Quality Measure Implementation Guide
1.0.0-ballot - ballot International flag

This page is part of the Quality Measure Implementation Guide (v1.0.0-ballot: STU1 (v1.0.0) Ballot 1) based on FHIR (HL7® FHIR® Standard) R4. . For a full list of available versions, see the Directory of published versions

Measure: EXM Measure (Experimental)

Official URL: http://hl7.org/fhir/uv/cqm/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: 001
Topic: 57024-2
Purpose:

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

Copyright:

Example Copyright Statement

Disclaimer:

Example disclaimer

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"