Quality Measure Implementation Guide
5.0.0 - STU5
Quality Measure Implementation Guide
5.0.0 - STU5
This page is part of the Quality Measure STU2 for FHIR R4 Implementation Guide (v5.0.0: STU5 (v5.0.0)) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions
| Active as of 2022-02-22 |
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<div xmlns="http://www.w3.org/1999/xhtml">
<div>
<table class="grid dict">
<tr>
<th scope="row"><b>Title: </b></th>
<td style="padding-left: 4px;">EXM130 - Colorectal Cancer Screening Measure</td>
</tr>
<tr>
<th scope="row"><b>Id: </b></th>
<td style="padding-left: 4px;">EXM130-FHIR</td>
</tr>
<tr>
<th scope="row"><b>Version: </b></th>
<td style="padding-left: 4px;">8.0.000</td>
</tr>
<tr>
<th scope="row"><b>Url: </b></th>
<td style="padding-left: 4px;"><a href="Measure-EXM130-FHIR.html">EXM130 - Colorectal Cancer Screening Measure</a></td>
</tr>
<tr>
<th scope="row">
<b>
Official
</b>
</th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<span>130</span>
</p>
</td>
</tr>
<tr>
<th scope="row">
<b>
Official
</b>
</th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<span>0034</span>
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Effective Period: </b></th>
<td style="padding-left: 4px;">2018-01-01..2018-12-31</td>
</tr>
<tr>
<th scope="row"><b>Experimental: </b></th>
<td style="padding-left: 4px;">true</td>
</tr>
<tr>
<th scope="row"><b>Publisher: </b></th>
<td style="padding-left: 4px;">HL7 International / Clinical Quality Information</td>
</tr>
<tr>
<th scope="row"><b>Description: </b></th>
<td style="padding-left: 4px;"><div><p>Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer</p>
</div></td>
</tr>
<tr>
<th scope="row"><b>Use Context: </b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr>
<th><b>code</b></th>
<th><b>value</b></th>
</tr>
<tr>
<td>venue</td>
<td/>
</tr>
</table>
</td>
</tr>
<tr>
<th scope="row"><b>Jurisdiction: </b></th>
<td style="padding-left: 4px;">US</td>
</tr>
<tr>
<th scope="row"><b>Topic: </b></th>
<td style="padding-left: 4px;">57024-2</td>
</tr>
<tr>
<th scope="row"><b>Purpose: </b></th>
<td style="padding-left: 4px;"><div><p>This measure has been developed to support improvement in clinical care.</p>
</div></td>
</tr>
<tr>
<th scope="row"><b>Copyright: </b></th>
<td style="padding-left: 4px;"><div><p>This Physician Performance Measure (Measure) and related data specifications were developed by the National Committee for Quality Assurance (NCQA). NCQA is not responsible for any use of the Measure. NCQA makes no representations, warranties, or endorsement about the quality of any organization or physician that uses or reports performance measures and NCQA has no liability to anyone who relies on such measures or specifications. NCQA holds a copyright in the Measure. The Measure can be reproduced and distributed, without modification, for noncommercial purposes (eg, use by healthcare providers in connection with their practices) without obtaining approval from NCQA. Commercial use is defined as the sale, licensing, or distribution of the Measure for commercial gain, or incorporation of the Measure into a product or service that is sold, licensed or distributed for commercial gain. All commercial uses or requests for modification must be approved by NCQA and are subject to a license at the discretion of NCQA. (C) 2012-2017 National Committee for Quality Assurance. All Rights Reserved. Limited proprietary coding is contained in the Measure specifications for user convenience. Users of proprietary code sets should obtain all necessary licenses from the owners of the code sets. NCQA disclaims all liability for use or accuracy of any third party codes contained in the specifications. CPT(R) contained in the Measure specifications is copyright 2004-2017 American Medical Association. LOINC(R) copyright 2004-2017 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R] ) copyright 2004-2017 International Health Terminology Standards Development Organisation. ICD-10 copyright 2017 World Health Organization. All Rights Reserved.</p>
</div></td>
</tr>
<tr>
<th scope="row"><b>Disclaimer: </b></th>
<td style="padding-left: 4px;"><div><p>The performance Measure is not a clinical guideline and does not establish a standard of medical care, and has not been tested for all potential applications. THE MEASURE AND SPECIFICATIONS ARE PROVIDED "AS IS" WITHOUT WARRANTY OF ANY KIND. Due to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM].</p>
</div></td>
</tr>
<tr>
<th scope="row"><b>Basis: </b></th>
<td style="padding-left: 4px;">
boolean
</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>Type: </b></th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<span>process </span>
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Rationale: </b></th>
<td style="padding-left: 4px;"><div><p>Colorectal cancer represents 8 percent of all new cancer cases and is the second leading cause of cancer deaths in the United States. In 2017, there were an estimated 135,430 new cases of colorectal cancer and an estimated 50,260 deaths attributed to it. According to the National Cancer Institute, about 4.3 percent of men and women will be diagnosed with colorectal cancer at some point during their lifetimes. For most adults, older age is the most important risk factor for colorectal cancer, although being male and black are also associated with higher incidence and mortality. Colorectal cancer is most frequently diagnosed among people 65 to 74 years old (Howlader et al. 2017). Screening can be effective for finding precancerous lesions (polyps) that could later become malignant, and for detecting early cancers that can be more easily and effectively treated. Precancerous polyps usually take about 10 to 15 years to develop into colorectal cancer, and most can be found and removed before turning into cancer. The five-year relative survival rate for people whose colorectal cancer is found in the early stage before it has spread is about 90 percent (American Cancer Society 2017).</p>
</div></td>
</tr>
<tr>
<th scope="row"><b>Clinical recommendation statement: </b></th>
<td style="padding-left: 4px;"><div><p>The U. S. Preventive Services Task Force (2016) recommends screening for colorectal cancer starting at age 50 years and continuing until age 75 years. This is a Grade A recommendation (U.S. Preventive Services Task Force 2016). Screening tests: -Colonoscopy (every 10 years) -Flexible sigmoidoscopy (every 5 years) -Fecal occult blood test (annually) -FIT-DNA (every 3 years) -Computed tomographic colonography (every 5 years)</p>
</div></td>
</tr>
<tr>
<th scope="row"><b>Improvement Notation: </b></th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<span>Increased score indicates improvement </span>
</p>
</td>
</tr>
<tr>
<th scope="row"><b> Supplemental Data Elements: </b></th>
<td style="padding-left: 4px;">
<p>SDE Ethnicity</p>
<p>SDE Payer</p>
<p>SDE Race</p>
<p>SDE Sex</p>
</td>
</tr>
<tr>
<th scope="row"><b>Libraries: </b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr>
<td><a href="Library-EXM130-FHIR.html">EXM130 - Colorectal Cancer Screening Library</a></td>
</tr>
</table>
</td>
</tr>
<tr>
<th scope="row"><b>Terminology and Other Dependencies: </b></th>
<td style="padding-left: 4px;">
<li><a href="Library-SupplementalDataElements.html">Supplemental Data Elements Libraryversion: null2.0.0)</a></li>
<li><code>http://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1</code></li>
<li><a href="Library-MATGlobalCommonFunctions.html">MAT Global Common Functions FHIR Libraryversion: null5.0.000)</a></li>
<li><a href="Library-AdultOutpatientEncounters.html">Adult Outpatient Encounters Common Libraryversion: null2.0.000)</a></li>
<li><a href="Library-Hospice.html">Hospice FHIR Libraryversion: null2.0.000)</a></li>
<li><code>http://snomed.info/sct|http://snomed.info/sct/731000124108/version/201709</code></li>
<li><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1020</code></li>
<li><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1011</code></li>
<li><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1010</code></li>
<li><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1039</code></li>
<li><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1038</code></li>
<li><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591</code></li>
<li><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001</code></li>
<li><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240</code></li>
<li><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025</code></li>
<li><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023</code></li>
<li><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016</code></li>
<li><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307</code></li>
<li><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.15</code></li>
<li><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1001</code></li>
<li><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1019</code></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 Exclusion</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>Resource Type</b></th>
<th><b>Resource Elements</b></th>
<th><b>Valueset Name</b></th>
<th><b>Valueset</b></th>
</tr>
<tr>
<td>Coverage(<a href="http://hl7.org/fhir/R4/coverage.html">Coverage</a>)</td>
<td>
period
type
</td>
<td>
Payer
</td>
<td><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591</code></td>
</tr>
<tr>
<td>Patient(<a href="http://hl7.org/fhir/R4/patient.html">Patient</a>)</td>
<td>
extension
value
url
</td>
<td>
</td>
<td/>
</tr>
<tr>
<td>Encounter(<a href="http://hl7.org/fhir/R4/encounter.html">Encounter</a>)</td>
<td>
type
</td>
<td>
Office Visit
</td>
<td><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001</code></td>
</tr>
<tr>
<td>Encounter(<a href="http://hl7.org/fhir/R4/encounter.html">Encounter</a>)</td>
<td>
type
</td>
<td>
Annual Wellness Visit
</td>
<td><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240</code></td>
</tr>
<tr>
<td>Encounter(<a href="http://hl7.org/fhir/R4/encounter.html">Encounter</a>)</td>
<td>
type
</td>
<td>
Preventive Care Services - Established Office Visit, 18 and Up
</td>
<td><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025</code></td>
</tr>
<tr>
<td>Encounter(<a href="http://hl7.org/fhir/R4/encounter.html">Encounter</a>)</td>
<td>
type
</td>
<td>
Preventive Care Services-Initial Office Visit, 18 and Up
</td>
<td><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023</code></td>
</tr>
<tr>
<td>Encounter(<a href="http://hl7.org/fhir/R4/encounter.html">Encounter</a>)</td>
<td>
type
</td>
<td>
Home Healthcare Services
</td>
<td><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016</code></td>
</tr>
<tr>
<td>Encounter(<a href="http://hl7.org/fhir/R4/encounter.html">Encounter</a>)</td>
<td>
period
hospitalization
hospitalization.dischargeDisposition
type
status
</td>
<td>
Encounter Inpatient
</td>
<td><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307</code></td>
</tr>
<tr>
<td>Condition(<a href="http://hl7.org/fhir/R4/condition.html">Condition</a>)</td>
<td>
code
onset
</td>
<td>
Malignant Neoplasm of Colon
</td>
<td><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1001</code></td>
</tr>
<tr>
<td>Observation(<a href="http://hl7.org/fhir/R4/observation.html">Observation</a>)</td>
<td>
effective
code
value
status
</td>
<td>
FIT DNA
</td>
<td><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1039</code></td>
</tr>
<tr>
<td>Observation(<a href="http://hl7.org/fhir/R4/observation.html">Observation</a>)</td>
<td>
effective
code
value
status
</td>
<td>
Fecal Occult Blood Test (FOBT)
</td>
<td><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1011</code></td>
</tr>
<tr>
<td>Procedure(<a href="http://hl7.org/fhir/R4/procedure.html">Procedure</a>)</td>
<td>
code
performed
status
</td>
<td>
Colonoscopy
</td>
<td><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1020</code></td>
</tr>
<tr>
<td>Procedure(<a href="http://hl7.org/fhir/R4/procedure.html">Procedure</a>)</td>
<td>
code
performed
status
</td>
<td>
Total Colectomy
</td>
<td><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1019</code></td>
</tr>
<tr>
<td>Procedure(<a href="http://hl7.org/fhir/R4/procedure.html">Procedure</a>)</td>
<td>
code
performed
status
</td>
<td>
CT Colonography
</td>
<td><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1038</code></td>
</tr>
<tr>
<td>Procedure(<a href="http://hl7.org/fhir/R4/procedure.html">Procedure</a>)</td>
<td>
code
performed
status
</td>
<td>
Hospice care ambulatory
</td>
<td><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.15</code></td>
</tr>
<tr>
<td>Procedure(<a href="http://hl7.org/fhir/R4/procedure.html">Procedure</a>)</td>
<td>
code
performed
status
</td>
<td>
Flexible Sigmoidoscopy
</td>
<td><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1010</code></td>
</tr>
<tr>
<td>ServiceRequest(<a href="http://hl7.org/fhir/R4/servicerequest.html">ServiceRequest</a>)</td>
<td>
code
authoredOn
intent
</td>
<td>
Hospice care ambulatory
</td>
<td><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.15</code></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">http://snomed.info/sct</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">http://snomed.info/sct</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 colspan="3" style="padding-left: 4px;">
<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 "Initial Population":
Global."CalendarAgeInYearsAt"(FHIRHelpers.ToDate(Patient.birthDate), start of "Measurement Period") in Interval[50, 75]
and exists AdultOutpatientEncounters."Qualifying Encounters"</code></pre>
</td>
</tr>
<tr>
<td/>
<td/>
<td>Numerator</td>
<td>
<pre><code class="language-cql">define "Numerator":
exists "Colonoscopy Performed"
or exists "Fecal Occult Blood Test Performed"
or exists "Flexible Sigmoidoscopy Performed"
or exists "Fecal Immunochemical Test DNA"
or exists "CT Colonography Performed"</code></pre>
</td>
</tr>
<tr>
<td/>
<td/>
<td>Denominator</td>
<td>
<pre><code class="language-cql">define "Denominator":
true</code></pre>
</td>
</tr>
<tr>
<td/>
<td/>
<td>Denominator Exclusion</td>
<td>
<pre><code class="language-cql">define "Denominator Exclusion":
Hospice."Has Hospice"
or exists "Malignant Neoplasm Ever"
or exists "Total Colectomy Performed"</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>
<pre class="highlight language-cql"><code class="language-cql">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</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>EXM130-FHIR</td>
<td>SDE Sex</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "SDE Sex":
SDE."SDE Sex"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>EXM130-FHIR</td>
<td>Colonoscopy Performed</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Colonoscopy Performed":
[Procedure: "Colonoscopy"] Colonoscopy
where Colonoscopy.status = 'completed'
and Global."Normalize Interval"(Colonoscopy.performed) ends 10 years or less on or before end of "Measurement Period"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>EXM130-FHIR</td>
<td>Fecal Occult Blood Test Performed</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Fecal Occult Blood Test Performed":
[Observation: "Fecal Occult Blood Test (FOBT)"] FecalOccultResult
where FecalOccultResult.status in {'final', 'amended', 'corrected', 'preliminary'}
and FecalOccultResult.value is not null
and Global."Normalize Interval"(FecalOccultResult.effective) during day of "Measurement Period"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>EXM130-FHIR</td>
<td>Flexible Sigmoidoscopy Performed</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Flexible Sigmoidoscopy Performed":
[Procedure: "Flexible Sigmoidoscopy"] FlexibleSigmoidoscopy
where FlexibleSigmoidoscopy.status = 'completed'
and Global."Normalize Interval"(FlexibleSigmoidoscopy.performed) ends 5 years or less on or before end of "Measurement Period"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>EXM130-FHIR</td>
<td>Fecal Immunochemical Test DNA</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Fecal Immunochemical Test DNA":
[Observation: "FIT DNA"] FitDNA
where FitDNA.status in {'final', 'amended', 'corrected', 'preliminary'}
and FitDNA.value is not null
and Global."Normalize Interval"(FitDNA.effective) occurs 3 years or less on or before day of end of "Measurement Period"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>EXM130-FHIR</td>
<td>CT Colonography Performed</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "CT Colonography Performed":
[Procedure: "CT Colonography"] Colonography
where Colonography.status = 'completed'
and Global."Normalize Interval"(Colonography.performed) ends 5 years or less on or before end of "Measurement Period"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>EXM130-FHIR</td>
<td>Numerator</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Numerator":
exists "Colonoscopy Performed"
or exists "Fecal Occult Blood Test Performed"
or exists "Flexible Sigmoidoscopy Performed"
or exists "Fecal Immunochemical Test DNA"
or exists "CT Colonography Performed"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>EXM130-FHIR</td>
<td>Denominator</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Denominator":
true</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>
<pre class="highlight language-cql"><code class="language-cql">define "SDE Payer":
[Coverage: type in "Payer"] 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>EXM130-FHIR</td>
<td>SDE Payer</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "SDE Payer":
SDE."SDE Payer"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>AdultOutpatientEncounters</td>
<td>Qualifying Encounters</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Qualifying Encounters":
(
[Encounter: "Office Visit"]
union [Encounter: "Annual Wellness Visit"]
union [Encounter: "Preventive Care Services - Established Office Visit, 18 and Up"]
union [Encounter: "Preventive Care Services-Initial Office Visit, 18 and Up"]
union [Encounter: "Home Healthcare Services"]
) ValidEncounter
where ValidEncounter.period during "Measurement Period"
and ValidEncounter.status = 'finished'</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>EXM130-FHIR</td>
<td>Initial Population</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Initial Population":
Global."CalendarAgeInYearsAt"(FHIRHelpers.ToDate(Patient.birthDate), start of "Measurement Period") in Interval[50, 75]
and exists AdultOutpatientEncounters."Qualifying Encounters"</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>
<pre class="highlight language-cql"><code class="language-cql">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</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>EXM130-FHIR</td>
<td>SDE Ethnicity</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "SDE Ethnicity":
SDE."SDE Ethnicity"</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>
<pre class="highlight language-cql"><code class="language-cql">define "Has Hospice":
exists (
[Encounter: "Encounter Inpatient"] DischargeHospice
where DischargeHospice.status = 'finished'
and (
DischargeHospice.hospitalization.dischargeDisposition ~ "Discharge to home for hospice care (procedure)"
or DischargeHospice.hospitalization.dischargeDisposition ~ "Discharge to healthcare facility for hospice care (procedure)"
)
and DischargeHospice.period ends during "Measurement Period"
)
or exists (
[ServiceRequest: "Hospice care ambulatory"] HospiceOrder
where HospiceOrder.intent = 'order'
and HospiceOrder.authoredOn in "Measurement Period"
)
or exists (
[Procedure: "Hospice care ambulatory"] HospicePerformed
where HospicePerformed.status = 'completed'
and Global."Normalize Interval"(HospicePerformed.performed) overlaps "Measurement Period"
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>EXM130-FHIR</td>
<td>Malignant Neoplasm Ever</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Malignant Neoplasm Ever":
[Condition: "Malignant Neoplasm of Colon"] ColorectalCancer
where Global."Normalize Interval"(ColorectalCancer.onset) starts on or before end of "Measurement Period"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>EXM130-FHIR</td>
<td>Total Colectomy Performed</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Total Colectomy Performed":
[Procedure: "Total Colectomy"] Colectomy
where Colectomy.status = 'completed'
and Global."Normalize Interval"(Colectomy.performed) starts on or before end of "Measurement Period"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>EXM130-FHIR</td>
<td>Denominator Exclusion</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Denominator Exclusion":
Hospice."Has Hospice"
or exists "Malignant Neoplasm Ever"
or exists "Total Colectomy Performed"</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>
<pre class="highlight language-cql"><code class="language-cql">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</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>EXM130-FHIR</td>
<td>SDE Race</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "SDE Race":
SDE."SDE Race"</code></pre>
</td>
</tr>
</table>
</td>
</tr>
</table>
</div>
</div>
</text>
<contained>
<Library>
<id value="effective-data-requirements-exm130"/>
<meta>
<profile
value="http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-moduledefinitionlibrary"/>
</meta>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-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/StructureDefinition/cqf-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/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="SupplementalDataElements"/>
</extension>
<extension url="name">
<valueString value="SDE Sex"/>
</extension>
<extension url="statement">
<valueString
value="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"/>
</extension>
<extension url="displaySequence">
<valueInteger value="0"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="EXM130-FHIR"/>
</extension>
<extension url="name">
<valueString value="SDE Sex"/>
</extension>
<extension url="statement">
<valueString
value="define "SDE Sex":
SDE."SDE Sex""/>
</extension>
<extension url="displaySequence">
<valueInteger value="1"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="EXM130-FHIR"/>
</extension>
<extension url="name">
<valueString value="Colonoscopy Performed"/>
</extension>
<extension url="statement">
<valueString
value="define "Colonoscopy Performed":
[Procedure: "Colonoscopy"] Colonoscopy
where Colonoscopy.status = 'completed'
and Global."Normalize Interval"(Colonoscopy.performed) ends 10 years or less on or before end of "Measurement Period""/>
</extension>
<extension url="displaySequence">
<valueInteger value="2"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="EXM130-FHIR"/>
</extension>
<extension url="name">
<valueString value="Fecal Occult Blood Test Performed"/>
</extension>
<extension url="statement">
<valueString
value="define "Fecal Occult Blood Test Performed":
[Observation: "Fecal Occult Blood Test (FOBT)"] FecalOccultResult
where FecalOccultResult.status in {'final', 'amended', 'corrected', 'preliminary'}
and FecalOccultResult.value is not null
and Global."Normalize Interval"(FecalOccultResult.effective) during day of "Measurement Period""/>
</extension>
<extension url="displaySequence">
<valueInteger value="3"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="EXM130-FHIR"/>
</extension>
<extension url="name">
<valueString value="Flexible Sigmoidoscopy Performed"/>
</extension>
<extension url="statement">
<valueString
value="define "Flexible Sigmoidoscopy Performed":
[Procedure: "Flexible Sigmoidoscopy"] FlexibleSigmoidoscopy
where FlexibleSigmoidoscopy.status = 'completed'
and Global."Normalize Interval"(FlexibleSigmoidoscopy.performed) ends 5 years or less on or before end of "Measurement Period""/>
</extension>
<extension url="displaySequence">
<valueInteger value="4"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="EXM130-FHIR"/>
</extension>
<extension url="name">
<valueString value="Fecal Immunochemical Test DNA"/>
</extension>
<extension url="statement">
<valueString
value="define "Fecal Immunochemical Test DNA":
[Observation: "FIT DNA"] FitDNA
where FitDNA.status in {'final', 'amended', 'corrected', 'preliminary'}
and FitDNA.value is not null
and Global."Normalize Interval"(FitDNA.effective) occurs 3 years or less on or before day of end of "Measurement Period""/>
</extension>
<extension url="displaySequence">
<valueInteger value="5"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="EXM130-FHIR"/>
</extension>
<extension url="name">
<valueString value="CT Colonography Performed"/>
</extension>
<extension url="statement">
<valueString
value="define "CT Colonography Performed":
[Procedure: "CT Colonography"] Colonography
where Colonography.status = 'completed'
and Global."Normalize Interval"(Colonography.performed) ends 5 years or less on or before end of "Measurement Period""/>
</extension>
<extension url="displaySequence">
<valueInteger value="6"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="EXM130-FHIR"/>
</extension>
<extension url="name">
<valueString value="Numerator"/>
</extension>
<extension url="statement">
<valueString
value="define "Numerator":
exists "Colonoscopy Performed"
or exists "Fecal Occult Blood Test Performed"
or exists "Flexible Sigmoidoscopy Performed"
or exists "Fecal Immunochemical Test DNA"
or exists "CT Colonography Performed""/>
</extension>
<extension url="displaySequence">
<valueInteger value="7"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="EXM130-FHIR"/>
</extension>
<extension url="name">
<valueString value="Denominator"/>
</extension>
<extension url="statement">
<valueString value="define "Denominator":
true"/>
</extension>
<extension url="displaySequence">
<valueInteger value="8"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="SupplementalDataElements"/>
</extension>
<extension url="name">
<valueString value="SDE Payer"/>
</extension>
<extension url="statement">
<valueString
value="define "SDE Payer":
[Coverage: type in "Payer"] Payer
return {
code: Payer.type,
period: Payer.period
}"/>
</extension>
<extension url="displaySequence">
<valueInteger value="9"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="EXM130-FHIR"/>
</extension>
<extension url="name">
<valueString value="SDE Payer"/>
</extension>
<extension url="statement">
<valueString
value="define "SDE Payer":
SDE."SDE Payer""/>
</extension>
<extension url="displaySequence">
<valueInteger value="10"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="AdultOutpatientEncounters"/>
</extension>
<extension url="name">
<valueString value="Qualifying Encounters"/>
</extension>
<extension url="statement">
<valueString
value="define "Qualifying Encounters":
(
[Encounter: "Office Visit"]
union [Encounter: "Annual Wellness Visit"]
union [Encounter: "Preventive Care Services - Established Office Visit, 18 and Up"]
union [Encounter: "Preventive Care Services-Initial Office Visit, 18 and Up"]
union [Encounter: "Home Healthcare Services"]
) ValidEncounter
where ValidEncounter.period during "Measurement Period"
and ValidEncounter.status = 'finished'"/>
</extension>
<extension url="displaySequence">
<valueInteger value="11"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="EXM130-FHIR"/>
</extension>
<extension url="name">
<valueString value="Initial Population"/>
</extension>
<extension url="statement">
<valueString
value="define "Initial Population":
Global."CalendarAgeInYearsAt"(FHIRHelpers.ToDate(Patient.birthDate), start of "Measurement Period") in Interval[50, 75]
and exists AdultOutpatientEncounters."Qualifying Encounters""/>
</extension>
<extension url="displaySequence">
<valueInteger value="12"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="SupplementalDataElements"/>
</extension>
<extension url="name">
<valueString value="SDE Ethnicity"/>
</extension>
<extension url="statement">
<valueString
value="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"/>
</extension>
<extension url="displaySequence">
<valueInteger value="13"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="EXM130-FHIR"/>
</extension>
<extension url="name">
<valueString value="SDE Ethnicity"/>
</extension>
<extension url="statement">
<valueString
value="define "SDE Ethnicity":
SDE."SDE Ethnicity""/>
</extension>
<extension url="displaySequence">
<valueInteger value="14"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="Hospice"/>
</extension>
<extension url="name">
<valueString value="Has Hospice"/>
</extension>
<extension url="statement">
<valueString
value="define "Has Hospice":
exists (
[Encounter: "Encounter Inpatient"] DischargeHospice
where DischargeHospice.status = 'finished'
and (
DischargeHospice.hospitalization.dischargeDisposition ~ "Discharge to home for hospice care (procedure)"
or DischargeHospice.hospitalization.dischargeDisposition ~ "Discharge to healthcare facility for hospice care (procedure)"
)
and DischargeHospice.period ends during "Measurement Period"
)
or exists (
[ServiceRequest: "Hospice care ambulatory"] HospiceOrder
where HospiceOrder.intent = 'order'
and HospiceOrder.authoredOn in "Measurement Period"
)
or exists (
[Procedure: "Hospice care ambulatory"] HospicePerformed
where HospicePerformed.status = 'completed'
and Global."Normalize Interval"(HospicePerformed.performed) overlaps "Measurement Period"
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="15"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="EXM130-FHIR"/>
</extension>
<extension url="name">
<valueString value="Malignant Neoplasm Ever"/>
</extension>
<extension url="statement">
<valueString
value="define "Malignant Neoplasm Ever":
[Condition: "Malignant Neoplasm of Colon"] ColorectalCancer
where Global."Normalize Interval"(ColorectalCancer.onset) starts on or before end of "Measurement Period""/>
</extension>
<extension url="displaySequence">
<valueInteger value="16"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="EXM130-FHIR"/>
</extension>
<extension url="name">
<valueString value="Total Colectomy Performed"/>
</extension>
<extension url="statement">
<valueString
value="define "Total Colectomy Performed":
[Procedure: "Total Colectomy"] Colectomy
where Colectomy.status = 'completed'
and Global."Normalize Interval"(Colectomy.performed) starts on or before end of "Measurement Period""/>
</extension>
<extension url="displaySequence">
<valueInteger value="17"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="EXM130-FHIR"/>
</extension>
<extension url="name">
<valueString value="Denominator Exclusion"/>
</extension>
<extension url="statement">
<valueString
value="define "Denominator Exclusion":
Hospice."Has Hospice"
or exists "Malignant Neoplasm Ever"
or exists "Total Colectomy Performed""/>
</extension>
<extension url="displaySequence">
<valueInteger value="18"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="SupplementalDataElements"/>
</extension>
<extension url="name">
<valueString value="SDE Race"/>
</extension>
<extension url="statement">
<valueString
value="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"/>
</extension>
<extension url="displaySequence">
<valueInteger value="19"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="EXM130-FHIR"/>
</extension>
<extension url="name">
<valueString value="SDE Race"/>
</extension>
<extension url="statement">
<valueString
value="define "SDE Race":
SDE."SDE Race""/>
</extension>
<extension url="displaySequence">
<valueInteger value="20"/>
</extension>
</extension>
<url
value="http://hl7.org/fhir/us/cqfmeasures/Library/effective-data-requirements-exm130"/>
<version value="1.0.0"/>
<name value="EffectiveDataRequirements"/>
<title value="Module Definition Library - EXM130"/>
<status value="active"/>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/library-type"/>
<code value="module-definition"/>
</coding>
</type>
<date value="2022-02-22T10:37:03-07:00"/>
<description
value="This library is used as an example module definition in the FHIR Quality Measure Implementation Guide"/>
<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 AdultOutpatientEncounters"/>
<resource
value="http://hl7.org/fhir/us/cqfmeasures/Library/AdultOutpatientEncounters|2.0.000"/>
</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 Colonoscopy"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1020"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Fecal Occult Blood Test (FOBT)"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1011"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Flexible Sigmoidoscopy"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1010"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set FIT DNA"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1039"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set CT Colonography"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1038"/>
</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 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 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>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Malignant Neoplasm of Colon"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1001"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Total Colectomy"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1019"/>
</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 Exclusion"/>
<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="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="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="Condition"/>
<profile value="http://hl7.org/fhir/StructureDefinition/Condition"/>
<mustSupport value="code"/>
<mustSupport value="onset"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1001"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Observation"/>
<profile value="http://hl7.org/fhir/StructureDefinition/Observation"/>
<mustSupport value="effective"/>
<mustSupport value="code"/>
<mustSupport value="value"/>
<mustSupport value="status"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1039"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Observation"/>
<profile value="http://hl7.org/fhir/StructureDefinition/Observation"/>
<mustSupport value="effective"/>
<mustSupport value="code"/>
<mustSupport value="value"/>
<mustSupport value="status"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1011"/>
</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/2.16.840.1.113883.3.464.1003.108.12.1020"/>
</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/2.16.840.1.113883.3.464.1003.198.12.1019"/>
</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/2.16.840.1.113883.3.464.1003.108.12.1038"/>
</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/2.16.840.1.113883.3.464.1003.198.12.1010"/>
</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>
</Library>
</contained>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis">
<valueCode value="boolean"/>
</extension>
<extension
url="http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-softwaresystem">
<valueReference>🔗
<reference value="Device/software-system-example"/>
</valueReference>
</extension>
<extension
url="http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements">
<valueCanonical value="#effective-data-requirements-exm130"/>
</extension>
<url value="http://hl7.org/fhir/us/cqfmeasures/Measure/EXM130-FHIR"/>
<identifier>
<use value="official"/>
<system value="http://example.org/fhir/cqi/ecqm/Measure/Identifier/cms"/>
<value value="130"/>
</identifier>
<identifier>
<use value="official"/>
<system value="http://example.org/fhir/cqi/ecqm/Measure/Identifier/nqf"/>
<value value="0034"/>
</identifier>
<version value="8.0.000"/>
<name value="EXM130"/>
<title value="EXM130 - Colorectal Cancer Screening Measure"/>
<status value="active"/>
<experimental value="true"/>
<date value="2022-02-22"/>
<publisher value="HL7 International / Clinical Quality Information"/>
<contact>
<telecom>
<system value="url"/>
<value value="http://www.hl7.org/Special/committees/cqi"/>
</telecom>
</contact>
<description
value="Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer"/>
<useContext>
<code>
<system
value="http://terminology.hl7.org/CodeSystem/usage-context-type"/>
<code value="venue"/>
<display value="Venue"/>
</code>
<valueCodeableConcept>
<coding>
<system
value="http://hl7.org/fhir/us/cqfmeasures/CodeSystem/intended-venue-codes"/>
<code value="ec"/>
<display value="EC"/>
</coding>
</valueCodeableConcept>
</useContext>
<jurisdiction>
<coding>
<system value="urn:iso:std:iso:3166"/>
<code value="US"/>
</coding>
</jurisdiction>
<purpose
value="This measure has been developed to support improvement in clinical care."/>
<copyright
value="This Physician Performance Measure (Measure) and related data specifications were developed by the National Committee for Quality Assurance (NCQA). NCQA is not responsible for any use of the Measure. NCQA makes no representations, warranties, or endorsement about the quality of any organization or physician that uses or reports performance measures and NCQA has no liability to anyone who relies on such measures or specifications. NCQA holds a copyright in the Measure. The Measure can be reproduced and distributed, without modification, for noncommercial purposes (eg, use by healthcare providers in connection with their practices) without obtaining approval from NCQA. Commercial use is defined as the sale, licensing, or distribution of the Measure for commercial gain, or incorporation of the Measure into a product or service that is sold, licensed or distributed for commercial gain. All commercial uses or requests for modification must be approved by NCQA and are subject to a license at the discretion of NCQA. (C) 2012-2017 National Committee for Quality Assurance. All Rights Reserved. Limited proprietary coding is contained in the Measure specifications for user convenience. Users of proprietary code sets should obtain all necessary licenses from the owners of the code sets. NCQA disclaims all liability for use or accuracy of any third party codes contained in the specifications. CPT(R) contained in the Measure specifications is copyright 2004-2017 American Medical Association. LOINC(R) copyright 2004-2017 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R] ) copyright 2004-2017 International Health Terminology Standards Development Organisation. ICD-10 copyright 2017 World Health Organization. All Rights Reserved."/>
<approvalDate value="2016-01-01"/>
<lastReviewDate value="2016-09-01"/>
<effectivePeriod>
<start value="2018-01-01"/>
<end value="2018-12-31"/>
</effectivePeriod>
<topic>
<coding>
<system value="http://loinc.org"/>
<code value="57024-2"/>
<display value="Health Quality Measure Document"/>
</coding>
</topic>
<library value="http://hl7.org/fhir/us/cqfmeasures/Library/EXM130-FHIR"/>
<disclaimer
value="The performance Measure is not a clinical guideline and does not establish a standard of medical care, and has not been tested for all potential applications. THE MEASURE AND SPECIFICATIONS ARE PROVIDED "AS IS" WITHOUT WARRANTY OF ANY KIND. Due to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM]."/>
<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>
<rationale
value="Colorectal cancer represents 8 percent of all new cancer cases and is the second leading cause of cancer deaths in the United States. In 2017, there were an estimated 135,430 new cases of colorectal cancer and an estimated 50,260 deaths attributed to it. According to the National Cancer Institute, about 4.3 percent of men and women will be diagnosed with colorectal cancer at some point during their lifetimes. For most adults, older age is the most important risk factor for colorectal cancer, although being male and black are also associated with higher incidence and mortality. Colorectal cancer is most frequently diagnosed among people 65 to 74 years old (Howlader et al. 2017). Screening can be effective for finding precancerous lesions (polyps) that could later become malignant, and for detecting early cancers that can be more easily and effectively treated. Precancerous polyps usually take about 10 to 15 years to develop into colorectal cancer, and most can be found and removed before turning into cancer. The five-year relative survival rate for people whose colorectal cancer is found in the early stage before it has spread is about 90 percent (American Cancer Society 2017)."/>
<clinicalRecommendationStatement
value="The U. S. Preventive Services Task Force (2016) recommends screening for colorectal cancer starting at age 50 years and continuing until age 75 years. This is a Grade A recommendation (U.S. Preventive Services Task Force 2016). Screening tests: -Colonoscopy (every 10 years) -Flexible sigmoidoscopy (every 5 years) -Fecal occult blood test (annually) -FIT-DNA (every 3 years) -Computed tomographic colonography (every 5 years)"/>
<improvementNotation>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-improvement-notation"/>
<code value="increase"/>
<display value="Increased score indicates improvement"/>
</coding>
</improvementNotation>
<guidance
value="Patient self-report for procedures as well as diagnostic studies should be recorded in "Procedure, Performed" template or "Diagnostic Study, Performed" template in QRDA-1. Do not count DRE, FOBT tests performed in an office setting or performed on a sample collected via DRE."/>
<group>
<population>
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="initial-population"/>
<display value="Initial Population"/>
</coding>
</code>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Initial Population"/>
</criteria>
</population>
<population>
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="numerator"/>
<display value="Numerator"/>
</coding>
</code>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Numerator"/>
</criteria>
</population>
<population>
<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>
<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 Exclusion"/>
</criteria>
</population>
</group>
<supplementalData>
<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>
<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>
<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>
<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>
IG © 2019+ HL7 International / Clinical Quality Information. Package hl7.fhir.us.cqfmeasures#5.0.0 based on FHIR 4.0.1. Generated 2024-11-04
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