The percentage of ED patients with a diagnosis of STEMI who received appropriate and timely treatment. The measure will be calculated using electronic health record (EHR) data and is intended for use at the facility level in a CMS accountability program, through which it may be publicly reported.
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1.14 Numerator
ED STEMI patients aged 18 and older whose time from ED arrival to fibrinolysis is 30 minutes or fewer OR Non-transfer ED STEMI patients who received PCI at a PCI-capable hospital within 90 minutes of arrival OR ED STEMI patients who were transferred from a non-PCI capable hospital within 45 minutes of ED arrival at a non-PCI capable hospital.
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1.15 Denominator
ED patients 18 years of age and older with STEMI who should have received appropriate and timely treatment for STEMI.
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Exclusions
The denominator exclusions were derived from the 2013 ACCF/AHA Guideline for the Management of STEMI (http://www.onlinejacc.org/content/accj/61/4/e78.full.pdf?download=true), which was also the basis of OP-2 (Fibrinolytic Therapy Received Within 30 Minutes of ED Arrival) and OP-3 (Median Time to Transfer to Another Facility for Acute Coronary Intervention). Denominator exclusions include the following conditions, which have to be documented as active in the patient’s history at the time of the encounter: active bleeding or bleeding diathesis (excluding menses); ischemic stroke; known malignant intracranial neoplasm (primary or metastatic); known structural cerebral vascular lesion (e.g., AVM); significant facial and/or closed head trauma, any prior intracranial hemorrhage or other known intracranial pathology; suspected aortic dissection; active peptic ulcer; cardiopulmonary arrest; intubation; mechanical circulatory assist device placement; oral anticoagulant therapy prior to arrival (including streptokinase treatment); patients with advanced dementia; pregnancy; recent internal bleeding; recent major surgery; intracranial or intraspinal surgery, and severe neurologic impairment (based on Glasgow coma).
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1.13a Data dictionary not attachedNo
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Most Recent Endorsement ActivityEndorsed Cardiovascular Spring 2021Initial EndorsementLast Updated
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StewardCenters for Medicare & Medicaid ServicesSteward Organization POC EmailSteward Organization Copyright
Limited proprietary coding is contained in the Measure specifications for user convenience. Users of proprietary code sets should obtain all necessary licenses from the owners of the code sets.
CPT® contained in the measure specifications is copyright 2004–2019 American Medical Association. LOINC® copyright 2004–2019 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms® (SNOMED CT®) copyright 2004–2019 International Health Terminology Standards Development Organisation. ICD-10 copyright 2019 World Health Organization. All Rights Reserved.Measure Developer Secondary Point Of Contact Email
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Risk AdjustmentRisk adjustment approachOffRisk adjustment approachOffConceptual model for risk adjustmentOffConceptual model for risk adjustmentOff
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6.1.2 Current or Planned Use(s)
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Planned Use
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