Quality Measure Implementation Guide
5.0.0 - STU5 United States of America flag

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

Measure: EXM Measure (Experimental)

Official URL: http://hl7.org/fhir/us/cqfmeasures/Measure/EXMLogic-FHIR Version: 2.0.0
Active as of 2022-02-22 Computable Name: MeasureEXM
Other Identifiers: http://example.org/fhir/cqi/ecqm/Measure/Identifier/exm#EXM

Usage:Venue: EC

Copyright/Legal: Example Copyright Statement

An example FHIR-based measure

This measure has been developed to support improvement in clinical care.

Title: EXM Measure
Id: EXMLogic-FHIR
Version: 2.0.0
Url: EXM Measure

EXM

Effective Period: 2018-01-01..2018-12-31
Experimental: true
Publisher: HL7 International / Clinical Quality Information
Author: Example Measure Content Developer
Description:

An example FHIR-based measure
Use Context:
code value
venue
Jurisdiction: US
Topic: 57024-2
Purpose:

This measure has been developed to support improvement in clinical care.
Copyright:

Example Copyright Statement
Disclaimer:

Example disclaimer
Basis: Encounter
Scoring:

Proportion

Type:

process

Risk Adjustment: Risk adjustment for this measure is performed by...
Rate Aggregation: Rate aggregation for this measure is performed by...
Rationale:

The purpose of this measure is to show how all the elements of a FHIR-based quality measure are represented.
Clinical recommendation statement:

The clinical recommendation statement for this measure is...
Improvement Notation:

Increased score indicates improvement

Guidance (Usage): Users of this measure should be aware that this is intentionally simplified to show specific aspects of a measure.
Supplemental Data Elements:

SDE Ethnicity

SDE Race

SDE Payer

SDE Sex
Libraries:
Example Logic Library
Terminology and Other Dependencies:
  • http://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1
  • Diagnosis Role
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.299
    		•
    Parameters:
    name use min max type
    Measurement Period In 0 1 Period
    SDE Sex Out 0 1 Coding
    Stratifier 3 Out 0 * Encounter
    Stratifier 4 Out 0 * Encounter
    SDE Payer Out 0 * Resource
    Initial Population Out 0 * Encounter
    SDE Ethnicity Out 0 * Coding
    SDE Race Out 0 * Coding
    Stratifier 1 Out 0 * Encounter
    Stratifier 2 Out 0 * Encounter
    DataRequirements:
    Resource Type Resource Elements Valueset Name Valueset
    Patient(http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient)
    Patient(http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient) url extension value
    Patient(http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient) url extension value
    Encounter(Encounter) period
    Coverage(Coverage) type period Payer http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591
    Direct Reference Codes:
    display code system
    Billing billing http://terminology.hl7.org/CodeSystem/diagnosis-role
    Logic Definitions:
    Group Scoring Population Criteria Expression
    group-1 Measure scoring:

    Proportion

    Initial Population 
    define "Initial Population" :
  "Inpatient Encounter" Encounter
    Numerator
    Denominator 
    define "Stratifier 1" :
  "Inpatient Encounter" Encounter
    where not (PrincipalDiagnosis(Encounter).code in "Psychiatric/Mental Health Patient")
    		 
    define "Stratifier 2" :
  "Inpatient Encounter" Encounter
    where PrincipalDiagnosis(Encounter).code in "Psychiatric/Mental Health Patient"
    		 
    define "Stratifier 3" :
  "Inpatient Encounter" Encounter
    where PrincipalDiagnosis(Encounter) is null
    		 
    define "Stratifier 4" :
  "Inpatient Encounter" Encounter
    where PrincipalDiagnosis(Encounter) is null
    Library Name Name
    EXMLogic-FHIR SDE Sex 
    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
    Library Name Name
    EXMLogic-FHIR Inpatient Encounter 
    define "Inpatient Encounter" :
  ["Encounter"] Encounter
    where LengthInDays(Encounter.period) <= 120
      and Encounter.period ends during "Measurement Period"
    Library Name Name
    EXMLogic-FHIR Stratifier 3 
    define "Stratifier 3" :
  "Inpatient Encounter" Encounter
    where PrincipalDiagnosis(Encounter) is null
    Library Name Name
    EXMLogic Stratifier 4 
    define "Stratifier 4" :
  "Inpatient Encounter" Encounter
    where PrincipalDiagnosis(Encounter) is null
    Library Name Name
    EXMLogic-FHIR SDE Payer 
    define "SDE Payer":
    [Coverage: type in "Payer"] Payer
      return {
        code: Payer.type,
        period: Payer.period
      }
    Library Name Name
    EXMLogic Initial Population 
    define "Initial Population" :
  "Inpatient Encounter" Encounter
    Library Name Name
    EXMLogic-FHIR SDE Ethnicity 
    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
    Library Name Name
    EXMLogic SDE Race 
    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
    Library Name Name
    EXMLogic-FHIR Stratifier 1 
    define "Stratifier 1" :
  "Inpatient Encounter" Encounter
    where not (PrincipalDiagnosis(Encounter).code in "Psychiatric/Mental Health Patient")
    Library Name Name
    EXMLogic-FHIR Stratifier 2 
    define "Stratifier 2" :
  "Inpatient Encounter" Encounter
    where PrincipalDiagnosis(Encounter).code in "Psychiatric/Mental Health Patient"