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

EXM55

@prefix fhir: <http://hl7.org/fhir/> .
@prefix loinc: <http://loinc.org/rdf#> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

# - resource -------------------------------------------------------------------

 a fhir:Measure;
  fhir:nodeRole fhir:treeRoot;
  fhir:Resource.id [ fhir:value "measure-exm55-FHIR"];
  fhir:Resource.meta [
     fhir:Meta.versionId [ fhir:value "12" ];
     fhir:Meta.lastUpdated [ fhir:value "2019-11-09T04:14:20.172+00:00"^^xsd:dateTime ];
     fhir:Meta.profile [
       fhir:value "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cv-measure-cqfm";
       fhir:index 0;
       fhir:link <http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cv-measure-cqfm>     ]
  ];
  fhir:DomainResource.text [
     fhir:Narrative.status [ fhir:value "generated" ];
     fhir:Narrative.div "<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\">Median ED Visit Duration</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\">EXM55</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>This example illustrates a continuous variable measure represented as a FHIR eCQM</p>\n</pre>\n                </div>\n            </td>\n        </tr>\n        <tr>\n            <td scope=\"row\" style=\"background-color:#656565; width:20%\"><span class=\"td_label\">Measurement Period</span></td>\n            <td colspan=\"3\" style=\"width:80%\">January 1 - December 31</td>\n        </tr>\n              <!-- <tr>\n            <td style=\"background-color:#656565; width:20%\" scope=\"row\"><span class=\"td_label\">Measure Steward</span></td>\n            <td style=\"width:80%\" colspan=\"3\" th:narrative=\"${resource.publisher}\"></td>\n        </tr>\n        <tr>\n            <td style=\"background-color:#656565; width:20%\" scope=\"row\"><span class=\"td_label\">Measure Developer</span></td>\n            <td style=\"width:80%\" colspan=\"3\" th:narrative=\"${resource.publisher}\"></td>\n        </tr> -->\n              <!-- <tr th:if=\"${resource.hasDisclaimer()}\">\n            <td style=\"background-color:#656565; width:20%\" scope=\"row\"><span class=\"td_label\">Disclaimer</span></td>\n            <td style=\"width:80%\" colspan=\"3\">\n                <div style=\"width:660px;overflow-x:hidden;overflow-y:auto\">\n                    <pre th:text=\"${resource.disclaimer}\"></pre>\n                </div>\n            </td>\n        </tr> -->\n        \n        \n        \n        <tr>\n            <td colspan=\"4\" scope=\"row\" style=\"background-color:#656565; width:100%\"><span class=\"td_label\">Characteristics</span></td>\n        </tr>\n        <tr>\n            <td scope=\"row\" style=\"width:20%\"><span>Scoring</span></td>\n            <td colspan=\"3\" style=\"width:80%\">Continuous-variable</td>\n        </tr>\n              <!-- <tr th:if=\"${resource.hasCompositeScoring()}\">\n            <td style=\"width:20%\" scope=\"row\"><span class=\"td_label\">Composite Scoring</span></td>\n            <td style=\"width:80%\" colspan=\"3\" th:narrative=\"${resource.compositeScoring.getText().substring(0, 1).toUpperCase() + resource.compositeScoring.getText().substring(1)}\"></td>\n        </tr> -->\n        \n            <tr style=\"vertical-align: top;\">\n                <td rowspan=\"1\" scope=\"row\" style=\"width:20%\"><span>Type</span></td>\n                <td colspan=\"3\" style=\"width:80%\">Process</td>\n            </tr>\n        \n              <!-- <tr th:if=\"${resource.hasStatus()}\" style=\"vertical-align: top;\">\n            <td style=\"background-color:#656565; width:20%\" scope=\"row\"><span class=\"td_label\">Status</span></td>\n            <td style=\"width:80%\" colspan=\"3\" th:narrative=\"${resource.status.toString().substring(0, 1).toUpperCase() + resource.status.toString().substring(1).toLowerCase()}\"></td>\n        </tr>\n        <tr th:if=\"${resource.hasPurpose()}\" style=\"vertical-align: top;\">\n            <td style=\"background-color:#656565; width:20%\" scope=\"row\"><span class=\"td_label\">Purpose</span></td>\n            <td style=\"width:80%\" colspan=\"3\" th:narrative=\"${resource.purpose}\"></td>\n        </tr>\n        <tr th:if=\"${resource.hasUsage()}\" style=\"vertical-align: top;\" >\n            <td style=\"background-color:#656565; width:20%\" scope=\"row\"><span class=\"td_label\">Usage</span></td>\n            <td style=\"width:80%\" colspan=\"3\" th:narrative=\"${resource.usage}\"></td>\n        </tr>\n        <th:block th:each=\"context, iter : ${resource.useContext}\" >\n            <tr style=\"vertical-align: top;\">\n                <td th:if=\"${iter.index == 0}\" th:rowspan=\"${iter.size}\" style=\"background-color:#656565; width:20%\" scope=\"row\"><span class=\"td_label\">Use Context</span></td>\n                <td style=\"width:80%\" colspan=\"3\" th:narrative=\"${context}\"></td>\n            </tr>\n        </th:block>\n        <th:block th:each=\"topics, iter : ${resource.topic}\" >\n            <tr style=\"vertical-align: top;\">\n                <td th:if=\"${iter.index == 0}\" th:rowspan=\"${iter.size}\" style=\"background-color:#656565; width:20%\" scope=\"row\"><span class=\"td_label\">Topic</span></td>\n                <td style=\"width:80%\" colspan=\"3\" th:narrative=\"${topics}\"></td>\n            </tr>\n        </th:block>\n        <th:block th:each=\"cont, iter : ${resource.contributor}\" >\n            <tr style=\"vertical-align: top;\">\n                <td th:if=\"${iter.index == 0}\" th:rowspan=\"${iter.size}\" style=\"background-color:#656565; width:20%\" scope=\"row\"><span class=\"td_label\">Contributor</span></td>\n                <td style=\"width:80%\" colspan=\"3\">\n                    <b><span th:narrative=\"${cont.type.toCode()}\"></span>: </b><span th:narrative=\"${cont.name}\"></span>\n                </td>\n            </tr>\n        </th:block> -->\n              <!-- <th:block th:each=\"lib, iter : ${resource.library}\" >\n            <tr style=\"vertical-align: top;\">\n                <td th:if=\"${iter.index == 0}\" th:rowspan=\"${iter.size}\" style=\"background-color:#656565; width:20%\" scope=\"row\"><span class=\"td_label\">Library</span></td>\n                <td style=\"width:80%\" colspan=\"3\">\n                    <p th:if=\"${lib.hasIdentifier()}\"><b>identifier: </b><span th:narrative=\"${lib.identifier}\"></span></p>\n                    <p th:if=\"${lib.hasReference()}\"><b>reference: </b><span th:narrative=\"${lib.reference}\"></span></p>\n                    <p th:if=\"${lib.hasDisplay()}\"><b>display: </b><span th:narrative=\"${lib.display}\"></span></p>\n                </td>\n            </tr>\n        </th:block> -->\n        \n              <!-- <tr th:if=\"${resource.hasRateAggregation()}\" >\n            <td style=\"background-color:#656565; width:20%\" scope=\"row\"><span class=\"td_label\">Rate Aggregation</span></td>\n            <td style=\"width:80%\" colspan=\"3\">\n                <div style=\"width:660px;overflow-x:hidden;overflow-y:auto\">\n                    <pre th:text=\"${resource.rateAggregation}\"></pre>\n                </div>\n            </td>\n        </tr>\n        <tr th:if=\"${resource.hasRationale()}\">\n            <td style=\"background-color:#656565; width:20%\" scope=\"row\"><span class=\"td_label\">Rationale</span></td>\n            <td style=\"width:80%\" colspan=\"3\">\n                <div style=\"width:660px;overflow-x:hidden;overflow-y:auto\">\n                    <pre th:text=\"${resource.rationale}\"></pre>\n                </div>\n            </td>\n        </tr> -->\n        <tr>\n            <td scope=\"row\" style=\"width:20%\"><span>Improvement Notation</span></td>\n            \n            <td colspan=\"3\" style=\"width:80%\">A lower rate indicates better performance.</td>\n        </tr>\n        \n        <tr>\n            <td colspan=\"4\" scope=\"row\" style=\"background-color:#656565; width:100%\"><span class=\"td_label\">Definitions</span></td>\n        </tr>\n        \n        \n              <!-- <th:block th:each=\"groups, iter : ${resource.uniquePopulationGroup}\" >\n            <tr style=\"vertical-align: top;\">\n                <td style=\"background-color:#656565; width:20%\" scope=\"row\"><span class=\"td_label\" th:text=\"${groups.identifier.value}\"></span></td>\n                <td style=\"width:80%\" colspan=\"3\">\n                    <div style=\"width:660px;overflow-x:hidden;overflow-y:auto\">\n                        <pre th:text=\"${pops.description}\"></pre>\n                    </div>\n                </td>\n            </tr>\n        </th:block> -->\n    </table>\n    <table style=\"width: 60%; border-top: none; border-bottom: none\" class=\"header_table\">\n        \n    </table>\n    <table style=\"width: 60%; border-top: none;\" class=\"header_table\">\n              <!-- <th:block th:each=\"supples, iter : ${resource.supplementalData}\">\n            <tr>\n                <th th:if=\"${iter.index == 0}\" th:rowspan=\"${iter.size}\" scope=\"row\"><b>Supplemental Data:</b></th>\n                <td style=\"width:80%\" colspan=\"3\" >\n                    <p style=\"margin-bottom: 5px;\" th:narrative=\"${supples.identifier}\"></p>\n                    <p style=\"margin-bottom: 5px;\" th:each=\"uses : ${supples.usage}\">\n                        <b>usage: </b>\n                        <span th:narrative=\"${uses}\"></span>\n                    </p>\n                    <p style=\"margin-bottom: 5px;\" th:if=\"${supples.hasCriteria()}\">\n                        <b>criteria: </b>\n                        <span th:narrative=\"${supples.criteria}\"></span>\n                    </p>\n                    <p style=\"margin-bottom: 5px;\" th:if=\"${supples.hasPath()}\">\n                        <b>path: </b>\n                        <span th:narrative=\"${supples.path}\"></span>\n                    </p>\n                </td>\n            </tr>\n        </th:block> -->\n              <!-- <th:block th:each=\"param, iter : ${resource.parameter}\">\n            <tr style=\"vertical-align: top;\">\n                <th th:if=\"${iter.index == 0}\" th:rowspan=\"${iter.size}\" scope=\"row\"><b>Parameter: </b></th>\n                <td style=\"width:80%\" colspan=\"3\" >\n                    <span th:if=\"${param.hasName()}\">\n                        <b>name: </b>\n                        <span th:narrative=\"${param.name}\"></span>\n                        <br/>\n                    </span>\n                    <b>use: </b>\n                    <span th:narrative=\"${param.use.toCode()}\"></span>\n                    <br/>\n                    <span th:if=\"${param.hasMin()}\">\n                        <b>minimum cardinality: </b>\n                        <span th:narrative=\"${param.min}\"></span>\n                        <br/>\n                    </span>\n                    <span th:if=\"${param.hasMax()}\">\n                        <b>maximum cardinality: </b>\n                        <span th:narrative=\"${param.max}\"></span>\n                        <br/>\n                    </span>\n                    <b>type: </b>\n                    <span th:narrative=\"${param.type}\"></span>\n                    <br/>\n                    <span th:if=\"${param.hasDocumentation()}\">\n                        <b>documentation: </b>\n                        <span th:narrative=\"${param.documentation}\"></span>\n                        <br/>\n                    </span>\n                    <span th:if=\"${param.hasProfile()}\">\n                        <b>profile: </b>\n                        <span th:narrative=\"${param.profile}\"></span>\n                        <br/>\n                    </span>\n                    <p style=\"margin-bottom: 5px;\"></p>\n                </td>\n            </tr>\n        </th:block> -->\n              <!-- <th:block th:each=\"dataReq, iter : ${resource.dataRequirement}\">\n            <tr style=\"vertical-align: top;\">\n                    <th th:if=\"${iter.index == 0}\" th:rowspan=\"${iter.size}\" scope=\"row\" ><b>Data Requirements: </b></th>\n                    <td style=\"width:80%\" colspan=\"3\" th:narrative=\"${dataReq}\"></td>\n            </tr>\n        </th:block> -->\n    </table>\n  <h2><a name=\"toc\">Table of Contents</a></h2>\n  <ul style=\"padding-left: 50px;\">\n   <li><a href=\"#d1e405\">Population Criteria</a></li>\n   <li><a href=\"#d1e649\">Definitions</a></li>\n   <li><a href=\"#d1e650\">Functions</a></li>\n   <li>  <!-- a href=\"#d1e555\" -->Terminology  <!-- /a --></li>\n   <li>  <!-- a href=\"#d1e647\" -->Data Criteria (QDM Data Elements)  <!-- /a --></li>\n   <li><a href=\"#d1e767\">Supplemental Data Elements</a></li>\n   <li><a href=\"#d1e879\">Risk Adjustment Variables</a></li>\n  </ul>\n  <div style=\"float:left; background:teal; height:3px; width:80%\"/>\n  \n    <pre><br/></pre>\n    <h3><a name=\"d1e405\" href=\"#toc\">Population Criteria</a></h3>\n    <div>\n    <ul style=\"list-style:none;padding-left:10px;\">\n        <li style=\"list-style:none;padding-left:0px;\" class=\"list-unstyled\">\n        \n        <div class=\"treeview hover p-l-10\">\n        <ul class=\"list-unstyled\">\n        <li class=\"list-unstyled\">\n            <ul class=\"code\">\n            <li class=\"list-unstyled\">\n            <div class=\"treeview hover p-l-10\">\n            <ul>\n                <li style=\"padding-left: 0px;\">\n                <div>\n                <pre class=\"cql-definition-body\">org.hl7.fhir.r4.model.Expression@688947d1</pre>\n                </div></li>\n            </ul> \n            </div></li>\n            </ul></li>\n        </ul>\n        </div>\n        \n        \n        <div class=\"treeview hover p-l-10\">\n        <ul class=\"list-unstyled\">\n        <li class=\"list-unstyled\">\n            <ul class=\"code\">\n            <li class=\"list-unstyled\">\n            <div class=\"treeview hover p-l-10\">\n            <ul>\n                <li style=\"padding-left: 0px;\">\n                <div>\n                <pre class=\"cql-definition-body\">org.hl7.fhir.r4.model.Expression@7ffc0daf</pre>\n                </div></li>\n            </ul> \n            </div></li>\n            </ul></li>\n        </ul>\n        </div>\n        \n        \n        <div class=\"treeview hover p-l-10\">\n        <ul class=\"list-unstyled\">\n        <li class=\"list-unstyled\">\n            <ul class=\"code\">\n            <li class=\"list-unstyled\">\n            <div class=\"treeview hover p-l-10\">\n            <ul>\n                <li style=\"padding-left: 0px;\">\n                <div>\n                <pre class=\"cql-definition-body\">org.hl7.fhir.r4.model.Expression@38e7ccad</pre>\n                </div></li>\n            </ul> \n            </div></li>\n            </ul></li>\n        </ul>\n        </div>\n        \n        \n        <div class=\"treeview hover p-l-10\">\n        <ul class=\"list-unstyled\">\n        <li class=\"list-unstyled\">\n            <ul class=\"code\">\n            <li class=\"list-unstyled\">\n            <div class=\"treeview hover p-l-10\">\n            <ul>\n                <li style=\"padding-left: 0px;\">\n                <div>\n                <pre class=\"cql-definition-body\">org.hl7.fhir.r4.model.Expression@5feedb6d</pre>\n                </div></li>\n            </ul> \n            </div></li>\n            </ul></li>\n        </ul>\n        </div>\n        \n        \n            <div class=\"treeview hover p-l-10\">\n            \n            </div>\n            \n        \n            <div class=\"treeview hover p-l-10\">\n            \n            </div>\n            \n        \n            <div class=\"treeview hover p-l-10\">\n            \n            </div>\n            \n    </li>\n    </ul>\n    </div>\n\n  <h3><a name=\"d1e649\" href=\"#toc\">Definitions</a></h3>\n  <div>\n   <ul style=\"list-style:none;padding-left: 10px;\">\n    <li style=\"list-style:none;\" class=\"list-unstyled\">\n     <div>\n      <ul style=\"list-style:none;padding-left:0;\" class=\"list-unstyled\">\n       <li class=\"list-unstyled\">\n        <div class=\"treeview hover p-l-10\">\n         \n         \n         <ul style=\"margin-right: 20%; opacity: 1;\" class=\"code\">\n          <li class=\"list-unstyled\">\n           <div>\n            <ul style=\"padding-left: 0px;\">\n             <li style=\"padding-left: 0px;\" class=\"list-unstyled\">\n              <div>\n               <pre class=\"cql-definition-body\">org.hl7.fhir.r4.model.Expression@7dfba88e</pre>\n              </div></li>\n            </ul> \n           </div></li>\n         </ul>\n        </div></li>\n      </ul>\n     </div></li>\n   </ul>\n  </div>\n  <div>\n   <ul style=\"list-style:none;padding-left: 10px;\">\n    <li style=\"list-style:none;\" class=\"list-unstyled\">\n     <div>\n      <ul style=\"list-style:none;padding-left:0;\" class=\"list-unstyled\">\n       <li class=\"list-unstyled\">\n        <div class=\"treeview hover p-l-10\">\n         \n         \n         <ul style=\"margin-right: 20%; opacity: 1;\" class=\"code\">\n          <li class=\"list-unstyled\">\n           <div>\n            <ul style=\"padding-left: 0px;\">\n             <li style=\"padding-left: 0px;\" class=\"list-unstyled\">\n              <div>\n               <pre class=\"cql-definition-body\">org.hl7.fhir.r4.model.Expression@25d07149</pre>\n              </div></li>\n            </ul> \n           </div></li>\n         </ul>\n        </div></li>\n      </ul>\n     </div></li>\n   </ul>\n  </div>\n  <div>\n   <ul style=\"list-style:none;padding-left: 10px;\">\n    <li style=\"list-style:none;\" class=\"list-unstyled\">\n     <div>\n      <ul style=\"list-style:none;padding-left:0;\" class=\"list-unstyled\">\n       <li class=\"list-unstyled\">\n        <div class=\"treeview hover p-l-10\">\n         \n         \n         <ul style=\"margin-right: 20%; opacity: 1;\" class=\"code\">\n          <li class=\"list-unstyled\">\n           <div>\n            <ul style=\"padding-left: 0px;\">\n             <li style=\"padding-left: 0px;\" class=\"list-unstyled\">\n              <div>\n               <pre class=\"cql-definition-body\">org.hl7.fhir.r4.model.Expression@4a03d056</pre>\n              </div></li>\n            </ul> \n           </div></li>\n         </ul>\n        </div></li>\n      </ul>\n     </div></li>\n   </ul>\n  </div>\n  <div>\n   <ul style=\"list-style:none;padding-left: 10px;\">\n    <li style=\"list-style:none;\" class=\"list-unstyled\">\n     <div>\n      <ul style=\"list-style:none;padding-left:0;\" class=\"list-unstyled\">\n       <li class=\"list-unstyled\">\n        <div class=\"treeview hover p-l-10\">\n         \n         \n         <ul style=\"margin-right: 20%; opacity: 1;\" class=\"code\">\n          <li class=\"list-unstyled\">\n           <div>\n            <ul style=\"padding-left: 0px;\">\n             <li style=\"padding-left: 0px;\" class=\"list-unstyled\">\n              <div>\n               <pre class=\"cql-definition-body\">org.hl7.fhir.r4.model.Expression@68d32869</pre>\n              </div></li>\n            </ul> \n           </div></li>\n         </ul>\n        </div></li>\n      </ul>\n     </div></li>\n   </ul>\n  </div>\n  <div>\n   <ul style=\"list-style:none;padding-left: 10px;\">\n    <li style=\"list-style:none;\" class=\"list-unstyled\">\n     <div>\n      <ul style=\"list-style:none;padding-left:0;\" class=\"list-unstyled\">\n       <li class=\"list-unstyled\">\n        <div class=\"treeview hover p-l-10\">\n         \n         \n         <ul style=\"margin-right: 20%; opacity: 1;\" class=\"code\">\n          <li class=\"list-unstyled\">\n           <div>\n            <ul style=\"padding-left: 0px;\">\n             <li style=\"padding-left: 0px;\" class=\"list-unstyled\">\n              <div>\n               <pre class=\"cql-definition-body\">org.hl7.fhir.r4.model.Expression@11b08ac1</pre>\n              </div></li>\n            </ul> \n           </div></li>\n         </ul>\n        </div></li>\n      </ul>\n     </div></li>\n   </ul>\n  </div>\n  <div>\n   <ul style=\"list-style:none;padding-left: 10px;\">\n    <li style=\"list-style:none;\" class=\"list-unstyled\">\n     <div>\n      <ul style=\"list-style:none;padding-left:0;\" class=\"list-unstyled\">\n       <li class=\"list-unstyled\">\n        <div class=\"treeview hover p-l-10\">\n         \n         \n         <ul style=\"margin-right: 20%; opacity: 1;\" class=\"code\">\n          <li class=\"list-unstyled\">\n           <div>\n            <ul style=\"padding-left: 0px;\">\n             <li style=\"padding-left: 0px;\" class=\"list-unstyled\">\n              <div>\n               <pre class=\"cql-definition-body\">org.hl7.fhir.r4.model.Expression@37cceb87</pre>\n              </div></li>\n            </ul> \n           </div></li>\n         </ul>\n        </div></li>\n      </ul>\n     </div></li>\n   </ul>\n  </div>\n  <div>\n   <ul style=\"list-style:none;padding-left: 10px;\">\n    <li style=\"list-style:none;\" class=\"list-unstyled\">\n     <div>\n      <ul style=\"list-style:none;padding-left:0;\" class=\"list-unstyled\">\n       <li class=\"list-unstyled\">\n        <div class=\"treeview hover p-l-10\">\n         \n         \n         <ul style=\"margin-right: 20%; opacity: 1;\" class=\"code\">\n          <li class=\"list-unstyled\">\n           <div>\n            <ul style=\"padding-left: 0px;\">\n             <li style=\"padding-left: 0px;\" class=\"list-unstyled\">\n              <div>\n               <pre class=\"cql-definition-body\">org.hl7.fhir.r4.model.Expression@63990c48</pre>\n              </div></li>\n            </ul> \n           </div></li>\n         </ul>\n        </div></li>\n      </ul>\n     </div></li>\n   </ul>\n  </div>\n  <h3><a name=\"d1e650\" href=\"#toc\">Functions</a></h3>\n  <div>\n   <ul style=\"list-style:none;padding-left: 10px;\">\n    <li style=\"list-style:none;\" class=\"list-unstyled\">\n     <div>\n      <ul style=\"list-style:none;padding-left:0;\" class=\"list-unstyled\">\n       <li class=\"list-unstyled\">\n        <div class=\"treeview hover p-l-10\">\n         \n         \n         <ul style=\"margin-right: 20%; opacity: 1;\" class=\"code\">\n          <li class=\"list-unstyled\">\n           <div>\n            <ul style=\"padding-left: 0px;\">\n             <li style=\"padding-left: 0px;\" class=\"list-unstyled\">\n              <div>\n               <pre class=\"cql-definition-body\">org.hl7.fhir.r4.model.Expression@12f8e032</pre>\n              </div></li>\n            </ul> \n           </div></li>\n         </ul>\n        </div></li>\n      </ul>\n     </div></li>\n   </ul>\n  </div>\n  <div>\n   <ul style=\"list-style:none;padding-left: 10px;\">\n    <li style=\"list-style:none;\" class=\"list-unstyled\">\n     <div>\n      <ul style=\"list-style:none;padding-left:0;\" class=\"list-unstyled\">\n       <li class=\"list-unstyled\">\n        <div class=\"treeview hover p-l-10\">\n         \n         \n         <ul style=\"margin-right: 20%; opacity: 1;\" class=\"code\">\n          <li class=\"list-unstyled\">\n           <div>\n            <ul style=\"padding-left: 0px;\">\n             <li style=\"padding-left: 0px;\" class=\"list-unstyled\">\n              <div>\n               <pre class=\"cql-definition-body\">org.hl7.fhir.r4.model.Expression@78b862e</pre>\n              </div></li>\n            </ul> \n           </div></li>\n         </ul>\n        </div></li>\n      </ul>\n     </div></li>\n   </ul>\n  </div>\n  <div>\n   <ul style=\"list-style:none;padding-left: 10px;\">\n    <li style=\"list-style:none;\" class=\"list-unstyled\">\n     <div>\n      <ul style=\"list-style:none;padding-left:0;\" class=\"list-unstyled\">\n       <li class=\"list-unstyled\">\n        <div class=\"treeview hover p-l-10\">\n         \n         \n         <ul style=\"margin-right: 20%; opacity: 1;\" class=\"code\">\n          <li class=\"list-unstyled\">\n           <div>\n            <ul style=\"padding-left: 0px;\">\n             <li style=\"padding-left: 0px;\" class=\"list-unstyled\">\n              <div>\n               <pre class=\"cql-definition-body\">org.hl7.fhir.r4.model.Expression@574bd58b</pre>\n              </div></li>\n            </ul> \n           </div></li>\n         </ul>\n        </div></li>\n      </ul>\n     </div></li>\n   </ul>\n  </div>\n  <div>\n   <ul style=\"list-style:none;padding-left: 10px;\">\n    <li style=\"list-style:none;\" class=\"list-unstyled\">\n     <div>\n      <ul style=\"list-style:none;padding-left:0;\" class=\"list-unstyled\">\n       <li class=\"list-unstyled\">\n        <div class=\"treeview hover p-l-10\">\n         \n         \n         <ul style=\"margin-right: 20%; opacity: 1;\" class=\"code\">\n          <li class=\"list-unstyled\">\n           <div>\n            <ul style=\"padding-left: 0px;\">\n             <li style=\"padding-left: 0px;\" class=\"list-unstyled\">\n              <div>\n               <pre class=\"cql-definition-body\">org.hl7.fhir.r4.model.Expression@7c9b7866</pre>\n              </div></li>\n            </ul> \n           </div></li>\n         </ul>\n        </div></li>\n      </ul>\n     </div></li>\n   </ul>\n  </div>\n  <div>\n   <ul style=\"list-style:none;padding-left: 10px;\">\n    <li style=\"list-style:none;\" class=\"list-unstyled\">\n     <div>\n      <ul style=\"list-style:none;padding-left:0;\" class=\"list-unstyled\">\n       <li class=\"list-unstyled\">\n        <div class=\"treeview hover p-l-10\">\n         \n         \n         <ul style=\"margin-right: 20%; opacity: 1;\" class=\"code\">\n          <li class=\"list-unstyled\">\n           <div>\n            <ul style=\"padding-left: 0px;\">\n             <li style=\"padding-left: 0px;\" class=\"list-unstyled\">\n              <div>\n               <pre class=\"cql-definition-body\">org.hl7.fhir.r4.model.Expression@7bb8d305</pre>\n              </div></li>\n            </ul> \n           </div></li>\n         </ul>\n        </div></li>\n      </ul>\n     </div></li>\n   </ul>\n  </div>\n        <!-- <h3><a name=\"d1e555\" href=\"#toc\">Terminology</a></h3> -->\n        <!-- <div> -->\n         <!-- <ul style=\"padding-left: 50px;\"> -->\n          <!-- <li th:each=\"terms, iter : ${resource.terminology}\" style=\"width:80%\" th:text=\"${terms.getDefinition()}\"></li> -->\n         <!-- </ul> -->\n        <!-- </div> -->\n        <!-- <h3><a name=\"d1e647\" href=\"#toc\">Data Criteria (QDM Data Elements)</a></h3> -->\n        <!-- <div> -->\n          <!-- <ul style=\"padding-left: 50px;\"> -->\n            <!-- <li th:each=\"data, iter : ${resource.dataCriteria}\" style=\"width:80%\" th:text=\"${data}\"></li> -->\n          <!-- </ul> -->\n        <!-- </div> -->\n  <h3><a name=\"d1e767\" href=\"#toc\">Supplemental Data Elements</a></h3>\n  \n  <div>\n    <ul style=\"list-style:none;padding-left: 25px;\">\n        <li>None</li>\n    </ul>\n </div>\n  <h3><a name=\"d1e879\" href=\"#toc\">Risk Adjustment Variables</a></h3>\n  <div>\n   <ul style=\"list-style:none;padding-left: 25px;\">\n    <li>None</li>\n   </ul>\n  </div>\n  <div style=\"float:left; background:teal; height:3px; width:80%\"/>\n  <table>\n              <!-- <tr th:if=\"${resource.hasSet()}\" > -->\n                  <!-- <td style=\"background-color:#656565; width:20%\" scope=\"row\"><span class=\"td_label\">Measure Set</span></td> -->\n                  <!-- <td style=\"width:80%\" th:narrative=\"${resource.set}\"></td> -->\n              <!-- </tr> -->\n              <!-- <th:block th:each=\"con, iter : ${resource.content}\">\n            <tr th:if=\"${con.contentType == 'text/cql'}\" style=\"vertical-align: top;\">\n                <td style=\"background-color:#656565; width:20%\" scope=\"row\"><span class=\"td_label\">Content</span></td>\n                <td style=\"width:80%\" ><b>type: </b><span th:text=\"${con.contentType}\"></span></td>\n            </tr>\n            <tr th:if=\"${con.contentType == 'text/cql'}\">\n                <td style=\"width:100%\" colspan=\"2\" >\n                    <th:block th:if=\"${con.getData() != null }\" >\n                        <pre><code th:class=\"${con.contentType == 'text/cql' ? 'language-cql' : 'language-xml'}\" th:text=\"${new java.lang.String(con.getData())}\"></code></pre>\n                    </th:block>\n                    <th:block th:if=\"${con.getData() == null }\" >\n                        <span><i>&lt;content is empty&gt;</i></span>\n                    </th:block>\n                </td>\n            </tr>\n        </th:block > -->\n    </table>\n</div>"
  ];
  fhir:DomainResource.extension [
     fhir:index 0;
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis" ];
     fhir:Extension.valueCode [ fhir:value "Encounter" ]
  ];
  fhir:Measure.url [ fhir:value "http://hl7.org/fhir/us/cqfmeasures/Measure/measure-exm55-FHIR"];
  fhir:Measure.identifier [
     fhir:index 0;
     fhir:Identifier.use [ fhir:value "official" ];
     fhir:Identifier.system [ fhir:value "http://example.org/fhir/cqi/ecqm/Measure/Identifier/exm" ];
     fhir:Identifier.value [ fhir:value "55" ]
  ];
  fhir:Measure.version [ fhir:value "1.1.0"];
  fhir:Measure.name [ fhir:value "EXM55"];
  fhir:Measure.title [ fhir:value "Median ED Visit Duration"];
  fhir:Measure.status [ fhir:value "active"];
  fhir:Measure.experimental [ fhir:value "true"^^xsd:boolean];
  fhir:Measure.date [ fhir:value "2019-02-21T00:00:00+00:00"^^xsd:dateTime];
  fhir:Measure.publisher [ fhir:value "Health Level 7 International - Clinical Quality Information Work Group"];
  fhir:Measure.contact [
     fhir:index 0;
     fhir:ContactDetail.telecom [
       fhir:index 0;
       fhir:ContactPoint.system [ fhir:value "url" ];
       fhir:ContactPoint.value [ fhir:value "http://www.hl7.org/Special/committees/cqi/index.cfm" ]     ]
  ];
  fhir:Measure.description [ fhir:value "This example illustrates a continuous variable measure represented as a FHIR eCQM"];
  fhir:Measure.useContext [
     fhir:index 0;
     fhir:UsageContext.code [
       fhir:Coding.code [ fhir:value "program" ]     ];
     fhir:UsageContext.valueCodeableConcept [
       fhir:CodeableConcept.text [ fhir:value "eligible-hospital" ]     ]
  ];
  fhir:Measure.jurisdiction [
     fhir:index 0;
     fhir:CodeableConcept.coding [
       fhir:index 0;
       fhir:Coding.system [ fhir:value "urn:iso:std:iso:3166" ];
       fhir:Coding.code [ fhir:value "US" ];
       fhir:Coding.display [ fhir:value "United States of America" ]     ]
  ];
  fhir:Measure.approvalDate [ fhir:value "2019-03-08"^^xsd:date];
  fhir:Measure.lastReviewDate [ fhir:value "2019-03-08"^^xsd:date];
  fhir:Measure.effectivePeriod [
     fhir:Period.start [ fhir:value "2018-01-01T00:00:00+00:00"^^xsd:dateTime ];
     fhir:Period.end [ fhir:value "2018-12-31T00:00:00+00:00"^^xsd:dateTime ]
  ];
  fhir:Measure.topic [
     fhir:index 0;
     fhir:CodeableConcept.coding [
       fhir:index 0;
       a loinc:57024-2;
       fhir:Coding.system [ fhir:value "http://loinc.org" ];
       fhir:Coding.code [ fhir:value "57024-2" ];
       fhir:Coding.display [ fhir:value "Health Quality Measure Document" ]     ]
  ];
  fhir:Measure.relatedArtifact [
     fhir:index 0;
     fhir:RelatedArtifact.type [ fhir:value "depends-on" ];
     fhir:RelatedArtifact.resource [ fhir:value "Library/fhirhelpers" ]
  ];
  fhir:Measure.library [
     fhir:value "http://hl7.org/fhir/us/cqfmeasures/Library/exm55-fhir";
     fhir:index 0;
     fhir:link <http://hl7.org/fhir/us/cqfmeasures/Library/exm55-fhir>
  ];
  fhir:Measure.scoring [
     fhir:CodeableConcept.coding [
       fhir:index 0;
       fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/measure-scoring" ];
       fhir:Coding.code [ fhir:value "continuous-variable" ];
       fhir:Coding.display [ fhir:value "Continuous Variable" ]     ]
  ];
  fhir:Measure.type [
     fhir:index 0;
     fhir:CodeableConcept.coding [
       fhir:index 0;
       fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/measure-type" ];
       fhir:Coding.code [ fhir:value "process" ]     ]
  ];
  fhir:Measure.improvementNotation [
     fhir:CodeableConcept.coding [
       fhir:index 0;
       fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/measure-improvement-notation" ];
       fhir:Coding.code [ fhir:value "decrease" ];
       fhir:Coding.display [ fhir:value "Decreased score indicates improvement" ]     ]
  ];
  fhir:Measure.group [
     fhir:index 0;
     fhir:Measure.group.population [
       fhir:index 0;
       fhir:Measure.group.population.code [
         fhir:CodeableConcept.coding [
           fhir:index 0;
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/measure-population" ];
           fhir:Coding.code [ fhir:value "initial-population" ];
           fhir:Coding.display [ fhir:value "Initial Population" ]         ]       ];
       fhir:Measure.group.population.criteria [
         fhir:Expression.language [ fhir:value "text/cql" ];
         fhir:Expression.expression [ fhir:value "Initial Population" ]       ]     ], [
       fhir:index 1;
       fhir:Measure.group.population.code [
         fhir:CodeableConcept.coding [
           fhir:index 0;
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/measure-population" ];
           fhir:Coding.code [ fhir:value "measure-population" ];
           fhir:Coding.display [ fhir:value "Measure Population" ]         ]       ];
       fhir:Measure.group.population.criteria [
         fhir:Expression.language [ fhir:value "text/cql" ];
         fhir:Expression.expression [ fhir:value "Measure Population" ]       ]     ], [
       fhir:index 2;
       fhir:Measure.group.population.code [
         fhir:CodeableConcept.coding [
           fhir:index 0;
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/measure-population" ];
           fhir:Coding.code [ fhir:value "measure-population-exclusion" ];
           fhir:Coding.display [ fhir:value "Measure Population Exclusion" ]         ]       ];
       fhir:Measure.group.population.criteria [
         fhir:Expression.language [ fhir:value "text/cql" ];
         fhir:Expression.expression [ fhir:value "Measure Population Exclusion" ]       ]     ], [
       fhir:index 3;
       fhir:Element.extension [
         fhir:index 0;
         fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-criteriaReference" ];
         fhir:Extension.valueString [ fhir:value "measure-population-identifier" ]       ], [
         fhir:index 1;
         fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-aggregateMethod" ];
         fhir:Extension.valueCode [ fhir:value "median" ]       ];
       fhir:Measure.group.population.code [
         fhir:CodeableConcept.coding [
           fhir:index 0;
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/measure-population" ];
           fhir:Coding.code [ fhir:value "measure-observation" ];
           fhir:Coding.display [ fhir:value "Measure Observation" ]         ]       ];
       fhir:Measure.group.population.criteria [
         fhir:Expression.language [ fhir:value "text/cql" ];
         fhir:Expression.expression [ fhir:value "Measure Observation" ]       ]     ];
     fhir:Measure.group.stratifier [
       fhir:index 0;
       fhir:Measure.group.stratifier.criteria [
         fhir:Expression.language [ fhir:value "text/cql" ];
         fhir:Expression.expression [ fhir:value "Stratification 1" ]       ]     ], [
       fhir:index 1;
       fhir:Measure.group.stratifier.criteria [
         fhir:Expression.language [ fhir:value "text/cql" ];
         fhir:Expression.expression [ fhir:value "Stratification 2" ]       ]     ], [
       fhir:index 2;
       fhir:Measure.group.stratifier.criteria [
         fhir:Expression.language [ fhir:value "text/cql" ];
         fhir:Expression.expression [ fhir:value "Stratification 3" ]       ]     ]
  ].

# - ontology header ------------------------------------------------------------

 a owl:Ontology;
  owl:imports fhir:fhir.ttl.