Quality Measure Implementation Guide (STU4)
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This page is part of the Quality Measure STU2 for FHIR R4 Implementation Guide (v4.0.0: STU4 (v4.0.0)) based on FHIR R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

: EXM Publishable Measure - TTL Representation

Active as of 2022-02-22

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

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

 a fhir:Measure ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:id [ fhir:v "measure-publishable-exm"] ; # 
  fhir:meta [
    ( fhir:profile [
fhir:v "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/publishable-measure-cqfm"^^xsd:anyURI ;
fhir:link <http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/publishable-measure-cqfm>     ] [
fhir:v "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-measure-cqfm"^^xsd:anyURI ;
fhir:link <http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-measure-cqfm>     ] )
  ] ; # 
  fhir:text [
fhir:status [ fhir:v "extensions" ] ;
fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b style=\"color: maroon\">Exception generating Narrative: unexpected non-end of element null::a  at line 288 column 37</b></p></div>"
  ] ; # 
  fhir:contained ( [
a fhir:Library ;
fhir:id [ fhir:v "effective-data-requirements" ] ;
    ( fhir:extension [
      ( fhir:extension [
fhir:url [ fhir:v "libraryName"^^xsd:anyURI ] ;
fhir:value [ fhir:v "EXMPublishableLibrary" ]       ] [
fhir:url [ fhir:v "name"^^xsd:anyURI ] ;
fhir:value [ fhir:v "SDE Sex" ]       ] [
fhir:url [ fhir:v "statement"^^xsd:anyURI ] ;
fhir:value [ fhir:v "define \"SDE Sex\":   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" ]       ] [
fhir:url [ fhir:v "displaySequence"^^xsd:anyURI ] ;
fhir:value [ fhir:v "0"^^xsd:integer ]       ] ) ;
fhir:url [ fhir:v "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"^^xsd:anyURI ]     ] [
      ( fhir:extension [
fhir:url [ fhir:v "libraryName"^^xsd:anyURI ] ;
fhir:value [ fhir:v "EXMPublishableLibrary" ]       ] [
fhir:url [ fhir:v "name"^^xsd:anyURI ] ;
fhir:value [ fhir:v "SDE Payer" ]       ] [
fhir:url [ fhir:v "statement"^^xsd:anyURI ] ;
fhir:value [ fhir:v "define \"SDE Payer\":     [Coverage: type in \"Payer\"] Payer       return {         code: Payer.type,         period: Payer.period       }" ]       ] [
fhir:url [ fhir:v "displaySequence"^^xsd:anyURI ] ;
fhir:value [ fhir:v "1"^^xsd:integer ]       ] ) ;
fhir:url [ fhir:v "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"^^xsd:anyURI ]     ] [
      ( fhir:extension [
fhir:url [ fhir:v "libraryName"^^xsd:anyURI ] ;
fhir:value [ fhir:v "EXMPublishableLibrary" ]       ] [
fhir:url [ fhir:v "name"^^xsd:anyURI ] ;
fhir:value [ fhir:v "Inpatient Encounter" ]       ] [
fhir:url [ fhir:v "statement"^^xsd:anyURI ] ;
fhir:value [ fhir:v "define \"Inpatient Encounter\" :   [\"Encounter\"] Encounter     where LengthInDays(Encounter.period) <= 120       and Encounter.period ends during \"Measurement Period\"" ]       ] [
fhir:url [ fhir:v "displaySequence"^^xsd:anyURI ] ;
fhir:value [ fhir:v "2"^^xsd:integer ]       ] ) ;
fhir:url [ fhir:v "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"^^xsd:anyURI ]     ] [
      ( fhir:extension [
fhir:url [ fhir:v "libraryName"^^xsd:anyURI ] ;
fhir:value [ fhir:v "EXMPublishableLibrary" ]       ] [
fhir:url [ fhir:v "name"^^xsd:anyURI ] ;
fhir:value [ fhir:v "Initial Population" ]       ] [
fhir:url [ fhir:v "statement"^^xsd:anyURI ] ;
fhir:value [ fhir:v "define \"Initial Population\" :   \"Inpatient Encounter\" Encounter" ]       ] [
fhir:url [ fhir:v "displaySequence"^^xsd:anyURI ] ;
fhir:value [ fhir:v "3"^^xsd:integer ]       ] ) ;
fhir:url [ fhir:v "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"^^xsd:anyURI ]     ] [
      ( fhir:extension [
fhir:url [ fhir:v "libraryName"^^xsd:anyURI ] ;
fhir:value [ fhir:v "EXMPublishableLibrary" ]       ] [
fhir:url [ fhir:v "name"^^xsd:anyURI ] ;
fhir:value [ fhir:v "SDE Ethnicity" ]       ] [
fhir:url [ fhir:v "statement"^^xsd:anyURI ] ;
fhir:value [ fhir:v "define \"SDE Ethnicity\":   (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" ]       ] [
fhir:url [ fhir:v "displaySequence"^^xsd:anyURI ] ;
fhir:value [ fhir:v "4"^^xsd:integer ]       ] ) ;
fhir:url [ fhir:v "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"^^xsd:anyURI ]     ] [
      ( fhir:extension [
fhir:url [ fhir:v "libraryName"^^xsd:anyURI ] ;
fhir:value [ fhir:v "EXMPublishableLibrary" ]       ] [
fhir:url [ fhir:v "name"^^xsd:anyURI ] ;
fhir:value [ fhir:v "SDE Race" ]       ] [
fhir:url [ fhir:v "statement"^^xsd:anyURI ] ;
fhir:value [ fhir:v "define \"SDE Race\":   (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" ]       ] [
fhir:url [ fhir:v "displaySequence"^^xsd:anyURI ] ;
fhir:value [ fhir:v "5"^^xsd:integer ]       ] ) ;
fhir:url [ fhir:v "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"^^xsd:anyURI ]     ] ) ;
fhir:name [ fhir:v "EffectiveDataRequirements" ] ;
fhir:status [ fhir:v "active" ] ;
fhir:type [
      ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/library-type"^^xsd:anyURI ] ;
fhir:code [ fhir:v "module-definition" ]       ] )     ] ;
fhir:date [ fhir:v "2022-02-22T10:37:03-07:00"^^xsd:dateTime ] ;
    ( fhir:relatedArtifact [
fhir:type [ fhir:v "depends-on" ] ;
fhir:display [ fhir:v "Library FHIRHelpers" ] ;
fhir:resource [
fhir:v "http://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1"^^xsd:anyURI ;
fhir:link <http://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1>       ]     ] [
fhir:type [ fhir:v "depends-on" ] ;
fhir:display [ fhir:v "Value set Payer" ] ;
fhir:resource [
fhir:v "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"^^xsd:anyURI ;
fhir:link <http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591>       ]     ] ) ;
    ( fhir:parameter [
fhir:name [ fhir:v "Measurement Period" ] ;
fhir:use [ fhir:v "in" ] ;
fhir:min [ fhir:v "0"^^xsd:integer ] ;
fhir:max [ fhir:v "1" ] ;
fhir:type [ fhir:v "Period" ]     ] [
fhir:name [ fhir:v "SDE Sex" ] ;
fhir:use [ fhir:v "out" ] ;
fhir:min [ fhir:v "0"^^xsd:integer ] ;
fhir:max [ fhir:v "1" ] ;
fhir:type [ fhir:v "Coding" ]     ] [
fhir:name [ fhir:v "SDE Payer" ] ;
fhir:use [ fhir:v "out" ] ;
fhir:min [ fhir:v "0"^^xsd:integer ] ;
fhir:max [ fhir:v "*" ] ;
fhir:type [ fhir:v "Resource" ]     ] [
fhir:name [ fhir:v "Initial Population" ] ;
fhir:use [ fhir:v "out" ] ;
fhir:min [ fhir:v "0"^^xsd:integer ] ;
fhir:max [ fhir:v "*" ] ;
fhir:type [ fhir:v "Encounter" ]     ] [
fhir:name [ fhir:v "SDE Ethnicity" ] ;
fhir:use [ fhir:v "out" ] ;
fhir:min [ fhir:v "0"^^xsd:integer ] ;
fhir:max [ fhir:v "*" ] ;
fhir:type [ fhir:v "Coding" ]     ] [
fhir:name [ fhir:v "SDE Race" ] ;
fhir:use [ fhir:v "out" ] ;
fhir:min [ fhir:v "0"^^xsd:integer ] ;
fhir:max [ fhir:v "*" ] ;
fhir:type [ fhir:v "Coding" ]     ] ) ;
    ( fhir:dataRequirement [
fhir:type [ fhir:v "Patient" ] ;
      ( fhir:profile [
fhir:v "http://hl7.org/fhir/StructureDefinition/Patient"^^xsd:anyURI ;
fhir:link <http://hl7.org/fhir/StructureDefinition/Patient>       ] ) ;
      ( fhir:mustSupport [ fhir:v "extension" ] [ fhir:v "value" ] [ fhir:v "url" ] )     ] [
fhir:type [ fhir:v "Encounter" ] ;
      ( fhir:profile [
fhir:v "http://hl7.org/fhir/StructureDefinition/Encounter"^^xsd:anyURI ;
fhir:link <http://hl7.org/fhir/StructureDefinition/Encounter>       ] ) ;
      ( fhir:mustSupport [ fhir:v "period" ] )     ] [
fhir:type [ fhir:v "Coverage" ] ;
      ( fhir:profile [
fhir:v "http://hl7.org/fhir/StructureDefinition/Coverage"^^xsd:anyURI ;
fhir:link <http://hl7.org/fhir/StructureDefinition/Coverage>       ] ) ;
      ( fhir:mustSupport [ fhir:v "period" ] [ fhir:v "type" ] ) ;
      ( fhir:codeFilter [
fhir:path [ fhir:v "type" ] ;
fhir:valueSet [
fhir:v "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"^^xsd:anyURI ;
fhir:link <http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591>         ]       ] )     ] )
  ] ) ; # 
  fhir:extension ( [
fhir:url [ fhir:v "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis"^^xsd:anyURI ] ;
fhir:value [ fhir:v "Encounter" ]
  ] [
fhir:url [ fhir:v "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-softwaresystem"^^xsd:anyURI ] ;
fhir:value [
a fhir:Reference ;
fhir:reference [ fhir:v "Device/software-system-example" ]     ]
  ] [
fhir:id [ fhir:v "effective-data-requirements" ] ;
fhir:url [ fhir:v "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-effectiveDataRequirements"^^xsd:anyURI ] ;
fhir:value [
a fhir:Reference ;
fhir:reference [ fhir:v "#effective-data-requirements" ]     ]
  ] ) ; # 
  fhir:url [ fhir:v "http://example.org/fhir/measures/publishable-measure-exm"^^xsd:anyURI] ; # 
  fhir:identifier ( [
fhir:use [ fhir:v "usual" ] ;
fhir:type [
      ( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type"^^xsd:anyURI ] ;
fhir:code [ fhir:v "short-name" ]       ] )     ] ;
fhir:system [ fhir:v "http://example.org/fhir/cqi/ecqm/Measure/Identifier/exm"^^xsd:anyURI ] ;
fhir:value [ fhir:v "EXM-123" ]
  ] [
fhir:use [ fhir:v "official" ] ;
fhir:type [
      ( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type"^^xsd:anyURI ] ;
fhir:code [ fhir:v "version-independent" ]       ] )     ] ;
fhir:system [ fhir:v "urn:ietf:rfc:3986"^^xsd:anyURI ] ;
fhir:value [ fhir:v "urn:uuid:11873bc9-ca0a-4cf3-b8f2-605a950aac74" ]
  ] [
fhir:use [ fhir:v "official" ] ;
fhir:type [
      ( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type"^^xsd:anyURI ] ;
fhir:code [ fhir:v "version-specific" ]       ] )     ] ;
fhir:system [ fhir:v "urn:ietf:rfc:3986"^^xsd:anyURI ] ;
fhir:value [ fhir:v "urn:uuid:b366f29b-347f-464e-8064-c83842d825c7" ]
  ] [
fhir:use [ fhir:v "official" ] ;
fhir:type [
      ( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type"^^xsd:anyURI ] ;
fhir:code [ fhir:v "endorser" ]       ] )     ] ;
fhir:system [ fhir:v "http://example.org/fhir/cqi/ecqm/Measure/Identifier/nqf"^^xsd:anyURI ] ;
fhir:value [ fhir:v "NQF-123" ] ;
fhir:assigner [
fhir:display [ fhir:v "NQF" ]     ]
  ] [
fhir:use [ fhir:v "official" ] ;
fhir:type [
      ( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type"^^xsd:anyURI ] ;
fhir:code [ fhir:v "publisher" ]       ] )     ] ;
fhir:system [ fhir:v "http://example.org/fhir/cqi/ecqm/Measure/Identifier/cms"^^xsd:anyURI ] ;
fhir:value [ fhir:v "CMS-123" ] ;
fhir:assigner [
fhir:display [ fhir:v "CMS" ]     ]
  ] ) ; # 
  fhir:version [ fhir:v "2.0.0"] ; # 
  fhir:name [ fhir:v "PublishableMeasureEXM"] ; # 
  fhir:title [ fhir:v "EXM Publishable Measure"] ; # 
  fhir:status [ fhir:v "active"] ; # 
  fhir:experimental [ fhir:v "true"^^xsd:boolean] ; # 
  fhir:date [ fhir:v "2022-02-22"^^xsd:date] ; # 
  fhir:publisher [ fhir:v "Clinical Quality Information WG"] ; # 
  fhir:contact ( [
    ( fhir:telecom [
fhir:system [ fhir:v "url" ] ;
fhir:value [ fhir:v "http://www.hl7.org/Special/committees/cqi" ]     ] )
  ] ) ; # 
  fhir:description [ fhir:v "An example FHIR-based publishable measure"] ; # 
  fhir:useContext ( [
fhir:code [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/usage-context-type"^^xsd:anyURI ] ;
fhir:code [ fhir:v "program" ]     ] ;
fhir:value [
a fhir:CodeableConcept ;
      ( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/us/cqfmeasures/CodeSystem/quality-programs"^^xsd:anyURI ] ;
fhir:code [ fhir:v "ep-ec" ]       ] ) ;
fhir:text [ fhir:v "eligible-provider" ]     ]
  ] ) ; # 
  fhir:jurisdiction ( [
    ( fhir:coding [
fhir:system [ fhir:v "urn:iso:std:iso:3166"^^xsd:anyURI ] ;
fhir:code [ fhir:v "US" ]     ] )
  ] ) ; # 
  fhir:purpose [ fhir:v "The purpose of this measure is to..."] ; # 
  fhir:usage [ fhir:v "Users of this measure should be aware of..."] ; # 
  fhir:copyright [ fhir:v "Example Copyright Statement"] ; # 
  fhir:approvalDate [ fhir:v "2019-02-17"^^xsd:date] ; # 
  fhir:lastReviewDate [ fhir:v "2019-02-17"^^xsd:date] ; # 
  fhir:effectivePeriod [
    ( fhir:extension [
fhir:url [ fhir:v "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-effectivePeriodAnchor"^^xsd:anyURI ] ;
fhir:value [ fhir:v "2018-01-01"^^xsd:date ]     ] [
fhir:url [ fhir:v "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-effectivePeriodDuration"^^xsd:anyURI ] ;
fhir:value [
a fhir:Duration ;
fhir:value [ fhir:v "1"^^xsd:decimal ] ;
fhir:system [ fhir:v "http://unitsofmeasure.org"^^xsd:anyURI ] ;
fhir:code [ fhir:v "a" ]       ]     ] ) ;
fhir:start [ fhir:v "2018-01-01"^^xsd:date ] ;
fhir:end [ fhir:v "2018-12-31"^^xsd:date ]
  ] ; # 
  fhir:topic ( [
    ( fhir:coding [
a loinc:57024-2 ;
fhir:system [ fhir:v "http://loinc.org"^^xsd:anyURI ] ;
fhir:code [ fhir:v "57024-2" ]     ] ) ;
fhir:text [ fhir:v "Health Quality Measure Document" ]
  ] ) ; # 
  fhir:author ( [
fhir:name [ fhir:v "Example Measure Content Developer" ]
  ] ) ; # 
  fhir:relatedArtifact ( [
    ( fhir:extension [
fhir:url [ fhir:v "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-isPrimaryCitation"^^xsd:anyURI ] ;
fhir:value [ fhir:v "true"^^xsd:boolean ]     ] ) ;
fhir:type [ fhir:v "citation" ] ;
fhir:citation [ fhir:v "Linder, J.A., D.W. Bates, G.M. Lee, J.A. Finkelstein. 2005. \"Antibiotic treatment       of children with sore throat.\" JAMA 294(18):2315-2322." ] ;
fhir:url [ fhir:v "https://pubmed.ncbi.nlm.nih.gov/16278359/"^^xsd:anyURI ] ;
fhir:document [
fhir:url [ fhir:v "https://pubmed.ncbi.nlm.nih.gov/16278359/"^^xsd:anyURI ]     ]
  ] [
    ( fhir:extension [
fhir:url [ fhir:v "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-isPrimaryCitation"^^xsd:anyURI ] ;
fhir:value [ fhir:v "true"^^xsd:boolean ]     ] ) ;
fhir:type [ fhir:v "citation" ] ;
fhir:citation [ fhir:v "Infectious Diseases Society of America. 2012. \"Clinical Practice Guideline for the Diagnosis and Management of Group A Streptococcal Pharyngitis: 2012 Update.\"" ] ;
fhir:url [ fhir:v "https://pubmed.ncbi.nlm.nih.gov/23091044/"^^xsd:anyURI ] ;
fhir:document [
fhir:url [ fhir:v "https://pubmed.ncbi.nlm.nih.gov/23091044/"^^xsd:anyURI ]     ]
  ] [
    ( fhir:extension [
fhir:url [ fhir:v "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-isPrimaryCitation"^^xsd:anyURI ] ;
fhir:value [ fhir:v "true"^^xsd:boolean ]     ] ) ;
fhir:type [ fhir:v "citation" ] ;
fhir:citation [ fhir:v "Roberts, R.R., B. Hota, I. Ahmad, et al. \"Hospital and Societal Costs of Antimicrobial-Resistant Infections in a Chicago Teaching Hospital: Implications for Antibiotic Stewardship.\" Clin Infect Dis. Oct 2009; 49(8):1175-84." ] ;
fhir:url [ fhir:v "https://pubmed.ncbi.nlm.nih.gov/19739972/"^^xsd:anyURI ] ;
fhir:document [
fhir:url [ fhir:v "https://pubmed.ncbi.nlm.nih.gov/19739972/"^^xsd:anyURI ]     ]
  ] [
    ( fhir:extension [
fhir:url [ fhir:v "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-publicationStatus"^^xsd:anyURI ] ;
fhir:value [ fhir:v "draft" ]     ] [
fhir:url [ fhir:v "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-publicationDate"^^xsd:anyURI ] ;
fhir:value [ fhir:v "2019-01-01"^^xsd:date ]     ] ) ;
fhir:type [ fhir:v "citation" ] ;
fhir:citation [ fhir:v "Example citation to draft publication" ] ;
fhir:url [ fhir:v "http://example.org/publications/1234"^^xsd:anyURI ] ;
fhir:document [
fhir:url [ fhir:v "http://example.org/publications/1234"^^xsd:anyURI ]     ]
  ] ) ; # 
  fhir:library ( [
fhir:v "http://hl7.org/fhir/us/cqfmeasures/Library/EXMPublishableLibrary"^^xsd:anyURI ;
fhir:link <http://hl7.org/fhir/us/cqfmeasures/Library/EXMPublishableLibrary>
  ] ) ; # 
  fhir:disclaimer [ fhir:v "Example disclaimer"] ; # 
  fhir:scoring [
    ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/measure-scoring"^^xsd:anyURI ] ;
fhir:code [ fhir:v "proportion" ] ;
fhir:display [ fhir:v "Proportion" ]     ] )
  ] ; # 
  fhir:type ( [
    ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/measure-type"^^xsd:anyURI ] ;
fhir:code [ fhir:v "process" ]     ] )
  ] ) ; # 
  fhir:riskAdjustment [ fhir:v "Risk adjustment for this measure is performed by..."] ; # 
  fhir:rateAggregation [ fhir:v "Rate aggregation for this measure is performed by..."] ; # 
  fhir:rationale [ fhir:v "Rationale for this measure is..."] ; # 
  fhir:clinicalRecommendationStatement [ fhir:v "The clinical recommendation statement for this measure is..."] ; # 
  fhir:improvementNotation [
    ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/measure-improvement-notation"^^xsd:anyURI ] ;
fhir:code [ fhir:v "increase" ] ;
fhir:display [ fhir:v "Increased score indicates improvement" ]     ] )
  ] ; # 
  fhir:definition ( [
    ( fhir:extension [
      ( fhir:extension [
fhir:url [ fhir:v "term"^^xsd:anyURI ] ;
fhir:value [ fhir:v "Term" ]       ] [
fhir:url [ fhir:v "definition"^^xsd:anyURI ] ;
fhir:value [ fhir:v "A term used in the measure that bears clearly definition to communicate the measure intent" ]       ] ) ;
fhir:url [ fhir:v "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-definitionTerm"^^xsd:anyURI ]     ] )
  ] ) ; # 
  fhir:group ( [
fhir:id [ fhir:v "group-1" ] ;
    ( fhir:population [
fhir:id [ fhir:v "initial-population" ] ;
fhir:code [
        ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/measure-population"^^xsd:anyURI ] ;
fhir:code [ fhir:v "initial-population" ] ;
fhir:display [ fhir:v "Initial Population" ]         ] )       ] ;
fhir:criteria [
fhir:language [ fhir:v "text/cql-identifier" ] ;
fhir:expression [ fhir:v "Initial Population" ]       ]     ] [
fhir:id [ fhir:v "numerator" ] ;
fhir:code [
        ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/measure-population"^^xsd:anyURI ] ;
fhir:code [ fhir:v "numerator" ] ;
fhir:display [ fhir:v "Numerator" ]         ] )       ] ;
fhir:criteria [
fhir:language [ fhir:v "text/cql-identifier" ] ;
fhir:expression [ fhir:v "Numerator" ]       ]     ] [
fhir:id [ fhir:v "denominator" ] ;
fhir:code [
        ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/measure-population"^^xsd:anyURI ] ;
fhir:code [ fhir:v "denominator" ] ;
fhir:display [ fhir:v "Denominator" ]         ] )       ] ;
fhir:criteria [
fhir:language [ fhir:v "text/cql-identifier" ] ;
fhir:expression [ fhir:v "Denominator" ]       ]     ] )
  ] ) ; # 
  fhir:supplementalData ( [
fhir:id [ fhir:v "sde-ethnicity" ] ;
    ( fhir:usage [
      ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/measure-data-usage"^^xsd:anyURI ] ;
fhir:code [ fhir:v "supplemental-data" ]       ] )     ] ) ;
fhir:criteria [
fhir:language [ fhir:v "text/cql-identifier" ] ;
fhir:expression [ fhir:v "SDE Ethnicity" ]     ]
  ] [
fhir:id [ fhir:v "sde-race" ] ;
    ( fhir:usage [
      ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/measure-data-usage"^^xsd:anyURI ] ;
fhir:code [ fhir:v "supplemental-data" ]       ] )     ] ) ;
fhir:criteria [
fhir:language [ fhir:v "text/cql-identifier" ] ;
fhir:expression [ fhir:v "SDE Race" ]     ]
  ] [
fhir:id [ fhir:v "sde-payer" ] ;
    ( fhir:usage [
      ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/measure-data-usage"^^xsd:anyURI ] ;
fhir:code [ fhir:v "supplemental-data" ]       ] )     ] ) ;
fhir:criteria [
fhir:language [ fhir:v "text/cql-identifier" ] ;
fhir:expression [ fhir:v "SDE Payer" ]     ]
  ] [
fhir:id [ fhir:v "sde-sex" ] ;
    ( fhir:usage [
      ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/measure-data-usage"^^xsd:anyURI ] ;
fhir:code [ fhir:v "supplemental-data" ]       ] )     ] ) ;
fhir:criteria [
fhir:language [ fhir:v "text/cql-identifier" ] ;
fhir:expression [ fhir:v "SDE Sex" ]     ]
  ] ) . #