Quality Measure Implementation Guide (STU5)
5.0.0-ballot - ballot United States of America flag

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

: EXM Ratio Measure - XML Representation

Active as of 2022-02-22

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<Measure xmlns="http://hl7.org/fhir">
  <id value="EXMRatio-FHIR"/>
  <meta>
    <profile
             value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/ratio-measure-cqfm"/>
    <profile
             value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-measure-cqfm"/>
  </meta>
  <text>
    <status value="extensions"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
    <table class="grid dict">
        
            <tr>
                <th scope="row"><b>Id: </b></th>
                <td style="padding-left: 4px;">EXMRatio-FHIR</td>
            </tr>
            
            
            <tr>
                <th scope="row"><b>Download cql: </b></th>
                <td style="padding-left: 4px;"><a href="Library-EXMRatio-FHIR.cql">EXMRatio-FHIR.cql</a></td>
            </tr>
            

        
        
            <tr>
                <th scope="row"><b>Url: </b></th>
                <td style="padding-left: 4px;"><a href="Measure-EXMRatio-FHIR.html">EXM Ratio Measure</a></td>
            </tr>
        
        
            <tr>
                <th scope="row"><b>Version: </b></th>
                <td style="padding-left: 4px;">5.0.0-ballot</td>
            </tr>
        
        
            <tr>
                <th scope="row"><b>Identifier: </b></th>
                <td style="padding-left: 4px;">
                    
                    
                        <p style="margin-bottom: 5px;">
                            <b>value: </b> <span>EXMRatio-FHIR</span>
                        </p>
                    
                </td>
            </tr>
        
        
            <tr>
                <th scope="row"><b>Name: </b></th>
                <td style="padding-left: 4px;">EXMRatioMeasure</td>
            </tr>
        
        
            <tr>
                <th scope="row"><b>Title: </b></th>
                <td style="padding-left: 4px;">EXM Ratio Measure</td>
            </tr>
        
        
        
            <tr>
                <th scope="row"><b>Status: </b></th>
                <td style="padding-left: 4px;">active</td>
            </tr>
        
        
            <tr>
                <th scope="row"><b>Experimental: </b></th>
                <td style="padding-left: 4px;">true</td>
            </tr>
        
        
            <tr>
                <th scope="row"><b>Scoring: </b></th>
                <td style="padding-left: 4px;">
                    
                        
                            <p style="margin-bottom: 5px;">
                                <span>Ratio </span>
                            </p>
                        
                    
                    
                </td>
            </tr>
        
        
            <tr>
                <th scope="row"><b>Improvement Notation: </b></th>
                <td style="padding-left: 4px;">
                    
                        
                            <p style="margin-bottom: 5px;">
                             <span>Decreased score indicates improvement </span>
                            </p>
                        
                    
                    
                </td>
            </tr>
        
        
            <tr>
                <th scope="row"><b>Type: </b></th>
                <td style="padding-left: 4px;">
                    
                        
                            <p style="margin-bottom: 5px;">
                            <span>process </span>
                            </p>
                        
                    
                    
                </td>
            </tr>
        
        
        
            <tr>
                <th scope="row"><b>Date: </b></th>
                <td style="padding-left: 4px;">2022-02-22</td>
            </tr>
        
        
            <tr>
                <th scope="row"><b>Publisher: </b></th>
                <td style="padding-left: 4px;">HL7 International / Clinical Quality Information</td>
            </tr>
        
        
            <tr>
                <th scope="row"><b>Description: </b></th>
                <td style="padding-left: 4px;"><div><p>An example FHIR-based publishable measure</p>
</div></td>
            </tr>
        
        
        
        
            <tr>
                <th scope="row"><b>Use Context: </b></th>
                <td style="padding-left: 4px;">
                    <table class="grid-dict">
                        <tr><th><b>code</b></th><th><b>value</b></th></tr>
                        
                            <tr>
                                <td>program</td>
                                <td>eligible-provider</td>
                            </tr>
                        
                    </table>
                </td>
            </tr>
        
        
            <tr>
                <th scope="row"><b>Jurisdiction: </b></th>
                <td style="padding-left: 25px;">US</td>
            </tr>
        
        
            <tr>
                <th scope="row"><b>Topic: </b></th>
                <td style="padding-left: 25px;">57024-2</td>
            </tr>
        
        
            <tr>
                <th scope="row"><b>Purpose: </b></th>
                <td style="padding-left: 4px;"><div><p>The purpose of this measure is to...</p>
</div></td>
            </tr>
        
        
            <tr>
                <th scope="row"><b>Guidance (Usage): </b></th>
                <td style="padding-left: 4px;">Users of this measure should be aware of...</td>
            </tr>
        
        
            <tr>
                <th scope="row"><b>Copyright: </b></th>
                <td style="padding-left: 25px;"><div><p>Example Copyright Statement</p>
</div></td>
            </tr>
        
        
            <tr>
                <th scope="row"><b>Disclaimer: </b></th>
                <td style="padding-left: 25px;"><div><p>Example disclaimer</p>
</div></td>
            </tr>
        
        
            <tr>
                <th scope="row"><b>Approval Date: </b></th>
                <td style="padding-left: 4px;">2019-02-17</td>
            </tr>
        
        
            <tr>
                <th scope="row"><b>Last Review Date: </b></th>
                <td style="padding-left: 4px;">2019-02-17</td>
            </tr>
        
        
            <tr>
                <th scope="row"><b>Effective Period: </b></th>
                <td style="padding-left: 4px;">2018-01-01..2018-12-31</td>
            </tr>
        
        
            
        
        
        
        
        
        
            <tr>
                <th scope="row"><b>Libraries: </b></th>
                <td style="padding-left: 4px;">
                    <table class="grid-dict">
                        
                            <tr><td><a href="Library-EXMRatio-FHIR.html">EXMRatio - Example Ratio Measure Library</a></td></tr>
                        
                    </table>
                </td>
            </tr>
        
        
            
                <tr>
                    <th scope="row"><b>Related Artifact Dependencies: </b></th>
                    <td style="padding-left: 4px;">
                        
                            <li><a href="http://example.org/fhir/ValueSet/inpatient">http://example.org/fhir/ValueSet/inpatient</a></li>
                        
                    </td>
                </tr>
                <tr>
                    <th scope="row"><b>Parameters:</b></th>
                    <td style="padding-left: 4px;">
                        <table class="grid-dict">
                            <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>
                            
                                <tr>
                                    <td>Numerator</td>
                                    <td>out</td>
                                    <td>0</td>
                                    <td>*</td>
                                    <td>Encounter</td>
                                </tr>
                            
                                <tr>
                                    <td>Denominator</td>
                                    <td>out</td>
                                    <td>0</td>
                                    <td>*</td>
                                    <td>Encounter</td>
                                </tr>
                            
                                <tr>
                                    <td>Initial Population</td>
                                    <td>out</td>
                                    <td>0</td>
                                    <td>*</td>
                                    <td>Encounter</td>
                                </tr>
                            
                        </table>
                    </td>
                </tr>
                <tr>
                    <th scope="row"><b>DataRequirements:</b></th>
                    <td style="padding-left: 4px;">
                        <table class="grid-dict">
                            <tr><th><b>Type</b></th><th><b>Must Support</b></th><th><b>Valueset Name</b></th><th><b>Valueset</b></th></tr>
                            
                                <tr>
                                    <td>Encounter</td>
                                    <td>
                                        
                                            type
                                        
                                    </td>
                                    <td>
                                        
                                            
                                                 Inpatient
                                            
                                        
                                    </td>
                                    <td><a href="http://example.org/fhir/ValueSet/inpatient">http://example.org/fhir/ValueSet/inpatient</a></td>
                                </tr>
                            
                        </table>
                    </td>
                </tr>
                
                
                    <tr>
                        <th scope="row"><b>Logic Definitions:</b></th>
                        <td style="padding-left: 4px;">
                            
                                <table class="grid-dict">
                                    <tr>
                                        <th><b>Group</b></th><th><b>Scoring</b></th><th><b>Population Criteria</b></th><th><b>Expression</b></th>
                                    </tr>
                                    <tr>
                                        
                                            <td> group-1 </td>
                                            <td>
                                                
                                                
                                                    <b>Measure scoring:</b>
                                                    
                                                        <p style="margin-bottom: 5px;">
                                                        <span>Ratio</span>
                                                        </p>
                                                    
                                                
                                            </td>
                                            
                                                <tr>
                                                    <td/>
                                                    <td/>
                                                    <td>Initial Population</td>
                                                    <td>
                                                        
                                                        <pre><code class="language-cql">define &quot;Initial Population&quot;:   &quot;Qualifying Encounters&quot;</code></pre>
                                                        
                                                    </td>
                                                </tr>
                                            
                                                <tr>
                                                    <td/>
                                                    <td/>
                                                    <td>Numerator</td>
                                                    <td>
                                                        
                                                        <pre><code class="language-cql">define &quot;Numerator&quot;:   &quot;Initial Population&quot;</code></pre>
                                                        
                                                    </td>
                                                </tr>
                                            
                                                <tr>
                                                    <td/>
                                                    <td/>
                                                    <td>Denominator</td>
                                                    <td>
                                                        
                                                        <pre><code class="language-cql">define &quot;Denominator&quot;:   &quot;Initial Population&quot;</code></pre>
                                                        
                                                    </td>
                                                </tr>
                                            
                                                <tr>
                                                    <td/>
                                                    <td/>
                                                    <td>Measure Observation</td>
                                                    <td>
                                                        
                                                        <pre><code class="language-cql"></code></pre>
                                                        
                                                    </td>
                                                </tr>
                                            
                                                <tr>
                                                    <td/>
                                                    <td/>
                                                    <td>Measure Observation</td>
                                                    <td>
                                                        
                                                        <pre><code class="language-cql"></code></pre>
                                                        
                                                    </td>
                                                </tr>
                                            

                                    
                                    </tr>
                                </table>
                            
                            <table class="grid-dict">
                                
                                    <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>
                                    <tr>
                                        
                                            <td>EXMRatio-FHIR</td>
                                        
                                        
                                            <td>Qualifying Encounters</td>
                                        
                                    </tr>
                                    <tr>
                                        
                                            <td></td>
                                        <td><pre class="highlight language-cql"><code class="language-cql">define &quot;Qualifying Encounters&quot;:   [&quot;Encounter&quot;: &quot;Inpatient&quot;]</code></pre></td>
                                        
                                    </tr>
                                
                                    <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>
                                    <tr>
                                        
                                            <td>EXMRatio-FHIR</td>
                                        
                                        
                                            <td>Initial Population</td>
                                        
                                    </tr>
                                    <tr>
                                        
                                            <td></td>
                                        <td><pre class="highlight language-cql"><code class="language-cql">define &quot;Initial Population&quot;:   &quot;Qualifying Encounters&quot;</code></pre></td>
                                        
                                    </tr>
                                
                                    <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>
                                    <tr>
                                        
                                            <td>EXMRatio-FHIR</td>
                                        
                                        
                                            <td>Numerator</td>
                                        
                                    </tr>
                                    <tr>
                                        
                                            <td></td>
                                        <td><pre class="highlight language-cql"><code class="language-cql">define &quot;Numerator&quot;:   &quot;Initial Population&quot;</code></pre></td>
                                        
                                    </tr>
                                
                                    <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>
                                    <tr>
                                        
                                            <td>EXMRatio-FHIR</td>
                                        
                                        
                                            <td>Denominator</td>
                                        
                                    </tr>
                                    <tr>
                                        
                                            <td></td>
                                        <td><pre class="highlight language-cql"><code class="language-cql">define &quot;Denominator&quot;:   &quot;Initial Population&quot;</code></pre></td>
                                        
                                    </tr>
                                
                            </table>
                        </td>
                    </tr>
                
            
        
    </table>
</div>
  </text>
  <contained>
    <Library>
      <id value="effective-data-requirements"/>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
        <extension url="libraryName">
          <valueString value="EXMRatio-FHIR"/>
        </extension>
        <extension url="name">
          <valueString value="Qualifying Encounters"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Qualifying Encounters&quot;:   [&quot;Encounter&quot;: &quot;Inpatient&quot;]"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="0"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
        <extension url="libraryName">
          <valueString value="EXMRatio-FHIR"/>
        </extension>
        <extension url="name">
          <valueString value="Initial Population"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Initial Population&quot;:   &quot;Qualifying Encounters&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="1"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
        <extension url="libraryName">
          <valueString value="EXMRatio-FHIR"/>
        </extension>
        <extension url="name">
          <valueString value="Numerator"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Numerator&quot;:   &quot;Initial Population&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="2"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
        <extension url="libraryName">
          <valueString value="EXMRatio-FHIR"/>
        </extension>
        <extension url="name">
          <valueString value="Denominator"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Denominator&quot;:   &quot;Initial Population&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="3"/>
        </extension>
      </extension>
      <name value="EffectiveDataRequirements"/>
      <status value="active"/>
      <type>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/library-type"/>
          <code value="module-definition"/>
        </coding>
      </type>
      <date value="2022-02-22T10:37:04-07:00"/>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Inpatient"/>
        <resource value="http://example.org/fhir/ValueSet/inpatient"/>
      </relatedArtifact>
      <parameter>
        <name value="Numerator"/>
        <use value="out"/>
        <min value="0"/>
        <max value="*"/>
        <type value="Encounter"/>
      </parameter>
      <parameter>
        <name value="Denominator"/>
        <use value="out"/>
        <min value="0"/>
        <max value="*"/>
        <type value="Encounter"/>
      </parameter>
      <parameter>
        <name value="Initial Population"/>
        <use value="out"/>
        <min value="0"/>
        <max value="*"/>
        <type value="Encounter"/>
      </parameter>
      <dataRequirement>
        <type value="Encounter"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Encounter"/>
        <mustSupport value="type"/>
        <codeFilter>
          <path value="type"/>
          <valueSet value="http://example.org/fhir/ValueSet/inpatient"/>
        </codeFilter>
      </dataRequirement>
    </Library>
  </contained>
  <extension
             url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis">
    <valueCode value="Encounter"/>
  </extension>
  <extension
             url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoringUnit">
    <valueCodeableConcept>
      <coding>
        <system value="http://unitsofmeasure.org"/>
        <code value="/1000.d"/>
      </coding>
    </valueCodeableConcept>
  </extension>
  <extension
             url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-softwaresystem">
    <valueReference>🔗 
      <reference value="Device/software-system-example"/>
    </valueReference>
  </extension>
  <extension
             url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-effectiveDataRequirements" id="effective-data-requirements">
    <valueReference>
      <reference value="#effective-data-requirements"/>
    </valueReference>
  </extension>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
    <valueCode value="cqi"/>
  </extension>
  <url value="http://example.org/fhir/measures/measure-ratio-exm"/>
  <identifier>
    <system value="http://example.org/fhir/cqi/ecqm/Measure/Identifier/exm"/>
    <value value="EXMRatio-FHIR"/>
  </identifier>
  <version value="5.0.0-ballot"/>
  <name value="EXMRatioMeasure"/>
  <title value="EXM Ratio Measure"/>
  <status value="active"/>
  <experimental value="true"/>
  <date value="2022-02-22"/>
  <publisher value="HL7 International / Clinical Quality Information"/>
  <contact>
    <telecom>
      <system value="url"/>
      <value value="http://www.hl7.org/Special/committees/cqi"/>
    </telecom>
  </contact>
  <description value="An example FHIR-based publishable measure"/>
  <useContext>
    <code>
      <system
              value="http://terminology.hl7.org/CodeSystem/usage-context-type"/>
      <code value="program"/>
    </code>
    <valueCodeableConcept>
      <coding>
        <system
                value="http://hl7.org/fhir/us/cqfmeasures/CodeSystem/quality-programs"/>
        <code value="ep-ec"/>
      </coding>
      <text value="eligible-provider"/>
    </valueCodeableConcept>
  </useContext>
  <jurisdiction>
    <coding>
      <system value="urn:iso:std:iso:3166"/>
      <code value="US"/>
    </coding>
  </jurisdiction>
  <purpose value="The purpose of this measure is to..."/>
  <usage value="Users of this measure should be aware of..."/>
  <copyright value="Example Copyright Statement"/>
  <approvalDate value="2019-02-17"/>
  <lastReviewDate value="2019-02-17"/>
  <effectivePeriod>
    <extension
               url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-effectivePeriodAnchor">
      <valueDateTime value="2018-01-01"/>
    </extension>
    <extension
               url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-effectivePeriodDuration">
      <valueDuration>
        <value value="1"/>
        <system value="http://unitsofmeasure.org"/>
        <code value="a"/>
      </valueDuration>
    </extension>
    <start value="2018-01-01"/>
    <end value="2018-12-31"/>
  </effectivePeriod>
  <topic>
    <coding>
      <system value="http://loinc.org"/>
      <code value="57024-2"/>
    </coding>
    <text value="Health Quality Measure Document"/>
  </topic>
  <author>
    <name value="Example Measure Content Developer"/>
  </author>
  <library value="http://hl7.org/fhir/us/cqfmeasures/Library/EXMRatio-FHIR"/>
  <disclaimer value="Example disclaimer"/>
  <scoring>
    <coding>
      <system value="http://terminology.hl7.org/CodeSystem/measure-scoring"/>
      <code value="ratio"/>
      <display value="Ratio"/>
    </coding>
  </scoring>
  <type>
    <coding>
      <system value="http://terminology.hl7.org/CodeSystem/measure-type"/>
      <code value="process"/>
    </coding>
  </type>
  <improvementNotation>
    <coding>
      <system
              value="http://terminology.hl7.org/CodeSystem/measure-improvement-notation"/>
      <code value="decrease"/>
      <display value="Decreased score indicates improvement"/>
    </coding>
  </improvementNotation>
  <group id="group-1">
    <population id="initial-population">
      <code>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/measure-population"/>
          <code value="initial-population"/>
          <display value="Initial Population"/>
        </coding>
      </code>
      <criteria>
        <language value="text/cql-identifier"/>
        <expression value="Initial Population"/>
      </criteria>
    </population>
    <population id="numerator">
      <code>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/measure-population"/>
          <code value="numerator"/>
          <display value="Numerator"/>
        </coding>
      </code>
      <criteria>
        <language value="text/cql-identifier"/>
        <expression value="Numerator"/>
      </criteria>
    </population>
    <population id="denominator">
      <code>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/measure-population"/>
          <code value="denominator"/>
          <display value="Denominator"/>
        </coding>
      </code>
      <criteria>
        <language value="text/cql-identifier"/>
        <expression value="Denominator"/>
      </criteria>
    </population>
    <population id="denominator-observation">
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-criteriaReference">
        <valueString value="denominator"/>
      </extension>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-aggregateMethod">
        <valueCode value="sum"/>
      </extension>
      <code>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/measure-population"/>
          <code value="measure-observation"/>
          <display value="Measure Observation"/>
        </coding>
      </code>
      <criteria>
        <language value="text/cql-identifier"/>
        <expression value="Measure Denominator Observation"/>
      </criteria>
    </population>
    <population id="numerator-observation">
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-criteriaReference">
        <valueString value="numerator"/>
      </extension>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-aggregateMethod">
        <valueCode value="sum"/>
      </extension>
      <code>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/measure-population"/>
          <code value="measure-observation"/>
          <display value="Measure Observation"/>
        </coding>
      </code>
      <criteria>
        <language value="text/cql-identifier"/>
        <expression value="Measure Numerator Observation"/>
      </criteria>
    </population>
  </group>
</Measure>