Quality Measure Implementation Guide (STU3 Ballot)
2.1.0 - ballot

Quality Measure Implementation Guide (STU3 Ballot), published by Clinical Quality Information WG. This is not an authorized publication; it is the continuous build for version 2.1.0). This version is based on the current content of https://github.com/HL7/cqf-measures/ and changes regularly. See the Directory of published versions

Example Library: Colorectal Cancer Screening

Id: EXM130
Url: http://hl7.org/fhir/us/cqfmeasures/Library/EXM130
Version: 8.0.000
Identifier:

value: EXM130

Name: EXM130
Title: Colorectal Cancer Screening
Status: active
Experimental: true
Type:

system: http://terminology.hl7.org/CodeSystem/library-type

code: logic-library

Date: 2019-09-03
Publisher: Clinical Quality Information WG
Description: This library is used as an example in the FHIR Quality Measure Implementation Guide
Use Context:
codevaluedisplay
program ep-ec EP/EC
Jurisdiction: US
Approval Date: 2019-08-03
Last Review Date: 2019-08-03
Related Artifacts:

Dependencies

  • http://fhir.org/guides/cqf/common/Library/FHIR-ModelInfo|4.0.1
  • http://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1
  • http://hl7.org/fhir/us/cqfmeasures/Library/Hospice|2.0.000
  • http://hl7.org/fhir/us/cqfmeasures/Library/AdultOutpatientEncounters|2.0.000
  • http://hl7.org/fhir/us/cqfmeasures/Library/MATGlobalCommonFunctions|5.0.000
  • http://hl7.org/fhir/us/cqfmeasures/Library/SupplementalDataElements|2.0.000
  • http://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1
  • http://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1
  • http://hl7.org/fhir/us/cqfmeasures/Library/MATGlobalCommonFunctions|5.0.000
  • http://snomed.info/sct|http://snomed.info/sct/731000124108/version/201709
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.836
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.837
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1020
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1011
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1010
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1001
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1019
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1039
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1038
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.15
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016
Parameters:
NameTypeMinMaxIn/Out
Measurement PeriodPeriod01in
Measurement PeriodPeriod01in
Measurement PeriodPeriod01in
PatientPatient01out
SDE EthnicityCoding0*out
SDE EthnicityCoding0*out
PatientPatient01out
SDE PayerAny0*out
SDE PayerAny0*out
SDE RaceCoding0*out
SDE RaceCoding0*out
SDE SexCoding01out
SDE SexCoding01out
Denominatorboolean01out
Flexible Sigmoidoscopy PerformedProcedure0*out
CT Colonography PerformedProcedure0*out
Total Colectomy PerformedProcedure0*out
Malignant Neoplasm EverCondition0*out
Fecal Occult Blood Test PerformedObservation0*out
Fecal Immunochemical Test DNAObservation0*out
Colonoscopy PerformedProcedure0*out
Numeratorboolean01out
Denominator Exclusionboolean01out
Has Hospiceboolean01out
Initial Populationboolean01out
Qualifying EncountersEncounter0*out
Data Requirements:
TypeProfileMSCode Filter
Patient http://hl7.org/fhir/StructureDefinition/Patient
Patient http://hl7.org/fhir/StructureDefinition/Patient
Coverage http://hl7.org/fhir/StructureDefinition/Coverage code filter:
path: type
value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591
Procedure http://hl7.org/fhir/StructureDefinition/Procedure code filter:
path: code
value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1010
Procedure http://hl7.org/fhir/StructureDefinition/Procedure code filter:
path: code
value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1038
Procedure http://hl7.org/fhir/StructureDefinition/Procedure code filter:
path: code
value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1019
Condition http://hl7.org/fhir/StructureDefinition/Condition code filter:
path: code
value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1001
Observation http://hl7.org/fhir/StructureDefinition/Observation code filter:
path: code
value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1011
Observation http://hl7.org/fhir/StructureDefinition/Observation code filter:
path: code
value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1039
Procedure http://hl7.org/fhir/StructureDefinition/Procedure code filter:
path: code
value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1020
Encounter http://hl7.org/fhir/StructureDefinition/Encounter code filter:
path: type
value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307
ServiceRequest http://hl7.org/fhir/StructureDefinition/ServiceRequest code filter:
path: code
value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.15
Procedure http://hl7.org/fhir/StructureDefinition/Procedure code filter:
path: code
value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.15
Encounter http://hl7.org/fhir/StructureDefinition/Encounter code filter:
path: type
value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001
Encounter http://hl7.org/fhir/StructureDefinition/Encounter code filter:
path: type
value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240
Encounter http://hl7.org/fhir/StructureDefinition/Encounter code filter:
path: type
value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025
Encounter http://hl7.org/fhir/StructureDefinition/Encounter code filter:
path: type
value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023
Encounter http://hl7.org/fhir/StructureDefinition/Encounter code filter:
path: type
value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016
Content: text/cql
/*
This example is a work in progress and should not be considered a final specification
or recommendation for guidance. This example will help guide and direct the process
of finding conventions and usage patterns that meet the needs of the various stakeholders
in the measure development community.

Based on CMS130v8 - Colorectal Cancer Screening
*/
library EXM130 version '8.0.000'

using FHIR version '4.0.1'

include FHIRHelpers version '4.0.1' called FHIRHelpers
include Hospice version '2.0.000' called Hospice
include AdultOutpatientEncounters version '2.0.000' called AdultOutpatientEncounters
include MATGlobalCommonFunctions version '5.0.000' called Global
include SupplementalDataElements version '2.0.000' called SDE

valueset "ONC Administrative Sex": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1'
valueset "Race": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.836'
valueset "Ethnicity": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.837'
valueset "Payer": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591'
valueset "Colonoscopy": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1020'
valueset "Fecal Occult Blood Test (FOBT)": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1011'
valueset "Flexible Sigmoidoscopy": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1010'
valueset "Malignant Neoplasm of Colon": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1001'
valueset "Total Colectomy": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1019'
valueset "FIT DNA": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1039'
valueset "CT Colonography": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1038'

parameter "Measurement Period" Interval<DateTime>
  default Interval[@2019-01-01T00:00:00.0, @2020-01-01T00:00:00.0)

context Patient

define "SDE Ethnicity":
  SDE."SDE Ethnicity"

define "SDE Payer":
  SDE."SDE Payer"

define "SDE Race":
  SDE."SDE Race"

define "SDE Sex":
  SDE."SDE Sex"

define "Denominator":
	true

define "Flexible Sigmoidoscopy Performed":
	[Procedure: "Flexible Sigmoidoscopy"] FlexibleSigmoidoscopy
		where FlexibleSigmoidoscopy.status = 'completed'
			and Global."Normalize Interval"(FlexibleSigmoidoscopy.performed) ends 5 years or less on or before end of "Measurement Period"

define "CT Colonography Performed":
	[Procedure: "CT Colonography"] Colonography
		where Colonography.status = 'completed'
			and Global."Normalize Interval"(Colonography.performed) ends 5 years or less on or before end of "Measurement Period"

define "Total Colectomy Performed":
	[Procedure: "Total Colectomy"] Colectomy
		where Colectomy.status = 'completed'
			and Global."Normalize Interval"(Colectomy.performed) starts on or before end of "Measurement Period"

define "Malignant Neoplasm Ever":
	[Condition: "Malignant Neoplasm of Colon"] ColorectalCancer
		where Global."Normalize Interval"(ColorectalCancer.onset) starts on or before end of "Measurement Period"

define "Fecal Occult Blood Test Performed":
	[Observation: "Fecal Occult Blood Test (FOBT)"] FecalOccultResult
		where FecalOccultResult.status in {'final', 'amended', 'corrected', 'preliminary'}
			and FecalOccultResult.value is not null
			and Global."Normalize Interval"(FecalOccultResult.effective) during day of "Measurement Period"

define "Fecal Immunochemical Test DNA":
	[Observation: "FIT DNA"] FitDNA
		where FitDNA.status in {'final', 'amended', 'corrected', 'preliminary'}
			and FitDNA.value is not null
			and Global."Normalize Interval"(FitDNA.effective) occurs 3 years or less on or before day of end of "Measurement Period"

define "Colonoscopy Performed":
	[Procedure: "Colonoscopy"] Colonoscopy
		where Colonoscopy.status = 'completed'
		  and Global."Normalize Interval"(Colonoscopy.performed) ends 10 years or less on or before end of "Measurement Period"

define "Numerator":
	exists "Colonoscopy Performed"
		or exists "Fecal Occult Blood Test Performed"
		or exists "Flexible Sigmoidoscopy Performed"
		or exists "Fecal Immunochemical Test DNA"
		or exists "CT Colonography Performed"

define "Denominator Exclusion":
	Hospice."Has Hospice"
		or exists "Malignant Neoplasm Ever"
		or exists "Total Colectomy Performed"

define "Initial Population":
	Global."CalendarAgeInYearsAt"(FHIRHelpers.ToDate(Patient.birthDate), start of "Measurement Period") in Interval[50, 75]
			and exists AdultOutpatientEncounters."Qualifying Encounters"
Content: application/elm+xml
Encoded data (92940 characters)
Content: application/elm+json
Encoded data (167088 characters)