Quality Measure Implementation Guide (STU3)
3.0.0 - STU 3 US

This page is part of the Quality Measure STU2 for FHIR R4 Implementation Guide (v3.0.0: STU3) based on FHIR R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

: Breast Cancer Screening - JSON Representation

Draft as of 2022-02-22

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{
  "resourceType" : "Measure",
  "id" : "BCSComponent",
  "meta" : {
    "profile" : [
      "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/proportion-measure-cqfm",
      "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-measure-cqfm"
    ]
  },
  "language" : "en",
  "text" : {
    "status" : "extensions",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\" xml:lang=\"en\" lang=\"en\">\n    <table class=\"grid dict\">\n        \n        <tr>\n            <th scope=\"row\"><b>Id: </b></th>\n            <td style=\"padding-left: 4px;\">BCSComponent</td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Url: </b></th>\n            <td style=\"padding-left: 4px;\">http://hl7.org/fhir/us/cqfmeasures/Measure/BCSComponent</td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Version: </b></th>\n            <td style=\"padding-left: 4px;\">0.0.001</td>\n        </tr>\n        \n        \n        \n        <tr>\n            <th scope=\"row\"><b>Name: </b></th>\n            <td style=\"padding-left: 4px;\">BCSComponent</td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Title: </b></th>\n            <td style=\"padding-left: 4px;\">Breast Cancer Screening</td>\n        </tr>\n        \n        \n        \n        <tr>\n            <th scope=\"row\"><b>Status: </b></th>\n            <td style=\"padding-left: 4px;\">draft</td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Experimental: </b></th>\n            <td style=\"padding-left: 4px;\">true</td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Scoring: </b></th>\n            <td style=\"padding-left: 4px;\">\n                \n                    \n                        \n                        <p style=\"margin-bottom: 5px;\">\n                            <b>system: </b> <span>http://terminology.hl7.org/CodeSystem/measure-scoring</span>\n                        </p>\n                        \n                        \n                        <p style=\"margin-bottom: 5px;\">\n                            <b>code: </b> <span>proportion</span>\n                        </p>\n                        \n                        \n                        <p style=\"margin-bottom: 5px;\">\n                            <b>display: </b> <span>Proportion</span>\n                        </p>\n                        \n                    \n                \n                \n            </td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Improvement Notation: </b></th>\n            <td style=\"padding-left: 4px;\">\n                \n                    \n                        \n                        <p style=\"margin-bottom: 5px;\">\n                            <b>system: </b> <span>http://terminology.hl7.org/CodeSystem/measure-improvement-notation</span>\n                        </p>\n                        \n                        \n                        <p style=\"margin-bottom: 5px;\">\n                            <b>code: </b> <span>increase</span>\n                        </p>\n                        \n                        \n                    \n                \n                \n            </td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Type: </b></th>\n            <td style=\"padding-left: 4px;\">\n                \n                    \n                        \n                        <p style=\"margin-bottom: 5px;\">\n                            <b>system: </b> <span>http://terminology.hl7.org/CodeSystem/measure-type</span>\n                        </p>\n                        \n                        \n                        <p style=\"margin-bottom: 5px;\">\n                            <b>code: </b> <span>process</span>\n                        </p>\n                        \n                        \n                    \n                \n                \n            </td>\n        </tr>\n        \n        \n        \n        <tr>\n            <th scope=\"row\"><b>Date: </b></th>\n            <td style=\"padding-left: 4px;\">2022-02-22T11:37:03-06:00</td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Publisher: </b></th>\n            <td style=\"padding-left: 4px;\">Clinical Quality Information WG</td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Description: </b></th>\n            <td style=\"padding-left: 4px;\">This is an example only.</td>\n        </tr>\n        \n        \n        \n        \n        \n        \n        \n            <tr>\n                <th scope=\"row\"><b>Supplemental Data: </b></th>\n                <td style=\"padding-left: 4px;\">\n                    <table class=\"grid-dict\">\n                        <tr><th><b>expression</b></th><th><b>system</b></th></tr>\n                        \n                        <tr>\n                            <td>SDE Ethnicity</td>\n                            <td>http://terminology.hl7.org/CodeSystem/measure-data-usage</td>\n                        </tr>\n                        \n                        <tr>\n                            <td>SDE Payer</td>\n                            <td>http://terminology.hl7.org/CodeSystem/measure-data-usage</td>\n                        </tr>\n                        \n                        <tr>\n                            <td>SDE Race</td>\n                            <td>http://terminology.hl7.org/CodeSystem/measure-data-usage</td>\n                        </tr>\n                        \n                        <tr>\n                            <td>SDE Sex</td>\n                            <td>http://terminology.hl7.org/CodeSystem/measure-data-usage</td>\n                        </tr>\n                        \n                    </table>\n                </td>\n            </tr>\n        \n        \n        \n        <tr>\n            <th scope=\"row\"><b>Jurisdiction: </b></th>\n            <td style=\"padding-left: 25px;\">US</td>\n        </tr>\n        \n        \n        \n        \n        \n        \n        \n        \n        \n        <tr>\n            <th scope=\"row\"><b>Effective Period: </b></th>\n            <td style=\"padding-left: 4px;\">2022-01-01..2022-12-31</td>\n        </tr>\n        \n        \n        \n        \n        \n        \n    </table>\n</div>"
  },
  "contained" : [
    {
      "resourceType" : "Library",
      "id" : "effective-data-requirements",
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
          "valueCoding" : {
            "system" : "http://snomed.info/sct",
            "version" : "http://snomed.info/sct/731000124108/version/201709",
            "code" : "428361000124107",
            "display" : "Discharge to home for hospice care (procedure)"
          }
        },
        {
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
          "valueCoding" : {
            "system" : "http://snomed.info/sct",
            "version" : "http://snomed.info/sct/731000124108/version/201709",
            "code" : "428371000124100",
            "display" : "Discharge to healthcare facility for hospice care (procedure)"
          }
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "SupplementalDataElements"
            },
            {
              "url" : "name",
              "valueString" : "SDE Sex"
            },
            {
              "url" : "statement",
              "valueString" : "define \"SDE Sex\":   case       when Patient.gender = 'male' then Code { code: 'M', system: 'http://hl7.org/fhir/v3/AdministrativeGender', display: 'Male' }       when Patient.gender = 'female' then Code { code: 'F', system: 'http://hl7.org/fhir/v3/AdministrativeGender', display: 'Female' }       else null     end"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 0
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "BCSComponent"
            },
            {
              "url" : "name",
              "valueString" : "SDE Sex"
            },
            {
              "url" : "statement",
              "valueString" : "define \"SDE Sex\":   SDE.\"SDE Sex\""
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 1
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "BCSComponent"
            },
            {
              "url" : "name",
              "valueString" : "Numerator"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Numerator\":   exists ( [DiagnosticReport: \"Mammography\"] Mammogram         where ( Global.\"Normalize Interval\" ( Mammogram.effective ) ends 27 months or less on or before           end of \"Measurement Period\"         )           and Mammogram.status in { 'final', 'amended', 'corrected', 'appended' }     )"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 2
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "AdultOutpatientEncounters"
            },
            {
              "url" : "name",
              "valueString" : "Qualifying Encounters"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Qualifying Encounters\":  (     [Encounter: \"Office Visit\"]     union [Encounter: \"Annual Wellness Visit\"]     union [Encounter: \"Preventive Care Services - Established Office Visit, 18 and Up\"]     union [Encounter: \"Preventive Care Services-Initial Office Visit, 18 and Up\"]     union [Encounter: \"Home Healthcare Services\"]   ) ValidEncounter   where ValidEncounter.period during \"Measurement Period\"     and ValidEncounter.status  = 'finished'"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 3
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "BCSComponent"
            },
            {
              "url" : "name",
              "valueString" : "Initial Population"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Initial Population\":   Patient.gender = 'female'       and Global.\"CalendarAgeInYearsAt\" ( FHIRHelpers.ToDate ( Patient.birthDate ), start of \"Measurement Period\" ) in Interval[51, 74 )       and exists AdultOutpatientEncounters.\"Qualifying Encounters\""
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 4
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "BCSComponent"
            },
            {
              "url" : "name",
              "valueString" : "Denominator"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Denominator\":   \"Initial Population\""
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 5
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "SupplementalDataElements"
            },
            {
              "url" : "name",
              "valueString" : "SDE Payer"
            },
            {
              "url" : "statement",
              "valueString" : "define \"SDE Payer\":   [Coverage: type in \"Payer\"] Payer         return {           code: Payer.type,           period: Payer.period         }"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 6
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "BCSComponent"
            },
            {
              "url" : "name",
              "valueString" : "SDE Payer"
            },
            {
              "url" : "statement",
              "valueString" : "define \"SDE Payer\":   SDE.\"SDE Payer\""
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 7
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "SupplementalDataElements"
            },
            {
              "url" : "name",
              "valueString" : "SDE Ethnicity"
            },
            {
              "url" : "statement",
              "valueString" : "define \"SDE Ethnicity\":   (flatten (       Patient.extension Extension         where Extension.url = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity'           return Extension.extension     )) E       where E.url = 'ombCategory'         or E.url = 'detailed'       return E.value as Coding"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 8
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "BCSComponent"
            },
            {
              "url" : "name",
              "valueString" : "SDE Ethnicity"
            },
            {
              "url" : "statement",
              "valueString" : "define \"SDE Ethnicity\":   SDE.\"SDE Ethnicity\""
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 9
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "Hospice"
            },
            {
              "url" : "name",
              "valueString" : "Has Hospice"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Has Hospice\":  exists (     [Encounter: \"Encounter Inpatient\"] DischargeHospice    where DischargeHospice.status = 'finished'       and (          DischargeHospice.hospitalization.dischargeDisposition ~ \"Discharge to home for hospice care (procedure)\"         or DischargeHospice.hospitalization.dischargeDisposition ~ \"Discharge to healthcare facility for hospice care (procedure)\"       )     and DischargeHospice.period ends during \"Measurement Period\"  )     or exists (       [ServiceRequest: \"Hospice care ambulatory\"] HospiceOrder         where HospiceOrder.intent = 'order'             and HospiceOrder.authoredOn in \"Measurement Period\"     )     or exists (       [Procedure: \"Hospice care ambulatory\"] HospicePerformed         where HospicePerformed.status = 'completed'           and Global.\"Normalize Interval\"(HospicePerformed.performed) overlaps \"Measurement Period\"     )"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 10
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "BCSComponent"
            },
            {
              "url" : "name",
              "valueString" : "Right Mastectomy Diagnosis"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Right Mastectomy Diagnosis\":   ( ( [Condition: \"Status Post Right Mastectomy\"] )       union ( [Condition: \"Unilateral Mastectomy, Unspecified Laterality\"] UnilateralMastectomyDiagnosis           where UnilateralMastectomyDiagnosis.bodySite in \"Right\"       ) ) RightMastectomy       where Global.\"Normalize Interval\" ( RightMastectomy.onset ) starts on or before       end of \"Measurement Period\""
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 11
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "BCSComponent"
            },
            {
              "url" : "name",
              "valueString" : "Right Mastectomy Procedure"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Right Mastectomy Procedure\":   [Procedure: \"Unilateral Mastectomy Right\"] UnilateralMastectomyRightPerformed       where Global.\"Normalize Interval\" ( UnilateralMastectomyRightPerformed.performed ) ends on or before       end of \"Measurement Period\"         and UnilateralMastectomyRightPerformed.status = 'completed'"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 12
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "BCSComponent"
            },
            {
              "url" : "name",
              "valueString" : "Left Mastectomy"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Left Mastectomy\":   ( ( [Condition: \"Status Post Left Mastectomy\"] )       union ( [Condition: \"Unilateral Mastectomy, Unspecified Laterality\"] UnilateralMastectomyDiagnosis           where UnilateralMastectomyDiagnosis.bodySite in \"Left\"       ) ) LeftMastectomy       where Global.\"Normalize Interval\" ( LeftMastectomy.onset ) starts on or before       end of \"Measurement Period\""
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 13
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "BCSComponent"
            },
            {
              "url" : "name",
              "valueString" : "Left Mastectomy Procedure"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Left Mastectomy Procedure\":   [Procedure: \"Unilateral Mastectomy Left\"] UnilateralMastectomyLeftPerformed       where Global.\"Normalize Interval\" ( UnilateralMastectomyLeftPerformed.performed ) ends on or before       end of \"Measurement Period\"         and UnilateralMastectomyLeftPerformed.status = 'completed'"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 14
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "BCSComponent"
            },
            {
              "url" : "name",
              "valueString" : "Bilateral Mastectomy Diagnosis"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Bilateral Mastectomy Diagnosis\":   [Condition: \"History of bilateral mastectomy\"] BilateralMastectomyHistory       where Global.\"Normalize Interval\" ( BilateralMastectomyHistory.onset ) starts on or before       end of \"Measurement Period\""
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 15
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "BCSComponent"
            },
            {
              "url" : "name",
              "valueString" : "Bilateral Mastectomy Procedure"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Bilateral Mastectomy Procedure\":   [Procedure: \"Bilateral Mastectomy\"] BilateralMastectomyPerformed       where Global.\"Normalize Interval\" ( BilateralMastectomyPerformed.performed ) ends on or before       end of \"Measurement Period\"         and BilateralMastectomyPerformed.status = 'completed'"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 16
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "AdvancedIllnessandFrailtyExclusion"
            },
            {
              "url" : "name",
              "valueString" : "Has Criteria Indicating Frailty"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Has Criteria Indicating Frailty\":   //Ask Bryn about devices        exists ( [DeviceRequest: \"Frailty Device\"] FrailtyDeviceOrder          where FrailtyDeviceOrder.authoredOn during \"Measurement Period\"        )           // DeviceUseStatement has a known issue with the publication tooling           // so it is removed to allow this IG to publish until that is fixed         //or exists ( [DeviceUseStatement: \"Frailty Device\"] FrailtyDeviceUse         //  where Global.\"Normalize Interval\"(FrailtyDeviceUse.timing) overlaps \"Measurement Period\"         //)         or exists ( [Condition: \"Frailty Diagnosis\"] FrailtyDiagnosis           where Global.\"Prevalence Period\"(FrailtyDiagnosis) overlaps \"Measurement Period\"         )         or exists ( [Encounter: \"Frailty Encounter\"] FrailtyEncounter           where FrailtyEncounter.period overlaps \"Measurement Period\"         )         or exists ( [Observation: \"Frailty Symptom\"] FrailtySymptomObservation           where Global.\"Normalize Interval\"(FrailtySymptomObservation.effective) overlaps \"Measurement Period\"         )"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 17
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "AdvancedIllnessandFrailtyExclusion"
            },
            {
              "url" : "name",
              "valueString" : "Outpatient Encounters with Advanced Illness"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Outpatient Encounters with Advanced Illness\":   ( [Encounter: \"Outpatient\"]         union [Encounter: \"Observation\"]         union [Encounter: \"ED\"]         union [Encounter: \"Nonacute Inpatient\"] ) OutpatientEncounter          with [Condition: \"Advanced Illness\"] AdvancedIllnessDiagnosis                   such that exists (                       OutpatientEncounter.diagnosis.condition EncounterDiagnosis                           where EndsWith(EncounterDiagnosis.reference, AdvancedIllnessDiagnosis.id)                   )                   and OutpatientEncounter.period starts 2 years or less on or before          end of \"Measurement Period\""
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 18
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "AdvancedIllnessandFrailtyExclusion"
            },
            {
              "url" : "name",
              "valueString" : "Inpatient Encounter with Advanced Illness"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Inpatient Encounter with Advanced Illness\":   [Encounter: \"Acute Inpatient\"] InpatientEncounter         with [Condition: \"Advanced Illness\"] AdvancedIllnessDiagnosis                   such that exists (                       InpatientEncounter.diagnosis.condition EncounterDiagnosis                           where EndsWith(EncounterDiagnosis.reference, AdvancedIllnessDiagnosis.id)                   )          and InpatientEncounter.period starts 2 years or less on or before          end of \"Measurement Period\""
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 19
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "AdvancedIllnessandFrailtyExclusion"
            },
            {
              "url" : "name",
              "valueString" : "Dementia Medications In Year Before or During Measurement Period"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Dementia Medications In Year Before or During Measurement Period\":   [\"MedicationDispense\": \"Dementia Medications\"] DementiaMed         where DementiaMed.whenHandedOver during Interval[                   ( start of \"Measurement Period\" - 1 year ), end of \"Measurement Period\"               ]"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 20
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "AdvancedIllnessandFrailtyExclusion"
            },
            {
              "url" : "name",
              "valueString" : "Advanced Illness and Frailty Exclusion Not Including Over Age 80"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Advanced Illness and Frailty Exclusion Not Including Over Age 80\":   //If the measure does NOT include populations age 80 and older, then use this logic:        Global.\"CalendarAgeInYearsAt\"(FHIRHelpers.ToDate(Patient.birthDate), start of \"Measurement Period\")>= 65               and \"Has Criteria Indicating Frailty\"               and ( Count(\"Outpatient Encounters with Advanced Illness\")>= 2                   or exists ( \"Inpatient Encounter with Advanced Illness\" )                   or exists \"Dementia Medications In Year Before or During Measurement Period\"               )"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 21
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "AdvancedIllnessandFrailtyExclusion"
            },
            {
              "url" : "name",
              "valueString" : "Long Term Care Periods During Measurement Period"
            },
            {
              "url" : "statement",
              "valueString" : "// start here define \"Long Term Care Periods During Measurement Period\":   ( [Encounter: \"Care Services in Long-Term Residential Facility\"]                 union [Encounter: \"Nursing Facility Visit\"] ) LongTermFacilityEncounter                 where LongTermFacilityEncounter.period overlaps \"Measurement Period\"                 return LongTermFacilityEncounter.period                  intersect \"Measurement Period\""
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 22
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "AdvancedIllnessandFrailtyExclusion"
            },
            {
              "url" : "name",
              "valueString" : "Long Term Care Periods Longer Than 90 Consecutive Days"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Long Term Care Periods Longer Than 90 Consecutive Days\":   exists ( \"Long Term Care Periods During Measurement Period\" LongTermCareDuringMP         where duration in days of LongTermCareDuringMP > 90     )"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 23
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "BCSComponent"
            },
            {
              "url" : "name",
              "valueString" : "Denominator Exclusion"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Denominator Exclusion\":   Hospice.\"Has Hospice\"       or ( ( exists \"Right Mastectomy Diagnosis\"             or exists \"Right Mastectomy Procedure\"         )           and ( exists \"Left Mastectomy\"               or exists \"Left Mastectomy Procedure\"           )       )       or exists \"Bilateral Mastectomy Diagnosis\"       or exists \"Bilateral Mastectomy Procedure\"       or Frailty.\"Advanced Illness and Frailty Exclusion Not Including Over Age 80\"       or ( Global.\"CalendarAgeInYearsAt\" ( FHIRHelpers.ToDate ( Patient.birthDate ), start of \"Measurement Period\" ) >= 65           and Frailty.\"Long Term Care Periods Longer Than 90 Consecutive Days\"       )"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 24
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "SupplementalDataElements"
            },
            {
              "url" : "name",
              "valueString" : "SDE Race"
            },
            {
              "url" : "statement",
              "valueString" : "define \"SDE Race\":   (flatten (       Patient.extension Extension         where Extension.url = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-race'           return Extension.extension     )) E       where E.url = 'ombCategory'         or E.url = 'detailed'       return E.value as Coding"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 25
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "BCSComponent"
            },
            {
              "url" : "name",
              "valueString" : "SDE Race"
            },
            {
              "url" : "statement",
              "valueString" : "define \"SDE Race\":   SDE.\"SDE Race\""
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 26
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        }
      ],
      "name" : "EffectiveDataRequirements",
      "status" : "active",
      "type" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/library-type",
            "code" : "module-definition"
          }
        ]
      },
      "date" : "2022-02-22T10:37:03-07:00",
      "relatedArtifact" : [
        {
          "type" : "depends-on",
          "display" : "Library SDE",
          "resource" : "http://hl7.org/fhir/us/cqfmeasures/Library/SupplementalDataElements|2.0.000"
        },
        {
          "type" : "depends-on",
          "display" : "Library FHIRHelpers",
          "resource" : "http://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1"
        },
        {
          "type" : "depends-on",
          "display" : "Library Global",
          "resource" : "http://hl7.org/fhir/us/cqfmeasures/Library/MATGlobalCommonFunctions|5.0.000"
        },
        {
          "type" : "depends-on",
          "display" : "Library AdultOutpatientEncounters",
          "resource" : "http://hl7.org/fhir/us/cqfmeasures/Library/AdultOutpatientEncounters|2.0.000"
        },
        {
          "type" : "depends-on",
          "display" : "Library Hospice",
          "resource" : "http://hl7.org/fhir/us/cqfmeasures/Library/Hospice|2.0.000"
        },
        {
          "type" : "depends-on",
          "display" : "Library Frailty",
          "resource" : "http://hl7.org/fhir/us/cqfmeasures/Library/AdvancedIllnessandFrailtyExclusion|5.12.000"
        },
        {
          "type" : "depends-on",
          "display" : "Code system SNOMEDCT:2017-09",
          "resource" : "http://snomed.info/sct|http://snomed.info/sct/731000124108/version/201709"
        },
        {
          "type" : "depends-on",
          "display" : "Value set Mammography",
          "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1018"
        },
        {
          "type" : "depends-on",
          "display" : "Value set Office Visit",
          "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001"
        },
        {
          "type" : "depends-on",
          "display" : "Value set Annual Wellness Visit",
          "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240"
        },
        {
          "type" : "depends-on",
          "display" : "Value set Preventive Care Services - Established Office Visit, 18 and Up",
          "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025"
        },
        {
          "type" : "depends-on",
          "display" : "Value set Preventive Care Services-Initial Office Visit, 18 and Up",
          "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023"
        },
        {
          "type" : "depends-on",
          "display" : "Value set Home Healthcare Services",
          "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016"
        },
        {
          "type" : "depends-on",
          "display" : "Value set Payer",
          "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"
        },
        {
          "type" : "depends-on",
          "display" : "Value set Encounter Inpatient",
          "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307"
        },
        {
          "type" : "depends-on",
          "display" : "Value set Hospice care ambulatory",
          "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.15"
        },
        {
          "type" : "depends-on",
          "display" : "Value set Status Post Right Mastectomy",
          "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1070"
        },
        {
          "type" : "depends-on",
          "display" : "Value set Unilateral Mastectomy, Unspecified Laterality",
          "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1071"
        },
        {
          "type" : "depends-on",
          "display" : "Value set Right",
          "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.122.12.1035"
        },
        {
          "type" : "depends-on",
          "display" : "Value set Unilateral Mastectomy Right",
          "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1134"
        },
        {
          "type" : "depends-on",
          "display" : "Value set Status Post Left Mastectomy",
          "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1069"
        },
        {
          "type" : "depends-on",
          "display" : "Value set Left",
          "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.122.12.1036"
        },
        {
          "type" : "depends-on",
          "display" : "Value set Unilateral Mastectomy Left",
          "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1133"
        },
        {
          "type" : "depends-on",
          "display" : "Value set History of bilateral mastectomy",
          "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1068"
        },
        {
          "type" : "depends-on",
          "display" : "Value set Bilateral Mastectomy",
          "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1005"
        },
        {
          "type" : "depends-on",
          "display" : "Value set Frailty Device",
          "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.118.12.1300"
        },
        {
          "type" : "depends-on",
          "display" : "Value set Frailty Diagnosis",
          "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.113.12.1074"
        },
        {
          "type" : "depends-on",
          "display" : "Value set Frailty Encounter",
          "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1088"
        },
        {
          "type" : "depends-on",
          "display" : "Value set Frailty Symptom",
          "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.113.12.1075"
        },
        {
          "type" : "depends-on",
          "display" : "Value set Outpatient",
          "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1087"
        },
        {
          "type" : "depends-on",
          "display" : "Value set Observation",
          "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1086"
        },
        {
          "type" : "depends-on",
          "display" : "Value set ED",
          "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1085"
        },
        {
          "type" : "depends-on",
          "display" : "Value set Nonacute Inpatient",
          "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1084"
        },
        {
          "type" : "depends-on",
          "display" : "Value set Advanced Illness",
          "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1082"
        },
        {
          "type" : "depends-on",
          "display" : "Value set Acute Inpatient",
          "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1083"
        },
        {
          "type" : "depends-on",
          "display" : "Value set Dementia Medications",
          "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.196.12.1510"
        },
        {
          "type" : "depends-on",
          "display" : "Value set Care Services in Long-Term Residential Facility",
          "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1014"
        },
        {
          "type" : "depends-on",
          "display" : "Value set Nursing Facility Visit",
          "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1012"
        }
      ],
      "parameter" : [
        {
          "name" : "Measurement Period",
          "use" : "in",
          "min" : 0,
          "max" : "1",
          "type" : "Period"
        },
        {
          "name" : "SDE Sex",
          "use" : "out",
          "min" : 0,
          "max" : "1",
          "type" : "Coding"
        },
        {
          "name" : "Numerator",
          "use" : "out",
          "min" : 0,
          "max" : "1",
          "type" : "boolean"
        },
        {
          "name" : "Denominator",
          "use" : "out",
          "min" : 0,
          "max" : "1",
          "type" : "boolean"
        },
        {
          "name" : "SDE Payer",
          "use" : "out",
          "min" : 0,
          "max" : "*",
          "type" : "Any"
        },
        {
          "name" : "Initial Population",
          "use" : "out",
          "min" : 0,
          "max" : "1",
          "type" : "boolean"
        },
        {
          "name" : "SDE Ethnicity",
          "use" : "out",
          "min" : 0,
          "max" : "*",
          "type" : "Coding"
        },
        {
          "name" : "Denominator Exclusion",
          "use" : "out",
          "min" : 0,
          "max" : "1",
          "type" : "boolean"
        },
        {
          "name" : "SDE Race",
          "use" : "out",
          "min" : 0,
          "max" : "*",
          "type" : "Coding"
        }
      ],
      "dataRequirement" : [
        {
          "type" : "Coverage",
          "profile" : [
            "http://hl7.org/fhir/StructureDefinition/Coverage"
          ],
          "mustSupport" : [
            "period",
            "type"
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          "codeFilter" : [
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              "path" : "type",
              "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"
            }
          ]
        },
        {
          "type" : "Patient",
          "profile" : [
            "http://hl7.org/fhir/StructureDefinition/Patient"
          ],
          "mustSupport" : [
            "extension",
            "value",
            "url"
          ]
        },
        {
          "type" : "Encounter",
          "profile" : [
            "http://hl7.org/fhir/StructureDefinition/Encounter"
          ],
          "mustSupport" : [
            "type"
          ],
          "codeFilter" : [
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              "path" : "type",
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            }
          ]
        },
        {
          "type" : "Encounter",
          "profile" : [
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          ],
          "mustSupport" : [
            "type"
          ],
          "codeFilter" : [
            {
              "path" : "type",
              "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1012"
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          ]
        },
        {
          "type" : "Encounter",
          "profile" : [
            "http://hl7.org/fhir/StructureDefinition/Encounter"
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          "mustSupport" : [
            "type"
          ],
          "codeFilter" : [
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              "path" : "type",
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            }
          ]
        },
        {
          "type" : "Encounter",
          "profile" : [
            "http://hl7.org/fhir/StructureDefinition/Encounter"
          ],
          "mustSupport" : [
            "type"
          ],
          "codeFilter" : [
            {
              "path" : "type",
              "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240"
            }
          ]
        },
        {
          "type" : "Encounter",
          "profile" : [
            "http://hl7.org/fhir/StructureDefinition/Encounter"
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          "mustSupport" : [
            "type"
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          "codeFilter" : [
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              "path" : "type",
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            }
          ]
        },
        {
          "type" : "Encounter",
          "profile" : [
            "http://hl7.org/fhir/StructureDefinition/Encounter"
          ],
          "mustSupport" : [
            "type"
          ],
          "codeFilter" : [
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              "path" : "type",
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          ]
        },
        {
          "type" : "Encounter",
          "profile" : [
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          "mustSupport" : [
            "type"
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          "codeFilter" : [
            {
              "path" : "type",
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            }
          ]
        },
        {
          "type" : "Encounter",
          "profile" : [
            "http://hl7.org/fhir/StructureDefinition/Encounter"
          ],
          "mustSupport" : [
            "period",
            "diagnosis",
            "type"
          ],
          "codeFilter" : [
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            }
          ]
        },
        {
          "type" : "Encounter",
          "profile" : [
            "http://hl7.org/fhir/StructureDefinition/Encounter"
          ],
          "mustSupport" : [
            "period",
            "hospitalization",
            "hospitalization.dischargeDisposition",
            "type",
            "status"
          ],
          "codeFilter" : [
            {
              "path" : "type",
              "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307"
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          ]
        },
        {
          "type" : "Encounter",
          "profile" : [
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          "mustSupport" : [
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          "codeFilter" : [
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              "path" : "type",
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          ]
        },
        {
          "type" : "Encounter",
          "profile" : [
            "http://hl7.org/fhir/StructureDefinition/Encounter"
          ],
          "mustSupport" : [
            "type"
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          "codeFilter" : [
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          ]
        },
        {
          "type" : "Encounter",
          "profile" : [
            "http://hl7.org/fhir/StructureDefinition/Encounter"
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          "mustSupport" : [
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          "codeFilter" : [
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              "path" : "type",
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        },
        {
          "type" : "Encounter",
          "profile" : [
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          "codeFilter" : [
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        },
        {
          "type" : "Encounter",
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        },
        {
          "type" : "Procedure",
          "profile" : [
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          "mustSupport" : [
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        },
        {
          "type" : "Procedure",
          "profile" : [
            "http://hl7.org/fhir/StructureDefinition/Procedure"
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          "mustSupport" : [
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            "status"
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          "codeFilter" : [
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              "path" : "code",
              "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.15"
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          ]
        },
        {
          "type" : "Procedure",
          "profile" : [
            "http://hl7.org/fhir/StructureDefinition/Procedure"
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          "mustSupport" : [
            "code",
            "performed",
            "status"
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          "codeFilter" : [
            {
              "path" : "code",
              "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1005"
            }
          ]
        },
        {
          "type" : "Procedure",
          "profile" : [
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}