Quality Measure Implementation Guide (STU3)
3.0.0 - STU 3
US
Quality Measure Implementation Guide (STU3)
3.0.0 - STU 3
US
This page is part of the Quality Measure STU2 for FHIR R4 Implementation Guide (v3.0.0: STU3) based on FHIR 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 |
<Measure xmlns="http://hl7.org/fhir">
<id value="measure-exm55-FHIR"/>
<meta>
<profile
value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cv-measure-cqfm"/>
<profile
value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-measure-cqfm"/>
</meta>
<text>
<status value="extensions"/>
<div xmlns="http://www.w3.org/1999/xhtml">
<table class="grid dict">
<tr>
<th scope="row"><b>Id: </b></th>
<td style="padding-left: 4px;">measure-exm55-FHIR</td>
</tr>
<tr>
<th scope="row"><b>Url: </b></th>
<td style="padding-left: 4px;">http://hl7.org/fhir/us/cqfmeasures/Measure/measure-exm55-FHIR</td>
</tr>
<tr>
<th scope="row"><b>Version: </b></th>
<td style="padding-left: 4px;">5.0.0</td>
</tr>
<tr>
<th scope="row"><b>Identifier: </b></th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<b>value: </b> <span>55</span>
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Name: </b></th>
<td style="padding-left: 4px;">EXM55</td>
</tr>
<tr>
<th scope="row"><b>Title: </b></th>
<td style="padding-left: 4px;">EXM55 - Median ED Visit Duration</td>
</tr>
<tr>
<th scope="row"><b>Status: </b></th>
<td style="padding-left: 4px;">active</td>
</tr>
<tr>
<th scope="row"><b>Experimental: </b></th>
<td style="padding-left: 4px;">true</td>
</tr>
<tr>
<th scope="row"><b>Scoring: </b></th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<b>system: </b> <span>http://terminology.hl7.org/CodeSystem/measure-scoring</span>
</p>
<p style="margin-bottom: 5px;">
<b>code: </b> <span>continuous-variable</span>
</p>
<p style="margin-bottom: 5px;">
<b>display: </b> <span>Continuous Variable</span>
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Improvement Notation: </b></th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<b>system: </b> <span>http://terminology.hl7.org/CodeSystem/measure-improvement-notation</span>
</p>
<p style="margin-bottom: 5px;">
<b>code: </b> <span>decrease</span>
</p>
<p style="margin-bottom: 5px;">
<b>display: </b> <span>Decreased score indicates improvement</span>
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Type: </b></th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<b>system: </b> <span>http://terminology.hl7.org/CodeSystem/measure-type</span>
</p>
<p style="margin-bottom: 5px;">
<b>code: </b> <span>process</span>
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Date: </b></th>
<td style="padding-left: 4px;">2022-02-22</td>
</tr>
<tr>
<th scope="row"><b>Publisher: </b></th>
<td style="padding-left: 4px;">Clinical Quality Information WG</td>
</tr>
<tr>
<th scope="row"><b>Description: </b></th>
<td style="padding-left: 4px;">This example illustrates a continuous variable measure represented as a FHIR eCQM</td>
</tr>
<tr>
<th scope="row"><b>Use Context: </b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr><th><b>code</b></th><th><b>value</b></th></tr>
<tr>
<td>program</td>
<td></td>
</tr>
</table>
</td>
</tr>
<tr>
<th scope="row"><b>Jurisdiction: </b></th>
<td style="padding-left: 25px;">US</td>
</tr>
<tr>
<th scope="row"><b>Topic: </b></th>
<td style="padding-left: 25px;">57024-2</td>
</tr>
<tr>
<th scope="row"><b>Approval Date: </b></th>
<td style="padding-left: 4px;">2019-03-08</td>
</tr>
<tr>
<th scope="row"><b>Last Review Date: </b></th>
<td style="padding-left: 4px;">2019-03-08</td>
</tr>
<tr>
<th scope="row"><b>Effective Period: </b></th>
<td style="padding-left: 4px;">2018-01-01..2018-12-31</td>
</tr>
</table>
</div>
</text>
<contained>
<Library>
<id value="effective-data-requirements"/>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
<valueCoding>
<system value="http://terminology.hl7.org/CodeSystem/diagnosis-role"/>
<code value="billing"/>
<display value="Billing"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="EXM55"/>
</extension>
<extension url="name">
<valueString value="Inpatient Encounter"/>
</extension>
<extension url="statement">
<valueString
value="define "Inpatient Encounter" :
["Encounter"] Encounter
where LengthInDays(Encounter.period) <= 120
and Encounter.period ends during "Measurement Period""/>
</extension>
<extension url="displaySequence">
<valueInteger value="0"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="EXM55"/>
</extension>
<extension url="name">
<valueString value="Stratification 3"/>
</extension>
<extension url="statement">
<valueString
value="define "Stratification 3" :
"Inpatient Encounter" Encounter
where PrincipalDiagnosis(Encounter) is null"/>
</extension>
<extension url="displaySequence">
<valueInteger value="1"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="EXM55"/>
</extension>
<extension url="name">
<valueString value="Stratification 2"/>
</extension>
<extension url="statement">
<valueString
value="define "Stratification 2" :
"Inpatient Encounter" Encounter
where PrincipalDiagnosis(Encounter).code in "Psychiatric/Mental Health Patient""/>
</extension>
<extension url="displaySequence">
<valueInteger value="2"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="EXM55"/>
</extension>
<extension url="name">
<valueString value="Measure Population Exclusion"/>
</extension>
<extension url="statement">
<valueString
value="define "Measure Population Exclusion" :
"Inpatient Encounter" Encounter
with ["Encounter" : "Emergency Department Visit"] ED
such that ED.period ends 1 hour or less before start of Encounter.period
and ED.status = 'finished'
and ED.hospitalization.admitSource in "Hospital Settings""/>
</extension>
<extension url="displaySequence">
<valueInteger value="3"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="EXM55"/>
</extension>
<extension url="name">
<valueString value="Stratification 1"/>
</extension>
<extension url="statement">
<valueString
value="define "Stratification 1" :
"Inpatient Encounter" Encounter
where not (PrincipalDiagnosis(Encounter).code in "Psychiatric/Mental Health Patient")"/>
</extension>
<extension url="displaySequence">
<valueInteger value="4"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="EXM55"/>
</extension>
<extension url="name">
<valueString value="Initial Population"/>
</extension>
<extension url="statement">
<valueString
value="define "Initial Population" :
"Inpatient Encounter" Encounter
with ["Encounter" : "Emergency Department Visit"] ED
such that ED.status = 'finished'
and ED.period ends 1 hour or less before start of Encounter.period"/>
</extension>
<extension url="displaySequence">
<valueInteger value="5"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="EXM55"/>
</extension>
<extension url="name">
<valueString value="Measure Population"/>
</extension>
<extension url="statement">
<valueString
value="define "Measure Population" :
"Initial Population""/>
</extension>
<extension url="displaySequence">
<valueInteger value="6"/>
</extension>
</extension>
<name value="EffectiveDataRequirements"/>
<status value="active"/>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/library-type"/>
<code value="module-definition"/>
</coding>
</type>
<date value="2022-02-22T10:37:03-07:00"/>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library FHIRHelpers"/>
<resource
value="http://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Code system Diagnosis Role"/>
<resource value="http://terminology.hl7.org/CodeSystem/diagnosis-role"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Psychiatric/Mental Health Patient"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.299"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Emergency Department Visit"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Hospital Settings"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.126"/>
</relatedArtifact>
<parameter>
<name value="Measurement Period"/>
<use value="in"/>
<min value="0"/>
<max value="1"/>
<type value="Period"/>
</parameter>
<parameter>
<name value="Stratification 3"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Encounter"/>
</parameter>
<parameter>
<name value="Stratification 2"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Encounter"/>
</parameter>
<parameter>
<name value="Measure Population Exclusion"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Encounter"/>
</parameter>
<parameter>
<name value="Stratification 1"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Encounter"/>
</parameter>
<parameter>
<name value="Initial Population"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Encounter"/>
</parameter>
<parameter>
<name value="Measure Population"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Encounter"/>
</parameter>
<dataRequirement>
<type value="Encounter"/>
<profile value="http://hl7.org/fhir/StructureDefinition/Encounter"/>
<mustSupport value="period"/>
<mustSupport value="hospitalization"/>
<mustSupport value="hospitalization.admitSource"/>
<mustSupport value="type"/>
<mustSupport value="status"/>
<codeFilter>
<path value="type"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Encounter"/>
<profile value="http://hl7.org/fhir/StructureDefinition/Encounter"/>
<mustSupport value="period"/>
</dataRequirement>
<dataRequirement>
<type value="Condition"/>
<profile value="http://hl7.org/fhir/StructureDefinition/Condition"/>
<mustSupport value="id"/>
<codeFilter>
<path value="id"/>
</codeFilter>
</dataRequirement>
</Library>
</contained>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis">
<valueCode value="Encounter"/>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-softwaresystem">
<valueReference>
<reference value="Device/software-system-example"/>
</valueReference>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-effectiveDataRequirements" id="effective-data-requirements">
<valueReference>
<reference value="#effective-data-requirements"/>
</valueReference>
</extension>
<url value="http://hl7.org/fhir/us/cqfmeasures/Measure/measure-exm55-FHIR"/>
<identifier>
<use value="official"/>
<system value="http://example.org/fhir/cqi/ecqm/Measure/Identifier/exm"/>
<value value="55"/>
</identifier>
<version value="5.0.0"/>
<name value="EXM55"/>
<title value="EXM55 - Median ED Visit Duration"/>
<status value="active"/>
<experimental value="true"/>
<date value="2022-02-22"/>
<publisher value="Clinical Quality Information WG"/>
<contact>
<telecom>
<system value="url"/>
<value value="http://www.hl7.org/Special/committees/cqi"/>
</telecom>
</contact>
<description
value="This example illustrates a continuous variable measure represented as a FHIR eCQM"/>
<useContext>
<code>
<system value="http://terminology.hl7.org/CodeSystem/usage-context-type"/>
<code value="program"/>
</code>
<valueCodeableConcept>
<coding>
<system
value="http://hl7.org/fhir/us/cqfmeasures/CodeSystem/quality-programs"/>
<code value="eh-cah"/>
<display value="EH/CAH"/>
</coding>
</valueCodeableConcept>
</useContext>
<jurisdiction>
<coding>
<system value="urn:iso:std:iso:3166"/>
<code value="US"/>
</coding>
</jurisdiction>
<approvalDate value="2019-03-08"/>
<lastReviewDate value="2019-03-08"/>
<effectivePeriod>
<start value="2018-01-01"/>
<end value="2018-12-31"/>
</effectivePeriod>
<topic>
<coding>
<system value="http://loinc.org"/>
<code value="57024-2"/>
<display value="Health Quality Measure Document"/>
</coding>
</topic>
<library value="http://hl7.org/fhir/us/cqfmeasures/Library/EXM55"/>
<scoring>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/measure-scoring"/>
<code value="continuous-variable"/>
<display value="Continuous Variable"/>
</coding>
</scoring>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/measure-type"/>
<code value="process"/>
</coding>
</type>
<improvementNotation>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-improvement-notation"/>
<code value="decrease"/>
<display value="Decreased score indicates improvement"/>
</coding>
</improvementNotation>
<group>
<population>
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="initial-population"/>
<display value="Initial Population"/>
</coding>
</code>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Initial Population"/>
</criteria>
</population>
<population>
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="measure-population"/>
<display value="Measure Population"/>
</coding>
</code>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Measure Population"/>
</criteria>
</population>
<population>
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="measure-population-exclusion"/>
<display value="Measure Population Exclusion"/>
</coding>
</code>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Measure Population Exclusion"/>
</criteria>
</population>
<population>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-criteriaReference">
<valueString value="measure-population-identifier"/>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-aggregateMethod">
<valueCode value="median"/>
</extension>
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="measure-observation"/>
<display value="Measure Observation"/>
</coding>
</code>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Measure Observation"/>
</criteria>
</population>
<stratifier>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo">
<valueCodeableConcept>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="initial-population"/>
<display value="Initial Population"/>
</coding>
</valueCodeableConcept>
</extension>
<code>
<coding>
<display value="Stratification 1"/>
</coding>
</code>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Stratification 1"/>
</criteria>
</stratifier>
<stratifier>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo">
<valueCodeableConcept>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="initial-population"/>
<display value="Initial Population"/>
</coding>
</valueCodeableConcept>
</extension>
<code>
<coding>
<display value="Stratification 2"/>
</coding>
</code>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Stratification 2"/>
</criteria>
</stratifier>
<stratifier>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo">
<valueCodeableConcept>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="initial-population"/>
<display value="Initial Population"/>
</coding>
</valueCodeableConcept>
</extension>
<code>
<coding>
<display value="Stratification 3"/>
</coding>
</code>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Stratification 3"/>
</criteria>
</stratifier>
</group>
</Measure>
IG © 2019+ Clinical Quality Information WG. Package hl7.fhir.us.cqfmeasures#3.0.0 based on FHIR 4.0.1. Generated 2022-04-28
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