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 
| Active as of 2022-02-22 |
{
"resourceType" : "Measure",
"id" : "measure-exm55-FHIR",
"meta" : {
"profile" : [
"http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cv-measure-cqfm",
"http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-measure-cqfm"
]
},
"text" : {
"status" : "extensions",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <table class=\"grid dict\">\n \n <tr>\n <th scope=\"row\"><b>Id: </b></th>\n <td style=\"padding-left: 4px;\">measure-exm55-FHIR</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/measure-exm55-FHIR\">http://hl7.org/fhir/us/cqfmeasures/Measure/measure-exm55-FHIR</a></td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Version: </b></th>\n <td style=\"padding-left: 4px;\">5.0.0</td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Identifier: </b></th>\n <td style=\"padding-left: 4px;\">\n \n \n <p style=\"margin-bottom: 5px;\">\n <b>value: </b> <span>55</span>\n </p>\n \n </td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Name: </b></th>\n <td style=\"padding-left: 4px;\">EXM55</td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Title: </b></th>\n <td style=\"padding-left: 4px;\">EXM55 - Median ED Visit Duration</td>\n </tr>\n \n \n \n <tr>\n <th scope=\"row\"><b>Status: </b></th>\n <td style=\"padding-left: 4px;\">active</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>continuous-variable</span>\n </p>\n \n \n <p style=\"margin-bottom: 5px;\">\n <b>display: </b> <span>Continuous Variable</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>decrease</span>\n </p>\n \n \n <p style=\"margin-bottom: 5px;\">\n <b>display: </b> <span>Decreased score indicates improvement</span>\n </p>\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</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 example illustrates a continuous variable measure represented as a FHIR eCQM</p>\n</div></td>\n </tr>\n \n \n \n \n \n \n \n \n <tr>\n <th scope=\"row\"><b>Use Context: </b></th>\n <td style=\"padding-left: 4px;\">\n <table class=\"grid-dict\">\n <tr><th><b>code</b></th><th><b>value</b></th></tr>\n \n <tr>\n <td>program</td>\n <td/>\n </tr>\n \n </table>\n </td>\n </tr>\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 <tr>\n <th scope=\"row\"><b>Topic: </b></th>\n <td style=\"padding-left: 25px;\">57024-2</td>\n </tr>\n \n \n \n \n \n \n <tr>\n <th scope=\"row\"><b>Approval Date: </b></th>\n <td style=\"padding-left: 4px;\">2019-03-08</td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Last Review Date: </b></th>\n <td style=\"padding-left: 4px;\">2019-03-08</td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Effective Period: </b></th>\n <td style=\"padding-left: 4px;\">2018-01-01..2018-12-31</td>\n </tr>\n \n \n \n \n \n \n </table>\n</div>"
},
"contained" : [
{
"resourceType" : "Library",
"id" : "effective-data-requirements",
"extension" : [
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
"valueCoding" : {
"system" : "http://terminology.hl7.org/CodeSystem/diagnosis-role",
"code" : "billing",
"display" : "Billing"
}
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "EXM55"
},
{
"url" : "name",
"valueString" : "Inpatient Encounter"
},
{
"url" : "statement",
"valueString" : "define \"Inpatient Encounter\" :\n [\"Encounter\"] Encounter\n where LengthInDays(Encounter.period) <= 120\n and Encounter.period ends during \"Measurement Period\""
},
{
"url" : "displaySequence",
"valueInteger" : 0
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "EXM55"
},
{
"url" : "name",
"valueString" : "Stratification 3"
},
{
"url" : "statement",
"valueString" : "define \"Stratification 3\" :\n \"Inpatient Encounter\" Encounter\n where PrincipalDiagnosis(Encounter) is null"
},
{
"url" : "displaySequence",
"valueInteger" : 1
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "EXM55"
},
{
"url" : "name",
"valueString" : "Stratification 2"
},
{
"url" : "statement",
"valueString" : "define \"Stratification 2\" :\n \"Inpatient Encounter\" Encounter\n where PrincipalDiagnosis(Encounter).code in \"Psychiatric/Mental Health Patient\""
},
{
"url" : "displaySequence",
"valueInteger" : 2
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "EXM55"
},
{
"url" : "name",
"valueString" : "Measure Population Exclusion"
},
{
"url" : "statement",
"valueString" : "define \"Measure Population Exclusion\" :\n \"Inpatient Encounter\" Encounter\n with [\"Encounter\" : \"Emergency Department Visit\"] ED\n such that ED.period ends 1 hour or less before start of Encounter.period\n and ED.status = 'finished'\n and ED.hospitalization.admitSource in \"Hospital Settings\""
},
{
"url" : "displaySequence",
"valueInteger" : 3
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "EXM55"
},
{
"url" : "name",
"valueString" : "Stratification 1"
},
{
"url" : "statement",
"valueString" : "define \"Stratification 1\" :\n \"Inpatient Encounter\" Encounter\n where not (PrincipalDiagnosis(Encounter).code in \"Psychiatric/Mental Health Patient\")"
},
{
"url" : "displaySequence",
"valueInteger" : 4
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "EXM55"
},
{
"url" : "name",
"valueString" : "Initial Population"
},
{
"url" : "statement",
"valueString" : "define \"Initial Population\" :\n \"Inpatient Encounter\" Encounter\n with [\"Encounter\" : \"Emergency Department Visit\"] ED\n such that ED.status = 'finished'\n and ED.period ends 1 hour or less before start of Encounter.period"
},
{
"url" : "displaySequence",
"valueInteger" : 5
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "EXM55"
},
{
"url" : "name",
"valueString" : "Measure Population"
},
{
"url" : "statement",
"valueString" : "define \"Measure Population\" :\n \"Initial Population\""
},
{
"url" : "displaySequence",
"valueInteger" : 6
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
}
],
"name" : "EffectiveDataRequirements",
"status" : "active",
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/library-type",
"code" : "module-definition"
}
]
},
"date" : "2022-02-22T10:37:03-07:00",
"relatedArtifact" : [
{
"type" : "depends-on",
"display" : "Library FHIRHelpers",
"resource" : "http://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1"
},
{
"type" : "depends-on",
"display" : "Code system Diagnosis Role",
"resource" : "http://terminology.hl7.org/CodeSystem/diagnosis-role"
},
{
"type" : "depends-on",
"display" : "Value set Psychiatric/Mental Health Patient",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.299"
},
{
"type" : "depends-on",
"display" : "Value set Emergency Department Visit",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292"
},
{
"type" : "depends-on",
"display" : "Value set Hospital Settings",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.126"
}
],
"parameter" : [
{
"name" : "Measurement Period",
"use" : "in",
"min" : 0,
"max" : "1",
"type" : "Period"
},
{
"name" : "Stratification 3",
"use" : "out",
"min" : 0,
"max" : "*",
"type" : "Encounter"
},
{
"name" : "Stratification 2",
"use" : "out",
"min" : 0,
"max" : "*",
"type" : "Encounter"
},
{
"name" : "Measure Population Exclusion",
"use" : "out",
"min" : 0,
"max" : "*",
"type" : "Encounter"
},
{
"name" : "Stratification 1",
"use" : "out",
"min" : 0,
"max" : "*",
"type" : "Encounter"
},
{
"name" : "Initial Population",
"use" : "out",
"min" : 0,
"max" : "*",
"type" : "Encounter"
},
{
"name" : "Measure Population",
"use" : "out",
"min" : 0,
"max" : "*",
"type" : "Encounter"
}
],
"dataRequirement" : [
{
"type" : "Encounter",
"profile" : [
"http://hl7.org/fhir/StructureDefinition/Encounter"
],
"mustSupport" : [
"period",
"hospitalization",
"hospitalization.admitSource",
"type",
"status"
],
"codeFilter" : [
{
"path" : "type",
"valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292"
}
]
},
{
"type" : "Encounter",
"profile" : [
"http://hl7.org/fhir/StructureDefinition/Encounter"
],
"mustSupport" : [
"period"
]
},
{
"type" : "Condition",
"profile" : [
"http://hl7.org/fhir/StructureDefinition/Condition"
],
"mustSupport" : [
"id"
],
"codeFilter" : [
{
"path" : "id"
}
]
}
]
}
],
"extension" : [
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis",
"valueCode" : "Encounter"
},
{
"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/measure-exm55-FHIR",
"identifier" : [
{
"use" : "official",
"system" : "http://example.org/fhir/cqi/ecqm/Measure/Identifier/exm",
"value" : "55"
}
],
"version" : "5.0.0",
"name" : "EXM55",
"title" : "EXM55 - Median ED Visit Duration",
"status" : "active",
"experimental" : true,
"date" : "2022-02-22",
"publisher" : "Clinical Quality Information WG",
"contact" : [
{
"telecom" : [
{
"system" : "url",
"value" : "http://www.hl7.org/Special/committees/cqi"
}
]
}
],
"description" : "This example illustrates a continuous variable measure represented as a FHIR eCQM",
"useContext" : [
{
"code" : {
"system" : "http://terminology.hl7.org/CodeSystem/usage-context-type",
"code" : "program"
},
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/us/cqfmeasures/CodeSystem/quality-programs",
"code" : "eh-cah",
"display" : "EH/CAH"
}
]
}
}
],
"jurisdiction" : [
{
"coding" : [
{
"system" : "urn:iso:std:iso:3166",
"code" : "US"
}
]
}
],
"approvalDate" : "2019-03-08",
"lastReviewDate" : "2019-03-08",
"effectivePeriod" : {
"start" : "2018-01-01",
"end" : "2018-12-31"
},
"topic" : [
{
"coding" : [
{
"system" : "http://loinc.org",
"code" : "57024-2",
"display" : "Health Quality Measure Document"
}
]
}
],
"library" : [
"http://hl7.org/fhir/us/cqfmeasures/Library/EXM55"
],
"scoring" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-scoring",
"code" : "continuous-variable",
"display" : "Continuous Variable"
}
]
},
"type" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-type",
"code" : "process"
}
]
}
],
"improvementNotation" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-improvement-notation",
"code" : "decrease",
"display" : "Decreased score indicates improvement"
}
]
},
"group" : [
{
"population" : [
{
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "initial-population",
"display" : "Initial Population"
}
]
},
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Initial Population"
}
},
{
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "measure-population",
"display" : "Measure Population"
}
]
},
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Measure Population"
}
},
{
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "measure-population-exclusion",
"display" : "Measure Population Exclusion"
}
]
},
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Measure Population Exclusion"
}
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-criteriaReference",
"valueString" : "measure-population-identifier"
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-aggregateMethod",
"valueCode" : "median"
}
],
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "measure-observation",
"display" : "Measure Observation"
}
]
},
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Measure Observation"
}
}
],
"stratifier" : [
{
"extension" : [
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "initial-population",
"display" : "Initial Population"
}
]
}
}
],
"code" : {
"coding" : [
{
"display" : "Stratification 1"
}
]
},
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Stratification 1"
}
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "initial-population",
"display" : "Initial Population"
}
]
}
}
],
"code" : {
"coding" : [
{
"display" : "Stratification 2"
}
]
},
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Stratification 2"
}
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "initial-population",
"display" : "Initial Population"
}
]
}
}
],
"code" : {
"coding" : [
{
"display" : "Stratification 3"
}
]
},
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Stratification 3"
}
}
]
}
]
}
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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