Quality Measure Implementation Guide (STU3)
3.0.0 - STU 3
US
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 
| Draft as of 2022-02-22 |
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"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;\">TSCComponent</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/TSCComponent</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;\">TSCComponent</td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Title: </b></th>\n <td style=\"padding-left: 4px;\">Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention</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;\">2022-02-22T11:37:04-06:00</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>"
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"url" : "name",
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"url" : "statement",
"valueString" : "define \"Most Recent Tobacco Use Screening Indicates Tobacco Non User\": ( Last([\"Observation\": \"Tobacco Use Screening\"] TobaccoUseScreening where Global.\"Normalize Interval\"(TobaccoUseScreening.effective)overlaps \"Measurement Period\" sort by start of Global.\"Normalize Interval\"(effective) )) MostRecentTobaccoUseScreening where MostRecentTobaccoUseScreening.value in \"Tobacco Non-User\""
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"extension" : [
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"url" : "name",
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"url" : "statement",
"valueString" : "define \"Most Recent Tobacco Use Screening Indicates Tobacco User\": ( Last([\"Observation\": \"Tobacco Use Screening\"] TobaccoUseScreening where Global.\"Normalize Interval\"(TobaccoUseScreening.effective)overlaps \"Measurement Period\" sort by start of Global.\"Normalize Interval\"(effective) )) MostRecentTobaccoUseScreening where MostRecentTobaccoUseScreening.value in \"Tobacco User\""
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"valueString" : "Tobacco Cessation Counseling Given"
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"valueString" : "// MedicationStatement is not available in R5, known publication issue //define \"Active Pharmacotherapy for Tobacco Cessation\": // [\"MedicationStatement\": \"Tobacco Use Cessation Pharmacotherapy\"] TakingCessationPharmacotherapy // where Global.\"Normalize Interval\" ( TakingCessationPharmacotherapy.effective ) overlaps after \"Measurement Period\" // and TakingCessationPharmacotherapy.status in { 'active', 'completed' } define \"Tobacco Cessation Counseling Given\": [\"Encounter\": \"Tobacco Use Cessation Counseling\"] TobaccoCessationCounseling where TobaccoCessationCounseling.period during \"Measurement Period\" and TobaccoCessationCounseling.status = 'finished'"
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"valueString" : "define \"Tobacco Cessation Pharmacotherapy Ordered\": [\"MedicationRequest\": \"Tobacco Use Cessation Pharmacotherapy\"] CessationPharmacotherapyOrdered where CessationPharmacotherapyOrdered.authoredOn during \"Measurement Period\" and CessationPharmacotherapyOrdered.status = 'active'"
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"valueString" : "define \"Numerator 3\": \"Most Recent Tobacco Use Screening Indicates Tobacco Non User\" is not null or ( \"Most Recent Tobacco Use Screening Indicates Tobacco User\" is not null and ( exists \"Tobacco Cessation Counseling Given\" or exists \"Tobacco Cessation Pharmacotherapy Ordered\" //or exists \"Active Pharmacotherapy for Tobacco Cessation\" ) )"
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"valueString" : "define \"Medical Reason for Not Screening for Tobacco Use\": [\"Observation\": \"Tobacco Use Screening\"] NoTobaccoUseScreening where NoTobaccoUseScreening.issued during \"Measurement Period\" and \"Not Done\"(NoTobaccoUseScreening) and \"Not Done Reason in Medical Reason\"(NoTobaccoUseScreening) and NoTobaccoUseScreening.status = 'final'"
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"valueString" : "Has Limited Life Expectancy"
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"valueString" : "//or exists \"Active Pharmacotherapy for Tobacco Cessation\" define \"Has Limited Life Expectancy\": exists ( [\"Condition\"] LimitedLifeExpectancy where Global.\"Prevalence Period\" ( LimitedLifeExpectancy ) overlaps after \"Measurement Period\" and LimitedLifeExpectancy.clinicalStatus ~ ToConcept(Global.\"active\") )"
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"valueString" : "TSCComponent"
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"url" : "name",
"valueString" : "Denominator Exceptions 1"
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"url" : "statement",
"valueString" : "define \"Denominator Exceptions 1\": exists \"Medical Reason for Not Screening for Tobacco Use\" or \"Has Limited Life Expectancy\""
},
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"valueInteger" : 7
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"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
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"url" : "libraryName",
"valueString" : "TSCComponent"
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"url" : "name",
"valueString" : "Numerator 1"
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"url" : "statement",
"valueString" : "define \"Numerator 1\": \"Most Recent Tobacco Use Screening Indicates Tobacco Non User\" is not null or \"Most Recent Tobacco Use Screening Indicates Tobacco User\" is not null"
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"url" : "displaySequence",
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"url" : "name",
"valueString" : "Numerator 2"
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"url" : "statement",
"valueString" : "define \"Numerator 2\": exists \"Tobacco Cessation Counseling Given\" or exists \"Tobacco Cessation Pharmacotherapy Ordered\""
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"url" : "displaySequence",
"valueInteger" : 9
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"extension" : [
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"url" : "libraryName",
"valueString" : "SupplementalDataElements"
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"url" : "name",
"valueString" : "SDE Race"
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{
"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"
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"valueInteger" : 10
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"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
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"url" : "libraryName",
"valueString" : "TSCComponent"
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"url" : "name",
"valueString" : "SDE Race"
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"url" : "statement",
"valueString" : "define \"SDE Race\": SDE.\"SDE Race\""
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"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
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"extension" : [
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"url" : "libraryName",
"valueString" : "SupplementalDataElements"
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{
"url" : "name",
"valueString" : "SDE Sex"
},
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"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"
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"extension" : [
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"url" : "libraryName",
"valueString" : "TSCComponent"
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"url" : "name",
"valueString" : "SDE Sex"
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"url" : "statement",
"valueString" : "define \"SDE Sex\": SDE.\"SDE Sex\""
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"url" : "displaySequence",
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"url" : "libraryName",
"valueString" : "TSCComponent"
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"url" : "statement",
"valueString" : "define \"Office Based Visit During Measurement Period\": ( [\"Encounter\": \"Health behavior intervention, individual, face-to-face; initial 30 minutes\"] union [\"Encounter\": \"Health behavior assessment, or re-assessment (ie, health-focused clinical interview, behavioral observations, clinical decision making)\"] union [\"Encounter\": \"Home Healthcare Services\"] union [\"Encounter\": \"Occupational Therapy Evaluation\"] union [\"Encounter\": \"Office Visit\"] union [\"Encounter\": \"Ophthalmological Services\"] union [\"Encounter\": \"Physical Therapy Evaluation\"] union [\"Encounter\": \"Psych Visit - Diagnostic Evaluation\"] union [\"Encounter\": \"Psych Visit - Psychotherapy\"] union [\"Encounter\": \"Psychoanalysis\"] union [\"Encounter\": \"Speech and Hearing Evaluation\"] ) OfficeBasedEncounter where OfficeBasedEncounter.period during \"Measurement Period\" and OfficeBasedEncounter.status = 'finished'"
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"url" : "libraryName",
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"url" : "statement",
"valueString" : "define \"Preventive Visit During Measurement Period\": ( [\"Encounter\": \"Annual Wellness Visit\"] union [\"Encounter\": \"Preventive Care Services - Established Office Visit, 18 and Up\"] union [\"Encounter\": \"Preventive Care Services - Group Counseling\"] union [\"Encounter\": \"Preventive Care Services - Other\"] union [\"Encounter\": \"Preventive Care Services-Individual Counseling\"] union [\"Encounter\": \"Preventive Care Services-Initial Office Visit, 18 and Up\"] ) PreventiveEncounter where PreventiveEncounter.period during \"Measurement Period\" and PreventiveEncounter.status = 'finished'"
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"valueString" : "TSCComponent"
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"url" : "name",
"valueString" : "Initial Population"
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"url" : "statement",
"valueString" : "define \"Initial Population\": exists ( [\"Patient\"] BirthDate where Global.\"CalendarAgeInYearsAt\" ( FHIRHelpers.ToDate ( BirthDate.birthDate ), start of \"Measurement Period\" ) >= 18 ) and ( Count(\"Office Based Visit During Measurement Period\")>= 2 or exists \"Preventive Visit During Measurement Period\" )"
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"url" : "statement",
"valueString" : "define \"Denominator 3\": \"Initial Population\""
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"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
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"valueString" : "TSCComponent"
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"url" : "name",
"valueString" : "Denominator 2"
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"url" : "statement",
"valueString" : "define \"Denominator 2\": \"Initial Population\" and \"Most Recent Tobacco Use Screening Indicates Tobacco User\" is not null"
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"valueInteger" : 18
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"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
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"url" : "libraryName",
"valueString" : "SupplementalDataElements"
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"url" : "name",
"valueString" : "SDE Payer"
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"url" : "statement",
"valueString" : "define \"SDE Payer\": [Coverage: type in \"Payer\"] Payer return { code: Payer.type, period: Payer.period }"
},
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"url" : "displaySequence",
"valueInteger" : 19
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"url" : "libraryName",
"valueString" : "TSCComponent"
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"url" : "name",
"valueString" : "SDE Payer"
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"url" : "statement",
"valueString" : "define \"SDE Payer\": SDE.\"SDE Payer\""
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"url" : "displaySequence",
"valueInteger" : 20
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"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
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"extension" : [
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"url" : "libraryName",
"valueString" : "SupplementalDataElements"
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"url" : "name",
"valueString" : "SDE Ethnicity"
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"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"
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"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
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"extension" : [
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"url" : "libraryName",
"valueString" : "TSCComponent"
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"url" : "name",
"valueString" : "SDE Ethnicity"
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"url" : "statement",
"valueString" : "define \"SDE Ethnicity\": SDE.\"SDE Ethnicity\""
},
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"url" : "displaySequence",
"valueInteger" : 22
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
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"extension" : [
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"url" : "libraryName",
"valueString" : "TSCComponent"
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{
"url" : "name",
"valueString" : "Medical Reason for Not Counseling Tobacco User"
},
{
"url" : "statement",
"valueString" : "define \"Medical Reason for Not Counseling Tobacco User\": [\"Procedure\": \"Tobacco Use Cessation Counseling\"] NoTobaccoCessationCounseling where Global.\"Normalize Interval\" ( NoTobaccoCessationCounseling.performed ) starts during \"Measurement Period\" and ( ( NoTobaccoCessationCounseling.status = 'not-done' and NoTobaccoCessationCounseling.statusReason in \"Medical Reason\" ) or ( \"Not Done\"(NoTobaccoCessationCounseling) and \"Not Done Reason in Medical Reason\"(NoTobaccoCessationCounseling) ) )"
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"valueString" : "TSCComponent"
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"url" : "name",
"valueString" : "Medical Reason for Not Ordering Tobacco Cessation Pharmacotherapy"
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"url" : "statement",
"valueString" : "define \"Medical Reason for Not Ordering Tobacco Cessation Pharmacotherapy\": [\"MedicationRequest\": \"Tobacco Use Cessation Pharmacotherapy\"] NoCessationPharmacotherapyOrdered where NoCessationPharmacotherapyOrdered.authoredOn during \"Measurement Period\" and NoCessationPharmacotherapyOrdered.status = 'completed' and ( ( \"Not Done\"(NoCessationPharmacotherapyOrdered) and \"Not Done Reason in Medical Reason\"(NoCessationPharmacotherapyOrdered) ) or ( NoCessationPharmacotherapyOrdered.doNotPerform = true and NoCessationPharmacotherapyOrdered.statusReason in \"Medical Reason\" ) )"
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"extension" : [
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"url" : "libraryName",
"valueString" : "TSCComponent"
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{
"url" : "name",
"valueString" : "Denominator Exceptions 2"
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{
"url" : "statement",
"valueString" : "define \"Denominator Exceptions 2\": exists \"Medical Reason for Not Counseling Tobacco User\" or exists \"Medical Reason for Not Ordering Tobacco Cessation Pharmacotherapy\" or \"Has Limited Life Expectancy\""
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"url" : "name",
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{
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{
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"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "denominator",
"display" : "Denominator"
}
]
},
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Denominator 2"
}
},
{
"id" : "3AE470CD-37DF-492D-A3A4-365BAF744C5A",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "denominator-exception",
"display" : "Denominator Exception"
}
]
},
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Denominator Exceptions 2"
}
},
{
"id" : "B1F8B729-7BBD-4616-B39C-E90444B7884C",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "numerator",
"display" : "Numerator"
}
]
},
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Numerator 2"
}
}
]
},
{
"id" : "group-3",
"code" : {
"text" : "Group 3"
},
"population" : [
{
"id" : "EA2696EE-326B-490A-82B5-E4D8FC581E77",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "initial-population",
"display" : "Initial Population"
}
]
},
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Initial Population"
}
},
{
"id" : "D346BB79-EFD1-4DB1-902A-36F027BE75E9",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "denominator",
"display" : "Denominator"
}
]
},
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Denominator 3"
}
},
{
"id" : "6BBFE753-2072-4848-B189-0E5B44BE1F52",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "denominator-exception",
"display" : "Denominator Exception"
}
]
},
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Denominator Exceptions 3"
}
},
{
"id" : "F8E22F0F-7307-4BED-9295-648803772928",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "numerator",
"display" : "Numerator"
}
]
},
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Numerator 3"
}
}
]
}
],
"supplementalData" : [
{
"id" : "fe7bab72-cc69-44bb-a678-473b24811e67",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "supplemental-data"
}
]
}
],
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "SDE Ethnicity"
}
},
{
"id" : "2486f84d-df90-489b-8f5c-e55cdcfb361e",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "supplemental-data"
}
]
}
],
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "SDE Payer"
}
},
{
"id" : "bb0949c4-1f7b-4ce2-a988-c2e60f1a0079",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "supplemental-data"
}
]
}
],
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "SDE Race"
}
},
{
"id" : "742028bc-5aa5-4a5b-927d-be1908e10aaf",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "supplemental-data"
}
]
}
],
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "SDE Sex"
}
}
]
}
IG © 2019+ Clinical Quality Information WG. Package hl7.fhir.us.cqfmeasures#3.0.0 based on FHIR 4.0.1. Generated 2022-04-28
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