Quality Measure STU2 for FHIR R4 Implementation Guide

This page is part of the Quality Measure STU2 for FHIR R4 Implementation Guide (v2.0.0: STU 2) based on FHIR R4. The current version which supercedes this version is 3.0.0. For a full list of available versions, see the Directory of published versions

EXMComputableLibrary

{
  "resourceType" : "Library",
  "id" : "EXMComputableLibrary",
  "meta" : {
    "profile" : [
      "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-library-cqfm"
    ]
  },
  "text" : {
    "status" : "extensions",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\r\n    <table class=\"grid dict\">\r\n        \r\n        <tr>\r\n            <th scope=\"row\"><b>Id: </b></th>\r\n            <td style=\"padding-left: 25px;\">EXMComputableLibrary</td>\r\n        </tr>\r\n        \r\n        \r\n        <tr>\r\n            <th scope=\"row\"><b>Url: </b></th>\r\n            <td style=\"padding-left: 25px;\">http://hl7.org/fhir/us/cqfmeasures/Library/EXMComputableLibrary</td>\r\n        </tr>\r\n        \r\n        \r\n        <tr>\r\n            <th scope=\"row\"><b>Version: </b></th>\r\n            <td style=\"padding-left: 25px;\">2.0.0</td>\r\n        </tr>\r\n        \r\n        \r\n        <tr>\r\n            <th scope=\"row\"><b>Identifier: </b></th>\r\n            <td style=\"padding-left: 25px;\">\r\n                \r\n                \r\n                <p style=\"margin-bottom: 5px;\">\r\n                    <b>value: </b> <span>EXMComputableLogic</span>\r\n                </p>\r\n                \r\n            </td>\r\n        </tr>\r\n        \r\n        \r\n        <tr>\r\n            <th scope=\"row\"><b>Name: </b></th>\r\n            <td style=\"padding-left: 25px;\">EXMComputableLibrary</td>\r\n        </tr>\r\n        \r\n        \r\n        <tr>\r\n            <th scope=\"row\"><b>Title: </b></th>\r\n            <td style=\"padding-left: 25px;\">Example Computable Library</td>\r\n        </tr>\r\n        \r\n        \r\n        \r\n        <tr>\r\n            <th scope=\"row\"><b>Status: </b></th>\r\n            <td style=\"padding-left: 25px;\">active</td>\r\n        </tr>\r\n        \r\n        \r\n        <tr>\r\n            <th scope=\"row\"><b>Experimental: </b></th>\r\n            <td style=\"padding-left: 25px;\">true</td>\r\n        </tr>\r\n        \r\n        \r\n        <tr>\r\n            <th scope=\"row\"><b>Type: </b></th>\r\n            <td style=\"padding-left: 25px;\">\r\n                \r\n                    \r\n                        \r\n                        <p style=\"margin-bottom: 5px;\">\r\n                            <b>system: </b> <span>http://terminology.hl7.org/CodeSystem/library-type</span>\r\n                        </p>\r\n                        \r\n                        \r\n                        <p style=\"margin-bottom: 5px;\">\r\n                            <b>code: </b> <span>logic-library</span>\r\n                        </p>\r\n                        \r\n                        \r\n                    \r\n                \r\n                \r\n            </td>\r\n        </tr>\r\n        \r\n        \r\n        \r\n        <tr>\r\n            <th scope=\"row\"><b>Date: </b></th>\r\n            <td style=\"padding-left: 25px;\">2019-09-03</td>\r\n        </tr>\r\n        \r\n        \r\n        <tr>\r\n            <th scope=\"row\"><b>Publisher: </b></th>\r\n            <td style=\"padding-left: 25px;\">Health Level 7 International - Clinical Quality Information Work Group</td>\r\n        </tr>\r\n        \r\n        \r\n        <tr>\r\n            <th scope=\"row\"><b>Description: </b></th>\r\n            <td style=\"padding-left: 25px;\">This library is used as an example in the FHIR Quality Measure Implementation Guide</td>\r\n        </tr>\r\n        \r\n        \r\n        <tr>\r\n            <th scope=\"row\"><b>Use Context: </b></th>\r\n            <td style=\"padding-left: 25px;\">\r\n                <table class=\"grid-dict\">\r\n                    <tr><th><b>code</b></th><th><b>value</b></th></tr>\r\n                    \r\n                      <tr>\r\n                        <td>program</td>\r\n                        <td>eh-cah</td>\r\n                      </tr>\r\n                    \r\n                </table>\r\n            </td>\r\n        </tr>\r\n        \r\n        \r\n        <tr>\r\n            <th scope=\"row\"><b>Jurisdiction: </b></th>\r\n            <td style=\"padding-left: 25px;\">US</td>\r\n        </tr>\r\n        \r\n        \r\n        \r\n        \r\n        \r\n        <tr>\r\n            <th scope=\"row\"><b>Approval Date: </b></th>\r\n            <td style=\"padding-left: 25px;\">2019-08-03</td>\r\n        </tr>\r\n        \r\n        \r\n        <tr>\r\n            <th scope=\"row\"><b>Last Review Date: </b></th>\r\n            <td style=\"padding-left: 25px;\">2019-08-03</td>\r\n        </tr>\r\n        \r\n        \r\n        \r\n        <tr>\r\n          <th scope=\"row\"><b>Related Artifacts: </b></th>\r\n          <td style=\"padding-left: 25px;\">\r\n            <table class=\"grid-dict\">\r\n              <tr><th><b>Type</b></th><th><b>Resource</b></th></tr>\r\n              \r\n                <tr><td>depends-on</td><td>http://hl7.org/fhir/Library/FHIR-ModelInfo|4.0.1</td></tr>\r\n              \r\n                <tr><td>depends-on</td><td>http://hl7.org/fhir/Library/FHIRHelpers|4.0.1</td></tr>\r\n              \r\n                <tr><td>depends-on</td><td>http://terminology.hl7.org/CodeSystem/diagnosis-role</td></tr>\r\n              \r\n                <tr><td>depends-on</td><td>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292</td></tr>\r\n              \r\n                <tr><td>depends-on</td><td>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.299</td></tr>\r\n              \r\n                <tr><td>depends-on</td><td>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.126</td></tr>\r\n              \r\n                <tr><td>depends-on</td><td>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1</td></tr>\r\n              \r\n                <tr><td>depends-on</td><td>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.836</td></tr>\r\n              \r\n                <tr><td>depends-on</td><td>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.837</td></tr>\r\n              \r\n                <tr><td>depends-on</td><td>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591</td></tr>\r\n              \r\n            </table>\r\n          </td>\r\n        </tr>\r\n        \r\n        \r\n        <tr>\r\n          <th scope=\"row\"><b>Parameters: </b></th>\r\n          <td style=\"padding-left: 25px;\">\r\n            <table class=\"grid-dict\">\r\n              <tr><th><b>Name</b></th><th><b>Type</b></th><th><b>Min</b></th><th><b>Max</b></th><th><b>In/Out</b></th></tr>\r\n              \r\n                <tr><th>Measurement Period</th><th>Period</th><th>0</th><th>1</th><th>in</th></tr>\r\n              \r\n                <tr><th>Patient</th><th>Patient</th><th>0</th><th>1</th><th>out</th></tr>\r\n              \r\n                <tr><th>Inpatient Encounter</th><th>Encounter</th><th>0</th><th>*</th><th>out</th></tr>\r\n              \r\n                <tr><th>Initial Population</th><th>Encounter</th><th>0</th><th>*</th><th>out</th></tr>\r\n              \r\n                <tr><th>Measure Population</th><th>Encounter</th><th>0</th><th>*</th><th>out</th></tr>\r\n              \r\n                <tr><th>Stratifier 1</th><th>Encounter</th><th>0</th><th>*</th><th>out</th></tr>\r\n              \r\n                <tr><th>Stratifier 2</th><th>Encounter</th><th>0</th><th>*</th><th>out</th></tr>\r\n              \r\n                <tr><th>Stratifier 3</th><th>Encounter</th><th>0</th><th>*</th><th>out</th></tr>\r\n              \r\n                <tr><th>Stratifier 4</th><th>Encounter</th><th>0</th><th>*</th><th>out</th></tr>\r\n              \r\n                <tr><th>SDE Ethnicity</th><th>Coding</th><th>0</th><th>*</th><th>out</th></tr>\r\n              \r\n                <tr><th>SDE Payer</th><th>Any</th><th>0</th><th>*</th><th>out</th></tr>\r\n              \r\n                <tr><th>SDE Race</th><th>Coding</th><th>0</th><th>*</th><th>out</th></tr>\r\n              \r\n                <tr><th>SDE Sex</th><th>Coding</th><th>0</th><th>1</th><th>out</th></tr>\r\n              \r\n            </table>\r\n          </td>\r\n        </tr>\r\n        \r\n        \r\n        <tr>\r\n          <th scope=\"row\"><b>Data Requirements:</b></th>\r\n          <td style=\"padding-left: 25px;\">\r\n            <table class=\"grid-dict\">\r\n              <tr><th><b>Type</b></th><th><b>Profile</b></th><th><b>MS</b></th><th><b>Code Filter</b></th></tr>\r\n              \r\n                <tr>\r\n                  <th>Encounter</th>\r\n                  <th>http://hl7.org/fhir/StructureDefinition/Encounter</th>\r\n                  <th></th>\r\n                  <th>\r\n                    \r\n                  </th>\r\n                </tr>\r\n              \r\n                <tr>\r\n                  <th>Encounter</th>\r\n                  <th>http://hl7.org/fhir/StructureDefinition/Encounter</th>\r\n                  <th></th>\r\n                  <th>\r\n                    \r\n                    <p style=\"margin-bottom: 5px;\">\r\n                        <b>code filter: </b>\r\n                        \r\n                        <br/>\r\n                        \r\n                        \r\n                        <span style=\"padding-left: 25px;\">\r\n                            <b>path: </b><span>type</span>\r\n                        </span>\r\n                        \r\n                        <br/>\r\n                        \r\n                        \r\n                        \r\n                        <span style=\"padding-left: 25px;\">\r\n                            <b>value set: </b><span>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292</span>\r\n                        </span>\r\n                        \r\n                        \r\n                    </p>\r\n                    \r\n                  </th>\r\n                </tr>\r\n              \r\n                <tr>\r\n                  <th>Condition</th>\r\n                  <th>http://hl7.org/fhir/StructureDefinition/Condition</th>\r\n                  <th></th>\r\n                  <th>\r\n                    \r\n                    <p style=\"margin-bottom: 5px;\">\r\n                        <b>code filter: </b>\r\n                        \r\n                        <br/>\r\n                        \r\n                        \r\n                        <span style=\"padding-left: 25px;\">\r\n                            <b>path: </b><span>id</span>\r\n                        </span>\r\n                        \r\n                        \r\n                        \r\n                        \r\n                    </p>\r\n                    \r\n                  </th>\r\n                </tr>\r\n              \r\n                <tr>\r\n                  <th>Coverage</th>\r\n                  <th>http://hl7.org/fhir/StructureDefinition/Coverage</th>\r\n                  <th></th>\r\n                  <th>\r\n                    \r\n                    <p style=\"margin-bottom: 5px;\">\r\n                        <b>code filter: </b>\r\n                        \r\n                        <br/>\r\n                        \r\n                        \r\n                        <span style=\"padding-left: 25px;\">\r\n                            <b>path: </b><span>type</span>\r\n                        </span>\r\n                        \r\n                        <br/>\r\n                        \r\n                        \r\n                        \r\n                        <span style=\"padding-left: 25px;\">\r\n                            <b>value set: </b><span>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591</span>\r\n                        </span>\r\n                        \r\n                        \r\n                    </p>\r\n                    \r\n                  </th>\r\n                </tr>\r\n              \r\n            </table>\r\n          </td>\r\n        </tr>\r\n        \r\n        \r\n        \r\n        <tr>\r\n          <table>\r\n            <tr><th><a id=\"cql-content\"><b>Content: </b></a> text/cql</th></tr>\r\n            <tr><td><pre><code>library EXMComputableLibrary version '2.0.0'\r\n\r\n/*\r\nThis example is purely for illustration purposes to show how all the elements of a\r\nFHIR-based quality measure are represented. It is intentionally simplified to show\r\nspecific aspects of a measure, and is not intended as an example of a clinically\r\nmeaningful measure.\r\n*/\r\n\r\n/*\r\nNOTE: This is the same library as EXMLogic, being used to illustrate the different flavors of profiles:\r\n* Computable: Focusing on computable/design-time aspects\r\n* Executable: Focusing on run-time aspects\r\n* Publishable: Focusing on knowledge management aspects\r\n*/\r\n\r\nusing FHIR version '4.0.1'\r\n\r\ninclude FHIRHelpers version '4.0.1' called FHIRHelpers\r\n\r\ncodesystem \"Diagnosis Role\": 'http://terminology.hl7.org/CodeSystem/diagnosis-role'\r\n\r\nvalueset \"Emergency Department Visit\" : 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292'\r\nvalueset \"Psychiatric/Mental Health Patient\" : 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.299'\r\nvalueset \"Hospital Settings\" : 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.126'\r\n\r\nvalueset \"ONC Administrative Sex\": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1'\r\nvalueset \"Race\": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.836'\r\nvalueset \"Ethnicity\": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.837'\r\nvalueset \"Payer\": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591'\r\n\r\ncode \"Billing\": 'billing' from \"Diagnosis Role\" display 'Billing'\r\n\r\nparameter \"Measurement Period\" Interval&lt;DateTime&gt;\r\n\r\ncontext Patient\r\n\r\ndefine \"Initial Population\" :\r\n  \"Inpatient Encounter\" Encounter\r\n\r\ndefine \"Measure Population\" :\r\n  \"Initial Population\"\r\n\r\ndefine function \"Measure Observation\" (Encounter \"Encounter\" ) :\r\n  duration in minutes of \"Related ED Visit\"(Encounter).period\r\n\r\ndefine \"Stratifier 1\" :\r\n  \"Inpatient Encounter\" Encounter\r\n    where not (PrincipalDiagnosis(Encounter).code in \"Psychiatric/Mental Health Patient\")\r\n\r\ndefine \"Stratifier 2\" :\r\n  \"Inpatient Encounter\" Encounter\r\n    where PrincipalDiagnosis(Encounter).code in \"Psychiatric/Mental Health Patient\"\r\n\r\ndefine \"Stratifier 3\" :\r\n  \"Inpatient Encounter\" Encounter\r\n    where PrincipalDiagnosis(Encounter) is null\r\n\r\ndefine \"Stratifier 4\" :\r\n  \"Inpatient Encounter\" Encounter\r\n    where PrincipalDiagnosis(Encounter) is null\r\n\r\ndefine \"Inpatient Encounter\" :\r\n  [\"Encounter\"] Encounter\r\n    where LengthInDays(Encounter.period) &lt;= 120\r\n      and Encounter.period ends during \"Measurement Period\"\r\n\r\ndefine function \"PrincipalDiagnosis\"(Encounter Encounter):\r\n\t(singleton from (Encounter.diagnosis D where D.use ~ ToConcept(\"Billing\") and D.rank.value = 1)) PD\r\n\t\treturn singleton from ([Condition: id in \"GetId\"(PD.condition.reference)])\r\n\r\ndefine function \"LengthInDays\"(Value Interval&lt;DateTime&gt;):\r\n\tdifference in days between start of Value and end of Value\r\n\r\ndefine function \"GetId\"(uri String):\r\n\tLast(Split(uri, '/'))\r\n\r\n//Measure Observation\r\ndefine function \"Related ED Visit\" (Encounter \"Encounter\" ) :\r\n  Last([\"Encounter\" : \"Emergency Department Visit\"] ED\r\n    where ED.status = 'finished'\r\n      and ED.period ends 1 hour or less before start of Encounter.period\r\n    sort by start of period )\r\n\r\ndefine \"SDE Ethnicity\":\r\n  (flatten (\r\n    Patient.extension Extension\r\n      where Extension.url = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity'\r\n        return Extension.extension\r\n  )) E\r\n    where E.url = 'ombCategory'\r\n      or E.url = 'detailed'\r\n    return E.value as Coding\r\n\r\ndefine \"SDE Payer\":\r\n    [Coverage: type in \"Payer\"] Payer\r\n      return {\r\n        code: Payer.type,\r\n        period: Payer.period\r\n      }\r\n\r\ndefine \"SDE Race\":\r\n  (flatten (\r\n    Patient.extension Extension\r\n      where Extension.url = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-race'\r\n        return Extension.extension\r\n  )) E\r\n    where E.url = 'ombCategory'\r\n      or E.url = 'detailed'\r\n    return E.value as Coding\r\n\r\ndefine \"SDE Sex\":\r\n  case\r\n    when Patient.gender = 'male' then Code { code: 'M', system: 'http://hl7.org/fhir/v3/AdministrativeGender', display: 'Male' }\r\n    when Patient.gender = 'female' then Code { code: 'F', system: 'http://hl7.org/fhir/v3/AdministrativeGender', display: 'Female' }\r\n    else null\r\n  end\r\n</code></pre></td></tr>\r\n          </table>\r\n        </tr>\r\n        \r\n        \r\n        \r\n    </table>\r\n</div>"
  },
  "url" : "http://hl7.org/fhir/us/cqfmeasures/Library/EXMComputableLibrary",
  "identifier" : [
    {
      "use" : "official",
      "system" : "http://example.org/fhir/cqi/ecqm/Library/Identifier",
      "value" : "EXMComputableLogic"
    }
  ],
  "version" : "2.0.0",
  "name" : "EXMComputableLibrary",
  "title" : "Example Computable Library",
  "status" : "active",
  "experimental" : true,
  "type" : {
    "coding" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/library-type",
        "code" : "logic-library"
      }
    ]
  },
  "date" : "2019-09-03",
  "publisher" : "Health Level 7 International - Clinical Quality Information Work Group",
  "contact" : [
    {
      "telecom" : [
        {
          "system" : "url",
          "value" : "http://www.hl7.org/Special/committees/cqi/index.cfm"
        }
      ]
    }
  ],
  "description" : "This library is used as an example in the FHIR Quality Measure Implementation Guide",
  "useContext" : [
    {
      "code" : {
        "system" : "http://terminology.hl7.org/CodeSystem/usage-context-type",
        "code" : "program"
      },
      "valueCodeableConcept" : {
        "coding" : [
          {
            "system" : "http://hl7.org/fhir/us/cqfmeasures/CodeSystem/quality-programs",
            "code" : "eh-cah",
            "display" : "EH/CAH"
          }
        ]
      }
    }
  ],
  "jurisdiction" : [
    {
      "coding" : [
        {
          "system" : "urn:iso:std:iso:3166",
          "code" : "US",
          "display" : "United States of America"
        }
      ]
    }
  ],
  "approvalDate" : "2019-08-03",
  "lastReviewDate" : "2019-08-03",
  "relatedArtifact" : [
    {
      "type" : "depends-on",
      "resource" : "http://hl7.org/fhir/Library/FHIR-ModelInfo|4.0.1"
    },
    {
      "type" : "depends-on",
      "resource" : "http://hl7.org/fhir/Library/FHIRHelpers|4.0.1"
    },
    {
      "type" : "depends-on",
      "resource" : "http://terminology.hl7.org/CodeSystem/diagnosis-role"
    },
    {
      "type" : "depends-on",
      "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292"
    },
    {
      "type" : "depends-on",
      "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.299"
    },
    {
      "type" : "depends-on",
      "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.126"
    },
    {
      "type" : "depends-on",
      "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1"
    },
    {
      "type" : "depends-on",
      "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.836"
    },
    {
      "type" : "depends-on",
      "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.837"
    },
    {
      "type" : "depends-on",
      "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"
    }
  ],
  "parameter" : [
    {
      "name" : "Measurement Period",
      "use" : "in",
      "min" : 0,
      "max" : "1",
      "type" : "Period"
    },
    {
      "name" : "Patient",
      "use" : "out",
      "min" : 0,
      "max" : "1",
      "type" : "Patient"
    },
    {
      "name" : "Inpatient Encounter",
      "use" : "out",
      "min" : 0,
      "max" : "*",
      "type" : "Encounter"
    },
    {
      "name" : "Initial Population",
      "use" : "out",
      "min" : 0,
      "max" : "*",
      "type" : "Encounter"
    },
    {
      "name" : "Measure Population",
      "use" : "out",
      "min" : 0,
      "max" : "*",
      "type" : "Encounter"
    },
    {
      "name" : "Stratifier 1",
      "use" : "out",
      "min" : 0,
      "max" : "*",
      "type" : "Encounter"
    },
    {
      "name" : "Stratifier 2",
      "use" : "out",
      "min" : 0,
      "max" : "*",
      "type" : "Encounter"
    },
    {
      "name" : "Stratifier 3",
      "use" : "out",
      "min" : 0,
      "max" : "*",
      "type" : "Encounter"
    },
    {
      "name" : "Stratifier 4",
      "use" : "out",
      "min" : 0,
      "max" : "*",
      "type" : "Encounter"
    },
    {
      "name" : "SDE Ethnicity",
      "use" : "out",
      "min" : 0,
      "max" : "*",
      "type" : "Coding"
    },
    {
      "name" : "SDE Payer",
      "use" : "out",
      "min" : 0,
      "max" : "*",
      "type" : "Any"
    },
    {
      "name" : "SDE Race",
      "use" : "out",
      "min" : 0,
      "max" : "*",
      "type" : "Coding"
    },
    {
      "name" : "SDE Sex",
      "use" : "out",
      "min" : 0,
      "max" : "1",
      "type" : "Coding"
    }
  ],
  "dataRequirement" : [
    {
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}