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 - XML Representation

Draft as of 2022-02-22

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<Measure xmlns="http://hl7.org/fhir">
  <id value="PVSComponent"/>
  <meta>
    <profile
             value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/proportion-measure-cqfm"/>
    <profile
             value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-measure-cqfm"/>
  </meta>
  <language value="en"/>
  <text>
    <status value="extensions"/>
    <div xmlns="http://www.w3.org/1999/xhtml" xml:lang="en" lang="en">
    <table class="grid dict">
        
            <tr>
                <th scope="row"><b>Id: </b></th>
                <td style="padding-left: 4px;">PVSComponent</td>
            </tr>
            
            
            <tr>
                <th scope="row"><b>Download cql: </b></th>
                <td style="padding-left: 4px;"><a href="Library-PVSComponent.cql">PVSComponent.cql</a></td>
            </tr>
            

        
        
            <tr>
                <th scope="row"><b>Url: </b></th>
                <td style="padding-left: 4px;"><a href="Measure-PVSComponent.html">Pneumococcal Vaccination Status for Older Adults</a></td>
            </tr>
        
        
            <tr>
                <th scope="row"><b>Version: </b></th>
                <td style="padding-left: 4px;">0.0.001</td>
            </tr>
        
        
        
            <tr>
                <th scope="row"><b>Name: </b></th>
                <td style="padding-left: 4px;">PVSComponent</td>
            </tr>
        
        
            <tr>
                <th scope="row"><b>Title: </b></th>
                <td style="padding-left: 4px;">Pneumococcal Vaccination Status for Older Adults</td>
            </tr>
        
        
        
            <tr>
                <th scope="row"><b>Status: </b></th>
                <td style="padding-left: 4px;">draft</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>Proportion </span>
                            </p>
                        
                    
                    
                </td>
            </tr>
        
        
            <tr>
                <th scope="row"><b>Improvement Notation: </b></th>
                <td style="padding-left: 4px;">
                    
                        
                            <p style="margin-bottom: 5px;">
                             <span>increase </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 11:37:04-0600</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>This is an example only.</p>
</div></td>
            </tr>
        
        
        
        
        
            <tr>
                <th scope="row"><b>Jurisdiction: </b></th>
                <td style="padding-left: 25px;">US</td>
            </tr>
        
        
        
        
        
        
        
        
        
            <tr>
                <th scope="row"><b>Effective Period: </b></th>
                <td style="padding-left: 4px;">2022-01-01..2022-12-31</td>
            </tr>
        
        
            
        
        
        
        
            <tr>
                <th scope="row"><b> Supplemental Data Elements: </b></th>
                <td style="padding-left: 4px;">
                    
                        
                            
                                
                                    SDE Ethnicity
                                
                            
                        
                    
                        
                            
                                
                                    SDE Payer
                                
                            
                        
                    
                        
                            
                                
                                    SDE Race
                                
                            
                        
                    
                        
                            
                                
                                    SDE Sex
                                
                            
                        
                    
                </td>
            </tr>
        
        
        
            <tr>
                <th scope="row"><b>Libraries: </b></th>
                <td style="padding-left: 4px;">
                    <table class="grid-dict">
                        
                            <tr><td><a href="Library-PVSComponent.html">PVS Component 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="Library-SupplementalDataElements.html">Supplemental Data Elements Library</a></li>
                        
                            <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>
                        
                            <li><a href="Library-MATGlobalCommonFunctions.html">MAT Global Common Functions FHIR Library</a></li>
                        
                            <li><a href="Library-Hospice.html">Hospice FHIR Library</a></li>
                        
                            <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>
                        
                            <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>
                        
                            <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>
                        
                            <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>
                        
                            <li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1240/expansion">Annual Wellness Visit</a></li>
                        
                            <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>
                        
                            <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>
                        
                            <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>
                        
                            <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>
                        
                            <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>
                        
                            <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>
                        
                            <li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.114222.4.11.3591/expansion">Payer</a></li>
                        
                            <li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.666.5.307/expansion">Encounter Inpatient</a></li>
                        
                            <li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1108.15/expansion">Hospice Care Ambulatory</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>Measurement Period</td>
                                    <td>in</td>
                                    <td>0</td>
                                    <td>1</td>
                                    <td>Period</td>
                                </tr>
                            
                                <tr>
                                    <td>SDE Sex</td>
                                    <td>out</td>
                                    <td>0</td>
                                    <td>1</td>
                                    <td>Coding</td>
                                </tr>
                            
                                <tr>
                                    <td>Numerator</td>
                                    <td>out</td>
                                    <td>0</td>
                                    <td>1</td>
                                    <td>boolean</td>
                                </tr>
                            
                                <tr>
                                    <td>Denominator</td>
                                    <td>out</td>
                                    <td>0</td>
                                    <td>1</td>
                                    <td>boolean</td>
                                </tr>
                            
                                <tr>
                                    <td>SDE Payer</td>
                                    <td>out</td>
                                    <td>0</td>
                                    <td>*</td>
                                    <td>Resource</td>
                                </tr>
                            
                                <tr>
                                    <td>Initial Population</td>
                                    <td>out</td>
                                    <td>0</td>
                                    <td>1</td>
                                    <td>boolean</td>
                                </tr>
                            
                                <tr>
                                    <td>SDE Ethnicity</td>
                                    <td>out</td>
                                    <td>0</td>
                                    <td>*</td>
                                    <td>Coding</td>
                                </tr>
                            
                                <tr>
                                    <td>Denominator Exclusions</td>
                                    <td>out</td>
                                    <td>0</td>
                                    <td>1</td>
                                    <td>boolean</td>
                                </tr>
                            
                                <tr>
                                    <td>SDE Race</td>
                                    <td>out</td>
                                    <td>0</td>
                                    <td>*</td>
                                    <td>Coding</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>Coverage</td>
                                    <td>
                                        
                                            period
                                        
                                            type
                                        
                                    </td>
                                    <td>
                                        
                                            
                                                 Payer
                                            
                                        
                                    </td>
                                    <td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.114222.4.11.3591/expansion">Payer</a></td>
                                </tr>
                            
                                <tr>
                                    <td>Patient</td>
                                    <td>
                                        
                                            extension
                                        
                                            value
                                        
                                            url
                                        
                                    </td>
                                    <td>
                                        
                                    </td>
                                    <td></td>
                                </tr>
                            
                                <tr>
                                    <td>Encounter</td>
                                    <td>
                                        
                                            period
                                        
                                            hospitalization
                                        
                                            hospitalization.dischargeDisposition
                                        
                                            type
                                        
                                            status
                                        
                                    </td>
                                    <td>
                                        
                                            
                                                 Encounter Inpatient
                                            
                                        
                                    </td>
                                    <td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.666.5.307/expansion">Encounter Inpatient</a></td>
                                </tr>
                            
                                <tr>
                                    <td>Encounter</td>
                                    <td>
                                        
                                            type
                                        
                                    </td>
                                    <td>
                                        
                                            
                                                 Office Visit
                                            
                                        
                                    </td>
                                    <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>
                                </tr>
                            
                                <tr>
                                    <td>Encounter</td>
                                    <td>
                                        
                                            type
                                        
                                    </td>
                                    <td>
                                        
                                            
                                                 Annual Wellness Visit
                                            
                                        
                                    </td>
                                    <td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1240/expansion">Annual Wellness Visit</a></td>
                                </tr>
                            
                                <tr>
                                    <td>Encounter</td>
                                    <td>
                                        
                                            type
                                        
                                    </td>
                                    <td>
                                        
                                            
                                                 Preventive Care Services - Established Office Visit, 18 and Up
                                            
                                        
                                    </td>
                                    <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>
                                </tr>
                            
                                <tr>
                                    <td>Encounter</td>
                                    <td>
                                        
                                            type
                                        
                                    </td>
                                    <td>
                                        
                                            
                                                 Preventive Care Services-Initial Office Visit, 18 and Up
                                            
                                        
                                    </td>
                                    <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>
                                </tr>
                            
                                <tr>
                                    <td>Encounter</td>
                                    <td>
                                        
                                            type
                                        
                                    </td>
                                    <td>
                                        
                                            
                                                 Home Healthcare Services
                                            
                                        
                                    </td>
                                    <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>
                                </tr>
                            
                                <tr>
                                    <td>Encounter</td>
                                    <td>
                                        
                                            type
                                        
                                    </td>
                                    <td>
                                        
                                            
                                                 Discharge Services - Nursing Facility
                                            
                                        
                                    </td>
                                    <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>
                                </tr>
                            
                                <tr>
                                    <td>Encounter</td>
                                    <td>
                                        
                                            type
                                        
                                    </td>
                                    <td>
                                        
                                            
                                                 Nursing Facility Visit
                                            
                                        
                                    </td>
                                    <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>
                                </tr>
                            
                                <tr>
                                    <td>Encounter</td>
                                    <td>
                                        
                                            type
                                        
                                    </td>
                                    <td>
                                        
                                            
                                                 Care Services in Long-Term Residential Facility
                                            
                                        
                                    </td>
                                    <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>
                                </tr>
                            
                                <tr>
                                    <td>ServiceRequest</td>
                                    <td>
                                        
                                            code
                                        
                                            authoredOn
                                        
                                            intent
                                        
                                    </td>
                                    <td>
                                        
                                            
                                                 Hospice care ambulatory
                                            
                                        
                                    </td>
                                    <td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1108.15/expansion">Hospice Care Ambulatory</a></td>
                                </tr>
                            
                                <tr>
                                    <td>Procedure</td>
                                    <td>
                                        
                                            code
                                        
                                            performed
                                        
                                            status
                                        
                                    </td>
                                    <td>
                                        
                                            
                                                 Hospice care ambulatory
                                            
                                        
                                    </td>
                                    <td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1108.15/expansion">Hospice Care Ambulatory</a></td>
                                </tr>
                            
                                <tr>
                                    <td>Procedure</td>
                                    <td>
                                        
                                            code
                                        
                                            performed
                                        
                                            status
                                        
                                    </td>
                                    <td>
                                        
                                            
                                                 Pneumococcal Vaccine Administered
                                            
                                        
                                    </td>
                                    <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>
                                </tr>
                            
                                <tr>
                                    <td>Immunization</td>
                                    <td>
                                        
                                            occurrence
                                        
                                            vaccineCode
                                        
                                            status
                                        
                                    </td>
                                    <td>
                                        
                                            
                                                 Pneumococcal Vaccine
                                            
                                        
                                    </td>
                                    <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>
                                </tr>
                            
                        </table>
                    </td>
                </tr>
                
                    <tr>
                        <th scope="row"><b>Direct Reference Codes:</b></th>
                        <td style="padding-left: 4px;">
                            <table class="grid-dict">
                                <tr><th><b>display</b></th><th><b>code</b></th><th><b>system</b></th></tr>
                                
                                    <tr>
                                        <td>Discharge to home for hospice care (procedure)</td>
                                        <td>428361000124107</td>
                                        <td><a href="http://hl7.org/fhir/R4/codesystem-snomedct.html">SNOMED CT (all versions)</a></td>
                                    </tr>
                                
                                    <tr>
                                        <td>Discharge to healthcare facility for hospice care (procedure)</td>
                                        <td>428371000124100</td>
                                        <td><a href="http://hl7.org/fhir/R4/codesystem-snomedct.html">SNOMED CT (all versions)</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>  </td>
                                            <td>
                                                
                                                
                                                    <b>Measure scoring:</b>
                                                    
                                                        <p style="margin-bottom: 5px;">
                                                        <span>Proportion</span>
                                                        </p>
                                                    
                                                
                                            </td>
                                            
                                                <tr>
                                                    <td/>
                                                    <td/>
                                                    <td>Initial Population</td>
                                                    <td>
                                                        
                                                        <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>
                                                        
                                                    </td>
                                                </tr>
                                            
                                                <tr>
                                                    <td/>
                                                    <td/>
                                                    <td>Denominator</td>
                                                    <td>
                                                        
                                                        <pre><code class="language-cql">define &quot;Denominator&quot;:   &quot;Initial Population&quot;</code></pre>
                                                        
                                                    </td>
                                                </tr>
                                            
                                                <tr>
                                                    <td/>
                                                    <td/>
                                                    <td>Denominator Exclusion</td>
                                                    <td>
                                                        
                                                        <pre><code class="language-cql">define &quot;Denominator Exclusions&quot;:   Hospice.&quot;Has Hospice&quot;</code></pre>
                                                        
                                                    </td>
                                                </tr>
                                            
                                                <tr>
                                                    <td/>
                                                    <td/>
                                                    <td>Numerator</td>
                                                    <td>
                                                        
                                                        <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>
                                                        
                                                    </td>
                                                </tr>
                                            

                                    
                                    </tr>
                                </table>
                            
                            <table class="grid-dict">
                                
                                    <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>
                                    <tr>
                                        
                                            <td>SupplementalDataElements</td>
                                        
                                        
                                            <td>SDE Sex</td>
                                        
                                    </tr>
                                    <tr>
                                        
                                            <td></td>
                                        <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>
                                        
                                    </tr>
                                
                                    <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>
                                    <tr>
                                        
                                            <td>PVSComponent</td>
                                        
                                        
                                            <td>SDE Sex</td>
                                        
                                    </tr>
                                    <tr>
                                        
                                            <td></td>
                                        <td><pre class="highlight language-cql"><code class="language-cql">define &quot;SDE Sex&quot;:   SDE.&quot;SDE Sex&quot;</code></pre></td>
                                        
                                    </tr>
                                
                                    <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>
                                    <tr>
                                        
                                            <td>PVSComponent</td>
                                        
                                        
                                            <td>Numerator</td>
                                        
                                    </tr>
                                    <tr>
                                        
                                            <td></td>
                                        <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>
                                        
                                    </tr>
                                
                                    <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>
                                    <tr>
                                        
                                            <td>PVSComponent</td>
                                        
                                        
                                            <td>Qualifying Encounters</td>
                                        
                                    </tr>
                                    <tr>
                                        
                                            <td></td>
                                        <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>
                                        
                                    </tr>
                                
                                    <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>
                                    <tr>
                                        
                                            <td>PVSComponent</td>
                                        
                                        
                                            <td>Initial Population</td>
                                        
                                    </tr>
                                    <tr>
                                        
                                            <td></td>
                                        <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>
                                        
                                    </tr>
                                
                                    <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>
                                    <tr>
                                        
                                            <td>PVSComponent</td>
                                        
                                        
                                            <td>Denominator</td>
                                        
                                    </tr>
                                    <tr>
                                        
                                            <td></td>
                                        <td><pre class="highlight language-cql"><code class="language-cql">define &quot;Denominator&quot;:   &quot;Initial Population&quot;</code></pre></td>
                                        
                                    </tr>
                                
                                    <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>
                                    <tr>
                                        
                                            <td>SupplementalDataElements</td>
                                        
                                        
                                            <td>SDE Payer</td>
                                        
                                    </tr>
                                    <tr>
                                        
                                            <td></td>
                                        <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>
                                        
                                    </tr>
                                
                                    <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>
                                    <tr>
                                        
                                            <td>PVSComponent</td>
                                        
                                        
                                            <td>SDE Payer</td>
                                        
                                    </tr>
                                    <tr>
                                        
                                            <td></td>
                                        <td><pre class="highlight language-cql"><code class="language-cql">define &quot;SDE Payer&quot;:   SDE.&quot;SDE Payer&quot;</code></pre></td>
                                        
                                    </tr>
                                
                                    <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>
                                    <tr>
                                        
                                            <td>SupplementalDataElements</td>
                                        
                                        
                                            <td>SDE Ethnicity</td>
                                        
                                    </tr>
                                    <tr>
                                        
                                            <td></td>
                                        <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>
                                        
                                    </tr>
                                
                                    <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>
                                    <tr>
                                        
                                            <td>PVSComponent</td>
                                        
                                        
                                            <td>SDE Ethnicity</td>
                                        
                                    </tr>
                                    <tr>
                                        
                                            <td></td>
                                        <td><pre class="highlight language-cql"><code class="language-cql">define &quot;SDE Ethnicity&quot;:   SDE.&quot;SDE Ethnicity&quot;</code></pre></td>
                                        
                                    </tr>
                                
                                    <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>
                                    <tr>
                                        
                                            <td>Hospice</td>
                                        
                                        
                                            <td>Has Hospice</td>
                                        
                                    </tr>
                                    <tr>
                                        
                                            <td></td>
                                        <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>
                                        
                                    </tr>
                                
                                    <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>
                                    <tr>
                                        
                                            <td>PVSComponent</td>
                                        
                                        
                                            <td>Denominator Exclusions</td>
                                        
                                    </tr>
                                    <tr>
                                        
                                            <td></td>
                                        <td><pre class="highlight language-cql"><code class="language-cql">define &quot;Denominator Exclusions&quot;:   Hospice.&quot;Has Hospice&quot;</code></pre></td>
                                        
                                    </tr>
                                
                                    <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>
                                    <tr>
                                        
                                            <td>SupplementalDataElements</td>
                                        
                                        
                                            <td>SDE Race</td>
                                        
                                    </tr>
                                    <tr>
                                        
                                            <td></td>
                                        <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>
                                        
                                    </tr>
                                
                                    <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>
                                    <tr>
                                        
                                            <td>PVSComponent</td>
                                        
                                        
                                            <td>SDE Race</td>
                                        
                                    </tr>
                                    <tr>
                                        
                                            <td></td>
                                        <td><pre class="highlight language-cql"><code class="language-cql">define &quot;SDE Race&quot;:   SDE.&quot;SDE Race&quot;</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-directReferenceCode">
        <valueCoding>
          <system value="http://snomed.info/sct"/>
          <version
                   value="http://snomed.info/sct/731000124108/version/201709"/>
          <code value="428361000124107"/>
          <display value="Discharge to home for hospice care (procedure)"/>
        </valueCoding>
      </extension>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
        <valueCoding>
          <system value="http://snomed.info/sct"/>
          <version
                   value="http://snomed.info/sct/731000124108/version/201709"/>
          <code value="428371000124100"/>
          <display
                   value="Discharge to healthcare facility for hospice care (procedure)"/>
        </valueCoding>
      </extension>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
        <extension url="libraryName">
          <valueString value="SupplementalDataElements"/>
        </extension>
        <extension url="name">
          <valueString value="SDE Sex"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="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"/>
        </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="PVSComponent"/>
        </extension>
        <extension url="name">
          <valueString value="SDE Sex"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;SDE Sex&quot;:   SDE.&quot;SDE Sex&quot;"/>
        </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="PVSComponent"/>
        </extension>
        <extension url="name">
          <valueString value="Numerator"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="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;       )"/>
        </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="PVSComponent"/>
        </extension>
        <extension url="name">
          <valueString value="Qualifying Encounters"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="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'"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="3"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
        <extension url="libraryName">
          <valueString value="PVSComponent"/>
        </extension>
        <extension url="name">
          <valueString value="Initial Population"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="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;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="4"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
        <extension url="libraryName">
          <valueString value="PVSComponent"/>
        </extension>
        <extension url="name">
          <valueString value="Denominator"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Denominator&quot;:   &quot;Initial Population&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="5"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
        <extension url="libraryName">
          <valueString value="SupplementalDataElements"/>
        </extension>
        <extension url="name">
          <valueString value="SDE Payer"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;SDE Payer&quot;:   [Coverage: type in &quot;Payer&quot;] Payer         return {           code: Payer.type,           period: Payer.period         }"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="6"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
        <extension url="libraryName">
          <valueString value="PVSComponent"/>
        </extension>
        <extension url="name">
          <valueString value="SDE Payer"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;SDE Payer&quot;:   SDE.&quot;SDE Payer&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="7"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
        <extension url="libraryName">
          <valueString value="SupplementalDataElements"/>
        </extension>
        <extension url="name">
          <valueString value="SDE Ethnicity"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="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"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="8"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
        <extension url="libraryName">
          <valueString value="PVSComponent"/>
        </extension>
        <extension url="name">
          <valueString value="SDE Ethnicity"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;SDE Ethnicity&quot;:   SDE.&quot;SDE Ethnicity&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="9"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
        <extension url="libraryName">
          <valueString value="Hospice"/>
        </extension>
        <extension url="name">
          <valueString value="Has Hospice"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="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;     )"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="10"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
        <extension url="libraryName">
          <valueString value="PVSComponent"/>
        </extension>
        <extension url="name">
          <valueString value="Denominator Exclusions"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Denominator Exclusions&quot;:   Hospice.&quot;Has Hospice&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="11"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
        <extension url="libraryName">
          <valueString value="SupplementalDataElements"/>
        </extension>
        <extension url="name">
          <valueString value="SDE Race"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="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"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="12"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
        <extension url="libraryName">
          <valueString value="PVSComponent"/>
        </extension>
        <extension url="name">
          <valueString value="SDE Race"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;SDE Race&quot;:   SDE.&quot;SDE Race&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="13"/>
        </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="Library SDE"/>
        <resource
                  value="http://hl7.org/fhir/us/cqfmeasures/Library/SupplementalDataElements|2.0.000"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Library FHIRHelpers"/>
        <resource
                  value="http://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Library Global"/>
        <resource
                  value="http://hl7.org/fhir/us/cqfmeasures/Library/MATGlobalCommonFunctions|5.0.000"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Library Hospice"/>
        <resource
                  value="http://hl7.org/fhir/us/cqfmeasures/Library/Hospice|2.0.000"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Code system SNOMEDCT:2017-09"/>
        <resource
                  value="http://snomed.info/sct|http://snomed.info/sct/731000124108/version/201709"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Pneumococcal Vaccine"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1027"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Pneumococcal Vaccine Administered"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1034"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Office Visit"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Annual Wellness Visit"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display
                 value="Value set Preventive Care Services - Established Office Visit, 18 and Up"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display
                 value="Value set Preventive Care Services-Initial Office Visit, 18 and Up"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Home Healthcare Services"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Discharge Services - Nursing Facility"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.11.1065"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Nursing Facility Visit"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1012"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display
                 value="Value set Care Services in Long-Term Residential Facility"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1014"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Payer"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Encounter Inpatient"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Hospice care ambulatory"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.15"/>
      </relatedArtifact>
      <parameter>
        <name value="Measurement Period"/>
        <use value="in"/>
        <min value="0"/>
        <max value="1"/>
        <type value="Period"/>
      </parameter>
      <parameter>
        <name value="SDE Sex"/>
        <use value="out"/>
        <min value="0"/>
        <max value="1"/>
        <type value="Coding"/>
      </parameter>
      <parameter>
        <name value="Numerator"/>
        <use value="out"/>
        <min value="0"/>
        <max value="1"/>
        <type value="boolean"/>
      </parameter>
      <parameter>
        <name value="Denominator"/>
        <use value="out"/>
        <min value="0"/>
        <max value="1"/>
        <type value="boolean"/>
      </parameter>
      <parameter>
        <name value="SDE Payer"/>
        <use value="out"/>
        <min value="0"/>
        <max value="*"/>
        <type value="Resource"/>
      </parameter>
      <parameter>
        <name value="Initial Population"/>
        <use value="out"/>
        <min value="0"/>
        <max value="1"/>
        <type value="boolean"/>
      </parameter>
      <parameter>
        <name value="SDE Ethnicity"/>
        <use value="out"/>
        <min value="0"/>
        <max value="*"/>
        <type value="Coding"/>
      </parameter>
      <parameter>
        <name value="Denominator Exclusions"/>
        <use value="out"/>
        <min value="0"/>
        <max value="1"/>
        <type value="boolean"/>
      </parameter>
      <parameter>
        <name value="SDE Race"/>
        <use value="out"/>
        <min value="0"/>
        <max value="*"/>
        <type value="Coding"/>
      </parameter>
      <dataRequirement>
        <type value="Coverage"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Coverage"/>
        <mustSupport value="period"/>
        <mustSupport value="type"/>
        <codeFilter>
          <path value="type"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Patient"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Patient"/>
        <mustSupport value="extension"/>
        <mustSupport value="value"/>
        <mustSupport value="url"/>
      </dataRequirement>
      <dataRequirement>
        <type value="Encounter"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Encounter"/>
        <mustSupport value="period"/>
        <mustSupport value="hospitalization"/>
        <mustSupport value="hospitalization.dischargeDisposition"/>
        <mustSupport value="type"/>
        <mustSupport value="status"/>
        <codeFilter>
          <path value="type"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Encounter"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Encounter"/>
        <mustSupport value="type"/>
        <codeFilter>
          <path value="type"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Encounter"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Encounter"/>
        <mustSupport value="type"/>
        <codeFilter>
          <path value="type"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Encounter"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Encounter"/>
        <mustSupport value="type"/>
        <codeFilter>
          <path value="type"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Encounter"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Encounter"/>
        <mustSupport value="type"/>
        <codeFilter>
          <path value="type"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Encounter"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Encounter"/>
        <mustSupport value="type"/>
        <codeFilter>
          <path value="type"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Encounter"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Encounter"/>
        <mustSupport value="type"/>
        <codeFilter>
          <path value="type"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.11.1065"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Encounter"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Encounter"/>
        <mustSupport value="type"/>
        <codeFilter>
          <path value="type"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1012"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Encounter"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Encounter"/>
        <mustSupport value="type"/>
        <codeFilter>
          <path value="type"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1014"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="ServiceRequest"/>
        <profile
                 value="http://hl7.org/fhir/StructureDefinition/ServiceRequest"/>
        <mustSupport value="code"/>
        <mustSupport value="authoredOn"/>
        <mustSupport value="intent"/>
        <codeFilter>
          <path value="code"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.15"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Procedure"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Procedure"/>
        <mustSupport value="code"/>
        <mustSupport value="performed"/>
        <mustSupport value="status"/>
        <codeFilter>
          <path value="code"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.15"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Procedure"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Procedure"/>
        <mustSupport value="code"/>
        <mustSupport value="performed"/>
        <mustSupport value="status"/>
        <codeFilter>
          <path value="code"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1034"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Immunization"/>
        <profile
                 value="http://hl7.org/fhir/StructureDefinition/Immunization"/>
        <mustSupport value="occurrence"/>
        <mustSupport value="vaccineCode"/>
        <mustSupport value="status"/>
        <codeFilter>
          <path value="vaccineCode"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1027"/>
        </codeFilter>
      </dataRequirement>
    </Library>
  </contained>
  <extension
             url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis">
    <valueCode value="boolean"/>
  </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://hl7.org/fhir/us/cqfmeasures/Measure/PVSComponent"/>
  <version value="0.0.001"/>
  <name value="PVSComponent"/>
  <title value="Pneumococcal Vaccination Status for Older Adults"/>
  <status value="draft"/>
  <experimental value="true"/>
  <date value="2022-02-22T11:37:04-06:00"/>
  <publisher value="Clinical Quality Information WG"/>
  <contact>
    <telecom>
      <system value="url"/>
      <value value="http://www.hl7.org/Special/committees/cqi"/>
    </telecom>
  </contact>
  <description value="This is an example only."/>
  <jurisdiction>
    <coding>
      <system value="urn:iso:std:iso:3166"/>
      <code value="US"/>
    </coding>
  </jurisdiction>
  <effectivePeriod>
    <start value="2022-01-01"/>
    <end value="2022-12-31"/>
  </effectivePeriod>
  <library value="http://hl7.org/fhir/us/cqfmeasures/Library/PVSComponent"/>
  <scoring>
    <coding>
      <system value="http://terminology.hl7.org/CodeSystem/measure-scoring"/>
      <code value="proportion"/>
      <display value="Proportion"/>
    </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="increase"/>
    </coding>
  </improvementNotation>
  <group>
    <population id="FB55A109-7AC0-4385-AD01-ED3814C92697">
      <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="7BFE8E56-FD1F-4E35-A79F-0E2569819358">
      <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="F74BB6AC-40CD-40BB-A9F8-06F4A4A0D2C5">
      <code>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/measure-population"/>
          <code value="denominator-exclusion"/>
          <display value="Denominator Exclusion"/>
        </coding>
      </code>
      <criteria>
        <language value="text/cql-identifier"/>
        <expression value="Denominator Exclusions"/>
      </criteria>
    </population>
    <population id="89B1D5A5-96B6-4002-B962-9989FED8A0E9">
      <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>
  </group>
  <supplementalData id="66567b90-12e8-4a1c-8425-2cb8106f9664">
    <usage>
      <coding>
        <system
                value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
        <code value="supplemental-data"/>
      </coding>
    </usage>
    <criteria>
      <language value="text/cql-identifier"/>
      <expression value="SDE Ethnicity"/>
    </criteria>
  </supplementalData>
  <supplementalData id="d431e0e9-8d05-4ca7-a0b2-6cf72313c6d6">
    <usage>
      <coding>
        <system
                value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
        <code value="supplemental-data"/>
      </coding>
    </usage>
    <criteria>
      <language value="text/cql-identifier"/>
      <expression value="SDE Payer"/>
    </criteria>
  </supplementalData>
  <supplementalData id="b5baeb14-bfba-4ad5-a150-8a5442d113f8">
    <usage>
      <coding>
        <system
                value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
        <code value="supplemental-data"/>
      </coding>
    </usage>
    <criteria>
      <language value="text/cql-identifier"/>
      <expression value="SDE Race"/>
    </criteria>
  </supplementalData>
  <supplementalData id="54129f83-97a7-4149-82c8-92ab0e8060ed">
    <usage>
      <coding>
        <system
                value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
        <code value="supplemental-data"/>
      </coding>
    </usage>
    <criteria>
      <language value="text/cql-identifier"/>
      <expression value="SDE Sex"/>
    </criteria>
  </supplementalData>
</Measure>