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-measure-exm55-FHIR

Formats: XML, JSON, Turtle

Measure Title

Median ED Visit Duration

Measure ID

EXM55

Description

This example illustrates a continuous variable measure represented as a FHIR eCQM

Measurement Period January 1 - December 31
Characteristics
Scoring Continuous-variable
Type Process
Improvement Notation A lower rate indicates better performance.
Definitions

Table of Contents


Population Criteria

        • 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
         
        • define "Measure Population" : 
            "Initial Population" 
         
        • 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" 
         
        • define function "Measure Observation" (Encounter "Encounter" ) : 
            duration in minutes of "Related ED Visit"(Encounter).period
         
        • define "Stratification 1" : 
            "Inpatient Encounter" Encounter 
              where not (PrincipalDiagnosis(Encounter).code in "Psychiatric/Mental Health Patient") 
         
        • define "Stratification 2" : 
            "Inpatient Encounter" Encounter
              where PrincipalDiagnosis(Encounter).code in "Psychiatric/Mental Health Patient" 
         
        • define "Stratification 3" : 
            "Inpatient Encounter" Encounter
              where PrincipalDiagnosis(Encounter) is null 
         

Definitions

        • 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
         
        • define "Inpatient Encounter" : 
            ["Encounter"] Encounter
              where LengthInDays(Encounter.period) <= 120
                and Encounter.period ends during "Measurement Period" 
         
        • define "Measure Population" : 
            "Initial Population" 
         
        • 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" 
         
        • define "Stratification 1" : 
            "Inpatient Encounter" Encounter 
              where not (PrincipalDiagnosis(Encounter).code in "Psychiatric/Mental Health Patient") 
         
        • define "Stratification 2" : 
            "Inpatient Encounter" Encounter
              where PrincipalDiagnosis(Encounter).code in "Psychiatric/Mental Health Patient" 
         
        • define "Stratification 3" : 
            "Inpatient Encounter" Encounter
              where PrincipalDiagnosis(Encounter) is null 
         

Functions

        • 	Last(Split(uri, '/'))
         
        • 	difference in days between start of Value and end of Value
         
        • define function "Measure Observation" (Encounter "Encounter" ) : 
            duration in minutes of "Related ED Visit"(Encounter).period
         
        • 	(singleton from (Encounter.diagnosis D where D.role ~ ToConcept("Billing") and D.rank = 1)) PD
          		return singleton from ([Condition: id in "GetId"(PD.condition.reference)])
         
        • define function "Related ED Visit" (Encounter "Encounter" ) : 
            Last(["Encounter" : "Emergency Department Visit"] ED 
              where ED.status = 'finished'
                and ED.period ends 1 hour or less before start of Encounter.period
              sort by start of period ) 
         

Terminology

  • codesystem "Diagnosis Role" : 'http://hl7.org/fhir/diagnosis-role'
  • code "Billing" : 'billing' from "Diagnosis Role" display 'Billing'
  • valueset "Emergency Department Visit" : 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292'
  • valueset "Hospital Settings" : 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.126'
  • valueset "Psychiatric/Mental Health Patient" : 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.299'

Data Criteria (QDM Data Elements)

  • "Encounter: Emergency Department Visit" using "Emergency Department Visit (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292)

Supplemental Data Elements

  • None

Risk Adjustment Variables

  • None