Quality Measure Implementation Guide (STU5)
5.0.0-ballot - ballot United States of America flag

Quality Measure Implementation Guide (STU5), published by HL7 International / Clinical Quality Information. This guide is not an authorized publication; it is the continuous build for version 5.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/cqf-measures/ and changes regularly. See the Directory of published versions

: Pneumococcal Vaccination Status for Older Adults - JSON Representation

Draft as of 2022-02-22

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{
  "resourceType" : "Measure",
  "id" : "PVSComponent",
  "meta" : {
    "profile" : [
      🔗 "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/proportion-measure-cqfm"🔗 ,
      "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-measure-cqfm"
    ]
  },
  "language" : "en",
  "text" : {
    "status" : "extensions",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\" xml:lang=\"en\" lang=\"en\">\n    <table class=\"grid dict\">\n        \n            <tr>\n                <th scope=\"row\"><b>Id: </b></th>\n                <td style=\"padding-left: 4px;\">PVSComponent</td>\n            </tr>\n            \n            \n            <tr>\n                <th scope=\"row\"><b>Download cql: </b></th>\n                <td style=\"padding-left: 4px;\"><a href=\"Library-PVSComponent.cql\">PVSComponent.cql</a></td>\n            </tr>\n            \n\n        \n        \n            <tr>\n                <th scope=\"row\"><b>Url: </b></th>\n                <td style=\"padding-left: 4px;\"><a href=\"Measure-PVSComponent.html\">Pneumococcal Vaccination Status for Older Adults</a></td>\n            </tr>\n        \n        \n            <tr>\n                <th scope=\"row\"><b>Version: </b></th>\n                <td style=\"padding-left: 4px;\">5.0.0-ballot</td>\n            </tr>\n        \n        \n        \n            <tr>\n                <th scope=\"row\"><b>Name: </b></th>\n                <td style=\"padding-left: 4px;\">PVSComponent</td>\n            </tr>\n        \n        \n            <tr>\n                <th scope=\"row\"><b>Title: </b></th>\n                <td style=\"padding-left: 4px;\">Pneumococcal Vaccination Status for Older Adults</td>\n            </tr>\n        \n        \n        \n            <tr>\n                <th scope=\"row\"><b>Status: </b></th>\n                <td style=\"padding-left: 4px;\">draft</td>\n            </tr>\n        \n        \n            <tr>\n                <th scope=\"row\"><b>Experimental: </b></th>\n                <td style=\"padding-left: 4px;\">true</td>\n            </tr>\n        \n        \n            <tr>\n                <th scope=\"row\"><b>Scoring: </b></th>\n                <td style=\"padding-left: 4px;\">\n                    \n                        \n                            <p style=\"margin-bottom: 5px;\">\n                                <span>Proportion </span>\n                            </p>\n                        \n                    \n                    \n                </td>\n            </tr>\n        \n        \n            <tr>\n                <th scope=\"row\"><b>Improvement Notation: </b></th>\n                <td style=\"padding-left: 4px;\">\n                    \n                        \n                            <p style=\"margin-bottom: 5px;\">\n                             <span>increase </span>\n                            </p>\n                        \n                    \n                    \n                </td>\n            </tr>\n        \n        \n            <tr>\n                <th scope=\"row\"><b>Type: </b></th>\n                <td style=\"padding-left: 4px;\">\n                    \n                        \n                            <p style=\"margin-bottom: 5px;\">\n                            <span>process </span>\n                            </p>\n                        \n                    \n                    \n                </td>\n            </tr>\n        \n        \n        \n            <tr>\n                <th scope=\"row\"><b>Date: </b></th>\n                <td style=\"padding-left: 4px;\">2022-02-22 11:37:04-0600</td>\n            </tr>\n        \n        \n            <tr>\n                <th scope=\"row\"><b>Publisher: </b></th>\n                <td style=\"padding-left: 4px;\">HL7 International / Clinical Quality Information</td>\n            </tr>\n        \n        \n            <tr>\n                <th scope=\"row\"><b>Description: </b></th>\n                <td style=\"padding-left: 4px;\"><div><p>This is an example only.</p>\n</div></td>\n            </tr>\n        \n        \n        \n        \n        \n            <tr>\n                <th scope=\"row\"><b>Jurisdiction: </b></th>\n                <td style=\"padding-left: 25px;\">US</td>\n            </tr>\n        \n        \n        \n        \n        \n        \n        \n        \n        \n            <tr>\n                <th scope=\"row\"><b>Effective Period: </b></th>\n                <td style=\"padding-left: 4px;\">2022-01-01..2022-12-31</td>\n            </tr>\n        \n        \n            \n        \n        \n        \n        \n            <tr>\n                <th scope=\"row\"><b> Supplemental Data Elements: </b></th>\n                <td style=\"padding-left: 4px;\">\n                    \n                        \n                            \n                                \n                                    SDE Ethnicity\n                                \n                            \n                        \n                    \n                        \n                            \n                                \n                                    SDE Payer\n                                \n                            \n                        \n                    \n                        \n                            \n                                \n                                    SDE Race\n                                \n                            \n                        \n                    \n                        \n                            \n                                \n                                    SDE Sex\n                                \n                            \n                        \n                    \n                </td>\n            </tr>\n        \n        \n        \n            <tr>\n                <th scope=\"row\"><b>Libraries: </b></th>\n                <td style=\"padding-left: 4px;\">\n                    <table class=\"grid-dict\">\n                        \n                            <tr><td><a href=\"Library-PVSComponent.html\">PVS Component Library</a></td></tr>\n                        \n                    </table>\n                </td>\n            </tr>\n        \n        \n            \n                <tr>\n                    <th scope=\"row\"><b>Related Artifact Dependencies: </b></th>\n                    <td style=\"padding-left: 4px;\">\n                        \n                            <li><a href=\"http://hl7.org/fhir/us/cqfmeasures/Library/SupplementalDataElements|2.0.000\">http://hl7.org/fhir/us/cqfmeasures/Library/SupplementalDataElements|2.0.000</a></li>\n                        \n                            <li><a href=\"http://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1\">http://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1</a></li>\n                        \n                            <li><a href=\"Library-MATGlobalCommonFunctions.html\">MAT Global Common Functions FHIR Library</a></li>\n                        \n                            <li><a href=\"http://hl7.org/fhir/us/cqfmeasures/Library/Hospice|2.0.000\">http://hl7.org/fhir/us/cqfmeasures/Library/Hospice|2.0.000</a></li>\n                        \n                            <li><a href=\"http://snomed.info/sct|http://snomed.info/sct/731000124108/version/201709\">http://snomed.info/sct|http://snomed.info/sct/731000124108/version/201709</a></li>\n                        \n                            <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.110.12.1027/expansion\">Pneumococcal Vaccine</a></li>\n                        \n                            <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.110.12.1034/expansion\">Pneumococcal Vaccine Administered</a></li>\n                        \n                            <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1001/expansion\">Office Visit</a></li>\n                        \n                            <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1240/expansion\">Annual Wellness Visit</a></li>\n                        \n                            <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1025/expansion\">Preventive Care Services Established Office Visit, 18 and Up</a></li>\n                        \n                            <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1023/expansion\">Preventive Care Services Initial Office Visit, 18 and Up</a></li>\n                        \n                            <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1016/expansion\">Home Healthcare Services</a></li>\n                        \n                            <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.11.1065/expansion\">Discharge Services Nursing Facility</a></li>\n                        \n                            <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1012/expansion\">Nursing Facility Visit</a></li>\n                        \n                            <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1014/expansion\">Care Services in Long Term Residential Facility</a></li>\n                        \n                            <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.114222.4.11.3591/expansion\">Payer Type</a></li>\n                        \n                            <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.666.5.307/expansion\">Encounter Inpatient</a></li>\n                        \n                            <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1108.15/expansion\">Hospice Care Ambulatory</a></li>\n                        \n                    </td>\n                </tr>\n                <tr>\n                    <th scope=\"row\"><b>Parameters:</b></th>\n                    <td style=\"padding-left: 4px;\">\n                        <table class=\"grid-dict\">\n                            <tr><th><b>name</b></th><th><b>use</b></th><th><b>min</b></th><th><b>max</b></th><th><b>type</b></th></tr>\n                            \n                                <tr>\n                                    <td>Measurement Period</td>\n                                    <td>in</td>\n                                    <td>0</td>\n                                    <td>1</td>\n                                    <td>Period</td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>SDE Sex</td>\n                                    <td>out</td>\n                                    <td>0</td>\n                                    <td>1</td>\n                                    <td>Coding</td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>Numerator</td>\n                                    <td>out</td>\n                                    <td>0</td>\n                                    <td>1</td>\n                                    <td>boolean</td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>Denominator</td>\n                                    <td>out</td>\n                                    <td>0</td>\n                                    <td>1</td>\n                                    <td>boolean</td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>SDE Payer</td>\n                                    <td>out</td>\n                                    <td>0</td>\n                                    <td>*</td>\n                                    <td>Resource</td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>Initial Population</td>\n                                    <td>out</td>\n                                    <td>0</td>\n                                    <td>1</td>\n                                    <td>boolean</td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>SDE Ethnicity</td>\n                                    <td>out</td>\n                                    <td>0</td>\n                                    <td>*</td>\n                                    <td>Coding</td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>Denominator Exclusions</td>\n                                    <td>out</td>\n                                    <td>0</td>\n                                    <td>1</td>\n                                    <td>boolean</td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>SDE Race</td>\n                                    <td>out</td>\n                                    <td>0</td>\n                                    <td>*</td>\n                                    <td>Coding</td>\n                                </tr>\n                            \n                        </table>\n                    </td>\n                </tr>\n                <tr>\n                    <th scope=\"row\"><b>DataRequirements:</b></th>\n                    <td style=\"padding-left: 4px;\">\n                        <table class=\"grid-dict\">\n                            <tr><th><b>Type</b></th><th><b>Must Support</b></th><th><b>Valueset Name</b></th><th><b>Valueset</b></th></tr>\n                            \n                                <tr>\n                                    <td>Coverage</td>\n                                    <td>\n                                        \n                                            period\n                                        \n                                            type\n                                        \n                                    </td>\n                                    <td>\n                                        \n                                            \n                                                 Payer\n                                            \n                                        \n                                    </td>\n                                    <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.114222.4.11.3591/expansion\">Payer Type</a></td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>Patient</td>\n                                    <td>\n                                        \n                                            extension\n                                        \n                                            value\n                                        \n                                            url\n                                        \n                                    </td>\n                                    <td>\n                                        \n                                    </td>\n                                    <td/>\n                                </tr>\n                            \n                                <tr>\n                                    <td>Encounter</td>\n                                    <td>\n                                        \n                                            period\n                                        \n                                            hospitalization\n                                        \n                                            hospitalization.dischargeDisposition\n                                        \n                                            type\n                                        \n                                            status\n                                        \n                                    </td>\n                                    <td>\n                                        \n                                            \n                                                 Encounter Inpatient\n                                            \n                                        \n                                    </td>\n                                    <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.666.5.307/expansion\">Encounter Inpatient</a></td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>Encounter</td>\n                                    <td>\n                                        \n                                            type\n                                        \n                                    </td>\n                                    <td>\n                                        \n                                            \n                                                 Office Visit\n                                            \n                                        \n                                    </td>\n                                    <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1001/expansion\">Office Visit</a></td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>Encounter</td>\n                                    <td>\n                                        \n                                            type\n                                        \n                                    </td>\n                                    <td>\n                                        \n                                            \n                                                 Annual Wellness Visit\n                                            \n                                        \n                                    </td>\n                                    <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1240/expansion\">Annual Wellness Visit</a></td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>Encounter</td>\n                                    <td>\n                                        \n                                            type\n                                        \n                                    </td>\n                                    <td>\n                                        \n                                            \n                                                 Preventive Care Services - Established Office Visit, 18 and Up\n                                            \n                                        \n                                    </td>\n                                    <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1025/expansion\">Preventive Care Services Established Office Visit, 18 and Up</a></td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>Encounter</td>\n                                    <td>\n                                        \n                                            type\n                                        \n                                    </td>\n                                    <td>\n                                        \n                                            \n                                                 Preventive Care Services-Initial Office Visit, 18 and Up\n                                            \n                                        \n                                    </td>\n                                    <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1023/expansion\">Preventive Care Services Initial Office Visit, 18 and Up</a></td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>Encounter</td>\n                                    <td>\n                                        \n                                            type\n                                        \n                                    </td>\n                                    <td>\n                                        \n                                            \n                                                 Home Healthcare Services\n                                            \n                                        \n                                    </td>\n                                    <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1016/expansion\">Home Healthcare Services</a></td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>Encounter</td>\n                                    <td>\n                                        \n                                            type\n                                        \n                                    </td>\n                                    <td>\n                                        \n                                            \n                                                 Discharge Services - Nursing Facility\n                                            \n                                        \n                                    </td>\n                                    <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.11.1065/expansion\">Discharge Services Nursing Facility</a></td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>Encounter</td>\n                                    <td>\n                                        \n                                            type\n                                        \n                                    </td>\n                                    <td>\n                                        \n                                            \n                                                 Nursing Facility Visit\n                                            \n                                        \n                                    </td>\n                                    <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1012/expansion\">Nursing Facility Visit</a></td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>Encounter</td>\n                                    <td>\n                                        \n                                            type\n                                        \n                                    </td>\n                                    <td>\n                                        \n                                            \n                                                 Care Services in Long-Term Residential Facility\n                                            \n                                        \n                                    </td>\n                                    <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1014/expansion\">Care Services in Long Term Residential Facility</a></td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>ServiceRequest</td>\n                                    <td>\n                                        \n                                            code\n                                        \n                                            authoredOn\n                                        \n                                            intent\n                                        \n                                    </td>\n                                    <td>\n                                        \n                                            \n                                                 Hospice care ambulatory\n                                            \n                                        \n                                    </td>\n                                    <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1108.15/expansion\">Hospice Care Ambulatory</a></td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>Procedure</td>\n                                    <td>\n                                        \n                                            code\n                                        \n                                            performed\n                                        \n                                            status\n                                        \n                                    </td>\n                                    <td>\n                                        \n                                            \n                                                 Hospice care ambulatory\n                                            \n                                        \n                                    </td>\n                                    <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1108.15/expansion\">Hospice Care Ambulatory</a></td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>Procedure</td>\n                                    <td>\n                                        \n                                            code\n                                        \n                                            performed\n                                        \n                                            status\n                                        \n                                    </td>\n                                    <td>\n                                        \n                                            \n                                                 Pneumococcal Vaccine Administered\n                                            \n                                        \n                                    </td>\n                                    <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.110.12.1034/expansion\">Pneumococcal Vaccine Administered</a></td>\n                                </tr>\n                            \n                                <tr>\n                                    <td>Immunization</td>\n                                    <td>\n                                        \n                                            occurrence\n                                        \n                                            vaccineCode\n                                        \n                                            status\n                                        \n                                    </td>\n                                    <td>\n                                        \n                                            \n                                                 Pneumococcal Vaccine\n                                            \n                                        \n                                    </td>\n                                    <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.110.12.1027/expansion\">Pneumococcal Vaccine</a></td>\n                                </tr>\n                            \n                        </table>\n                    </td>\n                </tr>\n                \n                    <tr>\n                        <th scope=\"row\"><b>Direct Reference Codes:</b></th>\n                        <td style=\"padding-left: 4px;\">\n                            <table class=\"grid-dict\">\n                                <tr><th><b>display</b></th><th><b>code</b></th><th><b>system</b></th></tr>\n                                \n                                    <tr>\n                                        <td>Discharge to home for hospice care (procedure)</td>\n                                        <td>428361000124107</td>\n                                        <td><a href=\"http://hl7.org/fhir/R4/codesystem-snomedct.html\">SNOMED CT (all versions)</a></td>\n                                    </tr>\n                                \n                                    <tr>\n                                        <td>Discharge to healthcare facility for hospice care (procedure)</td>\n                                        <td>428371000124100</td>\n                                        <td><a href=\"http://hl7.org/fhir/R4/codesystem-snomedct.html\">SNOMED CT (all versions)</a></td>\n                                    </tr>\n                                \n                            </table>\n                        </td>\n                    </tr>\n                \n                \n                    <tr>\n                        <th scope=\"row\"><b>Logic Definitions:</b></th>\n                        <td style=\"padding-left: 4px;\">\n                            \n                                <table class=\"grid-dict\">\n                                    <tr>\n                                        <th><b>Group</b></th><th><b>Scoring</b></th><th><b>Population Criteria</b></th><th><b>Expression</b></th>\n                                    </tr>\n                                    <tr>\n                                        \n                                            <td>  </td>\n                                            <td>\n                                                \n                                                \n                                                    <b>Measure scoring:</b>\n                                                    \n                                                        <p style=\"margin-bottom: 5px;\">\n                                                        <span>Proportion</span>\n                                                        </p>\n                                                    \n                                                \n                                            </td>\n                                            \n                                                <tr>\n                                                    <td/>\n                                                    <td/>\n                                                    <td>Initial Population</td>\n                                                    <td>\n                                                        \n                                                        <pre><code class=\"language-cql\">define &quot;Initial Population&quot;:   Global.&quot;CalendarAgeInYearsAt&quot; ( FHIRHelpers.ToDate ( Patient.birthDate ), start of &quot;Measurement Period&quot; ) &gt;= 65       and exists &quot;Qualifying Encounters&quot;</code></pre>\n                                                        \n                                                    </td>\n                                                </tr>\n                                            \n                                                <tr>\n                                                    <td/>\n                                                    <td/>\n                                                    <td>Denominator</td>\n                                                    <td>\n                                                        \n                                                        <pre><code class=\"language-cql\">define &quot;Denominator&quot;:   &quot;Initial Population&quot;</code></pre>\n                                                        \n                                                    </td>\n                                                </tr>\n                                            \n                                                <tr>\n                                                    <td/>\n                                                    <td/>\n                                                    <td>Denominator Exclusion</td>\n                                                    <td>\n                                                        \n                                                        <pre><code class=\"language-cql\">define &quot;Denominator Exclusions&quot;:   Hospice.&quot;Has Hospice&quot;</code></pre>\n                                                        \n                                                    </td>\n                                                </tr>\n                                            \n                                                <tr>\n                                                    <td/>\n                                                    <td/>\n                                                    <td>Numerator</td>\n                                                    <td>\n                                                        \n                                                        <pre><code class=\"language-cql\">define &quot;Numerator&quot;:   exists ( [Immunization: &quot;Pneumococcal Vaccine&quot;] PneumococcalVaccine         where PneumococcalVaccine.status = 'completed'           and PneumococcalVaccine.occurrence as dateTime on or before           end of &quot;Measurement Period&quot;     )       or exists ( [Procedure: &quot;Pneumococcal Vaccine Administered&quot;] PneumococcalVaccineGiven           where PneumococcalVaccineGiven.status = 'completed'             and PneumococcalVaccineGiven.performed as Period on or before             end of &quot;Measurement Period&quot;       )</code></pre>\n                                                        \n                                                    </td>\n                                                </tr>\n                                            \n\n                                    \n                                    </tr>\n                                </table>\n                            \n                            <table class=\"grid-dict\">\n                                \n                                    <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>\n                                    <tr>\n                                        \n                                            <td>SupplementalDataElements</td>\n                                        \n                                        \n                                            <td>SDE Sex</td>\n                                        \n                                    </tr>\n                                    <tr>\n                                        \n                                            <td/>\n                                        <td><pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;SDE Sex&quot;:   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</code></pre></td>\n                                        \n                                    </tr>\n                                \n                                    <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>\n                                    <tr>\n                                        \n                                            <td>PVSComponent</td>\n                                        \n                                        \n                                            <td>SDE Sex</td>\n                                        \n                                    </tr>\n                                    <tr>\n                                        \n                                            <td/>\n                                        <td><pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;SDE Sex&quot;:   SDE.&quot;SDE Sex&quot;</code></pre></td>\n                                        \n                                    </tr>\n                                \n                                    <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>\n                                    <tr>\n                                        \n                                            <td>PVSComponent</td>\n                                        \n                                        \n                                            <td>Numerator</td>\n                                        \n                                    </tr>\n                                    <tr>\n                                        \n                                            <td/>\n                                        <td><pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Numerator&quot;:   exists ( [Immunization: &quot;Pneumococcal Vaccine&quot;] PneumococcalVaccine         where PneumococcalVaccine.status = 'completed'           and PneumococcalVaccine.occurrence as dateTime on or before           end of &quot;Measurement Period&quot;     )       or exists ( [Procedure: &quot;Pneumococcal Vaccine Administered&quot;] PneumococcalVaccineGiven           where PneumococcalVaccineGiven.status = 'completed'             and PneumococcalVaccineGiven.performed as Period on or before             end of &quot;Measurement Period&quot;       )</code></pre></td>\n                                        \n                                    </tr>\n                                \n                                    <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>\n                                    <tr>\n                                        \n                                            <td>PVSComponent</td>\n                                        \n                                        \n                                            <td>Qualifying Encounters</td>\n                                        \n                                    </tr>\n                                    <tr>\n                                        \n                                            <td/>\n                                        <td><pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Qualifying Encounters&quot;:   ( [Encounter: &quot;Office Visit&quot;]       union [Encounter: &quot;Annual Wellness Visit&quot;]       union [Encounter: &quot;Preventive Care Services - Established Office Visit, 18 and Up&quot;]       union [Encounter: &quot;Preventive Care Services-Initial Office Visit, 18 and Up&quot;]       union [Encounter: &quot;Home Healthcare Services&quot;]       union [Encounter: &quot;Discharge Services - Nursing Facility&quot;]       union [Encounter: &quot;Nursing Facility Visit&quot;]       union [Encounter: &quot;Care Services in Long-Term Residential Facility&quot;] ) ValidEncounter       where ValidEncounter.period during &quot;Measurement Period&quot;         and ValidEncounter.status = 'finished'</code></pre></td>\n                                        \n                                    </tr>\n                                \n                                    <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>\n                                    <tr>\n                                        \n                                            <td>PVSComponent</td>\n                                        \n                                        \n                                            <td>Initial Population</td>\n                                        \n                                    </tr>\n                                    <tr>\n                                        \n                                            <td/>\n                                        <td><pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Initial Population&quot;:   Global.&quot;CalendarAgeInYearsAt&quot; ( FHIRHelpers.ToDate ( Patient.birthDate ), start of &quot;Measurement Period&quot; ) &gt;= 65       and exists &quot;Qualifying Encounters&quot;</code></pre></td>\n                                        \n                                    </tr>\n                                \n                                    <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>\n                                    <tr>\n                                        \n                                            <td>PVSComponent</td>\n                                        \n                                        \n                                            <td>Denominator</td>\n                                        \n                                    </tr>\n                                    <tr>\n                                        \n                                            <td/>\n                                        <td><pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Denominator&quot;:   &quot;Initial Population&quot;</code></pre></td>\n                                        \n                                    </tr>\n                                \n                                    <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>\n                                    <tr>\n                                        \n                                            <td>SupplementalDataElements</td>\n                                        \n                                        \n                                            <td>SDE Payer</td>\n                                        \n                                    </tr>\n                                    <tr>\n                                        \n                                            <td/>\n                                        <td><pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;SDE Payer&quot;:   [Coverage: type in &quot;Payer&quot;] Payer         return {           code: Payer.type,           period: Payer.period         }</code></pre></td>\n                                        \n                                    </tr>\n                                \n                                    <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>\n                                    <tr>\n                                        \n                                            <td>PVSComponent</td>\n                                        \n                                        \n                                            <td>SDE Payer</td>\n                                        \n                                    </tr>\n                                    <tr>\n                                        \n                                            <td/>\n                                        <td><pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;SDE Payer&quot;:   SDE.&quot;SDE Payer&quot;</code></pre></td>\n                                        \n                                    </tr>\n                                \n                                    <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>\n                                    <tr>\n                                        \n                                            <td>SupplementalDataElements</td>\n                                        \n                                        \n                                            <td>SDE Ethnicity</td>\n                                        \n                                    </tr>\n                                    <tr>\n                                        \n                                            <td/>\n                                        <td><pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;SDE Ethnicity&quot;:   (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</code></pre></td>\n                                        \n                                    </tr>\n                                \n                                    <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>\n                                    <tr>\n                                        \n                                            <td>PVSComponent</td>\n                                        \n                                        \n                                            <td>SDE Ethnicity</td>\n                                        \n                                    </tr>\n                                    <tr>\n                                        \n                                            <td/>\n                                        <td><pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;SDE Ethnicity&quot;:   SDE.&quot;SDE Ethnicity&quot;</code></pre></td>\n                                        \n                                    </tr>\n                                \n                                    <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>\n                                    <tr>\n                                        \n                                            <td>Hospice</td>\n                                        \n                                        \n                                            <td>Has Hospice</td>\n                                        \n                                    </tr>\n                                    <tr>\n                                        \n                                            <td/>\n                                        <td><pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Has Hospice&quot;:  exists (     [Encounter: &quot;Encounter Inpatient&quot;] DischargeHospice    where DischargeHospice.status = 'finished'       and (          DischargeHospice.hospitalization.dischargeDisposition ~ &quot;Discharge to home for hospice care (procedure)&quot;         or DischargeHospice.hospitalization.dischargeDisposition ~ &quot;Discharge to healthcare facility for hospice care (procedure)&quot;       )     and DischargeHospice.period ends during &quot;Measurement Period&quot;  )     or exists (       [ServiceRequest: &quot;Hospice care ambulatory&quot;] HospiceOrder         where HospiceOrder.intent = 'order'             and HospiceOrder.authoredOn in &quot;Measurement Period&quot;     )     or exists (       [Procedure: &quot;Hospice care ambulatory&quot;] HospicePerformed         where HospicePerformed.status = 'completed'           and Global.&quot;Normalize Interval&quot;(HospicePerformed.performed) overlaps &quot;Measurement Period&quot;     )</code></pre></td>\n                                        \n                                    </tr>\n                                \n                                    <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>\n                                    <tr>\n                                        \n                                            <td>PVSComponent</td>\n                                        \n                                        \n                                            <td>Denominator Exclusions</td>\n                                        \n                                    </tr>\n                                    <tr>\n                                        \n                                            <td/>\n                                        <td><pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Denominator Exclusions&quot;:   Hospice.&quot;Has Hospice&quot;</code></pre></td>\n                                        \n                                    </tr>\n                                \n                                    <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>\n                                    <tr>\n                                        \n                                            <td>SupplementalDataElements</td>\n                                        \n                                        \n                                            <td>SDE Race</td>\n                                        \n                                    </tr>\n                                    <tr>\n                                        \n                                            <td/>\n                                        <td><pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;SDE Race&quot;:   (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</code></pre></td>\n                                        \n                                    </tr>\n                                \n                                    <tr><th><b>Library Name</b></th><th><b>Name</b></th></tr>\n                                    <tr>\n                                        \n                                            <td>PVSComponent</td>\n                                        \n                                        \n                                            <td>SDE Race</td>\n                                        \n                                    </tr>\n                                    <tr>\n                                        \n                                            <td/>\n                                        <td><pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;SDE Race&quot;:   SDE.&quot;SDE Race&quot;</code></pre></td>\n                                        \n                                    </tr>\n                                \n                            </table>\n                        </td>\n                    </tr>\n                \n            \n        \n    </table>\n</div>"
  },
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      "resourceType" : "Library",
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      "extension" : [
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          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
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            "version" : "http://snomed.info/sct/731000124108/version/201709",
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          "extension" : [
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              "url" : "libraryName",
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            {
              "url" : "statement",
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            },
            {
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        "coding" : [
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          "type" : "depends-on",
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        {
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        },
        {
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        {
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        {
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        },
        {
          "type" : "depends-on",
          "display" : "Value set Preventive Care Services-Initial Office Visit, 18 and Up",
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        {
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        },
        {
          "type" : "depends-on",
          "display" : "Value set Discharge Services - Nursing Facility",
          "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.11.1065"
        },
        {
          "type" : "depends-on",
          "display" : "Value set Nursing Facility Visit",
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