Quality Measure STU2 for FHIR R4 Implementation Guide
This page is part of the Quality Measure STU2 for FHIR R4 Implementation Guide (v1.1.0: STU 2 Ballot 1) based on FHIR R4. 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 xmlns="http://hl7.org/fhir"> <id value="measure-exm124-FHIR"/> <meta> <versionId value="5"/> <lastUpdated value="2019-11-09T04:27:45.006+00:00"/> <profile value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/proportion-measure-cqfm"/> </meta> <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml"><table style="width: 60%; border-bottom: none;" class="header_table"> <!-- <tr th:if="${resource.hasId()}" style="vertical-align: top;"><th style="background-color:#656565; width:20%" scope="row"><span class="td_label">Id: </span></th><td style="width:80%" colspan="3" th:narrative="${resource.id}"></td></tr> --><tr style="vertical-align: top;"><td scope="row" style="background-color:#656565; width:20%"><span class="td_label">Measure Title</span></td><td colspan="1" style="width:60%"><h1 style="font-size:10px">Cervical Cancer Screening</h1></td><td scope="row" style="background-color:#656565; width:10%"><span class="td_label">Measure ID</span></td><td colspan="1" style="width:10%"><h1 style="font-size:10px">EXM124</h1></td></tr> <!-- <th:block th:each="ident, iter : ${resource.identifier}"><tr th:if="${ident.type.coding[0].code == 'CMS'}" style="vertical-align: top;"><td style="background-color:#656565; width:20%" scope="row"><span class="td_label">eCQM Identifier (Measure Authoring Tool)</span></td><td style="width:30%" th:narrative="${ident.value}"></td><td style="background-color:#656565; width:20%" scope="row"><span class="td_label">eCQM Version number</span></td><td style="width:30%" th:narrative="${resource.version}"></td></tr></th:block><th:block th:each="ident, iter : ${resource.identifier}"><tr th:if="${ident.type.coding[0].code == 'NQF'}" style="vertical-align: top;"><td style="background-color:#656565; width:20%" scope="row"><span class="td_label">NQF Number</span></td><td style="width:30%" th:narrative="${ident.value}"></td><td style="background-color:#656565; width:20%" scope="row"><span class="td_label">GUID</span></td><td style="width:30%" th:narrative="${resource.url}"></td></tr></th:block> --><tr style="vertical-align: top;"><td scope="row" style="background-color:#656565; width:20%"><span class="td_label">Description</span></td><td colspan="3" style="width:80%"><div style="width:660px;overflow-x:hidden;overflow-y:auto"><pre><p>Percentage of women 21-64 years of age who were screened for cervical cancer using either of the following criteria:</p> <ul> <li>Women age 21-64 who had cervical cytology performed every 3 years <br.* Women age 30-64 who had cervical cytology/human papillomavirus (HPV) co-testing performed every 5 years</li> </ul> </pre> </div> </td> </tr> <tr> <td scope="row" style="background-color:#656565; width:20%"><span class="td_label">Measurement Period</span></td> <td colspan="3" style="width:80%">January 1 - December 31</td> </tr> <!-- <tr> <td style="background-color:#656565; width:20%" scope="row"><span class="td_label">Measure Steward</span></td> <td style="width:80%" colspan="3" th:narrative="${resource.publisher}"></td> </tr> <tr> <td style="background-color:#656565; width:20%" scope="row"><span class="td_label">Measure Developer</span></td> <td style="width:80%" colspan="3" th:narrative="${resource.publisher}"></td> </tr> --> <!-- <tr th:if="${resource.hasDisclaimer()}"> <td style="background-color:#656565; width:20%" scope="row"><span class="td_label">Disclaimer</span></td> <td style="width:80%" colspan="3"> <div style="width:660px;overflow-x:hidden;overflow-y:auto"> <pre th:text="${resource.disclaimer}"></pre> </div> </td> </tr> --> <tr> <td scope="row" style="background-color:#656565; width:20%"><span class="td_label">Copyright and Disclaimer Notice</span></td> <td colspan="3" style="width:80%"> <div style="width:660px;overflow-x:hidden;overflow-y:auto"> <pre>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].</pre> <br/> <pre>This Physician Performance Measure (Measure) and related data specifications were developed by the National Committee for Quality Assurance (NCQA). NCQA is not responsible for any use of the Measure. NCQA makes no representations, warranties, or endorsement about the quality of any organization or physician that uses or reports performance measures and NCQA has no liability to anyone who relies on such measures or specifications. NCQA holds a copyright in the Measure. The Measure can be reproduced and distributed, without modification, for noncommercial purposes (eg, use by healthcare providers in connection with their practices) without obtaining approval from NCQA. Commercial use is defined as the sale, licensing, or distribution of the Measure for commercial gain, or incorporation of the Measure into a product or service that is sold, licensed or distributed for commercial gain. All commercial uses or requests for modification must be approved by NCQA and are subject to a license at the discretion of NCQA. (C) 2012-2017 National Committee for Quality Assurance. All Rights Reserved. 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. NCQA 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 2004-2017 American Medical Association. LOINC(R) copyright 2004-2017 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R] ) copyright 2004-2017 International Health Terminology Standards Development Organisation. ICD-10 copyright 2017 World Health Organization. All Rights Reserved.</pre> </div> </td> </tr> <tr> <td scope="row" style="background-color:#656565; width:20%"><span class="td_label">Clinical Recommendation Statement</span></td> <td colspan="3" style="width:80%"> <div style="width:660px;overflow-x:hidden;overflow-y:auto"><p>The U.S. Preventive Services Task Force (USPSTF) recommends biennial screening mammography for women aged 50-74 years (B recommendation).<br/> The decision to start screening mammography in women prior to age 50 years should be an individual one. Women who place a higher value on the potential benefit than the potential harms may choose to begin biennial screening between the ages of 40 and 49 years (C recommendation). (USPSTF, 2016)<br/> The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening mammography in women aged 75 years or older (I statement). (USPSTF, 2016)<br/> The USPSTF concludes that the current evidence is insufficient to assess the benefits and harms of digital breast tomosynthesis (DBT) as a primary screening method for breast cancer (I Statement). (USPSTF, 2016)<br/> The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of adjunctive screening for breast cancer using breast ultrasonography, magnetic resonance imaging, DBT, or other methods in women identified to have dense breasts on an otherwise negative screening mammogram (I statement). (USPSTF, 2016)</p> </div> </td> </tr> <tr style="vertical-align: top;"> <td rowspan="4" scope="row" style="background-color:#656565; width:20%"><span class="td_label">References</span></td> <td colspan="3" style="width:80%"> <div style="width:660px;overflow-x:hidden;overflow-y:auto"> <pre>Howlader, N., Noone, A.M., Krapcho, M., Miller, D., Bishop, K., Altekruse, S.F., Kosary, C.L., Yu, M., Ruhl, J., Tatalovich, Z., Mariotto, A., Lewis, D.R., Chen, H.S., Feuer, E.J., and Cronin, K.A. 2016. "SEER Cancer Statistics Review, 1975-2013." National Cancer Institute. (December 5, 2016) http://seer.cancer.gov/csr/1975_2013/</pre> </div> </td> </tr> <tr style="vertical-align: top;"> <td colspan="3" style="width:80%"> <div style="width:660px;overflow-x:hidden;overflow-y:auto"> <pre>National Business Group on Health. 2011. "Pathways to Managing Cancer in the Workplace." (May 8, 2012). http://www.tcyh.org/employers/downloads/Pathways_Managing_Cancer_2011.pdf</pre> </div> </td> </tr> <tr style="vertical-align: top;"> <td colspan="3" style="width:80%"> <div style="width:660px;overflow-x:hidden;overflow-y:auto"> <pre>Feig S. 2011. Comparison of Costs and Benefits of Breast Cancer Screening with Mammography, Ultrasonagraphy, and MRI. Obstetrics and Gynecology Clinics of North America. 38(1):179-96.</pre> </div> </td> </tr> <tr style="vertical-align: top;"> <td colspan="3" style="width:80%"> <div style="width:660px;overflow-x:hidden;overflow-y:auto"> <pre>U.S. Preventive Services Task Force (USPSTF). 2016. "Screening for Breast Cancer: U.S. Preventive Services Task Force Recommendation Statement." Ann Intern Med. 164(4):279-296. doi:10.7326/M15-2886.</pre> </div> </td> </tr> <tr> <td colspan="4" scope="row" style="background-color:#656565; width:100%"><span class="td_label">Characteristics</span></td> </tr> <tr> <td scope="row" style="width:20%"><span>Scoring</span></td> <td colspan="3" style="width:80%">Proportion</td> </tr> <!-- <tr th:if="${resource.hasCompositeScoring()}"> <td style="width:20%" scope="row"><span class="td_label">Composite Scoring</span></td> <td style="width:80%" colspan="3" th:narrative="${resource.compositeScoring.getText().substring(0, 1).toUpperCase() + resource.compositeScoring.getText().substring(1)}"></td> </tr> --> <tr style="vertical-align: top;"> <td rowspan="1" scope="row" style="width:20%"><span>Type</span></td> <td colspan="3" style="width:80%">Process</td> </tr> <!-- <tr th:if="${resource.hasStatus()}" style="vertical-align: top;"> <td style="background-color:#656565; width:20%" scope="row"><span class="td_label">Status</span></td> <td style="width:80%" colspan="3" th:narrative="${resource.status.toString().substring(0, 1).toUpperCase() + resource.status.toString().substring(1).toLowerCase()}"></td> </tr> <tr th:if="${resource.hasPurpose()}" style="vertical-align: top;"> <td style="background-color:#656565; width:20%" scope="row"><span class="td_label">Purpose</span></td> <td style="width:80%" colspan="3" th:narrative="${resource.purpose}"></td> </tr> <tr th:if="${resource.hasUsage()}" style="vertical-align: top;" > <td style="background-color:#656565; width:20%" scope="row"><span class="td_label">Usage</span></td> <td style="width:80%" colspan="3" th:narrative="${resource.usage}"></td> </tr> <th:block th:each="context, iter : ${resource.useContext}" > <tr style="vertical-align: top;"> <td th:if="${iter.index == 0}" th:rowspan="${iter.size}" style="background-color:#656565; width:20%" scope="row"><span class="td_label">Use Context</span></td> <td style="width:80%" colspan="3" th:narrative="${context}"></td> </tr> </th:block> <th:block th:each="topics, iter : ${resource.topic}" > <tr style="vertical-align: top;"> <td th:if="${iter.index == 0}" th:rowspan="${iter.size}" style="background-color:#656565; width:20%" scope="row"><span class="td_label">Topic</span></td> <td style="width:80%" colspan="3" th:narrative="${topics}"></td> </tr> </th:block> <th:block th:each="cont, iter : ${resource.contributor}" > <tr style="vertical-align: top;"> <td th:if="${iter.index == 0}" th:rowspan="${iter.size}" style="background-color:#656565; width:20%" scope="row"><span class="td_label">Contributor</span></td> <td style="width:80%" colspan="3"> <b><span th:narrative="${cont.type.toCode()}"></span>: </b><span th:narrative="${cont.name}"></span> </td> </tr> </th:block> --> <!-- <th:block th:each="lib, iter : ${resource.library}" > <tr style="vertical-align: top;"> <td th:if="${iter.index == 0}" th:rowspan="${iter.size}" style="background-color:#656565; width:20%" scope="row"><span class="td_label">Library</span></td> <td style="width:80%" colspan="3"> <p th:if="${lib.hasIdentifier()}"><b>identifier: </b><span th:narrative="${lib.identifier}"></span></p> <p th:if="${lib.hasReference()}"><b>reference: </b><span th:narrative="${lib.reference}"></span></p> <p th:if="${lib.hasDisplay()}"><b>display: </b><span th:narrative="${lib.display}"></span></p> </td> </tr> </th:block> --> <!-- <tr th:if="${resource.hasRateAggregation()}" > <td style="background-color:#656565; width:20%" scope="row"><span class="td_label">Rate Aggregation</span></td> <td style="width:80%" colspan="3"> <div style="width:660px;overflow-x:hidden;overflow-y:auto"> <pre th:text="${resource.rateAggregation}"></pre> </div> </td> </tr> <tr th:if="${resource.hasRationale()}"> <td style="background-color:#656565; width:20%" scope="row"><span class="td_label">Rationale</span></td> <td style="width:80%" colspan="3"> <div style="width:660px;overflow-x:hidden;overflow-y:auto"> <pre th:text="${resource.rationale}"></pre> </div> </td> </tr> --> <tr> <td scope="row" style="width:20%"><span>Improvement Notation</span></td> <td colspan="3" style="width:80%">A higher rate indicates better performance.</td> </tr> <tr> <td scope="row" style="width:20%"><span>Guidance</span></td> <td colspan="3" style="width:80%"> <div style="width:660px;overflow-x:hidden;overflow-y:auto"><p>To ensure the measure is only looking for a cervical cytology test only after a woman turns 21 years of age, the youngest age in the initial population is 23.<br/> 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.<br/> Include only cytology and HPV "co-testing"; in co-testing, both cytology and HPV tests are performed (i.e., the samples are collected and both tests are ordered, regardless of the cytology result) on the same date of service. Do not include reflex testing. In addition, if the medical record indicates the HPV test was performed only after determining the cytology result, this is considered reflex testing and does not meet criteria for the measure.</p> </div> </td> </tr> <tr> <td colspan="4" scope="row" style="background-color:#656565; width:100%"><span class="td_label">Definitions</span></td> </tr> <!-- <th:block th:each="groups, iter : ${resource.uniquePopulationGroup}" > <tr style="vertical-align: top;"> <td style="background-color:#656565; width:20%" scope="row"><span class="td_label" th:text="${groups.identifier.value}"></span></td> <td style="width:80%" colspan="3"> <div style="width:660px;overflow-x:hidden;overflow-y:auto"> <pre th:text="${pops.description}"></pre> </div> </td> </tr> </th:block> --> </table> <table style="width: 60%; border-top: none; border-bottom: none" class="header_table"> </table> <table style="width: 60%; border-top: none;" class="header_table"> <!-- <th:block th:each="supples, iter : ${resource.supplementalData}"> <tr> <th th:if="${iter.index == 0}" th:rowspan="${iter.size}" scope="row"><b>Supplemental Data:</b></th> <td style="width:80%" colspan="3" > <p style="margin-bottom: 5px;" th:narrative="${supples.identifier}"></p> <p style="margin-bottom: 5px;" th:each="uses : ${supples.usage}"> <b>usage: </b> <span th:narrative="${uses}"></span> </p> <p style="margin-bottom: 5px;" th:if="${supples.hasCriteria()}"> <b>criteria: </b> <span th:narrative="${supples.criteria}"></span> </p> <p style="margin-bottom: 5px;" th:if="${supples.hasPath()}"> <b>path: </b> <span th:narrative="${supples.path}"></span> </p> </td> </tr> </th:block> --> <!-- <th:block th:each="param, iter : ${resource.parameter}"> <tr style="vertical-align: top;"> <th th:if="${iter.index == 0}" th:rowspan="${iter.size}" scope="row"><b>Parameter: </b></th> <td style="width:80%" colspan="3" > <span th:if="${param.hasName()}"> <b>name: </b> <span th:narrative="${param.name}"></span> <br/> </span> <b>use: </b> <span th:narrative="${param.use.toCode()}"></span> <br/> <span th:if="${param.hasMin()}"> <b>minimum cardinality: </b> <span th:narrative="${param.min}"></span> <br/> </span> <span th:if="${param.hasMax()}"> <b>maximum cardinality: </b> <span th:narrative="${param.max}"></span> <br/> </span> <b>type: </b> <span th:narrative="${param.type}"></span> <br/> <span th:if="${param.hasDocumentation()}"> <b>documentation: </b> <span th:narrative="${param.documentation}"></span> <br/> </span> <span th:if="${param.hasProfile()}"> <b>profile: </b> <span th:narrative="${param.profile}"></span> <br/> </span> <p style="margin-bottom: 5px;"></p> </td> </tr> </th:block> --> <!-- <th:block th:each="dataReq, iter : ${resource.dataRequirement}"> <tr style="vertical-align: top;"> <th th:if="${iter.index == 0}" th:rowspan="${iter.size}" scope="row" ><b>Data Requirements: </b></th> <td style="width:80%" colspan="3" th:narrative="${dataReq}"></td> </tr> </th:block> --> </table> <h2><a name="toc">Table of Contents</a></h2> <ul style="padding-left: 50px;"> <li><a href="#d1e405">Population Criteria</a></li> <li><a href="#d1e649">Definitions</a></li> <li><a href="#d1e650">Functions</a></li> <li> <!-- a href="#d1e555" -->Terminology <!-- /a --></li> <li> <!-- a href="#d1e647" -->Data Criteria (QDM Data Elements) <!-- /a --></li> <li><a href="#d1e767">Supplemental Data Elements</a></li> <li><a href="#d1e879">Risk Adjustment Variables</a></li> </ul> <div style="float:left; background:teal; height:3px; width:80%"/> <pre><br/></pre> <h3><a name="d1e405" href="#toc">Population Criteria</a></h3> <div> <ul style="list-style:none;padding-left:10px;"> <li style="list-style:none;padding-left:0px;" class="list-unstyled"> <div class="treeview hover p-l-10"> <ul class="list-unstyled"> <li class="list-unstyled"> <ul class="code"> <li class="list-unstyled"> <div class="treeview hover p-l-10"> <ul> <li style="padding-left: 0px;"> <div> <pre class="cql-definition-body">org.hl7.fhir.r4.model.Expression@1878b216</pre> </div></li> </ul> </div></li> </ul></li> </ul> </div> <div class="treeview hover p-l-10"> <ul class="list-unstyled"> <li class="list-unstyled"> <ul class="code"> <li class="list-unstyled"> <div class="treeview hover p-l-10"> <ul> <li style="padding-left: 0px;"> <div> <pre class="cql-definition-body">org.hl7.fhir.r4.model.Expression@15234cf7</pre> </div></li> </ul> </div></li> </ul></li> </ul> </div> <div class="treeview hover p-l-10"> <ul class="list-unstyled"> <li class="list-unstyled"> <ul class="code"> <li class="list-unstyled"> <div class="treeview hover p-l-10"> <ul> <li style="padding-left: 0px;"> <div> <pre class="cql-definition-body">org.hl7.fhir.r4.model.Expression@15ff9b12</pre> </div></li> </ul> </div></li> </ul></li> </ul> </div> <div class="treeview hover p-l-10"> <ul class="list-unstyled"> <li class="list-unstyled"> <ul class="code"> <li class="list-unstyled"> <div class="treeview hover p-l-10"> <ul> <li style="padding-left: 0px;"> <div> <pre class="cql-definition-body">org.hl7.fhir.r4.model.Expression@6d82693d</pre> </div></li> </ul> </div></li> </ul></li> </ul> </div> </li> </ul> </div> <h3><a name="d1e649" href="#toc">Definitions</a></h3> <div> <ul style="list-style:none;padding-left: 10px;"> <li style="list-style:none;" class="list-unstyled"> <div> <ul style="list-style:none;padding-left:0;" class="list-unstyled"> <li class="list-unstyled"> <div class="treeview hover p-l-10"> <ul style="margin-right: 20%; opacity: 1;" class="code"> <li class="list-unstyled"> <div> <ul style="padding-left: 0px;"> <li style="padding-left: 0px;" class="list-unstyled"> <div> <pre class="cql-definition-body">org.hl7.fhir.r4.model.Expression@30379e99</pre> </div></li> </ul> </div></li> </ul> </div></li> </ul> </div></li> </ul> </div> <div> <ul style="list-style:none;padding-left: 10px;"> <li style="list-style:none;" class="list-unstyled"> <div> <ul style="list-style:none;padding-left:0;" class="list-unstyled"> <li class="list-unstyled"> <div class="treeview hover p-l-10"> <ul style="margin-right: 20%; opacity: 1;" class="code"> <li class="list-unstyled"> <div> <ul style="padding-left: 0px;"> <li style="padding-left: 0px;" class="list-unstyled"> <div> <pre class="cql-definition-body">org.hl7.fhir.r4.model.Expression@3ffc389c</pre> </div></li> </ul> </div></li> </ul> </div></li> </ul> </div></li> </ul> </div> <div> <ul style="list-style:none;padding-left: 10px;"> <li style="list-style:none;" class="list-unstyled"> <div> <ul style="list-style:none;padding-left:0;" class="list-unstyled"> <li class="list-unstyled"> <div class="treeview hover p-l-10"> <ul style="margin-right: 20%; opacity: 1;" class="code"> <li class="list-unstyled"> <div> <ul style="padding-left: 0px;"> <li style="padding-left: 0px;" class="list-unstyled"> <div> <pre class="cql-definition-body">org.hl7.fhir.r4.model.Expression@5632137a</pre> </div></li> </ul> </div></li> </ul> </div></li> </ul> </div></li> </ul> </div> <div> <ul style="list-style:none;padding-left: 10px;"> <li style="list-style:none;" class="list-unstyled"> <div> <ul style="list-style:none;padding-left:0;" class="list-unstyled"> <li class="list-unstyled"> <div class="treeview hover p-l-10"> <ul style="margin-right: 20%; opacity: 1;" class="code"> <li class="list-unstyled"> <div> <ul style="padding-left: 0px;"> <li style="padding-left: 0px;" class="list-unstyled"> <div> <pre class="cql-definition-body">org.hl7.fhir.r4.model.Expression@28074300</pre> </div></li> </ul> </div></li> </ul> </div></li> </ul> </div></li> </ul> </div> <div> <ul style="list-style:none;padding-left: 10px;"> <li style="list-style:none;" class="list-unstyled"> <div> <ul style="list-style:none;padding-left:0;" class="list-unstyled"> <li class="list-unstyled"> <div class="treeview hover p-l-10"> <ul style="margin-right: 20%; opacity: 1;" class="code"> <li class="list-unstyled"> <div> <ul style="padding-left: 0px;"> <li style="padding-left: 0px;" class="list-unstyled"> <div> <pre class="cql-definition-body">org.hl7.fhir.r4.model.Expression@24c8d3cf</pre> </div></li> </ul> </div></li> </ul> </div></li> </ul> </div></li> </ul> </div> <div> <ul style="list-style:none;padding-left: 10px;"> <li style="list-style:none;" class="list-unstyled"> <div> <ul style="list-style:none;padding-left:0;" class="list-unstyled"> <li class="list-unstyled"> <div class="treeview hover p-l-10"> <ul style="margin-right: 20%; opacity: 1;" class="code"> <li class="list-unstyled"> <div> <ul style="padding-left: 0px;"> <li style="padding-left: 0px;" class="list-unstyled"> <div> <pre class="cql-definition-body">org.hl7.fhir.r4.model.Expression@7a2e3712</pre> </div></li> </ul> </div></li> </ul> </div></li> </ul> </div></li> </ul> </div> <div> <ul style="list-style:none;padding-left: 10px;"> <li style="list-style:none;" class="list-unstyled"> <div> <ul style="list-style:none;padding-left:0;" class="list-unstyled"> <li class="list-unstyled"> <div class="treeview hover p-l-10"> <ul style="margin-right: 20%; opacity: 1;" class="code"> <li class="list-unstyled"> <div> <ul style="padding-left: 0px;"> <li style="padding-left: 0px;" class="list-unstyled"> <div> <pre class="cql-definition-body">org.hl7.fhir.r4.model.Expression@3cc142ee</pre> </div></li> </ul> </div></li> </ul> </div></li> </ul> </div></li> </ul> </div> <div> <ul style="list-style:none;padding-left: 10px;"> <li style="list-style:none;" class="list-unstyled"> <div> <ul style="list-style:none;padding-left:0;" class="list-unstyled"> <li class="list-unstyled"> <div class="treeview hover p-l-10"> <ul style="margin-right: 20%; opacity: 1;" class="code"> <li class="list-unstyled"> <div> <ul style="padding-left: 0px;"> <li style="padding-left: 0px;" class="list-unstyled"> <div> <pre class="cql-definition-body">org.hl7.fhir.r4.model.Expression@2ecc0935</pre> </div></li> </ul> </div></li> </ul> </div></li> </ul> </div></li> </ul> </div> <div> <ul style="list-style:none;padding-left: 10px;"> <li style="list-style:none;" class="list-unstyled"> <div> <ul style="list-style:none;padding-left:0;" class="list-unstyled"> <li class="list-unstyled"> <div class="treeview hover p-l-10"> <ul style="margin-right: 20%; opacity: 1;" class="code"> <li class="list-unstyled"> <div> <ul style="padding-left: 0px;"> <li style="padding-left: 0px;" class="list-unstyled"> <div> <pre class="cql-definition-body">org.hl7.fhir.r4.model.Expression@4cf8e188</pre> </div></li> </ul> </div></li> </ul> </div></li> </ul> </div></li> </ul> </div> <div> <ul style="list-style:none;padding-left: 10px;"> <li style="list-style:none;" class="list-unstyled"> <div> <ul style="list-style:none;padding-left:0;" class="list-unstyled"> <li class="list-unstyled"> <div class="treeview hover p-l-10"> <ul style="margin-right: 20%; opacity: 1;" class="code"> <li class="list-unstyled"> <div> <ul style="padding-left: 0px;"> <li style="padding-left: 0px;" class="list-unstyled"> <div> <pre class="cql-definition-body">org.hl7.fhir.r4.model.Expression@47e5c9a2</pre> </div></li> </ul> </div></li> </ul> </div></li> </ul> </div></li> </ul> </div> <div> <ul style="list-style:none;padding-left: 10px;"> <li style="list-style:none;" class="list-unstyled"> <div> <ul style="list-style:none;padding-left:0;" class="list-unstyled"> <li class="list-unstyled"> <div class="treeview hover p-l-10"> <ul style="margin-right: 20%; opacity: 1;" class="code"> <li class="list-unstyled"> <div> <ul style="padding-left: 0px;"> <li style="padding-left: 0px;" class="list-unstyled"> <div> <pre class="cql-definition-body">org.hl7.fhir.r4.model.Expression@71852582</pre> </div></li> </ul> </div></li> </ul> </div></li> </ul> </div></li> </ul> </div> <div> <ul style="list-style:none;padding-left: 10px;"> <li style="list-style:none;" class="list-unstyled"> <div> <ul style="list-style:none;padding-left:0;" class="list-unstyled"> <li class="list-unstyled"> <div class="treeview hover p-l-10"> <ul style="margin-right: 20%; opacity: 1;" class="code"> <li class="list-unstyled"> <div> <ul style="padding-left: 0px;"> <li style="padding-left: 0px;" class="list-unstyled"> <div> <pre class="cql-definition-body">org.hl7.fhir.r4.model.Expression@3fce1f26</pre> </div></li> </ul> </div></li> </ul> </div></li> </ul> </div></li> </ul> </div> <div> <ul style="list-style:none;padding-left: 10px;"> <li style="list-style:none;" class="list-unstyled"> <div> <ul style="list-style:none;padding-left:0;" class="list-unstyled"> <li class="list-unstyled"> <div class="treeview hover p-l-10"> <ul style="margin-right: 20%; opacity: 1;" class="code"> <li class="list-unstyled"> <div> <ul style="padding-left: 0px;"> <li style="padding-left: 0px;" class="list-unstyled"> <div> <pre class="cql-definition-body">org.hl7.fhir.r4.model.Expression@34314df6</pre> </div></li> </ul> </div></li> </ul> </div></li> </ul> </div></li> </ul> </div> <div> <ul style="list-style:none;padding-left: 10px;"> <li style="list-style:none;" class="list-unstyled"> <div> <ul style="list-style:none;padding-left:0;" class="list-unstyled"> <li class="list-unstyled"> <div class="treeview hover p-l-10"> <ul style="margin-right: 20%; opacity: 1;" class="code"> <li class="list-unstyled"> <div> <ul style="padding-left: 0px;"> <li style="padding-left: 0px;" class="list-unstyled"> <div> <pre class="cql-definition-body">org.hl7.fhir.r4.model.Expression@5df03a0b</pre> </div></li> </ul> </div></li> </ul> </div></li> </ul> </div></li> </ul> </div> <h3><a name="d1e650" href="#toc">Functions</a></h3> <!-- <h3><a name="d1e555" href="#toc">Terminology</a></h3> --> <!-- <div> --> <!-- <ul style="padding-left: 50px;"> --> <!-- <li th:each="terms, iter : ${resource.terminology}" style="width:80%" th:text="${terms.getDefinition()}"></li> --> <!-- </ul> --> <!-- </div> --> <!-- <h3><a name="d1e647" href="#toc">Data Criteria (QDM Data Elements)</a></h3> --> <!-- <div> --> <!-- <ul style="padding-left: 50px;"> --> <!-- <li th:each="data, iter : ${resource.dataCriteria}" style="width:80%" th:text="${data}"></li> --> <!-- </ul> --> <!-- </div> --> <h3><a name="d1e767" href="#toc">Supplemental Data Elements</a></h3> <div> <ul style="list-style:none;padding-left: 25px;"> <li class="list-unstyled"> <div class="treeview hover p-l-10"> <ul style="margin-right: 20%; opacity: 1;" class="code"> <li class="list-unstyled"> <div> <ul style="padding-left: 0px;"> <li style="padding-left: 0px;" class="list-unstyled"> <div> <pre class="cql-definition-body">org.hl7.fhir.r4.model.Expression@47e5c9a2</pre> </div></li> </ul> </div></li> </ul> </div></li> </ul> </div> <div> <ul style="list-style:none;padding-left: 25px;"> <li class="list-unstyled"> <div class="treeview hover p-l-10"> <ul style="margin-right: 20%; opacity: 1;" class="code"> <li class="list-unstyled"> <div> <ul style="padding-left: 0px;"> <li style="padding-left: 0px;" class="list-unstyled"> <div> <pre class="cql-definition-body">org.hl7.fhir.r4.model.Expression@71852582</pre> </div></li> </ul> </div></li> </ul> </div></li> </ul> </div> <div> <ul style="list-style:none;padding-left: 25px;"> <li class="list-unstyled"> <div class="treeview hover p-l-10"> <ul style="margin-right: 20%; opacity: 1;" class="code"> <li class="list-unstyled"> <div> <ul style="padding-left: 0px;"> <li style="padding-left: 0px;" class="list-unstyled"> <div> <pre class="cql-definition-body">org.hl7.fhir.r4.model.Expression@3fce1f26</pre> </div></li> </ul> </div></li> </ul> </div></li> </ul> </div> <div> <ul style="list-style:none;padding-left: 25px;"> <li class="list-unstyled"> <div class="treeview hover p-l-10"> <ul style="margin-right: 20%; opacity: 1;" class="code"> <li class="list-unstyled"> <div> <ul style="padding-left: 0px;"> <li style="padding-left: 0px;" class="list-unstyled"> <div> <pre class="cql-definition-body">org.hl7.fhir.r4.model.Expression@34314df6</pre> </div></li> </ul> </div></li> </ul> </div></li> </ul> </div> <h3><a name="d1e879" href="#toc">Risk Adjustment Variables</a></h3> <div> <ul style="list-style:none;padding-left: 25px;"> <li>None</li> </ul> </div> <div style="float:left; background:teal; height:3px; width:80%"/> <table> <!-- <tr th:if="${resource.hasSet()}" > --> <!-- <td style="background-color:#656565; width:20%" scope="row"><span class="td_label">Measure Set</span></td> --> <!-- <td style="width:80%" th:narrative="${resource.set}"></td> --> <!-- </tr> --> <!-- <th:block th:each="con, iter : ${resource.content}"> <tr th:if="${con.contentType == 'text/cql'}" style="vertical-align: top;"> <td style="background-color:#656565; width:20%" scope="row"><span class="td_label">Content</span></td> <td style="width:80%" ><b>type: </b><span th:text="${con.contentType}"></span></td> </tr> <tr th:if="${con.contentType == 'text/cql'}"> <td style="width:100%" colspan="2" > <th:block th:if="${con.getData() != null }" > <pre><code th:class="${con.contentType == 'text/cql' ? 'language-cql' : 'language-xml'}" th:text="${new java.lang.String(con.getData())}"></code></pre> </th:block> <th:block th:if="${con.getData() == null }" > <span><i><content is empty></i></span> </th:block> </td> </tr> </th:block > --> </table> </div> </text> <extension url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis"> <valueCode value="boolean"/> </extension> <url value="http://hl7.org/fhir/us/cqfmeasures/Measure/measure-exm124-FHIR"/> <identifier> <use value="official"/> <system value="http://example.org/fhir/cqi/ecqm/Measure/Identifier/cms"/> <value value="130"/> </identifier> <identifier> <use value="official"/> <system value="http://example.org/fhir/cqi/ecqm/Measure/Identifier/nqf"/> <value value="0034"/> </identifier> <version value="1.1.0"/> <name value="EXM124"/> <title value="Cervical Cancer Screening"/> <status value="active"/> <experimental value="true"/> <date value="2018-09-17T00:00:00+00:00"/> <publisher value="National Committee for Quality Assurance"/> <contact> <telecom> <system value="url"/> <value value="http://www.ncqa.org/"/> </telecom> </contact> <description value="Percentage of women 21-64 years of age who were screened for cervical cancer using either of the following criteria: * Women age 21-64 who had cervical cytology performed every 3 years <br.* Women age 30-64 who had cervical cytology/human papillomavirus (HPV) co-testing performed every 5 years "/> <useContext> <code> <code value="program"/> </code> <valueCodeableConcept> <text value="eligible-provider"/> </valueCodeableConcept> </useContext> <jurisdiction> <coding> <system value="urn:iso:std:iso:3166"/> <code value="US"/> <display value="United States of America"/> </coding> </jurisdiction> <purpose value="Women 23-64 years of age with a visit during the measurement period"/> <copyright value="This Physician Performance Measure (Measure) and related data specifications were developed by the National Committee for Quality Assurance (NCQA). NCQA is not responsible for any use of the Measure. NCQA makes no representations, warranties, or endorsement about the quality of any organization or physician that uses or reports performance measures and NCQA has no liability to anyone who relies on such measures or specifications. NCQA holds a copyright in the Measure. The Measure can be reproduced and distributed, without modification, for noncommercial purposes (eg, use by healthcare providers in connection with their practices) without obtaining approval from NCQA. Commercial use is defined as the sale, licensing, or distribution of the Measure for commercial gain, or incorporation of the Measure into a product or service that is sold, licensed or distributed for commercial gain. All commercial uses or requests for modification must be approved by NCQA and are subject to a license at the discretion of NCQA. (C) 2012-2017 National Committee for Quality Assurance. All Rights Reserved. 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. NCQA 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 2004-2017 American Medical Association. LOINC(R) copyright 2004-2017 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R] ) copyright 2004-2017 International Health Terminology Standards Development Organisation. ICD-10 copyright 2017 World Health Organization. All Rights Reserved."/> <approvalDate value="2016-01-01"/> <lastReviewDate value="2016-09-01"/> <effectivePeriod> <start value="2018-01-01T00:00:00+00:00"/> <end value="2018-12-31T00:00:00+00:00"/> </effectivePeriod> <topic> <coding> <system value="http://loinc.org"/> <code value="57024-2"/> <display value="Health Quality Measure Document"/> </coding> </topic> <relatedArtifact> <type value="citation"/> <citation value="Howlader, N., Noone, A.M., Krapcho, M., Miller, D., Bishop, K., Altekruse, S.F., Kosary, C.L., Yu, M., Ruhl, J., Tatalovich, Z., Mariotto, A., Lewis, D.R., Chen, H.S., Feuer, E.J., and Cronin, K.A. 2016. "SEER Cancer Statistics Review, 1975-2013." National Cancer Institute. (December 5, 2016) http://seer.cancer.gov/csr/1975_2013/"/> </relatedArtifact> <relatedArtifact> <type value="citation"/> <citation value="National Business Group on Health. 2011. "Pathways to Managing Cancer in the Workplace." (May 8, 2012). http://www.tcyh.org/employers/downloads/Pathways_Managing_Cancer_2011.pdf"/> </relatedArtifact> <relatedArtifact> <type value="citation"/> <citation value="Feig S. 2011. Comparison of Costs and Benefits of Breast Cancer Screening with Mammography, Ultrasonagraphy, and MRI. Obstetrics and Gynecology Clinics of North America. 38(1):179-96."/> </relatedArtifact> <relatedArtifact> <type value="citation"/> <citation value="U.S. Preventive Services Task Force (USPSTF). 2016. "Screening for Breast Cancer: U.S. Preventive Services Task Force Recommendation Statement." Ann Intern Med. 164(4):279-296. doi:10.7326/M15-2886."/> </relatedArtifact> <relatedArtifact> <type value="depends-on"/> <resource value="Library/fhirhelpers"/> </relatedArtifact> <relatedArtifact> <type value="depends-on"/> <resource value="Library/matglobalcommonfunctions-fhir"/> </relatedArtifact> <relatedArtifact> <type value="depends-on"/> <resource value="Library/adultoutpatientencounters-fhir"/> </relatedArtifact> <relatedArtifact> <type value="depends-on"/> <resource value="Library/hospice-fhir"/> </relatedArtifact> <relatedArtifact> <type value="depends-on"/> <resource value="Library/supplementaldataelements-fhir"/> </relatedArtifact> <library value="Library/exm124-fhir"/> <disclaimer value="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> <coding> <system value="http://terminology.hl7.org/CodeSystem/measure-scoring"/> <code value="proportion"/> <display value="Proportion"/> </coding> </scoring> <type> <coding> <system value="http://terminology.hl7.org/CodeSystem/measure-type"/> <code value="process"/> </coding> </type> <rationale value="Breast cancer is one of the most common types of cancers, accounting for 15 percent of all new cancer diagnoses in the U.S. (Howlader et al, 2016). In 2013, over 3 million women were estimated to be living with breast cancer in the U.S. and it is estimated that 12 percent of women will be diagnosed with breast cancer at some point during their lifetime (Howlader et al, 2016). While there are other factors that affect a woman's risk of developing breast cancer, advancing age is a primary risk factor. Breast cancer is most frequently diagnosed among women ages 55-64; the median age at diagnosis is 62 years (Howlader et al, 2016). The chance of a woman being diagnosed with breast cancer in a given year increases with age. By age 40, the chances are 1 in 235; by age 50 it becomes 1 in 54; by age 60, it is 1 in 25 (National Business Group on Health, 2011). In the U.S., costs associated with a diagnosis of breast cancer range from $451 to $2,520, factoring in continued testing, multiple office visits and procedures. The total costs related to breast cancer add up to nearly $7 billion per year in the U.S., including $2 billion spent on late-stage treatment (National Business Group on Health, 2011). If breast cancer is detected through mammography screening and diagnosed in its earliest stages, treatment may be less expensive (Feig, 2011)."/> <clinicalRecommendationStatement value="The U.S. Preventive Services Task Force (USPSTF) recommends biennial screening mammography for women aged 50-74 years (B recommendation). The decision to start screening mammography in women prior to age 50 years should be an individual one. Women who place a higher value on the potential benefit than the potential harms may choose to begin biennial screening between the ages of 40 and 49 years (C recommendation). (USPSTF, 2016) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening mammography in women aged 75 years or older (I statement). (USPSTF, 2016) The USPSTF concludes that the current evidence is insufficient to assess the benefits and harms of digital breast tomosynthesis (DBT) as a primary screening method for breast cancer (I Statement). (USPSTF, 2016) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of adjunctive screening for breast cancer using breast ultrasonography, magnetic resonance imaging, DBT, or other methods in women identified to have dense breasts on an otherwise negative screening mammogram (I statement). (USPSTF, 2016)"/> <improvementNotation> <coding> <system value="http://terminology.hl7.org/CodeSystem/measure-improvement-notation"/> <code value="increase"/> <display value="Increased score indicates improvement"/> </coding> </improvementNotation> <guidance value="To ensure the measure is only looking for a cervical cytology test only after a woman turns 21 years of age, the youngest age in the initial population is 23. 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. Include only cytology and HPV "co-testing"; in co-testing, both cytology and HPV tests are performed (i.e., the samples are collected and both tests are ordered, regardless of the cytology result) on the same date of service. Do not include reflex testing. In addition, if the medical record indicates the HPV test was performed only after determining the cytology result, this is considered reflex testing and does not meet criteria for the measure."/> <group> <population> <code> <coding> <system value="http://terminology.hl7.org/CodeSystem/measure-population"/> <code value="initial-population"/> <display value="Initial Population"/> </coding> </code> <criteria> <language value="text/cql"/> <expression value="Initial Population"/> </criteria> </population> <population> <code> <coding> <system value="http://terminology.hl7.org/CodeSystem/measure-population"/> <code value="numerator"/> <display value="Numerator"/> </coding> </code> <criteria> <language value="text/cql"/> <expression value="Numerator"/> </criteria> </population> <population> <code> <coding> <system value="http://terminology.hl7.org/CodeSystem/measure-population"/> <code value="denominator"/> <display value="Denominator"/> </coding> </code> <criteria> <language value="text/cql"/> <expression value="Denominator"/> </criteria> </population> <population> <code> <coding> <system value="http://terminology.hl7.org/CodeSystem/measure-population"/> <code value="denominator-exclusion"/> <display value="Denominator Exclusion"/> </coding> </code> <criteria> <language value="text/cql"/> <expression value="Denominator Exclusion"/> </criteria> </population> </group> <supplementalData> <usage> <coding> <system value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/> <code value="supplemental-data"/> </coding> </usage> <criteria> <language value="text/cql"/> <expression value="SDE Ethnicity"/> </criteria> </supplementalData> <supplementalData> <usage> <coding> <system value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/> <code value="supplemental-data"/> </coding> </usage> <criteria> <language value="text/cql"/> <expression value="SDE Payer"/> </criteria> </supplementalData> <supplementalData> <usage> <coding> <system value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/> <code value="supplemental-data"/> </coding> </usage> <criteria> <language value="text/cql"/> <expression value="SDE Race"/> </criteria> </supplementalData> <supplementalData> <usage> <coding> <system value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/> <code value="supplemental-data"/> </coding> </usage> <criteria> <language value="text/cql"/> <expression value="SDE Sex"/> </criteria> </supplementalData> </Measure>
© HL7.org (Clinical Quality Information WG). hl7.fhir.us.cqfmeasures#1.1.0 based on FHIR v4.0.1 generated 24/12/2019.
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