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 - XML Representation

Active as of 2019-02-21

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<Measure xmlns="http://hl7.org/fhir">
  <id value="measure-risk-adjustment-FHIR2"/>
  <meta>
    <profile
             value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/proportion-measure-cqfm"/>
  </meta>
  <text>
    <status value="generated"/>
    <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>
  </text>
  <extension
             url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis">
    <valueCode value="boolean"/>
  </extension>
  <url
       value="http://hl7.org/fhir/us/cqfmeasures/Measure/measure-risk-adjustment-FHIR2"/>
  <identifier>
    <use value="official"/>
    <system value="http://example.org/fhir/cqi/ecqm/Measure/Identifier/exm"/>
    <value value="RiskAdjustment_FHIR2"/>
  </identifier>
  <version value="0.0.001"/>
  <name value="RiskAdjustment_FHIR2"/>
  <title value="Risk Adjustment FHIR DSTU2"/>
  <status value="active"/>
  <experimental value="true"/>
  <date value="2019-02-21"/>
  <publisher value="HL7 International / Clinical Quality Information"/>
  <contact>
    <telecom>
      <system value="url"/>
      <value value="http://www.hl7.org/Special/committees/cqi"/>
    </telecom>
  </contact>
  <description
               value="This example illustrates the use of risk adjustment data within a measure represented as a FHIR eCQM"/>
  <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/risk-adjustment-FHIR2"/>
  <scoring>
    <coding>
      <system value="http://terminology.hl7.org/CodeSystem/measure-scoring"/>
      <code value="proportion"/>
      <display value="Proportion"/>
    </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="numerator"/>
          <display value="Numerator"/>
        </coding>
      </code>
      <criteria>
        <language value="text/cql-identifier"/>
        <expression value="Numerator"/>
      </criteria>
    </population>
    <population>
      <code>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/measure-population"/>
          <code value="denominator"/>
          <display value="Denominator"/>
        </coding>
      </code>
      <criteria>
        <language value="text/cql-identifier"/>
        <expression value="Denominator"/>
      </criteria>
    </population>
  </group>
  <supplementalData id="sde-ethnicity">
    <usage>
      <coding>
        <system
                value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
        <code value="supplemental-data"/>
      </coding>
    </usage>
    <criteria>
      <language value="text/cql-identifier"/>
      <expression value="SDE Ethnicity"/>
    </criteria>
  </supplementalData>
  <supplementalData id="sde-payer">
    <usage>
      <coding>
        <system
                value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
        <code value="supplemental-data"/>
      </coding>
    </usage>
    <criteria>
      <language value="text/cql-identifier"/>
      <expression value="SDE Payer"/>
    </criteria>
  </supplementalData>
  <supplementalData id="sde-race">
    <usage>
      <coding>
        <system
                value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
        <code value="supplemental-data"/>
      </coding>
    </usage>
    <criteria>
      <language value="text/cql-identifier"/>
      <expression value="SDE Race"/>
    </criteria>
  </supplementalData>
  <supplementalData id="sde-sex">
    <usage>
      <coding>
        <system
                value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
        <code value="supplemental-data"/>
      </coding>
    </usage>
    <criteria>
      <language value="text/cql-identifier"/>
      <expression value="SDE Sex"/>
    </criteria>
  </supplementalData>
  <supplementalData id="hepatic-failure">
    <usage>
      <coding>
        <system
                value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
        <code value="risk-adjustment-factor"/>
      </coding>
    </usage>
    <criteria>
      <language value="text/cql-identifier"/>
      <expression value="Hepatic Failure"/>
    </criteria>
  </supplementalData>
  <supplementalData id="cirrhosis-dx">
    <usage>
      <coding>
        <system
                value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
        <code value="risk-adjustment-factor"/>
      </coding>
    </usage>
    <criteria>
      <language value="text/cql-identifier"/>
      <expression value="Cirrhosis Dx"/>
    </criteria>
  </supplementalData>
  <supplementalData id="bilirubin-test">
    <usage>
      <coding>
        <system
                value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
        <code value="risk-adjustment-factor"/>
      </coding>
    </usage>
    <criteria>
      <language value="text/cql-identifier"/>
      <expression value="Bilirubin Test"/>
    </criteria>
  </supplementalData>
  <supplementalData id="serum-albumin-test">
    <usage>
      <coding>
        <system
                value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
        <code value="risk-adjustment-factor"/>
      </coding>
    </usage>
    <criteria>
      <language value="text/cql-identifier"/>
      <expression value="Serum Albumin Test"/>
    </criteria>
  </supplementalData>
</Measure>