, it represents a gap in care, and the report includes the entry.