# EXM108 - Venous Thromboembolism Prophylaxis - Quality Measure Implementation Guide v2.0.0-ballot

## Measure: EXM108 - Venous Thromboembolism Prophylaxis (Experimental) 

 
This measure assesses the number of patients who received VTE prophylaxis or have documentation why no VTE prophylaxis was given the day of or the day after hospital admission or surgery end date for surgeries that start the day of or the day after hospital admission 

* Metadata: Title
  * ?: EXM108 - Venous Thromboembolism Prophylaxis
* Metadata: Version
  * ?: 8.2.000
* Metadata: Identifier
  * ?: 108
* Metadata: Identifier
  * ?: urn:oid:2.16.840.1.113883.4.642.40.61.29.3
* Metadata: Effective Period
  * ?: 2018-01-01 through 2018-12-31
* Metadata: Approval Date
  * ?: 2019-03-08
* Metadata: Last Review Date
  * ?: 2019-03-08
* Metadata: Experimental
  * ?: true
* Metadata: Use Context
  * ?: Clinical Venue = EH
* Metadata: Jurisdiction
  * ?: 001 from[http://unstats.un.org/unsd/methods/m49/m49.htm](http://unstats.un.org/unsd/methods/m49/m49.htm)
* Metadata: Topic
  * ?: Health Quality Measure Document
* Metadata: Steward (Publisher)
  * ?: HL7 International / Clinical Quality Information
* Metadata: Description
  * ?: This measure assesses the number of patients who received VTE prophylaxis or have documentation why no VTE prophylaxis was given the day of or the day after hospital admission or surgery end date for surgeries that start the day of or the day after hospital admission
* Metadata: Copyright
  * ?: Measure specifications are in the Public Domain.LOINC(R) is a registered trademark of the Regenstrief Institute.This material contains SNOMED Clinical Terms(R) (SNOMED CT(C)) copyright 2004-2017 International Health Terminology Standards Development Organization. All rights reserved.
* Metadata: Disclaimer
  * ?: These performance measures are not clinical guidelines and do not establish a standard of medical care, and have not been tested for all potential applications. The measures and specifications are provided without warranty
* Metadata: Measure Basis
  * ?: Encounter
* Metadata: Measure Scoring
  * ?: Proportion
* Metadata: Improvement Notation
  * ?: Increased score indicates improvement
* Metadata: Measure Type
  * ?: process from[http://terminology.hl7.org/CodeSystem/measure-type](http://terminology.hl7.org/7.1.0/CodeSystem-measure-type.html)
* Metadata: Rationale
  * ?: Hospitalized patients at high-risk for VTE may develop an asymptomatic deep vein thrombosis (DVT), and die from pulmonary embolism (PE) even before the diagnosis is suspected. The majority of fatal events occur as sudden or abrupt death, underscoring the importance of prevention as the most critical action step for reducing death from PE (Geerts, et al, 2008).The estimated annual incidence of deep-vein thrombosis (DVT) and pulmonary embolism (PE), known collectively as venous thromboembolism (VTE), is approximately 900,000 (Geerts, et al, 2008). Approximately two-thirds of cases of DVT or PE are associated with recent hospitalization. This is consistent with the 2001 report by The Agency for Healthcare Research and Quality (AHRQ). AHRQ indicates that "the appropriate application of effective preventive measures in hospitals has major potential for improving patient safety by reducing the incidence of venous thromboembolism" (Shojania, 2001).Despite its proven effectiveness, rates of appropriate thromboprophylaxis remain low in both medical and surgical patients. A recent analysis from the ENDORSE survey, which evaluated prophylaxis rates in 17,084 major surgery patients, found that more than one third of patients at risk for VTE (38%) did not receive prophylaxis and that rates varied by surgery type (Cohen, et al., 2008).In a review of evidence-based patient safety practices, the Agency for Healthcare Research and Quality defined thromboprophylaxis against VTE as the "number one patient safety practice" for hospitalized patients (Shojania, 2001). Updated "safe practices" published by the National Quality Forum (NQF) recommend routine evaluation of hospitalized patients for risk of VTE and use of appropriate prophylaxis (National Quality Forum. National Voluntary Consensus Standards for Prevention and Care of Venous Thromboembolism, 2006).As noted by the ACCP, a vast number of randomized clinical trials provide irrefutable evidence that thromboprophylaxis reduces VTE events, and there are studies that have also shown that fatal PE is prevented by thromboprophylaxis (Geerts, et al. 2008).Some select surgeries have previously been monitored in the Surgical Care Improvement Project; since performance on these surgeries has achieved very high levels, they are not included in this measure.
* Metadata: Clinical Recommendation Statement
  * ?: Failure to recognize and protect patients at risk for venous thromboembolism (VTE) increases the chances for acutely ill hospitalized patients at high risk for developing a deep vein thrombosis or dying from a pulmonary emboli. Screening all patients is the only evidence based practice in reducing incidence of disease. All hospitalized patients should be evaluated for primary VTE prophylaxis, and given appropriate prophylaxis when indicated.
* Metadata: Measure Group (Rate) (ID: primary)
* Metadata: Supplemental Data Elements
* Metadata: Supplemental Data Element
  * ?: **Usage Code**:Supplemental Data**Description**: No description provided**Logic Definition**:[SDE Ethnicity](#exm108-sde-ethnicity)
* Metadata: Supplemental Data Element
  * ?: **Usage Code**:Supplemental Data**Description**: No description provided**Logic Definition**:[SDE Payer](#exm108-sde-payer)
* Metadata: Supplemental Data Element
  * ?: **Usage Code**:Supplemental Data**Description**: No description provided**Logic Definition**:[SDE Race](#exm108-sde-race)
* Metadata: Supplemental Data Element
  * ?: **Usage Code**:Supplemental Data**Description**: No description provided**Logic Definition**:[SDE Sex](#exm108-sde-sex)
* Metadata: Measure Logic
* Metadata: Primary Library
  * ?: [EXM108 - Venous Thromboembolism Prophylaxis Library](Library-EXM108.md)
* Metadata: Contents
  * ?: **[Population Criteria](#population-criteria)****[Logic Definitions](#definitions)****[Terminology](#terminology)****[Dependencies](#dependencies)****[Data Requirements](#data-requirements)****[Parameters](#parameters)**
* Metadata:  Population Criteria
* Metadata: Measure Group (Rate) (ID: primary)
* Metadata:  Logic Definitions
* Metadata: Logic Definition
  * ?: **Library Name:**SupplementalDataElements
* Metadata:  ````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````
* Metadata: Logic Definition
  * ?: **Library Name:**SupplementalDataElements
* Metadata:  ````define "SDE Payer": [Coverage: type in "Payer"] Payer return { code: Payer.type, period: Payer.period }````
* Metadata: Logic Definition
  * ?: **Library Name:**SupplementalDataElements
* Metadata:  ````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````
* Metadata: Logic Definition
  * ?: **Library Name:**SupplementalDataElements
* Metadata:  ````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````
* Metadata: Logic Definition
  * ?: **Library Name:**TJCOverall
* Metadata:  ````define function "CalendarDayOfOrDayAfter"(StartValue DateTime ): Interval(Global."ToDate"(StartValue), Global."ToDate"(StartValue + 2 days))````
* Metadata: Logic Definition
  * ?: **Library Name:**VTEICU
* Metadata:  ````define function "FromDayOfStartOfHospitalizationToDayAfterAdmission"(Encounter FHIR.Encounter ): Interval[Global."ToDate"(start of Global."HospitalizationWithObservation"(Encounter)), Global."ToDate"(start of Encounter.period + 2 days))````
* Metadata: Logic Definition
  * ?: **Library Name:**EXM108
* Metadata:  ````define "SDE Sex": SDE."SDE Sex"````
* Metadata: Logic Definition
  * ?: **Library Name:**EXM108
* Metadata:  ````define "Admission Without VTE or Obstetrical Conditions": Global."Inpatient Encounter" InpatientEncounter where not exists ( (Global.EncounterDiagnosis(InpatientEncounter)) EncounterDiagnosis where EncounterDiagnosis.code in "Obstetrics" or EncounterDiagnosis.code in "Venous Thromboembolism" or EncounterDiagnosis.code in "Obstetrics VTE" )````
* Metadata: Logic Definition
  * ?: **Library Name:**EXM108
* Metadata:  ````// Note: added FHIRHelpers.ToDate() in R4 define "Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions": ( Global."Inpatient Encounter" InpatientEncounter where Global."CalendarAgeInYearsAt"(FHIRHelpers.ToDate(Patient.birthDate), start of InpatientEncounter.period) >= 18 ) intersect "Admission Without VTE or Obstetrical Conditions"````
* Metadata: Logic Definition
  * ?: **Library Name:**EXM108
* Metadata:  ````// 10/29: Replaced DeviceUseStatement with Procedure with a new value set and procedure.usdCode for specifying devices define "VTE Prophylaxis by Medication Administered or Device Applied": ( ["MedicationAdministration": medication in "Low Dose Unfractionated Heparin for VTE Prophylaxis"] VTEMedication where VTEMedication.status ='completed' and VTEMedication.dosage.route in "Subcutaneous route" ) union (["MedicationAdministration": medication in "Low Molecular Weight Heparin for VTE Prophylaxis"] LMWH where LMWH.status = 'completed') union (["MedicationAdministration": medication in "Injectable Factor Xa Inhibitor for VTE Prophylaxis"] FactorXa where FactorXa.status = 'completed') union (["MedicationAdministration": medication in "Warfarin"] Warfarin where Warfarin.status = 'completed') union ( ["Procedure": "Device Application"] DeviceApplied where DeviceApplied.status = 'complete' and (DeviceApplied.usedCode in "Intermittent pneumatic compression devices (IPC)" or DeviceApplied.usedCode in"Venous foot pumps (VFP)" or DeviceApplied.usedCode in "Graduated compression stockings (GCS)" ) )````
* Metadata: Logic Definition
  * ?: **Library Name:**EXM108
* Metadata:  ````define "Encounter With VTE Prophylaxis Received on Day of or Day After Admission or Procedure": ( from "Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter, "VTE Prophylaxis by Medication Administered or Device Applied" VTEProphylaxis where Coalesce(Global."Normalize Interval"(VTEProphylaxis.effective), Global."Normalize Interval"(VTEProphylaxis.performed)) starts during TJC."CalendarDayOfOrDayAfter"(start of QualifyingEncounter.period) return QualifyingEncounter ) union ( from "Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter, ["Procedure": "General or Neuraxial Anesthesia"] AnesthesiaProcedure, "VTE Prophylaxis by Medication Administered or Device Applied" VTEProphylaxis where Global."Normalize Interval"(AnesthesiaProcedure.performed) ends 1 day after day of start of QualifyingEncounter.period and Coalesce(Global."Normalize Interval"(VTEProphylaxis.effective), Global."Normalize Interval"(VTEProphylaxis.performed)) starts during TJC."CalendarDayOfOrDayAfter"(end of Global."Normalize Interval"(AnesthesiaProcedure.performed)) return QualifyingEncounter )````
* Metadata: Logic Definition
  * ?: **Library Name:**EXM108
* Metadata:  ````define "Encounter With Medication Oral Factor Xa Inhibitor Administered on Day of or Day After Admission or Procedure": ( from "Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter, ["MedicationAdministration": medication in "Oral Factor Xa Inhibitor for VTE Prophylaxis or VTE Treatment"] FactorXaMedication where FactorXaMedication.status = 'completed' and Global."Normalize Interval"(FactorXaMedication.effective) starts during TJC."CalendarDayOfOrDayAfter"(start of QualifyingEncounter.period) return QualifyingEncounter ) union ( from "Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter, ["Procedure": "General or Neuraxial Anesthesia"] AnesthesiaProcedure, ["MedicationAdministration": medication in "Oral Factor Xa Inhibitor for VTE Prophylaxis or VTE Treatment"] FactorXaMedication where FactorXaMedication.status = 'completed' and AnesthesiaProcedure.status = 'completed' and Global."Normalize Interval"(AnesthesiaProcedure.performed) ends 1 day after day of start of QualifyingEncounter.period and Global."Normalize Interval"(FactorXaMedication.effective) starts during TJC."CalendarDayOfOrDayAfter"(end of Global."Normalize Interval"(AnesthesiaProcedure.performed)) return QualifyingEncounter )````
* Metadata: Logic Definition
  * ?: **Library Name:**EXM108
* Metadata:  ````define "Encounter With Prior or Present Diagnosis of Atrial Fibrillation or VTE": ( "Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter with ["Condition": code in "Atrial Fibrillation/Flutter"] AtrialFibrillation such that FHIRHelpers.ToConcept(AtrialFibrillation.clinicalStatus) in { Global."active", Global."recurrence", Global."relapse" } and Global."Normalize Interval"(AtrialFibrillation.onset) starts on or before end of QualifyingEncounter.period ) union ( "Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter where Global.EncounterDiagnosis(QualifyingEncounter).code in "Atrial Fibrillation/Flutter" ) union ( "Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter with ["Condition": code in "Venous Thromboembolism"] VTEDiagnosis such that FHIRHelpers.ToConcept(VTEDiagnosis.clinicalStatus) in { Global."inactive", Global."remission", Global."resolved" } //and VTEDiagnosis.verificationStatus = 'confirmed' and Global."Normalize Interval"(VTEDiagnosis.onset) before start of QualifyingEncounter.period )````
* Metadata: Logic Definition
  * ?: **Library Name:**EXM108
* Metadata:  ````define "Encounter With Prior or Present Procedure of Hip or Knee Replacement Surgery": "Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter with ( ["Procedure": "Hip Replacement Surgery"] union ["Procedure": "Knee Replacement Surgery"] ) HipKneeProcedure such that HipKneeProcedure.status = 'completed' and Global."Normalize Interval"(HipKneeProcedure.performed) starts on or before end of QualifyingEncounter.period````
* Metadata: Logic Definition
  * ?: **Library Name:**EXM108
* Metadata:  ````define "Is In Low Risk for VTE or On Anticoagulant": ( ["Observation": "Risk for venous thromboembolism"] VTERiskAssessment where VTERiskAssessment.value in "Low Risk" and VTERiskAssessment.status in {'final','amended', 'corrected'} ) union ( ["Observation": "INR"] INRLabTest where INRLabTest.value as Quantity > 3.0 and INRLabTest.status in {'final','amended', 'corrected'} return "Observation" { id: INRLabTest.id, effective: INRLabTest.issued } ) union ((( ["MedicationAdministration": "Unfractionated Heparin"] UnfractionatedHeparin where UnfractionatedHeparin.dosage.route in "Intravenous route" ) union ["MedicationAdministration": "Direct Thrombin Inhibitor"] union ["MedicationAdministration": "Glycoprotein IIb/IIIa Inhibitors"] ) AnticoagulantMedication where AnticoagulantMedication.status = 'complete' return "Observation" { id: AnticoagulantMedication.id, effective: AnticoagulantMedication.effective } )````
* Metadata: Logic Definition
  * ?: **Library Name:**EXM108
* Metadata:  ````define "Low Risk for VTE or Anticoagulant Administered From Day of Start of Hospitalization To Day After Admission": "Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter with "Is In Low Risk for VTE or On Anticoagulant" VTERiskAssessment such that Global."Normalize Interval"(VTERiskAssessment.effective) starts during VTEICU."FromDayOfStartOfHospitalizationToDayAfterAdmission"(QualifyingEncounter)````
* Metadata: Logic Definition
  * ?: **Library Name:**EXM108
* Metadata:  ````define "Low Risk for VTE or Anticoagulant Administered on Day of or Day After Procedure": from "Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter, ["Procedure": "General or Neuraxial Anesthesia"] AnesthesiaProcedure, "Is In Low Risk for VTE or On Anticoagulant" VTERiskAssessment where Global."Normalize Interval"(AnesthesiaProcedure.performed) ends 1 day after day of start of QualifyingEncounter.period and Global."Normalize Interval"(VTERiskAssessment.effective) starts during TJC."CalendarDayOfOrDayAfter"(end of Global."Normalize Interval"(AnesthesiaProcedure.performed)) return QualifyingEncounter````
* Metadata: Logic Definition
  * ?: **Library Name:**EXM108
* Metadata:  ````define "Encounter With Low Risk for VTE or Anticoagulant Administered": "Low Risk for VTE or Anticoagulant Administered From Day of Start of Hospitalization To Day After Admission" union "Low Risk for VTE or Anticoagulant Administered on Day of or Day After Procedure"````
* Metadata: Logic Definition
  * ?: **Library Name:**EXM108
* Metadata:  ````define "No VTE Prophylaxis Medication Administered or Ordered": (( ["MedicationAdministration": medication in "Low Dose Unfractionated Heparin for VTE Prophylaxis"] union ["MedicationAdministration": medication in "Low Molecular Weight Heparin for VTE Prophylaxis"] union ["MedicationAdministration": medication in "Injectable Factor Xa Inhibitor for VTE Prophylaxis"] union ["MedicationAdministration": medication in "Warfarin"] ) MedicationAdm where MedicationAdm.status = 'not-done' ) union (( ["MedicationRequest": medication in "Low Dose Unfractionated Heparin for VTE Prophylaxis"] union ["MedicationRequest": medication in "Low Molecular Weight Heparin for VTE Prophylaxis"] union ["MedicationRequest": medication in "Injectable Factor Xa Inhibitor for VTE Prophylaxis"] union ["MedicationRequest": medication in "Warfarin"] ) MedicationOrder where MedicationOrder.doNotPerform is true and MedicationOrder.status in {'completed', 'cancelled'} //11/5 discussion: all expressions for QI-Core must include a status. //Therefore, we need ServiceRequest.status = completed; and MedicationRequest.status = cancelled (or completed, since cancelled indicates it was once ordered but intentionally never filled). //So the not done issue is handled by ServiceRequest.doNotPerform = True Or MedicationRequest.doNotPerform = True )````
* Metadata: Logic Definition
  * ?: **Library Name:**EXM108
* Metadata:  ````define "No VTE Prophylaxis Medication Due to Medical Reason From Day of Start of Hospitalization To Day After Admission": "Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter with "No VTE Prophylaxis Medication Administered or Ordered" NoVTEMedication such that Coalesce(NoVTEMedication.statusReason,NoVTEMedication.reasonCode) in "Medical Reason" and Coalesce(NoVTEMedication.authoredOn, start of Global."Normalize Interval"(NoVTEMedication.effective)) during VTEICU."FromDayOfStartOfHospitalizationToDayAfterAdmission"(QualifyingEncounter)````
* Metadata: Logic Definition
  * ?: **Library Name:**EXM108
* Metadata:  ````define "No VTE Prophylaxis Device Applied or Ordered": (( ["ServiceRequest": "Venous foot pumps (VFP)"] union ["ServiceRequest": "Intermittent pneumatic compression devices (IPC)"] union ["ServiceRequest": "Graduated compression stockings (GCS)"] ) DeviceOrder where DeviceOrder.status = 'completed' and DeviceOrder.doNotPerform is true return {id: DeviceOrder.id, requestStatusReason: GetStatusReason(DeviceOrder), authoredOn: DeviceOrder.authoredOn} ) union ( ["Procedure": "Device Application"] DeviceApplied let DeviceNotDoneTiming: Global.GetExtension(DeviceApplied, 'qicore-recorded').value where (DeviceApplied.usedCode in "Intermittent pneumatic compression devices (IPC)" or DeviceApplied.usedCode in "Venous foot pumps (VFP)" or DeviceApplied.usedCode in "Graduated compression stockings (GCS)" ) and DeviceApplied.status = 'not-done' return {id: DeviceApplied.id, requestStatusReason: DeviceApplied.statusReason, authoredOn: DeviceNotDoneTiming} )````
* Metadata: Logic Definition
  * ?: **Library Name:**EXM108
* Metadata:  ````define "No VTE Prophylaxis Device Due to Medical Reason From Day of Start of Hospitalization To Day After Admission": "Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter with "No VTE Prophylaxis Device Applied or Ordered" NoVTEDevice such that NoVTEDevice.requestStatusReason in "Medical Reason" and NoVTEDevice.authoredOn during VTEICU."FromDayOfStartOfHospitalizationToDayAfterAdmission"(QualifyingEncounter)````
* Metadata: Logic Definition
  * ?: **Library Name:**EXM108
* Metadata:  ````define "No VTE Prophylaxis Medication Due to Medical Reason on Day of or Day After Procedure": from "Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter, ["Procedure": "General or Neuraxial Anesthesia"] AnesthesiaProcedure, "No VTE Prophylaxis Medication Administered or Ordered" NoVTEMedication where Coalesce(NoVTEMedication.statusReason,NoVTEMedication.reasonCode) in "Medical Reason" and AnesthesiaProcedure.status = 'completed' and Global."Normalize Interval"(AnesthesiaProcedure.performed) ends 1 day after day of start of QualifyingEncounter.period and Coalesce(NoVTEMedication.authoredOn, start of Global."Normalize Interval"(NoVTEMedication.effective)) during TJC."CalendarDayOfOrDayAfter"(end of Global."Normalize Interval"(AnesthesiaProcedure.performed)) return QualifyingEncounter````
* Metadata: Logic Definition
  * ?: **Library Name:**EXM108
* Metadata:  ````define "No VTE Prophylaxis Device Due to Medical Reason on Day of or Day After Procedure": from "Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter, ["Procedure": "General or Neuraxial Anesthesia"] AnesthesiaProcedure, "No VTE Prophylaxis Device Applied or Ordered" NoVTEDevice where NoVTEDevice.requestStatusReason in "Medical Reason" and AnesthesiaProcedure.status = 'completed' and Global."Normalize Interval"(AnesthesiaProcedure.performed) ends 1 day after day of start of QualifyingEncounter.period and NoVTEDevice.authoredOn during TJC."CalendarDayOfOrDayAfter"(end of Global."Normalize Interval"(AnesthesiaProcedure.performed)) return QualifyingEncounter````
* Metadata: Logic Definition
  * ?: **Library Name:**EXM108
* Metadata:  ````define "Encounter With No VTE Prophylaxis Due to Medical Reason": ( "No VTE Prophylaxis Medication Due to Medical Reason From Day of Start of Hospitalization To Day After Admission" intersect "No VTE Prophylaxis Device Due to Medical Reason From Day of Start of Hospitalization To Day After Admission" ) union ( "No VTE Prophylaxis Medication Due to Medical Reason on Day of or Day After Procedure" intersect "No VTE Prophylaxis Device Due to Medical Reason on Day of or Day After Procedure" )````
* Metadata: Logic Definition
  * ?: **Library Name:**EXM108
* Metadata:  ````define "No VTE Prophylaxis Medication or Device Due to Patient Refusal": ( "No VTE Prophylaxis Medication Administered or Ordered" NoVTEMedication where Coalesce(NoVTEMedication.statusReason,NoVTEMedication.reasonCode) in "Patient Refusal" ) union ("No VTE Prophylaxis Device Applied or Ordered" NoVTEDevice where NoVTEDevice.requestStatusReason in "Patient Refusal" )````
* Metadata: Logic Definition
  * ?: **Library Name:**EXM108
* Metadata:  ````define "No VTE Prophylaxis Due to Patient Refusal From Day of Start of Hospitalization To Day After Admission": "Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter with "No VTE Prophylaxis Medication or Device Due to Patient Refusal" PatientRefusal such that Coalesce(start of Global."Normalize Interval"(PatientRefusal.effective), PatientRefusal.authoredOn) during VTEICU."FromDayOfStartOfHospitalizationToDayAfterAdmission"(QualifyingEncounter)````
* Metadata: Logic Definition
  * ?: **Library Name:**EXM108
* Metadata:  ````define "No VTE Prophylaxis Due to Patient Refusal on Day of or Day After Procedure": from "Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter, ["Procedure": "General or Neuraxial Anesthesia"] AnesthesiaProcedure, "No VTE Prophylaxis Medication or Device Due to Patient Refusal" PatientRefusal where Global."Normalize Interval"(AnesthesiaProcedure.performed) ends 1 day after day of start of QualifyingEncounter.period and Coalesce(start of Global."Normalize Interval"(PatientRefusal.effective), PatientRefusal.authoredOn) during TJC."CalendarDayOfOrDayAfter"(end of Global."Normalize Interval"(AnesthesiaProcedure.performed)) return QualifyingEncounter````
* Metadata: Logic Definition
  * ?: **Library Name:**EXM108
* Metadata:  ````define "Encounter With No VTE Prophylaxis Due to Patient Refusal": "No VTE Prophylaxis Due to Patient Refusal From Day of Start of Hospitalization To Day After Admission" union "No VTE Prophylaxis Due to Patient Refusal on Day of or Day After Procedure"````
* Metadata: Logic Definition
  * ?: **Library Name:**EXM108
* Metadata:  ````define "Numerator": "Encounter With VTE Prophylaxis Received on Day of or Day After Admission or Procedure" union ( "Encounter With Medication Oral Factor Xa Inhibitor Administered on Day of or Day After Admission or Procedure" intersect ( "Encounter With Prior or Present Diagnosis of Atrial Fibrillation or VTE" union "Encounter With Prior or Present Procedure of Hip or Knee Replacement Surgery" ) ) union "Encounter With Low Risk for VTE or Anticoagulant Administered" union "Encounter With No VTE Prophylaxis Due to Medical Reason" union "Encounter With No VTE Prophylaxis Due to Patient Refusal"````
* Metadata: Logic Definition
  * ?: **Library Name:**EXM108
* Metadata:  ````define "Initial Population": "Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions"````
* Metadata: Logic Definition
  * ?: **Library Name:**EXM108
* Metadata:  ````define "Denominator": "Initial Population"````
* Metadata: Logic Definition
  * ?: **Library Name:**EXM108
* Metadata:  ````define "SDE Payer": SDE."SDE Payer"````
* Metadata: Logic Definition
  * ?: **Library Name:**EXM108
* Metadata:  ````define "SDE Ethnicity": SDE."SDE Ethnicity"````
* Metadata: Logic Definition
  * ?: **Library Name:**EXM108
* Metadata:  ````define "Encounter Less Than 2 Days": "Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter where Global."LengthInDays"(QualifyingEncounter.period)< 2````
* Metadata: Logic Definition
  * ?: **Library Name:**EXM108
* Metadata:  ````define "Encounter With ICU Location Stay 1 Day or More": "Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter where exists ( QualifyingEncounter.location Location where Global.GetLocation(Location.location).type in "Intensive Care Unit" and Global."LengthInDays"(Location.period)>= 1 and Location.period starts during TJC."CalendarDayOfOrDayAfter"(start of QualifyingEncounter.period) )````
* Metadata: Logic Definition
  * ?: **Library Name:**EXM108
* Metadata:  ````define "Encounter With Principal Diagnosis of Mental Disorder or Stroke": "Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter where Global."PrincipalDiagnosis"(QualifyingEncounter).code in "Mental Health Diagnoses" or Global."PrincipalDiagnosis"(QualifyingEncounter).code in "Hemorrhagic Stroke" or Global."PrincipalDiagnosis"(QualifyingEncounter).code in "Ischemic Stroke"````
* Metadata: Logic Definition
  * ?: **Library Name:**EXM108
* Metadata:  ````define "SCIP VTE Selected Surgery": ( ["Procedure": "General Surgery"] union ["Procedure": "Gynecological Surgery"] union ["Procedure": "Hip Fracture Surgery"] union ["Procedure": "Hip Replacement Surgery"] union ["Procedure": "Intracranial Neurosurgery"] union ["Procedure": "Knee Replacement Surgery"] union ["Procedure": "Urological Surgery"] ) Procedure where Procedure.status = 'completed'````
* Metadata: Logic Definition
  * ?: **Library Name:**EXM108
* Metadata:  ````define "Encounter With Principal Procedure of SCIP VTE Selected Surgery": from "Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter, "SCIP VTE Selected Surgery" SelectedProcedure let EncounterProcedure: Global.GetExtension(QualifyingEncounter, 'qicore-encounter-procedure') where FHIRHelpers.ToInteger(Global.GetExtension(EncounterProcedure, 'rank').value as FHIR.positiveInt) = 1 and Global.GetId(FHIRHelpers.ToString((Global.GetExtension(EncounterProcedure, 'procedure').value as FHIR.Reference).reference)) = SelectedProcedure.id and Global."Normalize Interval"(SelectedProcedure.performed) during QualifyingEncounter.period````
* Metadata: Logic Definition
  * ?: **Library Name:**EXM108
* Metadata:  ````define "Intervention Comfort Measures": (["ServiceRequest": "Comfort Measures"] P where P.intent = 'order' ) union (["Procedure": "Comfort Measures"] InterventionPerformed where InterventionPerformed.status in {'completed', 'in-progress'})````
* Metadata: Logic Definition
  * ?: **Library Name:**EXM108
* Metadata:  ````define "Encounter With Intervention Comfort Measures From Day of Start of Hospitalization To Day After Admission": "Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter with "Intervention Comfort Measures" ComfortMeasure such that Coalesce(start of Global."Normalize Interval"(ComfortMeasure.performed), ComfortMeasure.authoredOn) during VTEICU."FromDayOfStartOfHospitalizationToDayAfterAdmission"(QualifyingEncounter)````
* Metadata: Logic Definition
  * ?: **Library Name:**EXM108
* Metadata:  ````define "Encounter With Intervention Comfort Measures on Day of or Day After Procedure": from "Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter, ["Procedure": "General or Neuraxial Anesthesia"] AnesthesiaProcedure, "Intervention Comfort Measures" ComfortMeasure where AnesthesiaProcedure.status = 'completed' and Global."Normalize Interval"(AnesthesiaProcedure.performed) ends 1 day after day of start of QualifyingEncounter.period and Coalesce(start of Global."Normalize Interval"(ComfortMeasure.performed), ComfortMeasure.authoredOn) during TJC."CalendarDayOfOrDayAfter"(end of Global."Normalize Interval"(AnesthesiaProcedure.performed)) return QualifyingEncounter````
* Metadata: Logic Definition
  * ?: **Library Name:**EXM108
* Metadata:  ````define "Denominator Exclusion": "Encounter Less Than 2 Days" union "Encounter With ICU Location Stay 1 Day or More" union "Encounter With Principal Diagnosis of Mental Disorder or Stroke" union "Encounter With Principal Procedure of SCIP VTE Selected Surgery" union "Encounter With Intervention Comfort Measures From Day of Start of Hospitalization To Day After Admission" union "Encounter With Intervention Comfort Measures on Day of or Day After Procedure"````
* Metadata: Logic Definition
  * ?: **Library Name:**EXM108
* Metadata:  ````define "SDE Race": SDE."SDE Race"````
* Metadata: Logic Definition
  * ?: **Library Name:**EXM108
* Metadata:  ````//11/5: ServiceRequest not done reason is an extension in QI-Core R4 as ServiceRequest.extension:statusReason define function GetStatusReason(requestReason ServiceRequest): Global.GetBaseExtension(requestReason, 'request-statusReason')````
* Metadata: Logic Definition
  * ?: **Library Name:**MATGlobalCommonFunctions
* Metadata:  ````define "Inpatient Encounter": [Encounter: "Encounter Inpatient"] EncounterInpatient where EncounterInpatient.status = 'finished' and "LengthInDays"(EncounterInpatient.period) <= 120 and EncounterInpatient.period ends during "Measurement Period"````
* Metadata: Logic Definition
  * ?: **Library Name:**MATGlobalCommonFunctions
* Metadata:  ````define function "LengthInDays"(Value Interval<DateTime>): difference in days between start of Value and end of Value````
* Metadata: Logic Definition
  * ?: **Library Name:**MATGlobalCommonFunctions
* Metadata:  ````define function "CalendarAgeInYearsAt"(BirthDateTime DateTime, AsOf DateTime): years between ToDate(BirthDateTime)and ToDate(AsOf)````
* Metadata: Logic Definition
  * ?: **Library Name:**MATGlobalCommonFunctions
* Metadata:  ````define function "ToDate"(Value DateTime): DateTime(year from Value, month from Value, day from Value, 0, 0, 0, 0, timezoneoffset from Value)````
* Metadata: Logic Definition
  * ?: **Library Name:**MATGlobalCommonFunctions
* Metadata:  ````define function "EncounterDiagnosis"(Encounter Encounter): Encounter.diagnosis D return singleton from ([Condition] C where C.id = "GetId"(D.condition.reference))````
* Metadata: Logic Definition
  * ?: **Library Name:**MATGlobalCommonFunctions
* Metadata:  ````define function "GetId"(uri String): Last(Split(uri, '/'))````
* Metadata: Logic Definition
  * ?: **Library Name:**MATGlobalCommonFunctions
* Metadata:  ````/* * * CQFMeasures Common Logic * */ define function "Normalize Interval"(choice Choice<FHIR.dateTime, FHIR.Period, FHIR.Timing, FHIR.instant, FHIR.string, FHIR.Age, FHIR.Range>): case when choice is FHIR.dateTime then Interval[FHIRHelpers.ToDateTime(choice as FHIR.dateTime), FHIRHelpers.ToDateTime(choice as FHIR.dateTime)] when choice is FHIR.Period then FHIRHelpers.ToInterval(choice as FHIR.Period) when choice is FHIR.instant then Interval[FHIRHelpers.ToDateTime(choice as FHIR.instant), FHIRHelpers.ToDateTime(choice as FHIR.instant)] when choice is FHIR.Age then Interval[FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(choice as FHIR.Age), FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(choice as FHIR.Age) + 1 year) when choice is FHIR.Range then Interval[FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity((choice as FHIR.Range).low), FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity((choice as FHIR.Range).high) + 1 year) when choice is FHIR.Timing then Message(null as Interval<DateTime>, true, '1', 'Error', 'Cannot compute a single interval from a Timing type') when choice is FHIR.string then Message(null as Interval<DateTime>, true, '1', 'Error', 'Cannot compute an interval from a String value') else null as Interval<DateTime> end````
* Metadata: Logic Definition
  * ?: **Library Name:**MATGlobalCommonFunctions
* Metadata:  ````define function "HospitalizationWithObservation"(TheEncounter FHIR.Encounter): TheEncounter Visit let ObsVisit: Last([Encounter: "Observation Services"] LastObs where LastObs.period ends 1 hour or less on or before start of Visit.period sort by end of period ), VisitStart: Coalesce(start of ObsVisit.period, start of Visit.period), EDVisit: Last([Encounter: "Emergency Department Visit"] LastED where LastED.period ends 1 hour or less on or before VisitStart sort by end of period ) return Interval[Coalesce(start of EDVisit.period, VisitStart), end of Visit.period]````
* Metadata: Logic Definition
  * ?: **Library Name:**MATGlobalCommonFunctions
* Metadata:  ````define function "GetBaseExtension"(domainResource DomainResource, url String): singleton from "GetBaseExtensions"(domainResource, url)````
* Metadata: Logic Definition
  * ?: **Library Name:**MATGlobalCommonFunctions
* Metadata:  ````/* NOTE: Extensions are not the preferred approach, but are used as a way to access content that is defined by extensions but not yet surfaced in the CQL model info. */ define function "GetBaseExtensions"(domainResource DomainResource, url String): domainResource.extension E where E.url = ('http://hl7.org/fhir/StructureDefinition/' + url) return E````
* Metadata: Logic Definition
  * ?: **Library Name:**MATGlobalCommonFunctions
* Metadata:  ````define function "GetExtension"(domainResource DomainResource, url String): singleton from "GetExtensions"(domainResource, url)````
* Metadata: Logic Definition
  * ?: **Library Name:**MATGlobalCommonFunctions
* Metadata:  ````/* NOTE: Extensions are not the preferred approach, but are used as a way to access content that is defined by extensions but not yet surfaced in the CQL model info. */ define function "GetExtensions"(domainResource DomainResource, url String): domainResource.extension E where E.url = ('http://hl7.org/fhir/us/qicore/StructureDefinition/' + url) return E````
* Metadata: Logic Definition
  * ?: **Library Name:**MATGlobalCommonFunctions
* Metadata:  ````// Returns the location for the given location reference define function GetLocation(reference Reference): singleton from ( [Location] L where L.id = GetId(reference.reference) )````
* Metadata: Logic Definition
  * ?: **Library Name:**MATGlobalCommonFunctions
* Metadata:  ````// Returns the condition that is specified as the principal diagnosis for the encounter // TODO: BTR 2019-07-30: Shouldn't need the FHIRHelpers reference here, investigate define function "PrincipalDiagnosis"(Encounter Encounter): (singleton from (Encounter.diagnosis D where FHIRHelpers.ToInteger(D.rank) = 1)) PD return singleton from ([Condition] C where C.id = "GetId"(PD.condition.reference))````
* Metadata: Logic Definition
  * ?: **Library Name:**MATGlobalCommonFunctions
* Metadata:  ````define function "GetExtension"(element Element, url String): singleton from "GetExtensions"(element, url)````
* Metadata: Logic Definition
  * ?: **Library Name:**MATGlobalCommonFunctions
* Metadata:  ````/* NOTE: Extensions are not the preferred approach, but are used as a way to access content that is defined by extensions but not yet surfaced in the CQL model info. */ define function "GetExtensions"(element Element, url String): element.extension E where E.url = (url) return E````
* Metadata: Logic Definition
  * ?: **Library Name:**FHIRHelpers
* Metadata:  ````define function ToString(value AdministrativeGender): value.value````
* Metadata: Logic Definition
  * ?: **Library Name:**FHIRHelpers
* Metadata:  ````define function ToString(value EncounterStatus): value.value````
* Metadata: Logic Definition
  * ?: **Library Name:**FHIRHelpers
* Metadata:  ````/* @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]````
* Metadata: Logic Definition
  * ?: **Library Name:**FHIRHelpers
* Metadata:  ````define function ToDate(value date): value.value````
* Metadata: Logic Definition
  * ?: **Library Name:**FHIRHelpers
* Metadata:  ````define function ToString(value string): value.value````
* Metadata: Logic Definition
  * ?: **Library Name:**FHIRHelpers
* Metadata:  ````/* @description: Converts the given FHIR [CodeableConcept](https://hl7.org/fhir/datatypes.html#CodeableConcept) value to a CQL Concept. */ define function ToConcept(concept FHIR.CodeableConcept): if concept is null then null else System.Concept { codes: concept.coding C return ToCode(C), display: concept.text.value }````
* Metadata: Logic Definition
  * ?: **Library Name:**FHIRHelpers
* Metadata:  ````/* @description: Converts the given FHIR [Coding](https://hl7.org/fhir/datatypes.html#Coding) value to a CQL Code. */ define function ToCode(coding FHIR.Coding): if coding is null then null else System.Code { code: coding.code.value, system: coding.system.value, version: coding.version.value, display: coding.display.value }````
* Metadata: Logic Definition
  * ?: **Library Name:**FHIRHelpers
* Metadata:  ````define function ToString(value MedicationAdministrationStatus): value.value````
* Metadata: Logic Definition
  * ?: **Library Name:**FHIRHelpers
* Metadata:  ````define function ToString(value ProcedureStatus): value.value````
* Metadata: Logic Definition
  * ?: **Library Name:**FHIRHelpers
* Metadata:  ````define function ToDateTime(value dateTime): value.value````
* Metadata: Logic Definition
  * ?: **Library Name:**FHIRHelpers
* Metadata:  ````define function ToDateTime(value instant): value.value````
* Metadata: Logic Definition
  * ?: **Library Name:**FHIRHelpers
* Metadata:  ````/* @description: Converts the given FHIR [Quantity](https://hl7.org/fhir/datatypes.html#Quantity) value to a CQL Quantity @comment: If the given quantity has a comparator specified, a runtime error is raised. If the given quantity has a system other than UCUM (i.e. `http://unitsofmeasure.org`) or CQL calendar units (i.e. `http://hl7.org/fhirpath/CodeSystem/calendar-units`) an error is raised. For UCUM to calendar units, the `ToCalendarUnit` function is used. @seealso: ToCalendarUnit */ define function ToQuantity(quantity FHIR.Quantity): case when quantity is null then null when quantity.value is null then null when quantity.comparator is not null then Message(null, true, 'FHIRHelpers.ToQuantity.ComparatorQuantityNotSupported', 'Error', 'FHIR Quantity value has a comparator and cannot be converted to a System.Quantity value.') when quantity.system is null or quantity.system.value = 'http://unitsofmeasure.org' or quantity.system.value = 'http://hl7.org/fhirpath/CodeSystem/calendar-units' then System.Quantity { value: quantity.value.value, unit: ToCalendarUnit(Coalesce(quantity.code.value, quantity.unit.value, '1')) } else Message(null, true, 'FHIRHelpers.ToQuantity.InvalidFHIRQuantity', 'Error', 'Invalid FHIR Quantity code: ' & quantity.unit.value & ' (' & quantity.system.value & '|' & quantity.code.value & ')') end````
* Metadata: Logic Definition
  * ?: **Library Name:**FHIRHelpers
* Metadata:  ````/* @description: Converts a UCUM definite duration unit to a CQL calendar duration unit using conversions specified in the [quantities](https://cql.hl7.org/02-authorsguide.html#quantities) topic of the CQL specification. @comment: Note that for durations above days (or weeks), the conversion is understood to be approximate */ define function ToCalendarUnit(unit System.String): case unit when 'ms' then 'millisecond' when 's' then 'second' when 'min' then 'minute' when 'h' then 'hour' when 'd' then 'day' when 'wk' then 'week' when 'mo' then 'month' when 'a' then 'year' else unit end````
* Metadata: Logic Definition
  * ?: **Library Name:**FHIRHelpers
* Metadata:  ````define function ToString(value ObservationStatus): value.value````
* Metadata: Logic Definition
  * ?: **Library Name:**FHIRHelpers
* Metadata:  ````define function ToBoolean(value boolean): value.value````
* Metadata: Logic Definition
  * ?: **Library Name:**FHIRHelpers
* Metadata:  ````define function ToString(value MedicationRequestStatus): value.value````
* Metadata: Logic Definition
  * ?: **Library Name:**FHIRHelpers
* Metadata:  ````define function ToString(value ServiceRequestStatus): value.value````
* Metadata: Logic Definition
  * ?: **Library Name:**FHIRHelpers
* Metadata:  ````define function ToString(value uri): value.value````
* Metadata: Logic Definition
  * ?: **Library Name:**FHIRHelpers
* Metadata:  ````define function ToInteger(value integer): value.value````
* Metadata: Logic Definition
  * ?: **Library Name:**FHIRHelpers
* Metadata:  ````define function ToString(value ServiceRequestIntent): value.value````
* Metadata:  Terminology
* Metadata: Code System
  * ?: **Description**: Code system ConditionClinicalStatusCodes**Resource**:[Condition Clinical Status Codes](http://terminology.hl7.org/7.1.0/CodeSystem-condition-clinical.html)**Canonical URL**:http://terminology.hl7.org/CodeSystem/condition-clinical
* Metadata: Code System
  * ?: **Description**: Code system LOINC**Resource**:[Logical Observation Identifiers, Names and Codes (LOINC)](http://terminology.hl7.org/6.5.0/CodeSystem-v3-loinc.html)**Canonical URL**:http://loinc.org
* Metadata: Value Set
  * ?: **Description**: Value set Encounter Inpatient**Resource**:[Encounter Inpatient](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.666.5.307/expansion)**Canonical URL**:http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307
* Metadata: Value Set
  * ?: **Description**: Value set Obstetrics**Resource**:[Obstetrical or Pregnancy Related Conditions](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.263/expansion)**Canonical URL**:http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.263
* Metadata: Value Set
  * ?: **Description**: Value set Venous Thromboembolism**Resource**:[Venous Thromboembolism](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.279/expansion)**Canonical URL**:http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.279
* Metadata: Value Set
  * ?: **Description**: Value set Obstetrics VTE**Resource**:[Obstetrics VTE](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.264/expansion)**Canonical URL**:http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.264
* Metadata: Value Set
  * ?: **Description**: Value set Low Dose Unfractionated Heparin for VTE Prophylaxis**Resource**:[Low Dose Unfractionated Heparin for VTE Prophylaxis](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1045.39/expansion)**Canonical URL**:http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.39
* Metadata: Value Set
  * ?: **Description**: Value set Subcutaneous route**Resource**:[Subcutaneous route](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.223/expansion)**Canonical URL**:http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.223
* Metadata: Value Set
  * ?: **Description**: Value set Low Molecular Weight Heparin for VTE Prophylaxis**Resource**:[Low Molecular Weight Heparin for VTE Prophylaxis](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.219/expansion)**Canonical URL**:http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.219
* Metadata: Value Set
  * ?: **Description**: Value set Injectable Factor Xa Inhibitor for VTE Prophylaxis**Resource**:[Injectable Factor Xa Inhibitor for VTE Prophylaxis](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.211/expansion)**Canonical URL**:http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.211
* Metadata: Value Set
  * ?: **Description**: Value set Warfarin**Resource**:[Warfarin](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.232/expansion)**Canonical URL**:http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.232
* Metadata: Value Set
  * ?: **Description**: Value set Device Application**Resource**:[Device Application](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1110.48/expansion)**Canonical URL**:http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.48
* Metadata: Value Set
  * ?: **Description**: Value set Intermittent pneumatic compression devices (IPC)**Resource**:[Intermittent pneumatic compression devices](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.214/expansion)**Canonical URL**:http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.214
* Metadata: Value Set
  * ?: **Description**: Value set Venous foot pumps (VFP)**Resource**:[Venous foot pumps](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.230/expansion)**Canonical URL**:http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.230
* Metadata: Value Set
  * ?: **Description**: Value set Graduated compression stockings (GCS)**Resource**:[Graduated compression stockings](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.256/expansion)**Canonical URL**:http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.256
* Metadata: Value Set
  * ?: **Description**: Value set General or Neuraxial Anesthesia**Resource**:[General or Neuraxial Anesthesia](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.666.5.1743/expansion)**Canonical URL**:http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.1743
* Metadata: Value Set
  * ?: **Description**: Value set Oral Factor Xa Inhibitor for VTE Prophylaxis or VTE Treatment**Resource**:[Oral Factor Xa Inhibitor for VTE Prophylaxis or VTE Treatment](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.134/expansion)**Canonical URL**:http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.134
* Metadata: Value Set
  * ?: **Description**: Value set Atrial Fibrillation/Flutter**Resource**:[Atrial Fibrillation or Flutter](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.202/expansion)**Canonical URL**:http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.202
* Metadata: Value Set
  * ?: **Description**: Value set Hip Replacement Surgery**Resource**:[Hip Replacement Surgery](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.259/expansion)**Canonical URL**:http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.259
* Metadata: Value Set
  * ?: **Description**: Value set Knee Replacement Surgery**Resource**:[Knee Replacement Surgery](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.261/expansion)**Canonical URL**:http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.261
* Metadata: Value Set
  * ?: **Description**: Value set Low Risk**Resource**:[Low Risk](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.400/expansion)**Canonical URL**:http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.400
* Metadata: Value Set
  * ?: **Description**: Value set INR**Resource**:[INR](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.213/expansion)**Canonical URL**:http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.213
* Metadata: Value Set
  * ?: **Description**: Value set Unfractionated Heparin**Resource**:[Unfractionated Heparin](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.218/expansion)**Canonical URL**:http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.218
* Metadata: Value Set
  * ?: **Description**: Value set Intravenous route**Resource**:[Intravenous route](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.222/expansion)**Canonical URL**:http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.222
* Metadata: Value Set
  * ?: **Description**: Value set Direct Thrombin Inhibitor**Resource**:[Direct Thrombin Inhibitor](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.205/expansion)**Canonical URL**:http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.205
* Metadata: Value Set
  * ?: **Description**: Value set Glycoprotein IIb/IIIa Inhibitors**Resource**:[Glycoprotein IIb IIIa Inhibitors](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1045.41/expansion)**Canonical URL**:http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.41
* Metadata: Value Set
  * ?: **Description**: Value set Observation Services**Resource**:[Observation Services](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1111.143/expansion)**Canonical URL**:http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.143
* Metadata: Value Set
  * ?: **Description**: Value set Emergency Department Visit**Resource**:[Emergency Department Visit](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.292/expansion)**Canonical URL**:http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292
* Metadata: Value Set
  * ?: **Description**: Value set Medical Reason**Resource**:[Medical Reason For Not Providing Treatment](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.473/expansion)**Canonical URL**:http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.473
* Metadata: Value Set
  * ?: **Description**: Value set Patient Refusal**Resource**:[Patient Refusal](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.93/expansion)**Canonical URL**:http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.93
* Metadata: Value Set
  * ?: **Description**: Value set Payer**Resource**:[Payer Type](https://vsac.nlm.nih.gov/valueset/2.16.840.1.114222.4.11.3591/expansion)**Canonical URL**:http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591
* Metadata: Value Set
  * ?: **Description**: Value set Intensive Care Unit**Resource**:[Intensive Care Unit](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1110.23/expansion)**Canonical URL**:http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.23
* Metadata: Value Set
  * ?: **Description**: Value set Mental Health Diagnoses**Resource**:[Mental Health Diagnoses](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.105.12.1004/expansion)**Canonical URL**:http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.105.12.1004
* Metadata: Value Set
  * ?: **Description**: Value set Hemorrhagic Stroke**Resource**:[Hemorrhagic Stroke](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.212/expansion)**Canonical URL**:http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.212
* Metadata: Value Set
  * ?: **Description**: Value set Ischemic Stroke**Resource**:[Ischemic Stroke](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.247/expansion)**Canonical URL**:http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.247
* Metadata: Value Set
  * ?: **Description**: Value set General Surgery**Resource**:[General Surgery](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.255/expansion)**Canonical URL**:http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.255
* Metadata: Value Set
  * ?: **Description**: Value set Gynecological Surgery**Resource**:[Gynecological Surgery](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.257/expansion)**Canonical URL**:http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.257
* Metadata: Value Set
  * ?: **Description**: Value set Hip Fracture Surgery**Resource**:[Hip Fracture Surgery](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.258/expansion)**Canonical URL**:http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.258
* Metadata: Value Set
  * ?: **Description**: Value set Intracranial Neurosurgery**Resource**:[Intracranial Neurosurgery](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.260/expansion)**Canonical URL**:http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.260
* Metadata: Value Set
  * ?: **Description**: Value set Urological Surgery**Resource**:[Urological Surgery](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.272/expansion)**Canonical URL**:http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.272
* Metadata: Value Set
  * ?: **Description**: Value set Comfort Measures**Resource**:[Comfort Measures](https://vsac.nlm.nih.gov/valueset/1.3.6.1.4.1.33895.1.3.0.45/expansion)**Canonical URL**:http://cts.nlm.nih.gov/fhir/ValueSet/1.3.6.1.4.1.33895.1.3.0.45
* Metadata: Direct Reference Code
  * ?: **Code**: active**System**:http://terminology.hl7.org/CodeSystem/condition-clinical
* Metadata: Direct Reference Code
  * ?: **Code**: recurrence**System**:http://terminology.hl7.org/CodeSystem/condition-clinical
* Metadata: Direct Reference Code
  * ?: **Code**: relapse**System**:http://terminology.hl7.org/CodeSystem/condition-clinical
* Metadata: Direct Reference Code
  * ?: **Code**: inactive**System**:http://terminology.hl7.org/CodeSystem/condition-clinical
* Metadata: Direct Reference Code
  * ?: **Code**: remission**System**:http://terminology.hl7.org/CodeSystem/condition-clinical
* Metadata: Direct Reference Code
  * ?: **Code**: resolved**System**:http://terminology.hl7.org/CodeSystem/condition-clinical
* Metadata: Direct Reference Code
  * ?: **Display**: Risk for venous thromboembolism**Code**: 72136-5**System**:http://loinc.org
* Metadata:  Dependencies
* Metadata: Dependency
  * ?: **Description**: FHIR model information**Resource**:[http://hl7.org/fhir/uv/cql/Library/FHIR-ModelInfo|4.0.1](http://hl7.org/fhir/uv/cql/STU2/Library-FHIR-ModelInfo.html)**Canonical URL**:http://hl7.org/fhir/uv/cql/Library/FHIR-ModelInfo|4.0.1
* Metadata: Dependency
  * ?: **Description**: Library SDE**Resource**:[Supplemental Data Elementsversion: null2.0.000)](Library-SupplementalDataElements.md)**Canonical URL**:http://hl7.org/fhir/uv/cqm/Library/SupplementalDataElements|2.0.000
* Metadata: Dependency
  * ?: **Description**: Library FHIRHelpers**Resource**:[http://hl7.org/fhir/uv/cql/Library/FHIRHelpers|4.0.1](http://hl7.org/fhir/uv/cql/STU2/Library-FHIRHelpers.html)**Canonical URL**:http://hl7.org/fhir/uv/cql/Library/FHIRHelpers|4.0.1
* Metadata: Dependency
  * ?: **Description**: Library Global**Resource**:[MAT Global Common Functions FHIR Libraryversion: null5.0.000)](Library-MATGlobalCommonFunctions.md)**Canonical URL**:http://hl7.org/fhir/uv/cqm/Library/MATGlobalCommonFunctions|5.0.000
* Metadata: Dependency
  * ?: **Description**: Library TJC**Resource**:[TJC Overall Libraryversion: null4.0.000)](Library-TJCOverall.md)**Canonical URL**:http://hl7.org/fhir/uv/cqm/Library/TJCOverall|4.0.000
* Metadata: Dependency
  * ?: **Description**: Library VTEICU**Resource**:[VTE ICU Libraryversion: null5.0.000)](Library-VTEICU.md)**Canonical URL**:http://hl7.org/fhir/uv/cqm/Library/VTEICU|5.0.000
* Metadata:  Data Requirements
* Metadata: Data Requirement
  * ?: **Type**: Patient**Profile(s)**:[Patient](http://hl7.org/fhir/R4/patient.html)**Must Support Elements**: url, extension, value
* Metadata: Data Requirement
  * ?: **Type**: Encounter**Profile(s)**:[Encounter](http://hl7.org/fhir/R4/encounter.html)**Must Support Elements**: type, status, period, condition, condition.reference, location, rank**Code Filter(s)**:**Path**: type**ValueSet**:[Encounter Inpatient](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.666.5.307/expansion)
* Metadata: Data Requirement
  * ?: **Type**: Encounter**Profile(s)**:[Encounter](http://hl7.org/fhir/R4/encounter.html)**Must Support Elements**: type, period, condition, condition.reference, location, rank**Code Filter(s)**:**Path**: type**ValueSet**:[Observation Services](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1111.143/expansion)
* Metadata: Data Requirement
  * ?: **Type**: Encounter**Profile(s)**:[Encounter](http://hl7.org/fhir/R4/encounter.html)**Must Support Elements**: type, period, condition, condition.reference, location, rank**Code Filter(s)**:**Path**: type**ValueSet**:[Emergency Department Visit](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.292/expansion)
* Metadata: Data Requirement
  * ?: **Type**: Condition**Profile(s)**:[Condition](http://hl7.org/fhir/R4/condition.html)**Must Support Elements**: code, clinicalStatus, onset**Code Filter(s)**:**Path**: code**ValueSet**:[Atrial Fibrillation or Flutter](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.202/expansion)
* Metadata: Data Requirement
  * ?: **Type**: Condition**Profile(s)**:[Condition](http://hl7.org/fhir/R4/condition.html)**Must Support Elements**: code, clinicalStatus, onset**Code Filter(s)**:**Path**: code**ValueSet**:[Venous Thromboembolism](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.279/expansion)
* Metadata: Data Requirement
  * ?: **Type**: Condition**Profile(s)**:[Condition](http://hl7.org/fhir/R4/condition.html)**Must Support Elements**: id, code
* Metadata: Data Requirement
  * ?: **Type**: MedicationAdministration**Profile(s)**:[MedicationAdministration](http://hl7.org/fhir/R4/medicationadministration.html)**Must Support Elements**: medication, status, effective, dosage, dosage.route, id**Code Filter(s)**:**Path**: medication**ValueSet**:[Oral Factor Xa Inhibitor for VTE Prophylaxis or VTE Treatment](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.134/expansion)
* Metadata: Data Requirement
  * ?: **Type**: MedicationAdministration**Profile(s)**:[MedicationAdministration](http://hl7.org/fhir/R4/medicationadministration.html)**Must Support Elements**: medication, dosage, dosage.route, status, id, effective**Code Filter(s)**:**Path**: medication**ValueSet**:[Unfractionated Heparin](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.218/expansion)
* Metadata: Data Requirement
  * ?: **Type**: MedicationAdministration**Profile(s)**:[MedicationAdministration](http://hl7.org/fhir/R4/medicationadministration.html)**Must Support Elements**: medication, dosage, dosage.route, status, id, effective**Code Filter(s)**:**Path**: medication**ValueSet**:[Direct Thrombin Inhibitor](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.205/expansion)
* Metadata: Data Requirement
  * ?: **Type**: MedicationAdministration**Profile(s)**:[MedicationAdministration](http://hl7.org/fhir/R4/medicationadministration.html)**Must Support Elements**: medication, dosage, dosage.route, status, id, effective**Code Filter(s)**:**Path**: medication**ValueSet**:[Glycoprotein IIb IIIa Inhibitors](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1045.41/expansion)
* Metadata: Data Requirement
  * ?: **Type**: MedicationAdministration**Profile(s)**:[MedicationAdministration](http://hl7.org/fhir/R4/medicationadministration.html)**Must Support Elements**: medication.reference, dosage, dosage.route, status, id, effective
* Metadata: Data Requirement
  * ?: **Type**: MedicationAdministration**Profile(s)**:[MedicationAdministration](http://hl7.org/fhir/R4/medicationadministration.html)**Must Support Elements**: medication, status, dosage, dosage.route, id, effective**Code Filter(s)**:**Path**: medication**ValueSet**:[Low Dose Unfractionated Heparin for VTE Prophylaxis](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1045.39/expansion)
* Metadata: Data Requirement
  * ?: **Type**: MedicationAdministration**Profile(s)**:[MedicationAdministration](http://hl7.org/fhir/R4/medicationadministration.html)**Must Support Elements**: medication, status, dosage, dosage.route, id, effective**Code Filter(s)**:**Path**: medication**ValueSet**:[Low Molecular Weight Heparin for VTE Prophylaxis](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.219/expansion)
* Metadata: Data Requirement
  * ?: **Type**: MedicationAdministration**Profile(s)**:[MedicationAdministration](http://hl7.org/fhir/R4/medicationadministration.html)**Must Support Elements**: medication, status, dosage, dosage.route, id, effective**Code Filter(s)**:**Path**: medication**ValueSet**:[Injectable Factor Xa Inhibitor for VTE Prophylaxis](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.211/expansion)
* Metadata: Data Requirement
  * ?: **Type**: MedicationAdministration**Profile(s)**:[MedicationAdministration](http://hl7.org/fhir/R4/medicationadministration.html)**Must Support Elements**: medication, status, dosage, dosage.route, id, effective**Code Filter(s)**:**Path**: medication**ValueSet**:[Warfarin](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.232/expansion)
* Metadata: Data Requirement
  * ?: **Type**: Procedure**Profile(s)**:[Procedure](http://hl7.org/fhir/R4/procedure.html)**Must Support Elements**: code, status, usedCode, performed, id, statusReason**Code Filter(s)**:**Path**: code**ValueSet**:[Device Application](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1110.48/expansion)
* Metadata: Data Requirement
  * ?: **Type**: Procedure**Profile(s)**:[Procedure](http://hl7.org/fhir/R4/procedure.html)**Must Support Elements**: code, status, performed, id**Code Filter(s)**:**Path**: code**ValueSet**:[General Surgery](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.255/expansion)
* Metadata: Data Requirement
  * ?: **Type**: Procedure**Profile(s)**:[Procedure](http://hl7.org/fhir/R4/procedure.html)**Must Support Elements**: code, status, performed, id**Code Filter(s)**:**Path**: code**ValueSet**:[Gynecological Surgery](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.257/expansion)
* Metadata: Data Requirement
  * ?: **Type**: Procedure**Profile(s)**:[Procedure](http://hl7.org/fhir/R4/procedure.html)**Must Support Elements**: code, status, performed, id**Code Filter(s)**:**Path**: code**ValueSet**:[Hip Fracture Surgery](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.258/expansion)
* Metadata: Data Requirement
  * ?: **Type**: Procedure**Profile(s)**:[Procedure](http://hl7.org/fhir/R4/procedure.html)**Must Support Elements**: code, status, performed, id**Code Filter(s)**:**Path**: code**ValueSet**:[Hip Replacement Surgery](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.259/expansion)
* Metadata: Data Requirement
  * ?: **Type**: Procedure**Profile(s)**:[Procedure](http://hl7.org/fhir/R4/procedure.html)**Must Support Elements**: code, status, performed, id**Code Filter(s)**:**Path**: code**ValueSet**:[Intracranial Neurosurgery](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.260/expansion)
* Metadata: Data Requirement
  * ?: **Type**: Procedure**Profile(s)**:[Procedure](http://hl7.org/fhir/R4/procedure.html)**Must Support Elements**: code, status, performed, id**Code Filter(s)**:**Path**: code**ValueSet**:[Knee Replacement Surgery](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.261/expansion)
* Metadata: Data Requirement
  * ?: **Type**: Procedure**Profile(s)**:[Procedure](http://hl7.org/fhir/R4/procedure.html)**Must Support Elements**: code, status, performed, id**Code Filter(s)**:**Path**: code**ValueSet**:[Urological Surgery](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.272/expansion)
* Metadata: Data Requirement
  * ?: **Type**: Procedure**Profile(s)**:[Procedure](http://hl7.org/fhir/R4/procedure.html)**Must Support Elements**: code, status, performed, id**Code Filter(s)**:**Path**: code**ValueSet**:[Comfort Measures](https://vsac.nlm.nih.gov/valueset/1.3.6.1.4.1.33895.1.3.0.45/expansion)
* Metadata: Data Requirement
  * ?: **Type**: Procedure**Profile(s)**:[Procedure](http://hl7.org/fhir/R4/procedure.html)**Must Support Elements**: code, performed, status, id**Code Filter(s)**:**Path**: code**ValueSet**:[General or Neuraxial Anesthesia](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.666.5.1743/expansion)
* Metadata: Data Requirement
  * ?: **Type**: Observation**Profile(s)**:[Observation](http://hl7.org/fhir/R4/observation.html)**Must Support Elements**: code, value, status, effective**Code Filter(s)**:**Path**: code**Code(s)**: [LOINC: 72136-5](https://loinc.org/72136-5) (Risk for venous thromboembolism) 
* Metadata: Data Requirement
  * ?: **Type**: Observation**Profile(s)**:[Observation](http://hl7.org/fhir/R4/observation.html)**Must Support Elements**: code, value, status, id, issued, effective**Code Filter(s)**:**Path**: code**ValueSet**:[INR](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.213/expansion)
* Metadata: Data Requirement
  * ?: **Type**: Medication**Profile(s)**:[Medication](http://hl7.org/fhir/R4/medication.html)**Must Support Elements**: id, code
* Metadata: Data Requirement
  * ?: **Type**: MedicationRequest**Profile(s)**:[MedicationRequest](http://hl7.org/fhir/R4/medicationrequest.html)**Must Support Elements**: medication, doNotPerform, status**Code Filter(s)**:**Path**: medication**ValueSet**:[Low Dose Unfractionated Heparin for VTE Prophylaxis](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1045.39/expansion)
* Metadata: Data Requirement
  * ?: **Type**: MedicationRequest**Profile(s)**:[MedicationRequest](http://hl7.org/fhir/R4/medicationrequest.html)**Must Support Elements**: medication, doNotPerform, status**Code Filter(s)**:**Path**: medication**ValueSet**:[Low Molecular Weight Heparin for VTE Prophylaxis](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.219/expansion)
* Metadata: Data Requirement
  * ?: **Type**: MedicationRequest**Profile(s)**:[MedicationRequest](http://hl7.org/fhir/R4/medicationrequest.html)**Must Support Elements**: medication, doNotPerform, status**Code Filter(s)**:**Path**: medication**ValueSet**:[Injectable Factor Xa Inhibitor for VTE Prophylaxis](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.211/expansion)
* Metadata: Data Requirement
  * ?: **Type**: MedicationRequest**Profile(s)**:[MedicationRequest](http://hl7.org/fhir/R4/medicationrequest.html)**Must Support Elements**: medication, doNotPerform, status**Code Filter(s)**:**Path**: medication**ValueSet**:[Warfarin](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.232/expansion)
* Metadata: Data Requirement
  * ?: **Type**: ServiceRequest**Profile(s)**:[ServiceRequest](http://hl7.org/fhir/R4/servicerequest.html)**Must Support Elements**: code, status, doNotPerform, id, authoredOn**Code Filter(s)**:**Path**: code**ValueSet**:[Venous foot pumps](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.230/expansion)
* Metadata: Data Requirement
  * ?: **Type**: ServiceRequest**Profile(s)**:[ServiceRequest](http://hl7.org/fhir/R4/servicerequest.html)**Must Support Elements**: code, status, doNotPerform, id, authoredOn**Code Filter(s)**:**Path**: code**ValueSet**:[Intermittent pneumatic compression devices](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.214/expansion)
* Metadata: Data Requirement
  * ?: **Type**: ServiceRequest**Profile(s)**:[ServiceRequest](http://hl7.org/fhir/R4/servicerequest.html)**Must Support Elements**: code, status, doNotPerform, id, authoredOn**Code Filter(s)**:**Path**: code**ValueSet**:[Graduated compression stockings](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.256/expansion)
* Metadata: Data Requirement
  * ?: **Type**: ServiceRequest**Profile(s)**:[ServiceRequest](http://hl7.org/fhir/R4/servicerequest.html)**Must Support Elements**: code, intent, status, doNotPerform, id, authoredOn**Code Filter(s)**:**Path**: code**ValueSet**:[Comfort Measures](https://vsac.nlm.nih.gov/valueset/1.3.6.1.4.1.33895.1.3.0.45/expansion)
* Metadata: Data Requirement
  * ?: **Type**: Coverage**Profile(s)**:[Coverage](http://hl7.org/fhir/R4/coverage.html)**Must Support Elements**: type, period**Code Filter(s)**:**Path**: type**ValueSet**:[Payer Type](https://vsac.nlm.nih.gov/valueset/2.16.840.1.114222.4.11.3591/expansion)
* Metadata: Data Requirement
  * ?: **Type**: Location**Profile(s)**:[Location](http://hl7.org/fhir/R4/location.html)**Must Support Elements**: id
* Metadata:  Parameters
* Metadata: 
  * ?: 
| | | | | |
| :--- | :--- | :--- | :--- | :--- |
| **Name** | **Use** | **Card.** | **Type** | **Documentation** |
| Measurement Period | In | 0..1 | Period |  |
| SDE Sex | Out | 0..1 | Coding |  |
| Numerator | Out | 0..* | Encounter |  |
| Denominator | Out | 0..* | Encounter |  |
| SDE Payer | Out | 0..* | Resource |  |
| Initial Population | Out | 0..* | Encounter |  |
| SDE Ethnicity | Out | 0..* | Coding |  |
| Denominator Exclusion | Out | 0..* | Resource |  |
| SDE Race | Out | 0..* | Coding |  |

* Metadata: Generated using version 0.5.4 of the sample-content-ig Liquid templates



## Resource Content

```json
{
  "resourceType" : "Measure",
  "id" : "EXM108-FHIR",
  "meta" : {
    "profile" : ["http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-shareablemeasure",
    "http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-computablemeasure",
    "http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-proportionmeasure",
    "http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-cqlmeasure",
    "http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-computablemeasure"]
  },
  "contained" : [{
    "resourceType" : "Library",
    "id" : "effective-data-requirements",
    "extension" : [{
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
      "valueCoding" : {
        "system" : "http://terminology.hl7.org/CodeSystem/condition-clinical",
        "code" : "active"
      }
    },
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
      "valueCoding" : {
        "system" : "http://terminology.hl7.org/CodeSystem/condition-clinical",
        "code" : "recurrence"
      }
    },
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
      "valueCoding" : {
        "system" : "http://terminology.hl7.org/CodeSystem/condition-clinical",
        "code" : "relapse"
      }
    },
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
      "valueCoding" : {
        "system" : "http://terminology.hl7.org/CodeSystem/condition-clinical",
        "code" : "inactive"
      }
    },
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
      "valueCoding" : {
        "system" : "http://terminology.hl7.org/CodeSystem/condition-clinical",
        "code" : "remission"
      }
    },
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
      "valueCoding" : {
        "system" : "http://terminology.hl7.org/CodeSystem/condition-clinical",
        "code" : "resolved"
      }
    },
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
      "valueCoding" : {
        "system" : "http://loinc.org",
        "code" : "72136-5",
        "display" : "Risk for venous thromboembolism"
      }
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "SupplementalDataElements"
      },
      {
        "url" : "name",
        "valueString" : "SDE Sex"
      },
      {
        "url" : "statement",
        "valueString" : "define \"SDE Sex\":\n  case\n      when Patient.gender = 'male' then Code { code: 'M', system: 'http://hl7.org/fhir/v3/AdministrativeGender', display: 'Male' }\n      when Patient.gender = 'female' then Code { code: 'F', system: 'http://hl7.org/fhir/v3/AdministrativeGender', display: 'Female' }\n      else null\n    end"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 0
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "EXM108"
      },
      {
        "url" : "name",
        "valueString" : "SDE Sex"
      },
      {
        "url" : "statement",
        "valueString" : "define \"SDE Sex\":\n\tSDE.\"SDE Sex\""
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 1
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "MATGlobalCommonFunctions"
      },
      {
        "url" : "name",
        "valueString" : "Inpatient Encounter"
      },
      {
        "url" : "statement",
        "valueString" : "define \"Inpatient Encounter\":\n\t[Encounter: \"Encounter Inpatient\"] EncounterInpatient\n\t\twhere EncounterInpatient.status = 'finished'\n\t\t    and \"LengthInDays\"(EncounterInpatient.period) <= 120\n\t\t\tand EncounterInpatient.period ends during \"Measurement Period\""
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 2
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "EXM108"
      },
      {
        "url" : "name",
        "valueString" : "Admission Without VTE or Obstetrical Conditions"
      },
      {
        "url" : "statement",
        "valueString" : "define \"Admission Without VTE or Obstetrical Conditions\":\n  Global.\"Inpatient Encounter\" InpatientEncounter\n    where not exists (\n      (Global.EncounterDiagnosis(InpatientEncounter)) EncounterDiagnosis\n        where EncounterDiagnosis.code in \"Obstetrics\"\n          or EncounterDiagnosis.code in \"Venous Thromboembolism\"\n          or EncounterDiagnosis.code in \"Obstetrics VTE\"\n    )"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 3
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "EXM108"
      },
      {
        "url" : "name",
        "valueString" : "Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions"
      },
      {
        "url" : "statement",
        "valueString" : "// Note: added FHIRHelpers.ToDate() in R4\ndefine \"Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions\":\n  ( Global.\"Inpatient Encounter\" InpatientEncounter\n        where Global.\"CalendarAgeInYearsAt\"(FHIRHelpers.ToDate(Patient.birthDate), start of InpatientEncounter.period) >= 18\n  )\n    intersect \"Admission Without VTE or Obstetrical Conditions\""
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 4
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "EXM108"
      },
      {
        "url" : "name",
        "valueString" : "VTE Prophylaxis by Medication Administered or Device Applied"
      },
      {
        "url" : "statement",
        "valueString" : "// 10/29: Replaced DeviceUseStatement with Procedure with a new value set and procedure.usdCode for specifying devices\ndefine \"VTE Prophylaxis by Medication Administered or Device Applied\":\n  ( [\"MedicationAdministration\": medication in \"Low Dose Unfractionated Heparin for VTE Prophylaxis\"] VTEMedication\n      where VTEMedication.status ='completed'\n\t\t\t     and VTEMedication.dosage.route in \"Subcutaneous route\"\n  )\n   union ([\"MedicationAdministration\": medication in \"Low Molecular Weight Heparin for VTE Prophylaxis\"] LMWH where LMWH.status = 'completed')\n    union ([\"MedicationAdministration\": medication in \"Injectable Factor Xa Inhibitor for VTE Prophylaxis\"] FactorXa where FactorXa.status = 'completed')\n     union ([\"MedicationAdministration\": medication in \"Warfarin\"] Warfarin where Warfarin.status = 'completed')\n      union (\n          [\"Procedure\": \"Device Application\"] DeviceApplied\n          where DeviceApplied.status = 'complete'\n                and (DeviceApplied.usedCode in \"Intermittent pneumatic compression devices (IPC)\"\n                    or DeviceApplied.usedCode in\"Venous foot pumps (VFP)\"\n                    or DeviceApplied.usedCode in \"Graduated compression stockings (GCS)\"\n                    )\n          )"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 5
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "EXM108"
      },
      {
        "url" : "name",
        "valueString" : "Encounter With VTE Prophylaxis Received on Day of or Day After Admission or Procedure"
      },
      {
        "url" : "statement",
        "valueString" : "define \"Encounter With VTE Prophylaxis Received on Day of or Day After Admission or Procedure\":\n \t( from\n      \"Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions\" QualifyingEncounter,\n      \"VTE Prophylaxis by Medication Administered or Device Applied\" VTEProphylaxis\n    where Coalesce(Global.\"Normalize Interval\"(VTEProphylaxis.effective), Global.\"Normalize Interval\"(VTEProphylaxis.performed)) starts during TJC.\"CalendarDayOfOrDayAfter\"(start of QualifyingEncounter.period)\n    return QualifyingEncounter\n \t)\n \tunion (\n    from\n      \"Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions\" QualifyingEncounter,\n      [\"Procedure\": \"General or Neuraxial Anesthesia\"] AnesthesiaProcedure,\n      \"VTE Prophylaxis by Medication Administered or Device Applied\" VTEProphylaxis\n    where Global.\"Normalize Interval\"(AnesthesiaProcedure.performed) ends 1 day after day of start of QualifyingEncounter.period\n      and Coalesce(Global.\"Normalize Interval\"(VTEProphylaxis.effective), Global.\"Normalize Interval\"(VTEProphylaxis.performed)) starts during TJC.\"CalendarDayOfOrDayAfter\"(end of Global.\"Normalize Interval\"(AnesthesiaProcedure.performed))\n    return QualifyingEncounter\n\t)"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 6
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "EXM108"
      },
      {
        "url" : "name",
        "valueString" : "Encounter With Medication Oral Factor Xa Inhibitor Administered on Day of or Day After Admission or Procedure"
      },
      {
        "url" : "statement",
        "valueString" : "define \"Encounter With Medication Oral Factor Xa Inhibitor Administered on Day of or Day After Admission or Procedure\":\n\t( from\n    \t\t\"Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions\" QualifyingEncounter,\n  \t\t\t[\"MedicationAdministration\": medication in \"Oral Factor Xa Inhibitor for VTE Prophylaxis or VTE Treatment\"] FactorXaMedication\n    where FactorXaMedication.status = 'completed'\n      and Global.\"Normalize Interval\"(FactorXaMedication.effective) starts during TJC.\"CalendarDayOfOrDayAfter\"(start of QualifyingEncounter.period)\n    return QualifyingEncounter\n    )\n    union ( from\n    \t\t\t\t  \"Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions\" QualifyingEncounter,\n      \t\t\t\t[\"Procedure\": \"General or Neuraxial Anesthesia\"] AnesthesiaProcedure,\n      \t\t\t\t[\"MedicationAdministration\": medication in \"Oral Factor Xa Inhibitor for VTE Prophylaxis or VTE Treatment\"] FactorXaMedication\n      \t\t\twhere FactorXaMedication.status = 'completed'\n                and AnesthesiaProcedure.status = 'completed'\n      \t\t\t    and Global.\"Normalize Interval\"(AnesthesiaProcedure.performed) ends 1 day after day of start of QualifyingEncounter.period\n      \t\t\t\t\tand Global.\"Normalize Interval\"(FactorXaMedication.effective) starts during TJC.\"CalendarDayOfOrDayAfter\"(end of Global.\"Normalize Interval\"(AnesthesiaProcedure.performed))\n      \t\t\treturn QualifyingEncounter\n      \t\t)"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 7
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "EXM108"
      },
      {
        "url" : "name",
        "valueString" : "Encounter With Prior or Present Diagnosis of Atrial Fibrillation or VTE"
      },
      {
        "url" : "statement",
        "valueString" : "define \"Encounter With Prior or Present Diagnosis of Atrial Fibrillation or VTE\":\n\t( \"Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions\" QualifyingEncounter\n\t\twith [\"Condition\": code in \"Atrial Fibrillation/Flutter\"] AtrialFibrillation\n\t\tsuch that FHIRHelpers.ToConcept(AtrialFibrillation.clinicalStatus) in { Global.\"active\", Global.\"recurrence\", Global.\"relapse\" }\n\t\t\tand Global.\"Normalize Interval\"(AtrialFibrillation.onset) starts on or before end of QualifyingEncounter.period\n    )\n    union ( \"Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions\" QualifyingEncounter\n    \t\t\t\twhere Global.EncounterDiagnosis(QualifyingEncounter).code in \"Atrial Fibrillation/Flutter\"\n    \t\t\t)\n    union ( \"Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions\" QualifyingEncounter\n    \t\t\t\twith [\"Condition\": code in \"Venous Thromboembolism\"] VTEDiagnosis\n    \t\t\t\tsuch that  FHIRHelpers.ToConcept(VTEDiagnosis.clinicalStatus) in { Global.\"inactive\", Global.\"remission\", Global.\"resolved\" }\n      \t\t\t\t\t//and VTEDiagnosis.verificationStatus = 'confirmed'\n    \t\t\t\tand Global.\"Normalize Interval\"(VTEDiagnosis.onset) before start of QualifyingEncounter.period\n      \t\t)"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 8
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "EXM108"
      },
      {
        "url" : "name",
        "valueString" : "Encounter With Prior or Present Procedure of Hip or Knee Replacement Surgery"
      },
      {
        "url" : "statement",
        "valueString" : "define \"Encounter With Prior or Present Procedure of Hip or Knee Replacement Surgery\":\n\t\"Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions\" QualifyingEncounter\n\twith ( [\"Procedure\": \"Hip Replacement Surgery\"]\n    \t\t\tunion [\"Procedure\": \"Knee Replacement Surgery\"] ) HipKneeProcedure\n\tsuch that HipKneeProcedure.status = 'completed'\n\t     and Global.\"Normalize Interval\"(HipKneeProcedure.performed) starts on or before end of QualifyingEncounter.period"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 9
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "EXM108"
      },
      {
        "url" : "name",
        "valueString" : "Is In Low Risk for VTE or On Anticoagulant"
      },
      {
        "url" : "statement",
        "valueString" : "define \"Is In Low Risk for VTE or On Anticoagulant\":\n\t  ( [\"Observation\": \"Risk for venous thromboembolism\"] VTERiskAssessment\n\t\t\t  where VTERiskAssessment.value in \"Low Risk\"\n        and VTERiskAssessment.status in {'final','amended', 'corrected'}\n\t  )\n  union ( [\"Observation\": \"INR\"] INRLabTest\n        where INRLabTest.value as Quantity > 3.0\n            and INRLabTest.status in {'final','amended', 'corrected'}\n        return \"Observation\" { id: INRLabTest.id, effective: INRLabTest.issued }\n        )\n  union ((( [\"MedicationAdministration\": \"Unfractionated Heparin\"] UnfractionatedHeparin\n          where UnfractionatedHeparin.dosage.route in \"Intravenous route\"\n         )\n         union [\"MedicationAdministration\": \"Direct Thrombin Inhibitor\"]\n         union [\"MedicationAdministration\": \"Glycoprotein IIb/IIIa Inhibitors\"] ) AnticoagulantMedication\n         where AnticoagulantMedication.status = 'complete'\n         return \"Observation\" { id: AnticoagulantMedication.id, effective: AnticoagulantMedication.effective }\n      )"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 10
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "EXM108"
      },
      {
        "url" : "name",
        "valueString" : "Low Risk for VTE or Anticoagulant Administered From Day of Start of Hospitalization To Day After Admission"
      },
      {
        "url" : "statement",
        "valueString" : "define \"Low Risk for VTE or Anticoagulant Administered From Day of Start of Hospitalization To Day After Admission\":\n \t\"Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions\" QualifyingEncounter\n    with \"Is In Low Risk for VTE or On Anticoagulant\" VTERiskAssessment\n    such that Global.\"Normalize Interval\"(VTERiskAssessment.effective) starts during VTEICU.\"FromDayOfStartOfHospitalizationToDayAfterAdmission\"(QualifyingEncounter)"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 11
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "EXM108"
      },
      {
        "url" : "name",
        "valueString" : "Low Risk for VTE or Anticoagulant Administered on Day of or Day After Procedure"
      },
      {
        "url" : "statement",
        "valueString" : "define \"Low Risk for VTE or Anticoagulant Administered on Day of or Day After Procedure\":\n \tfrom\n   \t\t\"Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions\" QualifyingEncounter,\n   \t\t[\"Procedure\": \"General or Neuraxial Anesthesia\"] AnesthesiaProcedure,\n   \t\t\"Is In Low Risk for VTE or On Anticoagulant\" VTERiskAssessment\n\twhere Global.\"Normalize Interval\"(AnesthesiaProcedure.performed) ends 1 day after day of start of QualifyingEncounter.period\n \t\t\tand Global.\"Normalize Interval\"(VTERiskAssessment.effective) starts during TJC.\"CalendarDayOfOrDayAfter\"(end of Global.\"Normalize Interval\"(AnesthesiaProcedure.performed))\n\treturn QualifyingEncounter"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 12
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "EXM108"
      },
      {
        "url" : "name",
        "valueString" : "Encounter With Low Risk for VTE or Anticoagulant Administered"
      },
      {
        "url" : "statement",
        "valueString" : "define \"Encounter With Low Risk for VTE or Anticoagulant Administered\":\n   \"Low Risk for VTE or Anticoagulant Administered From Day of Start of Hospitalization To Day After Admission\"\n   \t union \"Low Risk for VTE or Anticoagulant Administered on Day of or Day After Procedure\""
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 13
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "EXM108"
      },
      {
        "url" : "name",
        "valueString" : "No VTE Prophylaxis Medication Administered or Ordered"
      },
      {
        "url" : "statement",
        "valueString" : "define \"No VTE Prophylaxis Medication Administered or Ordered\":\n   ((\t[\"MedicationAdministration\": medication in \"Low Dose Unfractionated Heparin for VTE Prophylaxis\"]\n     union\n\t    [\"MedicationAdministration\": medication in \"Low Molecular Weight Heparin for VTE Prophylaxis\"]\n     union\n\t    [\"MedicationAdministration\": medication in \"Injectable Factor Xa Inhibitor for VTE Prophylaxis\"]\n     union\n\t    [\"MedicationAdministration\": medication in \"Warfarin\"]\n       ) MedicationAdm\n       where MedicationAdm.status = 'not-done'\n        )\n  union\n\t   ((\t[\"MedicationRequest\": medication in \"Low Dose Unfractionated Heparin for VTE Prophylaxis\"]\n  \tunion\n  \t [\"MedicationRequest\": medication in \"Low Molecular Weight Heparin for VTE Prophylaxis\"]\n    union\n    \t[\"MedicationRequest\": medication in \"Injectable Factor Xa Inhibitor for VTE Prophylaxis\"]\n    union\n    \t[\"MedicationRequest\": medication in \"Warfarin\"]\n    ) MedicationOrder\n    \twhere\tMedicationOrder.doNotPerform is true\n        and MedicationOrder.status in {'completed', 'cancelled'}\n        //11/5 discussion: all expressions for QI-Core must include a status.\n        //Therefore, we need ServiceRequest.status = completed; and MedicationRequest.status = cancelled (or completed, since cancelled indicates it was once ordered but intentionally never filled).\n        //So the not done issue is handled by ServiceRequest.doNotPerform = True  Or MedicationRequest.doNotPerform = True\n    )"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 14
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "EXM108"
      },
      {
        "url" : "name",
        "valueString" : "No VTE Prophylaxis Medication Due to Medical Reason From Day of Start of Hospitalization To Day After Admission"
      },
      {
        "url" : "statement",
        "valueString" : "define \"No VTE Prophylaxis Medication Due to Medical Reason From Day of Start of Hospitalization To Day After Admission\":\n   \t\"Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions\" QualifyingEncounter\n       with\t\"No VTE Prophylaxis Medication Administered or Ordered\" NoVTEMedication\n     \tsuch that Coalesce(NoVTEMedication.statusReason,NoVTEMedication.reasonCode) in \"Medical Reason\"\n      \t\t\tand Coalesce(NoVTEMedication.authoredOn, start of Global.\"Normalize Interval\"(NoVTEMedication.effective)) during VTEICU.\"FromDayOfStartOfHospitalizationToDayAfterAdmission\"(QualifyingEncounter)"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 15
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "EXM108"
      },
      {
        "url" : "name",
        "valueString" : "No VTE Prophylaxis Device Applied or Ordered"
      },
      {
        "url" : "statement",
        "valueString" : "define \"No VTE Prophylaxis Device Applied or Ordered\":\n  ((\n    [\"ServiceRequest\": \"Venous foot pumps (VFP)\"]\n    union [\"ServiceRequest\": \"Intermittent pneumatic compression devices (IPC)\"]\n    union [\"ServiceRequest\": \"Graduated compression stockings (GCS)\"]\n    ) DeviceOrder\n    where DeviceOrder.status = 'completed'\n        and DeviceOrder.doNotPerform is true\n    return {id: DeviceOrder.id, requestStatusReason: GetStatusReason(DeviceOrder), authoredOn: DeviceOrder.authoredOn}\n    )\n  union\n    (\n      [\"Procedure\": \"Device Application\"] DeviceApplied\n      let DeviceNotDoneTiming: Global.GetExtension(DeviceApplied, 'qicore-recorded').value\n      where (DeviceApplied.usedCode in \"Intermittent pneumatic compression devices (IPC)\"\n            or DeviceApplied.usedCode in \"Venous foot pumps (VFP)\"\n            or DeviceApplied.usedCode in \"Graduated compression stockings (GCS)\"\n            )\n         and  DeviceApplied.status = 'not-done'\n         return {id: DeviceApplied.id, requestStatusReason: DeviceApplied.statusReason, authoredOn: DeviceNotDoneTiming}\n\n    )"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 16
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "EXM108"
      },
      {
        "url" : "name",
        "valueString" : "No VTE Prophylaxis Device Due to Medical Reason From Day of Start of Hospitalization To Day After Admission"
      },
      {
        "url" : "statement",
        "valueString" : "define \"No VTE Prophylaxis Device Due to Medical Reason From Day of Start of Hospitalization To Day After Admission\":\n  \"Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions\" QualifyingEncounter\n  \twith \"No VTE Prophylaxis Device Applied or Ordered\" NoVTEDevice\n      such that NoVTEDevice.requestStatusReason in \"Medical Reason\"\n        and  NoVTEDevice.authoredOn during VTEICU.\"FromDayOfStartOfHospitalizationToDayAfterAdmission\"(QualifyingEncounter)"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 17
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "EXM108"
      },
      {
        "url" : "name",
        "valueString" : "No VTE Prophylaxis Medication Due to Medical Reason on Day of or Day After Procedure"
      },
      {
        "url" : "statement",
        "valueString" : "define \"No VTE Prophylaxis Medication Due to Medical Reason on Day of or Day After Procedure\":\n\tfrom\n  \t\t\"Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions\" QualifyingEncounter,\n  \t\t[\"Procedure\": \"General or Neuraxial Anesthesia\"] AnesthesiaProcedure,\n  \t\t\"No VTE Prophylaxis Medication Administered or Ordered\" NoVTEMedication\n\twhere Coalesce(NoVTEMedication.statusReason,NoVTEMedication.reasonCode) in \"Medical Reason\"\n\t\t\tand AnesthesiaProcedure.status = 'completed'\n\t\t\tand Global.\"Normalize Interval\"(AnesthesiaProcedure.performed) ends 1 day after day of start of QualifyingEncounter.period\n\t\t\tand Coalesce(NoVTEMedication.authoredOn, start of Global.\"Normalize Interval\"(NoVTEMedication.effective)) during TJC.\"CalendarDayOfOrDayAfter\"(end of Global.\"Normalize Interval\"(AnesthesiaProcedure.performed))\n  return QualifyingEncounter"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 18
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "EXM108"
      },
      {
        "url" : "name",
        "valueString" : "No VTE Prophylaxis Device Due to Medical Reason on Day of or Day After Procedure"
      },
      {
        "url" : "statement",
        "valueString" : "define \"No VTE Prophylaxis Device Due to Medical Reason on Day of or Day After Procedure\":\n  from\n  \t\t\"Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions\" QualifyingEncounter,\n  \t\t[\"Procedure\": \"General or Neuraxial Anesthesia\"] AnesthesiaProcedure,\n  \t\t\"No VTE Prophylaxis Device Applied or Ordered\" NoVTEDevice\n  where  NoVTEDevice.requestStatusReason in \"Medical Reason\"\n      and AnesthesiaProcedure.status = 'completed'\n  \t\tand Global.\"Normalize Interval\"(AnesthesiaProcedure.performed) ends 1 day after day of start of QualifyingEncounter.period\n      and NoVTEDevice.authoredOn during TJC.\"CalendarDayOfOrDayAfter\"(end of Global.\"Normalize Interval\"(AnesthesiaProcedure.performed))\n  return QualifyingEncounter"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 19
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "EXM108"
      },
      {
        "url" : "name",
        "valueString" : "Encounter With No VTE Prophylaxis Due to Medical Reason"
      },
      {
        "url" : "statement",
        "valueString" : "define \"Encounter With No VTE Prophylaxis Due to Medical Reason\":\n   ( \"No VTE Prophylaxis Medication Due to Medical Reason From Day of Start of Hospitalization To Day After Admission\"\n     intersect \"No VTE Prophylaxis Device Due to Medical Reason From Day of Start of Hospitalization To Day After Admission\"\n   )\n   union ( \"No VTE Prophylaxis Medication Due to Medical Reason on Day of or Day After Procedure\"\n       intersect \"No VTE Prophylaxis Device Due to Medical Reason on Day of or Day After Procedure\"\n       )"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 20
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "EXM108"
      },
      {
        "url" : "name",
        "valueString" : "No VTE Prophylaxis Medication or Device Due to Patient Refusal"
      },
      {
        "url" : "statement",
        "valueString" : "define \"No VTE Prophylaxis Medication or Device Due to Patient Refusal\":\n    ( \"No VTE Prophylaxis Medication Administered or Ordered\" NoVTEMedication\n        where Coalesce(NoVTEMedication.statusReason,NoVTEMedication.reasonCode) in \"Patient Refusal\"\n    )\n  union (\"No VTE Prophylaxis Device Applied or Ordered\" NoVTEDevice\n           where NoVTEDevice.requestStatusReason in \"Patient Refusal\"\n        )"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 21
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "EXM108"
      },
      {
        "url" : "name",
        "valueString" : "No VTE Prophylaxis Due to Patient Refusal From Day of Start of Hospitalization To Day After Admission"
      },
      {
        "url" : "statement",
        "valueString" : "define \"No VTE Prophylaxis Due to Patient Refusal From Day of Start of Hospitalization To Day After Admission\":\n \t\"Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions\" QualifyingEncounter\n\t with \"No VTE Prophylaxis Medication or Device Due to Patient Refusal\" PatientRefusal\n   such that Coalesce(start of Global.\"Normalize Interval\"(PatientRefusal.effective), PatientRefusal.authoredOn)\n         during VTEICU.\"FromDayOfStartOfHospitalizationToDayAfterAdmission\"(QualifyingEncounter)"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 22
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "EXM108"
      },
      {
        "url" : "name",
        "valueString" : "No VTE Prophylaxis Due to Patient Refusal on Day of or Day After Procedure"
      },
      {
        "url" : "statement",
        "valueString" : "define \"No VTE Prophylaxis Due to Patient Refusal on Day of or Day After Procedure\":\n \tfrom\n   \t\t\"Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions\" QualifyingEncounter,\n   \t\t[\"Procedure\": \"General or Neuraxial Anesthesia\"] AnesthesiaProcedure,\n   \t\t\"No VTE Prophylaxis Medication or Device Due to Patient Refusal\" PatientRefusal\n\twhere Global.\"Normalize Interval\"(AnesthesiaProcedure.performed) ends 1 day after day of start of QualifyingEncounter.period\n \t\t\tand Coalesce(start of Global.\"Normalize Interval\"(PatientRefusal.effective), PatientRefusal.authoredOn)\n             during TJC.\"CalendarDayOfOrDayAfter\"(end of Global.\"Normalize Interval\"(AnesthesiaProcedure.performed))\n\treturn QualifyingEncounter"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 23
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "EXM108"
      },
      {
        "url" : "name",
        "valueString" : "Encounter With No VTE Prophylaxis Due to Patient Refusal"
      },
      {
        "url" : "statement",
        "valueString" : "define \"Encounter With No VTE Prophylaxis Due to Patient Refusal\":\n \"No VTE Prophylaxis Due to Patient Refusal From Day of Start of Hospitalization To Day After Admission\"\n \tunion \"No VTE Prophylaxis Due to Patient Refusal on Day of or Day After Procedure\""
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 24
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "EXM108"
      },
      {
        "url" : "name",
        "valueString" : "Numerator"
      },
      {
        "url" : "statement",
        "valueString" : "define \"Numerator\":\n  \"Encounter With VTE Prophylaxis Received on Day of or Day After Admission or Procedure\"\n    union ( \"Encounter With Medication Oral Factor Xa Inhibitor Administered on Day of or Day After Admission or Procedure\"\n    \t\t\t  intersect ( \"Encounter With Prior or Present Diagnosis of Atrial Fibrillation or VTE\"\n    \t\t\t\t\t\t    union \"Encounter With Prior or Present Procedure of Hip or Knee Replacement Surgery\"\n    \t\t\t            )\n          )\n    union \"Encounter With Low Risk for VTE or Anticoagulant Administered\"\n    union \"Encounter With No VTE Prophylaxis Due to Medical Reason\"\n    union \"Encounter With No VTE Prophylaxis Due to Patient Refusal\""
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 25
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "EXM108"
      },
      {
        "url" : "name",
        "valueString" : "Initial Population"
      },
      {
        "url" : "statement",
        "valueString" : "define \"Initial Population\":\n  \"Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions\""
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 26
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "EXM108"
      },
      {
        "url" : "name",
        "valueString" : "Denominator"
      },
      {
        "url" : "statement",
        "valueString" : "define \"Denominator\":\n      \"Initial Population\""
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 27
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "SupplementalDataElements"
      },
      {
        "url" : "name",
        "valueString" : "SDE Payer"
      },
      {
        "url" : "statement",
        "valueString" : "define \"SDE Payer\":\n  [Coverage: type in \"Payer\"] Payer\n        return {\n          code: Payer.type,\n          period: Payer.period\n        }"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 28
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "EXM108"
      },
      {
        "url" : "name",
        "valueString" : "SDE Payer"
      },
      {
        "url" : "statement",
        "valueString" : "define \"SDE Payer\":\n\tSDE.\"SDE Payer\""
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 29
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "SupplementalDataElements"
      },
      {
        "url" : "name",
        "valueString" : "SDE Ethnicity"
      },
      {
        "url" : "statement",
        "valueString" : "define \"SDE Ethnicity\":\n  (flatten (\n      Patient.extension Extension\n        where Extension.url = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity'\n          return Extension.extension\n    )) E\n      where E.url = 'ombCategory'\n        or E.url = 'detailed'\n      return E.value as Coding"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 30
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "EXM108"
      },
      {
        "url" : "name",
        "valueString" : "SDE Ethnicity"
      },
      {
        "url" : "statement",
        "valueString" : "define \"SDE Ethnicity\":\n  SDE.\"SDE Ethnicity\""
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 31
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "EXM108"
      },
      {
        "url" : "name",
        "valueString" : "Encounter Less Than 2 Days"
      },
      {
        "url" : "statement",
        "valueString" : "define \"Encounter Less Than 2 Days\":\n  \"Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions\" QualifyingEncounter\n  \twhere Global.\"LengthInDays\"(QualifyingEncounter.period)< 2"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 32
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "EXM108"
      },
      {
        "url" : "name",
        "valueString" : "Encounter With ICU Location Stay 1 Day or More"
      },
      {
        "url" : "statement",
        "valueString" : "define \"Encounter With ICU Location Stay 1 Day or More\":\n  \"Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions\" QualifyingEncounter\n    where exists ( QualifyingEncounter.location Location\n    \t\twhere Global.GetLocation(Location.location).type in \"Intensive Care Unit\"\n    \t\t\tand Global.\"LengthInDays\"(Location.period)>= 1\n    \t\t\tand Location.period starts during TJC.\"CalendarDayOfOrDayAfter\"(start of QualifyingEncounter.period)\n\t    )"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 33
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "EXM108"
      },
      {
        "url" : "name",
        "valueString" : "Encounter With Principal Diagnosis of Mental Disorder or Stroke"
      },
      {
        "url" : "statement",
        "valueString" : "define \"Encounter With Principal Diagnosis of Mental Disorder or Stroke\":\n  \"Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions\" QualifyingEncounter\n    where Global.\"PrincipalDiagnosis\"(QualifyingEncounter).code in \"Mental Health Diagnoses\"\n        or Global.\"PrincipalDiagnosis\"(QualifyingEncounter).code in \"Hemorrhagic Stroke\"\n        or Global.\"PrincipalDiagnosis\"(QualifyingEncounter).code in \"Ischemic Stroke\""
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 34
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "EXM108"
      },
      {
        "url" : "name",
        "valueString" : "SCIP VTE Selected Surgery"
      },
      {
        "url" : "statement",
        "valueString" : "define \"SCIP VTE Selected Surgery\":\n  (\t[\"Procedure\": \"General Surgery\"]\n    union [\"Procedure\": \"Gynecological Surgery\"]\n    union [\"Procedure\": \"Hip Fracture Surgery\"]\n    union [\"Procedure\": \"Hip Replacement Surgery\"]\n    union [\"Procedure\": \"Intracranial Neurosurgery\"]\n    union [\"Procedure\": \"Knee Replacement Surgery\"]\n    union [\"Procedure\": \"Urological Surgery\"] ) Procedure\n  where Procedure.status = 'completed'"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 35
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "EXM108"
      },
      {
        "url" : "name",
        "valueString" : "Encounter With Principal Procedure of SCIP VTE Selected Surgery"
      },
      {
        "url" : "statement",
        "valueString" : "define \"Encounter With Principal Procedure of SCIP VTE Selected Surgery\":\n  from\n    \"Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions\" QualifyingEncounter,\n    \"SCIP VTE Selected Surgery\" SelectedProcedure\n  let EncounterProcedure: Global.GetExtension(QualifyingEncounter, 'qicore-encounter-procedure')\n  where FHIRHelpers.ToInteger(Global.GetExtension(EncounterProcedure, 'rank').value as FHIR.positiveInt) = 1\n    and Global.GetId(FHIRHelpers.ToString((Global.GetExtension(EncounterProcedure, 'procedure').value as FHIR.Reference).reference)) = SelectedProcedure.id\n    and Global.\"Normalize Interval\"(SelectedProcedure.performed) during QualifyingEncounter.period"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 36
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "EXM108"
      },
      {
        "url" : "name",
        "valueString" : "Intervention Comfort Measures"
      },
      {
        "url" : "statement",
        "valueString" : "define \"Intervention Comfort Measures\":\n\t([\"ServiceRequest\": \"Comfort Measures\"] P\n    \t\twhere P.intent = 'order'\n  )\n  \tunion\n    \t([\"Procedure\": \"Comfort Measures\"] InterventionPerformed\n      \twhere InterventionPerformed.status in {'completed', 'in-progress'})"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 37
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "EXM108"
      },
      {
        "url" : "name",
        "valueString" : "Encounter With Intervention Comfort Measures From Day of Start of Hospitalization To Day After Admission"
      },
      {
        "url" : "statement",
        "valueString" : "define \"Encounter With Intervention Comfort Measures From Day of Start of Hospitalization To Day After Admission\":\n\t\"Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions\" QualifyingEncounter\n\t\twith \"Intervention Comfort Measures\" ComfortMeasure\n\t\tsuch that Coalesce(start of Global.\"Normalize Interval\"(ComfortMeasure.performed), ComfortMeasure.authoredOn) during VTEICU.\"FromDayOfStartOfHospitalizationToDayAfterAdmission\"(QualifyingEncounter)"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 38
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "EXM108"
      },
      {
        "url" : "name",
        "valueString" : "Encounter With Intervention Comfort Measures on Day of or Day After Procedure"
      },
      {
        "url" : "statement",
        "valueString" : "define \"Encounter With Intervention Comfort Measures on Day of or Day After Procedure\":\n  from\n    \"Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions\" QualifyingEncounter,\n    [\"Procedure\": \"General or Neuraxial Anesthesia\"] AnesthesiaProcedure,\n    \"Intervention Comfort Measures\" ComfortMeasure\n  where AnesthesiaProcedure.status = 'completed'\n      and Global.\"Normalize Interval\"(AnesthesiaProcedure.performed) ends 1 day after day of start of QualifyingEncounter.period\n      and Coalesce(start of Global.\"Normalize Interval\"(ComfortMeasure.performed), ComfortMeasure.authoredOn) during TJC.\"CalendarDayOfOrDayAfter\"(end of Global.\"Normalize Interval\"(AnesthesiaProcedure.performed))\n  return QualifyingEncounter"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 39
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "EXM108"
      },
      {
        "url" : "name",
        "valueString" : "Denominator Exclusion"
      },
      {
        "url" : "statement",
        "valueString" : "define \"Denominator Exclusion\":\n  \"Encounter Less Than 2 Days\"\n     union \"Encounter With ICU Location Stay 1 Day or More\"\n     union \"Encounter With Principal Diagnosis of Mental Disorder or Stroke\"\n     union \"Encounter With Principal Procedure of SCIP VTE Selected Surgery\"\n     union \"Encounter With Intervention Comfort Measures From Day of Start of Hospitalization To Day After Admission\"\n     union \"Encounter With Intervention Comfort Measures on Day of or Day After Procedure\""
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 40
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "SupplementalDataElements"
      },
      {
        "url" : "name",
        "valueString" : "SDE Race"
      },
      {
        "url" : "statement",
        "valueString" : "define \"SDE Race\":\n  (flatten (\n      Patient.extension Extension\n        where Extension.url = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-race'\n          return Extension.extension\n    )) E\n      where E.url = 'ombCategory'\n        or E.url = 'detailed'\n      return E.value as Coding"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 41
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "EXM108"
      },
      {
        "url" : "name",
        "valueString" : "SDE Race"
      },
      {
        "url" : "statement",
        "valueString" : "define \"SDE Race\":\n  SDE.\"SDE Race\""
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 42
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "FHIRHelpers"
      },
      {
        "url" : "name",
        "valueString" : "ToString"
      },
      {
        "url" : "statement",
        "valueString" : "define function ToString(value AdministrativeGender): value.value"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 43
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "FHIRHelpers"
      },
      {
        "url" : "name",
        "valueString" : "ToString"
      },
      {
        "url" : "statement",
        "valueString" : "define function ToString(value EncounterStatus): value.value"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 44
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "MATGlobalCommonFunctions"
      },
      {
        "url" : "name",
        "valueString" : "LengthInDays"
      },
      {
        "url" : "statement",
        "valueString" : "define function \"LengthInDays\"(Value Interval<DateTime>):\n\tdifference in days between start of Value and end of Value"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 45
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "FHIRHelpers"
      },
      {
        "url" : "name",
        "valueString" : "ToInterval"
      },
      {
        "url" : "statement",
        "valueString" : "/*\n@description: Converts the given [Period](https://hl7.org/fhir/datatypes.html#Period)\nvalue to a CQL DateTime Interval\n@comment: If the start value of the given period is unspecified, the starting\nboundary of the resulting interval will be open (meaning the start of the interval\nis unknown, as opposed to interpreted as the beginning of time).\n*/\ndefine function ToInterval(period FHIR.Period):\n    if period is null then\n        null\n    else\n        if period.\"start\" is null then\n            Interval(period.\"start\".value, period.\"end\".value]\n        else\n            Interval[period.\"start\".value, period.\"end\".value]"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 46
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "MATGlobalCommonFunctions"
      },
      {
        "url" : "name",
        "valueString" : "CalendarAgeInYearsAt"
      },
      {
        "url" : "statement",
        "valueString" : "define function \"CalendarAgeInYearsAt\"(BirthDateTime DateTime, AsOf DateTime):\n\tyears between ToDate(BirthDateTime)and ToDate(AsOf)"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 47
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "MATGlobalCommonFunctions"
      },
      {
        "url" : "name",
        "valueString" : "ToDate"
      },
      {
        "url" : "statement",
        "valueString" : "define function \"ToDate\"(Value DateTime):\n\tDateTime(year from Value, month from Value, day from Value, 0, 0, 0, 0, timezoneoffset from Value)"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 48
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "FHIRHelpers"
      },
      {
        "url" : "name",
        "valueString" : "ToDate"
      },
      {
        "url" : "statement",
        "valueString" : "define function ToDate(value date): value.value"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 49
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "MATGlobalCommonFunctions"
      },
      {
        "url" : "name",
        "valueString" : "EncounterDiagnosis"
      },
      {
        "url" : "statement",
        "valueString" : "define function \"EncounterDiagnosis\"(Encounter Encounter):\n  Encounter.diagnosis D\n    return singleton from ([Condition] C where C.id = \"GetId\"(D.condition.reference))"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 50
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "FHIRHelpers"
      },
      {
        "url" : "name",
        "valueString" : "ToString"
      },
      {
        "url" : "statement",
        "valueString" : "define function ToString(value string): value.value"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 51
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "MATGlobalCommonFunctions"
      },
      {
        "url" : "name",
        "valueString" : "GetId"
      },
      {
        "url" : "statement",
        "valueString" : "define function \"GetId\"(uri String):\n\tLast(Split(uri, '/'))"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 52
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "FHIRHelpers"
      },
      {
        "url" : "name",
        "valueString" : "ToConcept"
      },
      {
        "url" : "statement",
        "valueString" : "/*\n@description: Converts the given FHIR [CodeableConcept](https://hl7.org/fhir/datatypes.html#CodeableConcept) value to a CQL Concept.\n*/\ndefine function ToConcept(concept FHIR.CodeableConcept):\n    if concept is null then\n        null\n    else\n        System.Concept {\n            codes: concept.coding C return ToCode(C),\n            display: concept.text.value\n        }"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 53
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "FHIRHelpers"
      },
      {
        "url" : "name",
        "valueString" : "ToCode"
      },
      {
        "url" : "statement",
        "valueString" : "/*\n@description: Converts the given FHIR [Coding](https://hl7.org/fhir/datatypes.html#Coding) value to a CQL Code.\n*/\ndefine function ToCode(coding FHIR.Coding):\n    if coding is null then\n        null\n    else\n        System.Code {\n          code: coding.code.value,\n          system: coding.system.value,\n          version: coding.version.value,\n          display: coding.display.value\n        }"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 54
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "FHIRHelpers"
      },
      {
        "url" : "name",
        "valueString" : "ToString"
      },
      {
        "url" : "statement",
        "valueString" : "define function ToString(value MedicationAdministrationStatus): value.value"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 55
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "FHIRHelpers"
      },
      {
        "url" : "name",
        "valueString" : "ToString"
      },
      {
        "url" : "statement",
        "valueString" : "define function ToString(value ProcedureStatus): value.value"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 56
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "MATGlobalCommonFunctions"
      },
      {
        "url" : "name",
        "valueString" : "Normalize Interval"
      },
      {
        "url" : "statement",
        "valueString" : "/*\n*\n*    CQFMeasures Common Logic\n*\n*/\n\ndefine function \"Normalize Interval\"(choice Choice<FHIR.dateTime, FHIR.Period, FHIR.Timing, FHIR.instant, FHIR.string, FHIR.Age, FHIR.Range>):\n  case\n\t  when choice is FHIR.dateTime then\n    \tInterval[FHIRHelpers.ToDateTime(choice as FHIR.dateTime), FHIRHelpers.ToDateTime(choice as FHIR.dateTime)]\n\t\twhen choice is FHIR.Period then\n  \t\tFHIRHelpers.ToInterval(choice as FHIR.Period)\n\t\twhen choice is FHIR.instant then\n\t\t\tInterval[FHIRHelpers.ToDateTime(choice as FHIR.instant), FHIRHelpers.ToDateTime(choice as FHIR.instant)]\n\t\twhen choice is FHIR.Age then\n\t\t  Interval[FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(choice as FHIR.Age),\n\t\t\t  FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(choice as FHIR.Age) + 1 year)\n\t\twhen choice is FHIR.Range then\n\t\t  Interval[FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity((choice as FHIR.Range).low),\n\t\t\t  FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity((choice as FHIR.Range).high) + 1 year)\n\t\twhen choice is FHIR.Timing then\n\t\t  Message(null as Interval<DateTime>, true, '1', 'Error', 'Cannot compute a single interval from a Timing type')\n    when choice is FHIR.string then\n      Message(null as Interval<DateTime>, true, '1', 'Error', 'Cannot compute an interval from a String value')\n\t\telse\n\t\t\tnull as Interval<DateTime>\n\tend"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 57
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "FHIRHelpers"
      },
      {
        "url" : "name",
        "valueString" : "ToDateTime"
      },
      {
        "url" : "statement",
        "valueString" : "define function ToDateTime(value dateTime): value.value"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 58
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "FHIRHelpers"
      },
      {
        "url" : "name",
        "valueString" : "ToDateTime"
      },
      {
        "url" : "statement",
        "valueString" : "define function ToDateTime(value instant): value.value"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 59
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "FHIRHelpers"
      },
      {
        "url" : "name",
        "valueString" : "ToQuantity"
      },
      {
        "url" : "statement",
        "valueString" : "/*\n@description: Converts the given FHIR [Quantity](https://hl7.org/fhir/datatypes.html#Quantity) \nvalue to a CQL Quantity\n@comment: If the given quantity has a comparator specified, a runtime error is raised. If the given quantity\nhas a system other than UCUM (i.e. `http://unitsofmeasure.org`) or CQL calendar units (i.e. `http://hl7.org/fhirpath/CodeSystem/calendar-units`)\nan error is raised. For UCUM to calendar units, the `ToCalendarUnit` function is used.\n@seealso: ToCalendarUnit\n*/\ndefine function ToQuantity(quantity FHIR.Quantity):\n    case\n        when quantity is null then null\n        when quantity.value is null then null\n        when quantity.comparator is not null then\n            Message(null, true, 'FHIRHelpers.ToQuantity.ComparatorQuantityNotSupported', 'Error', 'FHIR Quantity value has a comparator and cannot be converted to a System.Quantity value.')\n        when quantity.system is null or quantity.system.value = 'http://unitsofmeasure.org'\n              or quantity.system.value = 'http://hl7.org/fhirpath/CodeSystem/calendar-units' then\n            System.Quantity { value: quantity.value.value, unit: ToCalendarUnit(Coalesce(quantity.code.value, quantity.unit.value, '1')) }\n        else\n            Message(null, true, 'FHIRHelpers.ToQuantity.InvalidFHIRQuantity', 'Error', 'Invalid FHIR Quantity code: ' & quantity.unit.value & ' (' & quantity.system.value & '|' & quantity.code.value & ')')\n    end"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 60
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "FHIRHelpers"
      },
      {
        "url" : "name",
        "valueString" : "ToCalendarUnit"
      },
      {
        "url" : "statement",
        "valueString" : "/*\n@description: Converts a UCUM definite duration unit to a CQL calendar duration\nunit using conversions specified in the [quantities](https://cql.hl7.org/02-authorsguide.html#quantities) \ntopic of the CQL specification.\n@comment: Note that for durations above days (or weeks), the conversion is understood to be approximate\n*/\ndefine function ToCalendarUnit(unit System.String):\n    case unit\n        when 'ms' then 'millisecond'\n        when 's' then 'second'\n        when 'min' then 'minute'\n        when 'h' then 'hour'\n        when 'd' then 'day'\n        when 'wk' then 'week'\n        when 'mo' then 'month'\n        when 'a' then 'year'\n        else unit\n    end"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 61
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "TJCOverall"
      },
      {
        "url" : "name",
        "valueString" : "CalendarDayOfOrDayAfter"
      },
      {
        "url" : "statement",
        "valueString" : "define function \"CalendarDayOfOrDayAfter\"(StartValue DateTime ):\n\tInterval(Global.\"ToDate\"(StartValue), Global.\"ToDate\"(StartValue + 2 days))"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 62
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "FHIRHelpers"
      },
      {
        "url" : "name",
        "valueString" : "ToString"
      },
      {
        "url" : "statement",
        "valueString" : "define function ToString(value ObservationStatus): value.value"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 63
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "VTEICU"
      },
      {
        "url" : "name",
        "valueString" : "FromDayOfStartOfHospitalizationToDayAfterAdmission"
      },
      {
        "url" : "statement",
        "valueString" : "define function \"FromDayOfStartOfHospitalizationToDayAfterAdmission\"(Encounter FHIR.Encounter ):\n\tInterval[Global.\"ToDate\"(start of Global.\"HospitalizationWithObservation\"(Encounter)), Global.\"ToDate\"(start of Encounter.period + 2 days))"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 64
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "MATGlobalCommonFunctions"
      },
      {
        "url" : "name",
        "valueString" : "HospitalizationWithObservation"
      },
      {
        "url" : "statement",
        "valueString" : "define function \"HospitalizationWithObservation\"(TheEncounter FHIR.Encounter):\n\tTheEncounter Visit\n\t\tlet ObsVisit: Last([Encounter: \"Observation Services\"] LastObs\n\t\t\t\twhere LastObs.period ends 1 hour or less on or before start of Visit.period\n\t\t\t\tsort by end of period\n\t\t\t),\n\t\t\tVisitStart: Coalesce(start of ObsVisit.period, start of Visit.period),\n\t\t\tEDVisit: Last([Encounter: \"Emergency Department Visit\"] LastED\n\t\t\t\twhere LastED.period ends 1 hour or less on or before VisitStart\n\t\t\t\tsort by end of period\n\t\t\t)\n\t\treturn Interval[Coalesce(start of EDVisit.period, VisitStart), end of Visit.period]"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 65
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "FHIRHelpers"
      },
      {
        "url" : "name",
        "valueString" : "ToBoolean"
      },
      {
        "url" : "statement",
        "valueString" : "define function ToBoolean(value boolean): value.value"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 66
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "FHIRHelpers"
      },
      {
        "url" : "name",
        "valueString" : "ToString"
      },
      {
        "url" : "statement",
        "valueString" : "define function ToString(value MedicationRequestStatus): value.value"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 67
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "FHIRHelpers"
      },
      {
        "url" : "name",
        "valueString" : "ToString"
      },
      {
        "url" : "statement",
        "valueString" : "define function ToString(value ServiceRequestStatus): value.value"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 68
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "EXM108"
      },
      {
        "url" : "name",
        "valueString" : "GetStatusReason"
      },
      {
        "url" : "statement",
        "valueString" : "//11/5: ServiceRequest not done reason is an extension in QI-Core R4 as ServiceRequest.extension:statusReason\ndefine function GetStatusReason(requestReason ServiceRequest):\n      Global.GetBaseExtension(requestReason, 'request-statusReason')"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 69
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "MATGlobalCommonFunctions"
      },
      {
        "url" : "name",
        "valueString" : "GetBaseExtension"
      },
      {
        "url" : "statement",
        "valueString" : "define function \"GetBaseExtension\"(domainResource DomainResource, url String):\n  singleton from \"GetBaseExtensions\"(domainResource, url)"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 70
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "MATGlobalCommonFunctions"
      },
      {
        "url" : "name",
        "valueString" : "GetBaseExtensions"
      },
      {
        "url" : "statement",
        "valueString" : "/*\nNOTE: Extensions are not the preferred approach, but are used as a way to access\ncontent that is defined by extensions but not yet surfaced in the\nCQL model info.\n*/\ndefine function \"GetBaseExtensions\"(domainResource DomainResource, url String):\n  domainResource.extension E\n\t  where E.url = ('http://hl7.org/fhir/StructureDefinition/' + url)\n\t\treturn E"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 71
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "FHIRHelpers"
      },
      {
        "url" : "name",
        "valueString" : "ToString"
      },
      {
        "url" : "statement",
        "valueString" : "define function ToString(value uri): value.value"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 72
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "MATGlobalCommonFunctions"
      },
      {
        "url" : "name",
        "valueString" : "GetExtension"
      },
      {
        "url" : "statement",
        "valueString" : "define function \"GetExtension\"(domainResource DomainResource, url String):\n  singleton from \"GetExtensions\"(domainResource, url)"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 73
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "MATGlobalCommonFunctions"
      },
      {
        "url" : "name",
        "valueString" : "GetExtensions"
      },
      {
        "url" : "statement",
        "valueString" : "/*\nNOTE: Extensions are not the preferred approach, but are used as a way to access\ncontent that is defined by extensions but not yet surfaced in the\nCQL model info.\n*/\ndefine function \"GetExtensions\"(domainResource DomainResource, url String):\n  domainResource.extension E\n\t  where E.url = ('http://hl7.org/fhir/us/qicore/StructureDefinition/' + url)\n\t\treturn E"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 74
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "MATGlobalCommonFunctions"
      },
      {
        "url" : "name",
        "valueString" : "GetLocation"
      },
      {
        "url" : "statement",
        "valueString" : "// Returns the location for the given location reference\ndefine function GetLocation(reference Reference):\n  singleton from (\n    [Location] L where L.id = GetId(reference.reference)\n  )"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 75
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "MATGlobalCommonFunctions"
      },
      {
        "url" : "name",
        "valueString" : "PrincipalDiagnosis"
      },
      {
        "url" : "statement",
        "valueString" : "// Returns the condition that is specified as the principal diagnosis for the encounter\n// TODO: BTR 2019-07-30: Shouldn't need the FHIRHelpers reference here, investigate\ndefine function \"PrincipalDiagnosis\"(Encounter Encounter):\n\t(singleton from (Encounter.diagnosis D where FHIRHelpers.ToInteger(D.rank) = 1)) PD\n\t\treturn singleton from ([Condition] C where C.id = \"GetId\"(PD.condition.reference))"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 76
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "FHIRHelpers"
      },
      {
        "url" : "name",
        "valueString" : "ToInteger"
      },
      {
        "url" : "statement",
        "valueString" : "define function ToInteger(value integer): value.value"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 77
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "MATGlobalCommonFunctions"
      },
      {
        "url" : "name",
        "valueString" : "GetExtension"
      },
      {
        "url" : "statement",
        "valueString" : "define function \"GetExtension\"(element Element, url String):\n  singleton from \"GetExtensions\"(element, url)"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 78
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "MATGlobalCommonFunctions"
      },
      {
        "url" : "name",
        "valueString" : "GetExtensions"
      },
      {
        "url" : "statement",
        "valueString" : "/*\nNOTE: Extensions are not the preferred approach, but are used as a way to access\ncontent that is defined by extensions but not yet surfaced in the\nCQL model info.\n*/\ndefine function \"GetExtensions\"(element Element, url String):\n  element.extension E\n\t  where E.url = (url)\n\t\treturn E"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 79
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "FHIRHelpers"
      },
      {
        "url" : "name",
        "valueString" : "ToString"
      },
      {
        "url" : "statement",
        "valueString" : "define function ToString(value ServiceRequestIntent): value.value"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 80
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    }],
    "name" : "EffectiveDataRequirements",
    "status" : "active",
    "type" : {
      "coding" : [{
        "system" : "http://terminology.hl7.org/CodeSystem/library-type",
        "code" : "module-definition"
      }]
    },
    "relatedArtifact" : [{
      "type" : "depends-on",
      "display" : "FHIR model information",
      "resource" : "http://hl7.org/fhir/uv/cql/Library/FHIR-ModelInfo|4.0.1"
    },
    {
      "type" : "depends-on",
      "display" : "Library SDE",
      "resource" : "http://hl7.org/fhir/uv/cqm/Library/SupplementalDataElements|2.0.000"
    },
    {
      "type" : "depends-on",
      "display" : "Library FHIRHelpers",
      "resource" : "http://hl7.org/fhir/uv/cql/Library/FHIRHelpers|4.0.1"
    },
    {
      "type" : "depends-on",
      "display" : "Library Global",
      "resource" : "http://hl7.org/fhir/uv/cqm/Library/MATGlobalCommonFunctions|5.0.000"
    },
    {
      "type" : "depends-on",
      "display" : "Library TJC",
      "resource" : "http://hl7.org/fhir/uv/cqm/Library/TJCOverall|4.0.000"
    },
    {
      "type" : "depends-on",
      "display" : "Library VTEICU",
      "resource" : "http://hl7.org/fhir/uv/cqm/Library/VTEICU|5.0.000"
    },
    {
      "type" : "depends-on",
      "display" : "Code system ConditionClinicalStatusCodes",
      "resource" : "http://terminology.hl7.org/CodeSystem/condition-clinical"
    },
    {
      "type" : "depends-on",
      "display" : "Code system LOINC",
      "resource" : "http://loinc.org"
    },
    {
      "type" : "depends-on",
      "display" : "Value set Encounter Inpatient",
      "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307"
    },
    {
      "type" : "depends-on",
      "display" : "Value set Obstetrics",
      "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.263"
    },
    {
      "type" : "depends-on",
      "display" : "Value set Venous Thromboembolism",
      "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.279"
    },
    {
      "type" : "depends-on",
      "display" : "Value set Obstetrics VTE",
      "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.264"
    },
    {
      "type" : "depends-on",
      "display" : "Value set Low Dose Unfractionated Heparin for VTE Prophylaxis",
      "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.39"
    },
    {
      "type" : "depends-on",
      "display" : "Value set Subcutaneous route",
      "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.223"
    },
    {
      "type" : "depends-on",
      "display" : "Value set Low Molecular Weight Heparin for VTE Prophylaxis",
      "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.219"
    },
    {
      "type" : "depends-on",
      "display" : "Value set Injectable Factor Xa Inhibitor for VTE Prophylaxis",
      "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.211"
    },
    {
      "type" : "depends-on",
      "display" : "Value set Warfarin",
      "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.232"
    },
    {
      "type" : "depends-on",
      "display" : "Value set Device Application",
      "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.48"
    },
    {
      "type" : "depends-on",
      "display" : "Value set Intermittent pneumatic compression devices (IPC)",
      "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.214"
    },
    {
      "type" : "depends-on",
      "display" : "Value set Venous foot pumps (VFP)",
      "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.230"
    },
    {
      "type" : "depends-on",
      "display" : "Value set Graduated compression stockings (GCS)",
      "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.256"
    },
    {
      "type" : "depends-on",
      "display" : "Value set General or Neuraxial Anesthesia",
      "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.1743"
    },
    {
      "type" : "depends-on",
      "display" : "Value set Oral Factor Xa Inhibitor for VTE Prophylaxis or VTE Treatment",
      "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.134"
    },
    {
      "type" : "depends-on",
      "display" : "Value set Atrial Fibrillation/Flutter",
      "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.202"
    },
    {
      "type" : "depends-on",
      "display" : "Value set Hip Replacement Surgery",
      "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.259"
    },
    {
      "type" : "depends-on",
      "display" : "Value set Knee Replacement Surgery",
      "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.261"
    },
    {
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  "jurisdiction" : [{
    "coding" : [{
      "system" : "http://unstats.un.org/unsd/methods/m49/m49.htm",
      "code" : "001"
    }]
  }],
  "copyright" : "Measure specifications are in the Public Domain.\n\nLOINC(R) is a registered trademark of the Regenstrief Institute.\n\nThis material contains SNOMED Clinical Terms(R) (SNOMED CT(C)) copyright 2004-2017 International Health Terminology Standards Development Organization. All rights reserved.",
  "approvalDate" : "2019-03-08",
  "lastReviewDate" : "2019-03-08",
  "effectivePeriod" : {
    "start" : "2018-01-01",
    "end" : "2018-12-31"
  },
  "topic" : [{
    "coding" : [{
      "system" : "http://loinc.org",
      "code" : "57024-2",
      "display" : "Health Quality Measure Document"
    }]
  }],
  "library" : ["http://hl7.org/fhir/uv/cqm/Library/EXM108"],
  "disclaimer" : "These performance measures are not clinical guidelines and do not establish a standard of medical care, and have not been tested for all potential applications. The measures and specifications are provided without warranty",
  "scoring" : {
    "coding" : [{
      "system" : "http://terminology.hl7.org/CodeSystem/measure-scoring",
      "code" : "proportion",
      "display" : "Proportion"
    }]
  },
  "type" : [{
    "coding" : [{
      "system" : "http://terminology.hl7.org/CodeSystem/measure-type",
      "code" : "process"
    }]
  }],
  "rationale" : "Hospitalized patients at high-risk for VTE may develop an asymptomatic deep vein thrombosis (DVT), and die from pulmonary embolism (PE) even before the diagnosis is suspected. The majority of fatal events occur as sudden or abrupt death, underscoring the importance of prevention as the most critical action step for reducing death from PE (Geerts, et al, 2008).\n\nThe estimated annual incidence of deep-vein thrombosis (DVT) and pulmonary embolism (PE), known collectively as venous thromboembolism (VTE), is approximately 900,000 (Geerts, et al, 2008). Approximately two-thirds of cases of DVT or PE are associated with recent hospitalization. This is consistent with the 2001 report by The Agency for Healthcare Research and Quality (AHRQ). AHRQ indicates that \"the appropriate application of effective preventive measures in hospitals has major potential for improving patient safety by reducing the incidence of venous thromboembolism\" (Shojania, 2001).\n\nDespite its proven effectiveness, rates of appropriate thromboprophylaxis remain low in both medical and surgical patients. A recent analysis from the ENDORSE survey, which evaluated prophylaxis rates in 17,084 major surgery patients, found that more than one third of patients at risk for VTE (38%) did not receive prophylaxis and that rates varied by surgery type (Cohen, et al., 2008).\n\nIn a review of evidence-based patient safety practices, the Agency for Healthcare Research and Quality defined thromboprophylaxis against VTE as the \"number one patient safety practice\" for hospitalized patients (Shojania, 2001). Updated \"safe practices\" published by the National Quality Forum (NQF) recommend routine evaluation of hospitalized patients for risk of VTE and use of appropriate prophylaxis (National Quality Forum. National Voluntary Consensus Standards for Prevention and Care of Venous Thromboembolism, 2006).\n\nAs noted by the ACCP, a vast number of randomized clinical trials provide irrefutable evidence that thromboprophylaxis reduces VTE events, and there are studies that have also shown that fatal PE is prevented by thromboprophylaxis (Geerts, et al. 2008).\n\nSome select surgeries have previously been monitored in the Surgical Care Improvement Project; since performance on these surgeries has achieved very high levels, they are not included in this measure.",
  "clinicalRecommendationStatement" : "Failure to recognize and protect patients at risk for venous thromboembolism (VTE) increases the chances for acutely ill hospitalized patients at high risk for developing a deep vein thrombosis or dying from a pulmonary emboli. Screening all patients is the only evidence based practice in reducing incidence of disease.  All hospitalized patients should be evaluated for primary VTE prophylaxis, and given appropriate prophylaxis when indicated.",
  "improvementNotation" : {
    "coding" : [{
      "system" : "http://terminology.hl7.org/CodeSystem/measure-improvement-notation",
      "code" : "increase",
      "display" : "Increased score indicates improvement"
    }]
  },
  "guidance" : "When low dose unfractionated heparin is administered for VTE Prophylaxis, the intended administration route for low dose unfractionated heparin is subcutaneous.\n\nReasons for no pharmacological and no mechanical VTE prophylaxis must be explicitly documented by the MD/APN/PA or pharmacist and linked with VTE prophylaxis. Ambulation alone is not a sufficient reason for not administering VTE prophylaxis. In order for ambulation/patient ambulating to be considered as an acceptable reason, there needs to be explicit documentation, e.g., \"patient out of bed and ambulating in halls - no VTE prophylaxis needed.\"",
  "group" : [{
    "id" : "group-1",
    "extension" : [{
      "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.linkId",
      "valueString" : "primary"
    }],
    "population" : [{
      "extension" : [{
        "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.population.linkId",
        "valueString" : "primary-exm108-initial-population"
      }],
      "code" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
          "code" : "initial-population",
          "display" : "Initial Population"
        }]
      },
      "description" : "Patients age 18 and older discharged from hospital inpatient acute care without a diagnosis of venous thromboembolism (VTE) or obstetrics with a length of stay less than or equal to 120 days that ends during the measurement period",
      "criteria" : {
        "language" : "text/cql-identifier",
        "expression" : "Initial Population"
      }
    },
    {
      "extension" : [{
        "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.population.linkId",
        "valueString" : "primary-exm108-numerator"
      }],
      "code" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
          "code" : "numerator",
          "display" : "Numerator"
        }]
      },
      "description" : "Patients who received VTE prophylaxis:\n- the day of or the day after hospital admission\n- the day of or the day after surgery end date for surgeries that end the day of or the day after hospital admission\n\nPatients who have documentation of a reason why no VTE prophylaxis was given:\n- between arrival and hospital admission\n- the day of or the day after hospital admission\n- the day of or the day after surgery end date (for surgeries that end the day of or the day after hospital admission)",
      "criteria" : {
        "language" : "text/cql-identifier",
        "expression" : "Numerator"
      }
    },
    {
      "extension" : [{
        "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.population.linkId",
        "valueString" : "primary-exm108-denominator"
      }],
      "code" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
          "code" : "denominator",
          "display" : "Denominator"
        }]
      },
      "description" : "All patients in the initial population",
      "criteria" : {
        "language" : "text/cql-identifier",
        "expression" : "Denominator"
      }
    },
    {
      "extension" : [{
        "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.population.linkId",
        "valueString" : "primary-exm108-denominator-exclusion"
      }],
      "code" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
          "code" : "denominator-exclusion",
          "display" : "Denominator Exclusion"
        }]
      },
      "description" : "* Patients who have a length of stay less than 2 days\n* Patients with comfort measures documented anytime between arrival and the day after hospital admission\n* Patients with comfort measures documented by the day after surgery end date for surgeries that start the day of or the day after hospital admission\n* Patients who are direct admits to intensive care unit (ICU), or transferred to ICU the day of or the day after hospital admission with ICU length of stay greater than or equal to one day\n* Patients with a principal diagnosis of mental disorders or stroke\n* Patients with a principal procedure of Surgical Care Improvement Project (SCIP) VTE selected surgeries",
      "criteria" : {
        "language" : "text/cql-identifier",
        "expression" : "Denominator Exclusion"
      }
    }]
  }],
  "supplementalData" : [{
    "extension" : [{
      "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.supplementalData.linkId",
      "valueString" : "primary-sde-ethnicity"
    },
    {
      "url" : "http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-includeInReportType",
      "valueCode" : "summary"
    }],
    "usage" : [{
      "coding" : [{
        "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
        "code" : "supplemental-data"
      }]
    }],
    "criteria" : {
      "language" : "text/cql-identifier",
      "expression" : "SDE Ethnicity"
    }
  },
  {
    "extension" : [{
      "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.supplementalData.linkId",
      "valueString" : "primary-sde-payer"
    },
    {
      "url" : "http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-includeInReportType",
      "valueCode" : "summary"
    }],
    "usage" : [{
      "coding" : [{
        "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
        "code" : "supplemental-data"
      }]
    }],
    "criteria" : {
      "language" : "text/cql-identifier",
      "expression" : "SDE Payer"
    }
  },
  {
    "extension" : [{
      "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.supplementalData.linkId",
      "valueString" : "primary-sde-race"
    },
    {
      "url" : "http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-includeInReportType",
      "valueCode" : "summary"
    }],
    "usage" : [{
      "coding" : [{
        "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
        "code" : "supplemental-data"
      }]
    }],
    "criteria" : {
      "language" : "text/cql-identifier",
      "expression" : "SDE Race"
    }
  },
  {
    "extension" : [{
      "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.supplementalData.linkId",
      "valueString" : "primary-sde-sex"
    },
    {
      "url" : "http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-includeInReportType",
      "valueCode" : "summary"
    }],
    "usage" : [{
      "coding" : [{
        "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
        "code" : "supplemental-data"
      }]
    }],
    "criteria" : {
      "language" : "text/cql-identifier",
      "expression" : "SDE Sex"
    }
  }]
}

```
