Quality Measure Implementation Guide (STU5)
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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

: Multi-Rate Example Measure - XML Representation

Draft as of 2022-02-22

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<Measure xmlns="http://hl7.org/fhir">
  <id value="MultiRateExample-FHIR"/>
  <meta>
    <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;">MultiRateExample-FHIR</td>
            </tr>
            
            
            <tr>
                <th scope="row"><b>Download cql: </b></th>
                <td style="padding-left: 4px;"><a href="Library-MultiRateExample-FHIR.cql">MultiRateExample-FHIR.cql</a></td>
            </tr>
            

        
        
            <tr>
                <th scope="row"><b>Url: </b></th>
                <td style="padding-left: 4px;"><a href="Measure-MultiRateExample-FHIR.html">Multi-Rate Example 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>Name: </b></th>
                <td style="padding-left: 4px;">MultiRateExample</td>
            </tr>
        
        
            <tr>
                <th scope="row"><b>Title: </b></th>
                <td style="padding-left: 4px;">Multi-Rate Example Measure</td>
            </tr>
        
        
        
            <tr>
                <th scope="row"><b>Status: </b></th>
                <td style="padding-left: 4px;">draft</td>
            </tr>
        
        
            <tr>
                <th scope="row"><b>Experimental: </b></th>
                <td style="padding-left: 4px;">true</td>
            </tr>
        
        
        
        
        
            <tr>
                <th scope="row"><b>Subject: </b></th>
                
                    <td style="padding-left: 4px;">
                        
                            
                               <p style="margin-bottom: 5px;">
                                <span>Location (http://hl7.org/fhir/resource-types)</span>
                               </p>
                            
                        
                        
                    </td>
                
                
            </tr>
        
        
            <tr>
                <th scope="row"><b>Date: </b></th>
                <td style="padding-left: 4px;">2022-02-22 10:37:03-0700</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>This measure example illustrates the use of the group-level computation extensions to describe a multi-rate measure with mixed population bases</p>
</div></td>
            </tr>
        
        
        
        
        
            <tr>
                <th scope="row"><b>Jurisdiction: </b></th>
                <td style="padding-left: 25px;">US</td>
            </tr>
        
        
        
        
        
        
        
        
        
        
            
                <tr>
                    <th scope="row"><b>Population Criteria: </b></th>
                    <td style="padding-left: 4px;">
                        
                            <table class="grid-dict">
                                
                                    <tr>
                                        <th><b>group-1</b></th>
                                    </tr>
                                
                                
                                    <tr>
                                        <td>: </td>
                                        <td>Total number of patients</td>
                                    </tr>
                                
                                    <tr>
                                        <td>: </td>
                                        <td>Total number of patients</td>
                                    </tr>
                                
                                    <tr>
                                        <td>: </td>
                                        <td>Total number of patients</td>
                                    </tr>
                                
                            </table>
                        
                            <table class="grid-dict">
                                
                                    <tr>
                                        <th><b>group-2</b></th>
                                    </tr>
                                
                                
                                    <tr>
                                        <td>: </td>
                                        <td>Total number of practitioners</td>
                                    </tr>
                                
                                    <tr>
                                        <td>: </td>
                                        <td>Total number of practitioners</td>
                                    </tr>
                                
                                    <tr>
                                        <td>: </td>
                                        <td>Total number of practitioners</td>
                                    </tr>
                                
                            </table>
                        
                            <table class="grid-dict">
                                
                                    <tr>
                                        <th><b>group-3</b></th>
                                    </tr>
                                
                                
                                    <tr>
                                        <td>: </td>
                                        <td>Total number of beds</td>
                                    </tr>
                                
                                    <tr>
                                        <td>: </td>
                                        <td>Total number of beds</td>
                                    </tr>
                                
                                    <tr>
                                        <td>: </td>
                                        <td>Total number of beds</td>
                                    </tr>
                                
                            </table>
                        
                            <table class="grid-dict">
                                
                                    <tr>
                                        <th><b>group-4</b></th>
                                    </tr>
                                
                                
                                    <tr>
                                        <td>: </td>
                                        <td>Total number of screening procedures</td>
                                    </tr>
                                
                                    <tr>
                                        <td>: </td>
                                        <td>Total number of screening procedures</td>
                                    </tr>
                                
                                    <tr>
                                        <td>: </td>
                                        <td>Total number of screening procedures</td>
                                    </tr>
                                
                            </table>
                        
                            <table class="grid-dict">
                                
                                    <tr>
                                        <th><b>group-5</b></th>
                                    </tr>
                                
                                
                                    <tr>
                                        <td>: </td>
                                        <td>Patients</td>
                                    </tr>
                                
                                    <tr>
                                        <td>: </td>
                                        <td>Eligible patients</td>
                                    </tr>
                                
                                    <tr>
                                        <td>: </td>
                                        <td>Patients with screening</td>
                                    </tr>
                                
                            </table>
                        
                            <table class="grid-dict">
                                
                                    <tr>
                                        <th><b>group-6</b></th>
                                    </tr>
                                
                                
                            </table>
                        
                    </td>
                </tr>
            
        
        
        
        
        
        
            <tr>
                <th scope="row"><b>Libraries: </b></th>
                <td style="padding-left: 4px;">
                    <table class="grid-dict">
                        
                            <tr><td><a href="Library-MultiRateExample-FHIR.html">Multi Rate Example Logic 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://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1">http://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1</a></li>
                        
                            <li><a href="http://example.org/fhir/ValueSet/TBD">http://example.org/fhir/ValueSet/TBD</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>Practitioners</td>
                                    <td>out</td>
                                    <td>0</td>
                                    <td>*</td>
                                    <td>PractitionerRole</td>
                                </tr>
                            
                                <tr>
                                    <td>Numerator</td>
                                    <td>out</td>
                                    <td>0</td>
                                    <td>*</td>
                                    <td>Patient</td>
                                </tr>
                            
                                <tr>
                                    <td>Denominator</td>
                                    <td>out</td>
                                    <td>0</td>
                                    <td>*</td>
                                    <td>Patient</td>
                                </tr>
                            
                                <tr>
                                    <td>Initial Population</td>
                                    <td>out</td>
                                    <td>0</td>
                                    <td>*</td>
                                    <td>Patient</td>
                                </tr>
                            
                                <tr>
                                    <td>Patients</td>
                                    <td>out</td>
                                    <td>0</td>
                                    <td>*</td>
                                    <td>Patient</td>
                                </tr>
                            
                                <tr>
                                    <td>Beds</td>
                                    <td>out</td>
                                    <td>0</td>
                                    <td>*</td>
                                    <td>Device</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>Patient</td>
                                    <td>
                                        
                                            gender
                                        
                                            id
                                        
                                    </td>
                                    <td>
                                        
                                    </td>
                                    <td></td>
                                </tr>
                            
                                <tr>
                                    <td>Device</td>
                                    <td>
                                        
                                            type
                                        
                                    </td>
                                    <td>
                                        
                                            
                                                 Screening Procedure Types
                                            
                                        
                                    </td>
                                    <td><a href="http://example.org/fhir/ValueSet/TBD">http://example.org/fhir/ValueSet/TBD</a></td>
                                </tr>
                            
                                <tr>
                                    <td>Procedure</td>
                                    <td>
                                        
                                            code
                                        
                                            subject
                                        
                                            subject.reference
                                        
                                    </td>
                                    <td>
                                        
                                            
                                                 Screening Procedure Types
                                            
                                        
                                    </td>
                                    <td><a href="http://example.org/fhir/ValueSet/TBD">http://example.org/fhir/ValueSet/TBD</a></td>
                                </tr>
                            
                                <tr>
                                    <td>PractitionerRole</td>
                                    <td>
                                        
                                    </td>
                                    <td>
                                        
                                    </td>
                                    <td></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>Group scoring:</b>
                                                    
                                                    <span>  continuous-variable </span>
                                                    
                                                
                                                
                                            </td>
                                            
                                                <tr>
                                                    <td/>
                                                    <td/>
                                                    <td></td>
                                                    <td>
                                                        
                                                        <pre><code class="language-cql">// Number of patients
define &quot;Patients&quot;:
  [Patient]</code></pre>
                                                        
                                                    </td>
                                                </tr>
                                            
                                                <tr>
                                                    <td/>
                                                    <td/>
                                                    <td></td>
                                                    <td>
                                                        
                                                        <pre><code class="language-cql">// Number of patients
define &quot;Patients&quot;:
  [Patient]</code></pre>
                                                        
                                                    </td>
                                                </tr>
                                            
                                                <tr>
                                                    <td/>
                                                    <td/>
                                                    <td></td>
                                                    <td>
                                                        
                                                        <pre><code class="language-cql"></code></pre>
                                                        
                                                    </td>
                                                </tr>
                                            

                                    
                                            <td> group-2 </td>
                                            <td>
                                                
                                                    <b>Group scoring:</b>
                                                    
                                                    <span>  continuous-variable </span>
                                                    
                                                
                                                
                                            </td>
                                            
                                                <tr>
                                                    <td/>
                                                    <td/>
                                                    <td></td>
                                                    <td>
                                                        
                                                        <pre><code class="language-cql">// Number of practitioners
define &quot;Practitioners&quot;:
  [PractitionerRole]</code></pre>
                                                        
                                                    </td>
                                                </tr>
                                            
                                                <tr>
                                                    <td/>
                                                    <td/>
                                                    <td></td>
                                                    <td>
                                                        
                                                        <pre><code class="language-cql">// Number of practitioners
define &quot;Practitioners&quot;:
  [PractitionerRole]</code></pre>
                                                        
                                                    </td>
                                                </tr>
                                            
                                                <tr>
                                                    <td/>
                                                    <td/>
                                                    <td></td>
                                                    <td>
                                                        
                                                        <pre><code class="language-cql"></code></pre>
                                                        
                                                    </td>
                                                </tr>
                                            

                                    
                                            <td> group-3 </td>
                                            <td>
                                                
                                                    <b>Group scoring:</b>
                                                    
                                                    <span>  continuous-variable </span>
                                                    
                                                
                                                
                                            </td>
                                            
                                                <tr>
                                                    <td/>
                                                    <td/>
                                                    <td></td>
                                                    <td>
                                                        
                                                        <pre><code class="language-cql">// Number of beds
define &quot;Beds&quot;:
  [Device: &quot;Bed Device Types&quot;]</code></pre>
                                                        
                                                    </td>
                                                </tr>
                                            
                                                <tr>
                                                    <td/>
                                                    <td/>
                                                    <td></td>
                                                    <td>
                                                        
                                                        <pre><code class="language-cql">// Number of beds
define &quot;Beds&quot;:
  [Device: &quot;Bed Device Types&quot;]</code></pre>
                                                        
                                                    </td>
                                                </tr>
                                            
                                                <tr>
                                                    <td/>
                                                    <td/>
                                                    <td></td>
                                                    <td>
                                                        
                                                        <pre><code class="language-cql"></code></pre>
                                                        
                                                    </td>
                                                </tr>
                                            

                                    
                                            <td> group-4 </td>
                                            <td>
                                                
                                                    <b>Group scoring:</b>
                                                    
                                                    <span>  continuous-variable </span>
                                                    
                                                
                                                
                                            </td>
                                            
                                                <tr>
                                                    <td/>
                                                    <td/>
                                                    <td></td>
                                                    <td>
                                                        
                                                        <pre><code class="language-cql"></code></pre>
                                                        
                                                    </td>
                                                </tr>
                                            
                                                <tr>
                                                    <td/>
                                                    <td/>
                                                    <td></td>
                                                    <td>
                                                        
                                                        <pre><code class="language-cql"></code></pre>
                                                        
                                                    </td>
                                                </tr>
                                            
                                                <tr>
                                                    <td/>
                                                    <td/>
                                                    <td></td>
                                                    <td>
                                                        
                                                        <pre><code class="language-cql"></code></pre>
                                                        
                                                    </td>
                                                </tr>
                                            

                                    
                                            <td> group-5 </td>
                                            <td>
                                                
                                                    <b>Group scoring:</b>
                                                    
                                                    <span>  proportion </span>
                                                    
                                                
                                                
                                            </td>
                                            
                                                <tr>
                                                    <td/>
                                                    <td/>
                                                    <td></td>
                                                    <td>
                                                        
                                                        <pre><code class="language-cql">// Percentage of patients who received screening
define &quot;Initial Population&quot;:
  &quot;Patients&quot;</code></pre>
                                                        
                                                    </td>
                                                </tr>
                                            
                                                <tr>
                                                    <td/>
                                                    <td/>
                                                    <td></td>
                                                    <td>
                                                        
                                                        <pre><code class="language-cql">define &quot;Denominator&quot;:
  &quot;Patients&quot; P
    where P.gender = 'female'</code></pre>
                                                        
                                                    </td>
                                                </tr>
                                            
                                                <tr>
                                                    <td/>
                                                    <td/>
                                                    <td></td>
                                                    <td>
                                                        
                                                        <pre><code class="language-cql">define &quot;Numerator&quot;:
  &quot;Patients&quot; P
    with &quot;Screening Procedures&quot; SP
      such that P.id = Last(Split(SP.subject.reference, '/'))</code></pre>
                                                        
                                                    </td>
                                                </tr>
                                            

                                    
                                            <td> group-6 </td>
                                            <td>
                                                
                                                    <b>Group scoring:</b>
                                                    
                                                    <span>  composite </span>
                                                    
                                                
                                                
                                            </td>
                                            

                                    
                                    </tr>
                                </table>
                            
                            <table class="grid-dict">
                                
                                    <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>
                                    <tr>
                                        
                                            <td>MultiRateExample-FHIR</td>
                                        
                                        
                                            <td>Practitioners</td>
                                        
                                    </tr>
                                    <tr>
                                        
                                            <td></td>
                                        <td><pre class="highlight language-cql"><code class="language-cql">// Number of practitioners
define &quot;Practitioners&quot;:
  [PractitionerRole]</code></pre></td>
                                        
                                    </tr>
                                
                                    <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>
                                    <tr>
                                        
                                            <td>MultiRateExample-FHIR</td>
                                        
                                        
                                            <td>Patients</td>
                                        
                                    </tr>
                                    <tr>
                                        
                                            <td></td>
                                        <td><pre class="highlight language-cql"><code class="language-cql">// Number of patients
define &quot;Patients&quot;:
  [Patient]</code></pre></td>
                                        
                                    </tr>
                                
                                    <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>
                                    <tr>
                                        
                                            <td>MultiRateExample-FHIR</td>
                                        
                                        
                                            <td>Screening Procedures</td>
                                        
                                    </tr>
                                    <tr>
                                        
                                            <td></td>
                                        <td><pre class="highlight language-cql"><code class="language-cql">// Number of screening procedures
define &quot;Screening Procedures&quot;:
  [Procedure: &quot;Screening Procedure Types&quot;]</code></pre></td>
                                        
                                    </tr>
                                
                                    <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>
                                    <tr>
                                        
                                            <td>MultiRateExample-FHIR</td>
                                        
                                        
                                            <td>Numerator</td>
                                        
                                    </tr>
                                    <tr>
                                        
                                            <td></td>
                                        <td><pre class="highlight language-cql"><code class="language-cql">define &quot;Numerator&quot;:
  &quot;Patients&quot; P
    with &quot;Screening Procedures&quot; SP
      such that P.id = Last(Split(SP.subject.reference, '/'))</code></pre></td>
                                        
                                    </tr>
                                
                                    <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>
                                    <tr>
                                        
                                            <td>MultiRateExample-FHIR</td>
                                        
                                        
                                            <td>Denominator</td>
                                        
                                    </tr>
                                    <tr>
                                        
                                            <td></td>
                                        <td><pre class="highlight language-cql"><code class="language-cql">define &quot;Denominator&quot;:
  &quot;Patients&quot; P
    where P.gender = 'female'</code></pre></td>
                                        
                                    </tr>
                                
                                    <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>
                                    <tr>
                                        
                                            <td>MultiRateExample-FHIR</td>
                                        
                                        
                                            <td>Initial Population</td>
                                        
                                    </tr>
                                    <tr>
                                        
                                            <td></td>
                                        <td><pre class="highlight language-cql"><code class="language-cql">// Percentage of patients who received screening
define &quot;Initial Population&quot;:
  &quot;Patients&quot;</code></pre></td>
                                        
                                    </tr>
                                
                                    <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>
                                    <tr>
                                        
                                            <td>MultiRateExample-FHIR</td>
                                        
                                        
                                            <td>Beds</td>
                                        
                                    </tr>
                                    <tr>
                                        
                                            <td></td>
                                        <td><pre class="highlight language-cql"><code class="language-cql">// Number of beds
define &quot;Beds&quot;:
  [Device: &quot;Bed Device Types&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="MultiRateExample-FHIR"/>
        </extension>
        <extension url="name">
          <valueString value="Practitioners"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="// Number of practitioners
define &quot;Practitioners&quot;:
  [PractitionerRole]"/>
        </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="MultiRateExample-FHIR"/>
        </extension>
        <extension url="name">
          <valueString value="Patients"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="// Number of patients
define &quot;Patients&quot;:
  [Patient]"/>
        </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="MultiRateExample-FHIR"/>
        </extension>
        <extension url="name">
          <valueString value="Screening Procedures"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="// Number of screening procedures
define &quot;Screening Procedures&quot;:
  [Procedure: &quot;Screening Procedure Types&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="MultiRateExample-FHIR"/>
        </extension>
        <extension url="name">
          <valueString value="Numerator"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Numerator&quot;:
  &quot;Patients&quot; P
    with &quot;Screening Procedures&quot; SP
      such that P.id = Last(Split(SP.subject.reference, '/'))"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="3"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
        <extension url="libraryName">
          <valueString value="MultiRateExample-FHIR"/>
        </extension>
        <extension url="name">
          <valueString value="Denominator"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Denominator&quot;:
  &quot;Patients&quot; P
    where P.gender = 'female'"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="4"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
        <extension url="libraryName">
          <valueString value="MultiRateExample-FHIR"/>
        </extension>
        <extension url="name">
          <valueString value="Initial Population"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="// Percentage of patients who received screening
define &quot;Initial Population&quot;:
  &quot;Patients&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="5"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
        <extension url="libraryName">
          <valueString value="MultiRateExample-FHIR"/>
        </extension>
        <extension url="name">
          <valueString value="Beds"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="// Number of beds
define &quot;Beds&quot;:
  [Device: &quot;Bed Device Types&quot;]"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="6"/>
        </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="2022-02-22T10:37:03-07:00"/>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Library FHIRHelpers"/>
        <resource
                  value="http://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Screening Procedure Types"/>
        <resource value="http://example.org/fhir/ValueSet/TBD"/>
      </relatedArtifact>
      <parameter>
        <name value="Practitioners"/>
        <use value="out"/>
        <min value="0"/>
        <max value="*"/>
        <type value="PractitionerRole"/>
      </parameter>
      <parameter>
        <name value="Numerator"/>
        <use value="out"/>
        <min value="0"/>
        <max value="*"/>
        <type value="Patient"/>
      </parameter>
      <parameter>
        <name value="Denominator"/>
        <use value="out"/>
        <min value="0"/>
        <max value="*"/>
        <type value="Patient"/>
      </parameter>
      <parameter>
        <name value="Initial Population"/>
        <use value="out"/>
        <min value="0"/>
        <max value="*"/>
        <type value="Patient"/>
      </parameter>
      <parameter>
        <name value="Patients"/>
        <use value="out"/>
        <min value="0"/>
        <max value="*"/>
        <type value="Patient"/>
      </parameter>
      <parameter>
        <name value="Beds"/>
        <use value="out"/>
        <min value="0"/>
        <max value="*"/>
        <type value="Device"/>
      </parameter>
      <dataRequirement>
        <type value="Patient"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Patient"/>
        <mustSupport value="gender"/>
        <mustSupport value="id"/>
      </dataRequirement>
      <dataRequirement>
        <type value="Device"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Device"/>
        <mustSupport value="type"/>
        <codeFilter>
          <path value="type"/>
          <valueSet value="http://example.org/fhir/ValueSet/TBD"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Procedure"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Procedure"/>
        <mustSupport value="code"/>
        <mustSupport value="subject"/>
        <mustSupport value="subject.reference"/>
        <codeFilter>
          <path value="code"/>
          <valueSet value="http://example.org/fhir/ValueSet/TBD"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="PractitionerRole"/>
        <profile
                 value="http://hl7.org/fhir/StructureDefinition/PractitionerRole"/>
      </dataRequirement>
    </Library>
  </contained>
  <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-populationBasis">
    <valueCode value="Patient"/>
  </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://hl7.org/fhir/us/cqfmeasures/Measure/MultiRateExample-FHIR"/>
  <version value="5.0.0-ballot"/>
  <name value="MultiRateExample"/>
  <title value="Multi-Rate Example Measure"/>
  <status value="draft"/>
  <experimental value="true"/>
  <subjectCodeableConcept>
    <coding>
      <system value="http://hl7.org/fhir/resource-types"/>
      <code value="Location"/>
    </coding>
  </subjectCodeableConcept>
  <date value="2022-02-22T10:37:03-07:00"/>
  <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="This measure example illustrates the use of the group-level computation extensions to describe a multi-rate measure with mixed population bases"/>
  <jurisdiction>
    <coding>
      <system value="urn:iso:std:iso:3166"/>
      <code value="US"/>
    </coding>
  </jurisdiction>
  <library
           value="http://hl7.org/fhir/us/cqfmeasures/Library/MultiRateExample-FHIR"/>
  <group id="group-1">
    <extension
               url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis">
      <valueCode value="Patient"/>
    </extension>
    <extension
               url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring">
      <valueCodeableConcept>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/measure-scoring"/>
          <code value="continuous-variable"/>
        </coding>
      </valueCodeableConcept>
    </extension>
    <extension
               url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-type">
      <valueCodeableConcept>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/measure-type"/>
          <code value="structure"/>
        </coding>
      </valueCodeableConcept>
    </extension>
    <extension
               url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-riskAdjustment">
      <valueString value="N/A"/>
    </extension>
    <extension
               url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-rateAggregation">
      <valueString value="N/A"/>
    </extension>
    <extension
               url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-improvementNotation">
      <valueCodeableConcept>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/measure-improvement-notation"/>
          <code value="increase"/>
        </coding>
      </valueCodeableConcept>
    </extension>
    <code>
      <text value="Patients"/>
    </code>
    <population>
      <code>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/measure-population"/>
          <code value="initial-population"/>
        </coding>
      </code>
      <description value="Total number of patients"/>
      <criteria>
        <language value="text/cql-identifier"/>
        <expression value="Patients"/>
      </criteria>
    </population>
    <population>
      <code>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/measure-population"/>
          <code value="measure-population"/>
        </coding>
      </code>
      <description value="Total number of patients"/>
      <criteria>
        <language value="text/cql-identifier"/>
        <expression value="Patients"/>
      </criteria>
    </population>
    <population>
      <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"/>
        </coding>
      </code>
      <description value="Total number of patients"/>
      <criteria>
        <language value="text/cql-identifier"/>
        <expression value="ToNumber"/>
      </criteria>
    </population>
  </group>
  <group id="group-2">
    <extension
               url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis">
      <valueCode value="PractitionerRole"/>
    </extension>
    <extension
               url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring">
      <valueCodeableConcept>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/measure-scoring"/>
          <code value="continuous-variable"/>
        </coding>
      </valueCodeableConcept>
    </extension>
    <extension
               url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-type">
      <valueCodeableConcept>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/measure-type"/>
          <code value="structure"/>
        </coding>
      </valueCodeableConcept>
    </extension>
    <extension
               url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-riskAdjustment">
      <valueString value="N/A"/>
    </extension>
    <extension
               url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-rateAggregation">
      <valueString value="N/A"/>
    </extension>
    <extension
               url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-improvementNotation">
      <valueCodeableConcept>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/measure-improvement-notation"/>
          <code value="increase"/>
        </coding>
      </valueCodeableConcept>
    </extension>
    <code>
      <text value="Practitioners"/>
    </code>
    <population>
      <code>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/measure-population"/>
          <code value="initial-population"/>
        </coding>
      </code>
      <description value="Total number of practitioners"/>
      <criteria>
        <language value="text/cql-identifier"/>
        <expression value="Practitioners"/>
      </criteria>
    </population>
    <population>
      <code>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/measure-population"/>
          <code value="measure-population"/>
        </coding>
      </code>
      <description value="Total number of practitioners"/>
      <criteria>
        <language value="text/cql-identifier"/>
        <expression value="Practitioners"/>
      </criteria>
    </population>
    <population>
      <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"/>
        </coding>
      </code>
      <description value="Total number of practitioners"/>
      <criteria>
        <language value="text/cql-identifier"/>
        <expression value="ToNumber"/>
      </criteria>
    </population>
  </group>
  <group id="group-3">
    <extension
               url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis">
      <valueCode value="Device"/>
    </extension>
    <extension
               url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring">
      <valueCodeableConcept>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/measure-scoring"/>
          <code value="continuous-variable"/>
        </coding>
      </valueCodeableConcept>
    </extension>
    <extension
               url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-type">
      <valueCodeableConcept>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/measure-type"/>
          <code value="structure"/>
        </coding>
      </valueCodeableConcept>
    </extension>
    <extension
               url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-riskAdjustment">
      <valueString value="N/A"/>
    </extension>
    <extension
               url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-rateAggregation">
      <valueString value="N/A"/>
    </extension>
    <extension
               url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-improvementNotation">
      <valueCodeableConcept>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/measure-improvement-notation"/>
          <code value="increase"/>
        </coding>
      </valueCodeableConcept>
    </extension>
    <code>
      <text value="Beds"/>
    </code>
    <population>
      <code>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/measure-population"/>
          <code value="initial-population"/>
        </coding>
      </code>
      <description value="Total number of beds"/>
      <criteria>
        <language value="text/cql-identifier"/>
        <expression value="Beds"/>
      </criteria>
    </population>
    <population>
      <code>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/measure-population"/>
          <code value="measure-population"/>
        </coding>
      </code>
      <description value="Total number of beds"/>
      <criteria>
        <language value="text/cql-identifier"/>
        <expression value="Beds"/>
      </criteria>
    </population>
    <population>
      <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"/>
        </coding>
      </code>
      <description value="Total number of beds"/>
      <criteria>
        <language value="text/cql-identifier"/>
        <expression value="ToNumber"/>
      </criteria>
    </population>
  </group>
  <group id="group-4">
    <extension
               url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis">
      <valueCode value="Procedure"/>
    </extension>
    <extension
               url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring">
      <valueCodeableConcept>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/measure-scoring"/>
          <code value="continuous-variable"/>
        </coding>
      </valueCodeableConcept>
    </extension>
    <extension
               url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-type">
      <valueCodeableConcept>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/measure-type"/>
          <code value="structure"/>
        </coding>
      </valueCodeableConcept>
    </extension>
    <extension
               url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-riskAdjustment">
      <valueString value="N/A"/>
    </extension>
    <extension
               url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-rateAggregation">
      <valueString value="N/A"/>
    </extension>
    <extension
               url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-improvementNotation">
      <valueCodeableConcept>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/measure-improvement-notation"/>
          <code value="increase"/>
        </coding>
      </valueCodeableConcept>
    </extension>
    <code>
      <text value="Screening Procedures"/>
    </code>
    <population>
      <code>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/measure-population"/>
          <code value="initial-population"/>
        </coding>
      </code>
      <description value="Total number of screening procedures"/>
      <criteria>
        <language value="text/cql-identifier"/>
        <expression value="Procedures"/>
      </criteria>
    </population>
    <population>
      <code>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/measure-population"/>
          <code value="measure-population"/>
        </coding>
      </code>
      <description value="Total number of screening procedures"/>
      <criteria>
        <language value="text/cql-identifier"/>
        <expression value="Procedures"/>
      </criteria>
    </population>
    <population>
      <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"/>
        </coding>
      </code>
      <description value="Total number of screening procedures"/>
      <criteria>
        <language value="text/cql-identifier"/>
        <expression value="ToNumber"/>
      </criteria>
    </population>
  </group>
  <group id="group-5">
    <extension
               url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis">
      <valueCode value="Patient"/>
    </extension>
    <extension
               url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring">
      <valueCodeableConcept>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/measure-scoring"/>
          <code value="proportion"/>
        </coding>
      </valueCodeableConcept>
    </extension>
    <extension
               url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-type">
      <valueCodeableConcept>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/measure-type"/>
          <code value="process"/>
        </coding>
      </valueCodeableConcept>
    </extension>
    <extension
               url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-riskAdjustment">
      <valueString value="N/A"/>
    </extension>
    <extension
               url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-rateAggregation">
      <valueString value="N/A"/>
    </extension>
    <extension
               url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-improvementNotation">
      <valueCodeableConcept>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/measure-improvement-notation"/>
          <code value="increase"/>
        </coding>
      </valueCodeableConcept>
    </extension>
    <code>
      <text value="Patients that recevied screenings"/>
    </code>
    <population>
      <code>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/measure-population"/>
          <code value="initial-population"/>
        </coding>
      </code>
      <description value="Patients"/>
      <criteria>
        <language value="text/cql-identifier"/>
        <expression value="Initial Population"/>
      </criteria>
    </population>
    <population>
      <code>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/measure-population"/>
          <code value="denominator"/>
        </coding>
      </code>
      <description value="Eligible patients"/>
      <criteria>
        <language value="text/cql-identifier"/>
        <expression value="Denominator"/>
      </criteria>
    </population>
    <population>
      <code>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/measure-population"/>
          <code value="numerator"/>
        </coding>
      </code>
      <description value="Patients with screening"/>
      <criteria>
        <language value="text/cql-identifier"/>
        <expression value="Numerator"/>
      </criteria>
    </population>
  </group>
  <group id="group-6">
    <extension
               url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-compositeScoring">
      <valueCodeableConcept>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/composite-measure-scoring"/>
          <code value="weighted"/>
        </coding>
      </valueCodeableConcept>
    </extension>
    <extension
               url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring">
      <valueCodeableConcept>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/measure-scoring"/>
          <code value="composite"/>
        </coding>
      </valueCodeableConcept>
    </extension>
    <extension
               url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-type">
      <valueCodeableConcept>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/measure-type"/>
          <code value="structure"/>
        </coding>
      </valueCodeableConcept>
    </extension>
    <extension
               url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-riskAdjustment">
      <valueString value="N/A"/>
    </extension>
    <extension
               url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-rateAggregation">
      <valueString value="N/A"/>
    </extension>
    <extension
               url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-improvementNotation">
      <valueCodeableConcept>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/measure-improvement-notation"/>
          <code value="increase"/>
        </coding>
      </valueCodeableConcept>
    </extension>
    <extension
               url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-component">
      <valueRelatedArtifact>
        <extension
                   url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-groupId">
          <valueString value="group-1"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-weight">
          <valueDecimal value="1.0"/>
        </extension>
        <type value="composed-of"/>
        <resource
                  value="http://hl7.org/fhir/us/cqfmeasures/Measure/MultiRateExample-FHIR"/>
      </valueRelatedArtifact>
    </extension>
    <extension
               url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-component">
      <valueRelatedArtifact>
        <extension
                   url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-groupId">
          <valueString value="group-2"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-weight">
          <valueDecimal value="5.0"/>
        </extension>
        <type value="composed-of"/>
        <resource
                  value="http://hl7.org/fhir/us/cqfmeasures/Measure/MultiRateExample-FHIR"/>
      </valueRelatedArtifact>
    </extension>
    <extension
               url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-component">
      <valueRelatedArtifact>
        <extension
                   url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-groupId">
          <valueString value="group-3"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-weight">
          <valueDecimal value="2.5"/>
        </extension>
        <type value="composed-of"/>
        <resource
                  value="http://hl7.org/fhir/us/cqfmeasures/Measure/MultiRateExample-FHIR"/>
      </valueRelatedArtifact>
    </extension>
    <extension
               url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-component">
      <valueRelatedArtifact>
        <extension
                   url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-groupId">
          <valueString value="group-4"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-weight">
          <valueDecimal value="1.0"/>
        </extension>
        <type value="composed-of"/>
        <resource
                  value="http://hl7.org/fhir/us/cqfmeasures/Measure/MultiRateExample-FHIR"/>
      </valueRelatedArtifact>
    </extension>
    <code>
      <text value="Weighted Average capacity"/>
    </code>
  </group>
</Measure>