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

EXM55

{
  "resourceType" : "Measure",
  "id" : "measure-exm55-FHIR",
  "meta" : {
    "versionId" : "4",
    "lastUpdated" : "2019-11-04T22:51:06.562-05:00",
    "profile" : [
      "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cv-measure-cqfm"
    ]
  },
  "text" : {
    "status" : "generated",
    "div" : "<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\">Median ED Visit Duration</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\">EXM55</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>This example illustrates a continuous variable measure represented as a FHIR eCQM</p>\n</pre>\n                </div>\n            </td>\n        </tr>\n        <tr>\n            <td scope=\"row\" style=\"background-color:#656565; width:20%\"><span class=\"td_label\">Measurement Period</span></td>\n            <td colspan=\"3\" style=\"width:80%\">January 1 - December 31</td>\n        </tr>\n              <!-- <tr>\n            <td style=\"background-color:#656565; width:20%\" scope=\"row\"><span class=\"td_label\">Measure Steward</span></td>\n            <td style=\"width:80%\" colspan=\"3\" th:narrative=\"${resource.publisher}\"></td>\n        </tr>\n        <tr>\n            <td style=\"background-color:#656565; width:20%\" scope=\"row\"><span class=\"td_label\">Measure Developer</span></td>\n            <td style=\"width:80%\" colspan=\"3\" th:narrative=\"${resource.publisher}\"></td>\n        </tr> -->\n              <!-- <tr th:if=\"${resource.hasDisclaimer()}\">\n            <td style=\"background-color:#656565; width:20%\" scope=\"row\"><span class=\"td_label\">Disclaimer</span></td>\n            <td style=\"width:80%\" colspan=\"3\">\n                <div style=\"width:660px;overflow-x:hidden;overflow-y:auto\">\n                    <pre th:text=\"${resource.disclaimer}\"></pre>\n                </div>\n            </td>\n        </tr> -->\n        \n        \n        \n        <tr>\n            <td colspan=\"4\" scope=\"row\" style=\"background-color:#656565; width:100%\"><span class=\"td_label\">Characteristics</span></td>\n        </tr>\n        <tr>\n            <td scope=\"row\" style=\"width:20%\"><span>Scoring</span></td>\n            <td colspan=\"3\" style=\"width:80%\">Continuous-variable</td>\n        </tr>\n              <!-- <tr th:if=\"${resource.hasCompositeScoring()}\">\n            <td style=\"width:20%\" scope=\"row\"><span class=\"td_label\">Composite Scoring</span></td>\n            <td style=\"width:80%\" colspan=\"3\" th:narrative=\"${resource.compositeScoring.getText().substring(0, 1).toUpperCase() + resource.compositeScoring.getText().substring(1)}\"></td>\n        </tr> -->\n        \n            <tr style=\"vertical-align: top;\">\n                <td rowspan=\"1\" scope=\"row\" style=\"width:20%\"><span>Type</span></td>\n                <td colspan=\"3\" style=\"width:80%\">Process</td>\n            </tr>\n        \n              <!-- <tr th:if=\"${resource.hasStatus()}\" style=\"vertical-align: top;\">\n            <td style=\"background-color:#656565; width:20%\" scope=\"row\"><span class=\"td_label\">Status</span></td>\n            <td style=\"width:80%\" colspan=\"3\" th:narrative=\"${resource.status.toString().substring(0, 1).toUpperCase() + resource.status.toString().substring(1).toLowerCase()}\"></td>\n        </tr>\n        <tr th:if=\"${resource.hasPurpose()}\" style=\"vertical-align: top;\">\n            <td style=\"background-color:#656565; width:20%\" scope=\"row\"><span class=\"td_label\">Purpose</span></td>\n            <td style=\"width:80%\" colspan=\"3\" th:narrative=\"${resource.purpose}\"></td>\n        </tr>\n        <tr th:if=\"${resource.hasUsage()}\" style=\"vertical-align: top;\" >\n            <td style=\"background-color:#656565; width:20%\" scope=\"row\"><span class=\"td_label\">Usage</span></td>\n            <td style=\"width:80%\" colspan=\"3\" th:narrative=\"${resource.usage}\"></td>\n        </tr>\n        <th:block th:each=\"context, iter : ${resource.useContext}\" >\n            <tr style=\"vertical-align: top;\">\n                <td th:if=\"${iter.index == 0}\" th:rowspan=\"${iter.size}\" style=\"background-color:#656565; width:20%\" scope=\"row\"><span class=\"td_label\">Use Context</span></td>\n                <td style=\"width:80%\" colspan=\"3\" th:narrative=\"${context}\"></td>\n            </tr>\n        </th:block>\n        <th:block th:each=\"topics, iter : ${resource.topic}\" >\n            <tr style=\"vertical-align: top;\">\n                <td th:if=\"${iter.index == 0}\" th:rowspan=\"${iter.size}\" style=\"background-color:#656565; width:20%\" scope=\"row\"><span class=\"td_label\">Topic</span></td>\n                <td style=\"width:80%\" colspan=\"3\" th:narrative=\"${topics}\"></td>\n            </tr>\n        </th:block>\n        <th:block th:each=\"cont, iter : ${resource.contributor}\" >\n            <tr style=\"vertical-align: top;\">\n                <td th:if=\"${iter.index == 0}\" th:rowspan=\"${iter.size}\" style=\"background-color:#656565; width:20%\" scope=\"row\"><span class=\"td_label\">Contributor</span></td>\n                <td style=\"width:80%\" colspan=\"3\">\n                    <b><span th:narrative=\"${cont.type.toCode()}\"></span>: </b><span th:narrative=\"${cont.name}\"></span>\n                </td>\n            </tr>\n        </th:block> -->\n              <!-- <th:block th:each=\"lib, iter : ${resource.library}\" >\n            <tr style=\"vertical-align: top;\">\n                <td th:if=\"${iter.index == 0}\" th:rowspan=\"${iter.size}\" style=\"background-color:#656565; width:20%\" scope=\"row\"><span class=\"td_label\">Library</span></td>\n                <td style=\"width:80%\" colspan=\"3\">\n                    <p th:if=\"${lib.hasIdentifier()}\"><b>identifier: </b><span th:narrative=\"${lib.identifier}\"></span></p>\n                    <p th:if=\"${lib.hasReference()}\"><b>reference: </b><span th:narrative=\"${lib.reference}\"></span></p>\n                    <p th:if=\"${lib.hasDisplay()}\"><b>display: </b><span th:narrative=\"${lib.display}\"></span></p>\n                </td>\n            </tr>\n        </th:block> -->\n        \n              <!-- <tr th:if=\"${resource.hasRateAggregation()}\" >\n            <td style=\"background-color:#656565; width:20%\" scope=\"row\"><span class=\"td_label\">Rate Aggregation</span></td>\n            <td style=\"width:80%\" colspan=\"3\">\n                <div style=\"width:660px;overflow-x:hidden;overflow-y:auto\">\n                    <pre th:text=\"${resource.rateAggregation}\"></pre>\n                </div>\n            </td>\n        </tr>\n        <tr th:if=\"${resource.hasRationale()}\">\n            <td style=\"background-color:#656565; width:20%\" scope=\"row\"><span class=\"td_label\">Rationale</span></td>\n            <td style=\"width:80%\" colspan=\"3\">\n                <div style=\"width:660px;overflow-x:hidden;overflow-y:auto\">\n                    <pre th:text=\"${resource.rationale}\"></pre>\n                </div>\n            </td>\n        </tr> -->\n        <tr>\n            <td scope=\"row\" style=\"width:20%\"><span>Improvement Notation</span></td>\n            \n            <td colspan=\"3\" style=\"width:80%\">A lower rate indicates better performance.</td>\n        </tr>\n        \n        <tr>\n            <td colspan=\"4\" scope=\"row\" style=\"background-color:#656565; width:100%\"><span class=\"td_label\">Definitions</span></td>\n        </tr>\n        \n        \n              <!-- <th:block th:each=\"groups, iter : ${resource.uniquePopulationGroup}\" >\n            <tr style=\"vertical-align: top;\">\n                <td style=\"background-color:#656565; width:20%\" scope=\"row\"><span class=\"td_label\" th:text=\"${groups.identifier.value}\"></span></td>\n                <td style=\"width:80%\" colspan=\"3\">\n                    <div style=\"width:660px;overflow-x:hidden;overflow-y:auto\">\n                        <pre th:text=\"${pops.description}\"></pre>\n                    </div>\n                </td>\n            </tr>\n        </th:block> -->\n    </table>\n    <table style=\"width: 60%; border-top: none; border-bottom: none\" class=\"header_table\">\n        \n    </table>\n    <table style=\"width: 60%; border-top: none;\" class=\"header_table\">\n              <!-- <th:block th:each=\"supples, iter : ${resource.supplementalData}\">\n            <tr>\n                <th th:if=\"${iter.index == 0}\" th:rowspan=\"${iter.size}\" scope=\"row\"><b>Supplemental Data:</b></th>\n                <td style=\"width:80%\" colspan=\"3\" >\n                    <p style=\"margin-bottom: 5px;\" th:narrative=\"${supples.identifier}\"></p>\n                    <p style=\"margin-bottom: 5px;\" th:each=\"uses : ${supples.usage}\">\n                        <b>usage: </b>\n                        <span th:narrative=\"${uses}\"></span>\n                    </p>\n                    <p style=\"margin-bottom: 5px;\" th:if=\"${supples.hasCriteria()}\">\n                        <b>criteria: </b>\n                        <span th:narrative=\"${supples.criteria}\"></span>\n                    </p>\n                    <p style=\"margin-bottom: 5px;\" th:if=\"${supples.hasPath()}\">\n                        <b>path: </b>\n                        <span th:narrative=\"${supples.path}\"></span>\n                    </p>\n                </td>\n            </tr>\n        </th:block> -->\n              <!-- <th:block th:each=\"param, iter : ${resource.parameter}\">\n            <tr style=\"vertical-align: top;\">\n                <th th:if=\"${iter.index == 0}\" th:rowspan=\"${iter.size}\" scope=\"row\"><b>Parameter: </b></th>\n                <td style=\"width:80%\" colspan=\"3\" >\n                    <span th:if=\"${param.hasName()}\">\n                        <b>name: </b>\n                        <span th:narrative=\"${param.name}\"></span>\n                        <br/>\n                    </span>\n                    <b>use: </b>\n                    <span th:narrative=\"${param.use.toCode()}\"></span>\n                    <br/>\n                    <span th:if=\"${param.hasMin()}\">\n                        <b>minimum cardinality: </b>\n                        <span th:narrative=\"${param.min}\"></span>\n                        <br/>\n                    </span>\n                    <span th:if=\"${param.hasMax()}\">\n                        <b>maximum cardinality: </b>\n                        <span th:narrative=\"${param.max}\"></span>\n                        <br/>\n                    </span>\n                    <b>type: </b>\n                    <span th:narrative=\"${param.type}\"></span>\n                    <br/>\n                    <span th:if=\"${param.hasDocumentation()}\">\n                        <b>documentation: </b>\n                        <span th:narrative=\"${param.documentation}\"></span>\n                        <br/>\n                    </span>\n                    <span th:if=\"${param.hasProfile()}\">\n                        <b>profile: </b>\n                        <span th:narrative=\"${param.profile}\"></span>\n                        <br/>\n                    </span>\n                    <p style=\"margin-bottom: 5px;\"></p>\n                </td>\n            </tr>\n        </th:block> -->\n              <!-- <th:block th:each=\"dataReq, iter : ${resource.dataRequirement}\">\n            <tr style=\"vertical-align: top;\">\n                    <th th:if=\"${iter.index == 0}\" th:rowspan=\"${iter.size}\" scope=\"row\" ><b>Data Requirements: </b></th>\n                    <td style=\"width:80%\" colspan=\"3\" th:narrative=\"${dataReq}\"></td>\n            </tr>\n        </th:block> -->\n    </table>\n  <h2><a name=\"toc\">Table of Contents</a></h2>\n  <ul style=\"padding-left: 50px;\">\n   <li><a href=\"#d1e405\">Population Criteria</a></li>\n   <li><a href=\"#d1e649\">Definitions</a></li>\n   <li><a href=\"#d1e650\">Functions</a></li>\n   <li><a href=\"#d1e555\">Terminology</a></li>\n   <li><a href=\"#d1e647\">Data Criteria (QDM Data Elements)</a></li>\n   <li><a href=\"#d1e767\">Supplemental Data Elements</a></li>\n   <li><a href=\"#d1e879\">Risk Adjustment Variables</a></li>\n  </ul>\n  <div style=\"float:left; background:teal; height:3px; width:80%\"/>\n  \n    <pre><br/></pre>\n    <h3><a name=\"d1e405\" href=\"#toc\">Population Criteria</a></h3>\n    <div>\n    <ul style=\"list-style:none;padding-left:10px;\">\n        <li style=\"list-style:none;padding-left:0px;\" class=\"list-unstyled\">\n        \n        <div class=\"treeview hover p-l-10\">\n        <ul class=\"list-unstyled\">\n        <li class=\"list-unstyled\"><input id=\"Initial Population\" type=\"checkbox\"/><label for=\"Initial Population\" class=\"list-header\"><strong>Initial Population</strong></label>\n            <ul class=\"code\">\n            <li class=\"list-unstyled\">\n            <div class=\"treeview hover p-l-10\">\n            <ul>\n                <li style=\"padding-left: 0px;\">\n                <div>\n                <pre class=\"cql-definition-body\">define &quot;Initial Population&quot; : \r\n  &quot;Inpatient Encounter&quot; Encounter \r\n    with [&quot;Encounter&quot; : &quot;Emergency Department Visit&quot;] ED\r\n     such that ED.status = 'finished'\r\n       and ED.period ends 1 hour or less before start of Encounter.period</pre>\n                </div></li>\n            </ul> \n            </div></li>\n            </ul></li>\n        </ul>\n        </div>\n        \n        \n        <div class=\"treeview hover p-l-10\">\n        <ul class=\"list-unstyled\">\n        <li class=\"list-unstyled\"><input id=\"Measure Population\" type=\"checkbox\"/><label for=\"Measure Population\" class=\"list-header\"><strong>Measure Population</strong></label>\n            <ul class=\"code\">\n            <li class=\"list-unstyled\">\n            <div class=\"treeview hover p-l-10\">\n            <ul>\n                <li style=\"padding-left: 0px;\">\n                <div>\n                <pre class=\"cql-definition-body\">define &quot;Measure Population&quot; : \r\n  &quot;Initial Population&quot; </pre>\n                </div></li>\n            </ul> \n            </div></li>\n            </ul></li>\n        </ul>\n        </div>\n        \n        \n        <div class=\"treeview hover p-l-10\">\n        <ul class=\"list-unstyled\">\n        <li class=\"list-unstyled\"><input id=\"Measure Population Exclusion\" type=\"checkbox\"/><label for=\"Measure Population Exclusion\" class=\"list-header\"><strong>Measure Population Exclusion</strong></label>\n            <ul class=\"code\">\n            <li class=\"list-unstyled\">\n            <div class=\"treeview hover p-l-10\">\n            <ul>\n                <li style=\"padding-left: 0px;\">\n                <div>\n                <pre class=\"cql-definition-body\">define &quot;Measure Population Exclusion&quot; : \r\n  &quot;Inpatient Encounter&quot; Encounter\r\n    with [&quot;Encounter&quot; : &quot;Emergency Department Visit&quot;] ED \r\n      such that ED.period ends 1 hour or less before start of Encounter.period\r\n        and ED.status = 'finished'\r\n        and ED.hospitalization.admitSource in &quot;Hospital Settings&quot; </pre>\n                </div></li>\n            </ul> \n            </div></li>\n            </ul></li>\n        </ul>\n        </div>\n        \n        \n        <div class=\"treeview hover p-l-10\">\n        <ul class=\"list-unstyled\">\n        <li class=\"list-unstyled\"><input id=\"Measure Observation\" type=\"checkbox\"/><label for=\"Measure Observation\" class=\"list-header\"><strong>Measure Observation</strong></label>\n            <ul class=\"code\">\n            <li class=\"list-unstyled\">\n            <div class=\"treeview hover p-l-10\">\n            <ul>\n                <li style=\"padding-left: 0px;\">\n                <div>\n                <pre class=\"cql-definition-body\">define function &quot;Measure Observation&quot; (Encounter &quot;Encounter&quot; ) : \r\n  duration in minutes of &quot;Related ED Visit&quot;(Encounter).period</pre>\n                </div></li>\n            </ul> \n            </div></li>\n            </ul></li>\n        </ul>\n        </div>\n        \n        \n            <div class=\"treeview hover p-l-10\">\n            <ul class=\"list-unstyled\">\n            <li class=\"list-unstyled\"><input id=\"stratifier-1-identifier\" type=\"checkbox\"/><label for=\"stratifier-1-identifier\" class=\"list-header\"><strong>Stratifier 1</strong></label>\n                <ul class=\"code\">\n                <li class=\"list-unstyled\">\n                <div class=\"treeview hover p-l-10\">\n                <ul>\n                    <li style=\"padding-left: 0px;\">\n                    <div>\n                    <pre class=\"cql-definition-body\">define &quot;Stratification 1&quot; : \r\n  &quot;Inpatient Encounter&quot; Encounter \r\n    where not (PrincipalDiagnosis(Encounter).code in &quot;Psychiatric/Mental Health Patient&quot;) </pre>\n                    </div></li>\n                </ul> \n                </div></li>\n                </ul></li>\n            </ul>\n            </div>\n            \n        \n            <div class=\"treeview hover p-l-10\">\n            <ul class=\"list-unstyled\">\n            <li class=\"list-unstyled\"><input id=\"stratifier-2-identifier\" type=\"checkbox\"/><label for=\"stratifier-2-identifier\" class=\"list-header\"><strong>Stratifier 2</strong></label>\n                <ul class=\"code\">\n                <li class=\"list-unstyled\">\n                <div class=\"treeview hover p-l-10\">\n                <ul>\n                    <li style=\"padding-left: 0px;\">\n                    <div>\n                    <pre class=\"cql-definition-body\">define &quot;Stratification 2&quot; : \r\n  &quot;Inpatient Encounter&quot; Encounter\r\n    where PrincipalDiagnosis(Encounter).code in &quot;Psychiatric/Mental Health Patient&quot; </pre>\n                    </div></li>\n                </ul> \n                </div></li>\n                </ul></li>\n            </ul>\n            </div>\n            \n        \n            <div class=\"treeview hover p-l-10\">\n            <ul class=\"list-unstyled\">\n            <li class=\"list-unstyled\"><input id=\"stratifier-3-identifier\" type=\"checkbox\"/><label for=\"stratifier-3-identifier\" class=\"list-header\"><strong>Stratifier 3</strong></label>\n                <ul class=\"code\">\n                <li class=\"list-unstyled\">\n                <div class=\"treeview hover p-l-10\">\n                <ul>\n                    <li style=\"padding-left: 0px;\">\n                    <div>\n                    <pre class=\"cql-definition-body\">define &quot;Stratification 3&quot; : \r\n  &quot;Inpatient Encounter&quot; Encounter\r\n    where PrincipalDiagnosis(Encounter) is null </pre>\n                    </div></li>\n                </ul> \n                </div></li>\n                </ul></li>\n            </ul>\n            </div>\n            \n    </li>\n    </ul>\n    </div>\n\n  <h3><a name=\"d1e649\" href=\"#toc\">Definitions</a></h3>\n  <div>\n   <ul style=\"list-style:none;padding-left: 10px;\">\n    <li style=\"list-style:none;\" class=\"list-unstyled\">\n     <div>\n      <ul style=\"list-style:none;padding-left:0;\" class=\"list-unstyled\">\n       <li class=\"list-unstyled\">\n        <div class=\"treeview hover p-l-10\">\n         <input id=\"Initial Population\" type=\"checkbox\"/>\n         <label for=\"Initial Population\" class=\"list-header\"><strong>Initial Population</strong></label>\n         <ul style=\"margin-right: 20%; opacity: 1;\" class=\"code\">\n          <li class=\"list-unstyled\">\n           <div>\n            <ul style=\"padding-left: 0px;\">\n             <li style=\"padding-left: 0px;\" class=\"list-unstyled\">\n              <div>\n               <pre class=\"cql-definition-body\">define &quot;Initial Population&quot; : \r\n  &quot;Inpatient Encounter&quot; Encounter \r\n    with [&quot;Encounter&quot; : &quot;Emergency Department Visit&quot;] ED\r\n     such that ED.status = 'finished'\r\n       and ED.period ends 1 hour or less before start of Encounter.period</pre>\n              </div></li>\n            </ul> \n           </div></li>\n         </ul>\n        </div></li>\n      </ul>\n     </div></li>\n   </ul>\n  </div>\n  <div>\n   <ul style=\"list-style:none;padding-left: 10px;\">\n    <li style=\"list-style:none;\" class=\"list-unstyled\">\n     <div>\n      <ul style=\"list-style:none;padding-left:0;\" class=\"list-unstyled\">\n       <li class=\"list-unstyled\">\n        <div class=\"treeview hover p-l-10\">\n         <input id=\"Inpatient Encounter\" type=\"checkbox\"/>\n         <label for=\"Inpatient Encounter\" class=\"list-header\"><strong>Inpatient Encounter</strong></label>\n         <ul style=\"margin-right: 20%; opacity: 1;\" class=\"code\">\n          <li class=\"list-unstyled\">\n           <div>\n            <ul style=\"padding-left: 0px;\">\n             <li style=\"padding-left: 0px;\" class=\"list-unstyled\">\n              <div>\n               <pre class=\"cql-definition-body\">define &quot;Inpatient Encounter&quot; : \r\n  [&quot;Encounter&quot;] Encounter\r\n    where LengthInDays(Encounter.period) &lt;= 120\r\n      and Encounter.period ends during &quot;Measurement Period&quot; </pre>\n              </div></li>\n            </ul> \n           </div></li>\n         </ul>\n        </div></li>\n      </ul>\n     </div></li>\n   </ul>\n  </div>\n  <div>\n   <ul style=\"list-style:none;padding-left: 10px;\">\n    <li style=\"list-style:none;\" class=\"list-unstyled\">\n     <div>\n      <ul style=\"list-style:none;padding-left:0;\" class=\"list-unstyled\">\n       <li class=\"list-unstyled\">\n        <div class=\"treeview hover p-l-10\">\n         <input id=\"Measure Population\" type=\"checkbox\"/>\n         <label for=\"Measure Population\" class=\"list-header\"><strong>Measure Population</strong></label>\n         <ul style=\"margin-right: 20%; opacity: 1;\" class=\"code\">\n          <li class=\"list-unstyled\">\n           <div>\n            <ul style=\"padding-left: 0px;\">\n             <li style=\"padding-left: 0px;\" class=\"list-unstyled\">\n              <div>\n               <pre class=\"cql-definition-body\">define &quot;Measure Population&quot; : \r\n  &quot;Initial Population&quot; </pre>\n              </div></li>\n            </ul> \n           </div></li>\n         </ul>\n        </div></li>\n      </ul>\n     </div></li>\n   </ul>\n  </div>\n  <div>\n   <ul style=\"list-style:none;padding-left: 10px;\">\n    <li style=\"list-style:none;\" class=\"list-unstyled\">\n     <div>\n      <ul style=\"list-style:none;padding-left:0;\" class=\"list-unstyled\">\n       <li class=\"list-unstyled\">\n        <div class=\"treeview hover p-l-10\">\n         <input id=\"Measure Population Exclusion\" type=\"checkbox\"/>\n         <label for=\"Measure Population Exclusion\" class=\"list-header\"><strong>Measure Population Exclusion</strong></label>\n         <ul style=\"margin-right: 20%; opacity: 1;\" class=\"code\">\n          <li class=\"list-unstyled\">\n           <div>\n            <ul style=\"padding-left: 0px;\">\n             <li style=\"padding-left: 0px;\" class=\"list-unstyled\">\n              <div>\n               <pre class=\"cql-definition-body\">define &quot;Measure Population Exclusion&quot; : \r\n  &quot;Inpatient Encounter&quot; Encounter\r\n    with [&quot;Encounter&quot; : &quot;Emergency Department Visit&quot;] ED \r\n      such that ED.period ends 1 hour or less before start of Encounter.period\r\n        and ED.status = 'finished'\r\n        and ED.hospitalization.admitSource in &quot;Hospital Settings&quot; </pre>\n              </div></li>\n            </ul> \n           </div></li>\n         </ul>\n        </div></li>\n      </ul>\n     </div></li>\n   </ul>\n  </div>\n  <div>\n   <ul style=\"list-style:none;padding-left: 10px;\">\n    <li style=\"list-style:none;\" class=\"list-unstyled\">\n     <div>\n      <ul style=\"list-style:none;padding-left:0;\" class=\"list-unstyled\">\n       <li class=\"list-unstyled\">\n        <div class=\"treeview hover p-l-10\">\n         <input id=\"Stratification 1\" type=\"checkbox\"/>\n         <label for=\"Stratification 1\" class=\"list-header\"><strong>Stratification 1</strong></label>\n         <ul style=\"margin-right: 20%; opacity: 1;\" class=\"code\">\n          <li class=\"list-unstyled\">\n           <div>\n            <ul style=\"padding-left: 0px;\">\n             <li style=\"padding-left: 0px;\" class=\"list-unstyled\">\n              <div>\n               <pre class=\"cql-definition-body\">define &quot;Stratification 1&quot; : \r\n  &quot;Inpatient Encounter&quot; Encounter \r\n    where not (PrincipalDiagnosis(Encounter).code in &quot;Psychiatric/Mental Health Patient&quot;) </pre>\n              </div></li>\n            </ul> \n           </div></li>\n         </ul>\n        </div></li>\n      </ul>\n     </div></li>\n   </ul>\n  </div>\n  <div>\n   <ul style=\"list-style:none;padding-left: 10px;\">\n    <li style=\"list-style:none;\" class=\"list-unstyled\">\n     <div>\n      <ul style=\"list-style:none;padding-left:0;\" class=\"list-unstyled\">\n       <li class=\"list-unstyled\">\n        <div class=\"treeview hover p-l-10\">\n         <input id=\"Stratification 2\" type=\"checkbox\"/>\n         <label for=\"Stratification 2\" class=\"list-header\"><strong>Stratification 2</strong></label>\n         <ul style=\"margin-right: 20%; opacity: 1;\" class=\"code\">\n          <li class=\"list-unstyled\">\n           <div>\n            <ul style=\"padding-left: 0px;\">\n             <li style=\"padding-left: 0px;\" class=\"list-unstyled\">\n              <div>\n               <pre class=\"cql-definition-body\">define &quot;Stratification 2&quot; : \r\n  &quot;Inpatient Encounter&quot; Encounter\r\n    where PrincipalDiagnosis(Encounter).code in &quot;Psychiatric/Mental Health Patient&quot; </pre>\n              </div></li>\n            </ul> \n           </div></li>\n         </ul>\n        </div></li>\n      </ul>\n     </div></li>\n   </ul>\n  </div>\n  <div>\n   <ul style=\"list-style:none;padding-left: 10px;\">\n    <li style=\"list-style:none;\" class=\"list-unstyled\">\n     <div>\n      <ul style=\"list-style:none;padding-left:0;\" class=\"list-unstyled\">\n       <li class=\"list-unstyled\">\n        <div class=\"treeview hover p-l-10\">\n         <input id=\"Stratification 3\" type=\"checkbox\"/>\n         <label for=\"Stratification 3\" class=\"list-header\"><strong>Stratification 3</strong></label>\n         <ul style=\"margin-right: 20%; opacity: 1;\" class=\"code\">\n          <li class=\"list-unstyled\">\n           <div>\n            <ul style=\"padding-left: 0px;\">\n             <li style=\"padding-left: 0px;\" class=\"list-unstyled\">\n              <div>\n               <pre class=\"cql-definition-body\">define &quot;Stratification 3&quot; : \r\n  &quot;Inpatient Encounter&quot; Encounter\r\n    where PrincipalDiagnosis(Encounter) is null </pre>\n              </div></li>\n            </ul> \n           </div></li>\n         </ul>\n        </div></li>\n      </ul>\n     </div></li>\n   </ul>\n  </div>\n  <h3><a name=\"d1e650\" href=\"#toc\">Functions</a></h3>\n  <div>\n   <ul style=\"list-style:none;padding-left: 10px;\">\n    <li style=\"list-style:none;\" class=\"list-unstyled\">\n     <div>\n      <ul style=\"list-style:none;padding-left:0;\" class=\"list-unstyled\">\n       <li class=\"list-unstyled\">\n        <div class=\"treeview hover p-l-10\">\n         <input id=\"GetId(uri String)\" type=\"checkbox\"/>\n         <label for=\"GetId(uri String)\" class=\"list-header\"><strong>GetId(uri String)</strong></label>\n         <ul style=\"margin-right: 20%; opacity: 1;\" class=\"code\">\n          <li class=\"list-unstyled\">\n           <div>\n            <ul style=\"padding-left: 0px;\">\n             <li style=\"padding-left: 0px;\" class=\"list-unstyled\">\n              <div>\n               <pre class=\"cql-definition-body\">\tLast(Split(uri, '/'))</pre>\n              </div></li>\n            </ul> \n           </div></li>\n         </ul>\n        </div></li>\n      </ul>\n     </div></li>\n   </ul>\n  </div>\n  <div>\n   <ul style=\"list-style:none;padding-left: 10px;\">\n    <li style=\"list-style:none;\" class=\"list-unstyled\">\n     <div>\n      <ul style=\"list-style:none;padding-left:0;\" class=\"list-unstyled\">\n       <li class=\"list-unstyled\">\n        <div class=\"treeview hover p-l-10\">\n         <input id=\"LengthInDays(Value Interval&lt;DateTime&gt;)\" type=\"checkbox\"/>\n         <label for=\"LengthInDays(Value Interval&lt;DateTime&gt;)\" class=\"list-header\"><strong>LengthInDays(Value Interval&lt;DateTime&gt;)</strong></label>\n         <ul style=\"margin-right: 20%; opacity: 1;\" class=\"code\">\n          <li class=\"list-unstyled\">\n           <div>\n            <ul style=\"padding-left: 0px;\">\n             <li style=\"padding-left: 0px;\" class=\"list-unstyled\">\n              <div>\n               <pre class=\"cql-definition-body\">\tdifference in days between start of Value and end of Value</pre>\n              </div></li>\n            </ul> \n           </div></li>\n         </ul>\n        </div></li>\n      </ul>\n     </div></li>\n   </ul>\n  </div>\n  <div>\n   <ul style=\"list-style:none;padding-left: 10px;\">\n    <li style=\"list-style:none;\" class=\"list-unstyled\">\n     <div>\n      <ul style=\"list-style:none;padding-left:0;\" class=\"list-unstyled\">\n       <li class=\"list-unstyled\">\n        <div class=\"treeview hover p-l-10\">\n         <input id=\"Measure Observation\" type=\"checkbox\"/>\n         <label for=\"Measure Observation\" class=\"list-header\"><strong>Measure Observation</strong></label>\n         <ul style=\"margin-right: 20%; opacity: 1;\" class=\"code\">\n          <li class=\"list-unstyled\">\n           <div>\n            <ul style=\"padding-left: 0px;\">\n             <li style=\"padding-left: 0px;\" class=\"list-unstyled\">\n              <div>\n               <pre class=\"cql-definition-body\">define function &quot;Measure Observation&quot; (Encounter &quot;Encounter&quot; ) : \r\n  duration in minutes of &quot;Related ED Visit&quot;(Encounter).period</pre>\n              </div></li>\n            </ul> \n           </div></li>\n         </ul>\n        </div></li>\n      </ul>\n     </div></li>\n   </ul>\n  </div>\n  <div>\n   <ul style=\"list-style:none;padding-left: 10px;\">\n    <li style=\"list-style:none;\" class=\"list-unstyled\">\n     <div>\n      <ul style=\"list-style:none;padding-left:0;\" class=\"list-unstyled\">\n       <li class=\"list-unstyled\">\n        <div class=\"treeview hover p-l-10\">\n         <input id=\"PrincipalDiagnosis(Encounter Encounter)\" type=\"checkbox\"/>\n         <label for=\"PrincipalDiagnosis(Encounter Encounter)\" class=\"list-header\"><strong>PrincipalDiagnosis(Encounter Encounter)</strong></label>\n         <ul style=\"margin-right: 20%; opacity: 1;\" class=\"code\">\n          <li class=\"list-unstyled\">\n           <div>\n            <ul style=\"padding-left: 0px;\">\n             <li style=\"padding-left: 0px;\" class=\"list-unstyled\">\n              <div>\n               <pre class=\"cql-definition-body\">\t(singleton from (Encounter.diagnosis D where D.role ~ ToConcept(&quot;Billing&quot;) and D.rank = 1)) PD\r\n\t\treturn singleton from ([Condition: id in &quot;GetId&quot;(PD.condition.reference)])</pre>\n              </div></li>\n            </ul> \n           </div></li>\n         </ul>\n        </div></li>\n      </ul>\n     </div></li>\n   </ul>\n  </div>\n  <div>\n   <ul style=\"list-style:none;padding-left: 10px;\">\n    <li style=\"list-style:none;\" class=\"list-unstyled\">\n     <div>\n      <ul style=\"list-style:none;padding-left:0;\" class=\"list-unstyled\">\n       <li class=\"list-unstyled\">\n        <div class=\"treeview hover p-l-10\">\n         <input id=\"Related ED Visit\" type=\"checkbox\"/>\n         <label for=\"Related ED Visit\" class=\"list-header\"><strong>Related ED Visit</strong></label>\n         <ul style=\"margin-right: 20%; opacity: 1;\" class=\"code\">\n          <li class=\"list-unstyled\">\n           <div>\n            <ul style=\"padding-left: 0px;\">\n             <li style=\"padding-left: 0px;\" class=\"list-unstyled\">\n              <div>\n               <pre class=\"cql-definition-body\">define function &quot;Related ED Visit&quot; (Encounter &quot;Encounter&quot; ) : \r\n  Last([&quot;Encounter&quot; : &quot;Emergency Department Visit&quot;] ED \r\n    where ED.status = 'finished'\r\n      and ED.period ends 1 hour or less before start of Encounter.period\r\n    sort by start of period ) </pre>\n              </div></li>\n            </ul> \n           </div></li>\n         </ul>\n        </div></li>\n      </ul>\n     </div></li>\n   </ul>\n  </div>\n  <h3><a name=\"d1e555\" href=\"#toc\">Terminology</a></h3>\n  <div>\n   <ul style=\"padding-left: 50px;\">\n    <li style=\"width:80%\">codesystem &quot;Diagnosis Role&quot; : 'http://hl7.org/fhir/diagnosis-role'</li>\n    <li style=\"width:80%\">code &quot;Billing&quot; : 'billing' from &quot;Diagnosis Role&quot; display 'Billing'</li>\n    <li style=\"width:80%\">valueset &quot;Emergency Department Visit&quot; : 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292'</li>\n    <li style=\"width:80%\">valueset &quot;Hospital Settings&quot; : 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.126'</li>\n    <li style=\"width:80%\">valueset &quot;Psychiatric/Mental Health Patient&quot; : 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.299'</li>\n   </ul>\n  </div>\n  <h3><a name=\"d1e647\" href=\"#toc\">Data Criteria (QDM Data Elements)</a></h3>\n  <div>\n    <ul style=\"padding-left: 50px;\">\n      <li style=\"width:80%\">&quot;Encounter: Emergency Department Visit&quot; using &quot;Emergency Department Visit (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292)</li>\n    </ul>\n  </div>\n  <h3><a name=\"d1e767\" href=\"#toc\">Supplemental Data Elements</a></h3>\n  \n  <div>\n    <ul style=\"list-style:none;padding-left: 25px;\">\n        <li>None</li>\n    </ul>\n </div>\n  <h3><a name=\"d1e879\" href=\"#toc\">Risk Adjustment Variables</a></h3>\n  <div>\n   <ul style=\"list-style:none;padding-left: 25px;\">\n    <li>None</li>\n   </ul>\n  </div>\n  <div style=\"float:left; background:teal; height:3px; width:80%\"/>\n  <table>\n        \n              <!-- <th:block th:each=\"con, iter : ${resource.content}\">\n            <tr th:if=\"${con.contentType == 'text/cql'}\" style=\"vertical-align: top;\">\n                <td style=\"background-color:#656565; width:20%\" scope=\"row\"><span class=\"td_label\">Content</span></td>\n                <td style=\"width:80%\" ><b>type: </b><span th:text=\"${con.contentType}\"></span></td>\n            </tr>\n            <tr th:if=\"${con.contentType == 'text/cql'}\">\n                <td style=\"width:100%\" colspan=\"2\" >\n                    <th:block th:if=\"${con.getData() != null }\" >\n                        <pre><code th:class=\"${con.contentType == 'text/cql' ? 'language-cql' : 'language-xml'}\" th:text=\"${new java.lang.String(con.getData())}\"></code></pre>\n                    </th:block>\n                    <th:block th:if=\"${con.getData() == null }\" >\n                        <span><i>&lt;content is empty&gt;</i></span>\n                    </th:block>\n                </td>\n            </tr>\n        </th:block > -->\n    </table>\n</div>"
  },
  "extension" : [
    {
      "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis",
      "valueCode" : "Encounter"
    }
  ],
  "url" : "http://hl7.org/fhir/us/cqfmeasures/Measure/measure-exm55-FHIR",
  "identifier" : [
    {
      "use" : "official",
      "system" : "http://example.org/fhir/cqi/ecqm/Measure/Identifier/exm",
      "value" : "55"
    }
  ],
  "version" : "1.0.0",
  "name" : "EXM55",
  "title" : "Median ED Visit Duration",
  "status" : "active",
  "experimental" : true,
  "date" : "2019-02-21T00:00:00-05:00",
  "publisher" : "Health Level 7 International - Clinical Quality Information Work Group",
  "description" : "This example illustrates a continuous variable measure represented as a FHIR eCQM",
  "approvalDate" : "2019-03-08",
  "lastReviewDate" : "2019-03-08",
  "effectivePeriod" : {
    "start" : "2018-01-01T00:00:00-05:00",
    "end" : "2018-12-31T00:00:00-05:00"
  },
  "useContext" : [
    {
      "code" : {
        "code" : "program"
      },
      "valueCodeableConcept" : {
        "text" : "eligible-hospital"
      }
    }
  ],
  "jurisdiction" : [
    {
      "coding" : [
        {
          "system" : "urn:iso:std:iso:3166",
          "code" : "US",
          "display" : "United States of America"
        }
      ]
    }
  ],
  "contact" : [
    {
      "telecom" : [
        {
          "system" : "url",
          "value" : "http://www.hl7.org/Special/committees/cqi/index.cfm"
        }
      ]
    }
  ],
  "relatedArtifact" : [
    {
      "type" : "depends-on",
      "resource" : {
        "reference" : "Library/fhirhelpers"
      }
    }
  ],
  "library" : [
    {
      "reference" : "Library/exm55-fhir"
    }
  ],
  "scoring" : {
    "coding" : [
      {
        "system" : "http://hl7.org/fhir/measure-scoring",
        "code" : "continuous-variable"
      }
    ]
  },
  "type" : [
    {
      "coding" : [
        {
          "system" : "http://hl7.org/fhir/measure-type",
          "code" : "process"
        }
      ]
    }
  ],
  "improvementNotation" : "decrease",
  "group" : [
    {
      "identifier" : {
        "value" : "group-1"
      },
      "population" : [
        {
          "code" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                "code" : "initial-population",
                "display" : "Initial Population"
              }
            ]
          },
          "criteria" : "Initial Population"
        },
        {
          "code" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                "code" : "measure-population",
                "display" : "Measure Population"
              }
            ]
          },
          "criteria" : "Measure Population"
        },
        {
          "code" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                "code" : "measure-population-exclusion",
                "display" : "Measure Population Exclusion"
              }
            ]
          },
          "criteria" : "Measure Population Exclusion"
        },
        {
          "code" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                "code" : "measure-observation",
                "display" : "Measure Observation"
              }
            ]
          },
          "criteria" : "Measure Observation"
        }
      ],
      "stratifier" : [
        {
          "identifier" : {
            "value" : "stratifier-1-identifier"
          },
          "criteria" : "Stratification 1"
        },
        {
          "identifier" : {
            "value" : "stratifier-2-identifier"
          },
          "criteria" : "Stratification 2"
        },
        {
          "identifier" : {
            "value" : "stratifier-3-identifier"
          },
          "criteria" : "Stratification 3"
        }
      ]
    }
  ]
}