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

## Examples

> NOTE: The examples in this implementation guide have been chosen to illlustrate specific capabilities of measure specifications, such as proportion measures, continuous variables, stratification, and composite measures. Some of the example content is based on measure specifications that were published in prior measurement years. For more examples of FHIR-based measure specifications, refer to the eCQM Content Index.

### Examples

- Simple Example Usage example illustrating all the common data elements of the CQF Measure profile - Library
- Proportion Example Encounter-based proportion measure example - Library
- Continuous-Variable Example Continuous-variable measure example - Library
- Ratio Example Ratio measure example - Library
- Terminology Example Example illustrating terminology usage - Library
- Promoting Interoperability Example Promoting Interoperability measure example
- Common Library Example Usage example illustrating a library to share logic between measures
- Supplemental Data Elements Example Library illustrating common supplemental data elements
- Age Stratified Example Measure illustrating value-based stratification by age group - Library
- Supporting Evidence Example Measure illustrating the use of supporting evidence - Library

### Screening Measures

These examples illustrate subject-based screening measures

- EXM124 Cervical Cancer Screening - Library
- EXM125 Breast Cancer Screening - Library
- EXM130 Colorectal Cancer Screening - Library

### Hospital Measures

- EXM108 Venous Thromboembolism Prophylaxis - Library

### Additional Supplemental Data Elements Measures

- NHSN Glycemic Control: Hyperglycemic Initial Population Example illustrating the use of supplemental data to gather additional information about a cohort. See the Data Exchange for Quality Measures IG for an example of the MeasureReport that results from this measure.

### Multiple-Rate Measures

- Multi-Rate Example Example measure illustrating multiple rates in a single Measure resource - Library

### Ratio Measures

A common use case involves reporting a ratio such as 'per 1000 catheter days'. These types of measures are represented as a ratio of continuous variable measures, as illustrated by the following example:

- Catheter-associated Urinary Tract Infection (CAUTI) Rate

### Risk-adjusted Measures

Applying risk-adjustment models to measures often involves calculation of a predicted denominator, such as the CAUTI SIR measure:

- Catheter-associated Urinary Tract Infection (CAUTI) Standardized Infection Ratio (SIR)

### Composite Measures

This section provides examples of all four composite measure scoring methods described by this implementation guide. Each composite is constructed using the same five component measures:

- Breast Cancer Screening (BCS) - Subject-based proportion measure
- Colorectal Cancer Screening (CCS) - Subject-based proportion measure
- High Blood Pressure Screening (HBP) - Encounter-based proportion measure
- Pneumococcal Vaccination (PVS) - Subject-based proportion measure
- Tobacco Screening (TSC) - Subject-based proportion measure

For each of these measures, the population criteria are summarized as:

Population | BCS | CCS | HBP | PVS | TSC
--- | --- | --- | --- | --- | ---
Initial Population | female, 51-74, with Qualifying Encounters | 50-75, with Qualifying Encounters | >= 18, Encounters in Encounter to Screen for Blood Pressure | >= 65, with Qualifying Encounters or Nursing/Long-term Facility encounters | >= 18 with Qualifying Encounters or Other/Counseling encounters or 2 or more Office visits
Denominator | Initial Population | Initial Population | Initial Population | Initial Population | Initial Population
Denominator Exclusions | Hospice or Mastectomy or AIFLTC | Hospice or Cancer or Colectomy or AIFLTC | Hypertension Diagnosis | Hospice | None
Denominator Exceptions | None | None | Medical or Patient Reason | None | Medical Reason or Limited Life Expectancy
Numerator | Mammography | Colonoscopy or FOBT or Flex Sig or FIT DNA or CT Colonography | Normal BP or High BP with followup | Pneumococcal Vaccine | Screened for Tobacco Use

#### All-or-nothing scoring

Interpretation: For each Eligible Clinician, the percentage of patients who received all preventive services for which they were eligible

Preventive Care and Wellness (All-or-nothing)

#### Opportunity scoring

Interpretation: For each Eligible Clinician (EC), the percentage of opportunities to provide preventive services that were completed.

Preventive Care and Wellness (Opportunity)

#### Patient-level linear

Interpretation: For each Eligible Clinician (EC), the percentage of completed preventive services, which gives EC partial numerator credit for meeting the criteria for some but not all components of the measure.

Preventive Care and Wellness (Patient-level linear)

#### Component-level weighted

Interpretation: For each Eligible Clinician (EC), percentage of patients who received preventive services, which gives EC partial numerator credit for meeting the criteria for some but not all components of the measure.

Preventive Care and Wellness (Component-level weighted)

### Manifest Examples

Manifests are used to communicate sets of measures together with all the information about their use. See the Manifest topic for more information on these examples:

- Manifest - Initial Draft
- Manifest - Final Draft
- Manifest - Release

### Test Case examples

The sections provide examples of test cases

- Simple Test Case - Example test case illustrating expected input parameters and expected output results given those input parameters.
- Bundled Test Case - Example test case in a bundle illustrating expected input parameters and expected output results given those input parameters along with evaluatedResources.