Quality Measure Implementation Guide

This page is part of the Quality Measure STU2 for FHIR R4 Implementation Guide (v0.1.0: STU 1 Ballot 1) based on FHIR R3. The current version which supercedes this version is 3.0.0. For a full list of available versions, see the Directory of published versions

Measure-measure-exm130-FHIR

Formats: XML, JSON, Turtle

Id: Measure/measure-exm130-FHIR
Type:
system: http://hl7.org/fhir/measure-type
code: process
Identifier: system: http://hl7.org/fhir/cqi/ecqm/Measure/Identifier/cms
value: 130
system: http://hl7.org/fhir/cqi/ecqm/Measure/Identifier/nqf
value: 0034
Title: Colorectal Cancer Screening
Status: active
Description: Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
Purpose: Patients 50-75 years of age with a visit during the measurement period
Use Context:

code: program

value:
text: eligible-provider

Topic:
system: http://loinc.org
code: 57024-2
display: Health Quality Measure Document
Contributor: author: National Committee for Quality Assurance
Related:

type: citation

citation:
U.S. Preventive Services Task Force. "Screening for Colorectal Cancer: U.S. Preventive Services Task Force Recommendation Statement." JAMA, vol. 315, no. 23, 2016, pp. 2564-2575. doi: 10.1001/jama.2016.5989

type: citation

citation:
Howlader, N., A.M. Noone, M. Krapcho, D. Miller, K. Bishop, C.L. Kosary, M. Yu, J. Ruhl, Z. Tatalovich, A. Mariotto, D.R. Lewis, H.S. Chen, E.J. Feuer, and K.A. Cronin. "SEER Cancer Statistics Review, 1975-2014." Washington, DC: National Cancer Institute, 2017. Available at https://seer.cancer.gov/csr/1975_2014/

type: citation

citation:
American Cancer Society. "Can Colorectal Polyps and Cancer Be Found Early?" Last modified March 2017. Washington, DC: American Cancer Society. Available at https://www.cancer.org/cancer/colon-rectal-cancer/detection-diagnosis-staging/detection.html.

Library:

reference: Library/library-exm130-FHIR

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. Due to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM].
Scoring:
system: http://hl7.org/fhir/measure-scoring
code: proportion
Rationale: Colorectal cancer represents 8 percent of all new cancer cases and is the second leading cause of cancer deaths in the United States. In 2017, there were an estimated 135,430 new cases of colorectal cancer and an estimated 50,260 deaths attributed to it. According to the National Cancer Institute, about 4.3 percent of men and women will be diagnosed with colorectal cancer at some point during their lifetimes. For most adults, older age is the most important risk factor for colorectal cancer, although being male and black are also associated with higher incidence and mortality. Colorectal cancer is most frequently diagnosed among people 65 to 74 years old (Howlader et al. 2017). Screening can be effective for finding precancerous lesions (polyps) that could later become malignant, and for detecting early cancers that can be more easily and effectively treated. Precancerous polyps usually take about 10 to 15 years to develop into colorectal cancer, and most can be found and removed before turning into cancer. The five-year relative survival rate for people whose colorectal cancer is found in the early stage before it has spread is about 90 percent (American Cancer Society 2017).
Clinical Recommendation: The U. S. Preventive Services Task Force (2016) recommends screening for colorectal cancer starting at age 50 years and continuing until age 75 years. This is a Grade A recommendation (U.S. Preventive Services Task Force 2016). Screening tests: -Colonoscopy (every 10 years) -Flexible sigmoidoscopy (every 5 years) -Fecal occult blood test (annually) -FIT-DNA (every 3 years) -Computed tomographic colonography (every 5 years)
Guidance: Patient self-report for procedures as well as diagnostic studies should be recorded in "Procedure, Performed" template or "Diagnostic Study, Performed" template in QRDA-1. Do not count DRE, FOBT tests performed in an office setting or performed on a sample collected via DRE.
Group:

Identifier:
value: group-1

Population:

Identifier:
value: initial-population-identifier

criteria: Initial Population

Identifier:
value: numerator-identifier

criteria: Numerator

Identifier:
value: denominator-identifier

criteria: Denominator

Identifier:
value: denominator-exclusions-identifier

criteria: Denominator Exclusion

Supplemental Data:

Identifier:
value: sde-ethnicity

usage:
system: http://hl7.org/fhir/measure-data-usage
code: supplemental-data

criteria: SDE Ethnicity

Identifier:
value: sde-payer

usage:
system: http://hl7.org/fhir/measure-data-usage
code: supplemental-data

criteria: SDE Payer

Identifier:
value: sde-race

usage:
system: http://hl7.org/fhir/measure-data-usage
code: supplemental-data

criteria: SDE Race

Identifier:
value: sde-sex

usage:
system: http://hl7.org/fhir/measure-data-usage
code: supplemental-data

criteria: SDE Sex