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 2022-02-22 |
<Measure xmlns="http://hl7.org/fhir">
<id value="EXMRatio-FHIR"/>
<meta>
<profile
value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/ratio-measure-cqfm"/>
<profile
value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-measure-cqfm"/>
</meta>
<text>
<status value="extensions"/>
<div xmlns="http://www.w3.org/1999/xhtml">
<table class="grid dict">
<tr>
<th scope="row"><b>Id: </b></th>
<td style="padding-left: 4px;">EXMRatio-FHIR</td>
</tr>
<tr>
<th scope="row"><b>Download cql: </b></th>
<td style="padding-left: 4px;"><a href="Library-EXMRatio-FHIR.cql">EXMRatio-FHIR.cql</a></td>
</tr>
<tr>
<th scope="row"><b>Url: </b></th>
<td style="padding-left: 4px;"><a href="Measure-EXMRatio-FHIR.html">EXM Ratio Measure</a></td>
</tr>
<tr>
<th scope="row"><b>Version: </b></th>
<td style="padding-left: 4px;">2.0.0</td>
</tr>
<tr>
<th scope="row"><b>Identifier: </b></th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<b>value: </b> <span>EXMRatio-FHIR</span>
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Name: </b></th>
<td style="padding-left: 4px;">EXMRatioMeasure</td>
</tr>
<tr>
<th scope="row"><b>Title: </b></th>
<td style="padding-left: 4px;">EXM Ratio Measure</td>
</tr>
<tr>
<th scope="row"><b>Status: </b></th>
<td style="padding-left: 4px;">active</td>
</tr>
<tr>
<th scope="row"><b>Experimental: </b></th>
<td style="padding-left: 4px;">true</td>
</tr>
<tr>
<th scope="row"><b>Scoring: </b></th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<span>Ratio </span>
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Improvement Notation: </b></th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<span>Decreased score indicates improvement </span>
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Type: </b></th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<span>process </span>
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Date: </b></th>
<td style="padding-left: 4px;">2022-02-22</td>
</tr>
<tr>
<th scope="row"><b>Publisher: </b></th>
<td style="padding-left: 4px;">Clinical Quality Information WG</td>
</tr>
<tr>
<th scope="row"><b>Description: </b></th>
<td style="padding-left: 4px;"><div><p>An example FHIR-based publishable measure</p>
</div></td>
</tr>
<tr>
<th scope="row"><b>Use Context: </b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr><th><b>code</b></th><th><b>value</b></th></tr>
<tr>
<td>program</td>
<td>eligible-provider</td>
</tr>
</table>
</td>
</tr>
<tr>
<th scope="row"><b>Jurisdiction: </b></th>
<td style="padding-left: 25px;">US</td>
</tr>
<tr>
<th scope="row"><b>Topic: </b></th>
<td style="padding-left: 25px;">57024-2</td>
</tr>
<tr>
<th scope="row"><b>Purpose: </b></th>
<td style="padding-left: 4px;"><div><p>The purpose of this measure is to...</p>
</div></td>
</tr>
<tr>
<th scope="row"><b>Guidance (Usage): </b></th>
<td style="padding-left: 4px;">Users of this measure should be aware of...</td>
</tr>
<tr>
<th scope="row"><b>Copyright: </b></th>
<td style="padding-left: 25px;"><div><p>Example Copyright Statement</p>
</div></td>
</tr>
<tr>
<th scope="row"><b>Disclaimer: </b></th>
<td style="padding-left: 25px;"><div><p>Example disclaimer</p>
</div></td>
</tr>
<tr>
<th scope="row"><b>Approval Date: </b></th>
<td style="padding-left: 4px;">2019-02-17</td>
</tr>
<tr>
<th scope="row"><b>Last Review Date: </b></th>
<td style="padding-left: 4px;">2019-02-17</td>
</tr>
<tr>
<th scope="row"><b>Effective Period: </b></th>
<td style="padding-left: 4px;">2018-01-01..2018-12-31</td>
</tr>
<tr>
<th scope="row"><b>Libraries: </b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr><td><a href="Library-EXMRatio-FHIR.html">EXMRatio - Example Ratio Measure Library</a></td></tr>
</table>
</td>
</tr>
<tr>
<th scope="row"><b>Related Artifact Dependencies: </b></th>
<td style="padding-left: 4px;">
<li><a href="http://example.org/fhir/ValueSet/inpatient">http://example.org/fhir/ValueSet/inpatient</a></li>
</td>
</tr>
<tr>
<th scope="row"><b>Parameters:</b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<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>
<tr>
<td>Numerator</td>
<td>out</td>
<td>0</td>
<td>*</td>
<td>Encounter</td>
</tr>
<tr>
<td>Denominator</td>
<td>out</td>
<td>0</td>
<td>*</td>
<td>Encounter</td>
</tr>
<tr>
<td>Initial Population</td>
<td>out</td>
<td>0</td>
<td>*</td>
<td>Encounter</td>
</tr>
</table>
</td>
</tr>
<tr>
<th scope="row"><b>DataRequirements:</b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr><th><b>Type</b></th><th><b>Must Support</b></th><th><b>Valueset Name</b></th><th><b>Valueset</b></th></tr>
<tr>
<td>Encounter</td>
<td>
type
</td>
<td>
Inpatient
</td>
<td><a href="http://example.org/fhir/ValueSet/inpatient">http://example.org/fhir/ValueSet/inpatient</a></td>
</tr>
</table>
</td>
</tr>
<tr>
<th scope="row"><b>Logic Definitions:</b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr>
<th><b>Group</b></th><th><b>Scoring</b></th><th><b>Population Criteria</b></th><th><b>Expression</b></th>
</tr>
<tr>
<td> group-1 </td>
<td>
<b>Measure scoring:</b>
<p style="margin-bottom: 5px;">
<span>Ratio</span>
</p>
</td>
<tr>
<td/>
<td/>
<td>Initial Population</td>
<td>
<pre><code class="language-cql">define "Initial Population": "Qualifying Encounters"</code></pre>
</td>
</tr>
<tr>
<td/>
<td/>
<td>Numerator</td>
<td>
<pre><code class="language-cql">define "Numerator": "Initial Population"</code></pre>
</td>
</tr>
<tr>
<td/>
<td/>
<td>Denominator</td>
<td>
<pre><code class="language-cql">define "Denominator": "Initial Population"</code></pre>
</td>
</tr>
<tr>
<td/>
<td/>
<td>Measure Observation</td>
<td>
<pre><code class="language-cql"></code></pre>
</td>
</tr>
<tr>
<td/>
<td/>
<td>Measure Observation</td>
<td>
<pre><code class="language-cql"></code></pre>
</td>
</tr>
</tr>
</table>
<table class="grid-dict">
<tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>
<tr>
<td>EXMRatio-FHIR</td>
<td>Qualifying Encounters</td>
</tr>
<tr>
<td></td>
<td><pre class="highlight language-cql"><code class="language-cql">define "Qualifying Encounters": ["Encounter": "Inpatient"]</code></pre></td>
</tr>
<tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>
<tr>
<td>EXMRatio-FHIR</td>
<td>Initial Population</td>
</tr>
<tr>
<td></td>
<td><pre class="highlight language-cql"><code class="language-cql">define "Initial Population": "Qualifying Encounters"</code></pre></td>
</tr>
<tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>
<tr>
<td>EXMRatio-FHIR</td>
<td>Numerator</td>
</tr>
<tr>
<td></td>
<td><pre class="highlight language-cql"><code class="language-cql">define "Numerator": "Initial Population"</code></pre></td>
</tr>
<tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>
<tr>
<td>EXMRatio-FHIR</td>
<td>Denominator</td>
</tr>
<tr>
<td></td>
<td><pre class="highlight language-cql"><code class="language-cql">define "Denominator": "Initial Population"</code></pre></td>
</tr>
</table>
</td>
</tr>
</table>
</div>
</text>
<contained>
<Library>
<id value="effective-data-requirements"/>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="EXMRatio-FHIR"/>
</extension>
<extension url="name">
<valueString value="Qualifying Encounters"/>
</extension>
<extension url="statement">
<valueString
value="define "Qualifying Encounters": ["Encounter": "Inpatient"]"/>
</extension>
<extension url="displaySequence">
<valueInteger value="0"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="EXMRatio-FHIR"/>
</extension>
<extension url="name">
<valueString value="Initial Population"/>
</extension>
<extension url="statement">
<valueString
value="define "Initial Population": "Qualifying Encounters""/>
</extension>
<extension url="displaySequence">
<valueInteger value="1"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="EXMRatio-FHIR"/>
</extension>
<extension url="name">
<valueString value="Numerator"/>
</extension>
<extension url="statement">
<valueString
value="define "Numerator": "Initial Population""/>
</extension>
<extension url="displaySequence">
<valueInteger value="2"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="EXMRatio-FHIR"/>
</extension>
<extension url="name">
<valueString value="Denominator"/>
</extension>
<extension url="statement">
<valueString
value="define "Denominator": "Initial Population""/>
</extension>
<extension url="displaySequence">
<valueInteger value="3"/>
</extension>
</extension>
<name value="EffectiveDataRequirements"/>
<status value="active"/>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/library-type"/>
<code value="module-definition"/>
</coding>
</type>
<date value="2022-02-22T10:37:04-07:00"/>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Inpatient"/>
<resource value="http://example.org/fhir/ValueSet/inpatient"/>
</relatedArtifact>
<parameter>
<name value="Numerator"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Encounter"/>
</parameter>
<parameter>
<name value="Denominator"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Encounter"/>
</parameter>
<parameter>
<name value="Initial Population"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Encounter"/>
</parameter>
<dataRequirement>
<type value="Encounter"/>
<profile value="http://hl7.org/fhir/StructureDefinition/Encounter"/>
<mustSupport value="type"/>
<codeFilter>
<path value="type"/>
<valueSet value="http://example.org/fhir/ValueSet/inpatient"/>
</codeFilter>
</dataRequirement>
</Library>
</contained>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis">
<valueCode value="Encounter"/>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoringUnit">
<valueCodeableConcept>
<coding>
<system value="http://unitsofmeasure.org"/>
<code value="/1000.d"/>
</coding>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-softwaresystem">
<valueReference>
<reference value="Device/software-system-example"/>
</valueReference>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-effectiveDataRequirements" id="effective-data-requirements">
<valueReference>
<reference value="#effective-data-requirements"/>
</valueReference>
</extension>
<url value="http://example.org/fhir/measures/measure-ratio-exm"/>
<identifier>
<system value="http://example.org/fhir/cqi/ecqm/Measure/Identifier/exm"/>
<value value="EXMRatio-FHIR"/>
</identifier>
<version value="2.0.0"/>
<name value="EXMRatioMeasure"/>
<title value="EXM Ratio Measure"/>
<status value="active"/>
<experimental value="true"/>
<date value="2022-02-22"/>
<publisher value="Clinical Quality Information WG"/>
<contact>
<telecom>
<system value="url"/>
<value value="http://www.hl7.org/Special/committees/cqi"/>
</telecom>
</contact>
<description value="An example FHIR-based publishable measure"/>
<useContext>
<code>
<system
value="http://terminology.hl7.org/CodeSystem/usage-context-type"/>
<code value="program"/>
</code>
<valueCodeableConcept>
<coding>
<system
value="http://hl7.org/fhir/us/cqfmeasures/CodeSystem/quality-programs"/>
<code value="ep-ec"/>
</coding>
<text value="eligible-provider"/>
</valueCodeableConcept>
</useContext>
<jurisdiction>
<coding>
<system value="urn:iso:std:iso:3166"/>
<code value="US"/>
</coding>
</jurisdiction>
<purpose value="The purpose of this measure is to..."/>
<usage value="Users of this measure should be aware of..."/>
<copyright value="Example Copyright Statement"/>
<approvalDate value="2019-02-17"/>
<lastReviewDate value="2019-02-17"/>
<effectivePeriod>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-effectivePeriodAnchor">
<valueDateTime value="2018-01-01"/>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-effectivePeriodDuration">
<valueDuration>
<value value="1"/>
<system value="http://unitsofmeasure.org"/>
<code value="a"/>
</valueDuration>
</extension>
<start value="2018-01-01"/>
<end value="2018-12-31"/>
</effectivePeriod>
<topic>
<coding>
<system value="http://loinc.org"/>
<code value="57024-2"/>
</coding>
<text value="Health Quality Measure Document"/>
</topic>
<author>
<name value="Example Measure Content Developer"/>
</author>
<library value="http://hl7.org/fhir/us/cqfmeasures/Library/EXMRatio-FHIR"/>
<disclaimer value="Example disclaimer"/>
<scoring>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/measure-scoring"/>
<code value="ratio"/>
<display value="Ratio"/>
</coding>
</scoring>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/measure-type"/>
<code value="process"/>
</coding>
</type>
<improvementNotation>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-improvement-notation"/>
<code value="decrease"/>
<display value="Decreased score indicates improvement"/>
</coding>
</improvementNotation>
<group id="group-1">
<population id="initial-population">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="initial-population"/>
<display value="Initial Population"/>
</coding>
</code>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Initial Population"/>
</criteria>
</population>
<population id="numerator">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="numerator"/>
<display value="Numerator"/>
</coding>
</code>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Numerator"/>
</criteria>
</population>
<population id="denominator">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="denominator"/>
<display value="Denominator"/>
</coding>
</code>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Denominator"/>
</criteria>
</population>
<population id="denominator-observation">
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-criteriaReference">
<valueString value="denominator"/>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-aggregateMethod">
<valueCode value="sum"/>
</extension>
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="measure-observation"/>
<display value="Measure Observation"/>
</coding>
</code>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Measure Denominator Observation"/>
</criteria>
</population>
<population id="numerator-observation">
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-criteriaReference">
<valueString value="numerator"/>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-aggregateMethod">
<valueCode value="sum"/>
</extension>
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="measure-observation"/>
<display value="Measure Observation"/>
</coding>
</code>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Measure Numerator Observation"/>
</criteria>
</population>
</group>
</Measure>
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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