ASCP Grant Measure 6 - Rate of Notification to the Responsible Provider of a New Diagnosis of Malignancy within 5 Days of Pathology Report

Percentage of pathology reports for patients with a new diagnosis of malignancy (other than squamous or basal cell carcinoma of the skin), and communication of the diagnosis from the pathologist to the responsible provider was made within 5 days of finalization of the report.

This appropriate utilization measure was developed through consensus of an ASCP technical expert panel and vetted through a formal review process by all medical specialties participating in the ABIM's Choosing Wisely Campaign, and is based on published Choosing Wisely recommendations.

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. IMPAQ disclaims all liability for use or accuracy of any third party codes contained in the specifications.

CPT(R) contained in the Measure specifications is copyright 2004-2018 American Medical Association. LOINC(R) is copyright 2004-2018 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2018 International Health Terminology Standards Development Organization. ICD-10 is copyright 2018 World Health Organization. All Rights Reserved.

This measure and specifications are subject to further revisions. 

The performance Measure is not a clinical guideline, 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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The diagnosis of a new malignancy has a significant impact on patient care, and is considered to be a "critical value" by most pathology laboratories. Just because a report is finalized in the laboratory information system does not ensure the responsible clinical provider receives the diagnosis in a timely fashion (or at all). Pathologists often notify the responsible provider through other means in addition the standard electronic reporting. This measure helps to avoid preventable harm by closing the loop on communicating a significant diagnosis that likely has a significant impact on patient treatment and outcomes.

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A higher rate indicates better quality.

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http://www.adasp.org/News/Guideline-on-Effective-Communication-of-Urgent-Diagnoses-Posted-to-AHRQ-National-Guidelines-Clearin.html

Communication is defined as a documented notification from the pathologist or laboratory personnel to the responsible provider. The notification can take many forms, e.g., telephone, or secure electronic transmission such as text messaging, Electronic Health Records systems, or email with read receipt functionality. Best practice is to document the communication modality, the date and time the communication was sent, to whom the communication was sent, and if the communication was received.

The responsible provider is identified by each pathology team based on their own clinical care and communication protocols.

This is an episode-based measure, meaning there may be more than one reportable event for a given patient during the measurement period. The level of analysis for this measure is each pathology report with a new diagnosis of malignancy (other than squamous or basal cell carcinoma of the skin) from that specimen during the measurement period, including instances where more than one pathology specimen was evaluated during the measurement period. Every pathology report with a new diagnosis of malignancy during the measurement period should be counted as a measurable denominator event for the measure calculation.

This measure specification defines how to determine if the diagnosis of malignancy is reported to the responsible provider is within 5 day of the completion of the pathology report, by calculating the time interval between the "Malignancy Pathology Report" authored date and time and the "Communication to Provider" sent date and time. 

This version of the eCQM uses QDM version 5.5.  Please refer to the eCQI resource center (https://ecqi.healthit.gov/qdm) for more information on the QDM.

TBD

Number of pathology reports for patients with a new diagnosis of malignancy (other than squamous or basal cell carcinoma of the skin) during the measurement year.

Equals Initial Population

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Number of pathology reports for patients with a new diagnosis of malignancy (other than squamous or basal cell carcinoma of the skin), and communication of the diagnosis from the pathologist to the responsible provider was made within 5 days of finalization of the report.

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For every patient evaluated by this measure also identify payer, race, ethnicity and sex