Quality Measure Implementation Guide (STU5)
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This page is part of the Quality Measure STU2 for FHIR R4 Implementation Guide (v5.0.0-ballot2: STU5 (v5.0.0) Ballot 2) based on FHIR (HL7® FHIR® Standard) R4. The current version which supersedes this version is 4.0.0. For a full list of available versions, see the Directory of published versions

Library: TJC Overall Library (Experimental)

Official URL: http://hl7.org/fhir/us/cqfmeasures/Library/TJCOverall Version: 4.0.000
Active as of 2019-09-03 Computable Name: TJCOverall
Other Identifiers: http://example.org/fhir/cqi/ecqm/Library/Identifier#TJCOverall (use: official)

This library is used as an example in the FHIR Quality Measure Implementation Guide

Title: TJC Overall Library
Id: TJCOverall
Version: 4.0.000
Url: TJC Overall Library
official

TJCOverall

Experimental: true
Type:

system: LibraryType

code: logic-library

Date: 2019-09-03
Publisher: HL7 International / Clinical Quality Information
Description:

This library is used as an example in the FHIR Quality Measure Implementation Guide
Jurisdiction: US
Approval Date: 2019-08-03
Last Review Date: 2019-08-03
Related Artifacts:

Dependencies
Parameters:
NameTypeMinMaxIn/Out
Measurement PeriodPeriod01in
PatientPatient01out
Intervention Comfort MeasuresResource0*out
Non Elective Inpatient EncounterEncounter0*out
All Stroke EncounterEncounter0*out
Encounter with Principal Diagnosis and AgeEncounter0*out
Ischemic Stroke EncounterEncounter0*out
Ischemic Stroke Encounters with Discharge DispositionEncounter0*out
Comfort Measures during HospitalizationEncounter0*out
Data Requirements:
TypeProfileMSCode Filter
Patient http://hl7.org/fhir/StructureDefinition/Patient
ServiceRequest http://hl7.org/fhir/StructureDefinition/ServiceRequest code filter:
path: code
value set: http://cts.nlm.nih.gov/fhir/ValueSet/1.3.6.1.4.1.33895.1.3.0.45
ServiceRequest http://hl7.org/fhir/StructureDefinition/ServiceRequest code filter:
path: code
value set: http://cts.nlm.nih.gov/fhir/ValueSet/1.3.6.1.4.1.33895.1.3.0.45
Procedure http://hl7.org/fhir/StructureDefinition/Procedure code filter:
path: code
value set: http://cts.nlm.nih.gov/fhir/ValueSet/1.3.6.1.4.1.33895.1.3.0.45
Procedure http://hl7.org/fhir/StructureDefinition/Procedure code filter:
path: code
value set: http://cts.nlm.nih.gov/fhir/ValueSet/1.3.6.1.4.1.33895.1.3.0.45
Encounter http://hl7.org/fhir/StructureDefinition/Encounter code filter:
path: type
value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.424
Condition http://hl7.org/fhir/StructureDefinition/Condition
Patient http://hl7.org/fhir/StructureDefinition/Patient
Encounter http://hl7.org/fhir/StructureDefinition/Encounter code filter:
path: type
value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.143
Encounter http://hl7.org/fhir/StructureDefinition/Encounter code filter:
path: type
value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292
Content: text/cql
/*
This example is a work in progress and should not be considered a final specification
or recommendation for guidance. This example will help guide and direct the process
of finding conventions and usage patterns that meet the needs of the various stakeholders
in the measure development community.
*/
library TJCOverall version '4.0.000'

using FHIR version '4.0.1'

include FHIRHelpers version '4.0.1' called FHIRHelpers
include MATGlobalCommonFunctions version '5.0.000' called Global
include SupplementalDataElements version '2.0.000' called SDE

codesystem "SNOMEDCT": 'http://snomed.info/sct'
codesystem "LOINC": 'http://loinc.org'

valueset "Comfort Measures": 'http://cts.nlm.nih.gov/fhir/ValueSet/1.3.6.1.4.1.33895.1.3.0.45'
valueset "Discharge To Acute Care Facility": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.87'
valueset "Discharged to Health Care Facility for Hospice Care": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.207'
valueset "Discharged to Home for Hospice Care": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.209'
valueset "Emergency Department Visit": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292'
valueset "Encounter Inpatient": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307'
valueset "Hemorrhagic Stroke": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.212'
valueset "Ischemic Stroke": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.247'
valueset "Left Against Medical Advice": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.308'
valueset "Non-Elective Inpatient Encounter": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.424'
valueset "Patient Expired": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.309'
valueset "Ticagrelor Therapy": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.39'
valueset "Observation Services": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.143'

code "Birth date": '21112-8' from "LOINC" display 'Birth date'

parameter "Measurement Period" Interval<DateTime>
  default Interval[@2019-01-01T00:00:00.0, @2020-01-01T00:00:00.0)

context Patient

define "Intervention Comfort Measures":
	(["ServiceRequest": "Comfort Measures"] P
		where P.intent = 'order')
		union
		(["Procedure": "Comfort Measures"] InterventionPerformed
		where InterventionPerformed.status = 'completed')

define "All Stroke Encounter":
	"Non Elective Inpatient Encounter" NonElectiveEncounter
    where Global.PrincipalDiagnosis(NonElectiveEncounter).code in "Hemorrhagic Stroke"
      or Global.PrincipalDiagnosis(NonElectiveEncounter).code in "Ischemic Stroke"

define "Ischemic Stroke Encounter":
	"Encounter with Principal Diagnosis and Age" EncounterWithAge
		where Global.PrincipalDiagnosis(EncounterWithAge).code in "Ischemic Stroke"

define "Non Elective Inpatient Encounter":
	["Encounter": "Non-Elective Inpatient Encounter"] NonElectiveEncounter
		where Global."LengthInDays"(NonElectiveEncounter.period) <= 120
			and NonElectiveEncounter.period ends during "Measurement Period"

define "Ischemic Stroke Encounters with Discharge Disposition":
	"Ischemic Stroke Encounter" IschemicStrokeEncounter
		where IschemicStrokeEncounter.hospitalization.dischargeDisposition in "Discharge To Acute Care Facility"
			or IschemicStrokeEncounter.hospitalization.dischargeDisposition in "Left Against Medical Advice"
			or IschemicStrokeEncounter.hospitalization.dischargeDisposition in "Patient Expired"
			or IschemicStrokeEncounter.hospitalization.dischargeDisposition in "Discharged to Home for Hospice Care"
			or IschemicStrokeEncounter.hospitalization.dischargeDisposition in "Discharged to Health Care Facility for Hospice Care"

define "Comfort Measures during Hospitalization":
	"Ischemic Stroke Encounter" IschemicStrokeEncounter
   	with "Intervention Comfort Measures" ComfortMeasure
    	such that FHIRHelpers.ToDateTime(Coalesce(ComfortMeasure.performed as dateTime,ComfortMeasure.authoredOn)) during Global."HospitalizationWithObservation"(IschemicStrokeEncounter)

define "Encounter with Principal Diagnosis and Age":
	"All Stroke Encounter" AllStrokeEncounter
		with ["Patient"] BirthDate
			such that Global."CalendarAgeInYearsAt"(FHIRHelpers.ToDate(BirthDate.birthDate), start of FHIRHelpers.ToInterval(AllStrokeEncounter.period)) >= 18

define function "CalendarDayOfOrDayAfter"(StartValue DateTime ):
	Interval(Global."ToDate"(StartValue), Global."ToDate"(StartValue + 2 days))
Content: application/elm+xml
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Content: application/elm+json
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