Quality Measure STU1 for FHIR STU3 Implementation Guide
This page is part of the Quality Measure STU2 for FHIR R4 Implementation Guide (v1.0.0: STU 1) based on FHIR R3. The current version which supercedes this version is 3.0.0. For a full list of available versions, see the Directory of published versions 
<Measure xmlns="http://hl7.org/fhir"> <id value="measure-exm130-FHIR"/> <meta> <versionId value="2"/> <lastUpdated value="2019-11-06T18:12:51.449-05:00"/> <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 style="width: 60%; border-bottom: none;" class="header_table"> <!-- <tr th:if="${resource.hasId()}" style="vertical-align: top;"><th style="background-color:#656565; width:20%" scope="row"><span class="td_label">Id: </span></th><td style="width:80%" colspan="3" th:narrative="${resource.id}"></td></tr> --><tr style="vertical-align: top;"><td scope="row" style="background-color:#656565; width:20%"><span class="td_label">Measure Title</span></td><td colspan="1" style="width:60%"><h1 style="font-size:10px">Colorectal Cancer Screening</h1></td><td scope="row" style="background-color:#656565; width:10%"><span class="td_label">Measure ID</span></td><td colspan="1" style="width:10%"><h1 style="font-size:10px">EXM130</h1></td></tr> <!-- <th:block th:each="ident, iter : ${resource.identifier}"><tr th:if="${ident.type.coding[0].code == 'CMS'}" style="vertical-align: top;"><td style="background-color:#656565; width:20%" scope="row"><span class="td_label">eCQM Identifier (Measure Authoring Tool)</span></td><td style="width:30%" th:narrative="${ident.value}"></td><td style="background-color:#656565; width:20%" scope="row"><span class="td_label">eCQM Version number</span></td><td style="width:30%" th:narrative="${resource.version}"></td></tr></th:block><th:block th:each="ident, iter : ${resource.identifier}"><tr th:if="${ident.type.coding[0].code == 'NQF'}" style="vertical-align: top;"><td style="background-color:#656565; width:20%" scope="row"><span class="td_label">NQF Number</span></td><td style="width:30%" th:narrative="${ident.value}"></td><td style="background-color:#656565; width:20%" scope="row"><span class="td_label">GUID</span></td><td style="width:30%" th:narrative="${resource.url}"></td></tr></th:block> --><tr style="vertical-align: top;"><td scope="row" style="background-color:#656565; width:20%"><span class="td_label">Description</span></td><td colspan="3" style="width:80%"><div style="width:660px;overflow-x:hidden;overflow-y:auto"><pre><p>Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer</p> </pre> </div> </td> </tr> <tr> <td scope="row" style="background-color:#656565; width:20%"><span class="td_label">Measurement Period</span></td> <td colspan="3" style="width:80%">January 1 - December 31</td> </tr> <!-- <tr> <td style="background-color:#656565; width:20%" scope="row"><span class="td_label">Measure Steward</span></td> <td style="width:80%" colspan="3" th:narrative="${resource.publisher}"></td> </tr> <tr> <td style="background-color:#656565; width:20%" scope="row"><span class="td_label">Measure Developer</span></td> <td style="width:80%" colspan="3" th:narrative="${resource.publisher}"></td> </tr> --> <!-- <tr th:if="${resource.hasDisclaimer()}"> <td style="background-color:#656565; width:20%" scope="row"><span class="td_label">Disclaimer</span></td> <td style="width:80%" colspan="3"> <div style="width:660px;overflow-x:hidden;overflow-y:auto"> <pre th:text="${resource.disclaimer}"></pre> </div> </td> </tr> --> <tr> <td scope="row" style="background-color:#656565; width:20%"><span class="td_label">Copyright and Disclaimer Notice</span></td> <td colspan="3" style="width:80%"> <div style="width:660px;overflow-x:hidden;overflow-y:auto"> <pre>The performance Measure is not a clinical guideline and does not establish a standard of medical care, and has not been tested for all potential applications. THE MEASURE AND SPECIFICATIONS ARE PROVIDED "AS IS" WITHOUT WARRANTY OF ANY KIND. Due to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM].</pre> <br/> <pre>This Physician Performance Measure (Measure) and related data specifications were developed by the National Committee for Quality Assurance (NCQA). NCQA is not responsible for any use of the Measure. NCQA makes no representations, warranties, or endorsement about the quality of any organization or physician that uses or reports performance measures and NCQA has no liability to anyone who relies on such measures or specifications. NCQA holds a copyright in the Measure. The Measure can be reproduced and distributed, without modification, for noncommercial purposes (eg, use by healthcare providers in connection with their practices) without obtaining approval from NCQA. Commercial use is defined as the sale, licensing, or distribution of the Measure for commercial gain, or incorporation of the Measure into a product or service that is sold, licensed or distributed for commercial gain. All commercial uses or requests for modification must be approved by NCQA and are subject to a license at the discretion of NCQA. (C) 2012-2017 National Committee for Quality Assurance. All Rights Reserved. Limited proprietary coding is contained in the Measure specifications for user convenience. Users of proprietary code sets should obtain all necessary licenses from the owners of the code sets. NCQA disclaims all liability for use or accuracy of any third party codes contained in the specifications. CPT(R) contained in the Measure specifications is copyright 2004-2017 American Medical Association. LOINC(R) copyright 2004-2017 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R] ) copyright 2004-2017 International Health Terminology Standards Development Organisation. ICD-10 copyright 2017 World Health Organization. All Rights Reserved.</pre> </div> </td> </tr> <tr> <td scope="row" style="background-color:#656565; width:20%"><span class="td_label">Clinical Recommendation Statement</span></td> <td colspan="3" style="width:80%"> <div style="width:660px;overflow-x:hidden;overflow-y:auto"><p>The U. S. Preventive Services Task Force (2016) recommends screening for colorectal cancer starting at age 50 years and continuing until age 75 years. This is a Grade A recommendation (U.S. Preventive Services Task Force 2016). Screening tests: -Colonoscopy (every 10 years) -Flexible sigmoidoscopy (every 5 years) -Fecal occult blood test (annually) -FIT-DNA (every 3 years) -Computed tomographic colonography (every 5 years)</p> </div> </td> </tr> <tr style="vertical-align: top;"> <td rowspan="3" scope="row" style="background-color:#656565; width:20%"><span class="td_label">References</span></td> <td colspan="3" style="width:80%"> <div style="width:660px;overflow-x:hidden;overflow-y:auto"> <pre>U.S. Preventive Services Task Force. "Screening for Colorectal Cancer: U.S. Preventive Services Task Force Recommendation Statement." JAMA, vol. 315, no. 23, 2016, pp. 2564-2575. doi: 10.1001/jama.2016.5989</pre> </div> </td> </tr> <tr style="vertical-align: top;"> <td colspan="3" style="width:80%"> <div style="width:660px;overflow-x:hidden;overflow-y:auto"> <pre>Howlader, N., A.M. Noone, M. Krapcho, D. Miller, K. Bishop, C.L. Kosary, M. Yu, J. Ruhl, Z. Tatalovich, A. Mariotto, D.R. Lewis, H.S. Chen, E.J. Feuer, and K.A. Cronin. "SEER Cancer Statistics Review, 1975-2014." Washington, DC: National Cancer Institute, 2017. Available at https://seer.cancer.gov/csr/1975_2014/</pre> </div> </td> </tr> <tr style="vertical-align: top;"> <td colspan="3" style="width:80%"> <div style="width:660px;overflow-x:hidden;overflow-y:auto"> <pre>American Cancer Society. "Can Colorectal Polyps and Cancer Be Found Early?" Last modified March 2017. Washington, DC: American Cancer Society. Available at https://www.cancer.org/cancer/colon-rectal-cancer/detection-diagnosis-staging/detection.html.</pre> </div> </td> </tr> <tr> <td colspan="4" scope="row" style="background-color:#656565; width:100%"><span class="td_label">Characteristics</span></td> </tr> <tr> <td scope="row" style="width:20%"><span>Scoring</span></td> <td colspan="3" style="width:80%">Proportion</td> </tr> <!-- <tr th:if="${resource.hasCompositeScoring()}"> <td style="width:20%" scope="row"><span class="td_label">Composite Scoring</span></td> <td style="width:80%" colspan="3" th:narrative="${resource.compositeScoring.getText().substring(0, 1).toUpperCase() + resource.compositeScoring.getText().substring(1)}"></td> </tr> --> <tr style="vertical-align: top;"> <td rowspan="1" scope="row" style="width:20%"><span>Type</span></td> <td colspan="3" style="width:80%">Process</td> </tr> <!-- <tr th:if="${resource.hasStatus()}" style="vertical-align: top;"> <td style="background-color:#656565; width:20%" scope="row"><span class="td_label">Status</span></td> <td style="width:80%" colspan="3" th:narrative="${resource.status.toString().substring(0, 1).toUpperCase() + resource.status.toString().substring(1).toLowerCase()}"></td> </tr> <tr th:if="${resource.hasPurpose()}" style="vertical-align: top;"> <td style="background-color:#656565; width:20%" scope="row"><span class="td_label">Purpose</span></td> <td style="width:80%" colspan="3" th:narrative="${resource.purpose}"></td> </tr> <tr th:if="${resource.hasUsage()}" style="vertical-align: top;" > <td style="background-color:#656565; width:20%" scope="row"><span class="td_label">Usage</span></td> <td style="width:80%" colspan="3" th:narrative="${resource.usage}"></td> </tr> <th:block th:each="context, iter : ${resource.useContext}" > <tr style="vertical-align: top;"> <td th:if="${iter.index == 0}" th:rowspan="${iter.size}" style="background-color:#656565; width:20%" scope="row"><span class="td_label">Use Context</span></td> <td style="width:80%" colspan="3" th:narrative="${context}"></td> </tr> </th:block> <th:block th:each="topics, iter : ${resource.topic}" > <tr style="vertical-align: top;"> <td th:if="${iter.index == 0}" th:rowspan="${iter.size}" style="background-color:#656565; width:20%" scope="row"><span class="td_label">Topic</span></td> <td style="width:80%" colspan="3" th:narrative="${topics}"></td> </tr> </th:block> <th:block th:each="cont, iter : ${resource.contributor}" > <tr style="vertical-align: top;"> <td th:if="${iter.index == 0}" th:rowspan="${iter.size}" style="background-color:#656565; width:20%" scope="row"><span class="td_label">Contributor</span></td> <td style="width:80%" colspan="3"> <b><span th:narrative="${cont.type.toCode()}"></span>: </b><span th:narrative="${cont.name}"></span> </td> </tr> </th:block> --> <!-- <th:block th:each="lib, iter : ${resource.library}" > <tr style="vertical-align: top;"> <td th:if="${iter.index == 0}" th:rowspan="${iter.size}" style="background-color:#656565; width:20%" scope="row"><span class="td_label">Library</span></td> <td style="width:80%" colspan="3"> <p th:if="${lib.hasIdentifier()}"><b>identifier: </b><span th:narrative="${lib.identifier}"></span></p> <p th:if="${lib.hasReference()}"><b>reference: </b><span th:narrative="${lib.reference}"></span></p> <p th:if="${lib.hasDisplay()}"><b>display: </b><span th:narrative="${lib.display}"></span></p> </td> </tr> </th:block> --> <!-- <tr th:if="${resource.hasRateAggregation()}" > <td style="background-color:#656565; width:20%" scope="row"><span class="td_label">Rate Aggregation</span></td> <td style="width:80%" colspan="3"> <div style="width:660px;overflow-x:hidden;overflow-y:auto"> <pre th:text="${resource.rateAggregation}"></pre> </div> </td> </tr> <tr th:if="${resource.hasRationale()}"> <td style="background-color:#656565; width:20%" scope="row"><span class="td_label">Rationale</span></td> <td style="width:80%" colspan="3"> <div style="width:660px;overflow-x:hidden;overflow-y:auto"> <pre th:text="${resource.rationale}"></pre> </div> </td> </tr> --> <tr> <td scope="row" style="width:20%"><span>Improvement Notation</span></td> <td colspan="3" style="width:80%">A higher rate indicates better performance.</td> </tr> <tr> <td scope="row" style="width:20%"><span>Guidance</span></td> <td colspan="3" style="width:80%"> <div style="width:660px;overflow-x:hidden;overflow-y:auto"><p>Patient self-report for procedures as well as diagnostic studies should be recorded in "Procedure, Performed" template or "Diagnostic Study, Performed" template in QRDA-1. Do not count DRE, FOBT tests performed in an office setting or performed on a sample collected via DRE.</p> </div> </td> </tr> <tr> <td colspan="4" scope="row" style="background-color:#656565; width:100%"><span class="td_label">Definitions</span></td> </tr> <!-- <th:block th:each="groups, iter : ${resource.uniquePopulationGroup}" > <tr style="vertical-align: top;"> <td style="background-color:#656565; width:20%" scope="row"><span class="td_label" th:text="${groups.identifier.value}"></span></td> <td style="width:80%" colspan="3"> <div style="width:660px;overflow-x:hidden;overflow-y:auto"> <pre th:text="${pops.description}"></pre> </div> </td> </tr> </th:block> --> </table> <table style="width: 60%; border-top: none; border-bottom: none" class="header_table"> </table> <table style="width: 60%; border-top: none;" class="header_table"> <!-- <th:block th:each="supples, iter : ${resource.supplementalData}"> <tr> <th th:if="${iter.index == 0}" th:rowspan="${iter.size}" scope="row"><b>Supplemental Data:</b></th> <td style="width:80%" colspan="3" > <p style="margin-bottom: 5px;" th:narrative="${supples.identifier}"></p> <p style="margin-bottom: 5px;" th:each="uses : ${supples.usage}"> <b>usage: </b> <span th:narrative="${uses}"></span> </p> <p style="margin-bottom: 5px;" th:if="${supples.hasCriteria()}"> <b>criteria: </b> <span th:narrative="${supples.criteria}"></span> </p> <p style="margin-bottom: 5px;" th:if="${supples.hasPath()}"> <b>path: </b> <span th:narrative="${supples.path}"></span> </p> </td> </tr> </th:block> --> <!-- <th:block th:each="param, iter : ${resource.parameter}"> <tr style="vertical-align: top;"> <th th:if="${iter.index == 0}" th:rowspan="${iter.size}" scope="row"><b>Parameter: </b></th> <td style="width:80%" colspan="3" > <span th:if="${param.hasName()}"> <b>name: </b> <span th:narrative="${param.name}"></span> <br/> </span> <b>use: </b> <span th:narrative="${param.use.toCode()}"></span> <br/> <span th:if="${param.hasMin()}"> <b>minimum cardinality: </b> <span th:narrative="${param.min}"></span> <br/> </span> <span th:if="${param.hasMax()}"> <b>maximum cardinality: </b> <span th:narrative="${param.max}"></span> <br/> </span> <b>type: </b> <span th:narrative="${param.type}"></span> <br/> <span th:if="${param.hasDocumentation()}"> <b>documentation: </b> <span th:narrative="${param.documentation}"></span> <br/> </span> <span th:if="${param.hasProfile()}"> <b>profile: </b> <span th:narrative="${param.profile}"></span> <br/> </span> <p style="margin-bottom: 5px;"></p> </td> </tr> </th:block> --> <!-- <th:block th:each="dataReq, iter : ${resource.dataRequirement}"> <tr style="vertical-align: top;"> <th th:if="${iter.index == 0}" th:rowspan="${iter.size}" scope="row" ><b>Data Requirements: </b></th> <td style="width:80%" colspan="3" th:narrative="${dataReq}"></td> </tr> </th:block> --> </table> <h2><a name="toc">Table of Contents</a></h2> <ul style="padding-left: 50px;"> <li><a href="#d1e405">Population Criteria</a></li> <li><a href="#d1e649">Definitions</a></li> <li><a href="#d1e650">Functions</a></li> <li><a href="#d1e555">Terminology</a></li> <li><a href="#d1e647">Data Criteria (QDM Data Elements)</a></li> <li><a href="#d1e767">Supplemental Data Elements</a></li> <li><a href="#d1e879">Risk Adjustment Variables</a></li> </ul> <div style="float:left; background:teal; height:3px; width:80%"/> <pre><br/></pre> <h3><a name="d1e405" href="#toc">Population Criteria</a></h3> <div> <ul style="list-style:none;padding-left:10px;"> <li style="list-style:none;padding-left:0px;" class="list-unstyled"> <div class="treeview hover p-l-10"> <ul class="list-unstyled"> <li class="list-unstyled"><input id="Initial Population" type="checkbox"/><label for="Initial Population" class="list-header"><strong>Initial Population</strong></label> <ul class="code"> <li class="list-unstyled"> <div class="treeview hover p-l-10"> <ul> <li style="padding-left: 0px;"> <div> <pre class="cql-definition-body"> Global."CalendarAgeInYearsAt"(FHIRHelpers.ToDate(Patient.birthDate), start of "Measurement Period") in Interval[50, 75] and exists AdultOutpatientEncounters."Qualifying Encounters"("Measurement Period")</pre> </div></li> </ul> </div></li> </ul></li> </ul> </div> <div class="treeview hover p-l-10"> <ul class="list-unstyled"> <li class="list-unstyled"><input id="Numerator" type="checkbox"/><label for="Numerator" class="list-header"><strong>Numerator</strong></label> <ul class="code"> <li class="list-unstyled"> <div class="treeview hover p-l-10"> <ul> <li style="padding-left: 0px;"> <div> <pre class="cql-definition-body"> exists "Colonoscopy Performed" or exists "Fecal Occult Blood Test Performed" or exists "Flexible Sigmoidoscopy Performed" or exists "Fecal Immunochemical Test DNA" or exists "CT Colonography Performed"</pre> </div></li> </ul> </div></li> </ul></li> </ul> </div> <div class="treeview hover p-l-10"> <ul class="list-unstyled"> <li class="list-unstyled"><input id="Denominator" type="checkbox"/><label for="Denominator" class="list-header"><strong>Denominator</strong></label> <ul class="code"> <li class="list-unstyled"> <div class="treeview hover p-l-10"> <ul> <li style="padding-left: 0px;"> <div> <pre class="cql-definition-body"> true</pre> </div></li> </ul> </div></li> </ul></li> </ul> </div> <div class="treeview hover p-l-10"> <ul class="list-unstyled"> <li class="list-unstyled"><input id="Denominator Exclusion" type="checkbox"/><label for="Denominator Exclusion" class="list-header"><strong>Denominator Exclusion</strong></label> <ul class="code"> <li class="list-unstyled"> <div class="treeview hover p-l-10"> <ul> <li style="padding-left: 0px;"> <div> <pre class="cql-definition-body"> Hospice."Has Hospice"("Measurement Period") or exists "Malignant Neoplasm" or exists "Total Colectomy Performed"</pre> </div></li> </ul> </div></li> </ul></li> </ul> </div> </li> </ul> </div> <h3><a name="d1e649" href="#toc">Definitions</a></h3> <div> <ul style="list-style:none;padding-left: 10px;"> <li style="list-style:none;" class="list-unstyled"> <div> <ul style="list-style:none;padding-left:0;" class="list-unstyled"> <li class="list-unstyled"> <div class="treeview hover p-l-10"> <input id="Colonoscopy Performed" type="checkbox"/> <label for="Colonoscopy Performed" class="list-header"><strong>Colonoscopy Performed</strong></label> <ul style="margin-right: 20%; opacity: 1;" class="code"> <li class="list-unstyled"> <div> <ul style="padding-left: 0px;"> <li style="padding-left: 0px;" class="list-unstyled"> <div> <pre class="cql-definition-body"> [Procedure: "Colonoscopy"] Colonoscopy where Colonoscopy.status = 'completed' and Colonoscopy.performed ends 10 years or less on or before end of "Measurement Period"</pre> </div></li> </ul> </div></li> </ul> </div></li> </ul> </div></li> </ul> </div> <div> <ul style="list-style:none;padding-left: 10px;"> <li style="list-style:none;" class="list-unstyled"> <div> <ul style="list-style:none;padding-left:0;" class="list-unstyled"> <li class="list-unstyled"> <div class="treeview hover p-l-10"> <input id="CT Colonography Performed" type="checkbox"/> <label for="CT Colonography Performed" class="list-header"><strong>CT Colonography Performed</strong></label> <ul style="margin-right: 20%; opacity: 1;" class="code"> <li class="list-unstyled"> <div> <ul style="padding-left: 0px;"> <li style="padding-left: 0px;" class="list-unstyled"> <div> <pre class="cql-definition-body"> [Procedure: "CT Colonography"] Colonography where Colonography.status = 'completed' and Colonography.performed ends 5 years or less on or before end of "Measurement Period"</pre> </div></li> </ul> </div></li> </ul> </div></li> </ul> </div></li> </ul> </div> <div> <ul style="list-style:none;padding-left: 10px;"> <li style="list-style:none;" class="list-unstyled"> <div> <ul style="list-style:none;padding-left:0;" class="list-unstyled"> <li class="list-unstyled"> <div class="treeview hover p-l-10"> <input id="Denominator" type="checkbox"/> <label for="Denominator" class="list-header"><strong>Denominator</strong></label> <ul style="margin-right: 20%; opacity: 1;" class="code"> <li class="list-unstyled"> <div> <ul style="padding-left: 0px;"> <li style="padding-left: 0px;" class="list-unstyled"> <div> <pre class="cql-definition-body"> true</pre> </div></li> </ul> </div></li> </ul> </div></li> </ul> </div></li> </ul> </div> <div> <ul style="list-style:none;padding-left: 10px;"> <li style="list-style:none;" class="list-unstyled"> <div> <ul style="list-style:none;padding-left:0;" class="list-unstyled"> <li class="list-unstyled"> <div class="treeview hover p-l-10"> <input id="Denominator Exclusion" type="checkbox"/> <label for="Denominator Exclusion" class="list-header"><strong>Denominator Exclusion</strong></label> <ul style="margin-right: 20%; opacity: 1;" class="code"> <li class="list-unstyled"> <div> <ul style="padding-left: 0px;"> <li style="padding-left: 0px;" class="list-unstyled"> <div> <pre class="cql-definition-body"> Hospice."Has Hospice"("Measurement Period") or exists "Malignant Neoplasm" or exists "Total Colectomy Performed"</pre> </div></li> </ul> </div></li> </ul> </div></li> </ul> </div></li> </ul> </div> <div> <ul style="list-style:none;padding-left: 10px;"> <li style="list-style:none;" class="list-unstyled"> <div> <ul style="list-style:none;padding-left:0;" class="list-unstyled"> <li class="list-unstyled"> <div class="treeview hover p-l-10"> <input id="Fecal Immunochemical Test DNA" type="checkbox"/> <label for="Fecal Immunochemical Test DNA" class="list-header"><strong>Fecal Immunochemical Test DNA</strong></label> <ul style="margin-right: 20%; opacity: 1;" class="code"> <li class="list-unstyled"> <div> <ul style="padding-left: 0px;"> <li style="padding-left: 0px;" class="list-unstyled"> <div> <pre class="cql-definition-body"> [Observation: "FIT DNA"] FitDNA where FitDNA.value is not null and FitDNA.effective occurs 3 years or less on or before day of end of "Measurement Period"</pre> </div></li> </ul> </div></li> </ul> </div></li> </ul> </div></li> </ul> </div> <div> <ul style="list-style:none;padding-left: 10px;"> <li style="list-style:none;" class="list-unstyled"> <div> <ul style="list-style:none;padding-left:0;" class="list-unstyled"> <li class="list-unstyled"> <div class="treeview hover p-l-10"> <input id="Fecal Occult Blood Test Performed" type="checkbox"/> <label for="Fecal Occult Blood Test Performed" class="list-header"><strong>Fecal Occult Blood Test Performed</strong></label> <ul style="margin-right: 20%; opacity: 1;" class="code"> <li class="list-unstyled"> <div> <ul style="padding-left: 0px;"> <li style="padding-left: 0px;" class="list-unstyled"> <div> <pre class="cql-definition-body"> [Observation: "Fecal Occult Blood Test (FOBT)"] FecalOccultResult where FecalOccultResult.status in {'final', 'amended', 'corrected', 'preliminary'} and FecalOccultResult.value is not null and FecalOccultResult.effective during day of "Measurement Period"</pre> </div></li> </ul> </div></li> </ul> </div></li> </ul> </div></li> </ul> </div> <div> <ul style="list-style:none;padding-left: 10px;"> <li style="list-style:none;" class="list-unstyled"> <div> <ul style="list-style:none;padding-left:0;" class="list-unstyled"> <li class="list-unstyled"> <div class="treeview hover p-l-10"> <input id="Flexible Sigmoidoscopy Performed" type="checkbox"/> <label for="Flexible Sigmoidoscopy Performed" class="list-header"><strong>Flexible Sigmoidoscopy Performed</strong></label> <ul style="margin-right: 20%; opacity: 1;" class="code"> <li class="list-unstyled"> <div> <ul style="padding-left: 0px;"> <li style="padding-left: 0px;" class="list-unstyled"> <div> <pre class="cql-definition-body"> [Procedure: "Flexible Sigmoidoscopy"] FlexibleSigmoidoscopy where FlexibleSigmoidoscopy.status = 'completed' and FlexibleSigmoidoscopy.performed ends 5 years or less on or before end of "Measurement Period"</pre> </div></li> </ul> </div></li> </ul> </div></li> </ul> </div></li> </ul> </div> <div> <ul style="list-style:none;padding-left: 10px;"> <li style="list-style:none;" class="list-unstyled"> <div> <ul style="list-style:none;padding-left:0;" class="list-unstyled"> <li class="list-unstyled"> <div class="treeview hover p-l-10"> <input id="Initial Population" type="checkbox"/> <label for="Initial Population" class="list-header"><strong>Initial Population</strong></label> <ul style="margin-right: 20%; opacity: 1;" class="code"> <li class="list-unstyled"> <div> <ul style="padding-left: 0px;"> <li style="padding-left: 0px;" class="list-unstyled"> <div> <pre class="cql-definition-body"> Global."CalendarAgeInYearsAt"(FHIRHelpers.ToDate(Patient.birthDate), start of "Measurement Period") in Interval[50, 75] and exists AdultOutpatientEncounters."Qualifying Encounters"("Measurement Period")</pre> </div></li> </ul> </div></li> </ul> </div></li> </ul> </div></li> </ul> </div> <div> <ul style="list-style:none;padding-left: 10px;"> <li style="list-style:none;" class="list-unstyled"> <div> <ul style="list-style:none;padding-left:0;" class="list-unstyled"> <li class="list-unstyled"> <div class="treeview hover p-l-10"> <input id="Malignant Neoplasm" type="checkbox"/> <label for="Malignant Neoplasm" class="list-header"><strong>Malignant Neoplasm</strong></label> <ul style="margin-right: 20%; opacity: 1;" class="code"> <li class="list-unstyled"> <div> <ul style="padding-left: 0px;"> <li style="padding-left: 0px;" class="list-unstyled"> <div> <pre class="cql-definition-body"> [Condition: "Malignant Neoplasm of Colon"] ColorectalCancer where Global."Normalize Onset"(ColorectalCancer.onset) starts on or before end of "Measurement Period"</pre> </div></li> </ul> </div></li> </ul> </div></li> </ul> </div></li> </ul> </div> <div> <ul style="list-style:none;padding-left: 10px;"> <li style="list-style:none;" class="list-unstyled"> <div> <ul style="list-style:none;padding-left:0;" class="list-unstyled"> <li class="list-unstyled"> <div class="treeview hover p-l-10"> <input id="Numerator" type="checkbox"/> <label for="Numerator" class="list-header"><strong>Numerator</strong></label> <ul style="margin-right: 20%; opacity: 1;" class="code"> <li class="list-unstyled"> <div> <ul style="padding-left: 0px;"> <li style="padding-left: 0px;" class="list-unstyled"> <div> <pre class="cql-definition-body"> exists "Colonoscopy Performed" or exists "Fecal Occult Blood Test Performed" or exists "Flexible Sigmoidoscopy Performed" or exists "Fecal Immunochemical Test DNA" or exists "CT Colonography Performed"</pre> </div></li> </ul> </div></li> </ul> </div></li> </ul> </div></li> </ul> </div> <div> <ul style="list-style:none;padding-left: 10px;"> <li style="list-style:none;" class="list-unstyled"> <div> <ul style="list-style:none;padding-left:0;" class="list-unstyled"> <li class="list-unstyled"> <div class="treeview hover p-l-10"> <input id="SDE Ethnicity" type="checkbox"/> <label for="SDE Ethnicity" class="list-header"><strong>SDE Ethnicity</strong></label> <ul style="margin-right: 20%; opacity: 1;" class="code"> <li class="list-unstyled"> <div> <ul style="padding-left: 0px;"> <li style="padding-left: 0px;" class="list-unstyled"> <div> <pre class="cql-definition-body"> SDE."SDE Ethnicity"</pre> </div></li> </ul> </div></li> </ul> </div></li> </ul> </div></li> </ul> </div> <div> <ul style="list-style:none;padding-left: 10px;"> <li style="list-style:none;" class="list-unstyled"> <div> <ul style="list-style:none;padding-left:0;" class="list-unstyled"> <li class="list-unstyled"> <div class="treeview hover p-l-10"> <input id="SDE Payer" type="checkbox"/> <label for="SDE Payer" class="list-header"><strong>SDE Payer</strong></label> <ul style="margin-right: 20%; opacity: 1;" class="code"> <li class="list-unstyled"> <div> <ul style="padding-left: 0px;"> <li style="padding-left: 0px;" class="list-unstyled"> <div> <pre class="cql-definition-body"> SDE."SDE Payer"</pre> </div></li> </ul> </div></li> </ul> </div></li> </ul> </div></li> </ul> </div> <div> <ul style="list-style:none;padding-left: 10px;"> <li style="list-style:none;" class="list-unstyled"> <div> <ul style="list-style:none;padding-left:0;" class="list-unstyled"> <li class="list-unstyled"> <div class="treeview hover p-l-10"> <input id="SDE Race" type="checkbox"/> <label for="SDE Race" class="list-header"><strong>SDE Race</strong></label> <ul style="margin-right: 20%; opacity: 1;" class="code"> <li class="list-unstyled"> <div> <ul style="padding-left: 0px;"> <li style="padding-left: 0px;" class="list-unstyled"> <div> <pre class="cql-definition-body"> SDE."SDE Race"</pre> </div></li> </ul> </div></li> </ul> </div></li> </ul> </div></li> </ul> </div> <div> <ul style="list-style:none;padding-left: 10px;"> <li style="list-style:none;" class="list-unstyled"> <div> <ul style="list-style:none;padding-left:0;" class="list-unstyled"> <li class="list-unstyled"> <div class="treeview hover p-l-10"> <input id="SDE Sex" type="checkbox"/> <label for="SDE Sex" class="list-header"><strong>SDE Sex</strong></label> <ul style="margin-right: 20%; opacity: 1;" class="code"> <li class="list-unstyled"> <div> <ul style="padding-left: 0px;"> <li style="padding-left: 0px;" class="list-unstyled"> <div> <pre class="cql-definition-body"> SDE."SDE Sex"</pre> </div></li> </ul> </div></li> </ul> </div></li> </ul> </div></li> </ul> </div> <div> <ul style="list-style:none;padding-left: 10px;"> <li style="list-style:none;" class="list-unstyled"> <div> <ul style="list-style:none;padding-left:0;" class="list-unstyled"> <li class="list-unstyled"> <div class="treeview hover p-l-10"> <input id="Total Colectomy Performed" type="checkbox"/> <label for="Total Colectomy Performed" class="list-header"><strong>Total Colectomy Performed</strong></label> <ul style="margin-right: 20%; opacity: 1;" class="code"> <li class="list-unstyled"> <div> <ul style="padding-left: 0px;"> <li style="padding-left: 0px;" class="list-unstyled"> <div> <pre class="cql-definition-body"> [Procedure: "Total Colectomy"] Colectomy where Colectomy.status = 'completed' and Global."Get Choice Interval - dateTime or Period"(Colectomy.performed) starts on or before end of "Measurement Period"</pre> </div></li> </ul> </div></li> </ul> </div></li> </ul> </div></li> </ul> </div> <h3><a name="d1e650" href="#toc">Functions</a></h3> <h3><a name="d1e555" href="#toc">Terminology</a></h3> <div> <ul style="padding-left: 50px;"> <li style="width:80%">valueset "Colonoscopy" : 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1020'</li> <li style="width:80%">valueset "CT Colonography" : 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1038'</li> <li style="width:80%">valueset "Ethnicity" : 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.837'</li> <li style="width:80%">valueset "Fecal Occult Blood Test (FOBT)" : 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1011'</li> <li style="width:80%">valueset "FIT DNA" : 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1039'</li> <li style="width:80%">valueset "Flexible Sigmoidoscopy" : 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1010'</li> <li style="width:80%">valueset "Malignant Neoplasm of Colon" : 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1001'</li> <li style="width:80%">valueset "ONC Administrative Sex" : 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1'</li> <li style="width:80%">valueset "Payer" : 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591'</li> <li style="width:80%">valueset "Race" : 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.836'</li> <li style="width:80%">valueset "Total Colectomy" : 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1019'</li> </ul> </div> <h3><a name="d1e647" href="#toc">Data Criteria (QDM Data Elements)</a></h3> <div> <ul style="padding-left: 50px;"> <li style="width:80%">"Condition: Malignant Neoplasm of Colon" using "Malignant Neoplasm of Colon (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1001)</li> <li style="width:80%">"Coverage: Payer" using "Payer (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591)</li> <li style="width:80%">"Observation: Fecal Occult Blood Test (FOBT)" using "Fecal Occult Blood Test (FOBT) (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1011)</li> <li style="width:80%">"Observation: FIT DNA" using "FIT DNA (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1039)</li> <li style="width:80%">"Procedure: Colonoscopy" using "Colonoscopy (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1020)</li> <li style="width:80%">"Procedure: CT Colonography" using "CT Colonography (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1038)</li> <li style="width:80%">"Procedure: Flexible Sigmoidoscopy" using "Flexible Sigmoidoscopy (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1010)</li> <li style="width:80%">"Procedure: Total Colectomy" using "Total Colectomy (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1019)</li> </ul> </div> <h3><a name="d1e767" href="#toc">Supplemental Data Elements</a></h3> <div> <ul style="list-style:none;padding-left: 25px;"> <li class="list-unstyled"> <div class="treeview hover p-l-10"> <input id="SDE Ethnicity" type="checkbox"/> <label for="SDE Ethnicity" class="list-header"><strong>SDE Ethnicity</strong></label> <ul style="margin-right: 20%; opacity: 1;" class="code"> <li class="list-unstyled"> <div> <ul style="padding-left: 0px;"> <li style="padding-left: 0px;" class="list-unstyled"> <div> <pre class="cql-definition-body"> SDE."SDE Ethnicity"</pre> </div></li> </ul> </div></li> </ul> </div></li> </ul> </div> <div> <ul style="list-style:none;padding-left: 25px;"> <li class="list-unstyled"> <div class="treeview hover p-l-10"> <input id="SDE Payer" type="checkbox"/> <label for="SDE Payer" class="list-header"><strong>SDE Payer</strong></label> <ul style="margin-right: 20%; opacity: 1;" class="code"> <li class="list-unstyled"> <div> <ul style="padding-left: 0px;"> <li style="padding-left: 0px;" class="list-unstyled"> <div> <pre class="cql-definition-body"> SDE."SDE Payer"</pre> </div></li> </ul> </div></li> </ul> </div></li> </ul> </div> <div> <ul style="list-style:none;padding-left: 25px;"> <li class="list-unstyled"> <div class="treeview hover p-l-10"> <input id="SDE Race" type="checkbox"/> <label for="SDE Race" class="list-header"><strong>SDE Race</strong></label> <ul style="margin-right: 20%; opacity: 1;" class="code"> <li class="list-unstyled"> <div> <ul style="padding-left: 0px;"> <li style="padding-left: 0px;" class="list-unstyled"> <div> <pre class="cql-definition-body"> SDE."SDE Race"</pre> </div></li> </ul> </div></li> </ul> </div></li> </ul> </div> <div> <ul style="list-style:none;padding-left: 25px;"> <li class="list-unstyled"> <div class="treeview hover p-l-10"> <input id="SDE Sex" type="checkbox"/> <label for="SDE Sex" class="list-header"><strong>SDE Sex</strong></label> <ul style="margin-right: 20%; opacity: 1;" class="code"> <li class="list-unstyled"> <div> <ul style="padding-left: 0px;"> <li style="padding-left: 0px;" class="list-unstyled"> <div> <pre class="cql-definition-body"> SDE."SDE Sex"</pre> </div></li> </ul> </div></li> </ul> </div></li> </ul> </div> <h3><a name="d1e879" href="#toc">Risk Adjustment Variables</a></h3> <div> <ul style="list-style:none;padding-left: 25px;"> <li>None</li> </ul> </div> <div style="float:left; background:teal; height:3px; width:80%"/> <table> <!-- <th:block th:each="con, iter : ${resource.content}"> <tr th:if="${con.contentType == 'text/cql'}" style="vertical-align: top;"> <td style="background-color:#656565; width:20%" scope="row"><span class="td_label">Content</span></td> <td style="width:80%" ><b>type: </b><span th:text="${con.contentType}"></span></td> </tr> <tr th:if="${con.contentType == 'text/cql'}"> <td style="width:100%" colspan="2" > <th:block th:if="${con.getData() != null }" > <pre><code th:class="${con.contentType == 'text/cql' ? 'language-cql' : 'language-xml'}" th:text="${new java.lang.String(con.getData())}"></code></pre> </th:block> <th:block th:if="${con.getData() == null }" > <span><i><content is empty></i></span> </th:block> </td> </tr> </th:block > --> </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-exm130-FHIR"/> <identifier> <use value="official"/> <system value="http://hl7.org/fhir/cqi/ecqm/Measure/Identifier/cms"/> <value value="130"/> </identifier> <identifier> <use value="official"/> <system value="http://hl7.org/fhir/cqi/ecqm/Measure/Identifier/nqf"/> <value value="0034"/> </identifier> <version value="1.0.0"/> <name value="EXM130"/> <title value="Colorectal Cancer Screening"/> <status value="active"/> <experimental value="true"/> <date value="2018-08-28T00:00:00-04:00"/> <publisher value="National Committee for Quality Assurance"/> <description value="Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer"/> <purpose value="Patients 50-75 years of age with a visit during the measurement period"/> <approvalDate value="2016-01-01"/> <lastReviewDate value="2016-09-01"/> <effectivePeriod> <start value="2018-01-01T00:00:00-05:00"/> <end value="2018-12-31T00:00:00-05:00"/> </effectivePeriod> <useContext> <code> <code value="program"/> </code> <valueCodeableConcept> <text value="eligible-provider"/> </valueCodeableConcept> </useContext> <jurisdiction> <coding> <system value="urn:iso:std:iso:3166"/> <code value="US"/> <display value="United States of America"/> </coding> </jurisdiction> <contributor> <type value="author"/> <name value="National Committee for Quality Assurance"/> </contributor> <contact> <telecom> <system value="url"/> <value value="http://www.ncqa.org/"/> </telecom> </contact> <copyright value="This Physician Performance Measure (Measure) and related data specifications were developed by the National Committee for Quality Assurance (NCQA). NCQA is not responsible for any use of the Measure. NCQA makes no representations, warranties, or endorsement about the quality of any organization or physician that uses or reports performance measures and NCQA has no liability to anyone who relies on such measures or specifications. NCQA holds a copyright in the Measure. The Measure can be reproduced and distributed, without modification, for noncommercial purposes (eg, use by healthcare providers in connection with their practices) without obtaining approval from NCQA. Commercial use is defined as the sale, licensing, or distribution of the Measure for commercial gain, or incorporation of the Measure into a product or service that is sold, licensed or distributed for commercial gain. All commercial uses or requests for modification must be approved by NCQA and are subject to a license at the discretion of NCQA. (C) 2012-2017 National Committee for Quality Assurance. All Rights Reserved. Limited proprietary coding is contained in the Measure specifications for user convenience. Users of proprietary code sets should obtain all necessary licenses from the owners of the code sets. NCQA disclaims all liability for use or accuracy of any third party codes contained in the specifications. CPT(R) contained in the Measure specifications is copyright 2004-2017 American Medical Association. LOINC(R) copyright 2004-2017 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R] ) copyright 2004-2017 International Health Terminology Standards Development Organisation. ICD-10 copyright 2017 World Health Organization. All Rights Reserved."/> <relatedArtifact> <type value="citation"/> <citation value="U.S. Preventive Services Task Force. "Screening for Colorectal Cancer: U.S. Preventive Services Task Force Recommendation Statement." JAMA, vol. 315, no. 23, 2016, pp. 2564-2575. doi: 10.1001/jama.2016.5989"/> </relatedArtifact> <relatedArtifact> <type value="citation"/> <citation value="Howlader, N., A.M. Noone, M. Krapcho, D. Miller, K. Bishop, C.L. Kosary, M. Yu, J. Ruhl, Z. Tatalovich, A. Mariotto, D.R. Lewis, H.S. Chen, E.J. Feuer, and K.A. Cronin. "SEER Cancer Statistics Review, 1975-2014." Washington, DC: National Cancer Institute, 2017. Available at https://seer.cancer.gov/csr/1975_2014/"/> </relatedArtifact> <relatedArtifact> <type value="citation"/> <citation value="American Cancer Society. "Can Colorectal Polyps and Cancer Be Found Early?" Last modified March 2017. Washington, DC: American Cancer Society. Available at https://www.cancer.org/cancer/colon-rectal-cancer/detection-diagnosis-staging/detection.html."/> </relatedArtifact> <relatedArtifact> <type value="depends-on"/> <resource> <reference value="Library/adultoutpatientencounters-fhir"/> </resource> </relatedArtifact> <relatedArtifact> <type value="depends-on"/> <resource> <reference value="Library/matglobalcommonfunctions-fhir"/> </resource> </relatedArtifact> <relatedArtifact> <type value="depends-on"/> <resource> <reference value="Library/hospice-fhir"/> </resource> </relatedArtifact> <relatedArtifact> <type value="depends-on"/> <resource> <reference value="Library/fhirhelpers"/> </resource> </relatedArtifact> <relatedArtifact> <type value="depends-on"/> <resource> <reference value="Library/supplementaldataelements-fhir"/> </resource> </relatedArtifact> <library> <reference value="Library/exm130-fhir"/> </library> <disclaimer value="The performance Measure is not a clinical guideline and does not establish a standard of medical care, and has not been tested for all potential applications. THE MEASURE AND SPECIFICATIONS ARE PROVIDED "AS IS" WITHOUT WARRANTY OF ANY KIND. Due to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM]."/> <scoring> <coding> <system value="http://hl7.org/fhir/measure-scoring"/> <code value="proportion"/> </coding> </scoring> <type> <coding> <system value="http://hl7.org/fhir/measure-type"/> <code value="process"/> </coding> </type> <rationale value="Colorectal cancer represents 8 percent of all new cancer cases and is the second leading cause of cancer deaths in the United States. In 2017, there were an estimated 135,430 new cases of colorectal cancer and an estimated 50,260 deaths attributed to it. According to the National Cancer Institute, about 4.3 percent of men and women will be diagnosed with colorectal cancer at some point during their lifetimes. For most adults, older age is the most important risk factor for colorectal cancer, although being male and black are also associated with higher incidence and mortality. Colorectal cancer is most frequently diagnosed among people 65 to 74 years old (Howlader et al. 2017). Screening can be effective for finding precancerous lesions (polyps) that could later become malignant, and for detecting early cancers that can be more easily and effectively treated. Precancerous polyps usually take about 10 to 15 years to develop into colorectal cancer, and most can be found and removed before turning into cancer. The five-year relative survival rate for people whose colorectal cancer is found in the early stage before it has spread is about 90 percent (American Cancer Society 2017)."/> <clinicalRecommendationStatement value="The U. S. Preventive Services Task Force (2016) recommends screening for colorectal cancer starting at age 50 years and continuing until age 75 years. This is a Grade A recommendation (U.S. Preventive Services Task Force 2016). Screening tests: -Colonoscopy (every 10 years) -Flexible sigmoidoscopy (every 5 years) -Fecal occult blood test (annually) -FIT-DNA (every 3 years) -Computed tomographic colonography (every 5 years)"/> <improvementNotation value="increase"/> <guidance value="Patient self-report for procedures as well as diagnostic studies should be recorded in "Procedure, Performed" template or "Diagnostic Study, Performed" template in QRDA-1. Do not count DRE, FOBT tests performed in an office setting or performed on a sample collected via DRE."/> <group> <identifier> <value value="group-1"/> </identifier> <population> <code> <coding> <system value="http://terminology.hl7.org/CodeSystem/measure-population"/> <code value="initial-population"/> <display value="Initial Population"/> </coding> </code> <criteria value="Initial Population"/> </population> <population> <code> <coding> <system value="http://terminology.hl7.org/CodeSystem/measure-population"/> <code value="numerator"/> <display value="Numerator"/> </coding> </code> <criteria value="Numerator"/> </population> <population> <code> <coding> <system value="http://terminology.hl7.org/CodeSystem/measure-population"/> <code value="denominator"/> <display value="Denominator"/> </coding> </code> <criteria value="Denominator"/> </population> <population> <code> <coding> <system value="http://terminology.hl7.org/CodeSystem/measure-population"/> <code value="denominator-exclusion"/> <display value="Denominator Exclusion"/> </coding> </code> <criteria value="Denominator Exclusion"/> </population> </group> </Measure>
© HL7.org (Clinical Quality Information WG). hl7.fhir.us.cqfmeasures#1.0.0 based on FHIR v3.0.2 generated 20/11/2019.
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