library TJCOverall version '4.0.000'

/*
This example is a work in progress and should not be considered a final specification
or recommendation for guidance. This example will help guide and direct the process
of finding conventions and usage patterns that meet the needs of the various stakeholders
in the measure development community.
*/

using FHIR version '4.0.1'

include FHIRHelpers version '4.0.1' called FHIRHelpers
include MATGlobalCommonFunctions version '5.0.000' called Global
include SupplementalDataElements version '2.0.0' called SDE

codesystem "SNOMEDCT": 'http://snomed.info/sct'
codesystem "LOINC": 'http://loinc.org'

valueset "Comfort Measures": 'http://cts.nlm.nih.gov/fhir/ValueSet/1.3.6.1.4.1.33895.1.3.0.45'
valueset "Discharge To Acute Care Facility": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.87'
valueset "Discharged to Health Care Facility for Hospice Care": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.207'
valueset "Discharged to Home for Hospice Care": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.209'
valueset "Emergency Department Visit": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292'
valueset "Encounter Inpatient": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307'
valueset "Hemorrhagic Stroke": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.212'
valueset "Ischemic Stroke": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.247'
valueset "Left Against Medical Advice": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.308'
valueset "Non-Elective Inpatient Encounter": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.424'
valueset "Patient Expired": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.309'
valueset "Ticagrelor Therapy": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.39'
valueset "Observation Services": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.143'

code "Birth date": '21112-8' from "LOINC" display 'Birth date'

parameter "Measurement Period" Interval<DateTime>
  default Interval[@2019-01-01T00:00:00.0, @2020-01-01T00:00:00.0)

context Patient

define "Intervention Comfort Measures":
	(["ServiceRequest": "Comfort Measures"] P
		where P.intent = 'order')
		union
		(["Procedure": "Comfort Measures"] InterventionPerformed
		where InterventionPerformed.status = 'completed')

define "All Stroke Encounter":
	"Non Elective Inpatient Encounter" NonElectiveEncounter
    where Global.PrincipalDiagnosis(NonElectiveEncounter).code in "Hemorrhagic Stroke"
      or Global.PrincipalDiagnosis(NonElectiveEncounter).code in "Ischemic Stroke"

define "Ischemic Stroke Encounter":
	"Encounter with Principal Diagnosis and Age" EncounterWithAge
		where Global.PrincipalDiagnosis(EncounterWithAge).code in "Ischemic Stroke"

define "Non Elective Inpatient Encounter":
	["Encounter": "Non-Elective Inpatient Encounter"] NonElectiveEncounter
		where Global."LengthInDays"(NonElectiveEncounter.period) <= 120
			and NonElectiveEncounter.period ends during "Measurement Period"

define "Ischemic Stroke Encounters with Discharge Disposition":
	"Ischemic Stroke Encounter" IschemicStrokeEncounter
		where IschemicStrokeEncounter.hospitalization.dischargeDisposition in "Discharge To Acute Care Facility"
			or IschemicStrokeEncounter.hospitalization.dischargeDisposition in "Left Against Medical Advice"
			or IschemicStrokeEncounter.hospitalization.dischargeDisposition in "Patient Expired"
			or IschemicStrokeEncounter.hospitalization.dischargeDisposition in "Discharged to Home for Hospice Care"
			or IschemicStrokeEncounter.hospitalization.dischargeDisposition in "Discharged to Health Care Facility for Hospice Care"

define "Comfort Measures during Hospitalization":
	"Ischemic Stroke Encounter" IschemicStrokeEncounter
   	with "Intervention Comfort Measures" ComfortMeasure
    	such that FHIRHelpers.ToDateTime(Coalesce(ComfortMeasure.performed as dateTime,ComfortMeasure.authoredOn)) during Global."HospitalizationWithObservation"(IschemicStrokeEncounter)

define "Encounter with Principal Diagnosis and Age":
	"All Stroke Encounter" AllStrokeEncounter
		with ["Patient"] BirthDate
			such that Global."CalendarAgeInYearsAt"(FHIRHelpers.ToDate(BirthDate.birthDate), start of FHIRHelpers.ToInterval(AllStrokeEncounter.period)) >= 18

define function "CalendarDayOfOrDayAfter"(StartValue DateTime ):
	Interval(Global."ToDate"(StartValue), Global."ToDate"(StartValue + 2 days))

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