Quality Measure Implementation Guide
1.0.0 - STU 1

Quality Measure Implementation Guide - Downloaded Version null 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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