Cypress v2.2 Released

[Dingwell, Robert A.]

Cypress V2.2 is now available.  Enhancements included in this release:  

 

·         New QRDA Cat I Test Workflow – the QRDA Category 1 test is now based off the test decks used for Eligible Provider and Eligible Hospital calculation testing; the former QRDA Category 1 test deck is no longer in use.  The new QRDA Category I test workflow is described in an update to  the Test Procedure for §170.314(c) Clinical quality measures, which can be found at:   http://www.healthit.gov/sites/default/files/170.314c123clinicalqualitymeasure_2014_approved_v1.4.pdf

 

·         Updated Measure Bundle – CMS published its annual update to  for Stage 2 of Meaningful Use (MU) Eligible Hospital Clinical Quality Measures (CQM) in April 2013.  Cypress has been updated to reflect the revised electronic specifications in this update:  http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/eCQM_Library.html

 

·         Test Deck Updates – described below

 

The source code for the application is available at http://github.com/projectcypress/cypress

 

The Updated measure bundle can be found at http://demo.projectcypress.org/bundles/bundle-latest.zip

 

A list of software changes in this release can be found in the Cypress source repository:  https://github.com/projectcypress/cypress/blob/master/CHANGLOG.txt

 

For those with an existing Cypress V2.1  installation instructions for upgrading an existing Cypress v2.1 installation can be found here.  https://github.com/projectcypress/cypress/wiki/V2.1-to-V2.2-Upgrade-Instructions 

 

Instructions for installing Cypress V2.2 can be found at this location: https://github.com/projectcypress/cypress/wiki/Cypress-v2.2-Installation-Guide

 

 

Incompatibilities within this release:

 

The latest measure bundle is not backward compatible with Cypress 2.0.  This bundle contains updated CQMs with additional functionality for calculating Continuous Variable measures and will need to be used in an upgraded system.  Please refers to the upgrade instruction mentioned above.

 

The latest version of Cypress is not forward compatible with the v2.0.0 or v2.0.1  measure bundles.  This has to do with changes made to the bundle format starting with v2.1.0 to support multiple versions of measures and value sets going forward and for dynamic CV measure support.  Again, if you have an existing system follow the upgrade instruction above.

 

Updates to the Test Decks:

 

In Cypress 2.1 a bug was introduced in the processing  order of  Denominators and Exclusions,  which has been resolved in this release.  As a result of this modification the following changes have been observed in the measure population calculations.

 

NQF 0371:

  A, CAP_ADULT - drops from the numerator and goes to the Exclusions

 

NQF 0372:

  A, AMI_ADULT - drops from denominator and exclusions

  B, AMI_ADULT - drops from denominator and exclusions

  B, SCIP_ADULT - drops from denominator and exclusions

  B, STROKE_ADULT - drops from denominator and exclusions

  C, AMI_ADULT - drops from denominator and exclusions

  C, VTE_ADULT - drops from denominator and exclusions

  D, AMI_ADULT - drops from denominator and exclusions

 

Cholesterol Screening Risk (all populations):

  B, Pregnancy_Adult - drops from denominator and exclusions

 

Fasting LDL Test (high risk and moderate risk):

  B, Pregnancy_Adult - drops from denominator and exclusions

 

The following data element changes have been made to the EH patient test deck records:

 

AMI_ADULT A

Diagnostic Study, Result: Hospital Measures Ecg becomes Diagnostic Study, Result: Hospital Measures Ecg impression

test result goes from "Hospital Measures-ST-segment elevation" to "Hospital Measures-Acute or Evolving Mi"

 

AMI_ADULT B

Diagnostic Study, Result: Hospital Measures Ecg becomes Diagnostic Study, Result: Hospital Measures Ecg impression

test result goes from "Hospital Measures-ST-segment elevation" to "Hospital Measures-Acute or Evolving Mi"

 

AMI_ADULT C

Diagnostic Study, Result: Hospital Measures Ecg becomes Diagnostic Study, Result: Hospital Measures Ecg impression

test result goes from "Hospital Measures-ST-segment elevation" to "Hospital Measures-Acute or Evolving Mi"

 

AMI_ADULT D

Diagnostic Study, Result: Hospital Measures Ecg becomes Diagnostic Study, Result: Hospital Measures Ecg impression

test result goes from "Hospital Measures-ST-segment elevation" to "Hospital Measures-Acute or Evolving Mi"

 

OB A

Diagnostic Study, Performed: Vte Diagnostic Test becomes Diagnostic Study, Result

 

OB B

Diagnostic Study, Performed: Vte Diagnostic Test becomes Diagnostic Study, Result

Diagnosis, Active: Normal Delivery And Other Indications For Care (Dropped from measure)

 

CAP_ADULT A

Encounter, Performed: ICU Admission or Transfer - end date shifted by 1 day to make length of stay > 1 day

[Dingwell, Robert A.]

With the recent release of Cypress v2.2 an incorrect version of the  pre-installed Virtual Machine was made available for download.  The version that was uploaded contained a bug that prevented downloading of the patient test records.  This bug was discovered and resolved before the official release of version 2.2 yet the virtual machine that was uploaded inadvertently  contained the issue. The correct version of the Virtual Machine has been uploaded and is now currently available.  This issue only impacted the pre installed VM and did not impact manual installations or using the Amazon Instance.

Sorry for the inconvenience that this may have caused. 

Rob Dingwell

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