Quality Measure Implementation Guide
2.0.0-ballot - STU 2 Ballot

Quality Measure Implementation Guide - Downloaded Version null See the Directory of published versions

## Measure: EXM Publishable Measure (Experimental)

Official URL: http://hl7.org/fhir/uv/cqm/Measure/measure-publishable-exm | Version: 2.0.0 | Highlight text changes?
Standards status: Informative Active as of 2025-08-13 | Computable Name: PublishableMeasureEXM
Other Identifiers: Short Name (use: usual, ), UUID:11873bc9-ca0a-4cf3-b8f2-605a950aac74 (use: official, ), UUID:b366f29b-347f-464e-8064-c83842d825c7 (use: official, ), Endorser (use: official, ), Publisher (use: official, ), OID:2.16.840.1.113883.4.642.40.61.29.23
Usage: Clinical Venue: EC
Copyright/Legal: Example Copyright Statement

An example FHIR-based publishable measure

Metadata
Title | EXM Publishable Measure
Version | 2.0.0
Short Name | EXM-123
GUID (Version Independent) | urn:uuid:11873bc9-ca0a-4cf3-b8f2-605a950aac74
GUID (Version Specific) | urn:uuid:b366f29b-347f-464e-8064-c83842d825c7
CMS Identifier | CMS-123
NQF Identifier | NQF-123
Identifier | urn:oid:2.16.840.1.113883.4.642.40.61.29.23
Effective Period | 2018-01-01 + 1 year(s)
Approval Date | 2019-02-17
Last Review Date | 2019-02-17
Experimental | true
Use Context | Clinical Venue = EC
Jurisdiction | 001 from http://unstats.un.org/unsd/methods/m49/m49.htm
Topic | Health Quality Measure Document
Steward (Publisher) | HL7 International / Clinical Quality Information
Developer | Example Measure Content Developer
Description | An example FHIR-based publishable measure
Purpose | This measure has been developed to support improvement in clinical care.
Copyright | Example Copyright Statement
Disclaimer | Example disclaimer
Measure Basis | Encounter
Measure Scoring | Continuous Variable
Improvement Notation | Increased score indicates improvement
Measure Type | process from http://terminology.hl7.org/CodeSystem/measure-type
Risk Adjustment | Risk adjustment for this measure is performed by...
Rate Aggregation | Rate aggregation for this measure is performed by...
Rationale | The rationale of this measure is to...
Clinical Recommendation Statement | The clinical recommendation statement for this measure is...
Citation | Linder, J.A., D.W. Bates, G.M. Lee, J.A. Finkelstein. 2005. 'Antibiotic treatment of children with sore throat.' JAMA 294(18):2315-2322. Content URL: https://pubmed.ncbi.nlm.nih.gov/16278359/ Document: null @ https://pubmed.ncbi.nlm.nih.gov/16278359/
Citation | Infectious Diseases Society of America. 2012. 'Clinical Practice Guideline for the Diagnosis and Management of Group A Streptococcal Pharyngitis: 2012 Update.' Content URL: https://pubmed.ncbi.nlm.nih.gov/23091044/ Document: null @ https://pubmed.ncbi.nlm.nih.gov/23091044/
Citation | Roberts, R.R., B. Hota, I. Ahmad, et al. 'Hospital and Societal Costs of Antimicrobial-Resistant Infections in a Chicago Teaching Hospital: Implications for Antibiotic Stewardship.' Clin Infect Dis. Oct 2009; 49(8):1175-84. Content URL: https://pubmed.ncbi.nlm.nih.gov/19739972/ Document: null @ https://pubmed.ncbi.nlm.nih.gov/19739972/
Citation | Example citation to draft publication Content URL: http://example.org/publications/1234 Document: null @ http://example.org/publications/1234
Guidance (Usage) | Users of this measure should be aware of...
Measure Group (Rate) (ID: primary)
Supplemental Data Elements
Supplemental Data Element | ID: sde-ethnicity Usage Code: Supplemental Data Description: No description provided Logic Definition: SDE Ethnicity
Supplemental Data Element | ID: sde-race Usage Code: Supplemental Data Description: No description provided Logic Definition: SDE Race
Supplemental Data Element | ID: sde-payer Usage Code: Supplemental Data Description: No description provided Logic Definition: SDE Payer
Supplemental Data Element | ID: sde-sex Usage Code: Supplemental Data Description: No description provided Logic Definition: SDE Sex
Measure Logic
Primary Library | Example Publishable Library
Contents | Population Criteria Logic Definitions Terminology Dependencies Data Requirements Parameters
Population Criteria
Measure Group (Rate) (ID: primary)
Logic Definitions
Logic Definition | Library Name: EXMPublishableLibrary
    define "SDE Sex":
      case
        when Patient.gender = 'male' then Code { code: 'M', system: 'http://hl7.org/fhir/v3/AdministrativeGender', display: 'Male' }
        when Patient.gender = 'female' then Code { code: 'F', system: 'http://hl7.org/fhir/v3/AdministrativeGender', display: 'Female' }
        else null
      end
Logic Definition | Library Name: EXMPublishableLibrary
    define "SDE Payer":
        [Coverage: type in "Payer"] Payer
          return {
            code: Payer.type,
            period: Payer.period
          }
Logic Definition | Library Name: EXMPublishableLibrary
    define "Inpatient Encounter" :
      ["Encounter"] Encounter
        where LengthInDays(Encounter.period) <= 120
          and Encounter.period ends during "Measurement Period"
Logic Definition | Library Name: EXMPublishableLibrary
    define "Initial Population" :
      "Inpatient Encounter" Encounter
Logic Definition | Library Name: EXMPublishableLibrary
    define "SDE Ethnicity":
      (flatten (
        Patient.extension Extension
          where Extension.url = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity'
            return Extension.extension
      )) E
        where E.url = 'ombCategory'
          or E.url = 'detailed'
        return E.value as Coding
Logic Definition | Library Name: EXMPublishableLibrary
    define "SDE Race":
      (flatten (
        Patient.extension Extension
          where Extension.url = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-race'
            return Extension.extension
      )) E
        where E.url = 'ombCategory'
          or E.url = 'detailed'
        return E.value as Coding
Logic Definition | Library Name: EXMPublishableLibrary
    define "Measure Population" :
      "Initial Population"
Logic Definition | Library Name: EXMPublishableLibrary
    define function "LengthInDays"(Value Interval<DateTime>):
    	difference in days between start of Value and end of Value
Logic Definition | Library Name: EXMPublishableLibrary
    define function "Measure Observation" (Encounter "Encounter" ) :
      duration in minutes of "Related ED Visit"(Encounter).period
Logic Definition | Library Name: EXMPublishableLibrary
    //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 )
Logic Definition | Library Name: FHIRHelpers
    define function ToString(value AdministrativeGender): value.value
Logic Definition | Library Name: FHIRHelpers
    /*
    @description: Converts the given [Period](https://hl7.org/fhir/datatypes.html#Period)
    value to a CQL DateTime Interval
    @comment: If the start value of the given period is unspecified, the starting
    boundary of the resulting interval will be open (meaning the start of the interval
    is unknown, as opposed to interpreted as the beginning of time).
    */
    define function ToInterval(period FHIR.Period):
        if period is null then
            null
        else
            if period."start" is null then
                Interval(period."start".value, period."end".value]
            else
                Interval[period."start".value, period."end".value]
Logic Definition | Library Name: FHIRHelpers
    define function ToString(value uri): value.value
Logic Definition | Library Name: FHIRHelpers
    define function ToString(value EncounterStatus): value.value
Terminology
Value Set | Description: Value set Payer Resource: Payer Type Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591`
Value Set | Description: Value set Emergency Department Visit Resource: Emergency Department Visit Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292`
Dependencies
Dependency | Description: FHIR model information Resource: http://hl7.org/fhir/uv/cql/Library/FHIR-ModelInfo|4.0.1 Canonical URL: `http://hl7.org/fhir/uv/cql/Library/FHIR-ModelInfo|4.0.1`
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`
Data Requirements
Data Requirement | Type: Patient Profile(s): Patient Must Support Elements: url, extension, value
Data Requirement | Type: Coverage Profile(s): Coverage Must Support Elements: type, period Code Filter(s): Path: type ValueSet: Payer Type
Data Requirement | Type: Encounter Profile(s): Encounter Must Support Elements: type, status, period Code Filter(s): Path: type ValueSet: Emergency Department Visit
Data Requirement | Type: Encounter Profile(s): Encounter Must Support Elements: period
Parameters
Name | Use | Card. | Type | Documentation
Measurement Period | In | 0..1 | Period |
SDE Sex | Out | 0..1 | Coding |
SDE Payer | Out | 0..* | Resource |
Initial Population | Out | 0..* | Encounter |
SDE Ethnicity | Out | 0..* | Coding |
SDE Race | Out | 0..* | Coding |
Measure Population | Out | 0..* | Encounter |
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