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

: Pneumococcal Vaccination Status for Older Adults - JSON Representation

Draft as of 2022-02-22

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{
  "resourceType" : "Measure",
  "id" : "PVSComponent",
  "meta" : {
    "profile" : [
      "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/proportion-measure-cqfm",
      "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-measure-cqfm"
    ]
  },
  "language" : "en",
  "text" : {
    "status" : "extensions",
    "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;\">PVSComponent</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-PVSComponent.cql\">PVSComponent.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-PVSComponent.html\">Pneumococcal Vaccination Status for Older Adults</a></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;\">PVSComponent</td>\n            </tr>\n        \n        \n            <tr>\n                <th scope=\"row\"><b>Title: </b></th>\n                <td style=\"padding-left: 4px;\">Pneumococcal Vaccination Status for Older Adults</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                            <p style=\"margin-bottom: 5px;\">\n                                <span>Proportion </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>increase </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 11:37:04-0600</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 is an example only.</p>\n</div></td>\n            </tr>\n        \n        \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        \n            <tr>\n                <th scope=\"row\"><b> Supplemental Data Elements: </b></th>\n                <td style=\"padding-left: 4px;\">\n                    \n                        \n                            \n                                \n                                    SDE Ethnicity\n                                \n                            \n                        \n                    \n                        \n                            \n                                \n                                    SDE Payer\n                                \n                            \n                        \n                    \n                        \n                            \n                                \n                                    SDE Race\n                                \n                            \n                        \n                    \n                        \n                            \n                                \n                                    SDE Sex\n                                \n                            \n                        \n                    \n                </td>\n            </tr>\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-PVSComponent.html\">PVS Component 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=\"Library-SupplementalDataElements.html\">Supplemental Data Elements Library</a></li>\n                        \n                            <li><a href=\"http://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1\">http://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1</a></li>\n                        \n                            <li><a href=\"Library-MATGlobalCommonFunctions.html\">MAT Global Common Functions FHIR Library</a></li>\n                        \n                            <li><a href=\"Library-Hospice.html\">Hospice FHIR Library</a></li>\n                        \n                            <li><a href=\"http://snomed.info/sct|http://snomed.info/sct/731000124108/version/201709\">http://snomed.info/sct|http://snomed.info/sct/731000124108/version/201709</a></li>\n                        \n                            <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.110.12.1027/expansion\">Pneumococcal Vaccine</a></li>\n                        \n                            <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.110.12.1034/expansion\">Pneumococcal Vaccine Administered</a></li>\n                        \n                            <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1001/expansion\">Office Visit</a></li>\n                        \n                            <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1240/expansion\">Annual Wellness Visit</a></li>\n                        \n                            <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1025/expansion\">Preventive Care Services Established Office Visit, 18 and Up</a></li>\n                        \n                            <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1023/expansion\">Preventive Care Services Initial Office Visit, 18 and Up</a></li>\n                        \n                            <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1016/expansion\">Home Healthcare Services</a></li>\n                        \n                            <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.11.1065/expansion\">Discharge Services Nursing Facility</a></li>\n                        \n                            <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1012/expansion\">Nursing Facility Visit</a></li>\n                        \n                            <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1014/expansion\">Care Services in Long Term Residential Facility</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                            <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.666.5.307/expansion\">Encounter Inpatient</a></li>\n                        \n                            <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1108.15/expansion\">Hospice Care Ambulatory</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>Measurement Period</td>\n                                    <td>in</td>\n                                    <td>0</td>\n                                    <td>1</td>\n                                    <td>Period</td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>SDE Sex</td>\n                                    <td>out</td>\n                                    <td>0</td>\n                                    <td>1</td>\n                                    <td>Coding</td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>Numerator</td>\n                                    <td>out</td>\n                                    <td>0</td>\n                                    <td>1</td>\n                                    <td>boolean</td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>Denominator</td>\n                                    <td>out</td>\n                                    <td>0</td>\n                                    <td>1</td>\n                                    <td>boolean</td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>SDE Payer</td>\n                                    <td>out</td>\n                                    <td>0</td>\n                                    <td>*</td>\n                                    <td>Resource</td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>Initial Population</td>\n                                    <td>out</td>\n                                    <td>0</td>\n                                    <td>1</td>\n                                    <td>boolean</td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>SDE Ethnicity</td>\n                                    <td>out</td>\n                                    <td>0</td>\n                                    <td>*</td>\n                                    <td>Coding</td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>Denominator Exclusions</td>\n                                    <td>out</td>\n                                    <td>0</td>\n                                    <td>1</td>\n                                    <td>boolean</td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>SDE Race</td>\n                                    <td>out</td>\n                                    <td>0</td>\n                                    <td>*</td>\n                                    <td>Coding</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>Coverage</td>\n                                    <td>\n                                        \n                                            period\n                                        \n                                            type\n                                        \n                                    </td>\n                                    <td>\n                                        \n                                            \n                                                 Payer\n                                            \n                                        \n                                    </td>\n                                    <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.114222.4.11.3591/expansion\">Payer</a></td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>Patient</td>\n                                    <td>\n                                        \n                                            extension\n                                        \n                                            value\n                                        \n                                            url\n                                        \n                                    </td>\n                                    <td>\n                                        \n                                    </td>\n                                    <td></td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>Encounter</td>\n                                    <td>\n                                        \n                                            period\n                                        \n                                            hospitalization\n                                        \n                                            hospitalization.dischargeDisposition\n                                        \n                                            type\n                                        \n                                            status\n                                        \n                                    </td>\n                                    <td>\n                                        \n                                            \n                                                 Encounter Inpatient\n                                            \n                                        \n                                    </td>\n                                    <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.666.5.307/expansion\">Encounter Inpatient</a></td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>Encounter</td>\n                                    <td>\n                                        \n                                            type\n                                        \n                                    </td>\n                                    <td>\n                                        \n                                            \n                                                 Office Visit\n                                            \n                                        \n                                    </td>\n                                    <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1001/expansion\">Office Visit</a></td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>Encounter</td>\n                                    <td>\n                                        \n                                            type\n                                        \n                                    </td>\n                                    <td>\n                                        \n                                            \n                                                 Annual Wellness Visit\n                                            \n                                        \n                                    </td>\n                                    <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1240/expansion\">Annual Wellness Visit</a></td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>Encounter</td>\n                                    <td>\n                                        \n                                            type\n                                        \n                                    </td>\n                                    <td>\n                                        \n                                            \n                                                 Preventive Care Services - Established Office Visit, 18 and Up\n                                            \n                                        \n                                    </td>\n                                    <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1025/expansion\">Preventive Care Services Established Office Visit, 18 and Up</a></td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>Encounter</td>\n                                    <td>\n                                        \n                                            type\n                                        \n                                    </td>\n                                    <td>\n                                        \n                                            \n                                                 Preventive Care Services-Initial Office Visit, 18 and Up\n                                            \n                                        \n                                    </td>\n                                    <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1023/expansion\">Preventive Care Services Initial Office Visit, 18 and Up</a></td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>Encounter</td>\n                                    <td>\n                                        \n                                            type\n                                        \n                                    </td>\n                                    <td>\n                                        \n                                            \n                                                 Home Healthcare Services\n                                            \n                                        \n                                    </td>\n                                    <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1016/expansion\">Home Healthcare Services</a></td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>Encounter</td>\n                                    <td>\n                                        \n                                            type\n                                        \n                                    </td>\n                                    <td>\n                                        \n                                            \n                                                 Discharge Services - Nursing Facility\n                                            \n                                        \n                                    </td>\n                                    <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.11.1065/expansion\">Discharge Services Nursing Facility</a></td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>Encounter</td>\n                                    <td>\n                                        \n                                            type\n                                        \n                                    </td>\n                                    <td>\n                                        \n                                            \n                                                 Nursing Facility Visit\n                                            \n                                        \n                                    </td>\n                                    <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1012/expansion\">Nursing Facility Visit</a></td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>Encounter</td>\n                                    <td>\n                                        \n                                            type\n                                        \n                                    </td>\n                                    <td>\n                                        \n                                            \n                                                 Care Services in Long-Term Residential Facility\n                                            \n                                        \n                                    </td>\n                                    <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1014/expansion\">Care Services in Long Term Residential Facility</a></td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>ServiceRequest</td>\n                                    <td>\n                                        \n                                            code\n                                        \n                                            authoredOn\n                                        \n                                            intent\n                                        \n                                    </td>\n                                    <td>\n                                        \n                                            \n                                                 Hospice care ambulatory\n                                            \n                                        \n                                    </td>\n                                    <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1108.15/expansion\">Hospice Care Ambulatory</a></td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>Procedure</td>\n                                    <td>\n                                        \n                                            code\n                                        \n                                            performed\n                                        \n                                            status\n                                        \n                                    </td>\n                                    <td>\n                                        \n                                            \n                                                 Hospice care ambulatory\n                                            \n                                        \n                                    </td>\n                                    <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1108.15/expansion\">Hospice Care Ambulatory</a></td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>Procedure</td>\n                                    <td>\n                                        \n                                            code\n                                        \n                                            performed\n                                        \n                                            status\n                                        \n                                    </td>\n                                    <td>\n                                        \n                                            \n                                                 Pneumococcal Vaccine Administered\n                                            \n                                        \n                                    </td>\n                                    <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.110.12.1034/expansion\">Pneumococcal Vaccine Administered</a></td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>Immunization</td>\n                                    <td>\n                                        \n                                            occurrence\n                                        \n                                            vaccineCode\n                                        \n                                            status\n                                        \n                                    </td>\n                                    <td>\n                                        \n                                            \n                                                 Pneumococcal Vaccine\n                                            \n                                        \n                                    </td>\n                                    <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.110.12.1027/expansion\">Pneumococcal Vaccine</a></td>\n                                </tr>\n                            \n                        </table>\n                    </td>\n                </tr>\n                \n                    <tr>\n                        <th scope=\"row\"><b>Direct Reference Codes:</b></th>\n                        <td style=\"padding-left: 4px;\">\n                            <table class=\"grid-dict\">\n                                <tr><th><b>display</b></th><th><b>code</b></th><th><b>system</b></th></tr>\n                                \n                                    <tr>\n                                        <td>Discharge to home for hospice care (procedure)</td>\n                                        <td>428361000124107</td>\n                                        <td><a href=\"http://hl7.org/fhir/R4/codesystem-snomedct.html\">SNOMED CT (all versions)</a></td>\n                                    </tr>\n                                \n                                    <tr>\n                                        <td>Discharge to healthcare facility for hospice care (procedure)</td>\n                                        <td>428371000124100</td>\n                                        <td><a href=\"http://hl7.org/fhir/R4/codesystem-snomedct.html\">SNOMED CT (all versions)</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>  </td>\n                                            <td>\n                                                \n                                                \n                                                    <b>Measure scoring:</b>\n                                                    \n                                                        <p style=\"margin-bottom: 5px;\">\n                                                        <span>Proportion</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;:   Global.&quot;CalendarAgeInYearsAt&quot; ( FHIRHelpers.ToDate ( Patient.birthDate ), start of &quot;Measurement Period&quot; ) &gt;= 65       and exists &quot;Qualifying Encounters&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>Denominator Exclusion</td>\n                                                    <td>\n                                                        \n                                                        <pre><code class=\"language-cql\">define &quot;Denominator Exclusions&quot;:   Hospice.&quot;Has Hospice&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;:   exists ( [Immunization: &quot;Pneumococcal Vaccine&quot;] PneumococcalVaccine         where PneumococcalVaccine.status = 'completed'           and PneumococcalVaccine.occurrence as dateTime on or before           end of &quot;Measurement Period&quot;     )       or exists ( [Procedure: &quot;Pneumococcal Vaccine Administered&quot;] PneumococcalVaccineGiven           where PneumococcalVaccineGiven.status = 'completed'             and PneumococcalVaccineGiven.performed as Period on or before             end of &quot;Measurement Period&quot;       )</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>SupplementalDataElements</td>\n                                        \n                                        \n                                            <td>SDE Sex</td>\n                                        \n                                    </tr>\n                                    <tr>\n                                        \n                                            <td></td>\n                                        <td><pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;SDE Sex&quot;:   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</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>PVSComponent</td>\n                                        \n                                        \n                                            <td>SDE Sex</td>\n                                        \n                                    </tr>\n                                    <tr>\n                                        \n                                            <td></td>\n                                        <td><pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;SDE Sex&quot;:   SDE.&quot;SDE Sex&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>PVSComponent</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;:   exists ( [Immunization: &quot;Pneumococcal Vaccine&quot;] PneumococcalVaccine         where PneumococcalVaccine.status = 'completed'           and PneumococcalVaccine.occurrence as dateTime on or before           end of &quot;Measurement Period&quot;     )       or exists ( [Procedure: &quot;Pneumococcal Vaccine Administered&quot;] PneumococcalVaccineGiven           where PneumococcalVaccineGiven.status = 'completed'             and PneumococcalVaccineGiven.performed as Period on or before             end of &quot;Measurement Period&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>PVSComponent</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;:   ( [Encounter: &quot;Office Visit&quot;]       union [Encounter: &quot;Annual Wellness Visit&quot;]       union [Encounter: &quot;Preventive Care Services - Established Office Visit, 18 and Up&quot;]       union [Encounter: &quot;Preventive Care Services-Initial Office Visit, 18 and Up&quot;]       union [Encounter: &quot;Home Healthcare Services&quot;]       union [Encounter: &quot;Discharge Services - Nursing Facility&quot;]       union [Encounter: &quot;Nursing Facility Visit&quot;]       union [Encounter: &quot;Care Services in Long-Term Residential Facility&quot;] ) ValidEncounter       where ValidEncounter.period during &quot;Measurement Period&quot;         and ValidEncounter.status = 'finished'</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>PVSComponent</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;:   Global.&quot;CalendarAgeInYearsAt&quot; ( FHIRHelpers.ToDate ( Patient.birthDate ), start of &quot;Measurement Period&quot; ) &gt;= 65       and exists &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>PVSComponent</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                                    <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>\n                                    <tr>\n                                        \n                                            <td>SupplementalDataElements</td>\n                                        \n                                        \n                                            <td>SDE Payer</td>\n                                        \n                                    </tr>\n                                    <tr>\n                                        \n                                            <td></td>\n                                        <td><pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;SDE Payer&quot;:   [Coverage: type in &quot;Payer&quot;] Payer         return {           code: Payer.type,           period: Payer.period         }</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>PVSComponent</td>\n                                        \n                                        \n                                            <td>SDE Payer</td>\n                                        \n                                    </tr>\n                                    <tr>\n                                        \n                                            <td></td>\n                                        <td><pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;SDE Payer&quot;:   SDE.&quot;SDE Payer&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>SupplementalDataElements</td>\n                                        \n                                        \n                                            <td>SDE Ethnicity</td>\n                                        \n                                    </tr>\n                                    <tr>\n                                        \n                                            <td></td>\n                                        <td><pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;SDE Ethnicity&quot;:   (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</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>PVSComponent</td>\n                                        \n                                        \n                                            <td>SDE Ethnicity</td>\n                                        \n                                    </tr>\n                                    <tr>\n                                        \n                                            <td></td>\n                                        <td><pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;SDE Ethnicity&quot;:   SDE.&quot;SDE Ethnicity&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>Hospice</td>\n                                        \n                                        \n                                            <td>Has Hospice</td>\n                                        \n                                    </tr>\n                                    <tr>\n                                        \n                                            <td></td>\n                                        <td><pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Has Hospice&quot;:  exists (     [Encounter: &quot;Encounter Inpatient&quot;] DischargeHospice    where DischargeHospice.status = 'finished'       and (          DischargeHospice.hospitalization.dischargeDisposition ~ &quot;Discharge to home for hospice care (procedure)&quot;         or DischargeHospice.hospitalization.dischargeDisposition ~ &quot;Discharge to healthcare facility for hospice care (procedure)&quot;       )     and DischargeHospice.period ends during &quot;Measurement Period&quot;  )     or exists (       [ServiceRequest: &quot;Hospice care ambulatory&quot;] HospiceOrder         where HospiceOrder.intent = 'order'             and HospiceOrder.authoredOn in &quot;Measurement Period&quot;     )     or exists (       [Procedure: &quot;Hospice care ambulatory&quot;] HospicePerformed         where HospicePerformed.status = 'completed'           and Global.&quot;Normalize Interval&quot;(HospicePerformed.performed) overlaps &quot;Measurement Period&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>PVSComponent</td>\n                                        \n                                        \n                                            <td>Denominator Exclusions</td>\n                                        \n                                    </tr>\n                                    <tr>\n                                        \n                                            <td></td>\n                                        <td><pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Denominator Exclusions&quot;:   Hospice.&quot;Has Hospice&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>SupplementalDataElements</td>\n                                        \n                                        \n                                            <td>SDE Race</td>\n                                        \n                                    </tr>\n                                    <tr>\n                                        \n                                            <td></td>\n                                        <td><pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;SDE Race&quot;:   (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</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>PVSComponent</td>\n                                        \n                                        \n                                            <td>SDE Race</td>\n                                        \n                                    </tr>\n                                    <tr>\n                                        \n                                            <td></td>\n                                        <td><pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;SDE Race&quot;:   SDE.&quot;SDE Race&quot;</code></pre></td>\n                                        \n                                    </tr>\n                                \n                            </table>\n                        </td>\n                    </tr>\n                \n            \n        \n    </table>\n</div>"
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        },
        {
          "type" : "depends-on",
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        },
        {
          "type" : "depends-on",
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        },
        {
          "type" : "depends-on",
          "display" : "Value set Nursing Facility Visit",
          "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1012"
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        {
          "type" : "depends-on",
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        {
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        },
        {
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        }
      ],
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          "use" : "in",
          "min" : 0,
          "max" : "1",
          "type" : "Period"
        },
        {
          "name" : "SDE Sex",
          "use" : "out",
          "min" : 0,
          "max" : "1",
          "type" : "Coding"
        },
        {
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        },
        {
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        },
        {
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          "max" : "1",
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        },
        {
          "name" : "SDE Ethnicity",
          "use" : "out",
          "min" : 0,
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        },
        {
          "name" : "Denominator Exclusions",
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          "max" : "1",
          "type" : "boolean"
        },
        {
          "name" : "SDE Race",
          "use" : "out",
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        }
      ],
      "dataRequirement" : [
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        {
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            "url"
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        },
        {
          "type" : "Encounter",
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          "mustSupport" : [
            "period",
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            "hospitalization.dischargeDisposition",
            "type",
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          "mustSupport" : [
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        },
        {
          "type" : "ServiceRequest",
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          "mustSupport" : [
            "code",
            "authoredOn",
            "intent"
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          ]
        },
        {
          "type" : "Procedure",
          "profile" : [
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          "mustSupport" : [
            "code",
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        {
          "type" : "Procedure",
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          ]
        },
        {
          "type" : "Immunization",
          "profile" : [
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          ],
          "mustSupport" : [
            "occurrence",
            "vaccineCode",
            "status"
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          "codeFilter" : [
            {
              "path" : "vaccineCode",
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          ]
        }
      ]
    }
  ],
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      "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis",
      "valueCode" : "boolean"
    },
    {
      "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"
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    }
  ],
  "url" : "http://hl7.org/fhir/us/cqfmeasures/Measure/PVSComponent",
  "version" : "0.0.001",
  "name" : "PVSComponent",
  "title" : "Pneumococcal Vaccination Status for Older Adults",
  "status" : "draft",
  "experimental" : true,
  "date" : "2022-02-22T11:37:04-06:00",
  "publisher" : "Clinical Quality Information WG",
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          "system" : "url",
          "value" : "http://www.hl7.org/Special/committees/cqi"
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      ]
    }
  ],
  "description" : "This is an example only.",
  "jurisdiction" : [
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      "coding" : [
        {
          "system" : "urn:iso:std:iso:3166",
          "code" : "US"
        }
      ]
    }
  ],
  "effectivePeriod" : {
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    "end" : "2022-12-31"
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  "library" : [
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  "scoring" : {
    "coding" : [
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        "system" : "http://terminology.hl7.org/CodeSystem/measure-scoring",
        "code" : "proportion",
        "display" : "Proportion"
      }
    ]
  },
  "type" : [
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      "coding" : [
        {
          "system" : "http://terminology.hl7.org/CodeSystem/measure-type",
          "code" : "process"
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      ]
    }
  ],
  "improvementNotation" : {
    "coding" : [
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        "system" : "http://terminology.hl7.org/CodeSystem/measure-improvement-notation",
        "code" : "increase"
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  },
  "group" : [
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                "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                "code" : "initial-population",
                "display" : "Initial Population"
              }
            ]
          },
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Initial Population"
          }
        },
        {
          "id" : "7BFE8E56-FD1F-4E35-A79F-0E2569819358",
          "code" : {
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                "display" : "Denominator"
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            ]
          },
          "criteria" : {
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            "expression" : "Denominator"
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        },
        {
          "id" : "F74BB6AC-40CD-40BB-A9F8-06F4A4A0D2C5",
          "code" : {
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                "code" : "denominator-exclusion",
                "display" : "Denominator Exclusion"
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            ]
          },
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Denominator Exclusions"
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        },
        {
          "id" : "89B1D5A5-96B6-4002-B962-9989FED8A0E9",
          "code" : {
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                "code" : "numerator",
                "display" : "Numerator"
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            ]
          },
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Numerator"
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        }
      ]
    }
  ],
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      "id" : "66567b90-12e8-4a1c-8425-2cb8106f9664",
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              "code" : "supplemental-data"
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          ]
        }
      ],
      "criteria" : {
        "language" : "text/cql-identifier",
        "expression" : "SDE Ethnicity"
      }
    },
    {
      "id" : "d431e0e9-8d05-4ca7-a0b2-6cf72313c6d6",
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              "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
              "code" : "supplemental-data"
            }
          ]
        }
      ],
      "criteria" : {
        "language" : "text/cql-identifier",
        "expression" : "SDE Payer"
      }
    },
    {
      "id" : "b5baeb14-bfba-4ad5-a150-8a5442d113f8",
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              "code" : "supplemental-data"
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          ]
        }
      ],
      "criteria" : {
        "language" : "text/cql-identifier",
        "expression" : "SDE Race"
      }
    },
    {
      "id" : "54129f83-97a7-4149-82c8-92ab0e8060ed",
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              "code" : "supplemental-data"
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          ]
        }
      ],
      "criteria" : {
        "language" : "text/cql-identifier",
        "expression" : "SDE Sex"
      }
    }
  ]
}