Quality Measure Implementation Guide
1.0.0 - STU 1 International flag

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

Measure: EXM Ratio Measure (Experimental)

Official URL: http://example.org/fhir/measures/measure-ratio-exm Version: 2.0.0
Standards status: Informative Computable Name: EXMRatioMeasure
Other Identifiers: http://example.org/fhir/cqi/ecqm/Measure/Identifier/exm#EXMRatio-FHIR, OID:2.16.840.1.113883.4.642.40.61.29.10

Usage:Clinical Venue: EC

Copyright/Legal: Example Copyright Statement

An example FHIR-based publishable measure

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

Metadata
Title EXM Ratio Measure
Version 2.0.0
Identifier EXMRatio-FHIR
Identifier urn:oid:2.16.840.1.113883.4.642.40.61.29.10
Effective Period 2018-01-01 + 1 year(s)
Approval Date 2019-02-17
Last Review Date 2019-02-17
Experimental true
Use Context Clinical Venue = EC
Jurisdiction Global (Whole world)
Topic Health Quality Measure Document
Steward (Publisher) HL7 International / Clinical Quality Information
Developer Example Measure Content Developer
Description

An example FHIR-based publishable measure
Purpose

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

Example Copyright Statement
Disclaimer

Example disclaimer
Measure Basis Encounter
Measure Scoring Ratio
Measure Scoring Unit /1000.d
Measure Type Process
Rationale

The rationale of this measure is...
Improvement Notation Decreased score indicates improvement
Guidance (Usage) Users of this measure should be aware of...
Measure Group (Rate) (ID: primary)
Initial Population ID: primary-exmratio-initial-population
Description: No description provided Criteria: Initial Population
Numerator ID: primary-exmratio-numerator
Description: No description provided Criteria: Numerator
Denominator ID: primary-exmratio-denominator
Description: No description provided Criteria: Denominator
Measure Observation ID: primary-exmratio-denominator-observation
Description: No description provided Criteria: Denominator Observation
Input Population: denominator AggregateMethod: sum
Measure Observation ID: primary-exmratio-numerator-observation
Description: No description provided Criteria: Numerator Observation
Input Population: numerator AggregateMethod: sum
Measure Logic
Primary Library EXMRatio - Example Ratio Measure Library
Contents Population Criteria
Logic Definitions
Terminology
Dependencies
Data Requirements
Population Criteria
Measure Group (Rate) (ID: primary)
Initial Population 
define "Initial Population":
  "Qualifying Encounters"
Definition
Numerator 
define "Numerator":
  "Initial Population"
Definition
Denominator 
define "Denominator":
  "Initial Population"
Definition
Measure Observation 
define function "Denominator Observation"(Encounter "Encounter"):
  duration in hours of Global.Hospitalization(Encounter) / 24
Definition
Measure Observation 
define function "Numerator Observation"(Encounter "Encounter"):
  Count(
    "Falls with Major Injury" Falls
      where Global."Normalize Interval"(Falls.effective) during Encounter.period
  )
Definition
Logic Definitions
Logic Definition Library Name: MATGlobalCommonFunctions 
define function "Hospitalization"(TheEncounter FHIR.Encounter):
	( "ED Visit"(TheEncounter) ) X
    return
        if X is null then TheEncounter.period
        else Interval[start of FHIRHelpers.ToInterval(X.period), end of FHIRHelpers.ToInterval(TheEncounter.period)]
Logic Definition Library Name: MATGlobalCommonFunctions 
define function "ED Visit"(TheEncounter FHIR.Encounter):
    singleton from (
        [Encounter: "Emergency Department Visit"] EDVisit
            where EDVisit.status = 'finished'
                and EDVisit.period ends 1 hour or less on or before start of FHIRHelpers.ToInterval(TheEncounter.period)
    )
Logic Definition Library Name: FHIRHelpers 
define function ToString(value EncounterStatus): value.value
Logic Definition Library Name: FHIRHelpers 
/*
@description: Converts the given [Period](https://hl7.org/fhir/datatypes.html#Period)
value to a CQL DateTime Interval
@comment: If the start value of the given period is unspecified, the starting
boundary of the resulting interval will be open (meaning the start of the interval
is unknown, as opposed to interpreted as the beginning of time).
*/
define function ToInterval(period FHIR.Period):
    if period is null then
        null
    else
        if period."start" is null then
            Interval(period."start".value, period."end".value]
        else
            Interval[period."start".value, period."end".value]
Logic Definition Library Name: EXMRatio 
define "Qualifying Encounters":
  ["Encounter": "Inpatient"]
Logic Definition Library Name: EXMRatio 
define "Initial Population":
  "Qualifying Encounters"
Logic Definition Library Name: EXMRatio 
define "Numerator":
  "Initial Population"
Logic Definition Library Name: EXMRatio 
define "Denominator":
  "Initial Population"
Logic Definition Library Name: EXMRatio 
define "Falls with Major Injury":
  ["Observation": "Fall"]
Logic Definition Library Name: EXMRatio 
define function "Denominator Observation"(Encounter "Encounter"):
  duration in hours of Global.Hospitalization(Encounter) / 24
Logic Definition Library Name: EXMRatio 
define function "Numerator Observation"(Encounter "Encounter"):
  Count(
    "Falls with Major Injury" Falls
      where Global."Normalize Interval"(Falls.effective) during Encounter.period
  )
Terminology
Value Set Description: Value set Inpatient
Resource: http://example.org/fhir/ValueSet/inpatient
Canonical URL: http://example.org/fhir/ValueSet/inpatient
Value Set Description: Value set Emergency Department Visit
Resource: Emergency Department Visit
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292
Value Set Description: Value set Fall
Resource: http://example.org/fhir/ValueSet/fall
Canonical URL: http://example.org/fhir/ValueSet/fall
Dependencies
Dependency Description: Library Global
Resource: MAT Global Common Functions FHIR Libraryversion: null5.0.000)
Canonical URL: http://hl7.org/fhir/uv/cqm/Library/MATGlobalCommonFunctions|5.0.000
Dependency Description: Library FHIRHelpers
Resource: http://hl7.org/fhir/uv/cql/Library/FHIRHelpers|4.0.1
Canonical URL: http://hl7.org/fhir/uv/cql/Library/FHIRHelpers|4.0.1
Data Requirements
Data Requirement Type: Encounter
Profile(s): Encounter
Must Support Elements: type, status, period
Code Filter(s):
Path: type
ValueSet: Emergency Department Visit
Data Requirement Type: Encounter
Profile(s): Encounter
Must Support Elements: type, period
Code Filter(s):
Path: type
ValueSet: http://example.org/fhir/ValueSet/inpatient
Data Requirement Type: Observation
Profile(s): Observation
Must Support Elements: code, effective
Code Filter(s):
Path: code
ValueSet: http://example.org/fhir/ValueSet/fall
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