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

: EXM Measure - JSON Representation

Active as of 2022-02-22

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{
  "resourceType" : "Measure",
  "id" : "EXMLogic-FHIR",
  "meta" : {
    "profile" : [
      🔗 "http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-proportionmeasure"🔗 ,
      "http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-computablemeasure"🔗 ,
      "http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-executablemeasure"🔗 ,
      "http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-cqlmeasure"🔗 ,
      "http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-elmmeasure"
    ]
  },
  "text" : {
    "status" : "extensions",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<div>\n    <table class=\"grid dict\">\n        \n            <tr>\n                <th scope=\"row\"><b>Title: </b></th>\n                <td style=\"padding-left: 4px;\">EXM Measure</td>\n            </tr>\n        \n\n        \n\n        \n            <tr>\n                <th scope=\"row\"><b>Id: </b></th>\n                <td style=\"padding-left: 4px;\">EXMLogic-FHIR</td>\n            </tr>\n        \n\n        \n            <tr>\n                <th scope=\"row\"><b>Version: </b></th>\n                <td style=\"padding-left: 4px;\">2.0.0</td>\n            </tr>\n        \n\n        \n            <tr>\n                <th scope=\"row\"><b>Url: </b></th>\n                <td style=\"padding-left: 4px;\"><a href=\"Measure-EXMLogic-FHIR.html\">EXM Measure</a></td>\n            </tr>\n        \n\n        \n            <tr>\n                <th scope=\"row\">\n                    <b>\n                        \n                            \n                        \n                    </b>\n                </th>\n\n                <td style=\"padding-left: 4px;\">\n                    \n                        <p style=\"margin-bottom: 5px;\">\n                            <span>EXM</span>\n                        </p>\n                    \n                </td>\n            </tr>\n        \n\n        \n            <tr>\n                <th scope=\"row\"><b>Effective Period: </b></th>\n                <td style=\"padding-left: 4px;\">2018-01-01..2018-12-31</td>\n            </tr>\n        \n\n        \n\n        \n            <tr>\n                <th scope=\"row\"><b>Experimental: </b></th>\n                <td style=\"padding-left: 4px;\">true</td>\n            </tr>\n        \n\n        \n            <tr>\n                <th scope=\"row\"><b>Publisher: </b></th>\n                <td style=\"padding-left: 4px;\">HL7 International / Clinical Quality Information</td>\n            </tr>\n        \n\n        \n        <tr>\n            <th scope=\"row\"><b>Author: </b></th>\n            <td style=\"padding-left: 4px;\">Example Measure Content Developer</td>\n        </tr>\n        \n\n        \n\n        \n            <tr>\n                <th scope=\"row\"><b>Description: </b></th>\n                <td style=\"padding-left: 4px;\"><div><p>An example FHIR-based measure</p>\n</div></td>\n            </tr>\n        \n\n        \n\n        \n\n        \n            <tr>\n                <th scope=\"row\"><b>Use Context: </b></th>\n                <td style=\"padding-left: 4px;\">\n                    <table class=\"grid-dict\">\n                        <tr>\n                            <th><b>code</b></th>\n                            <th><b>value</b></th>\n                        </tr>\n                        \n                            <tr>\n                                <td>venue</td>\n                                <td/>\n                            </tr>\n                        \n                    </table>\n                </td>\n            </tr>\n        \n\n        \n            <tr>\n                <th scope=\"row\"><b>Jurisdiction: </b></th>\n                <td style=\"padding-left: 4px;\">001</td>\n            </tr>\n        \n\n        \n            <tr>\n                <th scope=\"row\"><b>Topic: </b></th>\n                <td style=\"padding-left: 4px;\">57024-2</td>\n            </tr>\n        \n\n        \n            <tr>\n                <th scope=\"row\"><b>Purpose: </b></th>\n                <td style=\"padding-left: 4px;\"><div><p>This measure has been developed to support improvement in clinical care.</p>\n</div></td>\n            </tr>\n        \n\n        \n            <tr>\n                <th scope=\"row\"><b>Copyright: </b></th>\n                <td style=\"padding-left: 4px;\"><div><p>Example Copyright Statement</p>\n</div></td>\n            </tr>\n        \n\n        \n            <tr>\n                <th scope=\"row\"><b>Disclaimer: </b></th>\n                <td style=\"padding-left: 4px;\"><div><p>Example disclaimer</p>\n</div></td>\n            </tr>\n        \n\n        \n\n        \n\n        \n            <tr>\n                <th scope=\"row\"><b>Scoring: </b></th>\n                <td style=\"padding-left: 4px;\">\n                    \n                        \n                            <p style=\"margin-bottom: 5px;\">\n                                <span>Proportion </span>\n                            </p>\n                        \n                    \n                    \n                </td>\n            </tr>\n        \n\n        \n\n        \n            <tr>\n                <th scope=\"row\"><b>Type: </b></th>\n                <td style=\"padding-left: 4px;\">\n                    \n                        \n                            <p style=\"margin-bottom: 5px;\">\n                                <span>process </span>\n                            </p>\n                        \n                    \n                    \n                </td>\n            </tr>\n        \n\n        \n        <tr>\n            <th scope=\"row\"><b>Risk Adjustment: </b></th>\n            <td style=\"padding-left: 4px;\">Risk adjustment for this measure is performed by...</td>\n        </tr>\n        \n\n        \n        <tr>\n            <th scope=\"row\"><b>Rate Aggregation: </b></th>\n            <td style=\"padding-left: 4px;\">Rate aggregation for this measure is performed by...</td>\n        </tr>\n        \n\n        \n        <tr>\n            <th scope=\"row\"><b>Rationale: </b></th>\n            <td style=\"padding-left: 4px;\"><div><p>The purpose of this measure is to show how all the elements of a FHIR-based quality measure are represented.</p>\n</div></td>\n        </tr>\n        \n\n        \n        <tr>\n            <th scope=\"row\"><b>Clinical recommendation statement: </b></th>\n            <td style=\"padding-left: 4px;\"><div><p>The clinical recommendation statement for this measure is...</p>\n</div></td>\n        </tr>\n        \n\n        \n            <tr>\n                <th scope=\"row\"><b>Improvement Notation: </b></th>\n                <td style=\"padding-left: 4px;\">\n                    \n                        \n                            <p style=\"margin-bottom: 5px;\">\n                                <span>Increased score indicates improvement </span>\n                            </p>\n                        \n                    \n                    \n                </td>\n            </tr>\n        \n\n        \n            <tr>\n                <th scope=\"row\"><b>Guidance (Usage): </b></th>\n                <td style=\"padding-left: 4px;\">Users of this measure should be aware that this is intentionally simplified to show specific aspects of a measure.</td>\n            </tr>\n        \n\n        \n            \n        \n\n        \n            <tr>\n                <th scope=\"row\"><b> Supplemental Data Elements: </b></th>\n                <td style=\"padding-left: 4px;\">\n                    \n                        \n                            \n                                \n                                    <p>SDE Ethnicity</p>\n                                \n                            \n                        \n                    \n                        \n                            \n                                \n                                    <p>SDE Race</p>\n                                \n                            \n                        \n                    \n                        \n                            \n                                \n                                    <p>SDE Payer</p>\n                                \n                            \n                        \n                    \n                        \n                            \n                                \n                                    <p>SDE Sex</p>\n                                \n                            \n                        \n                    \n                </td>\n            </tr>\n        \n\n        \n\n        \n\n        \n            <tr>\n                <th scope=\"row\"><b>Libraries: </b></th>\n                <td style=\"padding-left: 4px;\">\n                    <table class=\"grid-dict\">\n                        \n                            <tr>\n                                <td><a href=\"Library-EXMLogic-FHIR.html\">Example Logic Library</a></td>\n                            </tr>\n                        \n                    </table>\n                </td>\n            </tr>\n        \n\n        \n\n        \n            \n                <tr>\n                    <th scope=\"row\"><b>Terminology and Other Dependencies: </b></th>\n                    <td style=\"padding-left: 4px;\">\n                        \n                            <li><code>http://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1</code></li>\n                        \n                            <li><a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-diagnosis-role.html\">Diagnosis Role</a></li>\n                        \n                            <li><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591</code></li>\n                        \n                            <li><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.299</code></li>\n                        \n                    </td>\n                </tr>\n                <tr>\n                    <th scope=\"row\"><b>Parameters:</b></th>\n                    <td style=\"padding-left: 4px;\">\n                        <table class=\"grid-dict\">\n                            <tr>\n                                <th><b>name</b></th>\n                                <th><b>use</b></th>\n                                <th><b>min</b></th>\n                                <th><b>max</b></th>\n                                <th><b>type</b></th>\n                            </tr>\n                            \n                                <tr>\n                                    <td>Measurement Period</td>\n                                    <td>In</td>\n                                    <td>0</td>\n                                    <td>1</td>\n                                    <td>Period</td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>SDE Sex</td>\n                                    <td>Out</td>\n                                    <td>0</td>\n                                    <td>1</td>\n                                    <td>Coding</td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>Stratifier 3</td>\n                                    <td>Out</td>\n                                    <td>0</td>\n                                    <td>*</td>\n                                    <td>Encounter</td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>Stratifier 4</td>\n                                    <td>Out</td>\n                                    <td>0</td>\n                                    <td>*</td>\n                                    <td>Encounter</td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>SDE Payer</td>\n                                    <td>Out</td>\n                                    <td>0</td>\n                                    <td>*</td>\n                                    <td>Resource</td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>Initial Population</td>\n                                    <td>Out</td>\n                                    <td>0</td>\n                                    <td>*</td>\n                                    <td>Encounter</td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>SDE Ethnicity</td>\n                                    <td>Out</td>\n                                    <td>0</td>\n                                    <td>*</td>\n                                    <td>Coding</td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>SDE Race</td>\n                                    <td>Out</td>\n                                    <td>0</td>\n                                    <td>*</td>\n                                    <td>Coding</td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>Stratifier 1</td>\n                                    <td>Out</td>\n                                    <td>0</td>\n                                    <td>*</td>\n                                    <td>Encounter</td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>Stratifier 2</td>\n                                    <td>Out</td>\n                                    <td>0</td>\n                                    <td>*</td>\n                                    <td>Encounter</td>\n                                </tr>\n                            \n                        </table>\n                    </td>\n                </tr>\n\n                <tr>\n                    <th scope=\"row\"><b>DataRequirements:</b></th>\n                    <td style=\"padding-left: 4px;\">\n                        <table class=\"grid-dict\">\n                            <tr>\n                                <th><b>Resource Type</b></th>\n                                <th><b>Resource Elements</b></th>\n                                <th><b>Valueset Name</b></th>\n                                <th><b>Valueset</b></th>\n                            </tr>\n                            \n                                <tr>\n                                    <td>Patient(<code>http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient</code>)</td>\n                                    <td>\n                                        \n                                    </td>\n                                    <td>\n                                        \n                                    </td>\n                                    <td/>\n                                </tr>\n                            \n                                <tr>\n                                    <td>Patient(<code>http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient</code>)</td>\n                                    <td>\n                                        \n                                            url\n                                        \n                                            extension\n                                        \n                                            value\n                                        \n                                    </td>\n                                    <td>\n                                        \n                                    </td>\n                                    <td/>\n                                </tr>\n                            \n                                <tr>\n                                    <td>Patient(<code>http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient</code>)</td>\n                                    <td>\n                                        \n                                            url\n                                        \n                                            extension\n                                        \n                                            value\n                                        \n                                    </td>\n                                    <td>\n                                        \n                                    </td>\n                                    <td/>\n                                </tr>\n                            \n                                <tr>\n                                    <td>Encounter(<a href=\"http://hl7.org/fhir/R4/encounter.html\">Encounter</a>)</td>\n                                    <td>\n                                        \n                                            period\n                                        \n                                    </td>\n                                    <td>\n                                        \n                                    </td>\n                                    <td/>\n                                </tr>\n                            \n                                <tr>\n                                    <td>Coverage(<a href=\"http://hl7.org/fhir/R4/coverage.html\">Coverage</a>)</td>\n                                    <td>\n                                        \n                                            type\n                                        \n                                            period\n                                        \n                                    </td>\n                                    <td>\n                                        \n                                            \n                                                 Payer\n                                            \n                                        \n                                    </td>\n                                    <td><code>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591</code></td>\n                                </tr>\n                            \n                        </table>\n                    </td>\n                </tr>\n\n                \n\n                \n                    <tr>\n                        <th scope=\"row\"><b>Direct Reference Codes:</b></th>\n                        <td style=\"padding-left: 4px;\">\n                            <table class=\"grid-dict\">\n                                <tr>\n                                    <th><b>display</b></th>\n                                    <th><b>code</b></th>\n                                    <th><b>system</b></th>\n                                </tr>\n                                \n                                    <tr>\n                                        <td>Billing</td>\n                                        <td>billing</td>\n                                        <td><a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-diagnosis-role.html\">http://terminology.hl7.org/CodeSystem/diagnosis-role</a></td>\n                                    </tr>\n                                \n                            </table>\n                        </td>\n                    </tr>\n                \n\n                \n                <tr>\n                    <th scope=\"row\"><b>Logic Definitions:</b></th>\n                    <td style=\"padding-left: 4px;\">\n                        \n                        <table class=\"grid-dict\">\n                            <tr>\n                                <th><b>Group</b></th>\n                                <th><b>Scoring</b></th>\n                                <th><b>Population Criteria</b></th>\n                                <th><b>Expression</b></th>\n                            </tr>\n                            <tr>\n                                \n                                <td> group-1 </td>\n                                <td colspan=\"3\" style=\"padding-left: 4px;\">\n                                    \n\n                                    \n\n                                    \n                                        <b>Measure scoring:</b>\n                                        \n                                            <p style=\"margin-bottom: 5px;\">\n                                                <span>Proportion</span>\n                                            </p>\n                                        \n                                    \n\n                                    \n\n                                    \n\n                                    \n\n                                    \n\n                                    \n\n                                    \n\n                                </td>\n                                \n                                <tr>\n                                    <td/>\n                                    <td/>\n                                    <td>Initial Population</td>\n                                    <td>\n                                        \n                                            <pre><code class=\"language-cql\">define &quot;Initial Population&quot; :\n  &quot;Inpatient Encounter&quot; Encounter</code></pre>\n                                        \n                                    </td>\n                                </tr>\n                                \n                                <tr>\n                                    <td/>\n                                    <td/>\n                                    <td>Numerator</td>\n                                    <td>\n                                        \n                                            <pre><code class=\"language-cql\"/></pre>\n                                        \n                                    </td>\n                                </tr>\n                                \n                                <tr>\n                                    <td/>\n                                    <td/>\n                                    <td>Denominator</td>\n                                    <td>\n                                        \n                                            <pre><code class=\"language-cql\"/></pre>\n                                        \n                                    </td>\n                                </tr>\n                                \n                                \n                                <tr>\n                                    <td/>\n                                    <td/>\n                                    <td/>\n                                    <td>\n                                        \n                                            <pre><code class=\"language-cql\">define &quot;Stratifier 1&quot; :\n  &quot;Inpatient Encounter&quot; Encounter\n    where not (PrincipalDiagnosis(Encounter).code in &quot;Psychiatric/Mental Health Patient&quot;)</code></pre>\n                                        \n                                    </td>\n                                </tr>\n                                \n                                <tr>\n                                    <td/>\n                                    <td/>\n                                    <td/>\n                                    <td>\n                                        \n                                            <pre><code class=\"language-cql\">define &quot;Stratifier 2&quot; :\n  &quot;Inpatient Encounter&quot; Encounter\n    where PrincipalDiagnosis(Encounter).code in &quot;Psychiatric/Mental Health Patient&quot;</code></pre>\n                                        \n                                    </td>\n                                </tr>\n                                \n                                <tr>\n                                    <td/>\n                                    <td/>\n                                    <td/>\n                                    <td>\n                                        \n                                            <pre><code class=\"language-cql\">define &quot;Stratifier 3&quot; :\n  &quot;Inpatient Encounter&quot; Encounter\n    where PrincipalDiagnosis(Encounter) is null</code></pre>\n                                        \n                                    </td>\n                                </tr>\n                                \n                                <tr>\n                                    <td/>\n                                    <td/>\n                                    <td/>\n                                    <td>\n                                        \n                                            <pre><code class=\"language-cql\">define &quot;Stratifier 4&quot; :\n  &quot;Inpatient Encounter&quot; Encounter\n    where PrincipalDiagnosis(Encounter) is null</code></pre>\n                                        \n                                    </td>\n                                </tr>\n                                \n                            \n                            </tr>\n                        </table>\n                \n\n                <table class=\"grid-dict\">\n                    \n                        <tr>\n                            <th><b>Library Name</b></th>\n                            <th><b>Name</b></th>\n                        </tr>\n                        <tr>\n                            \n                                <td>EXMLogic-FHIR</td>\n                            \n                            \n                                <td>SDE Sex</td>\n                            \n                        </tr>\n                        <tr>\n                            \n                                <td/>\n                                <td>\n                                    <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;SDE Sex&quot;:\n  case\n    when Patient.gender = 'male' then Code { code: 'M', system: 'http://hl7.org/fhir/v3/AdministrativeGender', display: 'Male' }\n    when Patient.gender = 'female' then Code { code: 'F', system: 'http://hl7.org/fhir/v3/AdministrativeGender', display: 'Female' }\n    else null\n  end</code></pre>\n                                </td>\n                            \n                        </tr>\n                    \n                        <tr>\n                            <th><b>Library Name</b></th>\n                            <th><b>Name</b></th>\n                        </tr>\n                        <tr>\n                            \n                                <td>EXMLogic-FHIR</td>\n                            \n                            \n                                <td>Inpatient Encounter</td>\n                            \n                        </tr>\n                        <tr>\n                            \n                                <td/>\n                                <td>\n                                    <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Inpatient Encounter&quot; :\n  [&quot;Encounter&quot;] Encounter\n    where LengthInDays(Encounter.period) &lt;= 120\n      and Encounter.period ends during &quot;Measurement Period&quot;</code></pre>\n                                </td>\n                            \n                        </tr>\n                    \n                        <tr>\n                            <th><b>Library Name</b></th>\n                            <th><b>Name</b></th>\n                        </tr>\n                        <tr>\n                            \n                                <td>EXMLogic-FHIR</td>\n                            \n                            \n                                <td>Stratifier 3</td>\n                            \n                        </tr>\n                        <tr>\n                            \n                                <td/>\n                                <td>\n                                    <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Stratifier 3&quot; :\n  &quot;Inpatient Encounter&quot; Encounter\n    where PrincipalDiagnosis(Encounter) is null</code></pre>\n                                </td>\n                            \n                        </tr>\n                    \n                        <tr>\n                            <th><b>Library Name</b></th>\n                            <th><b>Name</b></th>\n                        </tr>\n                        <tr>\n                            \n                                <td>EXMLogic</td>\n                            \n                            \n                                <td>Stratifier 4</td>\n                            \n                        </tr>\n                        <tr>\n                            \n                                <td/>\n                                <td>\n                                    <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Stratifier 4&quot; :\n  &quot;Inpatient Encounter&quot; Encounter\n    where PrincipalDiagnosis(Encounter) is null</code></pre>\n                                </td>\n                            \n                        </tr>\n                    \n                        <tr>\n                            <th><b>Library Name</b></th>\n                            <th><b>Name</b></th>\n                        </tr>\n                        <tr>\n                            \n                                <td>EXMLogic-FHIR</td>\n                            \n                            \n                                <td>SDE Payer</td>\n                            \n                        </tr>\n                        <tr>\n                            \n                                <td/>\n                                <td>\n                                    <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;SDE Payer&quot;:\n    [Coverage: type in &quot;Payer&quot;] Payer\n      return {\n        code: Payer.type,\n        period: Payer.period\n      }</code></pre>\n                                </td>\n                            \n                        </tr>\n                    \n                        <tr>\n                            <th><b>Library Name</b></th>\n                            <th><b>Name</b></th>\n                        </tr>\n                        <tr>\n                            \n                                <td>EXMLogic</td>\n                            \n                            \n                                <td>Initial Population</td>\n                            \n                        </tr>\n                        <tr>\n                            \n                                <td/>\n                                <td>\n                                    <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Initial Population&quot; :\n  &quot;Inpatient Encounter&quot; Encounter</code></pre>\n                                </td>\n                            \n                        </tr>\n                    \n                        <tr>\n                            <th><b>Library Name</b></th>\n                            <th><b>Name</b></th>\n                        </tr>\n                        <tr>\n                            \n                                <td>EXMLogic-FHIR</td>\n                            \n                            \n                                <td>SDE Ethnicity</td>\n                            \n                        </tr>\n                        <tr>\n                            \n                                <td/>\n                                <td>\n                                    <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;SDE Ethnicity&quot;:\n  (flatten (\n    Patient.extension Extension\n      where Extension.url = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity'\n        return Extension.extension\n  )) E\n    where E.url = 'ombCategory'\n      or E.url = 'detailed'\n    return E.value as Coding</code></pre>\n                                </td>\n                            \n                        </tr>\n                    \n                        <tr>\n                            <th><b>Library Name</b></th>\n                            <th><b>Name</b></th>\n                        </tr>\n                        <tr>\n                            \n                                <td>EXMLogic</td>\n                            \n                            \n                                <td>SDE Race</td>\n                            \n                        </tr>\n                        <tr>\n                            \n                                <td/>\n                                <td>\n                                    <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;SDE Race&quot;:\n  (flatten (\n    Patient.extension Extension\n      where Extension.url = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-race'\n        return Extension.extension\n  )) E\n    where E.url = 'ombCategory'\n      or E.url = 'detailed'\n    return E.value as Coding</code></pre>\n                                </td>\n                            \n                        </tr>\n                    \n                        <tr>\n                            <th><b>Library Name</b></th>\n                            <th><b>Name</b></th>\n                        </tr>\n                        <tr>\n                            \n                                <td>EXMLogic-FHIR</td>\n                            \n                            \n                                <td>Stratifier 1</td>\n                            \n                        </tr>\n                        <tr>\n                            \n                                <td/>\n                                <td>\n                                    <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Stratifier 1&quot; :\n  &quot;Inpatient Encounter&quot; Encounter\n    where not (PrincipalDiagnosis(Encounter).code in &quot;Psychiatric/Mental Health Patient&quot;)</code></pre>\n                                </td>\n                            \n                        </tr>\n                    \n                        <tr>\n                            <th><b>Library Name</b></th>\n                            <th><b>Name</b></th>\n                        </tr>\n                        <tr>\n                            \n                                <td>EXMLogic-FHIR</td>\n                            \n                            \n                                <td>Stratifier 2</td>\n                            \n                        </tr>\n                        <tr>\n                            \n                                <td/>\n                                <td>\n                                    <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Stratifier 2&quot; :\n  &quot;Inpatient Encounter&quot; Encounter\n    where PrincipalDiagnosis(Encounter).code in &quot;Psychiatric/Mental Health Patient&quot;</code></pre>\n                                </td>\n                            \n                        </tr>\n                    \n                    </table>\n                </td>\n            </tr>\n            \n        \n    \n\n    </table>\n</div>\n</div>"
  },
  "contained" : [
    {
      "resourceType" : "Library",
      "id" : "effective-data-requirements-exmlogic",
      "meta" : {
        "profile" : [
          🔗 "http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-moduledefinitionlibrary"
        ]
      },
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
          "valueCoding" : {
            "system" : "http://terminology.hl7.org/CodeSystem/diagnosis-role",
            "code" : "billing",
            "display" : "Billing"
          }
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "EXMLogic-FHIR"
            },
            {
              "url" : "name",
              "valueString" : "SDE Sex"
            },
            {
              "url" : "statement",
              "valueString" : "define \"SDE Sex\":\n  case\n    when Patient.gender = 'male' then Code { code: 'M', system: 'http://hl7.org/fhir/v3/AdministrativeGender', display: 'Male' }\n    when Patient.gender = 'female' then Code { code: 'F', system: 'http://hl7.org/fhir/v3/AdministrativeGender', display: 'Female' }\n    else null\n  end"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 0
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "EXMLogic-FHIR"
            },
            {
              "url" : "name",
              "valueString" : "Inpatient Encounter"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Inpatient Encounter\" :\n  [\"Encounter\"] Encounter\n    where LengthInDays(Encounter.period) <= 120\n      and Encounter.period ends during \"Measurement Period\""
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 1
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "EXMLogic-FHIR"
            },
            {
              "url" : "name",
              "valueString" : "Stratifier 3"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Stratifier 3\" :\n  \"Inpatient Encounter\" Encounter\n    where PrincipalDiagnosis(Encounter) is null"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 2
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "EXMLogic"
            },
            {
              "url" : "name",
              "valueString" : "Stratifier 4"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Stratifier 4\" :\n  \"Inpatient Encounter\" Encounter\n    where PrincipalDiagnosis(Encounter) is null"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 3
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "EXMLogic-FHIR"
            },
            {
              "url" : "name",
              "valueString" : "SDE Payer"
            },
            {
              "url" : "statement",
              "valueString" : "define \"SDE Payer\":\n    [Coverage: type in \"Payer\"] Payer\n      return {\n        code: Payer.type,\n        period: Payer.period\n      }"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 4
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "EXMLogic"
            },
            {
              "url" : "name",
              "valueString" : "Initial Population"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Initial Population\" :\n  \"Inpatient Encounter\" Encounter"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 5
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "EXMLogic-FHIR"
            },
            {
              "url" : "name",
              "valueString" : "SDE Ethnicity"
            },
            {
              "url" : "statement",
              "valueString" : "define \"SDE Ethnicity\":\n  (flatten (\n    Patient.extension Extension\n      where Extension.url = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity'\n        return Extension.extension\n  )) E\n    where E.url = 'ombCategory'\n      or E.url = 'detailed'\n    return E.value as Coding"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 6
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "EXMLogic"
            },
            {
              "url" : "name",
              "valueString" : "SDE Race"
            },
            {
              "url" : "statement",
              "valueString" : "define \"SDE Race\":\n  (flatten (\n    Patient.extension Extension\n      where Extension.url = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-race'\n        return Extension.extension\n  )) E\n    where E.url = 'ombCategory'\n      or E.url = 'detailed'\n    return E.value as Coding"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 7
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "EXMLogic-FHIR"
            },
            {
              "url" : "name",
              "valueString" : "Stratifier 1"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Stratifier 1\" :\n  \"Inpatient Encounter\" Encounter\n    where not (PrincipalDiagnosis(Encounter).code in \"Psychiatric/Mental Health Patient\")"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 8
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "EXMLogic-FHIR"
            },
            {
              "url" : "name",
              "valueString" : "Stratifier 2"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Stratifier 2\" :\n  \"Inpatient Encounter\" Encounter\n    where PrincipalDiagnosis(Encounter).code in \"Psychiatric/Mental Health Patient\""
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 9
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        }
      ],
      "url" : "http://hl7.org/fhir/uv/cqm/Library/effective-data-requirements-exmlogic",
      "version" : "1.0.0",
      "name" : "EffectiveDataRequirements",
      "title" : "Module Definition Library - EXM Logic",
      "status" : "active",
      "type" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/library-type",
            "code" : "module-definition"
          }
        ]
      },
      "description" : "This library is used as an example module definition in the FHIR Quality Measure Implementation Guide",
      "relatedArtifact" : [
        {
          "type" : "depends-on",
          "display" : "Library FHIRHelpers",
          "resource" : "http://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1"
        },
        {
          "type" : "depends-on",
          "display" : "Code system Diagnosis Role",
          "resource" : "http://terminology.hl7.org/CodeSystem/diagnosis-role"
        },
        {
          "type" : "depends-on",
          "display" : "Value set Payer",
          "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"
        },
        {
          "type" : "depends-on",
          "display" : "Value set Psychiatric/Mental Health Patient",
          "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.299"
        }
      ],
      "parameter" : [
        {
          "name" : "Measurement Period",
          "use" : "in",
          "min" : 0,
          "max" : "1",
          "type" : "Period"
        },
        {
          "name" : "SDE Sex",
          "use" : "out",
          "min" : 0,
          "max" : "1",
          "type" : "Coding"
        },
        {
          "name" : "Stratifier 3",
          "use" : "out",
          "min" : 0,
          "max" : "*",
          "type" : "Encounter"
        },
        {
          "name" : "Stratifier 4",
          "use" : "out",
          "min" : 0,
          "max" : "*",
          "type" : "Encounter"
        },
        {
          "name" : "SDE Payer",
          "use" : "out",
          "min" : 0,
          "max" : "*",
          "type" : "Resource"
        },
        {
          "name" : "Initial Population",
          "use" : "out",
          "min" : 0,
          "max" : "*",
          "type" : "Encounter"
        },
        {
          "name" : "SDE Ethnicity",
          "use" : "out",
          "min" : 0,
          "max" : "*",
          "type" : "Coding"
        },
        {
          "name" : "SDE Race",
          "use" : "out",
          "min" : 0,
          "max" : "*",
          "type" : "Coding"
        },
        {
          "name" : "Stratifier 1",
          "use" : "out",
          "min" : 0,
          "max" : "*",
          "type" : "Encounter"
        },
        {
          "name" : "Stratifier 2",
          "use" : "out",
          "min" : 0,
          "max" : "*",
          "type" : "Encounter"
        }
      ],
      "dataRequirement" : [
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-fhirQueryPattern",
              "valueString" : "Patient?_id={{context.patientId}}"
            }
          ],
          "type" : "Patient",
          "profile" : [
            "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"
          ]
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-fhirQueryPattern",
              "valueString" : "Patient?_id={{context.patientId}}"
            },
            {
              "extension" : [
                {
                  "url" : "path",
                  "valueString" : "url"
                },
                {
                  "url" : "comparator",
                  "valueCode" : "eq"
                },
                {
                  "url" : "value",
                  "valueString" : "http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity"
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-valueFilter"
            }
          ],
          "type" : "Patient",
          "profile" : [
            "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"
          ],
          "mustSupport" : [
            "url",
            "extension",
            "value"
          ]
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-fhirQueryPattern",
              "valueString" : "Patient?_id={{context.patientId}}"
            }
          ],
          "type" : "Patient",
          "profile" : [
            "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"
          ],
          "mustSupport" : [
            "url",
            "extension",
            "value"
          ],
          "codeFilter" : [
            {
              "path" : "url",
              "code" : [
                {
                  "system" : "urn:ietf:rfc:3986",
                  "code" : "http://hl7.org/fhir/us/core/StructureDefinition/us-core-race"
                }
              ]
            }
          ]
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-fhirQueryPattern",
              "valueString" : "Encounter?subject=Patient/{{context.patientId}}"
            },
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-isSelective",
              "valueBoolean" : true
            }
          ],
          "type" : "Encounter",
          "profile" : [
            🔗 "http://hl7.org/fhir/StructureDefinition/Encounter"
          ],
          "mustSupport" : [
            "period"
          ],
          "dateFilter" : [
            {
              "path" : "period",
              "valuePeriod" : {
                "extension" : [
                  {
                    "url" : "http://hl7.org/fhir/StructureDefinition/cqf-expression",
                    "valueExpression" : {
                      "language" : "text/cql-identifier",
                      "expression" : "Measurement Period"
                    }
                  }
                ]
              }
            }
          ]
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-fhirQueryPattern",
              "valueString" : "Coverage?policy-holder=Patient/{{context.patientId}}&type:in=http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"
            }
          ],
          "type" : "Coverage",
          "profile" : [
            🔗 "http://hl7.org/fhir/StructureDefinition/Coverage"
          ],
          "mustSupport" : [
            "type",
            "period"
          ],
          "codeFilter" : [
            {
              "path" : "type",
              "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"
            }
          ]
        }
      ]
    }
  ],
  "extension" : [
    {
      "extension" : [
        {
          "url" : "type",
          "valueCode" : "documentation"
        },
        {
          "url" : "text",
          "valueMarkdown" : "This illustrates an example comment"
        }
      ],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-artifactComment"
    },
    {
      "url" : "http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis",
      "valueCode" : "Encounter"
    },
    {
      "url" : "http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-softwaresystem",
      "valueReference" : {
        🔗 "reference" : "Device/software-system-example"
      }
    },
    {
      "url" : "http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements",
      "valueCanonical" : "#effective-data-requirements-exmlogic"
    },
    {
      "url" : "http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringPrecision",
      "valuePositiveInt" : 2
    }
  ],
  "url" : "http://hl7.org/fhir/uv/cqm/Measure/EXMLogic-FHIR",
  "identifier" : [
    {
      "system" : "http://example.org/fhir/cqi/ecqm/Measure/Identifier/exm",
      "value" : "EXM"
    }
  ],
  "version" : "2.0.0",
  "name" : "MeasureEXM",
  "title" : "EXM Measure",
  "status" : "active",
  "experimental" : true,
  "date" : "2022-02-22",
  "publisher" : "HL7 International / Clinical Quality Information",
  "contact" : [
    {
      "telecom" : [
        {
          "system" : "url",
          "value" : "http://www.hl7.org/Special/committees/cqi"
        }
      ]
    }
  ],
  "description" : "An example FHIR-based measure",
  "useContext" : [
    {
      "code" : {
        "system" : "http://terminology.hl7.org/CodeSystem/usage-context-type",
        "code" : "venue",
        "display" : "Venue"
      },
      "valueCodeableConcept" : {
        "coding" : [
          {
            "system" : "http://hl7.org/fhir/uv/cqm/CodeSystem/intended-venue-codes",
            "code" : "ec",
            "display" : "EC"
          }
        ]
      }
    }
  ],
  "jurisdiction" : [
    {
      "coding" : [
        {
          "system" : "http://unstats.un.org/unsd/methods/m49/m49.htm",
          "code" : "001"
        }
      ]
    }
  ],
  "purpose" : "This measure has been developed to support improvement in clinical care.",
  "usage" : "Users of this measure should be aware that this is intentionally simplified to show specific aspects of a measure.",
  "copyright" : "Example Copyright Statement",
  "approvalDate" : "2019-02-17",
  "lastReviewDate" : "2019-02-17",
  "effectivePeriod" : {
    "extension" : [
      {
        "url" : "http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-effectivePeriodAnchor",
        "valueDateTime" : "2018-01-01"
      },
      {
        "url" : "http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-effectivePeriodDuration",
        "valueDuration" : {
          "value" : 1,
          "system" : "http://unitsofmeasure.org",
          "code" : "a"
        }
      }
    ],
    "start" : "2018-01-01",
    "end" : "2018-12-31"
  },
  "topic" : [
    {
      "coding" : [
        {
          "system" : "http://loinc.org",
          "code" : "57024-2"
        }
      ],
      "text" : "Health Quality Measure Document"
    }
  ],
  "author" : [
    {
      "name" : "Example Measure Content Developer"
    }
  ],
  "library" : [
    🔗 "http://hl7.org/fhir/uv/cqm/Library/EXMLogic-FHIR"
  ],
  "disclaimer" : "Example disclaimer",
  "scoring" : {
    "coding" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/measure-scoring",
        "code" : "proportion",
        "display" : "Proportion"
      }
    ]
  },
  "type" : [
    {
      "coding" : [
        {
          "system" : "http://terminology.hl7.org/CodeSystem/measure-type",
          "code" : "process"
        }
      ]
    }
  ],
  "riskAdjustment" : "Risk adjustment for this measure is performed by...",
  "rateAggregation" : "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.",
  "clinicalRecommendationStatement" : "The clinical recommendation statement for this measure is...",
  "improvementNotation" : {
    "coding" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/measure-improvement-notation",
        "code" : "increase",
        "display" : "Increased score indicates improvement"
      }
    ]
  },
  "guidance" : "Additional guidance provided to help communicate the intent of the measure",
  "group" : [
    {
      "id" : "group-1",
      "code" : {
        "coding" : [
          {
            "system" : "http://example.org/group",
            "code" : "group",
            "display" : "group-1"
          }
        ]
      },
      "population" : [
        {
          "id" : "initial-population-1",
          "code" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                "code" : "initial-population",
                "display" : "Initial Population"
              }
            ]
          },
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Initial Population"
          }
        },
        {
          "id" : "numerator",
          "code" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                "code" : "numerator",
                "display" : "Numerator"
              }
            ]
          },
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Numerator"
          }
        },
        {
          "id" : "denominator",
          "code" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                "code" : "denominator",
                "display" : "Denominator"
              }
            ]
          },
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Denominator"
          }
        }
      ],
      "stratifier" : [
        {
          "id" : "stratifier-1",
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-appliesTo",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                    "code" : "initial-population",
                    "display" : "Initial Population"
                  }
                ],
                "text" : "initial-population"
              }
            }
          ],
          "code" : {
            "text" : "Stratifier 1"
          },
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Stratifier 1"
          }
        },
        {
          "id" : "stratifier-2",
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-appliesTo",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                    "code" : "initial-population",
                    "display" : "Initial Population"
                  }
                ],
                "text" : "initial-population"
              }
            }
          ],
          "code" : {
            "text" : "Stratifier 2"
          },
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Stratifier 2"
          }
        },
        {
          "id" : "stratifier-3",
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-appliesTo",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                    "code" : "initial-population",
                    "display" : "Initial Population"
                  }
                ],
                "text" : "initial-population"
              }
            }
          ],
          "code" : {
            "text" : "Stratifier 3"
          },
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Stratifier 3"
          }
        },
        {
          "id" : "stratifier-4",
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-appliesTo",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                    "code" : "initial-population",
                    "display" : "Initial Population"
                  }
                ],
                "text" : "initial-population"
              }
            }
          ],
          "code" : {
            "text" : "Stratifier 4"
          },
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Stratifier 4"
          }
        }
      ]
    }
  ],
  "supplementalData" : [
    {
      "id" : "sde-ethnicity",
      "usage" : [
        {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
              "code" : "supplemental-data"
            }
          ]
        }
      ],
      "criteria" : {
        "language" : "text/cql-identifier",
        "expression" : "SDE Ethnicity"
      }
    },
    {
      "id" : "sde-race",
      "usage" : [
        {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
              "code" : "supplemental-data"
            }
          ]
        }
      ],
      "criteria" : {
        "language" : "text/cql-identifier",
        "expression" : "SDE Race"
      }
    },
    {
      "id" : "sde-payer",
      "usage" : [
        {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
              "code" : "supplemental-data"
            }
          ]
        }
      ],
      "criteria" : {
        "language" : "text/cql-identifier",
        "expression" : "SDE Payer"
      }
    },
    {
      "id" : "sde-sex",
      "usage" : [
        {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
              "code" : "supplemental-data"
            }
          ]
        }
      ],
      "criteria" : {
        "language" : "text/cql-identifier",
        "expression" : "SDE Sex"
      }
    }
  ]
}