Quality Measure Implementation Guide (STU5)
5.0.0-ballot - ballot
Quality Measure Implementation Guide (STU5)
5.0.0-ballot - ballot
This page is part of the Quality Measure STU2 for FHIR R4 Implementation Guide (v5.0.0-ballot: STU5 (v5.0.0) Ballot 1) based on FHIR (HL7® FHIR® Standard) R4. The current version which supersedes this version is 4.0.0. For a full list of available versions, see the Directory of published versions
| Active as of 2022-02-22 |
{
"resourceType" : "Measure",
"id" : "EXMLogic-FHIR",
"meta" : {
"profile" : [
🔗 "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/proportion-measure-cqfm"🔗 ,
"http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-measure-cqfm"🔗 ,
"http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/executable-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;\">EXMLogic-FHIR</td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Download cql: </b></th>\n <td style=\"padding-left: 4px;\"><a href=\"Library-EXMLogic-FHIR.cql\">EXMLogic-FHIR.cql</a></td>\n </tr>\n \n\n \n \n <tr>\n <th scope=\"row\"><b>Url: </b></th>\n <td style=\"padding-left: 4px;\"><a href=\"Measure-EXMLogic-FHIR.html\">EXM Measure</a></td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Version: </b></th>\n <td style=\"padding-left: 4px;\">5.0.0-ballot</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 <p style=\"margin-bottom: 5px;\">\n <span>Proportion </span>\n </p>\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 <p style=\"margin-bottom: 5px;\">\n <span>Increased score indicates improvement </span>\n </p>\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 <p style=\"margin-bottom: 5px;\">\n <span>process </span>\n </p>\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;\">2022-02-22</td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Publisher: </b></th>\n <td style=\"padding-left: 4px;\">HL7 International / Clinical Quality Information</td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Description: </b></th>\n <td style=\"padding-left: 4px;\"><div><p>An example FHIR-based measure</p>\n</div></td>\n </tr>\n \n \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;\"><div><p>The purpose of this measure is to show how all the elements of a FHIR-based quality measure are represented.</p>\n</div></td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Guidance (Usage): </b></th>\n <td style=\"padding-left: 4px;\">Users of this measure should be aware that this is intentionally simplified to show specific aspects of a measure.</td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Copyright: </b></th>\n <td style=\"padding-left: 25px;\"><div><p>Example Copyright Statement</p>\n</div></td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Disclaimer: </b></th>\n <td style=\"padding-left: 25px;\"><div><p>Example disclaimer</p>\n</div></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 \n \n \n \n \n <tr>\n <th scope=\"row\"><b> Supplemental Data Elements: </b></th>\n <td style=\"padding-left: 4px;\">\n \n \n \n \n SDE Ethnicity\n \n \n \n \n \n \n \n SDE Race\n \n \n \n \n \n \n \n SDE Payer\n \n \n \n \n \n \n \n SDE Sex\n \n \n \n \n </td>\n </tr>\n \n \n \n <tr>\n <th scope=\"row\"><b>Libraries: </b></th>\n <td style=\"padding-left: 4px;\">\n <table class=\"grid-dict\">\n \n <tr><td><a href=\"Library-EXMLogic-FHIR.html\">Example Logic Library</a></td></tr>\n \n </table>\n </td>\n </tr>\n \n \n \n <tr>\n <th scope=\"row\"><b>Related Artifact Dependencies: </b></th>\n <td style=\"padding-left: 4px;\">\n \n <li><a href=\"http://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1\">http://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1</a></li>\n \n <li><a href=\"http://terminology.hl7.org/5.4.0/CodeSystem-diagnosis-role.html\">Diagnosis Role</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.114222.4.11.3591/expansion\">Payer</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.299/expansion\">Psychiatric/Mental Health Diagnosis</a></li>\n \n </td>\n </tr>\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>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>Resource</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>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 <tr>\n <th scope=\"row\"><b>DataRequirements:</b></th>\n <td style=\"padding-left: 4px;\">\n <table class=\"grid-dict\">\n <tr><th><b>Type</b></th><th><b>Must Support</b></th><th><b>Valueset Name</b></th><th><b>Valueset</b></th></tr>\n \n <tr>\n <td>Patient</td>\n <td>\n \n </td>\n <td>\n \n </td>\n <td></td>\n </tr>\n \n <tr>\n <td>Patient</td>\n <td>\n \n url\n \n extension\n \n value\n \n </td>\n <td>\n \n </td>\n <td></td>\n </tr>\n \n <tr>\n <td>Patient</td>\n <td>\n \n url\n \n extension\n \n value\n \n </td>\n <td>\n \n </td>\n <td></td>\n </tr>\n \n <tr>\n <td>Encounter</td>\n <td>\n \n period\n \n </td>\n <td>\n \n </td>\n <td></td>\n </tr>\n \n <tr>\n <td>Coverage</td>\n <td>\n \n type\n \n period\n \n </td>\n <td>\n \n \n Payer\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.114222.4.11.3591/expansion\">Payer</a></td>\n </tr>\n \n </table>\n </td>\n </tr>\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><a href=\"http://terminology.hl7.org/5.4.0/CodeSystem-diagnosis-role.html\">Diagnosis Role</a></td>\n </tr>\n \n </table>\n </td>\n </tr>\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>\n <th><b>Group</b></th><th><b>Scoring</b></th><th><b>Population Criteria</b></th><th><b>Expression</b></th>\n </tr>\n <tr>\n \n <td> group-1 </td>\n <td>\n \n \n <b>Measure scoring:</b>\n \n <p style=\"margin-bottom: 5px;\">\n <span>Proportion</span>\n </p>\n \n \n </td>\n \n <tr>\n <td/>\n <td/>\n <td>Initial Population</td>\n <td>\n \n <pre><code class=\"language-cql\">define "Initial Population" :\n "Inpatient Encounter" Encounter</code></pre>\n \n </td>\n </tr>\n \n <tr>\n <td/>\n <td/>\n <td>Numerator</td>\n <td>\n \n <pre><code class=\"language-cql\"></code></pre>\n \n </td>\n </tr>\n \n <tr>\n <td/>\n <td/>\n <td>Denominator</td>\n <td>\n \n <pre><code class=\"language-cql\"></code></pre>\n \n </td>\n </tr>\n \n\n \n </tr>\n </table>\n \n <table class=\"grid-dict\">\n \n <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>\n <tr>\n \n <td>EXMLogic-FHIR</td>\n \n \n <td>SDE Sex</td>\n \n </tr>\n <tr>\n \n <td></td>\n <td><pre class=\"highlight language-cql\"><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></td>\n \n </tr>\n \n <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>\n <tr>\n \n <td>EXMLogic-FHIR</td>\n \n \n <td>Inpatient Encounter</td>\n \n </tr>\n <tr>\n \n <td></td>\n <td><pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Inpatient Encounter" :\n ["Encounter"] Encounter\n where LengthInDays(Encounter.period) <= 120\n and Encounter.period ends during "Measurement Period"</code></pre></td>\n \n </tr>\n \n <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>\n <tr>\n \n <td>EXMLogic-FHIR</td>\n \n \n <td>Stratifier 3</td>\n \n </tr>\n <tr>\n \n <td></td>\n <td><pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Stratifier 3" :\n "Inpatient Encounter" Encounter\n where PrincipalDiagnosis(Encounter) is null</code></pre></td>\n \n </tr>\n \n <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>\n <tr>\n \n <td>EXMLogic</td>\n \n \n <td>Stratifier 4</td>\n \n </tr>\n <tr>\n \n <td></td>\n <td><pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Stratifier 4" :\n "Inpatient Encounter" Encounter\n where PrincipalDiagnosis(Encounter) is null</code></pre></td>\n \n </tr>\n \n <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>\n <tr>\n \n <td>EXMLogic-FHIR</td>\n \n \n <td>SDE Payer</td>\n \n </tr>\n <tr>\n \n <td></td>\n <td><pre class=\"highlight language-cql\"><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></td>\n \n </tr>\n \n <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>\n <tr>\n \n <td>EXMLogic</td>\n \n \n <td>Initial Population</td>\n \n </tr>\n <tr>\n \n <td></td>\n <td><pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Initial Population" :\n "Inpatient Encounter" Encounter</code></pre></td>\n \n </tr>\n \n <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>\n <tr>\n \n <td>EXMLogic-FHIR</td>\n \n \n <td>SDE Ethnicity</td>\n \n </tr>\n <tr>\n \n <td></td>\n <td><pre class=\"highlight language-cql\"><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></td>\n \n </tr>\n \n <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>\n <tr>\n \n <td>EXMLogic</td>\n \n \n <td>SDE Race</td>\n \n </tr>\n <tr>\n \n <td></td>\n <td><pre class=\"highlight language-cql\"><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></td>\n \n </tr>\n \n <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>\n <tr>\n \n <td>EXMLogic-FHIR</td>\n \n \n <td>Stratifier 1</td>\n \n </tr>\n <tr>\n \n <td></td>\n <td><pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Stratifier 1" :\n "Inpatient Encounter" Encounter\n where not (PrincipalDiagnosis(Encounter).code in "Psychiatric/Mental Health Patient")</code></pre></td>\n \n </tr>\n \n <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>\n <tr>\n \n <td>EXMLogic-FHIR</td>\n \n \n <td>Stratifier 2</td>\n \n </tr>\n <tr>\n \n <td></td>\n <td><pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Stratifier 2" :\n "Inpatient Encounter" Encounter\n where PrincipalDiagnosis(Encounter).code in "Psychiatric/Mental Health Patient"</code></pre></td>\n \n </tr>\n \n </table>\n </td>\n </tr>\n \n \n \n </table>\n</div>"
},
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{
"resourceType" : "Library",
"id" : "effective-data-requirements",
"extension" : [
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
"valueCoding" : {
"system" : "http://terminology.hl7.org/CodeSystem/diagnosis-role",
"code" : "billing",
"display" : "Billing"
}
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{
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"url" : "libraryName",
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{
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"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"
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"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
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"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
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{
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"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
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{
"extension" : [
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"url" : "libraryName",
"valueString" : "EXMLogic-FHIR"
},
{
"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" : [
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"url" : "libraryName",
"valueString" : "EXMLogic"
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{
"url" : "name",
"valueString" : "Initial Population"
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"url" : "statement",
"valueString" : "define \"Initial Population\" :\n \"Inpatient Encounter\" Encounter"
},
{
"url" : "displaySequence",
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"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "EXMLogic-FHIR"
},
{
"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-FHIR"
},
{
"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-FHIR"
},
{
"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"
}
],
"name" : "EffectiveDataRequirements",
"status" : "active",
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/library-type",
"code" : "module-definition"
}
]
},
"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"
}
],
"parameter" : [
{
"name" : "Measurement Period",
"use" : "in",
"min" : 0,
"max" : "1",
"type" : "Period"
},
{
"name" : "SDE Sex",
"use" : "out",
"min" : 0,
"max" : "1",
"type" : "Coding"
},
{
"name" : "Stratifier 3",
"use" : "out",
"min" : 0,
"max" : "*",
"type" : "Encounter"
},
{
"name" : "Stratifier 4",
"use" : "out",
"min" : 0,
"max" : "*",
"type" : "Encounter"
},
{
"name" : "SDE Payer",
"use" : "out",
"min" : 0,
"max" : "*",
"type" : "Resource"
},
{
"name" : "Initial Population",
"use" : "out",
"min" : 0,
"max" : "*",
"type" : "Encounter"
},
{
"name" : "SDE Ethnicity",
"use" : "out",
"min" : 0,
"max" : "*",
"type" : "Coding"
},
{
"name" : "SDE Race",
"use" : "out",
"min" : 0,
"max" : "*",
"type" : "Coding"
},
{
"name" : "Stratifier 1",
"use" : "out",
"min" : 0,
"max" : "*",
"type" : "Encounter"
},
{
"name" : "Stratifier 2",
"use" : "out",
"min" : 0,
"max" : "*",
"type" : "Encounter"
}
],
"dataRequirement" : [
{
"extension" : [
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-fhirQueryPattern",
"valueString" : "Patient?_id={{context.patientId}}"
}
],
"type" : "Patient",
"profile" : [
🔗 "http://hl7.org/fhir/StructureDefinition/Patient"
]
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-fhirQueryPattern",
"valueString" : "Patient?_id={{context.patientId}}"
},
{
"extension" : [
{
"url" : "path",
"valueString" : "url"
},
{
"url" : "comparator",
"valueCode" : "eq"
},
{
"url" : "value",
"valueString" : "http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity"
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-valueFilter"
}
],
"type" : "Patient",
"profile" : [
🔗 "http://hl7.org/fhir/StructureDefinition/Patient"
],
"mustSupport" : [
"url",
"extension",
"value"
]
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-fhirQueryPattern",
"valueString" : "Patient?_id={{context.patientId}}"
}
],
"type" : "Patient",
"profile" : [
🔗 "http://hl7.org/fhir/StructureDefinition/Patient"
],
"mustSupport" : [
"url",
"extension",
"value"
],
"codeFilter" : [
{
"path" : "url",
"code" : [
{
"system" : "urn:ietf:rfc:3986",
"code" : "http://hl7.org/fhir/us/core/StructureDefinition/us-core-race"
}
]
}
]
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-fhirQueryPattern",
"valueString" : "Encounter?subject=Patient/{{context.patientId}}"
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-isSelective",
"valueBoolean" : true
}
],
"type" : "Encounter",
"profile" : [
🔗 "http://hl7.org/fhir/StructureDefinition/Encounter"
],
"mustSupport" : [
"period"
],
"dateFilter" : [
{
"path" : "period",
"valuePeriod" : {
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-expression",
"valueExpression" : {
"language" : "text/cql-identifier",
"expression" : "Measurement Period"
}
}
]
}
}
]
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-fhirQueryPattern",
"valueString" : "Coverage?policy-holder=Patient/{{context.patientId}}&type:in=http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"
}
],
"type" : "Coverage",
"profile" : [
🔗 "http://hl7.org/fhir/StructureDefinition/Coverage"
],
"mustSupport" : [
"type",
"period"
],
"codeFilter" : [
{
"path" : "type",
"valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"
}
]
}
]
}
],
"extension" : [
{
"extension" : [
{
"url" : "type",
"valueCode" : "documentation"
},
{
"url" : "text",
"valueMarkdown" : "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-softwaresystem",
"valueReference" : {
🔗 "reference" : "Device/software-system-example"
}
},
{
"id" : "effective-data-requirements",
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-effectiveDataRequirements",
"valueReference" : {
"reference" : "#effective-data-requirements"
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoringPrecision",
"valuePositiveInt" : 2
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
"valueCode" : "cqi"
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/Measure/EXMLogic-FHIR",
"identifier" : [
{
"system" : "http://example.org/fhir/cqi/ecqm/Measure/Identifier/exm",
"value" : "EXM"
}
],
"version" : "5.0.0-ballot",
"name" : "MeasureEXM",
"title" : "EXM Measure",
"status" : "active",
"experimental" : true,
"date" : "2022-02-22",
"publisher" : "HL7 International / Clinical Quality Information",
"contact" : [
{
"telecom" : [
{
"system" : "url",
"value" : "http://www.hl7.org/Special/committees/cqi"
}
]
}
],
"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 show how all the elements of a FHIR-based quality measure are represented.",
"usage" : "Users of this measure should be aware that this is intentionally simplified to show specific aspects of a measure.",
"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"
}
],
"library" : [
🔗 "http://hl7.org/fhir/us/cqfmeasures/Library/EXMLogic-FHIR"
],
"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",
"extension" : [
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population"
}
],
"text" : "initial-population"
}
}
],
"code" : {
"text" : "Stratifier 1"
},
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Stratifier 1"
}
},
{
"id" : "stratifier-2",
"extension" : [
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population"
}
],
"text" : "initial-population"
}
}
],
"code" : {
"text" : "Stratifier 2"
},
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Stratifier 2"
}
},
{
"id" : "stratifier-3",
"extension" : [
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population"
}
],
"text" : "initial-population"
}
}
],
"code" : {
"text" : "Stratifier 3"
},
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Stratifier 3"
}
},
{
"id" : "stratifier-4",
"extension" : [
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population"
}
],
"text" : "initial-population"
}
}
],
"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"
}
}
]
}
IG © 2019+ HL7 International / Clinical Quality Information. Package hl7.fhir.us.cqfmeasures#5.0.0-ballot based on FHIR 4.0.1. Generated 2023-12-15
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