Metadata Title Advanced Illness and Frailty Exclusion Library Version 5.12.000 Identifier urn:oid:2.16.840.1.113883.4.642.40.61.28.2 Status Draft Jurisdiction 001 from http://unstats.un.org/unsd/methods/m49/m49.htm Topic FHIR Topic CQL Steward (Publisher) HL7 International / Clinical Quality Information Description Advanced Illness and Frailty Exclusion Example Library Type logic-library from http://terminology.hl7.org/CodeSystem/library-type Dependency Description: Library FHIRHelpers Resource: http://hl7.org/fhir/uv/cql/Library/FHIRHelpers|4.0.1 Canonical URL: http://hl7.org/fhir/uv/cql/Library/FHIRHelpers|4.0.1 Dependency Description: Library Global Resource: MAT Global Common Functions FHIR Libraryversion: null5.0.000) Canonical URL: http://hl7.org/fhir/uv/cqm/Library/MATGlobalCommonFunctions|5.0.000 Dependency Description: Code System LOINC Resource: Logical Observation Identifiers, Names and Codes (LOINC) Canonical URL: http://loinc.org Dependency Description: Value Set Acute Inpatient Resource: Acute Inpatient Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1083 Dependency Description: Value Set Advanced Illness Resource: Advanced Illness Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1082 Dependency Description: Value Set Care Services in Long-Term Residential Facility Resource: Care Services in Long Term Residential Facility Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1014 Dependency Description: Value Set Dementia Medications Resource: Dementia Medications Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.196.12.1510 Dependency Description: Value Set ED Resource: ED Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1085 Dependency Description: Value Set Frailty Device Resource: Frailty Device Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.118.12.1300 Dependency Description: Value Set Frailty Diagnosis Resource: Frailty Diagnosis Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.113.12.1074 Dependency Description: Value Set Frailty Encounter Resource: Frailty Encounter Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1088 Dependency Description: Value Set Frailty Symptom Resource: Frailty Symptom Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.113.12.1075 Dependency Description: Value Set Nonacute Inpatient Resource: Nonacute Inpatient Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1084 Dependency Description: Value Set Nursing Facility Visit Resource: Nursing Facility Visit Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1012 Dependency Description: Value Set Observation Resource: Observation Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1086 Dependency Description: Value Set Outpatient Resource: Outpatient Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1087 Data Requirement Type: DeviceRequest Profile(s): DeviceRequest Code Filter(s): Path: code ValueSet: Frailty Device Data Requirement Type: Condition Profile(s): Condition Code Filter(s): Path: code ValueSet: Frailty Diagnosis Data Requirement Type: Encounter Profile(s): Encounter Code Filter(s): Path: type ValueSet: Frailty Encounter Data Requirement Type: Observation Profile(s): Observation Code Filter(s): Path: code ValueSet: Frailty Symptom Data Requirement Type: Encounter Profile(s): Encounter Code Filter(s): Path: type ValueSet: Outpatient Data Requirement Type: Encounter Profile(s): Encounter Code Filter(s): Path: type ValueSet: Observation Data Requirement Type: Encounter Profile(s): Encounter Code Filter(s): Path: type ValueSet: ED Data Requirement Type: Encounter Profile(s): Encounter Code Filter(s): Path: type ValueSet: Nonacute Inpatient Data Requirement Type: Encounter Profile(s): Encounter Code Filter(s): Path: type ValueSet: Acute Inpatient Data Requirement Type: Condition Profile(s): Condition Code Filter(s): Path: code ValueSet: Advanced Illness Data Requirement Type: MedicationDispense Profile(s): MedicationDispense Data Requirement Type: Medication Profile(s): Medication Data Requirement Type: Encounter Profile(s): Encounter Code Filter(s): Path: type ValueSet: Care Services in Long Term Residential Facility Data Requirement Type: Encounter Profile(s): Encounter Code Filter(s): Path: type ValueSet: Nursing Facility Visit Parameters Name Use Card. Type Documentation Measurement Period In 0..1 Period Patient Out 0..1 Patient Has Criteria Indicating Frailty Out 0..1 boolean Outpatient Encounters with Advanced Illness Out 0..* Encounter Inpatient Encounter with Advanced Illness Out 0..* Encounter Dementia Medications In Year Before or During Measurement Period Out 0..* MedicationDispense Advanced Illness and Frailty Exclusion Including Over Age 80 Out 0..1 boolean Advanced Illness and Frailty Exclusion Not Including Over Age 80 Out 0..1 boolean Long Term Care Periods During Measurement Period Out 0..* Period Long Term Care Periods Longer Than 90 Consecutive Days Out 0..1 boolean Library Content CQL Content /* 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 AdvancedIllnessandFrailtyExclusion version '5.12.000' using FHIR version '4.0.1' include hl7.fhir.uv.cql.FHIRHelpers version '4.0.1' called FHIRHelpers include MATGlobalCommonFunctions version '5.0.000' called Global codesystem "LOINC": 'http://loinc.org' valueset "Acute Inpatient": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1083' valueset "Advanced Illness": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1082' valueset "Care Services in Long-Term Residential Facility": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1014' valueset "Dementia Medications": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.196.12.1510' valueset "ED": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1085' valueset "Frailty Device": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.118.12.1300' valueset "Frailty Diagnosis": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.113.12.1074' valueset "Frailty Encounter": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1088' valueset "Frailty Symptom": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.113.12.1075' valueset "Nonacute Inpatient": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1084' valueset "Nursing Facility Visit": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1012' valueset "Observation": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1086' valueset "Outpatient": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1087' code "Birth date": '21112-8' from "LOINC" display 'Birth date' parameter "Measurement Period" Interval<DateTime> default Interval[@2019-01-01T00:00:00.0, @2020-01-01T00:00:00.0) context Patient define "Advanced Illness and Frailty Exclusion Including Over Age 80": //If the measure includes populations age 80 and older, then use this logic: ( Global."CalendarAgeInYearsAt"(FHIRHelpers.ToDate(Patient.birthDate), start of "Measurement Period")in Interval[66, 80] and "Has Criteria Indicating Frailty" and ( Count("Outpatient Encounters with Advanced Illness")>= 2 or exists ( "Inpatient Encounter with Advanced Illness" ) or exists "Dementia Medications In Year Before or During Measurement Period" ) ) or ( Global."CalendarAgeInYearsAt"(FHIRHelpers.ToDate(Patient.birthDate), start of "Measurement Period")>= 81 and "Has Criteria Indicating Frailty" ) define "Advanced Illness and Frailty Exclusion Not Including Over Age 80": //If the measure does NOT include populations age 80 and older, then use this logic: Global."CalendarAgeInYearsAt"(FHIRHelpers.ToDate(Patient.birthDate), start of "Measurement Period")>= 65 and "Has Criteria Indicating Frailty" and ( Count("Outpatient Encounters with Advanced Illness")>= 2 or exists ( "Inpatient Encounter with Advanced Illness" ) or exists "Dementia Medications In Year Before or During Measurement Period" ) define "Dementia Medications In Year Before or During Measurement Period": ["MedicationDispense": "Dementia Medications"] DementiaMed where DementiaMed.whenHandedOver during Interval[ ( start of "Measurement Period" - 1 year ), end of "Measurement Period" ] define "Has Criteria Indicating Frailty": //Ask Bryn about devices exists ( [DeviceRequest: "Frailty Device"] FrailtyDeviceOrder where FrailtyDeviceOrder.authoredOn during "Measurement Period" ) // DeviceUseStatement has a known issue with the publication tooling // so it is removed to allow this IG to publish until that is fixed //or exists ( [DeviceUseStatement: "Frailty Device"] FrailtyDeviceUse // where Global."Normalize Interval"(FrailtyDeviceUse.timing) overlaps "Measurement Period" //) or exists ( [Condition: "Frailty Diagnosis"] FrailtyDiagnosis where Global."Prevalence Period"(FrailtyDiagnosis) overlaps "Measurement Period" ) or exists ( [Encounter: "Frailty Encounter"] FrailtyEncounter where FrailtyEncounter.period overlaps "Measurement Period" ) or exists ( [Observation: "Frailty Symptom"] FrailtySymptomObservation where Global."Normalize Interval"(FrailtySymptomObservation.effective) overlaps "Measurement Period" ) define "Inpatient Encounter with Advanced Illness": [Encounter: "Acute Inpatient"] InpatientEncounter with [Condition: "Advanced Illness"] AdvancedIllnessDiagnosis such that exists ( InpatientEncounter.diagnosis.condition EncounterDiagnosis where EndsWith(EncounterDiagnosis.reference, AdvancedIllnessDiagnosis.id) ) and InpatientEncounter.period starts 2 years or less on or before end of "Measurement Period" // start here define "Long Term Care Periods During Measurement Period": ( [Encounter: "Care Services in Long-Term Residential Facility"] union [Encounter: "Nursing Facility Visit"] ) LongTermFacilityEncounter where LongTermFacilityEncounter.period overlaps "Measurement Period" return LongTermFacilityEncounter.period intersect "Measurement Period" define "Long Term Care Periods Longer Than 90 Consecutive Days": exists ( "Long Term Care Periods During Measurement Period" LongTermCareDuringMP where duration in days of LongTermCareDuringMP > 90 ) define "Outpatient Encounters with Advanced Illness": ( [Encounter: "Outpatient"] union [Encounter: "Observation"] union [Encounter: "ED"] union [Encounter: "Nonacute Inpatient"] ) OutpatientEncounter with [Condition: "Advanced Illness"] AdvancedIllnessDiagnosis such that exists ( OutpatientEncounter.diagnosis.condition EncounterDiagnosis where EndsWith(EncounterDiagnosis.reference, AdvancedIllnessDiagnosis.id) ) and OutpatientEncounter.period starts 2 years or less on or before end of "Measurement Period" define function "CumulativeDays"(Intervals List<Interval<DateTime>> ): Sum((collapse Intervals)CollapsedInterval return all duration in days of CollapsedInterval ) ELM XML Content Encoded data ELM JSON Content Encoded data Generated using version 0.5.4 of the sample-content-ig Liquid templates
Advanced Illness and Frailty Exclusion Library
HL7 International / Clinical Quality Information
Advanced Illness and Frailty Exclusion Example Library
Value Set Care Services in Long-Term Residential Facility
Outpatient Encounters with Advanced Illness
Inpatient Encounter with Advanced Illness
Dementia Medications In Year Before or During Measurement Period
Advanced Illness and Frailty Exclusion Including Over Age 80
Advanced Illness and Frailty Exclusion Not Including Over Age 80
Long Term Care Periods During Measurement Period
Long Term Care Periods Longer Than 90 Consecutive Days