| eCQM Title | CU-SINC, Postpartum: The annual percentage of most or moderately effective contraceptive method users, among postpartum patients, ages 15-44, excluding those who did not want to discuss their contraceptive needs (Contraceptive Use, Self-Identified Need for Contraception, Postpartum) |
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| CMS ID | eCQM Version Number | Draft based on 0.0.000 | |
| CBE Number | 3682e | GUID | 1fe78e7f-82e5-4e44-b5ed-f2b5490c214f |
| Measurement Period | January 1, 2023 through December 31, 2023 | ||
| Measure Steward | University of California, San Francisco, Department of Family | ||
| Measure Developer | Far Harbor LLC | ||
| Measure Developer | University of California, San Francisco, Department of Family | ||
| Endorsed By | CMS Consensus Based Entity | ||
| Description |
Primary Measure - Most and Moderately Effective Contraceptive Provision or Use: Percentage of patients ages 15-44 assigned female at birth with a live birth delivery who were provided or were documented to use a most or moderately effective contraceptive method, in the postpartum period. The primary measure captures new provision as well as current use of most and moderately effective contraceptive methods to accurately capture postpartum contraceptive utilization even if provided in a different calendar year or a different health care site. Submeasure - Access to LARC (LARC-SINC): Percentage of patients ages 15-44 assigned female at birth with a live birth delivery who were provided LARC in the postpartum period. The submeasure captures LARC provision to ensure access to these methods by identifying low provision rates (i.e., below 2%). For both measures: to focus on the population of postpartum patients interested in contraceptive services, the denominator excludes those individuals who were not provided nor were documented to be using a most or moderately effective contraceptive method if they indicated through a Self-Identified Need for Contraception screening question (SINC) they did not want to discuss their contraceptive needs. |
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| Copyright |
Not applicable. |
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| Disclaimer |
The performance measure is not a clinical guideline and does not establish a standard of medical care, and has not been tested for all potential applications. THE MEASURE AND SPECIFICATIONS ARE PROVIDED "AS IS" WITHOUT WARRANTY OF ANY KIND. |
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| Measure Scoring | Proportion | ||
| Measure Type | Intermediate Outcome | ||
| Stratification |
None |
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| Risk Adjustment |
None |
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| Rate Aggregation |
None |
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| Rationale |
Many people – and especially women of color and women of low socioeconomic status – experience barriers accessing contraceptive care. Disparities in reproductive health outcomes could be mitigated by innovative approaches that expand options for receiving contraceptive care. The eCQMs assess the degree to which patients have their contraceptive needs met and provides an opportunity to have public reporting and Quality Improvement around meeting people’s contraceptive needs. This measure is specified for calculation at two levels of analysis: facility and clinician group/practice. |
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| Clinical Recommendation Statement |
The Women's Preventive Services Initiative recommends that adolescent and adult women have access to the full range of female-controlled contraceptives to prevent undesired pregnancy and improve birth outcomes. Contraceptive care should include contraceptive counseling, initiation of contraceptive use, and follow-up care (e.g., management, and evaluation as well as changes to and removal or discontinuation of the contraceptive method). The Women’s Preventive Services Initiative recommends that the full range of female-controlled U.S. Food and Drug Administration-approved contraceptive methods, effective family planning practices, and sterilization procedures be available as part of contraceptive care. |
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| Improvement Notation |
Increased score indicates improvement - While increased score indicates improvement for #3682e, the sub-measure for LARC is a floor measure. Specifically, the goal of the sub-measure is to ensure access to LARC methods in the postpartum population by monitoring very low rates of provision (e.g., below 2%). This measure therefore will not have a benchmark encouraging high rates of use. In addition, utilization in pay-for-performance or similar programs or setting a high benchmark will be explicitly defined as inappropriate, as doing so may incentivize coercive practices. Contraceptive services must be offered in a client-centered manner, as recommended by CDC and OPA. |
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| Reference |
Reference Type: Citation Reference Text: 'Health Resources and Services Administration (HRSA). (2019). Women’s Preventive Services Guidelines. Maryland: U.S. Department of Health and Human Services.' Accessed online on 12/17/2021 at https://www.hrsa.gov/womens-guidelines-2019' |
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| Definition |
None |
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| Guidance |
The denominator exclusion using SINC applies only to those who were not provided nor were documented to be using contraception during the postpartum period, as being provided or using contraception is an indication of interest in these services. Any patient who responds to SINC that she does wish to discuss contraceptive needs is included in the denominator, even if she answered no at any other point. Live birth date, if documented, is preferred over estimated delivery date (EDD). If live birth date is not documented, the EDD can be used, with documentation of contraceptive provision or use having to be documented between 24 weeks of gestation according to the EDD and 90 days after the EDD. This range allows for the possibility of a preterm birth and provision or documented use during the postpartum period of those pregnancies that ended before the EDD. For further guidance on using the CU-eCQMs, please visit our website at https://pcrhp.ucsf.edu/contraceptive-use-ecqms This eCQM is a patient-based measure. This version of the eCQM uses QDM version 5.6. Please refer to the eCQI resource center (https://ecqi.healthit.gov/qdm) for more information on the QDM. |
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| Transmission Format |
None |
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| Initial Population |
Primary Measure, Submeasure: Patients assigned female at birth, aged 15-44 with a qualifying encounter from 3 months prior to the start of the calendar year through the end of the calendar year (i.e., 10/1/XX-1 through 12/31/XX), and; those who had a prenatal care visit in the year prior to the calendar year through the first 9 months of the calendar year (i.e., 1/1/XX-1 through 9/30/XX) with a documented live birth delivery date, or a documented estimated delivery date (EDD) between 3 months prior to the calendar year and 9 months into the calendar year (i.e., 10/1/XX-1 through 9/30/XX), |
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| Denominator |
Primary Measure, Submeasure: Initial Population |
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| Denominator Exclusions |
Primary Measure, Submeasure 1) Had a non-live birth: Those who were documented to not have had a live birth, including those with ectopic pregnancies, intrauterine fetal demise, early pregnancy loss, or abortion from 3 months prior to the start of the calendar year through the end of the calendar year (i.e., 10/1/XX - 1 through 12/31/XX), or 2) Answered “No” to all instances of the Self-Identified Need for Contraception (SINC) question: those who did not want to discuss their contraceptive needs every time they were asked the SINC question from among those who were not provided nor were documented to use a most or moderately effective contraceptive method throughout the postpartum period (i.e., within 90 days after live birth delivery). Documented no responses to SINC must occur no earlier than 12 weeks before EDD and within 90 days after live birth delivery date. |
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| Numerator |
Primary Measure: Of patients in the denominator, those who were provided or were documented to be using a most (i.e., sterilization, implants, intrauterine devices or systems (IUD/IUS) or moderately effective (i.e., injectables, oral pills, patch, or ring) contraceptive method within 90 days after live birth delivery date. If a live birth date is documented, provision or documentation of method use must occur in a visit within 90 days after this date. If no live birth date is documented, then the visit in which contraception was provided or use documented must occur after 24 weeks of pregnancy as determined by the EDD, and within 90 days after the EDD. Submeasure: Of patients in the denominator, those who were provided a long-acting reversible method of contraception (LARC, i.e., IUD or implant) within 90 days after live birth delivery date. If a live birth date is documented, provision of the method must occur in a visit within 90 days after this date. If no live birth date is documented, then the visit in which contraception was provided must occur after 24 weeks of pregnancy as determined by the EDD, and within 90 days after the EDD. |
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| Numerator Exclusions |
None |
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| Denominator Exceptions |
None |
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| Supplemental Data Elements |
For every patient evaluated by this measure, these supplemental data elements (SDE) are available but not required for eCQM calculation: payer, race, and ethnicity. |
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( AgeInYearsAt(date from start of "Measurement Period") in Interval[15, 44]
and exists ( ["Patient Characteristic Sex": "Female"] )
and exists ( "Qualifying Encounters" ) )
and ( exists ( "Had Live Birth Delivery" )
or ( exists ( "Had Estimated Delivery Date" )
and not exists ( "Had Live Birth Delivery" )
and not exists ( "Had Non Live Birth Event" ) )
and ( "Prenatal Care Visits Group" ) )
"Contraceptive Use Postpartum Initial Population"
exists ( "Had Non Live Birth Event" ) or ( ( "SINC No Responses Only and No Most Mod" ) )
exists ( "Postpartum Most and Moderately Effective Contraceptive Use and Provision After Live Birth Delivery" )
or ( exists ( "Postpartum Most and Moderately Effective Contraceptive Use and Provision After Estimated Delivery Date" )
and not exists ( "Had Live Birth Delivery" ) )
None
None
None
( AgeInYearsAt(date from start of "Measurement Period") in Interval[15, 44]
and exists ( ["Patient Characteristic Sex": "Female"] )
and exists ( "Qualifying Encounters" ) )
and ( exists ( "Had Live Birth Delivery" )
or ( exists ( "Had Estimated Delivery Date" )
and not exists ( "Had Live Birth Delivery" )
and not exists ( "Had Non Live Birth Event" ) )
and ( "Prenatal Care Visits Group" ) )
"Contraceptive Use Postpartum Initial Population"
exists ( "Had Non Live Birth Event" ) or ( ( "SINC No Responses Only and No Most Mod" ) )
exists ( "Postpartum LARC After Live Birth" )
or ( exists ( "Postpartum LARC After EDD" )
and not exists ( "Had Live Birth Delivery" )
)
None
None
None
not exists ( "Postpartum Most and Moderately Effective Contraceptive Use and Provision" )
( ( ["Assessment, Performed": "No - I am already using contraception"] )
union ( ["Assessment, Performed": "No - I am hoping to become pregnant in the near future"] )
union ( ["Assessment, Performed": "No - I am unsure or dont want to use contraception"] )
union ( ["Assessment, Performed": "No - I do not want to talk about contraception today because I am here for something else"] )
union ( ["Assessment, Performed": "No - This question does not apply to me/I prefer not to answer"] ) ) SINCNoPostpartum
where Global."NormalizeInterval" ( SINCNoPostpartum.relevantDatetime, SINCNoPostpartum.relevantPeriod ) starts 3 months or less on or before start of "Measurement Period"
or Global."NormalizeInterval" ( SINCNoPostpartum.relevantDatetime, SINCNoPostpartum.relevantPeriod ) starts 12 months or less on or after start of "Measurement Period"
( ["Assessment, Performed": "Do you want to talk about contraception or pregnancy prevention during your visit today"] ) SINCScreeningQuestion
where Global."NormalizeInterval" ( SINCScreeningQuestion.relevantDatetime, SINCScreeningQuestion.relevantPeriod ) starts 3 months or less on or before start of "Measurement Period"
or Global."NormalizeInterval" ( SINCScreeningQuestion.relevantDatetime, SINCScreeningQuestion.relevantPeriod ) starts 12 months or less on or after start of "Measurement Period"
"Contraceptive Use Postpartum Initial Population"
exists ( "Had Non Live Birth Event" ) or ( ( "SINC No Responses Only and No Most Mod" ) )
( AgeInYearsAt(date from start of "Measurement Period") in Interval[15, 44]
and exists ( ["Patient Characteristic Sex": "Female"] )
and exists ( "Qualifying Encounters" ) )
and ( exists ( "Had Live Birth Delivery" )
or ( exists ( "Had Estimated Delivery Date" )
and not exists ( "Had Live Birth Delivery" )
and not exists ( "Had Non Live Birth Event" ) )
and ( "Prenatal Care Visits Group" ) )
( ["Assessment, Performed": "Delivery date Estimated"] ) EstimatedDeliveryDatePerformed where EstimatedDeliveryDatePerformed.relevantPeriod overlaps Interval ( start of "Measurement Period" - 3 months, start of "Measurement Period" + 9 months )
( ( ["Encounter, Performed": "General Prenatal Care Visits"] )
union ( ["Encounter, Performed": "Telephone Visits"] )
union ( ["Encounter, Performed": "Virtual Encounter"] ) ) GeneralPrenatalCareVisitPerformed
where Global."NormalizeInterval" ( GeneralPrenatalCareVisitPerformed.authorDatetime, GeneralPrenatalCareVisitPerformed.relevantPeriod ) starts 12 months or less on or before start of "Measurement Period"
or Global."NormalizeInterval" ( GeneralPrenatalCareVisitPerformed.authorDatetime, GeneralPrenatalCareVisitPerformed.relevantPeriod ) starts 9 months or less on or after start of "Measurement Period"
( ( ["Assessment, Performed": "Date and time of obstetric delivery"] )
union ( ["Procedure, Performed": "Live Birth Delivery Procedures"] ) ) LiveBirthDeliveryReported
where Global."NormalizeInterval" ( LiveBirthDeliveryReported.relevantDatetime, LiveBirthDeliveryReported.relevantPeriod ) starts 3 months or less on or before start of "Measurement Period"
or Global."NormalizeInterval" ( LiveBirthDeliveryReported.relevantDatetime, LiveBirthDeliveryReported.relevantPeriod ) starts 9 months or less on or after start of "Measurement Period"
( ( ["Diagnosis": "Non Live Birth Diagnoses"] )
union ( ["Procedure, Performed": "Non Live Birth Procedures"] ) ) NonLiveBirthReported
where Global."NormalizeInterval" ( NonLiveBirthReported.relevantDatetime, NonLiveBirthReported.relevantPeriod ) starts 3 months or less on or before start of "Measurement Period"
or Global."NormalizeInterval" ( NonLiveBirthReported.relevantDatetime, NonLiveBirthReported.relevantPeriod ) starts 12 months or less on or after start of "Measurement Period"
( ["Diagnosis": "Pregnancy Related Diagnoses"] ) PregnancyRelatedDiagnoses
where Global."NormalizeInterval" ( PregnancyRelatedDiagnoses.authorDatetime, PregnancyRelatedDiagnoses.prevalencePeriod ) starts 12 months or less on or before start of "Measurement Period"
or Global."NormalizeInterval" ( PregnancyRelatedDiagnoses.authorDatetime, PregnancyRelatedDiagnoses.prevalencePeriod ) starts 9 months or less on or after start of "Measurement Period"
( ["Encounter, Performed": "Prenatal Care Bundle Visits"] ) PrenatalCareBundleVisit
where Global."NormalizeInterval" ( PrenatalCareBundleVisit.authorDatetime, PrenatalCareBundleVisit.relevantPeriod ) starts 12 months or less on or before start of "Measurement Period"
or Global."NormalizeInterval" ( PrenatalCareBundleVisit.authorDatetime, PrenatalCareBundleVisit.relevantPeriod ) starts 9 months or less on or after start of "Measurement Period"
( ["Encounter, Performed": "Prenatal Care Specific Visits"] ) PrenatalCareSpecificVisit
where Global."NormalizeInterval" ( PrenatalCareSpecificVisit.authorDatetime, PrenatalCareSpecificVisit.relevantPeriod ) starts 12 months or less on or before start of "Measurement Period"
or Global."NormalizeInterval" ( PrenatalCareSpecificVisit.authorDatetime, PrenatalCareSpecificVisit.relevantPeriod ) starts 9 months or less on or after start of "Measurement Period"
( ["Encounter, Performed": "Contraceptive Implant ICD10CM Provision Encounters"] )
union ( ["Encounter, Performed": "Intrauterine Devices ICD10CM Provision Encounters"] ) LARCProvisionEncountersPostpartum
where Global."NormalizeInterval" ( LARCProvisionEncountersPostpartum.authorDatetime, LARCProvisionEncountersPostpartum.relevantPeriod ) starts 3 months or less on or before start of "Measurement Period"
or Global."NormalizeInterval" (LARCProvisionEncountersPostpartum.authorDatetime, LARCProvisionEncountersPostpartum.relevantPeriod ) starts 12 months or less on or after start of "Measurement Period"
( ["Procedure, Performed": "Contraceptive Implant Provision Procedures"] )
union ( ["Procedure, Performed": "IUD Provision Procedures"] ) LARCProvisionProceduresPostpartum
where Global."NormalizeInterval" ( LARCProvisionProceduresPostpartum.relevantDatetime, LARCProvisionProceduresPostpartum.relevantPeriod ) starts 3 months or less on or before start of "Measurement Period"
or Global."NormalizeInterval" ( LARCProvisionProceduresPostpartum.relevantDatetime, LARCProvisionProceduresPostpartum.relevantPeriod ) starts 12 months or less on or after start of "Measurement Period"
( "Postpartum LARC Provision" ) ProvidedLARCAfterEDD
with ( "Had Estimated Delivery Date" ) EDDLP
such that ProvidedLARCAfterEDD.relevantPeriod 90 days or less on or after EDDLP.relevantPeriod
and ProvidedLARCAfterEDD.relevantPeriod 16 weeks on or before EDDLP.relevantPeriod
( "Postpartum LARC Provision" ) ProvidedLARCAfterBirth
with ( "Had Live Birth Delivery" ) LiveBirthDelivery
such that ProvidedLARCAfterBirth.relevantPeriod 90 days or less on or after end of LiveBirthDelivery.relevantPeriod
exists ( "Postpartum LARC After Live Birth" )
or ( exists ( "Postpartum LARC After EDD" )
and not exists ( "Had Live Birth Delivery" )
)
( "Postpartum Provided LARC Device" )
union ( "Postpartum Had LARC Provision Encounter" )
union ( "Postpartum Provided LARC Medication" )
union ( "Postpartum Had LARC Provision Procedures" ) LARCProvided
where Global."NormalizeInterval" ( LARCProvided.relevantDatetime, LARCProvided.relevantPeriod ) starts 3 months or less on or before start of "Measurement Period"
or Global."NormalizeInterval" ( LARCProvided.relevantDatetime, LARCProvided.relevantPeriod ) starts 12 months or less on or after start of "Measurement Period"
( ( ["Device, Order": "Permanent implantable contraceptive intratubal occlusion device(s) and delivery system"] )
union ( ["Device, Order": "IUD Devices"] )
union ( ["Device, Order": "Contraceptive Implant Devices"] )
union ( ["Device, Order": "Contraceptive Patch Devices"] )
union ( ["Device, Order": "Contraceptive Ring HCPCS Devices"] ) ) MostModDevicesPostpartum
where ( ( MostModDevicesPostpartum.authorDatetime 3 months or less on or before start of "Measurement Period" )
or ( MostModDevicesPostpartum.authorDatetime 12 months or less on or after start of "Measurement Period" ) )
( ( ["Encounter, Performed": "Encounter for sterilization"] )
union ( ["Encounter, Performed": "Tubal ligation status"] )
union ( ["Encounter, Performed": "Contraceptive Implant ICD10CM Provision Encounters"] )
union ( ["Encounter, Performed": "Contraceptive Implant ICD10CM Surveillance"] )
union ( ["Encounter, Performed": "Intrauterine Devices ICD10CM Provision Encounters"] )
union ( ["Encounter, Performed": "Intrauterine Devices ICD10CM Surveillance"] )
union ( ["Encounter, Performed": "Injectable Contraceptive ICD10CM Provision Encounters"] )
union ( ["Encounter, Performed": "Injectable Contraceptive ICD10CM Surveillance"] )
union ( ["Encounter, Performed": "Oral Contraceptive Pill ICD10CM Provision Encounters"] )
union ( ["Encounter, Performed": "Oral Contraceptive Pill ICD10CM Surveillance"] )
union ( ["Encounter, Performed": "Contraceptive Patch ICD10CM Provision Encounters"] )
union ( ["Encounter, Performed": "Contraceptive Patch ICD10CM Surveillance"] )
union ( ["Encounter, Performed": "Contraceptive Ring ICD10CM Provision Encounters"] )
union ( ["Encounter, Performed": "Contraceptive Ring ICD10CM Surveillance"] ) ) MostModEncountersPostpartum
where ( ( MostModEncountersPostpartum.authorDatetime 3 months or less on or before start of "Measurement Period" )
or ( MostModEncountersPostpartum.authorDatetime 12 months or less on or after start of "Measurement Period" ) )
( ["Assessment, Performed": "Sterilization SNOMED Findings" ] )
union ( ["Assessment, Performed": "Partner had vasectomy (situation)"] )
union ( ["Assessment, Performed": "Contraceptive Implant SNOMED Findings"] )
union ( ["Assessment, Performed": "Intrauterine Devices SNOMED Findings"] )
union ( ["Assessment, Performed": "Injectable Contraceptive SNOMED Findings"] )
union ( ["Assessment, Performed": "Oral Contraceptive Pill SNOMED Findings"] )
union ( ["Assessment, Performed": "Contraceptive Patch SNOMED Findings"] )
union ( ["Assessment, Performed": "Contraceptive Ring SNOMED Findings"] ) MostModFindingsPostpartum
where Global."NormalizeInterval" ( MostModFindingsPostpartum.relevantDatetime, MostModFindingsPostpartum.relevantPeriod ) starts 3 months or less on or before start of "Measurement Period"
or Global."NormalizeInterval" ( MostModFindingsPostpartum.relevantDatetime, MostModFindingsPostpartum.relevantPeriod ) starts 12 months or less on or after start of "Measurement Period"
( ["Assessment, Performed": "Female sterilization"] )
union ( ["Assessment, Performed": "Contraceptive Implant LOINC"] )
union ( ["Assessment, Performed": "Intrauterine Devices LOINC"] )
union ( ["Assessment, Performed": "Injectable Contraceptive LOINC"] )
union ( ["Assessment, Performed": "Oral Contraceptive Pill LOINC"] )
union ( ["Assessment, Performed": "Contraceptive Patch LOINC"] )
union ( ["Assessment, Performed": "Contraceptive Ring LOINC"] ) MostModLOINCPostpartum
where Global."NormalizeInterval" ( MostModLOINCPostpartum.relevantDatetime, MostModLOINCPostpartum.relevantPeriod ) starts 3 months or less on or before start of "Measurement Period"
or Global."NormalizeInterval" ( MostModLOINCPostpartum.relevantDatetime, MostModLOINCPostpartum.relevantPeriod ) starts 12 months or less on or after start of "Measurement Period"
( ["Procedure, Performed": "Female Sterilization Provision Procedures"] )
union ( ["Procedure, Performed": "Contraceptive Implant Provision Procedures"] )
union ( ["Procedure, Performed": "Contraceptive Implant SNOMED Surveillance Procedures"] )
union ( ["Procedure, Performed": "IUD Provision Procedures"] )
union ( ["Procedure, Performed": "Intrauterine Devices SNOMED Surveillance Procedures"] )
union ( ["Procedure, Performed": "Injectable Contraceptive Provision Procedures"] )
union ( ["Procedure, Performed": "Oral Contraceptive Pill Provision Procedures"] )
union ( ["Procedure, Performed": "Contraceptive Patch SNOMED Provision Procedures"] ) MostModProceduresPostpartum
where Global."NormalizeInterval" ( MostModProceduresPostpartum.relevantDatetime, MostModProceduresPostpartum.relevantPeriod ) starts 3 months or less on or before start of "Measurement Period"
or Global."NormalizeInterval" ( MostModProceduresPostpartum.relevantDatetime, MostModProceduresPostpartum.relevantPeriod ) starts 12 months or less on or after start of "Measurement Period"
( ["Medication, Order": "Contraceptive Implants RXNORM Medications"] )
union ( ["Medication, Order": "Intrauterine Devices RXNORM Medications"] )
union ( ["Medication, Order": "Injectable Contraceptive RXNORM Medications"] )
union ( ["Medication, Order": "Oral Contraceptive Pills RXNORM Medications"] )
union ( ["Medication, Order": "Contraceptive Patch RXNORM Medications"] )
union ( ["Medication, Order": "Contraceptive Ring RXNORM Medications"] ) MostModPrescriptionsPostpartum
where ( ( MostModPrescriptionsPostpartum.relevantPeriod starts 3 months or less on or before start of "Measurement Period" )
or ( MostModPrescriptionsPostpartum.relevantPeriod starts 12 months or less on or after start of "Measurement Period" ) )
( ["Medication, Active": "Contraceptive Implants RXNORM Medications"] )
union ( ["Medication, Active": "Intrauterine Devices RXNORM Medications"] )
union ( ["Medication, Active": "Injectable Contraceptive RXNORM Medications"] )
union ( ["Medication, Active": "Oral Contraceptive Pills RXNORM Medications"] )
union ( ["Medication, Active": "Contraceptive Patch RXNORM Medications"] )
union ( ["Medication, Active": "Contraceptive Ring RXNORM Medications"] ) MostModMedicationsPostpartum
where ( ( MostModMedicationsPostpartum.relevantPeriod starts 3 months or less on or before start of "Measurement Period" )
or ( MostModMedicationsPostpartum.relevantPeriod starts 12 months or less on or after start of "Measurement Period" ) )
( "Postpartum Most and Moderately Effective Contraceptive Encounters" )
union ( "Postpartum Most and Moderately Effective Contraceptive Procedures" )
union ( "Postpartum Most and Moderately Effective Contraceptive Devices" )
union ( "Postpartum Most and Moderately Effective Contraceptive Provision" )
union ( "Postpartum Most and Moderately Effective Contraceptive Use" )
union ( "Postpartum Most and Moderately Effective Contraceptive Findings" )
union ( "Postpartum Most and Moderately Effective Contraceptive LOINC" ) MostModUsePostpartum
where Global."NormalizeInterval" ( MostModUsePostpartum.relevantDatetime, MostModUsePostpartum.relevantPeriod ) starts 3 months or less on or before start of "Measurement Period"
or Global."NormalizeInterval" ( MostModUsePostpartum.relevantDatetime, MostModUsePostpartum.relevantPeriod ) starts 12 months or less on or after start of "Measurement Period"
"Postpartum Most and Moderately Effective Contraceptive Use and Provision" MostModAfterEDD
with "Had Estimated Delivery Date" EDDandMostMod
such that MostModAfterEDD.relevantPeriod 90 days or less on or after EDDandMostMod.relevantPeriod
and EDDandMostMod.relevantPeriod 16 weeks on or before EDDandMostMod.relevantPeriod
"Postpartum Most and Moderately Effective Contraceptive Use and Provision" MostModAfterLBD
with "Had Live Birth Delivery" LiveBirthDeliveryandMostMod
such that MostModAfterLBD.relevantPeriod 90 days or less on or after LiveBirthDeliveryandMostMod.relevantPeriod
exists ( "Postpartum Most and Moderately Effective Contraceptive Use and Provision After Live Birth Delivery" )
or ( exists ( "Postpartum Most and Moderately Effective Contraceptive Use and Provision After Estimated Delivery Date" )
and not exists ( "Had Live Birth Delivery" ) )
( ["Device, Order": "Contraceptive Implant Devices"] )
union ( ["Device, Order": "IUD Devices"] ) LARCProvisionDevicesPostpartum
where ( ( LARCProvisionDevicesPostpartum.authorDatetime 3 months or less on or before start of "Measurement Period" )
or ( LARCProvisionDevicesPostpartum.authorDatetime 12 months or less on or after start of "Measurement Period" ) )
( ["Medication, Order": "Contraceptive Implants RXNORM Medications"] )
union ( ["Medication, Order": "Intrauterine Devices RXNORM Medications"] ) LARCProvisionMedicationsPostpartum
where Global."NormalizeInterval" ( LARCProvisionMedicationsPostpartum.authorDatetime, LARCProvisionMedicationsPostpartum.relevantPeriod ) starts 3 months or less on or before start of "Measurement Period"
or Global."NormalizeInterval" ( LARCProvisionMedicationsPostpartum.authorDatetime, LARCProvisionMedicationsPostpartum.relevantPeriod ) starts 12 months or less on or after start of "Measurement Period"
exists ( "Had Prenatal Care Specific Visit" )
or exists ( "Had Prenatal Care Bundle Visit" )
or ( exists ( "Had Pregnancy Related Diagnoses" )
and exists ( "Had General Prenatal Care Visit" ) )
( ( ["Encounter, Performed": "Office Visit"] )
union ( ["Encounter, Performed": "Preventive Care Services Established Office Visit, 18 and Up"] )
union ( ["Encounter, Performed": "Preventive Care Services Initial Office Visit, 18 and Up"] )
union ( ["Encounter, Performed": "Preventive Care Services, Initial Office Visit, 0 to 17"] )
union ( ["Encounter, Performed": "Preventive Care, Established Office Visit, 0 to 17"] )
union ( ["Encounter, Performed": "Home Healthcare Services"] )
union ( ["Encounter, Performed": "Telephone Visits"] )
union ( ["Encounter, Performed": "Virtual Encounter"] ) )
ValidEncounters
where Global."NormalizeInterval" ( ValidEncounters.authorDatetime, ValidEncounters.relevantPeriod ) starts 3 months or less on or before start of "Measurement Period"
or Global."NormalizeInterval" (ValidEncounters.authorDatetime, ValidEncounters.relevantPeriod ) starts 12 months or less on or after start of "Measurement Period"
["Patient Characteristic Ethnicity": "Ethnicity"]
["Patient Characteristic Payer": "Payer Type"]
["Patient Characteristic Race": "Race"]
( ( "SINC No within Interval of 16 weeks before EDD and 90 days after Live Birth Delivery" ) union ( "SINC No within Live Birth Delivery Postpartum Interval" ) union ( "SINC No within EDD Postpartum Interval" ) )
( ( "Absence of Postpartum Most Mod Contraception" ) and exists ( "SINC No Exclusion within Postpartum Periods" ) )
from "Had Estimated Delivery Date" EDD16wks,
"Answered No SINC Postpartum" NotoSINCPP
where ( Global."NormalizeInterval" ( NotoSINCPP.relevantDatetime, NotoSINCPP.relevantPeriod ) starts during day of Interval[( start of EDD16wks.relevantPeriod
) - 16 weeks, (
end of EDD16wks.relevantPeriod
) + 90 days ] )
and not exists "Had Live Birth Delivery"
and exists "Asked SINC Question"
from "Had Live Birth Delivery" LBDD90daysafter,
"Had Estimated Delivery Date" EDD16weeksbefore,
"Answered No SINC Postpartum" NotoSINCPP
where ( Global."NormalizeInterval" ( NotoSINCPP.relevantDatetime, NotoSINCPP.relevantPeriod ) starts during day of Interval[( start of EDD16weeksbefore.relevantPeriod
) - 16 weeks, (
end of LBDD90daysafter.relevantPeriod
) + 90 days ] )
and exists "Asked SINC Question"
from "Had Live Birth Delivery" LBDD90,
"Answered No SINC Postpartum" NotoSINCPP
where ( Global."NormalizeInterval" ( NotoSINCPP.relevantDatetime, NotoSINCPP.relevantPeriod ) starts during day of Interval[( start of LBDD90.relevantPeriod
) - 16 weeks, (
end of LBDD90.relevantPeriod
) + 90 days ] )
and not exists "Had Estimated Delivery Date"
and exists "Asked SINC Question"
if pointInTime is not null then Interval[pointInTime, pointInTime]
else if period is not null then period
else null as Interval<DateTime>
["Patient Characteristic Ethnicity": "Ethnicity"]
["Patient Characteristic Payer": "Payer Type"]
["Patient Characteristic Race": "Race"]
| Measure Set |
|
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|---|---|---|---|