Quality Measure Implementation Guide (STU4)
4.0.0-ballot - ballot
US
Quality Measure Implementation Guide (STU4)
4.0.0-ballot - ballot
US
This page is part of the Quality Measure STU2 for FHIR R4 Implementation Guide (v4.0.0-ballot: STU 4 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 
| Draft as of 2022-02-22 |
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"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\" xml:lang=\"en\" lang=\"en\">\n <table class=\"grid dict\">\n \n <tr>\n <th scope=\"row\"><b>Id: </b></th>\n <td style=\"padding-left: 4px;\">CCSComponent</td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Url: </b></th>\n <td style=\"padding-left: 4px;\"><a href=\"http://hl7.org/fhir/us/cqfmeasures/Measure/CCSComponent\">http://hl7.org/fhir/us/cqfmeasures/Measure/CCSComponent</a></td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Version: </b></th>\n <td style=\"padding-left: 4px;\">0.0.001</td>\n </tr>\n \n \n \n <tr>\n <th scope=\"row\"><b>Name: </b></th>\n <td style=\"padding-left: 4px;\">CCSComponent</td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Title: </b></th>\n <td style=\"padding-left: 4px;\">Cervical Cancer Screening</td>\n </tr>\n \n \n \n <tr>\n <th scope=\"row\"><b>Status: </b></th>\n <td style=\"padding-left: 4px;\">draft</td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Experimental: </b></th>\n <td style=\"padding-left: 4px;\">true</td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Scoring: </b></th>\n <td style=\"padding-left: 4px;\">\n \n \n \n <p style=\"margin-bottom: 5px;\">\n <b>system: </b> <span><a href=\"http://terminology.hl7.org/CodeSystem/measure-scoring\">http://terminology.hl7.org/CodeSystem/measure-scoring</a></span>\n </p>\n \n \n <p style=\"margin-bottom: 5px;\">\n <b>code: </b> <span>proportion</span>\n </p>\n \n \n <p style=\"margin-bottom: 5px;\">\n <b>display: </b> <span>Proportion</span>\n </p>\n \n \n \n \n </td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Improvement Notation: </b></th>\n <td style=\"padding-left: 4px;\">\n \n \n \n <p style=\"margin-bottom: 5px;\">\n <b>system: </b> <span><a href=\"http://terminology.hl7.org/CodeSystem/measure-improvement-notation\">http://terminology.hl7.org/CodeSystem/measure-improvement-notation</a></span>\n </p>\n \n \n <p style=\"margin-bottom: 5px;\">\n <b>code: </b> <span>increase</span>\n </p>\n \n \n \n \n \n </td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Type: </b></th>\n <td style=\"padding-left: 4px;\">\n \n \n \n <p style=\"margin-bottom: 5px;\">\n <b>system: </b> <span><a href=\"http://terminology.hl7.org/CodeSystem/measure-type\">http://terminology.hl7.org/CodeSystem/measure-type</a></span>\n </p>\n \n \n <p style=\"margin-bottom: 5px;\">\n <b>code: </b> <span>process</span>\n </p>\n \n \n \n \n \n </td>\n </tr>\n \n \n \n <tr>\n <th scope=\"row\"><b>Date: </b></th>\n <td style=\"padding-left: 4px;\">2022-02-22 11:37:03-0600</td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Publisher: </b></th>\n <td style=\"padding-left: 4px;\">Clinical Quality Information WG</td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Description: </b></th>\n <td style=\"padding-left: 4px;\"><div><p>This is only an example.</p>\n</div></td>\n </tr>\n \n \n \n \n \n \n \n <tr>\n <th scope=\"row\"><b>Supplemental Data: </b></th>\n <td style=\"padding-left: 4px;\">\n <table class=\"grid-dict\">\n <tr><th><b>expression</b></th><th><b>system</b></th></tr>\n \n <tr>\n <td>SDE Ethnicity</td>\n <td><a href=\"http://terminology.hl7.org/CodeSystem/measure-data-usage\">http://terminology.hl7.org/CodeSystem/measure-data-usage</a></td>\n </tr>\n \n <tr>\n <td>SDE Payer</td>\n <td><a href=\"http://terminology.hl7.org/CodeSystem/measure-data-usage\">http://terminology.hl7.org/CodeSystem/measure-data-usage</a></td>\n </tr>\n \n <tr>\n <td>SDE Race</td>\n <td><a href=\"http://terminology.hl7.org/CodeSystem/measure-data-usage\">http://terminology.hl7.org/CodeSystem/measure-data-usage</a></td>\n </tr>\n \n <tr>\n <td>SDE Sex</td>\n <td><a href=\"http://terminology.hl7.org/CodeSystem/measure-data-usage\">http://terminology.hl7.org/CodeSystem/measure-data-usage</a></td>\n </tr>\n \n </table>\n </td>\n </tr>\n \n \n \n <tr>\n <th scope=\"row\"><b>Jurisdiction: </b></th>\n <td style=\"padding-left: 25px;\">US</td>\n </tr>\n \n \n \n \n \n \n \n \n \n <tr>\n <th scope=\"row\"><b>Effective Period: </b></th>\n <td style=\"padding-left: 4px;\">2022-01-01..2022-12-31</td>\n </tr>\n \n \n \n \n \n \n </table>\n</div>"
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{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
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"valueString" : "define \"Colonoscopy Performed\": [Procedure: \"Colonoscopy\"] Colonoscopy where Colonoscopy.status = 'completed' and Global.\"Normalize Interval\" ( Colonoscopy.performed ) ends 10 years or less on or before end of \"Measurement Period\""
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"valueString" : "define \"Flexible Sigmoidoscopy Performed\": [Procedure: \"Flexible Sigmoidoscopy\"] FlexibleSigmoidoscopy where FlexibleSigmoidoscopy.status = 'completed' and Global.\"Normalize Interval\" ( FlexibleSigmoidoscopy.performed ) ends 5 years or less on or before end of \"Measurement Period\""
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"valueString" : "define \"Fecal Immunochemical Test DNA\": [Observation: \"FIT DNA\"] FitDNA where FitDNA.status in { 'final', 'amended', 'corrected', 'preliminary' } and FitDNA.value is not null and Global.\"Normalize Interval\" ( FitDNA.effective ) occurs 3 years or less on or before day of end of \"Measurement Period\""
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"url" : "statement",
"valueString" : "define \"Numerator\": exists \"Colonoscopy Performed\" or exists \"Fecal Occult Blood Test Performed\" or exists \"Flexible Sigmoidoscopy Performed\" or exists \"Fecal Immunochemical Test DNA\" or exists \"CT Colonography Performed\""
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"url" : "name",
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"url" : "statement",
"valueString" : "define \"Qualifying Encounters\": ( [Encounter: \"Office Visit\"] union [Encounter: \"Annual Wellness Visit\"] union [Encounter: \"Preventive Care Services - Established Office Visit, 18 and Up\"] union [Encounter: \"Preventive Care Services-Initial Office Visit, 18 and Up\"] union [Encounter: \"Home Healthcare Services\"] ) ValidEncounter where ValidEncounter.period during \"Measurement Period\" and ValidEncounter.status = 'finished'"
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"url" : "libraryName",
"valueString" : "CCSComponent"
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{
"url" : "name",
"valueString" : "Initial Population"
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"url" : "statement",
"valueString" : "define \"Initial Population\": Global.\"CalendarAgeInYearsAt\" ( FHIRHelpers.ToDate ( Patient.birthDate ), start of \"Measurement Period\" ) in Interval[50, 75] and exists AdultOutpatientEncounters.\"Qualifying Encounters\""
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"url" : "name",
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"url" : "libraryName",
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"url" : "name",
"valueString" : "SDE Payer"
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"url" : "statement",
"valueString" : "define \"SDE Payer\": [Coverage: type in \"Payer\"] Payer return { code: Payer.type, period: Payer.period }"
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"url" : "name",
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"url" : "statement",
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{
"extension" : [
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"url" : "libraryName",
"valueString" : "SupplementalDataElements"
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{
"url" : "name",
"valueString" : "SDE Ethnicity"
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"url" : "statement",
"valueString" : "define \"SDE Ethnicity\": (flatten ( Patient.extension Extension where Extension.url = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity' return Extension.extension )) E where E.url = 'ombCategory' or E.url = 'detailed' return E.value as Coding"
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{
"extension" : [
{
"url" : "libraryName",
"valueString" : "Hospice"
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{
"url" : "name",
"valueString" : "Has Hospice"
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{
"url" : "statement",
"valueString" : "define \"Has Hospice\": exists ( [Encounter: \"Encounter Inpatient\"] DischargeHospice where DischargeHospice.status = 'finished' and ( DischargeHospice.hospitalization.dischargeDisposition ~ \"Discharge to home for hospice care (procedure)\" or DischargeHospice.hospitalization.dischargeDisposition ~ \"Discharge to healthcare facility for hospice care (procedure)\" ) and DischargeHospice.period ends during \"Measurement Period\" ) or exists ( [ServiceRequest: \"Hospice care ambulatory\"] HospiceOrder where HospiceOrder.intent = 'order' and HospiceOrder.authoredOn in \"Measurement Period\" ) or exists ( [Procedure: \"Hospice care ambulatory\"] HospicePerformed where HospicePerformed.status = 'completed' and Global.\"Normalize Interval\"(HospicePerformed.performed) overlaps \"Measurement Period\" )"
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"url" : "libraryName",
"valueString" : "CCSComponent"
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"url" : "name",
"valueString" : "Malignant Neoplasm"
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{
"url" : "statement",
"valueString" : "define \"Malignant Neoplasm\": [Condition: \"Malignant Neoplasm of Colon\"] ColorectalCancer where Global.\"Prevalence Period\" ( ColorectalCancer ) starts on or before end of \"Measurement Period\""
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"valueString" : "CCSComponent"
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"url" : "name",
"valueString" : "Total Colectomy Performed"
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"url" : "statement",
"valueString" : "define \"Total Colectomy Performed\": [Procedure: \"Total Colectomy\"] Colectomy where Colectomy.status = 'completed' and Global.\"Normalize Interval\" ( Colectomy.performed ) starts on or before end of \"Measurement Period\""
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"url" : "libraryName",
"valueString" : "AdvancedIllnessandFrailtyExclusion"
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"url" : "name",
"valueString" : "Has Criteria Indicating Frailty"
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"url" : "statement",
"valueString" : "define \"Has Criteria Indicating Frailty\": //Ask Bryn about devices exists ( [DeviceRequest: \"Frailty Device\"] FrailtyDeviceOrder where FrailtyDeviceOrder.authoredOn during \"Measurement Period\" ) // DeviceUseStatement has a known issue with the publication tooling // so it is removed to allow this IG to publish until that is fixed //or exists ( [DeviceUseStatement: \"Frailty Device\"] FrailtyDeviceUse // where Global.\"Normalize Interval\"(FrailtyDeviceUse.timing) overlaps \"Measurement Period\" //) or exists ( [Condition: \"Frailty Diagnosis\"] FrailtyDiagnosis where Global.\"Prevalence Period\"(FrailtyDiagnosis) overlaps \"Measurement Period\" ) or exists ( [Encounter: \"Frailty Encounter\"] FrailtyEncounter where FrailtyEncounter.period overlaps \"Measurement Period\" ) or exists ( [Observation: \"Frailty Symptom\"] FrailtySymptomObservation where Global.\"Normalize Interval\"(FrailtySymptomObservation.effective) overlaps \"Measurement Period\" )"
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"url" : "libraryName",
"valueString" : "AdvancedIllnessandFrailtyExclusion"
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{
"url" : "name",
"valueString" : "Outpatient Encounters with Advanced Illness"
},
{
"url" : "statement",
"valueString" : "define \"Outpatient Encounters with Advanced Illness\": ( [Encounter: \"Outpatient\"] union [Encounter: \"Observation\"] union [Encounter: \"ED\"] union [Encounter: \"Nonacute Inpatient\"] ) OutpatientEncounter with [Condition: \"Advanced Illness\"] AdvancedIllnessDiagnosis such that exists ( OutpatientEncounter.diagnosis.condition EncounterDiagnosis where EndsWith(EncounterDiagnosis.reference, AdvancedIllnessDiagnosis.id) ) and OutpatientEncounter.period starts 2 years or less on or before end of \"Measurement Period\""
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"extension" : [
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"url" : "libraryName",
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"url" : "name",
"valueString" : "Inpatient Encounter with Advanced Illness"
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"url" : "statement",
"valueString" : "define \"Inpatient Encounter with Advanced Illness\": [Encounter: \"Acute Inpatient\"] InpatientEncounter with [Condition: \"Advanced Illness\"] AdvancedIllnessDiagnosis such that exists ( InpatientEncounter.diagnosis.condition EncounterDiagnosis where EndsWith(EncounterDiagnosis.reference, AdvancedIllnessDiagnosis.id) ) and InpatientEncounter.period starts 2 years or less on or before end of \"Measurement Period\""
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"url" : "libraryName",
"valueString" : "AdvancedIllnessandFrailtyExclusion"
},
{
"url" : "name",
"valueString" : "Dementia Medications In Year Before or During Measurement Period"
},
{
"url" : "statement",
"valueString" : "define \"Dementia Medications In Year Before or During Measurement Period\": [\"MedicationDispense\": \"Dementia Medications\"] DementiaMed where DementiaMed.whenHandedOver during Interval[ ( start of \"Measurement Period\" - 1 year ), end of \"Measurement Period\" ]"
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"extension" : [
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"url" : "libraryName",
"valueString" : "AdvancedIllnessandFrailtyExclusion"
},
{
"url" : "name",
"valueString" : "Advanced Illness and Frailty Exclusion Not Including Over Age 80"
},
{
"url" : "statement",
"valueString" : "define \"Advanced Illness and Frailty Exclusion Not Including Over Age 80\": //If the measure does NOT include populations age 80 and older, then use this logic: Global.\"CalendarAgeInYearsAt\"(FHIRHelpers.ToDate(Patient.birthDate), start of \"Measurement Period\")>= 65 and \"Has Criteria Indicating Frailty\" and ( Count(\"Outpatient Encounters with Advanced Illness\")>= 2 or exists ( \"Inpatient Encounter with Advanced Illness\" ) or exists \"Dementia Medications In Year Before or During Measurement Period\" )"
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"url" : "libraryName",
"valueString" : "AdvancedIllnessandFrailtyExclusion"
},
{
"url" : "name",
"valueString" : "Long Term Care Periods During Measurement Period"
},
{
"url" : "statement",
"valueString" : "// start here define \"Long Term Care Periods During Measurement Period\": ( [Encounter: \"Care Services in Long-Term Residential Facility\"] union [Encounter: \"Nursing Facility Visit\"] ) LongTermFacilityEncounter where LongTermFacilityEncounter.period overlaps \"Measurement Period\" return LongTermFacilityEncounter.period intersect \"Measurement Period\""
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"url" : "libraryName",
"valueString" : "AdvancedIllnessandFrailtyExclusion"
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"url" : "name",
"valueString" : "Long Term Care Periods Longer Than 90 Consecutive Days"
},
{
"url" : "statement",
"valueString" : "define \"Long Term Care Periods Longer Than 90 Consecutive Days\": exists ( \"Long Term Care Periods During Measurement Period\" LongTermCareDuringMP where duration in days of LongTermCareDuringMP > 90 )"
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"valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.196.12.1510"
}
]
}
]
}
],
"extension" : [
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis",
"valueCode" : "boolean"
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-softwaresystem",
"valueReference" : {
"reference" : "Device/software-system-example"
}
},
{
"id" : "effective-data-requirements",
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-effectiveDataRequirements",
"valueReference" : {
"reference" : "#effective-data-requirements"
}
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/Measure/CCSComponent",
"version" : "0.0.001",
"name" : "CCSComponent",
"title" : "Cervical Cancer Screening",
"status" : "draft",
"experimental" : true,
"date" : "2022-02-22T11:37:03-06:00",
"publisher" : "Clinical Quality Information WG",
"contact" : [
{
"telecom" : [
{
"system" : "url",
"value" : "http://www.hl7.org/Special/committees/cqi"
}
]
}
],
"description" : "This is only an example.",
"jurisdiction" : [
{
"coding" : [
{
"system" : "urn:iso:std:iso:3166",
"code" : "US"
}
]
}
],
"effectivePeriod" : {
"start" : "2022-01-01",
"end" : "2022-12-31"
},
"library" : [
"http://hl7.org/fhir/us/cqfmeasures/Library/CCSComponent"
],
"scoring" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-scoring",
"code" : "proportion",
"display" : "Proportion"
}
]
},
"type" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-type",
"code" : "process"
}
]
}
],
"improvementNotation" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-improvement-notation",
"code" : "increase"
}
]
},
"group" : [
{
"population" : [
{
"id" : "93644713-B761-4A71-A6DB-38675B4D4AA0",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "initial-population",
"display" : "Initial Population"
}
]
},
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Initial Population"
}
},
{
"id" : "CCC5263F-B14C-4EFC-B726-3C323A137132",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "denominator",
"display" : "Denominator"
}
]
},
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Denominator"
}
},
{
"id" : "C8F51A00-EDC7-4F91-8415-25395BF16D16",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "denominator-exclusion",
"display" : "Denominator Exclusion"
}
]
},
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Denominator Exclusion"
}
},
{
"id" : "9E219037-5E8B-40F6-A304-4460BD8D3FFA",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "numerator",
"display" : "Numerator"
}
]
},
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Numerator"
}
}
]
}
],
"supplementalData" : [
{
"id" : "4d3fff25-29d7-4e61-9fdd-a02a85c1472f",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "supplemental-data"
}
]
}
],
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "SDE Ethnicity"
}
},
{
"id" : "4732f9d3-e4c9-4a24-ab3c-9247a55d73ef",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "supplemental-data"
}
]
}
],
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "SDE Payer"
}
},
{
"id" : "523c2619-71c6-4e60-83f8-3d8eeef75398",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "supplemental-data"
}
]
}
],
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "SDE Race"
}
},
{
"id" : "336d1356-61a7-4220-9635-ffc50b90af2f",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "supplemental-data"
}
]
}
],
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "SDE Sex"
}
}
]
}
IG © 2019+ Clinical Quality Information WG. Package hl7.fhir.us.cqfmeasures#4.0.0-ballot based on FHIR 4.0.1. Generated 2022-12-04
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