Quality Measure Implementation Guide (STU3 Ballot)
2.1.0 - ballot

This page is part of the Quality Measure STU2 for FHIR R4 Implementation Guide (v2.1.0: STU3 Ballot 1) based on FHIR R4. The current version which supercedes this version is 3.0.0. For a full list of available versions, see the Directory of published versions

: EXM Measure - JSON Representation

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{
  "resourceType" : "Measure",
  "id" : "measure-exm",
  "meta" : {
    "profile" : [
      "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/proportion-measure-cqfm",
      "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-measure-cqfm"
    ]
  },
  "text" : {
    "status" : "extensions",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n    <table class=\"grid dict\">\n        \n        <tr>\n            <th scope=\"row\"><b>Id: </b></th>\n            <td style=\"padding-left: 4px;\">measure-exm</td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Url: </b></th>\n            <td style=\"padding-left: 4px;\">http://hl7.org/fhir/us/cqfmeasures/Measure/measure-exm</td>\n        </tr>\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        <tr>\n            <th scope=\"row\"><b>Identifier: </b></th>\n            <td style=\"padding-left: 4px;\">\n                \n                \n                <p style=\"margin-bottom: 5px;\">\n                    <b>value: </b> <span>EXM</span>\n                </p>\n                \n            </td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Name: </b></th>\n            <td style=\"padding-left: 4px;\">MeasureEXM</td>\n        </tr>\n        \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        <tr>\n            <th scope=\"row\"><b>Status: </b></th>\n            <td style=\"padding-left: 4px;\">active</td>\n        </tr>\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        <tr>\n            <th scope=\"row\"><b>Scoring: </b></th>\n            <td style=\"padding-left: 4px;\">\n                \n                    \n                        \n                        <p style=\"margin-bottom: 5px;\">\n                            <b>system: </b> <span>http://terminology.hl7.org/CodeSystem/measure-scoring</span>\n                        </p>\n                        \n                        \n                        <p style=\"margin-bottom: 5px;\">\n                            <b>code: </b> <span>proportion</span>\n                        </p>\n                        \n                        \n                        <p style=\"margin-bottom: 5px;\">\n                            <b>display: </b> <span>Proportion</span>\n                        </p>\n                        \n                    \n                \n                \n            </td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Improvement Notation: </b></th>\n            <td style=\"padding-left: 4px;\">\n                \n                    \n                        \n                        <p style=\"margin-bottom: 5px;\">\n                            <b>system: </b> <span>http://terminology.hl7.org/CodeSystem/measure-improvement-notation</span>\n                        </p>\n                        \n                        \n                        <p style=\"margin-bottom: 5px;\">\n                            <b>code: </b> <span>increase</span>\n                        </p>\n                        \n                        \n                        <p style=\"margin-bottom: 5px;\">\n                            <b>display: </b> <span>Increased score indicates improvement</span>\n                        </p>\n                        \n                    \n                \n                \n            </td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Type: </b></th>\n            <td style=\"padding-left: 4px;\">\n                \n                    \n                        \n                        <p style=\"margin-bottom: 5px;\">\n                            <b>system: </b> <span>http://terminology.hl7.org/CodeSystem/measure-type</span>\n                        </p>\n                        \n                        \n                        <p style=\"margin-bottom: 5px;\">\n                            <b>code: </b> <span>process</span>\n                        </p>\n                        \n                        \n                    \n                \n                \n            </td>\n        </tr>\n        \n        \n        \n        <tr>\n            <th scope=\"row\"><b>Date: </b></th>\n            <td style=\"padding-left: 4px;\">2021-04-03</td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Publisher: </b></th>\n            <td style=\"padding-left: 4px;\">Clinical Quality Information WG</td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Description: </b></th>\n            <td style=\"padding-left: 4px;\">An example FHIR-based measure</td>\n        </tr>\n        \n        \n        \n        \n        <tr>\n            <th scope=\"row\"><b>Parameters: </b></th>\n            <td style=\"padding-left: 4px;\">\n                <table class=\"grid-dict\">\n                    <tr><th><b>name</b></th><th><b>use</b></th><th><b>min</b></th><th><b>max</b></th><th><b>type</b></th></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>Inpatient Encounter</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>Any</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>Patient</td>\n                        <td>out</td>\n                        <td>0</td>\n                        <td>1</td>\n                        <td>Patient</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        \n        <tr>\n          <th scope=\"row\"><b>Data Requirements: </b></th>\n          <td style=\"padding-left: 4px;\">\n                <table class=\"grid-dict\">\n                    <tr><th><b>type</b></th><th><b>path</b></th><th><b>valueSet or system</b></th><th><b>code</b></th></tr>\n                    \n                        <tr>\n                            <td>Encounter</td>\n                            <td></td>\n                            \n                            \n                        </tr>\n                    \n                        <tr>\n                            <td>Condition</td>\n                            <td>id</td>\n                            \n                            \n                        </tr>\n                    \n                        <tr>\n                            <td>Coverage</td>\n                            <td>type</td>\n                            \n                                <td>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591</td>\n                                <td></td>\n                            \n                            \n                        </tr>\n                    \n                        <tr>\n                            <td>Patient</td>\n                            <td></td>\n                            \n                            \n                        </tr>\n                    \n                </table>\n          </td>\n        </tr>\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><th><b>display</b></th><th><b>code</b></th><th><b>system</b></th></tr>\n                    \n                        <tr>\n                            <td>Billing</td>\n                            <td>billing</td>\n                            <td></td>\n                        </tr>\n                    \n                </table>\n          </td>\n        </tr>\n        \n        \n            <tr>\n                <th scope=\"row\"><b>Supplemental Data: </b></th>\n                <td style=\"padding-left: 4px;\">\n                    <table class=\"grid-dict\">\n                        <tr><th><b>expression</b></th><th><b>system</b></th></tr>\n                        \n                        <tr>\n                            <td>SDE Ethnicity</td>\n                            <td>http://terminology.hl7.org/CodeSystem/measure-data-usage</td>\n                        </tr>\n                        \n                        <tr>\n                            <td>SDE Race</td>\n                            <td>http://terminology.hl7.org/CodeSystem/measure-data-usage</td>\n                        </tr>\n                        \n                        <tr>\n                            <td>SDE Payer</td>\n                            <td>http://terminology.hl7.org/CodeSystem/measure-data-usage</td>\n                        </tr>\n                        \n                        <tr>\n                            <td>SDE Sex</td>\n                            <td>http://terminology.hl7.org/CodeSystem/measure-data-usage</td>\n                        </tr>\n                        \n                    </table>\n                </td>\n            </tr>\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><th><b>code</b></th><th><b>value</b></th></tr>\n                    \n                      <tr>\n                        <td>program</td>\n                        <td>eligible-provider</td>\n                      </tr>\n                    \n                </table>\n            </td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Jurisdiction: </b></th>\n            <td style=\"padding-left: 25px;\">US</td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Topic: </b></th>\n            <td style=\"padding-left: 25px;\">57024-2</td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Purpose: </b></th>\n            <td style=\"padding-left: 4px;\">The purpose of this measure is to...</td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Usage: </b></th>\n            <td style=\"padding-left: 4px;\">Users of this measure should be aware of...</td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Copyright: </b></th>\n            <td style=\"padding-left: 25px;\">Example Copyright Statement</td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Disclaimer: </b></th>\n            <td style=\"padding-left: 25px;\">Example disclaimer</td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Approval Date: </b></th>\n            <td style=\"padding-left: 4px;\">2019-02-17</td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Last Review Date: </b></th>\n            <td style=\"padding-left: 4px;\">2019-02-17</td>\n        </tr>\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        <tr>\n          <th scope=\"row\"><b>Related Artifacts: </b></th>\n          <td style=\"padding-left: 4px;\">\n            \n            \n            \n            <p><b>Dependencies</b></p>\n            <ul>\n              \n                <li>http://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1</li>\n              \n                <li>http://terminology.hl7.org/CodeSystem/diagnosis-role</li>\n              \n                <li>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591</li>\n              \n                <li>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.299</li>\n              \n            </ul>\n            \n            \n            \n            \n            \n          </td>\n        </tr>\n        \n        \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><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>\n                    <tr>\n                        \n                            <td>EXMLogic</td>\n                        \n                        \n                            <td>SDE Sex</td>\n                        \n                        \n                    </tr>\n                </table>\n                \n                    <pre><code class=\"language-cql\">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</code></pre>\n                \n                <br/><br/>\n            \n                <table class=\"grid-dict\">\n                    <tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>\n                    <tr>\n                        \n                            <td>EXMLogic</td>\n                        \n                        \n                            <td>Stratifier 3</td>\n                        \n                        \n                    </tr>\n                </table>\n                \n                    <pre><code class=\"language-cql\">define \"Stratifier 3\" :\n  \"Inpatient Encounter\" Encounter\n    where PrincipalDiagnosis(Encounter) is null</code></pre>\n                \n                <br/><br/>\n            \n                <table class=\"grid-dict\">\n                    <tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>\n                    <tr>\n                        \n                            <td>EXMLogic</td>\n                        \n                        \n                            <td>Inpatient Encounter</td>\n                        \n                        \n                    </tr>\n                </table>\n                \n                    <pre><code class=\"language-cql\">define \"Inpatient Encounter\" :\n  [\"Encounter\"] Encounter\n    where LengthInDays(Encounter.period) &lt;= 120\n      and Encounter.period ends during \"Measurement Period\"</code></pre>\n                \n                <br/><br/>\n            \n                <table class=\"grid-dict\">\n                    <tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>\n                    <tr>\n                        \n                            <td>EXMLogic</td>\n                        \n                        \n                            <td>Stratifier 4</td>\n                        \n                        \n                    </tr>\n                </table>\n                \n                    <pre><code class=\"language-cql\">define \"Stratifier 4\" :\n  \"Inpatient Encounter\" Encounter\n    where PrincipalDiagnosis(Encounter) is null</code></pre>\n                \n                <br/><br/>\n            \n                <table class=\"grid-dict\">\n                    <tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>\n                    <tr>\n                        \n                            <td>EXMLogic</td>\n                        \n                        \n                            <td>SDE Payer</td>\n                        \n                        \n                    </tr>\n                </table>\n                \n                    <pre><code class=\"language-cql\">define \"SDE Payer\":\n    [Coverage: type in \"Payer\"] Payer\n      return {\n        code: Payer.type,\n        period: Payer.period\n      }</code></pre>\n                \n                <br/><br/>\n            \n                <table class=\"grid-dict\">\n                    <tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>\n                    <tr>\n                        \n                            <td>EXMLogic</td>\n                        \n                        \n                            <td>Initial Population</td>\n                        \n                        \n                    </tr>\n                </table>\n                \n                    <pre><code class=\"language-cql\">define \"Initial Population\" :\n  \"Inpatient Encounter\" Encounter</code></pre>\n                \n                <br/><br/>\n            \n                <table class=\"grid-dict\">\n                    <tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>\n                    <tr>\n                        \n                            <td>EXMLogic</td>\n                        \n                        \n                            <td>SDE Ethnicity</td>\n                        \n                        \n                    </tr>\n                </table>\n                \n                    <pre><code class=\"language-cql\">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</code></pre>\n                \n                <br/><br/>\n            \n                <table class=\"grid-dict\">\n                    <tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>\n                    <tr>\n                        \n                            <td>EXMLogic</td>\n                        \n                        \n                            <td>SDE Race</td>\n                        \n                        \n                    </tr>\n                </table>\n                \n                    <pre><code class=\"language-cql\">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</code></pre>\n                \n                <br/><br/>\n            \n                <table class=\"grid-dict\">\n                    <tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>\n                    <tr>\n                        \n                            <td>EXMLogic</td>\n                        \n                        \n                            <td>Stratifier 1</td>\n                        \n                        \n                    </tr>\n                </table>\n                \n                    <pre><code class=\"language-cql\">define \"Stratifier 1\" :\n  \"Inpatient Encounter\" Encounter\n    where not (PrincipalDiagnosis(Encounter).code in \"Psychiatric/Mental Health Patient\")</code></pre>\n                \n                <br/><br/>\n            \n                <table class=\"grid-dict\">\n                    <tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>\n                    <tr>\n                        \n                            <td>EXMLogic</td>\n                        \n                        \n                            <td>Stratifier 2</td>\n                        \n                        \n                    </tr>\n                </table>\n                \n                    <pre><code class=\"language-cql\">define \"Stratifier 2\" :\n  \"Inpatient Encounter\" Encounter\n    where PrincipalDiagnosis(Encounter).code in \"Psychiatric/Mental Health Patient\"</code></pre>\n                \n                <br/><br/>\n            \n          </td>\n        </tr>\n        \n    </table>\n</div>"
  },
  "extension" : [
    {
      "extension" : [
        {
          "url" : "type",
          "valueCode" : "documentation"
        },
        {
          "url" : "text",
          "valueString" : "This illustrates an example comment"
        }
      ],
      "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-artifactComment"
    },
    {
      "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis",
      "valueCode" : "Encounter"
    },
    {
      "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-allocation",
      "valueMarkdown" : "Additional guidance for allocation"
    },
    {
      "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-parameter",
      "valueParameterDefinition" : {
        "name" : "Measurement Period",
        "use" : "in",
        "min" : 0,
        "max" : "1",
        "type" : "Period"
      }
    },
    {
      "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-parameter",
      "valueParameterDefinition" : {
        "name" : "SDE Sex",
        "use" : "out",
        "min" : 0,
        "max" : "1",
        "type" : "Coding"
      }
    },
    {
      "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-parameter",
      "valueParameterDefinition" : {
        "name" : "Stratifier 3",
        "use" : "out",
        "min" : 0,
        "max" : "*",
        "type" : "Encounter"
      }
    },
    {
      "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-parameter",
      "valueParameterDefinition" : {
        "name" : "Inpatient Encounter",
        "use" : "out",
        "min" : 0,
        "max" : "*",
        "type" : "Encounter"
      }
    },
    {
      "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-parameter",
      "valueParameterDefinition" : {
        "name" : "Stratifier 4",
        "use" : "out",
        "min" : 0,
        "max" : "*",
        "type" : "Encounter"
      }
    },
    {
      "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-parameter",
      "valueParameterDefinition" : {
        "name" : "SDE Payer",
        "use" : "out",
        "min" : 0,
        "max" : "*",
        "type" : "Any"
      }
    },
    {
      "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-parameter",
      "valueParameterDefinition" : {
        "name" : "Initial Population",
        "use" : "out",
        "min" : 0,
        "max" : "*",
        "type" : "Encounter"
      }
    },
    {
      "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-parameter",
      "valueParameterDefinition" : {
        "name" : "SDE Ethnicity",
        "use" : "out",
        "min" : 0,
        "max" : "*",
        "type" : "Coding"
      }
    },
    {
      "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-parameter",
      "valueParameterDefinition" : {
        "name" : "Patient",
        "use" : "out",
        "min" : 0,
        "max" : "1",
        "type" : "Patient"
      }
    },
    {
      "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-parameter",
      "valueParameterDefinition" : {
        "name" : "SDE Race",
        "use" : "out",
        "min" : 0,
        "max" : "*",
        "type" : "Coding"
      }
    },
    {
      "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-parameter",
      "valueParameterDefinition" : {
        "name" : "Stratifier 1",
        "use" : "out",
        "min" : 0,
        "max" : "*",
        "type" : "Encounter"
      }
    },
    {
      "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-parameter",
      "valueParameterDefinition" : {
        "name" : "Stratifier 2",
        "use" : "out",
        "min" : 0,
        "max" : "*",
        "type" : "Encounter"
      }
    },
    {
      "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-dataRequirement",
      "valueDataRequirement" : {
        "type" : "Encounter",
        "profile" : [
          "http://hl7.org/fhir/StructureDefinition/Encounter"
        ]
      }
    },
    {
      "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-dataRequirement",
      "valueDataRequirement" : {
        "type" : "Condition",
        "profile" : [
          "http://hl7.org/fhir/StructureDefinition/Condition"
        ],
        "codeFilter" : [
          {
            "path" : "id"
          }
        ]
      }
    },
    {
      "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-dataRequirement",
      "valueDataRequirement" : {
        "type" : "Coverage",
        "profile" : [
          "http://hl7.org/fhir/StructureDefinition/Coverage"
        ],
        "codeFilter" : [
          {
            "path" : "type",
            "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"
          }
        ]
      }
    },
    {
      "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-dataRequirement",
      "valueDataRequirement" : {
        "type" : "Patient",
        "profile" : [
          "http://hl7.org/fhir/StructureDefinition/Patient"
        ]
      }
    },
    {
      "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
      "valueCoding" : {
        "system" : "http://terminology.hl7.org/CodeSystem/diagnosis-role",
        "code" : "billing",
        "display" : "Billing"
      }
    },
    {
      "extension" : [
        {
          "url" : "libraryName",
          "valueString" : "EXMLogic"
        },
        {
          "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/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
    },
    {
      "extension" : [
        {
          "url" : "libraryName",
          "valueString" : "EXMLogic"
        },
        {
          "url" : "name",
          "valueString" : "Stratifier 3"
        },
        {
          "url" : "statement",
          "valueString" : "define \"Stratifier 3\" :\n  \"Inpatient Encounter\" Encounter\n    where PrincipalDiagnosis(Encounter) is null"
        },
        {
          "url" : "displaySequence",
          "valueInteger" : 1
        }
      ],
      "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
    },
    {
      "extension" : [
        {
          "url" : "libraryName",
          "valueString" : "EXMLogic"
        },
        {
          "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" : 2
        }
      ],
      "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-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/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
    },
    {
      "extension" : [
        {
          "url" : "libraryName",
          "valueString" : "EXMLogic"
        },
        {
          "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/us/cqfmeasures/StructureDefinition/cqfm-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/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
    },
    {
      "extension" : [
        {
          "url" : "libraryName",
          "valueString" : "EXMLogic"
        },
        {
          "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/us/cqfmeasures/StructureDefinition/cqfm-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/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
    },
    {
      "extension" : [
        {
          "url" : "libraryName",
          "valueString" : "EXMLogic"
        },
        {
          "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/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
    },
    {
      "extension" : [
        {
          "url" : "libraryName",
          "valueString" : "EXMLogic"
        },
        {
          "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/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
    }
  ],
  "url" : "http://hl7.org/fhir/us/cqfmeasures/Measure/measure-exm",
  "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" : "2021-04-03",
  "publisher" : "Clinical Quality Information WG",
  "contact" : [
    {
      "telecom" : [
        {
          "system" : "url",
          "value" : "http://www.hl7.org/Special/committees/cqi/index.cfm"
        }
      ]
    }
  ],
  "description" : "An example FHIR-based measure",
  "useContext" : [
    {
      "code" : {
        "system" : "http://terminology.hl7.org/CodeSystem/usage-context-type",
        "code" : "program"
      },
      "valueCodeableConcept" : {
        "text" : "eligible-provider"
      }
    }
  ],
  "jurisdiction" : [
    {
      "coding" : [
        {
          "system" : "urn:iso:std:iso:3166",
          "code" : "US"
        }
      ]
    }
  ],
  "purpose" : "The purpose of this measure is to...",
  "usage" : "Users of this measure should be aware of...",
  "copyright" : "Example Copyright Statement",
  "approvalDate" : "2019-02-17",
  "lastReviewDate" : "2019-02-17",
  "effectivePeriod" : {
    "extension" : [
      {
        "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-effectivePeriodAnchor",
        "valueDateTime" : "2018-01-01"
      },
      {
        "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-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"
    }
  ],
  "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"
    }
  ],
  "library" : [
    "http://hl7.org/fhir/us/cqfmeasures/Library/EXMLogic"
  ],
  "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" : "Rationale for this measure is...",
  "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"
      }
    ]
  },
  "_definition" : [
    {
      "extension" : [
        {
          "extension" : [
            {
              "url" : "term",
              "valueString" : "Term"
            },
            {
              "url" : "definition",
              "valueMarkdown" : "A term used in the measure that bears clearly definition to communicate the measure intent"
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-definitionTerm"
        }
      ]
    }
  ],
  "guidance" : "Additional guidance provided to help communicate the intent of the measure",
  "group" : [
    {
      "id" : "group-1",
      "code" : {
        "coding" : [
          {
            "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",
          "code" : {
            "text" : "Stratifier 1"
          },
          "criteria" : {
            "language" : "text/cql.identifier",
            "expression" : "Stratifier 1"
          }
        },
        {
          "id" : "stratifier-2",
          "code" : {
            "text" : "Stratifier 2"
          },
          "criteria" : {
            "language" : "text/cql.identifier",
            "expression" : "Stratifier 2"
          }
        },
        {
          "id" : "stratifier-3",
          "code" : {
            "text" : "Stratifier 3"
          },
          "criteria" : {
            "language" : "text/cql.identifier",
            "expression" : "Stratifier 3"
          }
        },
        {
          "id" : "stratifier-4",
          "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"
      }
    }
  ]
}