Quality Measure Implementation Guide
5.0.0 - STU5
Quality Measure Implementation Guide
5.0.0 - STU5
This page is part of the Quality Measure STU2 for FHIR R4 Implementation Guide (v5.0.0: STU5 (v5.0.0)) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions
| Active as of 2022-02-22 |
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"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<div>\n <table class=\"grid dict\">\n \n <tr>\n <th scope=\"row\"><b>Title: </b></th>\n <td style=\"padding-left: 4px;\">EXM55 - Median Emergency Department Visit Duration</td>\n </tr>\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Id: </b></th>\n <td style=\"padding-left: 4px;\">EXM55-FHIR</td>\n </tr>\n \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 \n <tr>\n <th scope=\"row\"><b>Url: </b></th>\n <td style=\"padding-left: 4px;\"><a href=\"Measure-EXM55-FHIR.html\">EXM55 - Median Emergency Department Visit Duration</a></td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\">\n <b>\n \n Official\n \n </b>\n </th>\n\n <td style=\"padding-left: 4px;\">\n \n <p style=\"margin-bottom: 5px;\">\n <span>55</span>\n </p>\n \n </td>\n </tr>\n \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 <tr>\n <th scope=\"row\"><b>Experimental: </b></th>\n <td style=\"padding-left: 4px;\">true</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\n \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 <tr>\n <th scope=\"row\"><b>Use Context: </b></th>\n <td style=\"padding-left: 4px;\">\n <table class=\"grid-dict\">\n <tr>\n <th><b>code</b></th>\n <th><b>value</b></th>\n </tr>\n \n <tr>\n <td>venue</td>\n <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: 4px;\">US</td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Topic: </b></th>\n <td style=\"padding-left: 4px;\">57024-2</td>\n </tr>\n \n\n \n\n \n\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Basis: </b></th>\n <td style=\"padding-left: 4px;\">\n Encounter\n </td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Scoring: </b></th>\n <td style=\"padding-left: 4px;\">\n \n \n <p style=\"margin-bottom: 5px;\">\n <span>Continuous Variable </span>\n </p>\n \n \n \n </td>\n </tr>\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Type: </b></th>\n <td style=\"padding-left: 4px;\">\n \n \n <p style=\"margin-bottom: 5px;\">\n <span>process </span>\n </p>\n \n \n \n </td>\n </tr>\n \n\n \n\n \n\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Improvement Notation: </b></th>\n <td style=\"padding-left: 4px;\">\n \n \n <p style=\"margin-bottom: 5px;\">\n <span>Decreased score indicates improvement </span>\n </p>\n \n \n \n </td>\n </tr>\n \n\n \n\n \n \n \n\n \n\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Libraries: </b></th>\n <td style=\"padding-left: 4px;\">\n <table class=\"grid-dict\">\n \n <tr>\n <td><a href=\"Library-EXM55-FHIR.html\">EXM55 - Median Emergency Department Visit Duration Library (Example Continuous Variable Measure Library)</a></td>\n </tr>\n \n </table>\n </td>\n </tr>\n \n\n \n\n \n \n <tr>\n <th scope=\"row\"><b>Terminology and Other Dependencies: </b></th>\n <td style=\"padding-left: 4px;\">\n \n <li><code>http://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1</code></li>\n \n <li><a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-diagnosis-role.html\">Diagnosis Role</a></li>\n \n <li><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.299</code></li>\n \n <li><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292</code></li>\n \n <li><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.126</code></li>\n \n </td>\n </tr>\n <tr>\n <th scope=\"row\"><b>Parameters:</b></th>\n <td style=\"padding-left: 4px;\">\n <table class=\"grid-dict\">\n <tr>\n <th><b>name</b></th>\n <th><b>use</b></th>\n <th><b>min</b></th>\n <th><b>max</b></th>\n <th><b>type</b></th>\n </tr>\n \n <tr>\n <td>Measurement Period</td>\n <td>In</td>\n <td>0</td>\n <td>1</td>\n <td>Period</td>\n </tr>\n \n <tr>\n <td>Stratification 3</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Encounter</td>\n </tr>\n \n <tr>\n <td>Stratification 2</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Encounter</td>\n </tr>\n \n <tr>\n <td>Measure Population Exclusion</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Encounter</td>\n </tr>\n \n <tr>\n <td>Stratification 1</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Encounter</td>\n </tr>\n \n <tr>\n <td>Initial Population</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Encounter</td>\n </tr>\n \n <tr>\n <td>Measure Population</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Encounter</td>\n </tr>\n \n </table>\n </td>\n </tr>\n\n <tr>\n <th scope=\"row\"><b>DataRequirements:</b></th>\n <td style=\"padding-left: 4px;\">\n <table class=\"grid-dict\">\n <tr>\n <th><b>Resource Type</b></th>\n <th><b>Resource Elements</b></th>\n <th><b>Valueset Name</b></th>\n <th><b>Valueset</b></th>\n </tr>\n \n <tr>\n <td>Encounter(<a href=\"http://hl7.org/fhir/R4/encounter.html\">Encounter</a>)</td>\n <td>\n \n period\n \n hospitalization\n \n hospitalization.admitSource\n \n type\n \n status\n \n </td>\n <td>\n \n \n Emergency Department Visit\n \n \n </td>\n <td><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292</code></td>\n </tr>\n \n <tr>\n <td>Encounter(<a href=\"http://hl7.org/fhir/R4/encounter.html\">Encounter</a>)</td>\n <td>\n \n period\n \n </td>\n <td>\n \n </td>\n <td/>\n </tr>\n \n <tr>\n <td>Condition(<a href=\"http://hl7.org/fhir/R4/condition.html\">Condition</a>)</td>\n <td>\n \n id\n \n </td>\n <td>\n \n </td>\n <td/>\n </tr>\n \n </table>\n </td>\n </tr>\n\n \n\n \n <tr>\n <th scope=\"row\"><b>Direct Reference Codes:</b></th>\n <td style=\"padding-left: 4px;\">\n <table class=\"grid-dict\">\n <tr>\n <th><b>display</b></th>\n <th><b>code</b></th>\n <th><b>system</b></th>\n </tr>\n \n <tr>\n <td>Billing</td>\n <td>billing</td>\n <td><a href=\"http://hl7.org/fhir/R4/codesystem-diagnosis-role.html\">http://terminology.hl7.org/CodeSystem/diagnosis-role</a></td>\n </tr>\n \n </table>\n </td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Logic Definitions:</b></th>\n <td style=\"padding-left: 4px;\">\n \n <table class=\"grid-dict\">\n <tr>\n <th><b>Group</b></th>\n <th><b>Scoring</b></th>\n <th><b>Population Criteria</b></th>\n <th><b>Expression</b></th>\n </tr>\n <tr>\n \n <td> </td>\n <td colspan=\"3\" style=\"padding-left: 4px;\">\n \n\n \n\n \n <b>Measure scoring:</b>\n \n <p style=\"margin-bottom: 5px;\">\n <span>Continuous Variable</span>\n </p>\n \n \n\n \n\n \n\n \n\n \n\n \n\n \n\n </td>\n \n <tr>\n <td/>\n <td/>\n <td>Initial Population</td>\n <td>\n \n <pre><code class=\"language-cql\">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</code></pre>\n \n </td>\n </tr>\n \n <tr>\n <td/>\n <td/>\n <td>Measure Population</td>\n <td>\n \n <pre><code class=\"language-cql\">define "Measure Population" :\n "Initial Population"</code></pre>\n \n </td>\n </tr>\n \n <tr>\n <td/>\n <td/>\n <td>Measure Population Exclusion</td>\n <td>\n \n <pre><code class=\"language-cql\">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"</code></pre>\n \n </td>\n </tr>\n \n <tr>\n <td/>\n <td/>\n <td>Measure Observation</td>\n <td>\n \n <pre><code class=\"language-cql\"/></pre>\n \n </td>\n </tr>\n \n \n <tr>\n <td/>\n <td/>\n <td>Stratification 1</td>\n <td>\n \n <pre><code class=\"language-cql\">define "Stratification 1" :\n "Inpatient Encounter" Encounter\n where not (PrincipalDiagnosis(Encounter).code in "Psychiatric/Mental Health Patient")</code></pre>\n \n </td>\n </tr>\n \n <tr>\n <td/>\n <td/>\n <td>Stratification 2</td>\n <td>\n \n <pre><code class=\"language-cql\">define "Stratification 2" :\n "Inpatient Encounter" Encounter\n where PrincipalDiagnosis(Encounter).code in "Psychiatric/Mental Health Patient"</code></pre>\n \n </td>\n </tr>\n \n <tr>\n <td/>\n <td/>\n <td>Stratification 3</td>\n <td>\n \n <pre><code class=\"language-cql\">define "Stratification 3" :\n "Inpatient Encounter" Encounter\n where PrincipalDiagnosis(Encounter) is null</code></pre>\n \n </td>\n </tr>\n \n \n </tr>\n </table>\n \n\n <table class=\"grid-dict\">\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>EXM55-FHIR</td>\n \n \n <td>Inpatient Encounter</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Inpatient Encounter" :\n ["Encounter"] Encounter\n where LengthInDays(Encounter.period) <= 120\n and Encounter.period ends during "Measurement Period"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>EXM55-FHIR</td>\n \n \n <td>Stratification 3</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Stratification 3" :\n "Inpatient Encounter" Encounter\n where PrincipalDiagnosis(Encounter) is null</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>EXM55-FHIR</td>\n \n \n <td>Stratification 2</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Stratification 2" :\n "Inpatient Encounter" Encounter\n where PrincipalDiagnosis(Encounter).code in "Psychiatric/Mental Health Patient"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>EXM55-FHIR</td>\n \n \n <td>Measure Population Exclusion</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">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"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>EXM55-FHIR</td>\n \n \n <td>Stratification 1</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Stratification 1" :\n "Inpatient Encounter" Encounter\n where not (PrincipalDiagnosis(Encounter).code in "Psychiatric/Mental Health Patient")</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>EXM55-FHIR</td>\n \n \n <td>Initial Population</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">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</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>EXM55-FHIR</td>\n \n \n <td>Measure Population</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Measure Population" :\n "Initial Population"</code></pre>\n </td>\n \n </tr>\n \n </table>\n </td>\n </tr>\n \n \n \n\n </table>\n</div>\n</div>"
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},
{
"url" : "http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-softwaresystem",
"valueReference" : {
🔗 "reference" : "Device/software-system-example"
}
},
{
"url" : "http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements",
"valueCanonical" : "#effective-data-requirements-exm55"
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/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 Emergency Department Visit Duration",
"status" : "active",
"experimental" : true,
"date" : "2022-02-22",
"publisher" : "HL7 International / Clinical Quality Information",
"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" : "venue",
"display" : "Venue"
},
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/us/cqfmeasures/CodeSystem/intended-venue-codes",
"code" : "eh",
"display" : "EH"
}
]
}
}
],
"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-FHIR"
],
"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" : [
{
"system" : "http://example.org/stratification",
"code" : "Stratification 1",
"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" : [
{
"system" : "http://example.org/stratification",
"code" : "Stratification 2",
"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" : [
{
"system" : "http://example.org/stratification",
"code" : "Stratification 3",
"display" : "Stratification 3"
}
]
},
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Stratification 3"
}
}
]
}
]
}
IG © 2019+ HL7 International / Clinical Quality Information. Package hl7.fhir.us.cqfmeasures#5.0.0 based on FHIR 4.0.1. Generated 2024-11-04
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