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

@prefix fhir: <http://hl7.org/fhir/> .
@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:Library;
  fhir:nodeRole fhir:treeRoot;
  fhir:Resource.id [ fhir:value "EXMComputableLibrary"];
  fhir:Resource.meta [
     fhir:Meta.profile [
       fhir:value "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-library-cqfm";
       fhir:index 0;
       fhir:link <http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-library-cqfm>     ]
  ];
  fhir:DomainResource.text [
     fhir:Narrative.status [ fhir:value "extensions" ];
     fhir:Narrative.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	(singleton from (Encounter.diagnosis D where D.use ~ ToConcept(\"Billing\") and D.rank.value = 1)) PD\r\n		return singleton from ([Condition: id in \"GetId\"(PD.condition.reference)])\r\n\r\ndefine function \"LengthInDays\"(Value Interval&lt;DateTime&gt;):\r\n	difference in days between start of Value and end of Value\r\n\r\ndefine function \"GetId\"(uri String):\r\n	Last(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>"
  ];
  fhir:Library.url [ fhir:value "http://hl7.org/fhir/us/cqfmeasures/Library/EXMComputableLibrary"];
  fhir:Library.identifier [
     fhir:index 0;
     fhir:Identifier.use [ fhir:value "official" ];
     fhir:Identifier.system [ fhir:value "http://example.org/fhir/cqi/ecqm/Library/Identifier" ];
     fhir:Identifier.value [ fhir:value "EXMComputableLogic" ]
  ];
  fhir:Library.version [ fhir:value "2.0.0"];
  fhir:Library.name [ fhir:value "EXMComputableLibrary"];
  fhir:Library.title [ fhir:value "Example Computable Library"];
  fhir:Library.status [ fhir:value "active"];
  fhir:Library.experimental [ fhir:value "true"^^xsd:boolean];
  fhir:Library.type [
     fhir:CodeableConcept.coding [
       fhir:index 0;
       fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/library-type" ];
       fhir:Coding.code [ fhir:value "logic-library" ]     ]
  ];
  fhir:Library.date [ fhir:value "2019-09-03"^^xsd:date];
  fhir:Library.publisher [ fhir:value "Health Level 7 International - Clinical Quality Information Work Group"];
  fhir:Library.contact [
     fhir:index 0;
     fhir:ContactDetail.telecom [
       fhir:index 0;
       fhir:ContactPoint.system [ fhir:value "url" ];
       fhir:ContactPoint.value [ fhir:value "http://www.hl7.org/Special/committees/cqi/index.cfm" ]     ]
  ];
  fhir:Library.description [ fhir:value "This library is used as an example in the FHIR Quality Measure Implementation Guide"];
  fhir:Library.useContext [
     fhir:index 0;
     fhir:UsageContext.code [
       fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/usage-context-type" ];
       fhir:Coding.code [ fhir:value "program" ]     ];
     fhir:UsageContext.valueCodeableConcept [
       fhir:CodeableConcept.coding [
         fhir:index 0;
         fhir:Coding.system [ fhir:value "http://hl7.org/fhir/us/cqfmeasures/CodeSystem/quality-programs" ];
         fhir:Coding.code [ fhir:value "eh-cah" ];
         fhir:Coding.display [ fhir:value "EH/CAH" ]       ]     ]
  ];
  fhir:Library.jurisdiction [
     fhir:index 0;
     fhir:CodeableConcept.coding [
       fhir:index 0;
       fhir:Coding.system [ fhir:value "urn:iso:std:iso:3166" ];
       fhir:Coding.code [ fhir:value "US" ];
       fhir:Coding.display [ fhir:value "United States of America" ]     ]
  ];
  fhir:Library.approvalDate [ fhir:value "2019-08-03"^^xsd:date];
  fhir:Library.lastReviewDate [ fhir:value "2019-08-03"^^xsd:date];
  fhir:Library.relatedArtifact [
     fhir:index 0;
     fhir:RelatedArtifact.type [ fhir:value "depends-on" ];
     fhir:RelatedArtifact.resource [
       fhir:value "http://hl7.org/fhir/Library/FHIR-ModelInfo|4.0.1";
       fhir:link <http://hl7.org/fhir/Library/FHIR-ModelInfo|4.0.1>     ]
  ], [
     fhir:index 1;
     fhir:RelatedArtifact.type [ fhir:value "depends-on" ];
     fhir:RelatedArtifact.resource [
       fhir:value "http://hl7.org/fhir/Library/FHIRHelpers|4.0.1";
       fhir:link <http://hl7.org/fhir/Library/FHIRHelpers|4.0.1>     ]
  ], [
     fhir:index 2;
     fhir:RelatedArtifact.type [ fhir:value "depends-on" ];
     fhir:RelatedArtifact.resource [
       fhir:value "http://terminology.hl7.org/CodeSystem/diagnosis-role";
       fhir:link <http://terminology.hl7.org/CodeSystem/diagnosis-role>     ]
  ], [
     fhir:index 3;
     fhir:RelatedArtifact.type [ fhir:value "depends-on" ];
     fhir:RelatedArtifact.resource [
       fhir:value "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292";
       fhir:link <http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292>     ]
  ], [
     fhir:index 4;
     fhir:RelatedArtifact.type [ fhir:value "depends-on" ];
     fhir:RelatedArtifact.resource [
       fhir:value "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.299";
       fhir:link <http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.299>     ]
  ], [
     fhir:index 5;
     fhir:RelatedArtifact.type [ fhir:value "depends-on" ];
     fhir:RelatedArtifact.resource [
       fhir:value "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.126";
       fhir:link <http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.126>     ]
  ], [
     fhir:index 6;
     fhir:RelatedArtifact.type [ fhir:value "depends-on" ];
     fhir:RelatedArtifact.resource [
       fhir:value "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1";
       fhir:link <http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1>     ]
  ], [
     fhir:index 7;
     fhir:RelatedArtifact.type [ fhir:value "depends-on" ];
     fhir:RelatedArtifact.resource [
       fhir:value "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.836";
       fhir:link <http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.836>     ]
  ], [
     fhir:index 8;
     fhir:RelatedArtifact.type [ fhir:value "depends-on" ];
     fhir:RelatedArtifact.resource [
       fhir:value "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.837";
       fhir:link <http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.837>     ]
  ], [
     fhir:index 9;
     fhir:RelatedArtifact.type [ fhir:value "depends-on" ];
     fhir:RelatedArtifact.resource [
       fhir:value "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591";
       fhir:link <http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591>     ]
  ];
  fhir:Library.parameter [
     fhir:index 0;
     fhir:ParameterDefinition.name [ fhir:value "Measurement Period" ];
     fhir:ParameterDefinition.use [ fhir:value "in" ];
     fhir:ParameterDefinition.min [ fhir:value "0"^^xsd:integer ];
     fhir:ParameterDefinition.max [ fhir:value "1" ];
     fhir:ParameterDefinition.type [ fhir:value "Period" ]
  ], [
     fhir:index 1;
     fhir:ParameterDefinition.name [ fhir:value "Patient" ];
     fhir:ParameterDefinition.use [ fhir:value "out" ];
     fhir:ParameterDefinition.min [ fhir:value "0"^^xsd:integer ];
     fhir:ParameterDefinition.max [ fhir:value "1" ];
     fhir:ParameterDefinition.type [ fhir:value "Patient" ]
  ], [
     fhir:index 2;
     fhir:ParameterDefinition.name [ fhir:value "Inpatient Encounter" ];
     fhir:ParameterDefinition.use [ fhir:value "out" ];
     fhir:ParameterDefinition.min [ fhir:value "0"^^xsd:integer ];
     fhir:ParameterDefinition.max [ fhir:value "*" ];
     fhir:ParameterDefinition.type [ fhir:value "Encounter" ]
  ], [
     fhir:index 3;
     fhir:ParameterDefinition.name [ fhir:value "Initial Population" ];
     fhir:ParameterDefinition.use [ fhir:value "out" ];
     fhir:ParameterDefinition.min [ fhir:value "0"^^xsd:integer ];
     fhir:ParameterDefinition.max [ fhir:value "*" ];
     fhir:ParameterDefinition.type [ fhir:value "Encounter" ]
  ], [
     fhir:index 4;
     fhir:ParameterDefinition.name [ fhir:value "Measure Population" ];
     fhir:ParameterDefinition.use [ fhir:value "out" ];
     fhir:ParameterDefinition.min [ fhir:value "0"^^xsd:integer ];
     fhir:ParameterDefinition.max [ fhir:value "*" ];
     fhir:ParameterDefinition.type [ fhir:value "Encounter" ]
  ], [
     fhir:index 5;
     fhir:ParameterDefinition.name [ fhir:value "Stratifier 1" ];
     fhir:ParameterDefinition.use [ fhir:value "out" ];
     fhir:ParameterDefinition.min [ fhir:value "0"^^xsd:integer ];
     fhir:ParameterDefinition.max [ fhir:value "*" ];
     fhir:ParameterDefinition.type [ fhir:value "Encounter" ]
  ], [
     fhir:index 6;
     fhir:ParameterDefinition.name [ fhir:value "Stratifier 2" ];
     fhir:ParameterDefinition.use [ fhir:value "out" ];
     fhir:ParameterDefinition.min [ fhir:value "0"^^xsd:integer ];
     fhir:ParameterDefinition.max [ fhir:value "*" ];
     fhir:ParameterDefinition.type [ fhir:value "Encounter" ]
  ], [
     fhir:index 7;
     fhir:ParameterDefinition.name [ fhir:value "Stratifier 3" ];
     fhir:ParameterDefinition.use [ fhir:value "out" ];
     fhir:ParameterDefinition.min [ fhir:value "0"^^xsd:integer ];
     fhir:ParameterDefinition.max [ fhir:value "*" ];
     fhir:ParameterDefinition.type [ fhir:value "Encounter" ]
  ], [
     fhir:index 8;
     fhir:ParameterDefinition.name [ fhir:value "Stratifier 4" ];
     fhir:ParameterDefinition.use [ fhir:value "out" ];
     fhir:ParameterDefinition.min [ fhir:value "0"^^xsd:integer ];
     fhir:ParameterDefinition.max [ fhir:value "*" ];
     fhir:ParameterDefinition.type [ fhir:value "Encounter" ]
  ], [
     fhir:index 9;
     fhir:ParameterDefinition.name [ fhir:value "SDE Ethnicity" ];
     fhir:ParameterDefinition.use [ fhir:value "out" ];
     fhir:ParameterDefinition.min [ fhir:value "0"^^xsd:integer ];
     fhir:ParameterDefinition.max [ fhir:value "*" ];
     fhir:ParameterDefinition.type [ fhir:value "Coding" ]
  ], [
     fhir:index 10;
     fhir:ParameterDefinition.name [ fhir:value "SDE Payer" ];
     fhir:ParameterDefinition.use [ fhir:value "out" ];
     fhir:ParameterDefinition.min [ fhir:value "0"^^xsd:integer ];
     fhir:ParameterDefinition.max [ fhir:value "*" ];
     fhir:ParameterDefinition.type [ fhir:value "Any" ]
  ], [
     fhir:index 11;
     fhir:ParameterDefinition.name [ fhir:value "SDE Race" ];
     fhir:ParameterDefinition.use [ fhir:value "out" ];
     fhir:ParameterDefinition.min [ fhir:value "0"^^xsd:integer ];
     fhir:ParameterDefinition.max [ fhir:value "*" ];
     fhir:ParameterDefinition.type [ fhir:value "Coding" ]
  ], [
     fhir:index 12;
     fhir:ParameterDefinition.name [ fhir:value "SDE Sex" ];
     fhir:ParameterDefinition.use [ fhir:value "out" ];
     fhir:ParameterDefinition.min [ fhir:value "0"^^xsd:integer ];
     fhir:ParameterDefinition.max [ fhir:value "1" ];
     fhir:ParameterDefinition.type [ fhir:value "Coding" ]
  ];
  fhir:Library.dataRequirement [
     fhir:index 0;
     fhir:DataRequirement.type [ fhir:value "Encounter" ];
     fhir:DataRequirement.profile [
       fhir:value "http://hl7.org/fhir/StructureDefinition/Encounter";
       fhir:index 0;
       fhir:link <http://hl7.org/fhir/StructureDefinition/Encounter>     ]
  ], [
     fhir:index 1;
     fhir:DataRequirement.type [ fhir:value "Encounter" ];
     fhir:DataRequirement.profile [
       fhir:value "http://hl7.org/fhir/StructureDefinition/Encounter";
       fhir:index 0;
       fhir:link <http://hl7.org/fhir/StructureDefinition/Encounter>     ];
     fhir:DataRequirement.codeFilter [
       fhir:index 0;
       fhir:DataRequirement.codeFilter.path [ fhir:value "type" ];
       fhir:DataRequirement.codeFilter.valueSet [
         fhir:value "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292";
         fhir:link <http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292>       ]     ]
  ], [
     fhir:index 2;
     fhir:DataRequirement.type [ fhir:value "Condition" ];
     fhir:DataRequirement.profile [
       fhir:value "http://hl7.org/fhir/StructureDefinition/Condition";
       fhir:index 0;
       fhir:link <http://hl7.org/fhir/StructureDefinition/Condition>     ];
     fhir:DataRequirement.codeFilter [
       fhir:index 0;
       fhir:DataRequirement.codeFilter.path [ fhir:value "id" ]     ]
  ], [
     fhir:index 3;
     fhir:DataRequirement.type [ fhir:value "Coverage" ];
     fhir:DataRequirement.profile [
       fhir:value "http://hl7.org/fhir/StructureDefinition/Coverage";
       fhir:index 0;
       fhir:link <http://hl7.org/fhir/StructureDefinition/Coverage>     ];
     fhir:DataRequirement.codeFilter [
       fhir:index 0;
       fhir:DataRequirement.codeFilter.path [ fhir:value "type" ];
       fhir:DataRequirement.codeFilter.valueSet [
         fhir:value "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591";
         fhir:link <http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591>       ]     ]
  ];
  fhir:Library.content [
     fhir:index 0;
     fhir:Attachment.contentType [ fhir:value "text/cql" ];
     fhir:Attachment.data [ fhir:value "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"^^xsd:base64Binary ]
  ].

# - ontology header ------------------------------------------------------------

 a owl:Ontology;
  owl:imports fhir:fhir.ttl.