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

: Module Definition Library - EXM Logic - JSON Representation

Active as of 2024-04-09

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{
  "resourceType" : "Library",
  "id" : "effective-data-requirements-exmlogic",
  "meta" : {
    "profile" : [
      🔗 "http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-moduledefinitionlibrary"
    ]
  },
  "text" : {
    "status" : "extensions",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n    <table class=\"grid dict\">\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Title: </b></th>\n            <td style=\"padding-left: 4px;\">Module Definition Library - EXM Logic</td>\n        </tr>\n        \n\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Id: </b></th>\n            <td style=\"padding-left: 4px;\">effective-data-requirements-exmlogic</td>\n        </tr>\n        \n\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Version: </b></th>\n            <td style=\"padding-left: 4px;\">1.0.0</td>\n        </tr>\n        \n\n        \n        <tr>\n            <th scope=\"row\"><b>Url: </b></th>\n            <td style=\"padding-left: 4px;\"><a href=\"Library-effective-data-requirements-exmlogic.html\">Module Definition Library - EXM Logic</a></td>\n        </tr>\n        \n\n        \n\n        \n\n        \n\n        \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/5.5.0/CodeSystem-library-type.html\">LibraryType</a></span>\n                        </p>\n                        \n                        \n                        <p style=\"margin-bottom: 5px;\">\n                            <b>code: </b> <span>module-definition</span>\n                        </p>\n                        \n                        \n                    \n                \n                \n            </td>\n        </tr>\n        \n\n        \n\n        \n        <tr>\n            <th scope=\"row\"><b>Date: </b></th>\n            <td style=\"padding-left: 4px;\">2024-04-09 13:20:21+0000</td>\n        </tr>\n        \n\n        \n        <tr>\n            <th scope=\"row\"><b>Publisher: </b></th>\n            <td style=\"padding-left: 4px;\">HL7 International / Clinical Quality Information</td>\n        </tr>\n        \n\n        \n        <tr>\n            <th scope=\"row\"><b>Description: </b></th>\n            <td style=\"padding-left: 4px;\"><div><p>This library is used as an example module definition in the FHIR Quality Measure Implementation Guide</p>\n</div></td>\n        </tr>\n        \n\n        \n\n        \n\n        \n\n        \n        <tr>\n            <th scope=\"row\"><b>Jurisdiction: </b></th>\n            <td style=\"padding-left: 4px;\">US</td>\n        </tr>\n        \n\n        \n\n        \n\n        \n\n        \n\n        \n\n        \n\n        \n\n        \n        <tr>\n            <th scope=\"row\"><b>Related Artifacts: </b></th>\n            <td style=\"padding-left: 4px;\">\n                \n                \n                \n                <p><b>Dependencies</b></p>\n                <ul>\n                  \n                    <li><a href=\"http://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1\">http://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1</a></li>\n                  \n                    <li><a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-diagnosis-role.html\">Diagnosis Role</a></li>\n                  \n                    <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.114222.4.11.3591/expansion\">Payer</a></li>\n                  \n                    <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.299/expansion\">Psychiatric/Mental Health Diagnosis</a></li>\n                  \n                </ul>\n                \n                \n                \n                \n                \n            </td>\n        </tr>\n        \n\n        \n        <tr>\n          <th scope=\"row\"><b>Parameters: </b></th>\n          <td style=\"padding-left: 4px;\">\n            <table class=\"grid-dict\">\n              <tr><th><b>Name</b></th><th><b>Type</b></th><th><b>Min</b></th><th><b>Max</b></th><th><b>In/Out</b></th></tr>\n              \n                <tr><th>Measurement Period</th><th>Period</th><th>0</th><th>1</th><th>in</th></tr>\n              \n                <tr><th>SDE Sex</th><th>Coding</th><th>0</th><th>1</th><th>out</th></tr>\n              \n                <tr><th>Stratifier 3</th><th>Encounter</th><th>0</th><th>*</th><th>out</th></tr>\n              \n                <tr><th>Stratifier 4</th><th>Encounter</th><th>0</th><th>*</th><th>out</th></tr>\n              \n                <tr><th>SDE Payer</th><th>Resource</th><th>0</th><th>*</th><th>out</th></tr>\n              \n                <tr><th>Initial Population</th><th>Encounter</th><th>0</th><th>*</th><th>out</th></tr>\n              \n                <tr><th>SDE Ethnicity</th><th>Coding</th><th>0</th><th>*</th><th>out</th></tr>\n              \n                <tr><th>SDE Race</th><th>Coding</th><th>0</th><th>*</th><th>out</th></tr>\n              \n                <tr><th>Stratifier 1</th><th>Encounter</th><th>0</th><th>*</th><th>out</th></tr>\n              \n                <tr><th>Stratifier 2</th><th>Encounter</th><th>0</th><th>*</th><th>out</th></tr>\n              \n            </table>\n          </td>\n        </tr>\n        \n\n        \n        <tr>\n          <th scope=\"row\"><b>Data Requirements:</b></th>\n          <td style=\"padding-left: 4px;\">\n            <table class=\"grid-dict\">\n              <tr><th><b>Type</b></th><th><b>Profile</b></th><th><b>MS</b></th><th><b>Code Filter</b></th></tr>\n              \n                <tr>\n                  <th>Patient</th>\n                  <th>http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient</th>\n                  <th/>\n                  <th>\n                    \n                  </th>\n                </tr>\n              \n                <tr>\n                  <th>Patient</th>\n                  <th>http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient</th>\n                  <th>;;;</th>\n                  <th>\n                    \n                  </th>\n                </tr>\n              \n                <tr>\n                  <th>Patient</th>\n                  <th>http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient</th>\n                  <th>;;;</th>\n                  <th>\n                    \n                      <b>code filter: </b>\n                      \n                      <br/>\n                      \n                      \n                      <span style=\"padding-left: 4px;\">\n                          <b>path: </b><span>url</span>\n                      </span>\n                      \n                      <br/>\n                      \n                      \n                      \n                      \n                          \n                          <p style=\"margin-bottom: 5px;\">\n                              <b>system: </b> <span>urn:ietf:rfc:3986</span>\n                          </p>\n                          \n                          \n                          <p style=\"margin-bottom: 5px;\">\n                              <b>code: </b> <span>http://hl7.org/fhir/us/core/StructureDefinition/us-core-race</span>\n                          </p>\n                          \n                          \n                      \n                    \n                  </th>\n                </tr>\n              \n                <tr>\n                  <th>Encounter</th>\n                  <th>http://hl7.org/fhir/StructureDefinition/Encounter</th>\n                  <th>;</th>\n                  <th>\n                    \n                  </th>\n                </tr>\n              \n                <tr>\n                  <th>Coverage</th>\n                  <th>http://hl7.org/fhir/StructureDefinition/Coverage</th>\n                  <th>;;</th>\n                  <th>\n                    \n                      <b>code filter: </b>\n                      \n                      <br/>\n                      \n                      \n                      <span style=\"padding-left: 4px;\">\n                          <b>path: </b><span>type</span>\n                      </span>\n                      \n                      <br/>\n                      \n                      \n                      \n                      <span style=\"padding-left: 4px;\">\n                          <b>value set: </b><span>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591</span>\n                      </span>\n                      \n                      \n                    \n                  </th>\n                </tr>\n              \n            </table>\n          </td>\n        </tr>\n        \n\n        \n    </table>\n</div>"
  },
  "extension" : [
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
      "valueCoding" : {
        "system" : "http://terminology.hl7.org/CodeSystem/diagnosis-role",
        "code" : "billing",
        "display" : "Billing"
      }
    },
    {
      "extension" : [
        {
          "url" : "libraryName",
          "valueString" : "EXMLogic-FHIR"
        },
        {
          "url" : "name",
          "valueString" : "SDE Sex"
        },
        {
          "url" : "statement",
          "valueString" : "define \"SDE Sex\":\n  case\n    when Patient.gender = 'male' then Code { code: 'M', system: 'http://hl7.org/fhir/v3/AdministrativeGender', display: 'Male' }\n    when Patient.gender = 'female' then Code { code: 'F', system: 'http://hl7.org/fhir/v3/AdministrativeGender', display: 'Female' }\n    else null\n  end"
        },
        {
          "url" : "displaySequence",
          "valueInteger" : 0
        }
      ],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [
        {
          "url" : "libraryName",
          "valueString" : "EXMLogic-FHIR"
        },
        {
          "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" : 1
        }
      ],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [
        {
          "url" : "libraryName",
          "valueString" : "EXMLogic-FHIR"
        },
        {
          "url" : "name",
          "valueString" : "Stratifier 3"
        },
        {
          "url" : "statement",
          "valueString" : "define \"Stratifier 3\" :\n  \"Inpatient Encounter\" Encounter\n    where PrincipalDiagnosis(Encounter) is null"
        },
        {
          "url" : "displaySequence",
          "valueInteger" : 2
        }
      ],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [
        {
          "url" : "libraryName",
          "valueString" : "EXMLogic"
        },
        {
          "url" : "name",
          "valueString" : "Stratifier 4"
        },
        {
          "url" : "statement",
          "valueString" : "define \"Stratifier 4\" :\n  \"Inpatient Encounter\" Encounter\n    where PrincipalDiagnosis(Encounter) is null"
        },
        {
          "url" : "displaySequence",
          "valueInteger" : 3
        }
      ],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [
        {
          "url" : "libraryName",
          "valueString" : "EXMLogic-FHIR"
        },
        {
          "url" : "name",
          "valueString" : "SDE Payer"
        },
        {
          "url" : "statement",
          "valueString" : "define \"SDE Payer\":\n    [Coverage: type in \"Payer\"] Payer\n      return {\n        code: Payer.type,\n        period: Payer.period\n      }"
        },
        {
          "url" : "displaySequence",
          "valueInteger" : 4
        }
      ],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [
        {
          "url" : "libraryName",
          "valueString" : "EXMLogic"
        },
        {
          "url" : "name",
          "valueString" : "Initial Population"
        },
        {
          "url" : "statement",
          "valueString" : "define \"Initial Population\" :\n  \"Inpatient Encounter\" Encounter"
        },
        {
          "url" : "displaySequence",
          "valueInteger" : 5
        }
      ],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [
        {
          "url" : "libraryName",
          "valueString" : "EXMLogic-FHIR"
        },
        {
          "url" : "name",
          "valueString" : "SDE Ethnicity"
        },
        {
          "url" : "statement",
          "valueString" : "define \"SDE Ethnicity\":\n  (flatten (\n    Patient.extension Extension\n      where Extension.url = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity'\n        return Extension.extension\n  )) E\n    where E.url = 'ombCategory'\n      or E.url = 'detailed'\n    return E.value as Coding"
        },
        {
          "url" : "displaySequence",
          "valueInteger" : 6
        }
      ],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [
        {
          "url" : "libraryName",
          "valueString" : "EXMLogic"
        },
        {
          "url" : "name",
          "valueString" : "SDE Race"
        },
        {
          "url" : "statement",
          "valueString" : "define \"SDE Race\":\n  (flatten (\n    Patient.extension Extension\n      where Extension.url = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-race'\n        return Extension.extension\n  )) E\n    where E.url = 'ombCategory'\n      or E.url = 'detailed'\n    return E.value as Coding"
        },
        {
          "url" : "displaySequence",
          "valueInteger" : 7
        }
      ],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [
        {
          "url" : "libraryName",
          "valueString" : "EXMLogic-FHIR"
        },
        {
          "url" : "name",
          "valueString" : "Stratifier 1"
        },
        {
          "url" : "statement",
          "valueString" : "define \"Stratifier 1\" :\n  \"Inpatient Encounter\" Encounter\n    where not (PrincipalDiagnosis(Encounter).code in \"Psychiatric/Mental Health Patient\")"
        },
        {
          "url" : "displaySequence",
          "valueInteger" : 8
        }
      ],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [
        {
          "url" : "libraryName",
          "valueString" : "EXMLogic-FHIR"
        },
        {
          "url" : "name",
          "valueString" : "Stratifier 2"
        },
        {
          "url" : "statement",
          "valueString" : "define \"Stratifier 2\" :\n  \"Inpatient Encounter\" Encounter\n    where PrincipalDiagnosis(Encounter).code in \"Psychiatric/Mental Health Patient\""
        },
        {
          "url" : "displaySequence",
          "valueInteger" : 9
        }
      ],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
      "valueCode" : "cqi"
    }
  ],
  "url" : "http://hl7.org/fhir/us/cqfmeasures/Library/effective-data-requirements-exmlogic",
  "version" : "1.0.0",
  "name" : "EffectiveDataRequirements",
  "title" : "Module Definition Library - EXM Logic",
  "status" : "active",
  "type" : {
    "coding" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/library-type",
        "code" : "module-definition"
      }
    ]
  },
  "date" : "2024-04-09T13:20:21+00:00",
  "publisher" : "HL7 International / Clinical Quality Information",
  "contact" : [
    {
      "telecom" : [
        {
          "system" : "url",
          "value" : "http://www.hl7.org/Special/committees/cqi"
        }
      ]
    }
  ],
  "description" : "This library is used as an example module definition in the FHIR Quality Measure Implementation Guide",
  "jurisdiction" : [
    {
      "coding" : [
        {
          "system" : "urn:iso:std:iso:3166",
          "code" : "US"
        }
      ]
    }
  ],
  "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 Payer",
      "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"
    },
    {
      "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"
    }
  ],
  "parameter" : [
    {
      "name" : "Measurement Period",
      "use" : "in",
      "min" : 0,
      "max" : "1",
      "type" : "Period"
    },
    {
      "name" : "SDE Sex",
      "use" : "out",
      "min" : 0,
      "max" : "1",
      "type" : "Coding"
    },
    {
      "name" : "Stratifier 3",
      "use" : "out",
      "min" : 0,
      "max" : "*",
      "type" : "Encounter"
    },
    {
      "name" : "Stratifier 4",
      "use" : "out",
      "min" : 0,
      "max" : "*",
      "type" : "Encounter"
    },
    {
      "name" : "SDE Payer",
      "use" : "out",
      "min" : 0,
      "max" : "*",
      "type" : "Resource"
    },
    {
      "name" : "Initial Population",
      "use" : "out",
      "min" : 0,
      "max" : "*",
      "type" : "Encounter"
    },
    {
      "name" : "SDE Ethnicity",
      "use" : "out",
      "min" : 0,
      "max" : "*",
      "type" : "Coding"
    },
    {
      "name" : "SDE Race",
      "use" : "out",
      "min" : 0,
      "max" : "*",
      "type" : "Coding"
    },
    {
      "name" : "Stratifier 1",
      "use" : "out",
      "min" : 0,
      "max" : "*",
      "type" : "Encounter"
    },
    {
      "name" : "Stratifier 2",
      "use" : "out",
      "min" : 0,
      "max" : "*",
      "type" : "Encounter"
    }
  ],
  "dataRequirement" : [
    {
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-fhirQueryPattern",
          "valueString" : "Patient?_id={{context.patientId}}"
        }
      ],
      "type" : "Patient",
      "profile" : [
        🔗 "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"
      ]
    },
    {
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-fhirQueryPattern",
          "valueString" : "Patient?_id={{context.patientId}}"
        },
        {
          "extension" : [
            {
              "url" : "path",
              "valueString" : "url"
            },
            {
              "url" : "comparator",
              "valueCode" : "eq"
            },
            {
              "url" : "value",
              "valueString" : "http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity"
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-valueFilter"
        }
      ],
      "type" : "Patient",
      "profile" : [
        🔗 "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"
      ],
      "mustSupport" : [
        "url",
        "extension",
        "value"
      ]
    },
    {
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-fhirQueryPattern",
          "valueString" : "Patient?_id={{context.patientId}}"
        }
      ],
      "type" : "Patient",
      "profile" : [
        🔗 "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"
      ],
      "mustSupport" : [
        "url",
        "extension",
        "value"
      ],
      "codeFilter" : [
        {
          "path" : "url",
          "code" : [
            {
              "system" : "urn:ietf:rfc:3986",
              "code" : "http://hl7.org/fhir/us/core/StructureDefinition/us-core-race"
            }
          ]
        }
      ]
    },
    {
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-fhirQueryPattern",
          "valueString" : "Encounter?subject=Patient/{{context.patientId}}"
        },
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-isSelective",
          "valueBoolean" : true
        }
      ],
      "type" : "Encounter",
      "profile" : [
        🔗 "http://hl7.org/fhir/StructureDefinition/Encounter"
      ],
      "mustSupport" : [
        "period"
      ],
      "dateFilter" : [
        {
          "path" : "period",
          "valuePeriod" : {
            "extension" : [
              {
                "url" : "http://hl7.org/fhir/StructureDefinition/cqf-expression",
                "valueExpression" : {
                  "language" : "text/cql-identifier",
                  "expression" : "Measurement Period"
                }
              }
            ]
          }
        }
      ]
    },
    {
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-fhirQueryPattern",
          "valueString" : "Coverage?policy-holder=Patient/{{context.patientId}}&type:in=http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"
        }
      ],
      "type" : "Coverage",
      "profile" : [
        🔗 "http://hl7.org/fhir/StructureDefinition/Coverage"
      ],
      "mustSupport" : [
        "type",
        "period"
      ],
      "codeFilter" : [
        {
          "path" : "type",
          "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"
        }
      ]
    }
  ]
}