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 
| Active as of 2022-02-22 |
{
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"status" : "extensions",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <table class=\"grid dict\">\n \n <tr>\n <th scope=\"row\"><b>Id: </b></th>\n <td style=\"padding-left: 4px;\">measure-exm</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/measure-exm</td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Version: </b></th>\n <td style=\"padding-left: 4px;\">2.0.0</td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Identifier: </b></th>\n <td style=\"padding-left: 4px;\">\n \n \n <p style=\"margin-bottom: 5px;\">\n <b>value: </b> <span>EXM</span>\n </p>\n \n </td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Name: </b></th>\n <td style=\"padding-left: 4px;\">MeasureEXM</td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Title: </b></th>\n <td style=\"padding-left: 4px;\">EXM Measure</td>\n </tr>\n \n \n \n <tr>\n <th scope=\"row\"><b>Status: </b></th>\n <td style=\"padding-left: 4px;\">active</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 <p style=\"margin-bottom: 5px;\">\n <b>display: </b> <span>Increased score indicates improvement</span>\n </p>\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;\">2022-02-22</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;\">An example FHIR-based measure</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 Race</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 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 <tr>\n <th scope=\"row\"><b>Use Context: </b></th>\n <td style=\"padding-left: 4px;\">\n <table class=\"grid-dict\">\n <tr><th><b>code</b></th><th><b>value</b></th></tr>\n \n <tr>\n <td>program</td>\n <td>eligible-provider</td>\n </tr>\n \n </table>\n </td>\n </tr>\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 <tr>\n <th scope=\"row\"><b>Topic: </b></th>\n <td style=\"padding-left: 25px;\">57024-2</td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Purpose: </b></th>\n <td style=\"padding-left: 4px;\">The purpose of this measure is to...</td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Usage: </b></th>\n <td style=\"padding-left: 4px;\">Users of this measure should be aware of...</td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Copyright: </b></th>\n <td style=\"padding-left: 25px;\">Example Copyright Statement</td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Disclaimer: </b></th>\n <td style=\"padding-left: 25px;\">Example disclaimer</td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Approval Date: </b></th>\n <td style=\"padding-left: 4px;\">2019-02-17</td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Last Review Date: </b></th>\n <td style=\"padding-left: 4px;\">2019-02-17</td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Effective Period: </b></th>\n <td style=\"padding-left: 4px;\">2018-01-01..2018-12-31</td>\n </tr>\n \n \n \n \n \n \n </table>\n</div>"
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"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
"valueCoding" : {
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"code" : "billing",
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}
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"valueString" : "EXMLogic"
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"valueString" : "SDE Sex"
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"url" : "statement",
"valueString" : "define \"Inpatient Encounter\" :\n [\"Encounter\"] Encounter\n where LengthInDays(Encounter.period) <= 120\n and Encounter.period ends during \"Measurement Period\""
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"url" : "statement",
"valueString" : "define \"SDE Payer\":\n [Coverage: type in \"Payer\"] Payer\n return {\n code: Payer.type,\n period: Payer.period\n }"
},
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"url" : "displaySequence",
"valueInteger" : 4
}
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"url" : "name",
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"url" : "statement",
"valueString" : "define \"Initial Population\" :\n \"Inpatient Encounter\" Encounter"
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"url" : "statement",
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"url" : "libraryName",
"valueString" : "EXMLogic"
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{
"url" : "name",
"valueString" : "SDE Race"
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{
"url" : "statement",
"valueString" : "define \"SDE Race\":\n (flatten (\n Patient.extension Extension\n where Extension.url = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-race'\n return Extension.extension\n )) E\n where E.url = 'ombCategory'\n or E.url = 'detailed'\n return E.value as Coding"
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"valueInteger" : 7
}
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{
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"url" : "statement",
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"valueInteger" : 8
}
],
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{
"extension" : [
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"url" : "libraryName",
"valueString" : "EXMLogic"
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"url" : "name",
"valueString" : "Stratifier 2"
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{
"url" : "statement",
"valueString" : "define \"Stratifier 2\" :\n \"Inpatient Encounter\" Encounter\n where PrincipalDiagnosis(Encounter).code in \"Psychiatric/Mental Health Patient\""
},
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"url" : "displaySequence",
"valueInteger" : 9
}
],
"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"
}
]
},
"relatedArtifact" : [
{
"type" : "depends-on",
"display" : "Library FHIRHelpers",
"resource" : "http://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1"
},
{
"type" : "depends-on",
"display" : "Code system Diagnosis Role",
"resource" : "http://terminology.hl7.org/CodeSystem/diagnosis-role"
},
{
"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 Psychiatric/Mental Health Patient",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.299"
}
],
"parameter" : [
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"name" : "Measurement Period",
"use" : "in",
"min" : 0,
"max" : "1",
"type" : "Period"
},
{
"name" : "SDE Sex",
"use" : "out",
"min" : 0,
"max" : "1",
"type" : "Coding"
},
{
"name" : "Stratifier 3",
"use" : "out",
"min" : 0,
"max" : "*",
"type" : "Encounter"
},
{
"name" : "Stratifier 4",
"use" : "out",
"min" : 0,
"max" : "*",
"type" : "Encounter"
},
{
"name" : "SDE Payer",
"use" : "out",
"min" : 0,
"max" : "*",
"type" : "Any"
},
{
"name" : "Initial Population",
"use" : "out",
"min" : 0,
"max" : "*",
"type" : "Encounter"
},
{
"name" : "SDE Ethnicity",
"use" : "out",
"min" : 0,
"max" : "*",
"type" : "Coding"
},
{
"name" : "SDE Race",
"use" : "out",
"min" : 0,
"max" : "*",
"type" : "Coding"
},
{
"name" : "Stratifier 1",
"use" : "out",
"min" : 0,
"max" : "*",
"type" : "Encounter"
},
{
"name" : "Stratifier 2",
"use" : "out",
"min" : 0,
"max" : "*",
"type" : "Encounter"
}
],
"dataRequirement" : [
{
"extension" : [
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-fhirQueryPattern",
"valueString" : "Patient?_id={{context.patientId}}"
}
],
"type" : "Patient",
"profile" : [
"http://hl7.org/fhir/StructureDefinition/Patient"
]
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-fhirQueryPattern",
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},
{
"extension" : [
{
"url" : "path",
"valueString" : "url"
},
{
"url" : "comparator",
"valueCode" : "eq"
},
{
"url" : "value",
"valueString" : "http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity"
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-valueFilter"
}
],
"type" : "Patient",
"profile" : [
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"mustSupport" : [
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},
{
"extension" : [
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"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-fhirQueryPattern",
"valueString" : "Patient?_id={{context.patientId}}"
}
],
"type" : "Patient",
"profile" : [
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"mustSupport" : [
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"codeFilter" : [
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"path" : "url",
"code" : [
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"system" : "urn:ietf:rfc:3986",
"code" : "http://hl7.org/fhir/us/core/StructureDefinition/us-core-race"
}
]
}
]
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-fhirQueryPattern",
"valueString" : "Encounter?subject=Patient/{{context.patientId}}"
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-isSelective",
"valueBoolean" : true
}
],
"type" : "Encounter",
"profile" : [
"http://hl7.org/fhir/StructureDefinition/Encounter"
],
"mustSupport" : [
"period"
],
"dateFilter" : [
{
"path" : "period",
"valuePeriod" : {
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-expression",
"valueExpression" : {
"language" : "text/cql-identifier",
"expression" : "Measurement Period"
}
}
]
}
}
]
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-fhirQueryPattern",
"valueString" : "Coverage?policy-holder=Patient/{{context.patientId}}&type:in=http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"
}
],
"type" : "Coverage",
"profile" : [
"http://hl7.org/fhir/StructureDefinition/Coverage"
],
"mustSupport" : [
"type",
"period"
],
"codeFilter" : [
{
"path" : "type",
"valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"
}
]
}
]
}
],
"extension" : [
{
"extension" : [
{
"url" : "type",
"valueCode" : "documentation"
},
{
"url" : "text",
"valueString" : "This illustrates an example comment"
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-artifactComment"
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis",
"valueCode" : "Encounter"
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-allocation",
"valueMarkdown" : "Additional guidance for allocation"
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-softwaresystem",
"valueReference" : {
"reference" : "Device/software-system-example"
}
},
{
"id" : "effective-data-requirements",
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-effectiveDataRequirements",
"valueReference" : {
"reference" : "#effective-data-requirements"
}
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/Measure/measure-exm",
"identifier" : [
{
"system" : "http://example.org/fhir/cqi/ecqm/Measure/Identifier/exm",
"value" : "EXM"
}
],
"version" : "2.0.0",
"name" : "MeasureEXM",
"title" : "EXM Measure",
"status" : "active",
"experimental" : true,
"date" : "2022-02-22",
"publisher" : "Clinical Quality Information WG",
"contact" : [
{
"telecom" : [
{
"system" : "url",
"value" : "http://www.hl7.org/Special/committees/cqi"
}
]
}
],
"description" : "An example FHIR-based measure",
"useContext" : [
{
"code" : {
"system" : "http://terminology.hl7.org/CodeSystem/usage-context-type",
"code" : "program"
},
"valueCodeableConcept" : {
"text" : "eligible-provider"
}
}
],
"jurisdiction" : [
{
"coding" : [
{
"system" : "urn:iso:std:iso:3166",
"code" : "US"
}
]
}
],
"purpose" : "The purpose of this measure is to...",
"usage" : "Users of this measure should be aware of...",
"copyright" : "Example Copyright Statement",
"approvalDate" : "2019-02-17",
"lastReviewDate" : "2019-02-17",
"effectivePeriod" : {
"extension" : [
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-effectivePeriodAnchor",
"valueDateTime" : "2018-01-01"
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-effectivePeriodDuration",
"valueDuration" : {
"value" : 1,
"system" : "http://unitsofmeasure.org",
"code" : "a"
}
}
],
"start" : "2018-01-01",
"end" : "2018-12-31"
},
"topic" : [
{
"coding" : [
{
"system" : "http://loinc.org",
"code" : "57024-2"
}
],
"text" : "Health Quality Measure Document"
}
],
"author" : [
{
"name" : "Example Measure Content Developer"
}
],
"library" : [
"http://hl7.org/fhir/us/cqfmeasures/Library/EXMLogic"
],
"disclaimer" : "Example disclaimer",
"scoring" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-scoring",
"code" : "proportion",
"display" : "Proportion"
}
]
},
"type" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-type",
"code" : "process"
}
]
}
],
"riskAdjustment" : "Risk adjustment for this measure is performed by...",
"rateAggregation" : "Rate aggregation for this measure is performed by...",
"rationale" : "Rationale for this measure is...",
"clinicalRecommendationStatement" : "The clinical recommendation statement for this measure is...",
"improvementNotation" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-improvement-notation",
"code" : "increase",
"display" : "Increased score indicates improvement"
}
]
},
"_definition" : [
{
"extension" : [
{
"extension" : [
{
"url" : "term",
"valueString" : "Term"
},
{
"url" : "definition",
"valueMarkdown" : "A term used in the measure that bears clearly definition to communicate the measure intent"
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-definitionTerm"
}
]
}
],
"guidance" : "Additional guidance provided to help communicate the intent of the measure",
"group" : [
{
"id" : "group-1",
"code" : {
"coding" : [
{
"display" : "group-1"
}
]
},
"population" : [
{
"id" : "initial-population-1",
"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" : "numerator",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "numerator",
"display" : "Numerator"
}
]
},
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Numerator"
}
},
{
"id" : "denominator",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "denominator",
"display" : "Denominator"
}
]
},
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Denominator"
}
}
],
"stratifier" : [
{
"id" : "stratifier-1",
"extension" : [
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population"
}
],
"text" : "initial-population"
}
}
],
"code" : {
"text" : "Stratifier 1"
},
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Stratifier 1"
}
},
{
"id" : "stratifier-2",
"extension" : [
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population"
}
],
"text" : "initial-population"
}
}
],
"code" : {
"text" : "Stratifier 2"
},
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Stratifier 2"
}
},
{
"id" : "stratifier-3",
"extension" : [
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population"
}
],
"text" : "initial-population"
}
}
],
"code" : {
"text" : "Stratifier 3"
},
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Stratifier 3"
}
},
{
"id" : "stratifier-4",
"extension" : [
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population"
}
],
"text" : "initial-population"
}
}
],
"code" : {
"text" : "Stratifier 4"
},
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Stratifier 4"
}
}
]
}
],
"supplementalData" : [
{
"id" : "sde-ethnicity",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "supplemental-data"
}
]
}
],
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "SDE Ethnicity"
}
},
{
"id" : "sde-race",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "supplemental-data"
}
]
}
],
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "SDE Race"
}
},
{
"id" : "sde-payer",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "supplemental-data"
}
]
}
],
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "SDE Payer"
}
},
{
"id" : "sde-sex",
"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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