Quality Measure Implementation Guide (STU4)
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Quality Measure Implementation Guide (STU4), published by Clinical Quality Information WG. This is not an authorized publication; it is the continuous build for version 4.0.0-ballot). 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: HBP Component Library

Draft as of 2022-12-03
Id: HBPComponent
Url: http://hl7.org/fhir/us/cqfmeasures/Library/HBPComponent
Version: 0.0.001
Name: HBPComponent
Title: HBP Component Library
Status: draft
Experimental: true
Type:

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

code: logic-library

Date: 2022-12-03 16:52:11+0000
Publisher: Clinical Quality Information WG
Description:

Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented

Jurisdiction: US
Related Artifacts:

Dependencies

Parameters:
NameTypeMinMaxIn/Out
Measurement PeriodPeriod01in
PatientPatient01out
SDE EthnicityCoding0*out
SDE EthnicityCoding0*out
PatientPatient01out
SDE PayerResource0*out
SDE PayerResource0*out
SDE RaceCoding0*out
SDE RaceCoding0*out
SDE SexCoding01out
SDE SexCoding01out
Qualifying Encounter During Measurement PeriodEncounter0*out
Encounter with High Blood Pressure ReadingEncounter0*out
Encounter with High Blood Pressure Reading Within Year PriorEncounter0*out
Encounter with Second Hypertensive ReadingEncounter0*out
Encounter with Normal Blood Pressure ReadingEncounter0*out
Encounter with Prehypertensive Blood Pressure ReadingEncounter0*out
Encounter with Order for Intervention for HypertensionEncounter0*out
Encounter with Order for Follow Up Within One YearEncounter0*out
Encounter with Referral to Alternate Provider for High Blood Pressure ReadingEncounter0*out
Encounter with First Hypertensive ReadingEncounter0*out
Encounter with Order for Follow Up Within 4 WeeksEncounter0*out
Encounter with Order for Laboratory Test for HypertensionEncounter0*out
Encounter with Order for Electrocardiogram for HypertensionEncounter0*out
Encounter with Order for Hypertension MedicationEncounter0*out
NumeratorEncounter0*out
Initial PopulationEncounter0*out
Encounter with Order for Hypertension Follow Up Declined by PatientEncounter0*out
Encounter with Medical Reason for Not Obtaining or Patient Declined Blood Pressure MeasurementEncounter0*out
Denominator ExceptionsEncounter0*out
Denominator ExclusionsEncounter0*out
DenominatorEncounter0*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
Encounter http://hl7.org/fhir/StructureDefinition/Encounter code filter:
path: type
value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1920
Observation http://hl7.org/fhir/StructureDefinition/Observation code filter:
path: code

system: http://loinc.org

code: 8480-6

display: Systolic blood pressure

Observation http://hl7.org/fhir/StructureDefinition/Observation code filter:
path: code

system: http://loinc.org

code: 8462-4

display: Diastolic blood pressure

Observation http://hl7.org/fhir/StructureDefinition/Observation code filter:
path: code

system: http://loinc.org

code: 8480-6

display: Systolic blood pressure

Observation http://hl7.org/fhir/StructureDefinition/Observation code filter:
path: code

system: http://loinc.org

code: 8462-4

display: Diastolic blood pressure

Observation http://hl7.org/fhir/StructureDefinition/Observation code filter:
path: code

system: http://loinc.org

code: 8480-6

display: Systolic blood pressure

Observation http://hl7.org/fhir/StructureDefinition/Observation code filter:
path: code

system: http://loinc.org

code: 8462-4

display: Diastolic blood pressure

Observation http://hl7.org/fhir/StructureDefinition/Observation code filter:
path: code

system: http://loinc.org

code: 8480-6

display: Systolic blood pressure

Observation http://hl7.org/fhir/StructureDefinition/Observation code filter:
path: code

system: http://loinc.org

code: 8462-4

display: Diastolic blood pressure

ServiceRequest http://hl7.org/fhir/StructureDefinition/ServiceRequest code filter:
path: code
value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1581
ServiceRequest http://hl7.org/fhir/StructureDefinition/ServiceRequest code filter:
path: code
value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1510
ServiceRequest http://hl7.org/fhir/StructureDefinition/ServiceRequest code filter:
path: code
value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1515
ServiceRequest http://hl7.org/fhir/StructureDefinition/ServiceRequest code filter:
path: code
value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1518
ServiceRequest http://hl7.org/fhir/StructureDefinition/ServiceRequest code filter:
path: code
value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1583
ServiceRequest http://hl7.org/fhir/StructureDefinition/ServiceRequest code filter:
path: code
value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1579
ServiceRequest http://hl7.org/fhir/StructureDefinition/ServiceRequest code filter:
path: code
value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1580
ServiceRequest http://hl7.org/fhir/StructureDefinition/ServiceRequest code filter:
path: code
value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1578
ServiceRequest http://hl7.org/fhir/StructureDefinition/ServiceRequest code filter:
path: code
value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1482
ServiceRequest http://hl7.org/fhir/StructureDefinition/ServiceRequest code filter:
path: code

system: http://loinc.org

code: 34534-8

display: EKG 12 channel panel

ServiceRequest http://hl7.org/fhir/StructureDefinition/ServiceRequest code filter:
path: code

system: http://loinc.org

code: 11524-6

display: EKG study

MedicationRequest http://hl7.org/fhir/StructureDefinition/MedicationRequest code filter:
path: medication
value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.1577
Patient http://hl7.org/fhir/StructureDefinition/Patient
ServiceRequest http://hl7.org/fhir/StructureDefinition/ServiceRequest code filter:
path: code

system: http://loinc.org

code: 34534-8

display: EKG 12 channel panel

ServiceRequest http://hl7.org/fhir/StructureDefinition/ServiceRequest code filter:
path: code

system: http://loinc.org

code: 11524-6

display: EKG study

ServiceRequest http://hl7.org/fhir/StructureDefinition/ServiceRequest code filter:
path: code
value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1579
ServiceRequest http://hl7.org/fhir/StructureDefinition/ServiceRequest code filter:
path: code
value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1578
ServiceRequest http://hl7.org/fhir/StructureDefinition/ServiceRequest code filter:
path: code
value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1580
ServiceRequest http://hl7.org/fhir/StructureDefinition/ServiceRequest code filter:
path: code
value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1581
ServiceRequest http://hl7.org/fhir/StructureDefinition/ServiceRequest code filter:
path: code
value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1510
ServiceRequest http://hl7.org/fhir/StructureDefinition/ServiceRequest code filter:
path: code
value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1515
ServiceRequest http://hl7.org/fhir/StructureDefinition/ServiceRequest code filter:
path: code
value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1518
ServiceRequest http://hl7.org/fhir/StructureDefinition/ServiceRequest code filter:
path: code
value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1583
ServiceRequest http://hl7.org/fhir/StructureDefinition/ServiceRequest code filter:
path: code

system: http://loinc.org

code: 34534-8

display: EKG 12 channel panel

ServiceRequest http://hl7.org/fhir/StructureDefinition/ServiceRequest code filter:
path: code

system: http://loinc.org

code: 11524-6

display: EKG study

ServiceRequest http://hl7.org/fhir/StructureDefinition/ServiceRequest code filter:
path: code
value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1579
ServiceRequest http://hl7.org/fhir/StructureDefinition/ServiceRequest code filter:
path: code
value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1578
ServiceRequest http://hl7.org/fhir/StructureDefinition/ServiceRequest code filter:
path: code
value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1580
ServiceRequest http://hl7.org/fhir/StructureDefinition/ServiceRequest code filter:
path: code
value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1581
ServiceRequest http://hl7.org/fhir/StructureDefinition/ServiceRequest code filter:
path: code
value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1510
ServiceRequest http://hl7.org/fhir/StructureDefinition/ServiceRequest code filter:
path: code
value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1515
ServiceRequest http://hl7.org/fhir/StructureDefinition/ServiceRequest code filter:
path: code
value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1518
ServiceRequest http://hl7.org/fhir/StructureDefinition/ServiceRequest code filter:
path: code
value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1583
ServiceRequest http://hl7.org/fhir/StructureDefinition/ServiceRequest code filter:
path: code
value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1482
ServiceRequest http://hl7.org/fhir/StructureDefinition/ServiceRequest code filter:
path: code
value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1482
MedicationRequest http://hl7.org/fhir/StructureDefinition/MedicationRequest code filter:
path: medication
value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.1577
MedicationRequest http://hl7.org/fhir/StructureDefinition/MedicationRequest code filter:
path: medication
value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.1577
ServiceRequest http://hl7.org/fhir/StructureDefinition/ServiceRequest code filter:
path: code
value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1482
ServiceRequest http://hl7.org/fhir/StructureDefinition/ServiceRequest code filter:
path: code
value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1482
MedicationRequest http://hl7.org/fhir/StructureDefinition/MedicationRequest code filter:
path: medication
value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.1577
MedicationRequest http://hl7.org/fhir/StructureDefinition/MedicationRequest code filter:
path: medication
value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.1577
Observation http://hl7.org/fhir/StructureDefinition/Observation code filter:
path: code

system: http://loinc.org

code: 8480-6

display: Systolic blood pressure

Observation http://hl7.org/fhir/StructureDefinition/Observation code filter:
path: code

system: http://loinc.org

code: 8462-4

display: Diastolic blood pressure

Condition http://hl7.org/fhir/StructureDefinition/Condition code filter:
path: code
value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.263
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.
*/
library HBPComponent version '0.0.001'

using FHIR version '4.0.1'

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

codesystem "LOINC": 'http://loinc.org'

valueset "Diagnosis of Hypertension": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.263'
valueset "Dietary Recommendations": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1515'
valueset "Encounter to Screen for Blood Pressure": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1920'
valueset "Ethnicity": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.837'
valueset "Finding of Elevated Blood Pressure or Hypertension": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1047.514'
valueset "Follow Up Within 4 Weeks": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1578'
valueset "Follow Up Within One Year": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1579'
valueset "Laboratory Tests for Hypertension": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1482'
valueset "Lifestyle Recommendation": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1581'
valueset "Medical Reason": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1007'
valueset "ONC Administrative Sex": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1'
valueset "Patient Declined": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1582'
valueset "Pharmacologic Therapy for Hypertension": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.1577'
valueset "Recommendation to Increase Physical Activity": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1518'
valueset "Referral or Counseling for Alcohol Consumption": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1583'
valueset "Referral to Primary Care or Alternate Provider": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1580'
valueset "Weight Reduction Recommended": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1510'

code "Birth date": '21112-8' from "LOINC" display 'Birth date'
code "Diastolic blood pressure": '8462-4' from "LOINC" display 'Diastolic blood pressure'
code "EKG 12 channel panel": '34534-8' from "LOINC" display 'EKG 12 channel panel'
code "EKG study": '11524-6' from "LOINC" display 'EKG study'
code "Systolic blood pressure": '8480-6' from "LOINC" display 'Systolic blood pressure'

parameter "Measurement Period" Interval<DateTime>

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 "Encounter with Second Hypertensive Reading":
  "Encounter with High Blood Pressure Reading"
      intersect "Encounter with High Blood Pressure Reading Within Year Prior"

define "Numerator":
  "Encounter with Normal Blood Pressure Reading"
      union ( "Encounter with Prehypertensive Blood Pressure Reading"
          intersect ( ( "Encounter with Order for Intervention for Hypertension"
                intersect "Encounter with Order for Follow Up Within One Year"
            )
              union "Encounter with Referral to Alternate Provider for High Blood Pressure Reading"
          )
      )
      union ( "Encounter with First Hypertensive Reading"
          intersect ( ( "Encounter with Order for Intervention for Hypertension"
                intersect "Encounter with Order for Follow Up Within 4 Weeks"
            )
              union "Encounter with Referral to Alternate Provider for High Blood Pressure Reading"
          )
      )
      union ( "Encounter with Second Hypertensive Reading"
          intersect ( ( "Encounter with Order for Intervention for Hypertension"
                intersect ( "Encounter with Order for Laboratory Test for Hypertension"
                    union "Encounter with Order for Electrocardiogram for Hypertension"
                    union "Encounter with Order for Hypertension Medication"
                )
            )
              union "Encounter with Referral to Alternate Provider for High Blood Pressure Reading"
          )
      )

define "Encounter with First Hypertensive Reading":
  "Encounter with High Blood Pressure Reading"
      except "Encounter with High Blood Pressure Reading Within Year Prior"

define "Initial Population":
  "Qualifying Encounter During Measurement Period" QualifyingEncounter
      with [Patient] BirthDate
        such that Global."CalendarAgeInYearsAt" ( FHIRHelpers.ToDate ( BirthDate.birthDate ), start of "Measurement Period" ) >= 18

define "Encounter with Order for Follow Up Within One Year":
  "Qualifying Encounter During Measurement Period" QualifyingEncounter
      with [ServiceRequest: "Follow Up Within One Year"] FollowupOneYear
        such that FollowupOneYear.authoredOn same day as start of QualifyingEncounter.period

define "Encounter with Order for Follow Up Within 4 Weeks":
  "Qualifying Encounter During Measurement Period" QualifyingEncounter
      with [ServiceRequest: "Follow Up Within 4 Weeks"] Followup4Weeks
        such that Followup4Weeks.authoredOn same day as start of QualifyingEncounter.period

define "Encounter with Order for Hypertension Medication":
  "Qualifying Encounter During Measurement Period" QualifyingEncounter
      with [MedicationRequest: "Pharmacologic Therapy for Hypertension"] AntihypertensiveMedication
        such that AntihypertensiveMedication.authoredOn same day as start of QualifyingEncounter.period

define "Encounter with Order for Laboratory Test for Hypertension":
  "Qualifying Encounter During Measurement Period" QualifyingEncounter
      with [ServiceRequest: "Laboratory Tests for Hypertension"] HypertensionLabs
        such that HypertensionLabs.authoredOn same day as start of QualifyingEncounter.period

define "Encounter with Referral to Alternate Provider for High Blood Pressure Reading":
  "Qualifying Encounter During Measurement Period" QualifyingEncounter
      with [ServiceRequest: "Referral to Primary Care or Alternate Provider"] Referral
        such that Referral.authoredOn same day as start of QualifyingEncounter.period
          and Referral.reasonCode in "Finding of Elevated Blood Pressure or Hypertension"

define "Encounter with Order for Hypertension Follow Up Declined by Patient":
  "Qualifying Encounter During Measurement Period" QualifyingEncounter
      with ( [ServiceRequest: "EKG 12 channel panel"]
        union [ServiceRequest: "EKG study"]
        union [ServiceRequest: "Follow Up Within One Year"]
        union [ServiceRequest: "Follow Up Within 4 Weeks"]
        union [ServiceRequest: "Referral to Primary Care or Alternate Provider"]
        union [ServiceRequest: "Lifestyle Recommendation"]
        union [ServiceRequest: "Weight Reduction Recommended"]
        union [ServiceRequest: "Dietary Recommendations"]
        union [ServiceRequest: "Recommendation to Increase Physical Activity"]
        union [ServiceRequest: "Referral or Counseling for Alcohol Consumption"]
        union [ServiceRequest: "Laboratory Tests for Hypertension"]
        union [MedicationRequest: "Pharmacologic Therapy for Hypertension"] ) NoFollowUpOrdered
        such that NoFollowUpOrdered.doNotPerform is true
          and NoFollowUpOrdered.code in "Patient Declined"
          and NoFollowUpOrdered.authoredOn same day as start of QualifyingEncounter.period

define "Encounter with Medical Reason for Not Obtaining or Patient Declined Blood Pressure Measurement":
  "Qualifying Encounter During Measurement Period" QualifyingEncounter
      with ( [Observation: "Systolic blood pressure"]
        union [Observation: "Diastolic blood pressure"] ) NoBPScreen
        such that ( NoBPScreen.code in "Medical Reason"
            or NoBPScreen.code in "Patient Declined"
        )
          and NoBPScreen.effective same day as start of QualifyingEncounter.period
          and "Not Done"(NoBPScreen)
          and NoBPScreen.status = 'final'

define "Denominator Exceptions":
  "Encounter with Medical Reason for Not Obtaining or Patient Declined Blood Pressure Measurement"
      union "Encounter with Order for Hypertension Follow Up Declined by Patient"

define "Denominator Exclusions":
  "Qualifying Encounter During Measurement Period" QualifyingEncounter
      with [Condition: "Diagnosis of Hypertension"] Hypertension
        such that Global."Prevalence Period" ( Hypertension ) overlaps before QualifyingEncounter.period

define "Denominator":
  "Initial Population"

define "Encounter with Order for Electrocardiogram for Hypertension":
  "Qualifying Encounter During Measurement Period" QualifyingEncounter
      with ( [ServiceRequest: "EKG 12 channel panel"]
        union [ServiceRequest: "EKG study"] ) ECG
        such that ECG.authoredOn same day as start of QualifyingEncounter.period

define "Encounter with Order for Intervention for Hypertension":
  "Qualifying Encounter During Measurement Period" QualifyingEncounter
      with ( [ServiceRequest: "Lifestyle Recommendation"]
        union [ServiceRequest: "Weight Reduction Recommended"]
        union [ServiceRequest: "Dietary Recommendations"]
        union [ServiceRequest: "Recommendation to Increase Physical Activity"]
        union [ServiceRequest: "Referral or Counseling for Alcohol Consumption"] ) HighBloodPressureIntervention
        such that HighBloodPressureIntervention.authoredOn same day as start of QualifyingEncounter.period

define "Encounter with High Blood Pressure Reading":
  "Qualifying Encounter During Measurement Period" QualifyingEncounter
      let EncounterLastSystolicBP: Last([Observation: "Systolic blood pressure"] SystolicBP
          where SystolicBP.effective during QualifyingEncounter.period
          sort by effective
      ),
      EncounterLastDiastolicBP: Last([Observation: "Diastolic blood pressure"] DiastolicBP
          where DiastolicBP.effective during QualifyingEncounter.period
          sort by effective
      )
      where EncounterLastSystolicBP.value > 0 'mm[Hg]'
        and EncounterLastDiastolicBP.value > 0 'mm[Hg]'
        and ( EncounterLastSystolicBP.value >= 140 'mm[Hg]'
            or EncounterLastDiastolicBP.value >= 90 'mm[Hg]'
        )

define "Encounter with High Blood Pressure Reading Within Year Prior":
  "Qualifying Encounter During Measurement Period" QualifyingEncounter
      let EncounterLastSystolicBP: Last([Observation: "Systolic blood pressure"] SystolicBP
          where SystolicBP.effective 1 year or less before start of QualifyingEncounter.period
          sort by effective
      ),
      EncounterLastDiastolicBP: Last([Observation: "Diastolic blood pressure"] DiastolicBP
          where DiastolicBP.effective 1 year or less before start of QualifyingEncounter.period
          sort by effective
      )
      where EncounterLastSystolicBP.value > 0 'mm[Hg]'
        and EncounterLastDiastolicBP.value > 0 'mm[Hg]'
        and ( EncounterLastSystolicBP.value >= 140 'mm[Hg]'
            or EncounterLastDiastolicBP.value >= 90 'mm[Hg]'
        )

define "Encounter with Normal Blood Pressure Reading":
  "Qualifying Encounter During Measurement Period" QualifyingEncounter
      let EncounterLastSystolicBP: Last([Observation: "Systolic blood pressure"] SystolicBP
          where SystolicBP.effective during QualifyingEncounter.period
          sort by effective
      ),
      EncounterLastDiastolicBP: Last([Observation: "Diastolic blood pressure"] DiastolicBP
          where DiastolicBP.effective during QualifyingEncounter.period
          sort by effective
      )
      where EncounterLastSystolicBP.value included in Interval[1 'mm[Hg]', 120 'mm[Hg]' )
        and EncounterLastDiastolicBP.value included in Interval[1 'mm[Hg]', 80 'mm[Hg]' )

define "Encounter with Prehypertensive Blood Pressure Reading":
  "Qualifying Encounter During Measurement Period" QualifyingEncounter
      let EncounterLastSystolicBP: Last([Observation: "Systolic blood pressure"] SystolicBP
          where SystolicBP.effective during QualifyingEncounter.period
          sort by effective
      ),
      EncounterLastDiastolicBP: Last([Observation: "Diastolic blood pressure"] DiastolicBP
          where DiastolicBP.effective during QualifyingEncounter.period
          sort by effective
      )
      where EncounterLastSystolicBP.value included in Interval[1 'mm[Hg]', 140 'mm[Hg]' )
        and EncounterLastDiastolicBP.value included in Interval[1 'mm[Hg]', 90 'mm[Hg]' )
        and ( EncounterLastSystolicBP.value >= 120 'mm[Hg]'
            or EncounterLastDiastolicBP.value >= 80 'mm[Hg]'
        )

define "Qualifying Encounter During Measurement Period":
  [Encounter: "Encounter to Screen for Blood Pressure"] ValidEncounter
      where ValidEncounter.period during "Measurement Period"

define function "Not Done"(res DomainResource ):
  if ( res R
      where ( "GetModiferExtension"(R, 'http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDone').value = true )
  ) is not null then true
    else false

define function "GetModifierExtensions"(res DomainResource, url String ):
  res.modifierExtension E
    where E.url = ( url )
    return E

define function "GetModiferExtension"(res DomainResource, url String ):
  singleton from "GetModifierExtensions"(res, url)
Content: application/elm+xml
Encoded data (275000 characters)
Content: application/elm+json
Encoded data (492800 characters)