Quality Measure Implementation Guide
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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

: Risk Adjustment FHIR DSTU2 - JSON Representation

Active as of 2019-02-21

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{
  "resourceType" : "Measure",
  "id" : "measure-risk-adjustment-FHIR2",
  "meta" : {
    "profile" : [
      🔗 "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/proportion-measure-cqfm"
    ]
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"grid dict\"><tr style=\"vertical-align: top;\"><th scope=\"row\"><b>Id: </b></th><td style=\"padding-left: 25px; padding-right: 25px;\">Measure/measure-risk-adjustment-FHIR2</td></tr><tr style=\"vertical-align: top;\"><th rowspan=\"1\" scope=\"row\"><b>Type: </b></th><td style=\"padding-left: 25px; padding-right: 25px;\"><span><br/><span><span style=\"padding-left: 25px;\"><b>system: </b><span>http://terminology.hl7.org/CodeSystem/measure-type</span><br/></span><span style=\"padding-left: 25px;\"><b>code: </b><span>process</span></span></span></span></td></tr><tr style=\"vertical-align: top;\"><th rowspan=\"1\" scope=\"row\"><b>Identifier: </b></th><td style=\"padding-left: 25px; padding-right: 25px;\"><b>system: </b><span>http://example.org/fhir/cqi/ecqm/Measure/Identifier/exm</span><br/><b>value: </b><span>RiskAdjustment_FHIR2</span></td></tr><tr style=\"vertical-align: top;\"><th scope=\"row\"><b>Title: </b></th><td style=\"padding-left: 25px; padding-right: 25px;\">Risk Adjustment FHIR DSTU2</td></tr><tr style=\"vertical-align: top;\"><th scope=\"row\"><b>Status: </b></th><td style=\"padding-left: 25px; padding-right: 25px;\">active</td></tr><tr style=\"vertical-align: top;\"><th scope=\"row\"><b>Description: </b></th><td style=\"padding-left: 25px; padding-right: 25px;\">This example illustrates the use of risk adjustment data within a measure represented as a FHIR eCQM</td></tr><tr style=\"vertical-align: top;\"><th rowspan=\"1\" scope=\"row\"><b>Topic: </b></th><td style=\"padding-right: 25px;\"><span><br/><span><span style=\"padding-left: 25px;\"><b>system: </b><span>http://loinc.org</span><br/></span><span style=\"padding-left: 25px;\"><b>code: </b><span>57024-2</span><br/></span><span style=\"padding-left: 25px;\"><b>display: </b><span>Health Quality Measure Document</span></span></span></span></td></tr><tr style=\"vertical-align: top;\"><th rowspan=\"1\" scope=\"row\"><b>Library: </b></th><td><p style=\"padding-left: 25px; padding-right: 25px;\"><b>reference: </b><span>Library/library-risk-adjustment-FHIR2</span></p></td></tr><tr><th scope=\"row\"><b>Scoring: </b></th><td style=\"padding-left: 25px; padding-right: 25px;\"><span><br/><span><span style=\"padding-left: 25px;\"><b>system: </b><span>http://terminology.hl7.org/CodeSystem/measure-scoring</span><br/></span><span style=\"padding-left: 25px;\"><b>code: </b><span>proportion</span></span></span></span></td></tr><tr style=\"vertical-align: top;\"><th scope=\"row\"><b>Group:</b></th><td><p style=\"padding-left: 25px; padding-right: 25px;\"><b>Identifier:</b><br/><span style=\"padding-left: 25px;\"><b>value: </b><span>group-1</span><br/></span></p></td></tr><tr style=\"vertical-align: top;\"><td colspan=\"2\"><table style=\"margin-bottom: 5px; width: 100%\"><tr style=\"vertical-align: top;\"><th rowspan=\"3\" scope=\"row\" style=\"padding-left: 25px;\"><b>Population:</b></th><td><p style=\"margin-bottom: 5px; padding-left: 25px;\"><b>Identifier:</b><br/><span style=\"padding-left: 25px;\"><b>value: </b><span>initial-population-identifier</span><br/></span></p><p style=\"margin-bottom: 5px; padding-left: 25px;\"><b>criteria: </b><span>Initial Population</span></p></td></tr><tr style=\"vertical-align: top;\"><td><p style=\"margin-bottom: 5px; padding-left: 25px;\"><b>Identifier:</b><br/><span style=\"padding-left: 25px;\"><b>value: </b><span>numerator-identifier</span><br/></span></p><p style=\"margin-bottom: 5px; padding-left: 25px;\"><b>criteria: </b><span>Numerator</span></p></td></tr><tr style=\"vertical-align: top;\"><td><p style=\"margin-bottom: 5px; padding-left: 25px;\"><b>Identifier:</b><br/><span style=\"padding-left: 25px;\"><b>value: </b><span>denominator-identifier</span><br/></span></p><p style=\"margin-bottom: 5px; padding-left: 25px;\"><b>criteria: </b><span>Denominator</span></p></td></tr></table></td></tr><tr><th rowspan=\"8\" scope=\"row\"><b>Supplemental Data:</b></th><td style=\"padding-left: 25px; padding-right: 25px;\"><p style=\"margin-bottom: 5px;\"><b>Identifier:</b><br/><span style=\"padding-left: 25px;\"><b>value: </b><span>sde-ethnicity</span><br/></span></p><p style=\"margin-bottom: 5px;\"><b>usage: </b><span><span><br/><span><span style=\"padding-left: 25px;\"><b>system: </b><span>http://terminology.hl7.org/CodeSystem/measure-data-usage</span><br/></span><span style=\"padding-left: 25px;\"><b>code: </b><span>supplemental-data</span></span></span></span></span></p><p style=\"margin-bottom: 5px;\"><b>criteria: </b><span>SDE Ethnicity</span></p></td></tr><tr><td style=\"padding-left: 25px; padding-right: 25px;\"><p style=\"margin-bottom: 5px;\"><b>Identifier:</b><br/><span style=\"padding-left: 25px;\"><b>value: </b><span>sde-payer</span><br/></span></p><p style=\"margin-bottom: 5px;\"><b>usage: </b><span><span><br/><span><span style=\"padding-left: 25px;\"><b>system: </b><span>http://terminology.hl7.org/CodeSystem/measure-data-usage</span><br/></span><span style=\"padding-left: 25px;\"><b>code: </b><span>supplemental-data</span></span></span></span></span></p><p style=\"margin-bottom: 5px;\"><b>criteria: </b><span>SDE Payer</span></p></td></tr><tr><td style=\"padding-left: 25px; padding-right: 25px;\"><p style=\"margin-bottom: 5px;\"><b>Identifier:</b><br/><span style=\"padding-left: 25px;\"><b>value: </b><span>sde-race</span><br/></span></p><p style=\"margin-bottom: 5px;\"><b>usage: </b><span><span><br/><span><span style=\"padding-left: 25px;\"><b>system: </b><span>http://terminology.hl7.org/CodeSystem/measure-data-usage</span><br/></span><span style=\"padding-left: 25px;\"><b>code: </b><span>supplemental-data</span></span></span></span></span></p><p style=\"margin-bottom: 5px;\"><b>criteria: </b><span>SDE Race</span></p></td></tr><tr><td style=\"padding-left: 25px; padding-right: 25px;\"><p style=\"margin-bottom: 5px;\"><b>Identifier:</b><br/><span style=\"padding-left: 25px;\"><b>value: </b><span>sde-sex</span><br/></span></p><p style=\"margin-bottom: 5px;\"><b>usage: </b><span><span><br/><span><span style=\"padding-left: 25px;\"><b>system: </b><span>http://terminology.hl7.org/CodeSystem/measure-data-usage</span><br/></span><span style=\"padding-left: 25px;\"><b>code: </b><span>supplemental-data</span></span></span></span></span></p><p style=\"margin-bottom: 5px;\"><b>criteria: </b><span>SDE Sex</span></p></td></tr><tr><td style=\"padding-left: 25px; padding-right: 25px;\"><p style=\"margin-bottom: 5px;\"><b>Identifier:</b><br/><span style=\"padding-left: 25px;\"><b>value: </b><span>hepatic-failure</span><br/></span></p><p style=\"margin-bottom: 5px;\"><b>usage: </b><span><span><br/><span><span style=\"padding-left: 25px;\"><b>system: </b><span>http://terminology.hl7.org/CodeSystem/measure-data-usage</span><br/></span><span style=\"padding-left: 25px;\"><b>code: </b><span>risk-adjustment-factor</span></span></span></span></span></p><p style=\"margin-bottom: 5px;\"><b>criteria: </b><span>Hepatic Failure</span></p></td></tr><tr><td style=\"padding-left: 25px; padding-right: 25px;\"><p style=\"margin-bottom: 5px;\"><b>Identifier:</b><br/><span style=\"padding-left: 25px;\"><b>value: </b><span>cirrhosis-dx</span><br/></span></p><p style=\"margin-bottom: 5px;\"><b>usage: </b><span><span><br/><span><span style=\"padding-left: 25px;\"><b>system: </b><span>http://terminology.hl7.org/CodeSystem/measure-data-usage</span><br/></span><span style=\"padding-left: 25px;\"><b>code: </b><span>risk-adjustment-factor</span></span></span></span></span></p><p style=\"margin-bottom: 5px;\"><b>criteria: </b><span>Cirrhosis Dx</span></p></td></tr><tr><td style=\"padding-left: 25px; padding-right: 25px;\"><p style=\"margin-bottom: 5px;\"><b>Identifier:</b><br/><span style=\"padding-left: 25px;\"><b>value: </b><span>bilirubin-test</span><br/></span></p><p style=\"margin-bottom: 5px;\"><b>usage: </b><span><span><br/><span><span style=\"padding-left: 25px;\"><b>system: </b><span>http://terminology.hl7.org/CodeSystem/measure-data-usage</span><br/></span><span style=\"padding-left: 25px;\"><b>code: </b><span>risk-adjustment-factor</span></span></span></span></span></p><p style=\"margin-bottom: 5px;\"><b>criteria: </b><span>Bilirubin Test</span></p></td></tr><tr><td style=\"padding-left: 25px; padding-right: 25px;\"><p style=\"margin-bottom: 5px;\"><b>Identifier:</b><br/><span style=\"padding-left: 25px;\"><b>value: </b><span>serum-albumin-test</span><br/></span></p><p style=\"margin-bottom: 5px;\"><b>usage: </b><span><span><br/><span><span style=\"padding-left: 25px;\"><b>system: </b><span>http://terminology.hl7.org/CodeSystem/measure-data-usage</span><br/></span><span style=\"padding-left: 25px;\"><b>code: </b><span>risk-adjustment-factor</span></span></span></span></span></p><p style=\"margin-bottom: 5px;\"><b>criteria: </b><span>Serum Albumin Test</span></p></td></tr></table></div>"
  },
  "extension" : [
    {
      "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis",
      "valueCode" : "boolean"
    }
  ],
  "url" : "http://hl7.org/fhir/us/cqfmeasures/Measure/measure-risk-adjustment-FHIR2",
  "identifier" : [
    {
      "use" : "official",
      "system" : "http://example.org/fhir/cqi/ecqm/Measure/Identifier/exm",
      "value" : "RiskAdjustment_FHIR2"
    }
  ],
  "version" : "0.0.001",
  "name" : "RiskAdjustment_FHIR2",
  "title" : "Risk Adjustment FHIR DSTU2",
  "status" : "active",
  "experimental" : true,
  "date" : "2019-02-21",
  "publisher" : "HL7 International / Clinical Quality Information",
  "contact" : [
    {
      "telecom" : [
        {
          "system" : "url",
          "value" : "http://www.hl7.org/Special/committees/cqi"
        }
      ]
    }
  ],
  "description" : "This example illustrates the use of risk adjustment data within a measure represented as a FHIR eCQM",
  "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/risk-adjustment-FHIR2"
  ],
  "scoring" : {
    "coding" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/measure-scoring",
        "code" : "proportion",
        "display" : "Proportion"
      }
    ]
  },
  "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" : "numerator",
                "display" : "Numerator"
              }
            ]
          },
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Numerator"
          }
        },
        {
          "code" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                "code" : "denominator",
                "display" : "Denominator"
              }
            ]
          },
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Denominator"
          }
        }
      ]
    }
  ],
  "supplementalData" : [
    {
      "id" : "sde-ethnicity",
      "usage" : [
        {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
              "code" : "supplemental-data"
            }
          ]
        }
      ],
      "criteria" : {
        "language" : "text/cql-identifier",
        "expression" : "SDE Ethnicity"
      }
    },
    {
      "id" : "sde-payer",
      "usage" : [
        {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
              "code" : "supplemental-data"
            }
          ]
        }
      ],
      "criteria" : {
        "language" : "text/cql-identifier",
        "expression" : "SDE Payer"
      }
    },
    {
      "id" : "sde-race",
      "usage" : [
        {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
              "code" : "supplemental-data"
            }
          ]
        }
      ],
      "criteria" : {
        "language" : "text/cql-identifier",
        "expression" : "SDE Race"
      }
    },
    {
      "id" : "sde-sex",
      "usage" : [
        {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
              "code" : "supplemental-data"
            }
          ]
        }
      ],
      "criteria" : {
        "language" : "text/cql-identifier",
        "expression" : "SDE Sex"
      }
    },
    {
      "id" : "hepatic-failure",
      "usage" : [
        {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
              "code" : "risk-adjustment-factor"
            }
          ]
        }
      ],
      "criteria" : {
        "language" : "text/cql-identifier",
        "expression" : "Hepatic Failure"
      }
    },
    {
      "id" : "cirrhosis-dx",
      "usage" : [
        {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
              "code" : "risk-adjustment-factor"
            }
          ]
        }
      ],
      "criteria" : {
        "language" : "text/cql-identifier",
        "expression" : "Cirrhosis Dx"
      }
    },
    {
      "id" : "bilirubin-test",
      "usage" : [
        {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
              "code" : "risk-adjustment-factor"
            }
          ]
        }
      ],
      "criteria" : {
        "language" : "text/cql-identifier",
        "expression" : "Bilirubin Test"
      }
    },
    {
      "id" : "serum-albumin-test",
      "usage" : [
        {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
              "code" : "risk-adjustment-factor"
            }
          ]
        }
      ],
      "criteria" : {
        "language" : "text/cql-identifier",
        "expression" : "Serum Albumin Test"
      }
    }
  ]
}