Quality Measure Implementation Guide
1.0.0 - STU 1

Quality Measure Implementation Guide - Downloaded Version null See the Directory of published versions

## Library: EXM125 - Breast Cancer Screening Library (Experimental)

Official URL: http://hl7.org/fhir/uv/cqm/Library/EXM125 | Version: 8.0.000
Standards status: Informative | Computable Name: EXM125
Other Identifiers: http://example.org/fhir/cqi/ecqm/Library/Identifier#EXM125 (use: official, ), OID:2.16.840.1.113883.4.642.40.61.28.10

This library is used as an example in the FHIR Quality Measure Implementation Guide

Metadata
Title | EXM125 - Breast Cancer Screening Library
Version | 8.0.000
Identifier | EXM125
Identifier | urn:oid:2.16.840.1.113883.4.642.40.61.28.10
Approval Date | 2019-08-03
Last Review Date | 2019-08-03
Experimental | true
Jurisdiction | Global (Whole world)
Steward (Publisher) | HL7 International / Clinical Quality Information
Description | This library is used as an example in the FHIR Quality Measure Implementation Guide
Type | Logic Library
Parameter | Name: Measurement Period Use: In Min Cardinality: 0 Max Cardinality: 1 Type: Period
Parameter | Name: Patient Use: Out Min Cardinality: 0 Max Cardinality: 1 Type: Patient
Parameter | Name: SDE Ethnicity Use: Out Min Cardinality: 0 Max Cardinality: * Type: Coding
Parameter | Name: SDE Payer Use: Out Min Cardinality: 0 Max Cardinality: * Type: Resource
Parameter | Name: SDE Race Use: Out Min Cardinality: 0 Max Cardinality: * Type: Coding
Parameter | Name: SDE Sex Use: Out Min Cardinality: 0 Max Cardinality: 1 Type: Coding
Parameter | Name: Initial Population Use: Out Min Cardinality: 0 Max Cardinality: 1 Type: boolean
Parameter | Name: Denominator Use: Out Min Cardinality: 0 Max Cardinality: 1 Type: boolean
Parameter | Name: Unilateral Mastectomy Procedure Use: Out Min Cardinality: 0 Max Cardinality: * Type: Procedure
Parameter | Name: Right Mastectomy Use: Out Min Cardinality: 0 Max Cardinality: * Type: Condition
Parameter | Name: Left Mastectomy Use: Out Min Cardinality: 0 Max Cardinality: * Type: Condition
Parameter | Name: History Bilateral Mastectomy Use: Out Min Cardinality: 0 Max Cardinality: * Type: Condition
Parameter | Name: Bilateral Mastectomy Procedure Use: Out Min Cardinality: 0 Max Cardinality: * Type: Procedure
Parameter | Name: Numerator Use: Out Min Cardinality: 0 Max Cardinality: 1 Type: boolean
Parameter | Name: Denominator Exclusion Use: Out Min Cardinality: 0 Max Cardinality: 1 Type: boolean
Data Requirement | Type: Patient Profile(s): Patient
Data Requirement | Type: Procedure Profile(s): Procedure Must Support Elements: code, performed, status Code Filter(s): Path: code ValueSet: Unilateral Mastectomy
Data Requirement | Type: Procedure Profile(s): Procedure Must Support Elements: code, performed, status Code Filter(s): Path: code ValueSet: Bilateral Mastectomy
Data Requirement | Type: Condition Profile(s): Condition Must Support Elements: code, clinicalStatus, onset Code Filter(s): Path: code ValueSet: Status Post Right Mastectomy
Data Requirement | Type: Condition Profile(s): Condition Must Support Elements: code, clinicalStatus, onset Code Filter(s): Path: code ValueSet: Status Post Left Mastectomy
Data Requirement | Type: Condition Profile(s): Condition Must Support Elements: code, bodySite, clinicalStatus, onset Code Filter(s): Path: code ValueSet: Unilateral Mastectomy, Unspecified Laterality
Data Requirement | Type: Condition Profile(s): Condition Must Support Elements: code, onset, clinicalStatus Code Filter(s): Path: code ValueSet: History of bilateral mastectomy
Data Requirement | Type: DiagnosticReport Profile(s): DiagnosticReport Must Support Elements: code, effective, status Code Filter(s): Path: code ValueSet: Mammography
Library Content
CQL Content |
    /*
    This example is a work in progress and should not be considered a final specification
    or recommendation for guidance. This example will help guide and direct the process
    of finding conventions and usage patterns that meet the needs of the various stakeholders
    in the measure development community.

    Based on CMS125v8 - Breast Cancer Screening
    */
    library EXM125 version '8.0.000'

    using FHIR version '4.0.1'

    include hl7.fhir.uv.cql.FHIRHelpers version '4.0.1' called FHIRHelpers

    include Hospice version '2.0.000' called Hospice
    include AdultOutpatientEncounters version '2.0.000' called AdultOutpatientEncounters
    include MATGlobalCommonFunctions version '5.0.000' called Global
    include SupplementalDataElements version '2.0.000' called SDE

    valueset "ONC Administrative Sex": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1'
    valueset "Race": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.836'
    valueset "Ethnicity": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.837'
    valueset "Payer": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591'
    valueset "Bilateral Mastectomy": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1005'
    valueset "Female": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.560.100.2'
    valueset "Mammography": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1018'
    valueset "Unilateral Mastectomy": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1020'
    valueset "History of bilateral mastectomy": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1068'
    valueset "Status Post Left Mastectomy": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1069'
    valueset "Status Post Right Mastectomy": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1070'
    valueset "Left": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.122.12.1036'
    valueset "Right": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.122.12.1035'
    valueset "Unilateral Mastectomy, Unspecified Laterality": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1071'

    parameter "Measurement Period" Interval<DateTime>
      default Interval[@2019-01-01T00:00:00.0, @2020-01-01T00:00:00.0)

    context Patient

    define "SDE Ethnicity":
      SDE."SDE Ethnicity"

    define "SDE Payer":
      SDE."SDE Payer"

    define "SDE Race":
      SDE."SDE Race"

    define "SDE Sex":
      SDE."SDE Sex"

    define "Denominator":
    		"Initial Population"

    define "Unilateral Mastectomy Procedure":
    		[Procedure: "Unilateral Mastectomy"] UnilateralMastectomyProcedure
    				where Global."Normalize Interval"(UnilateralMastectomyProcedure.performed) ends before day of end of "Measurement Period"
    						and UnilateralMastectomyProcedure.status = 'completed'

    define "Right Mastectomy":
    		(
    				( [Condition: "Status Post Right Mastectomy"] C
              where C.clinicalStatus ~ ToConcept(Global."active")
            )
    				union (
    						[Condition: "Unilateral Mastectomy, Unspecified Laterality"] UnilateralMastectomyDiagnosis
    								where UnilateralMastectomyDiagnosis.bodySite in "Right"
                      and UnilateralMastectomyDiagnosis.clinicalStatus ~ ToConcept(Global."active")
    				)
    		) RightMastectomy
    				where Global."Normalize Interval"(RightMastectomy.onset) starts before day of end of "Measurement Period"

    define "Left Mastectomy":
    		(
    		    ( [Condition: "Status Post Left Mastectomy"] C
              where C.clinicalStatus ~ ToConcept(Global."active")
            )
    				union (
    						[Condition: "Unilateral Mastectomy, Unspecified Laterality"] UnilateralMastectomyDiagnosis
    								where UnilateralMastectomyDiagnosis.bodySite in "Left"
                      and UnilateralMastectomyDiagnosis.clinicalStatus ~ ToConcept(Global."active")
    				)
    		) LeftMastectomy
    				where Global."Normalize Interval"(LeftMastectomy.onset) starts before day of end of "Measurement Period"

    define "History Bilateral Mastectomy":
    		[Condition: "History of bilateral mastectomy"] BilateralMastectomyHistory
    				where Global."Normalize Interval"(BilateralMastectomyHistory.onset) starts before day of end of "Measurement Period"
              and BilateralMastectomyHistory.clinicalStatus ~ ToConcept(Global."active")

    define "Bilateral Mastectomy Procedure":
    		[Procedure: "Bilateral Mastectomy"] BilateralMastectomyPerformed
    				where Global."Normalize Interval"(BilateralMastectomyPerformed.performed) ends before day of end of "Measurement Period"
    						and BilateralMastectomyPerformed.status = 'completed'

    define "Numerator":
    		exists (
    				[DiagnosticReport: "Mammography"] Mammogram
    						where ( Global."Normalize Interval"(Mammogram.effective) ends 27 months or less before day of end of "Measurement Period" )
    								and Mammogram.status in { 'final', 'amended', 'corrected', 'appended' }
    		)

    define "Denominator Exclusion":
    		Hospice."Has Hospice"
    				or ( Count("Unilateral Mastectomy Procedure") = 2 )
    				or ( exists "Right Mastectomy" and exists "Left Mastectomy" )
    				or exists "History Bilateral Mastectomy"
    				or exists "Bilateral Mastectomy Procedure"

    define "Initial Population":
    		Patient.gender = 'female'
    				and Global."CalendarAgeInYearsAt"(FHIRHelpers.ToDate(Patient.birthDate), start of "Measurement Period") in Interval[51, 74]
    				and exists AdultOutpatientEncounters."Qualifying Encounters"
ELM XML Content |
    Encoded data (111208 characters)
ELM JSON Content |
    Encoded data (207468 characters)
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