Quality Measure Implementation Guide (STU4)
4.0.0 - STU4 United States of America flag

This page is part of the Quality Measure STU2 for FHIR R4 Implementation Guide (v4.0.0: STU4 (v4.0.0)) based on FHIR R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

Example Library: EXM55 - Median Emergency Department Visit Duration (Example Continuous Variable Measure Library)

Active as of 2019-09-03
Id: EXM55 - Median Emergency Department Visit Duration
Url: EXM55 - Median Emergency Department Visit Duration (Example Continuous Variable Measure Library)
Version: 5.0.0
Identifier:

value: EXM55

Name: EXM55
Title: EXM55 - Median Emergency Department Visit Duration (Example Continuous Variable Measure Library)
Status: active
Experimental: true
Type:

system: LibraryType

code: logic-library

Date: 2019-09-03
Publisher: Clinical Quality Information WG
Description:

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

Use Context:
codevaluedisplay
program eh-cah EH/CAH
Jurisdiction: US
Approval Date: 2019-08-03
Last Review Date: 2019-08-03
Related Artifacts:

Dependencies

Parameters:
NameTypeMinMaxIn/Out
Measurement PeriodPeriod01in
PatientPatient01out
Inpatient EncounterEncounter0*out
Initial PopulationEncounter0*out
Measure PopulationEncounter0*out
Measure Population ExclusionEncounter0*out
Stratification 1Encounter0*out
Stratification 2Encounter0*out
Stratification 3Encounter0*out
Data Requirements:
TypeProfileMSCode Filter
Patient http://hl7.org/fhir/StructureDefinition/Patient
Encounter http://hl7.org/fhir/StructureDefinition/Encounter
Encounter http://hl7.org/fhir/StructureDefinition/Encounter code filter:
path: type
value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292
Encounter http://hl7.org/fhir/StructureDefinition/Encounter code filter:
path: type
value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292
Condition http://hl7.org/fhir/StructureDefinition/Condition code filter:
path: id
Encounter http://hl7.org/fhir/StructureDefinition/Encounter code filter:
path: type
value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292
Content: text/cql
/*
This example is a work in progress and should not be considered a final specification
or recommendation for guidance. This example will help guide and direct the process
of finding conventions and usage patterns that meet the needs of the various stakeholders
in the measure development community.
*/

library EXM55 version '5.0.0'

using FHIR version '4.0.1'

include FHIRHelpers version '4.0.1' called FHIRHelpers

codesystem "Diagnosis Role": 'http://terminology.hl7.org/CodeSystem/diagnosis-role'

valueset "Emergency Department Visit" : 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292'
valueset "Psychiatric/Mental Health Patient" : 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.299'
valueset "Hospital Settings" : 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.126'

code "Billing": 'billing' from "Diagnosis Role" display 'Billing'

parameter "Measurement Period" Interval<DateTime>

context Patient

define "Initial Population" :
  "Inpatient Encounter" Encounter
    with ["Encounter" : "Emergency Department Visit"] ED
     such that ED.status = 'finished'
       and ED.period ends 1 hour or less before start of Encounter.period

define "Measure Population" :
  "Initial Population"

define "Inpatient Encounter" :
  ["Encounter"] Encounter
    where LengthInDays(Encounter.period) <= 120
      and Encounter.period ends during "Measurement Period"

define "Measure Population Exclusion" :
  "Inpatient Encounter" Encounter
    with ["Encounter" : "Emergency Department Visit"] ED
      such that ED.period ends 1 hour or less before start of Encounter.period
        and ED.status = 'finished'
        and ED.hospitalization.admitSource in "Hospital Settings"

define function "PrincipalDiagnosis"(Encounter Encounter):
	(singleton from (Encounter.diagnosis D where D.use ~ ToConcept("Billing") and D.rank.value = 1)) PD
		return singleton from ([Condition: id in "GetId"(PD.condition.reference)])

define function "LengthInDays"(Value Interval<DateTime>):
	difference in days between start of Value and end of Value

define function "GetId"(uri String):
	Last(Split(uri, '/'))

define "Stratification 1" :
  "Inpatient Encounter" Encounter
    where not (PrincipalDiagnosis(Encounter).code in "Psychiatric/Mental Health Patient")

define "Stratification 2" :
  "Inpatient Encounter" Encounter
    where PrincipalDiagnosis(Encounter).code in "Psychiatric/Mental Health Patient"

define "Stratification 3" :
  "Inpatient Encounter" Encounter
    where PrincipalDiagnosis(Encounter) is null

//Measure Observation
define function "Related ED Visit" (Encounter "Encounter" ) :
  Last(["Encounter" : "Emergency Department Visit"] ED
    where ED.status = 'finished'
      and ED.period ends 1 hour or less before start of Encounter.period
    sort by start of period )

define function "Measure Observation" (Encounter "Encounter" ) :
  duration in minutes of "Related ED Visit"(Encounter).period
Content: application/elm+xml
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Content: application/elm+json
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