Quality Measure Implementation Guide (STU4)
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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

: EXM Ratio Measure - TTL Representation

Active as of 2022-02-22

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@prefix fhir: <http://hl7.org/fhir/> .
@prefix loinc: <https://loinc.org/rdf/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

# - resource -------------------------------------------------------------------

 a fhir:Measure ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:id [ fhir:v "EXMRatio-FHIR"] ; # 
  fhir:meta [
    ( fhir:profile [
fhir:v "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/ratio-measure-cqfm"^^xsd:anyURI ;
fhir:link <http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/ratio-measure-cqfm>     ] [
fhir:v "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-measure-cqfm"^^xsd:anyURI ;
fhir:link <http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-measure-cqfm>     ] )
  ] ; # 
  fhir:text [
fhir:status [ fhir:v "extensions" ] ;
fhir: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;\">EXMRatio-FHIR</td>\n            </tr>\n            \n            \n            <tr>\n                <th scope=\"row\"><b>Download cql: </b></th>\n                <td style=\"padding-left: 4px;\"><a href=\"Library-EXMRatio-FHIR.cql\">EXMRatio-FHIR.cql</a></td>\n            </tr>\n            \n\n        \n        \n            <tr>\n                <th scope=\"row\"><b>Url: </b></th>\n                <td style=\"padding-left: 4px;\"><a href=\"Measure-EXMRatio-FHIR.html\">EXM Ratio Measure</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>EXMRatio-FHIR</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;\">EXMRatioMeasure</td>\n            </tr>\n        \n        \n            <tr>\n                <th scope=\"row\"><b>Title: </b></th>\n                <td style=\"padding-left: 4px;\">EXM Ratio 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                            <p style=\"margin-bottom: 5px;\">\n                                <span>Ratio </span>\n                            </p>\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                            <p style=\"margin-bottom: 5px;\">\n                             <span>Decreased score indicates improvement </span>\n                            </p>\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                            <p style=\"margin-bottom: 5px;\">\n                            <span>process </span>\n                            </p>\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;\"><div><p>An example FHIR-based publishable measure</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></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;\"><div><p>The purpose of this measure is to...</p>\n</div></td>\n            </tr>\n        \n        \n            <tr>\n                <th scope=\"row\"><b>Guidance (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;\"><div><p>Example Copyright Statement</p>\n</div></td>\n            </tr>\n        \n        \n            <tr>\n                <th scope=\"row\"><b>Disclaimer: </b></th>\n                <td style=\"padding-left: 25px;\"><div><p>Example disclaimer</p>\n</div></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        \n        \n        \n            <tr>\n                <th scope=\"row\"><b>Libraries: </b></th>\n                <td style=\"padding-left: 4px;\">\n                    <table class=\"grid-dict\">\n                        \n                            <tr><td><a href=\"Library-EXMRatio-FHIR.html\">EXMRatio - Example Ratio Measure Library</a></td></tr>\n                        \n                    </table>\n                </td>\n            </tr>\n        \n        \n            \n                <tr>\n                    <th scope=\"row\"><b>Related Artifact Dependencies: </b></th>\n                    <td style=\"padding-left: 4px;\">\n                        \n                            <li><a href=\"http://example.org/fhir/ValueSet/inpatient\">http://example.org/fhir/ValueSet/inpatient</a></li>\n                        \n                    </td>\n                </tr>\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>use</b></th><th><b>min</b></th><th><b>max</b></th><th><b>type</b></th></tr>\n                            \n                                <tr>\n                                    <td>Numerator</td>\n                                    <td>out</td>\n                                    <td>0</td>\n                                    <td>*</td>\n                                    <td>Encounter</td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>Denominator</td>\n                                    <td>out</td>\n                                    <td>0</td>\n                                    <td>*</td>\n                                    <td>Encounter</td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>Initial Population</td>\n                                    <td>out</td>\n                                    <td>0</td>\n                                    <td>*</td>\n                                    <td>Encounter</td>\n                                </tr>\n                            \n                        </table>\n                    </td>\n                </tr>\n                <tr>\n                    <th scope=\"row\"><b>DataRequirements:</b></th>\n                    <td style=\"padding-left: 4px;\">\n                        <table class=\"grid-dict\">\n                            <tr><th><b>Type</b></th><th><b>Must Support</b></th><th><b>Valueset Name</b></th><th><b>Valueset</b></th></tr>\n                            \n                                <tr>\n                                    <td>Encounter</td>\n                                    <td>\n                                        \n                                            type\n                                        \n                                    </td>\n                                    <td>\n                                        \n                                            \n                                                 Inpatient\n                                            \n                                        \n                                    </td>\n                                    <td><a href=\"http://example.org/fhir/ValueSet/inpatient\">http://example.org/fhir/ValueSet/inpatient</a></td>\n                                </tr>\n                            \n                        </table>\n                    </td>\n                </tr>\n                \n                \n                    <tr>\n                        <th scope=\"row\"><b>Logic Definitions:</b></th>\n                        <td style=\"padding-left: 4px;\">\n                            \n                                <table class=\"grid-dict\">\n                                    <tr>\n                                        <th><b>Group</b></th><th><b>Scoring</b></th><th><b>Population Criteria</b></th><th><b>Expression</b></th>\n                                    </tr>\n                                    <tr>\n                                        \n                                            <td> group-1 </td>\n                                            <td>\n                                                \n                                                \n                                                    <b>Measure scoring:</b>\n                                                    \n                                                        <p style=\"margin-bottom: 5px;\">\n                                                        <span>Ratio</span>\n                                                        </p>\n                                                    \n                                                \n                                            </td>\n                                            \n                                                <tr>\n                                                    <td/>\n                                                    <td/>\n                                                    <td>Initial Population</td>\n                                                    <td>\n                                                        \n                                                        <pre><code class=\"language-cql\">define &quot;Initial Population&quot;:   &quot;Qualifying Encounters&quot;</code></pre>\n                                                        \n                                                    </td>\n                                                </tr>\n                                            \n                                                <tr>\n                                                    <td/>\n                                                    <td/>\n                                                    <td>Numerator</td>\n                                                    <td>\n                                                        \n                                                        <pre><code class=\"language-cql\">define &quot;Numerator&quot;:   &quot;Initial Population&quot;</code></pre>\n                                                        \n                                                    </td>\n                                                </tr>\n                                            \n                                                <tr>\n                                                    <td/>\n                                                    <td/>\n                                                    <td>Denominator</td>\n                                                    <td>\n                                                        \n                                                        <pre><code class=\"language-cql\">define &quot;Denominator&quot;:   &quot;Initial Population&quot;</code></pre>\n                                                        \n                                                    </td>\n                                                </tr>\n                                            \n                                                <tr>\n                                                    <td/>\n                                                    <td/>\n                                                    <td>Measure Observation</td>\n                                                    <td>\n                                                        \n                                                        <pre><code class=\"language-cql\"></code></pre>\n                                                        \n                                                    </td>\n                                                </tr>\n                                            \n                                                <tr>\n                                                    <td/>\n                                                    <td/>\n                                                    <td>Measure Observation</td>\n                                                    <td>\n                                                        \n                                                        <pre><code class=\"language-cql\"></code></pre>\n                                                        \n                                                    </td>\n                                                </tr>\n                                            \n\n                                    \n                                    </tr>\n                                </table>\n                            \n                            <table class=\"grid-dict\">\n                                \n                                    <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>\n                                    <tr>\n                                        \n                                            <td>EXMRatio-FHIR</td>\n                                        \n                                        \n                                            <td>Qualifying Encounters</td>\n                                        \n                                    </tr>\n                                    <tr>\n                                        \n                                            <td></td>\n                                        <td><pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Qualifying Encounters&quot;:   [&quot;Encounter&quot;: &quot;Inpatient&quot;]</code></pre></td>\n                                        \n                                    </tr>\n                                \n                                    <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>\n                                    <tr>\n                                        \n                                            <td>EXMRatio-FHIR</td>\n                                        \n                                        \n                                            <td>Initial Population</td>\n                                        \n                                    </tr>\n                                    <tr>\n                                        \n                                            <td></td>\n                                        <td><pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Initial Population&quot;:   &quot;Qualifying Encounters&quot;</code></pre></td>\n                                        \n                                    </tr>\n                                \n                                    <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>\n                                    <tr>\n                                        \n                                            <td>EXMRatio-FHIR</td>\n                                        \n                                        \n                                            <td>Numerator</td>\n                                        \n                                    </tr>\n                                    <tr>\n                                        \n                                            <td></td>\n                                        <td><pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Numerator&quot;:   &quot;Initial Population&quot;</code></pre></td>\n                                        \n                                    </tr>\n                                \n                                    <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>\n                                    <tr>\n                                        \n                                            <td>EXMRatio-FHIR</td>\n                                        \n                                        \n                                            <td>Denominator</td>\n                                        \n                                    </tr>\n                                    <tr>\n                                        \n                                            <td></td>\n                                        <td><pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Denominator&quot;:   &quot;Initial Population&quot;</code></pre></td>\n                                        \n                                    </tr>\n                                \n                            </table>\n                        </td>\n                    </tr>\n                \n            \n        \n    </table>\n</div>"
  ] ; # 
  fhir:contained ( [
a fhir:Library ;
fhir:id [ fhir:v "effective-data-requirements" ] ;
    ( fhir:extension [
      ( fhir:extension [
fhir:url [ fhir:v "libraryName"^^xsd:anyURI ] ;
fhir:value [ fhir:v "EXMRatio-FHIR" ]       ] [
fhir:url [ fhir:v "name"^^xsd:anyURI ] ;
fhir:value [ fhir:v "Qualifying Encounters" ]       ] [
fhir:url [ fhir:v "statement"^^xsd:anyURI ] ;
fhir:value [ fhir:v "define \"Qualifying Encounters\":   [\"Encounter\": \"Inpatient\"]" ]       ] [
fhir:url [ fhir:v "displaySequence"^^xsd:anyURI ] ;
fhir:value [ fhir:v "0"^^xsd:integer ]       ] ) ;
fhir:url [ fhir:v "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"^^xsd:anyURI ]     ] [
      ( fhir:extension [
fhir:url [ fhir:v "libraryName"^^xsd:anyURI ] ;
fhir:value [ fhir:v "EXMRatio-FHIR" ]       ] [
fhir:url [ fhir:v "name"^^xsd:anyURI ] ;
fhir:value [ fhir:v "Initial Population" ]       ] [
fhir:url [ fhir:v "statement"^^xsd:anyURI ] ;
fhir:value [ fhir:v "define \"Initial Population\":   \"Qualifying Encounters\"" ]       ] [
fhir:url [ fhir:v "displaySequence"^^xsd:anyURI ] ;
fhir:value [ fhir:v "1"^^xsd:integer ]       ] ) ;
fhir:url [ fhir:v "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"^^xsd:anyURI ]     ] [
      ( fhir:extension [
fhir:url [ fhir:v "libraryName"^^xsd:anyURI ] ;
fhir:value [ fhir:v "EXMRatio-FHIR" ]       ] [
fhir:url [ fhir:v "name"^^xsd:anyURI ] ;
fhir:value [ fhir:v "Numerator" ]       ] [
fhir:url [ fhir:v "statement"^^xsd:anyURI ] ;
fhir:value [ fhir:v "define \"Numerator\":   \"Initial Population\"" ]       ] [
fhir:url [ fhir:v "displaySequence"^^xsd:anyURI ] ;
fhir:value [ fhir:v "2"^^xsd:integer ]       ] ) ;
fhir:url [ fhir:v "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"^^xsd:anyURI ]     ] [
      ( fhir:extension [
fhir:url [ fhir:v "libraryName"^^xsd:anyURI ] ;
fhir:value [ fhir:v "EXMRatio-FHIR" ]       ] [
fhir:url [ fhir:v "name"^^xsd:anyURI ] ;
fhir:value [ fhir:v "Denominator" ]       ] [
fhir:url [ fhir:v "statement"^^xsd:anyURI ] ;
fhir:value [ fhir:v "define \"Denominator\":   \"Initial Population\"" ]       ] [
fhir:url [ fhir:v "displaySequence"^^xsd:anyURI ] ;
fhir:value [ fhir:v "3"^^xsd:integer ]       ] ) ;
fhir:url [ fhir:v "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"^^xsd:anyURI ]     ] ) ;
fhir:name [ fhir:v "EffectiveDataRequirements" ] ;
fhir:status [ fhir:v "active" ] ;
fhir:type [
      ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/library-type"^^xsd:anyURI ] ;
fhir:code [ fhir:v "module-definition" ]       ] )     ] ;
fhir:date [ fhir:v "2022-02-22T10:37:04-07:00"^^xsd:dateTime ] ;
    ( fhir:relatedArtifact [
fhir:type [ fhir:v "depends-on" ] ;
fhir:display [ fhir:v "Value set Inpatient" ] ;
fhir:resource [
fhir:v "http://example.org/fhir/ValueSet/inpatient"^^xsd:anyURI ;
fhir:link <http://example.org/fhir/ValueSet/inpatient>       ]     ] ) ;
    ( fhir:parameter [
fhir:name [ fhir:v "Numerator" ] ;
fhir:use [ fhir:v "out" ] ;
fhir:min [ fhir:v "0"^^xsd:integer ] ;
fhir:max [ fhir:v "*" ] ;
fhir:type [ fhir:v "Encounter" ]     ] [
fhir:name [ fhir:v "Denominator" ] ;
fhir:use [ fhir:v "out" ] ;
fhir:min [ fhir:v "0"^^xsd:integer ] ;
fhir:max [ fhir:v "*" ] ;
fhir:type [ fhir:v "Encounter" ]     ] [
fhir:name [ fhir:v "Initial Population" ] ;
fhir:use [ fhir:v "out" ] ;
fhir:min [ fhir:v "0"^^xsd:integer ] ;
fhir:max [ fhir:v "*" ] ;
fhir:type [ fhir:v "Encounter" ]     ] ) ;
    ( fhir:dataRequirement [
fhir:type [ fhir:v "Encounter" ] ;
      ( fhir:profile [
fhir:v "http://hl7.org/fhir/StructureDefinition/Encounter"^^xsd:anyURI ;
fhir:link <http://hl7.org/fhir/StructureDefinition/Encounter>       ] ) ;
      ( fhir:mustSupport [ fhir:v "type" ] ) ;
      ( fhir:codeFilter [
fhir:path [ fhir:v "type" ] ;
fhir:valueSet [
fhir:v "http://example.org/fhir/ValueSet/inpatient"^^xsd:anyURI ;
fhir:link <http://example.org/fhir/ValueSet/inpatient>         ]       ] )     ] )
  ] ) ; # 
  fhir:extension ( [
fhir:url [ fhir:v "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis"^^xsd:anyURI ] ;
fhir:value [ fhir:v "Encounter" ]
  ] [
fhir:url [ fhir:v "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoringUnit"^^xsd:anyURI ] ;
fhir:value [
a fhir:CodeableConcept ;
      ( fhir:coding [
fhir:system [ fhir:v "http://unitsofmeasure.org"^^xsd:anyURI ] ;
fhir:code [ fhir:v "/1000.d" ]       ] )     ]
  ] [
fhir:url [ fhir:v "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-softwaresystem"^^xsd:anyURI ] ;
fhir:value [
a fhir:Reference ;
fhir:reference [ fhir:v "Device/software-system-example" ]     ]
  ] [
fhir:id [ fhir:v "effective-data-requirements" ] ;
fhir:url [ fhir:v "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-effectiveDataRequirements"^^xsd:anyURI ] ;
fhir:value [
a fhir:Reference ;
fhir:reference [ fhir:v "#effective-data-requirements" ]     ]
  ] ) ; # 
  fhir:url [ fhir:v "http://example.org/fhir/measures/measure-ratio-exm"^^xsd:anyURI] ; # 
  fhir:identifier ( [
fhir:system [ fhir:v "http://example.org/fhir/cqi/ecqm/Measure/Identifier/exm"^^xsd:anyURI ] ;
fhir:value [ fhir:v "EXMRatio-FHIR" ]
  ] ) ; # 
  fhir:version [ fhir:v "2.0.0"] ; # 
  fhir:name [ fhir:v "EXMRatioMeasure"] ; # 
  fhir:title [ fhir:v "EXM Ratio Measure"] ; # 
  fhir:status [ fhir:v "active"] ; # 
  fhir:experimental [ fhir:v "true"^^xsd:boolean] ; # 
  fhir:date [ fhir:v "2022-02-22"^^xsd:date] ; # 
  fhir:publisher [ fhir:v "Clinical Quality Information WG"] ; # 
  fhir:contact ( [
    ( fhir:telecom [
fhir:system [ fhir:v "url" ] ;
fhir:value [ fhir:v "http://www.hl7.org/Special/committees/cqi" ]     ] )
  ] ) ; # 
  fhir:description [ fhir:v "An example FHIR-based publishable measure"] ; # 
  fhir:useContext ( [
fhir:code [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/usage-context-type"^^xsd:anyURI ] ;
fhir:code [ fhir:v "program" ]     ] ;
fhir:value [
a fhir:CodeableConcept ;
      ( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/us/cqfmeasures/CodeSystem/quality-programs"^^xsd:anyURI ] ;
fhir:code [ fhir:v "ep-ec" ]       ] ) ;
fhir:text [ fhir:v "eligible-provider" ]     ]
  ] ) ; # 
  fhir:jurisdiction ( [
    ( fhir:coding [
fhir:system [ fhir:v "urn:iso:std:iso:3166"^^xsd:anyURI ] ;
fhir:code [ fhir:v "US" ]     ] )
  ] ) ; # 
  fhir:purpose [ fhir:v "The purpose of this measure is to..."] ; # 
  fhir:usage [ fhir:v "Users of this measure should be aware of..."] ; # 
  fhir:copyright [ fhir:v "Example Copyright Statement"] ; # 
  fhir:approvalDate [ fhir:v "2019-02-17"^^xsd:date] ; # 
  fhir:lastReviewDate [ fhir:v "2019-02-17"^^xsd:date] ; # 
  fhir:effectivePeriod [
    ( fhir:extension [
fhir:url [ fhir:v "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-effectivePeriodAnchor"^^xsd:anyURI ] ;
fhir:value [ fhir:v "2018-01-01"^^xsd:date ]     ] [
fhir:url [ fhir:v "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-effectivePeriodDuration"^^xsd:anyURI ] ;
fhir:value [
a fhir:Duration ;
fhir:value [ fhir:v "1"^^xsd:decimal ] ;
fhir:system [ fhir:v "http://unitsofmeasure.org"^^xsd:anyURI ] ;
fhir:code [ fhir:v "a" ]       ]     ] ) ;
fhir:start [ fhir:v "2018-01-01"^^xsd:date ] ;
fhir:end [ fhir:v "2018-12-31"^^xsd:date ]
  ] ; # 
  fhir:topic ( [
    ( fhir:coding [
a loinc:57024-2 ;
fhir:system [ fhir:v "http://loinc.org"^^xsd:anyURI ] ;
fhir:code [ fhir:v "57024-2" ]     ] ) ;
fhir:text [ fhir:v "Health Quality Measure Document" ]
  ] ) ; # 
  fhir:author ( [
fhir:name [ fhir:v "Example Measure Content Developer" ]
  ] ) ; # 
  fhir:library ( [
fhir:v "http://hl7.org/fhir/us/cqfmeasures/Library/EXMRatio-FHIR"^^xsd:anyURI ;
fhir:link <http://hl7.org/fhir/us/cqfmeasures/Library/EXMRatio-FHIR>
  ] ) ; # 
  fhir:disclaimer [ fhir:v "Example disclaimer"] ; # 
  fhir:scoring [
    ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/measure-scoring"^^xsd:anyURI ] ;
fhir:code [ fhir:v "ratio" ] ;
fhir:display [ fhir:v "Ratio" ]     ] )
  ] ; # 
  fhir:type ( [
    ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/measure-type"^^xsd:anyURI ] ;
fhir:code [ fhir:v "process" ]     ] )
  ] ) ; # 
  fhir:improvementNotation [
    ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/measure-improvement-notation"^^xsd:anyURI ] ;
fhir:code [ fhir:v "decrease" ] ;
fhir:display [ fhir:v "Decreased score indicates improvement" ]     ] )
  ] ; # 
  fhir:group ( [
fhir:id [ fhir:v "group-1" ] ;
    ( fhir:population [
fhir:id [ fhir:v "initial-population" ] ;
fhir:code [
        ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/measure-population"^^xsd:anyURI ] ;
fhir:code [ fhir:v "initial-population" ] ;
fhir:display [ fhir:v "Initial Population" ]         ] )       ] ;
fhir:criteria [
fhir:language [ fhir:v "text/cql-identifier" ] ;
fhir:expression [ fhir:v "Initial Population" ]       ]     ] [
fhir:id [ fhir:v "numerator" ] ;
fhir:code [
        ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/measure-population"^^xsd:anyURI ] ;
fhir:code [ fhir:v "numerator" ] ;
fhir:display [ fhir:v "Numerator" ]         ] )       ] ;
fhir:criteria [
fhir:language [ fhir:v "text/cql-identifier" ] ;
fhir:expression [ fhir:v "Numerator" ]       ]     ] [
fhir:id [ fhir:v "denominator" ] ;
fhir:code [
        ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/measure-population"^^xsd:anyURI ] ;
fhir:code [ fhir:v "denominator" ] ;
fhir:display [ fhir:v "Denominator" ]         ] )       ] ;
fhir:criteria [
fhir:language [ fhir:v "text/cql-identifier" ] ;
fhir:expression [ fhir:v "Denominator" ]       ]     ] [
fhir:id [ fhir:v "denominator-observation" ] ;
      ( fhir:extension [
fhir:url [ fhir:v "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-criteriaReference"^^xsd:anyURI ] ;
fhir:value [ fhir:v "denominator" ]       ] [
fhir:url [ fhir:v "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-aggregateMethod"^^xsd:anyURI ] ;
fhir:value [ fhir:v "sum" ]       ] ) ;
fhir:code [
        ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/measure-population"^^xsd:anyURI ] ;
fhir:code [ fhir:v "measure-observation" ] ;
fhir:display [ fhir:v "Measure Observation" ]         ] )       ] ;
fhir:criteria [
fhir:language [ fhir:v "text/cql-identifier" ] ;
fhir:expression [ fhir:v "Measure Denominator Observation" ]       ]     ] [
fhir:id [ fhir:v "numerator-observation" ] ;
      ( fhir:extension [
fhir:url [ fhir:v "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-criteriaReference"^^xsd:anyURI ] ;
fhir:value [ fhir:v "numerator" ]       ] [
fhir:url [ fhir:v "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-aggregateMethod"^^xsd:anyURI ] ;
fhir:value [ fhir:v "sum" ]       ] ) ;
fhir:code [
        ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/measure-population"^^xsd:anyURI ] ;
fhir:code [ fhir:v "measure-observation" ] ;
fhir:display [ fhir:v "Measure Observation" ]         ] )       ] ;
fhir:criteria [
fhir:language [ fhir:v "text/cql-identifier" ] ;
fhir:expression [ fhir:v "Measure Numerator Observation" ]       ]     ] )
  ] ) . #