Quality Measure Implementation Guide (STU4)
4.0.0 - STU4
Quality Measure Implementation Guide (STU4)
4.0.0 - STU4
This page is part of the Quality Measure STU2 for FHIR R4 Implementation Guide (v4.0.0: STU4 (v4.0.0)) 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 2019-09-03 |
{
"resourceType" : "Library",
"id" : "EXMComputableLibrary",
"meta" : {
"profile" : [
"http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-library-cqfm"
]
},
"text" : {
"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;\"><a href=\"Library-EXMComputableLibrary.html\">Example Computable Library</a></td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Url: </b></th>\n <td style=\"padding-left: 4px;\"><a href=\"Library-EXMComputableLibrary.html\">Example Computable Library</a></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>EXMComputableLogic</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;\">EXMComputableLibrary</td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Title: </b></th>\n <td style=\"padding-left: 4px;\">Example Computable Library</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>Type: </b></th>\n <td style=\"padding-left: 4px;\">\n \n \n \n <p style=\"margin-bottom: 5px;\">\n <b>system: </b> <span><a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-library-type.html\">LibraryType</a></span>\n </p>\n \n \n <p style=\"margin-bottom: 5px;\">\n <b>code: </b> <span>logic-library</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;\">2019-09-03</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;\"><div><p>This library is used as an example in the FHIR Quality Measure Implementation Guide</p>\n</div></td>\n </tr>\n \n \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><th><b>display</b></th></tr>\n \n <tr>\n <td>program</td>\n <td>eh-cah</td>\n <td>EH/CAH</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: 4px;\">US</td>\n </tr>\n \n \n \n \n \n <tr>\n <th scope=\"row\"><b>Approval Date: </b></th>\n <td style=\"padding-left: 4px;\">2019-08-03</td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Last Review Date: </b></th>\n <td style=\"padding-left: 4px;\">2019-08-03</td>\n </tr>\n \n \n \n <tr>\n <th scope=\"row\"><b>Related Artifacts: </b></th>\n <td style=\"padding-left: 4px;\">\n \n \n \n <p><b>Dependencies</b></p>\n <ul>\n \n <li><a href=\"http://fhir.org/guides/common/Library/FHIR-ModelInfo|4.0.1\">http://fhir.org/guides/common/Library/FHIR-ModelInfo|4.0.1</a></li>\n \n <li><a href=\"http://fhir.org/guides/common/Library/FHIRHelpers|4.0.1\">http://fhir.org/guides/common/Library/FHIRHelpers|4.0.1</a></li>\n \n <li><a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-diagnosis-role.html\">Diagnosis Role</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.292/expansion\">Emergency Department Visit</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.299/expansion\">Psychiatric/Mental Health Diagnosis</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1111.126/expansion\">Hospital Settings</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1/expansion\">ONC Administrative Sex</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.114222.4.11.836/expansion\">Race</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.114222.4.11.837/expansion\">Ethnicity</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.114222.4.11.3591/expansion\">Payer</a></li>\n \n </ul>\n \n \n \n \n \n </td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Parameters: </b></th>\n <td style=\"padding-left: 4px;\">\n <table class=\"grid-dict\">\n <tr><th><b>Name</b></th><th><b>Type</b></th><th><b>Min</b></th><th><b>Max</b></th><th><b>In/Out</b></th></tr>\n \n <tr><th>Measurement Period</th><th>Period</th><th>0</th><th>1</th><th>in</th></tr>\n \n <tr><th>Patient</th><th>Patient</th><th>0</th><th>1</th><th>out</th></tr>\n \n <tr><th>Inpatient Encounter</th><th>Encounter</th><th>0</th><th>*</th><th>out</th></tr>\n \n <tr><th>Initial Population</th><th>Encounter</th><th>0</th><th>*</th><th>out</th></tr>\n \n <tr><th>Measure Population</th><th>Encounter</th><th>0</th><th>*</th><th>out</th></tr>\n \n <tr><th>Stratifier 1</th><th>Encounter</th><th>0</th><th>*</th><th>out</th></tr>\n \n <tr><th>Stratifier 2</th><th>Encounter</th><th>0</th><th>*</th><th>out</th></tr>\n \n <tr><th>Stratifier 3</th><th>Encounter</th><th>0</th><th>*</th><th>out</th></tr>\n \n <tr><th>Stratifier 4</th><th>Encounter</th><th>0</th><th>*</th><th>out</th></tr>\n \n <tr><th>SDE Ethnicity</th><th>Coding</th><th>0</th><th>*</th><th>out</th></tr>\n \n <tr><th>SDE Payer</th><th>Resource</th><th>0</th><th>*</th><th>out</th></tr>\n \n <tr><th>SDE Race</th><th>Coding</th><th>0</th><th>*</th><th>out</th></tr>\n \n <tr><th>SDE Sex</th><th>Coding</th><th>0</th><th>1</th><th>out</th></tr>\n \n </table>\n </td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Data Requirements:</b></th>\n <td style=\"padding-left: 4px;\">\n <table class=\"grid-dict\">\n <tr><th><b>Type</b></th><th><b>Profile</b></th><th><b>MS</b></th><th><b>Code Filter</b></th></tr>\n \n <tr>\n <th>Encounter</th>\n <th>http://hl7.org/fhir/StructureDefinition/Encounter</th>\n <th></th>\n <th>\n \n </th>\n </tr>\n \n <tr>\n <th>Encounter</th>\n <th>http://hl7.org/fhir/StructureDefinition/Encounter</th>\n <th></th>\n <th>\n \n <b>code filter: </b>\n \n <br/>\n \n \n <span style=\"padding-left: 4px;\">\n <b>path: </b><span>type</span>\n </span>\n \n <br/>\n \n \n \n <span style=\"padding-left: 4px;\">\n <b>value set: </b><span>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292</span>\n </span>\n \n \n \n </th>\n </tr>\n \n <tr>\n <th>Condition</th>\n <th>http://hl7.org/fhir/StructureDefinition/Condition</th>\n <th></th>\n <th>\n \n <b>code filter: </b>\n \n <br/>\n \n \n <span style=\"padding-left: 4px;\">\n <b>path: </b><span>id</span>\n </span>\n \n \n \n \n \n </th>\n </tr>\n \n <tr>\n <th>Coverage</th>\n <th>http://hl7.org/fhir/StructureDefinition/Coverage</th>\n <th></th>\n <th>\n \n <b>code filter: </b>\n \n <br/>\n \n \n <span style=\"padding-left: 4px;\">\n <b>path: </b><span>type</span>\n </span>\n \n <br/>\n \n \n \n <span style=\"padding-left: 4px;\">\n <b>value set: </b><span>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591</span>\n </span>\n \n \n \n </th>\n </tr>\n \n </table>\n </td>\n </tr>\n \n \n \n <tr>\n <td colspan=\"2\">\n <table>\n <tr><th><a id=\"cql-content\"><b>Content: </b></a> text/cql</th></tr>\n <tr><td><pre><code class=\"language-cql\">library EXMComputableLibrary version '2.0.0'\r\n\r\n/*\r\nThis example is purely for illustration purposes to show how all the elements of a\r\nFHIR-based quality measure are represented. It is intentionally simplified to show\r\nspecific aspects of a measure, and is not intended as an example of a clinically\r\nmeaningful measure.\r\n*/\r\n\r\n/*\r\nNOTE: This is the same library as EXMLogic, being used to illustrate the different flavors of profiles:\r\n* Computable: Focusing on computable/design-time aspects\r\n* Executable: Focusing on run-time aspects\r\n* Publishable: Focusing on knowledge management aspects\r\n*/\r\n\r\nusing FHIR version '4.0.1'\r\n\r\ninclude FHIRHelpers version '4.0.1' called FHIRHelpers\r\n\r\ncodesystem "Diagnosis Role": 'http://terminology.hl7.org/CodeSystem/diagnosis-role'\r\n\r\nvalueset "Emergency Department Visit" : 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292'\r\nvalueset "Psychiatric/Mental Health Patient" : 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.299'\r\nvalueset "Hospital Settings" : 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.126'\r\n\r\nvalueset "ONC Administrative Sex": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1'\r\nvalueset "Race": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.836'\r\nvalueset "Ethnicity": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.837'\r\nvalueset "Payer": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591'\r\n\r\ncode "Billing": 'billing' from "Diagnosis Role" display 'Billing'\r\n\r\nparameter "Measurement Period" Interval<DateTime>\r\n\r\ncontext Patient\r\n\r\ndefine "Initial Population" :\r\n "Inpatient Encounter" Encounter\r\n\r\ndefine "Measure Population" :\r\n "Initial Population"\r\n\r\ndefine function "Measure Observation" (Encounter "Encounter" ) :\r\n duration in minutes of "Related ED Visit"(Encounter).period\r\n\r\ndefine "Stratifier 1" :\r\n "Inpatient Encounter" Encounter\r\n where not (PrincipalDiagnosis(Encounter).code in "Psychiatric/Mental Health Patient")\r\n\r\ndefine "Stratifier 2" :\r\n "Inpatient Encounter" Encounter\r\n where PrincipalDiagnosis(Encounter).code in "Psychiatric/Mental Health Patient"\r\n\r\ndefine "Stratifier 3" :\r\n "Inpatient Encounter" Encounter\r\n where PrincipalDiagnosis(Encounter) is null\r\n\r\ndefine "Stratifier 4" :\r\n "Inpatient Encounter" Encounter\r\n where PrincipalDiagnosis(Encounter) is null\r\n\r\ndefine "Inpatient Encounter" :\r\n ["Encounter"] Encounter\r\n where LengthInDays(Encounter.period) <= 120\r\n and Encounter.period ends during "Measurement Period"\r\n\r\ndefine function "PrincipalDiagnosis"(Encounter Encounter):\r\n\t(singleton from (Encounter.diagnosis D where D.use ~ ToConcept("Billing") and D.rank.value = 1)) PD\r\n\t\treturn singleton from ([Condition: id in "GetId"(PD.condition.reference)])\r\n\r\ndefine function "LengthInDays"(Value Interval<DateTime>):\r\n\tdifference in days between start of Value and end of Value\r\n\r\ndefine function "GetId"(uri String):\r\n\tLast(Split(uri, '/'))\r\n\r\n//Measure Observation\r\ndefine function "Related ED Visit" (Encounter "Encounter" ) :\r\n Last(["Encounter" : "Emergency Department Visit"] ED\r\n where ED.status = 'finished'\r\n and ED.period ends 1 hour or less before start of Encounter.period\r\n sort by start of period )\r\n\r\ndefine "SDE Ethnicity":\r\n (flatten (\r\n Patient.extension Extension\r\n where Extension.url = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity'\r\n return Extension.extension\r\n )) E\r\n where E.url = 'ombCategory'\r\n or E.url = 'detailed'\r\n return E.value as Coding\r\n\r\ndefine "SDE Payer":\r\n [Coverage: type in "Payer"] Payer\r\n return {\r\n code: Payer.type,\r\n period: Payer.period\r\n }\r\n\r\ndefine "SDE Race":\r\n (flatten (\r\n Patient.extension Extension\r\n where Extension.url = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-race'\r\n return Extension.extension\r\n )) E\r\n where E.url = 'ombCategory'\r\n or E.url = 'detailed'\r\n return E.value as Coding\r\n\r\ndefine "SDE Sex":\r\n case\r\n when Patient.gender = 'male' then Code { code: 'M', system: 'http://hl7.org/fhir/v3/AdministrativeGender', display: 'Male' }\r\n when Patient.gender = 'female' then Code { code: 'F', system: 'http://hl7.org/fhir/v3/AdministrativeGender', display: 'Female' }\r\n else null\r\n end\r\n</code></pre></td></tr>\n </table>\n </td>\n </tr>\n \n \n \n </table>\n</div>"
},
"url" : "http://hl7.org/fhir/us/cqfmeasures/Library/EXMComputableLibrary",
"identifier" : [
{
"use" : "official",
"system" : "http://example.org/fhir/cqi/ecqm/Library/Identifier",
"value" : "EXMComputableLogic"
}
],
"version" : "2.0.0",
"name" : "EXMComputableLibrary",
"title" : "Example Computable Library",
"status" : "active",
"experimental" : true,
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/library-type",
"code" : "logic-library"
}
]
},
"date" : "2019-09-03",
"publisher" : "Clinical Quality Information WG",
"contact" : [
{
"telecom" : [
{
"system" : "url",
"value" : "http://www.hl7.org/Special/committees/cqi"
}
]
}
],
"description" : "This library is used as an example in the FHIR Quality Measure Implementation Guide",
"useContext" : [
{
"code" : {
"system" : "http://terminology.hl7.org/CodeSystem/usage-context-type",
"code" : "program"
},
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/us/cqfmeasures/CodeSystem/quality-programs",
"code" : "eh-cah",
"display" : "EH/CAH"
}
]
}
}
],
"jurisdiction" : [
{
"coding" : [
{
"system" : "urn:iso:std:iso:3166",
"code" : "US"
}
]
}
],
"approvalDate" : "2019-08-03",
"lastReviewDate" : "2019-08-03",
"relatedArtifact" : [
{
"type" : "depends-on",
"resource" : "http://fhir.org/guides/common/Library/FHIR-ModelInfo|4.0.1"
},
{
"type" : "depends-on",
"resource" : "http://fhir.org/guides/common/Library/FHIRHelpers|4.0.1"
},
{
"type" : "depends-on",
"resource" : "http://terminology.hl7.org/CodeSystem/diagnosis-role"
},
{
"type" : "depends-on",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292"
},
{
"type" : "depends-on",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.299"
},
{
"type" : "depends-on",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.126"
},
{
"type" : "depends-on",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1"
},
{
"type" : "depends-on",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.836"
},
{
"type" : "depends-on",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.837"
},
{
"type" : "depends-on",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"
}
],
"parameter" : [
{
"name" : "Measurement Period",
"use" : "in",
"min" : 0,
"max" : "1",
"type" : "Period"
},
{
"name" : "Patient",
"use" : "out",
"min" : 0,
"max" : "1",
"type" : "Patient"
},
{
"name" : "Inpatient Encounter",
"use" : "out",
"min" : 0,
"max" : "*",
"type" : "Encounter"
},
{
"name" : "Initial Population",
"use" : "out",
"min" : 0,
"max" : "*",
"type" : "Encounter"
},
{
"name" : "Measure Population",
"use" : "out",
"min" : 0,
"max" : "*",
"type" : "Encounter"
},
{
"name" : "Stratifier 1",
"use" : "out",
"min" : 0,
"max" : "*",
"type" : "Encounter"
},
{
"name" : "Stratifier 2",
"use" : "out",
"min" : 0,
"max" : "*",
"type" : "Encounter"
},
{
"name" : "Stratifier 3",
"use" : "out",
"min" : 0,
"max" : "*",
"type" : "Encounter"
},
{
"name" : "Stratifier 4",
"use" : "out",
"min" : 0,
"max" : "*",
"type" : "Encounter"
},
{
"name" : "SDE Ethnicity",
"use" : "out",
"min" : 0,
"max" : "*",
"type" : "Coding"
},
{
"name" : "SDE Payer",
"use" : "out",
"min" : 0,
"max" : "*",
"type" : "Resource"
},
{
"name" : "SDE Race",
"use" : "out",
"min" : 0,
"max" : "*",
"type" : "Coding"
},
{
"name" : "SDE Sex",
"use" : "out",
"min" : 0,
"max" : "1",
"type" : "Coding"
}
],
"dataRequirement" : [
{
"type" : "Encounter",
"profile" : [
"http://hl7.org/fhir/StructureDefinition/Encounter"
]
},
{
"type" : "Encounter",
"profile" : [
"http://hl7.org/fhir/StructureDefinition/Encounter"
],
"codeFilter" : [
{
"path" : "type",
"valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292"
}
]
},
{
"type" : "Condition",
"profile" : [
"http://hl7.org/fhir/StructureDefinition/Condition"
],
"codeFilter" : [
{
"path" : "id"
}
]
},
{
"type" : "Coverage",
"profile" : [
"http://hl7.org/fhir/StructureDefinition/Coverage"
],
"codeFilter" : [
{
"path" : "type",
"valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"
}
]
}
],
"content" : [
{
"contentType" : "text/cql",
"language" : "AllLanguages",
"data" : 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}
]
}
IG © 2019+ Clinical Quality Information WG. Package hl7.fhir.us.cqfmeasures#4.0.0 based on FHIR 4.0.1. Generated 2023-08-28
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