Quality Measure Implementation Guide
1.0.0 - STU 1

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

## Library: EXM124 - Cervical Cancer Screening Library (Experimental)

Official URL: http://hl7.org/fhir/uv/cqm/Library/EXM124 | Version: 9.0.000
Standards status: Informative | Computable Name: EXM124
Other Identifiers: http://example.org/fhir/cqi/ecqm/Library/Identifier#EXM124 (use: official, ), OID:2.16.840.1.113883.4.642.40.61.28.9

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

Metadata
Title | EXM124 - Cervical Cancer Screening Library
Version | 9.0.000
Identifier | EXM124
Identifier | urn:oid:2.16.840.1.113883.4.642.40.61.28.9
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: Absence of Cervix Use: Out Min Cardinality: 0 Max Cardinality: * Type: Resource
Parameter | Name: Denominator Exclusion Use: Out Min Cardinality: 0 Max Cardinality: 1 Type: boolean
Parameter | Name: Cervical Cytology Within 3 Years Use: Out Min Cardinality: 0 Max Cardinality: * Type: Observation
Parameter | Name: HPV Test Within 5 Years for Women Age 30 and Older Use: Out Min Cardinality: 0 Max Cardinality: * Type: Observation
Parameter | Name: Numerator 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: Hysterectomy with No Residual Cervix
Data Requirement | Type: Condition Profile(s): Condition Must Support Elements: code, onset Code Filter(s): Path: code Code(s): SNOMED CT 37687000: Congenital absence of cervix (disorder) (version = http://snomed.info/sct/731000124108/version/201709 )
Data Requirement | Type: Observation Profile(s): Observation Must Support Elements: code, value, status, effective Code Filter(s): Path: code ValueSet: Pap Test
Data Requirement | Type: Observation Profile(s): Observation Must Support Elements: code, value, status, effective Code Filter(s): Path: code ValueSet: HPV Test
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 CMS124v9 - Cervical Cancer Screening
    */
    library EXM124 version '9.0.000'

    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

    codesystem "SNOMEDCT:2017-09": 'http://snomed.info/sct' version 'http://snomed.info/sct/731000124108/version/201709'

    valueset "Hysterectomy with No Residual Cervix": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1014'
    valueset "Pap Test": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1017'
    valueset "HPV Test": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1059'

    code "Congenital absence of cervix (disorder)": '37687000' from "SNOMEDCT:2017-09" display 'Congenital absence of cervix (disorder)'

    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 "Initial Population":
    	Patient.gender = 'female'
    		and Global."CalendarAgeInYearsAt"(FHIRHelpers.ToDate(Patient.birthDate), start of "Measurement Period") in Interval[23, 64]
    		and exists AdultOutpatientEncounters."Qualifying Encounters"

    define "Denominator":
    	"Initial Population"

    define "Denominator Exclusion":
    	Hospice."Has Hospice"
    		or exists "Absence of Cervix"

    define "Absence of Cervix":
      ([Procedure: "Hysterectomy with No Residual Cervix"] NoCervixProcedure
       where Global."Normalize Interval"(NoCervixProcedure.performed) ends on or before end of "Measurement Period"
         and NoCervixProcedure.status = 'completed'
         )
      union [Condition : "Congenital absence of cervix (disorder)"] NoCervixBirth
    		where Global."Normalize Interval"(NoCervixBirth.onset) starts on or before end of "Measurement Period"

    define "Numerator":
    	exists "Cervical Cytology Within 3 Years"
    		or exists "HPV Test Within 5 Years for Women Age 30 and Older"

    define "Cervical Cytology Within 3 Years":
    	[Observation: "Pap Test"] CervicalCytology
    		where CervicalCytology.value is not null
    			and CervicalCytology.status in { 'final', 'amended', 'corrected', 'preliminary' }
    		  and Global."Normalize Interval"(CervicalCytology.effective) ends 3 years or less on or before end of "Measurement Period"

    define "HPV Test Within 5 Years for Women Age 30 and Older":
    	[Observation: "HPV Test"] HPVTest
          where HPVTest.value is not null
            and HPVTest.status in { 'final', 'amended', 'corrected', 'preliminary' }
            and  Global."CalendarAgeInYearsAt"(FHIRHelpers.ToDate(Patient.birthDate), start of Global."Normalize Interval"(HPVTest.effective))>= 30
            and Global."Normalize Interval"(HPVTest.effective) ends 5 years or less on or before end of "Measurement Period"
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