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

: Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention - JSON Representation

Draft as of 2022-02-22

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{
  "resourceType" : "Measure",
  "id" : "TSCComponent",
  "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;\">TSCComponent</td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Url: </b></th>\n            <td style=\"padding-left: 4px;\"><a href=\"http://hl7.org/fhir/us/cqfmeasures/Measure/TSCComponent\">http://hl7.org/fhir/us/cqfmeasures/Measure/TSCComponent</a></td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Version: </b></th>\n            <td style=\"padding-left: 4px;\">0.0.001</td>\n        </tr>\n        \n        \n        \n        <tr>\n            <th scope=\"row\"><b>Name: </b></th>\n            <td style=\"padding-left: 4px;\">TSCComponent</td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Title: </b></th>\n            <td style=\"padding-left: 4px;\">Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention</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                        \n                        <p style=\"margin-bottom: 5px;\">\n                            <b>system: </b> <span><a href=\"http://terminology.hl7.org/CodeSystem/measure-scoring\">http://terminology.hl7.org/CodeSystem/measure-scoring</a></span>\n                        </p>\n                        \n                        \n                        <p style=\"margin-bottom: 5px;\">\n                            <b>code: </b> <span>proportion</span>\n                        </p>\n                        \n                        \n                        <p style=\"margin-bottom: 5px;\">\n                            <b>display: </b> <span>Proportion</span>\n                        </p>\n                        \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                        \n                        <p style=\"margin-bottom: 5px;\">\n                            <b>system: </b> <span><a href=\"http://terminology.hl7.org/CodeSystem/measure-improvement-notation\">http://terminology.hl7.org/CodeSystem/measure-improvement-notation</a></span>\n                        </p>\n                        \n                        \n                        <p style=\"margin-bottom: 5px;\">\n                            <b>code: </b> <span>increase</span>\n                        </p>\n                        \n                        \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                        \n                        <p style=\"margin-bottom: 5px;\">\n                            <b>system: </b> <span><a href=\"http://terminology.hl7.org/CodeSystem/measure-type\">http://terminology.hl7.org/CodeSystem/measure-type</a></span>\n                        </p>\n                        \n                        \n                        <p style=\"margin-bottom: 5px;\">\n                            <b>code: </b> <span>process</span>\n                        </p>\n                        \n                        \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;\">Clinical Quality Information WG</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        \n        \n            <tr>\n                <th scope=\"row\"><b>Supplemental Data: </b></th>\n                <td style=\"padding-left: 4px;\">\n                    <table class=\"grid-dict\">\n                        <tr><th><b>expression</b></th><th><b>system</b></th></tr>\n                        \n                        <tr>\n                            <td>SDE Ethnicity</td>\n                            <td><a href=\"http://terminology.hl7.org/CodeSystem/measure-data-usage\">http://terminology.hl7.org/CodeSystem/measure-data-usage</a></td>\n                        </tr>\n                        \n                        <tr>\n                            <td>SDE Payer</td>\n                            <td><a href=\"http://terminology.hl7.org/CodeSystem/measure-data-usage\">http://terminology.hl7.org/CodeSystem/measure-data-usage</a></td>\n                        </tr>\n                        \n                        <tr>\n                            <td>SDE Race</td>\n                            <td><a href=\"http://terminology.hl7.org/CodeSystem/measure-data-usage\">http://terminology.hl7.org/CodeSystem/measure-data-usage</a></td>\n                        </tr>\n                        \n                        <tr>\n                            <td>SDE Sex</td>\n                            <td><a href=\"http://terminology.hl7.org/CodeSystem/measure-data-usage\">http://terminology.hl7.org/CodeSystem/measure-data-usage</a></td>\n                        </tr>\n                        \n                    </table>\n                </td>\n            </tr>\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    </table>\n</div>"
  },
  "contained" : [
    {
      "resourceType" : "Library",
      "id" : "effective-data-requirements",
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
          "valueCoding" : {
            "system" : "http://terminology.hl7.org/CodeSystem/condition-clinical",
            "code" : "active"
          }
        },
        {
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
          "valueCoding" : {
            "system" : "http://www.ama-assn.org/go/cpt",
            "code" : "96158",
            "display" : "Health behavior intervention, individual, face-to-face; initial 30 minutes"
          }
        },
        {
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
          "valueCoding" : {
            "system" : "http://www.ama-assn.org/go/cpt",
            "code" : "96156",
            "display" : "Health behavior assessment, or re-assessment (ie, health-focused clinical interview, behavioral observations, clinical decision making)"
          }
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "TSCComponent"
            },
            {
              "url" : "name",
              "valueString" : "Most Recent Tobacco Use Screening Indicates Tobacco Non User"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Most Recent Tobacco Use Screening Indicates Tobacco Non User\":   ( Last([\"Observation\": \"Tobacco Use Screening\"] TobaccoUseScreening         where Global.\"Normalize Interval\"(TobaccoUseScreening.effective)overlaps \"Measurement Period\"         sort by start of Global.\"Normalize Interval\"(effective)     )) MostRecentTobaccoUseScreening       where MostRecentTobaccoUseScreening.value in \"Tobacco Non-User\""
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 0
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "TSCComponent"
            },
            {
              "url" : "name",
              "valueString" : "Most Recent Tobacco Use Screening Indicates Tobacco User"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Most Recent Tobacco Use Screening Indicates Tobacco User\":   ( Last([\"Observation\": \"Tobacco Use Screening\"] TobaccoUseScreening         where Global.\"Normalize Interval\"(TobaccoUseScreening.effective)overlaps \"Measurement Period\"         sort by start of Global.\"Normalize Interval\"(effective)     )) MostRecentTobaccoUseScreening       where MostRecentTobaccoUseScreening.value in \"Tobacco User\""
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 1
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "TSCComponent"
            },
            {
              "url" : "name",
              "valueString" : "Tobacco Cessation Counseling Given"
            },
            {
              "url" : "statement",
              "valueString" : "// MedicationStatement is not available in R5, known publication issue //define \"Active Pharmacotherapy for Tobacco Cessation\": //  [\"MedicationStatement\": \"Tobacco Use Cessation Pharmacotherapy\"] TakingCessationPharmacotherapy //      where Global.\"Normalize Interval\" ( TakingCessationPharmacotherapy.effective ) overlaps after \"Measurement Period\" //        and TakingCessationPharmacotherapy.status in { 'active', 'completed' } define \"Tobacco Cessation Counseling Given\":   [\"Encounter\": \"Tobacco Use Cessation Counseling\"] TobaccoCessationCounseling       where TobaccoCessationCounseling.period during \"Measurement Period\"         and TobaccoCessationCounseling.status = 'finished'"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 2
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "TSCComponent"
            },
            {
              "url" : "name",
              "valueString" : "Tobacco Cessation Pharmacotherapy Ordered"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Tobacco Cessation Pharmacotherapy Ordered\":   [\"MedicationRequest\": \"Tobacco Use Cessation Pharmacotherapy\"] CessationPharmacotherapyOrdered       where CessationPharmacotherapyOrdered.authoredOn during \"Measurement Period\"         and CessationPharmacotherapyOrdered.status = 'active'"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 3
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "TSCComponent"
            },
            {
              "url" : "name",
              "valueString" : "Numerator 3"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Numerator 3\":   \"Most Recent Tobacco Use Screening Indicates Tobacco Non User\" is not null       or ( \"Most Recent Tobacco Use Screening Indicates Tobacco User\" is not null           and ( exists \"Tobacco Cessation Counseling Given\"               or exists \"Tobacco Cessation Pharmacotherapy Ordered\"               //or exists \"Active Pharmacotherapy for Tobacco Cessation\"           )       )"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 4
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "TSCComponent"
            },
            {
              "url" : "name",
              "valueString" : "Medical Reason for Not Screening for Tobacco Use"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Medical Reason for Not Screening for Tobacco Use\":   [\"Observation\": \"Tobacco Use Screening\"] NoTobaccoUseScreening       where NoTobaccoUseScreening.issued during \"Measurement Period\"         and \"Not Done\"(NoTobaccoUseScreening)         and \"Not Done Reason in Medical Reason\"(NoTobaccoUseScreening)         and NoTobaccoUseScreening.status = 'final'"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 5
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "TSCComponent"
            },
            {
              "url" : "name",
              "valueString" : "Has Limited Life Expectancy"
            },
            {
              "url" : "statement",
              "valueString" : "//or exists \"Active Pharmacotherapy for Tobacco Cessation\" define \"Has Limited Life Expectancy\":   exists ( [\"Condition\"] LimitedLifeExpectancy         where Global.\"Prevalence Period\" ( LimitedLifeExpectancy ) overlaps after \"Measurement Period\"           and LimitedLifeExpectancy.clinicalStatus ~ ToConcept(Global.\"active\")     )"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 6
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "TSCComponent"
            },
            {
              "url" : "name",
              "valueString" : "Denominator Exceptions 1"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Denominator Exceptions 1\":   exists \"Medical Reason for Not Screening for Tobacco Use\"       or \"Has Limited Life Expectancy\""
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 7
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "TSCComponent"
            },
            {
              "url" : "name",
              "valueString" : "Numerator 1"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Numerator 1\":   \"Most Recent Tobacco Use Screening Indicates Tobacco Non User\" is not null       or \"Most Recent Tobacco Use Screening Indicates Tobacco User\" is not null"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 8
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "TSCComponent"
            },
            {
              "url" : "name",
              "valueString" : "Numerator 2"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Numerator 2\":   exists \"Tobacco Cessation Counseling Given\"       or exists \"Tobacco Cessation Pharmacotherapy Ordered\""
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 9
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "SupplementalDataElements"
            },
            {
              "url" : "name",
              "valueString" : "SDE Race"
            },
            {
              "url" : "statement",
              "valueString" : "define \"SDE Race\":   (flatten (       Patient.extension Extension         where Extension.url = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-race'           return Extension.extension     )) E       where E.url = 'ombCategory'         or E.url = 'detailed'       return E.value as Coding"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 10
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "TSCComponent"
            },
            {
              "url" : "name",
              "valueString" : "SDE Race"
            },
            {
              "url" : "statement",
              "valueString" : "define \"SDE Race\":   SDE.\"SDE Race\""
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 11
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "SupplementalDataElements"
            },
            {
              "url" : "name",
              "valueString" : "SDE Sex"
            },
            {
              "url" : "statement",
              "valueString" : "define \"SDE Sex\":   case       when Patient.gender = 'male' then Code { code: 'M', system: 'http://hl7.org/fhir/v3/AdministrativeGender', display: 'Male' }       when Patient.gender = 'female' then Code { code: 'F', system: 'http://hl7.org/fhir/v3/AdministrativeGender', display: 'Female' }       else null     end"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 12
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "TSCComponent"
            },
            {
              "url" : "name",
              "valueString" : "SDE Sex"
            },
            {
              "url" : "statement",
              "valueString" : "define \"SDE Sex\":   SDE.\"SDE Sex\""
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 13
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "TSCComponent"
            },
            {
              "url" : "name",
              "valueString" : "Office Based Visit During Measurement Period"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Office Based Visit During Measurement Period\":   ( [\"Encounter\": \"Health behavior intervention, individual, face-to-face; initial 30 minutes\"]       union [\"Encounter\": \"Health behavior assessment, or re-assessment (ie, health-focused clinical interview, behavioral observations, clinical decision making)\"]       union [\"Encounter\": \"Home Healthcare Services\"]       union [\"Encounter\": \"Occupational Therapy Evaluation\"]       union [\"Encounter\": \"Office Visit\"]       union [\"Encounter\": \"Ophthalmological Services\"]       union [\"Encounter\": \"Physical Therapy Evaluation\"]       union [\"Encounter\": \"Psych Visit - Diagnostic Evaluation\"]       union [\"Encounter\": \"Psych Visit - Psychotherapy\"]       union [\"Encounter\": \"Psychoanalysis\"]       union [\"Encounter\": \"Speech and Hearing Evaluation\"] ) OfficeBasedEncounter       where OfficeBasedEncounter.period during \"Measurement Period\"         and OfficeBasedEncounter.status = 'finished'"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 14
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "TSCComponent"
            },
            {
              "url" : "name",
              "valueString" : "Preventive Visit During Measurement Period"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Preventive Visit During Measurement Period\":   ( [\"Encounter\": \"Annual Wellness Visit\"]       union [\"Encounter\": \"Preventive Care Services - Established Office Visit, 18 and Up\"]       union [\"Encounter\": \"Preventive Care Services - Group Counseling\"]       union [\"Encounter\": \"Preventive Care Services - Other\"]       union [\"Encounter\": \"Preventive Care Services-Individual Counseling\"]       union [\"Encounter\": \"Preventive Care Services-Initial Office Visit, 18 and Up\"] ) PreventiveEncounter       where PreventiveEncounter.period during \"Measurement Period\"         and PreventiveEncounter.status = 'finished'"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 15
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "TSCComponent"
            },
            {
              "url" : "name",
              "valueString" : "Initial Population"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Initial Population\":   exists ( [\"Patient\"] BirthDate         where Global.\"CalendarAgeInYearsAt\" ( FHIRHelpers.ToDate ( BirthDate.birthDate ), start of \"Measurement Period\" ) >= 18     )       and ( Count(\"Office Based Visit During Measurement Period\")>= 2           or exists \"Preventive Visit During Measurement Period\"       )"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 16
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "TSCComponent"
            },
            {
              "url" : "name",
              "valueString" : "Denominator 3"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Denominator 3\":   \"Initial Population\""
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 17
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "TSCComponent"
            },
            {
              "url" : "name",
              "valueString" : "Denominator 2"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Denominator 2\":   \"Initial Population\"       and \"Most Recent Tobacco Use Screening Indicates Tobacco User\" is not null"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 18
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "SupplementalDataElements"
            },
            {
              "url" : "name",
              "valueString" : "SDE Payer"
            },
            {
              "url" : "statement",
              "valueString" : "define \"SDE Payer\":   [Coverage: type in \"Payer\"] Payer         return {           code: Payer.type,           period: Payer.period         }"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 19
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "TSCComponent"
            },
            {
              "url" : "name",
              "valueString" : "SDE Payer"
            },
            {
              "url" : "statement",
              "valueString" : "define \"SDE Payer\":   SDE.\"SDE Payer\""
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 20
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "SupplementalDataElements"
            },
            {
              "url" : "name",
              "valueString" : "SDE Ethnicity"
            },
            {
              "url" : "statement",
              "valueString" : "define \"SDE Ethnicity\":   (flatten (       Patient.extension Extension         where Extension.url = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity'           return Extension.extension     )) E       where E.url = 'ombCategory'         or E.url = 'detailed'       return E.value as Coding"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 21
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "TSCComponent"
            },
            {
              "url" : "name",
              "valueString" : "SDE Ethnicity"
            },
            {
              "url" : "statement",
              "valueString" : "define \"SDE Ethnicity\":   SDE.\"SDE Ethnicity\""
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 22
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "TSCComponent"
            },
            {
              "url" : "name",
              "valueString" : "Medical Reason for Not Counseling Tobacco User"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Medical Reason for Not Counseling Tobacco User\":   [\"Procedure\": \"Tobacco Use Cessation Counseling\"] NoTobaccoCessationCounseling       where Global.\"Normalize Interval\" ( NoTobaccoCessationCounseling.performed ) starts during \"Measurement Period\"         and ( ( NoTobaccoCessationCounseling.status = 'not-done'               and NoTobaccoCessationCounseling.statusReason in \"Medical Reason\"           )             or ( \"Not Done\"(NoTobaccoCessationCounseling)                 and \"Not Done Reason in Medical Reason\"(NoTobaccoCessationCounseling)             )         )"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 23
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "TSCComponent"
            },
            {
              "url" : "name",
              "valueString" : "Medical Reason for Not Ordering Tobacco Cessation Pharmacotherapy"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Medical Reason for Not Ordering Tobacco Cessation Pharmacotherapy\":   [\"MedicationRequest\": \"Tobacco Use Cessation Pharmacotherapy\"] NoCessationPharmacotherapyOrdered       where NoCessationPharmacotherapyOrdered.authoredOn during \"Measurement Period\"         and NoCessationPharmacotherapyOrdered.status = 'completed'         and ( ( \"Not Done\"(NoCessationPharmacotherapyOrdered)               and \"Not Done Reason in Medical Reason\"(NoCessationPharmacotherapyOrdered)           )             or ( NoCessationPharmacotherapyOrdered.doNotPerform = true                 and NoCessationPharmacotherapyOrdered.statusReason in \"Medical Reason\"             )         )"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 24
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "TSCComponent"
            },
            {
              "url" : "name",
              "valueString" : "Denominator Exceptions 2"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Denominator Exceptions 2\":   exists \"Medical Reason for Not Counseling Tobacco User\"       or exists \"Medical Reason for Not Ordering Tobacco Cessation Pharmacotherapy\"       or \"Has Limited Life Expectancy\""
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 25
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "TSCComponent"
            },
            {
              "url" : "name",
              "valueString" : "Denominator Exceptions 3"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Denominator Exceptions 3\":   exists \"Medical Reason for Not Screening for Tobacco Use\"       or exists \"Medical Reason for Not Counseling Tobacco User\"       or exists \"Medical Reason for Not Ordering Tobacco Cessation Pharmacotherapy\"       or \"Has Limited Life Expectancy\""
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 26
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "TSCComponent"
            },
            {
              "url" : "name",
              "valueString" : "Denominator 1"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Denominator 1\":   \"Initial Population\""
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 27
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        }
      ],
      "name" : "EffectiveDataRequirements",
      "status" : "active",
      "type" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/library-type",
            "code" : "module-definition"
          }
        ]
      },
      "date" : "2022-02-22T10:37:04-07:00",
      "relatedArtifact" : [
        {
          "type" : "depends-on",
          "display" : "Library Global",
          "resource" : "http://hl7.org/fhir/us/cqfmeasures/Library/MATGlobalCommonFunctions|5.0.000"
        },
        {
          "type" : "depends-on",
          "display" : "Library FHIRHelpers",
          "resource" : "http://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1"
        },
        {
          "type" : "depends-on",
          "display" : "Library SDE",
          "resource" : "http://hl7.org/fhir/us/cqfmeasures/Library/SupplementalDataElements|2.0.000"
        },
        {
          "type" : "depends-on",
          "display" : "Code system ConditionClinicalStatusCodes",
          "resource" : "http://terminology.hl7.org/CodeSystem/condition-clinical"
        },
        {
          "type" : "depends-on",
          "display" : "Code system CPT",
          "resource" : "http://www.ama-assn.org/go/cpt"
        },
        {
          "type" : "depends-on",
          "display" : "Value set Tobacco Use Screening",
          "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1278"
        },
        {
          "type" : "depends-on",
          "display" : "Value set Tobacco Non-User",
          "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1189"
        },
        {
          "type" : "depends-on",
          "display" : "Value set Tobacco User",
          "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1170"
        },
        {
          "type" : "depends-on",
          "display" : "Value set Tobacco Use Cessation Counseling",
          "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.509"
        },
        {
          "type" : "depends-on",
          "display" : "Value set Tobacco Use Cessation Pharmacotherapy",
          "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1190"
        },
        {
          "type" : "depends-on",
          "display" : "Value set Home Healthcare Services",
          "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016"
        },
        {
          "type" : "depends-on",
          "display" : "Value set Occupational Therapy Evaluation",
          "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1011"
        },
        {
          "type" : "depends-on",
          "display" : "Value set Office Visit",
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        },
        {
          "type" : "depends-on",
          "display" : "Value set Ophthalmological Services",
          "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1285"
        },
        {
          "type" : "depends-on",
          "display" : "Value set Physical Therapy Evaluation",
          "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1022"
        },
        {
          "type" : "depends-on",
          "display" : "Value set Psych Visit - Diagnostic Evaluation",
          "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1492"
        },
        {
          "type" : "depends-on",
          "display" : "Value set Psych Visit - Psychotherapy",
          "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1496"
        },
        {
          "type" : "depends-on",
          "display" : "Value set Psychoanalysis",
          "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1141"
        },
        {
          "type" : "depends-on",
          "display" : "Value set Speech and Hearing Evaluation",
          "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1530"
        },
        {
          "type" : "depends-on",
          "display" : "Value set Annual Wellness Visit",
          "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240"
        },
        {
          "type" : "depends-on",
          "display" : "Value set Preventive Care Services - Established Office Visit, 18 and Up",
          "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025"
        },
        {
          "type" : "depends-on",
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        },
        {
          "type" : "depends-on",
          "display" : "Value set Preventive Care Services - Other",
          "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1030"
        },
        {
          "type" : "depends-on",
          "display" : "Value set Preventive Care Services-Individual Counseling",
          "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1026"
        },
        {
          "type" : "depends-on",
          "display" : "Value set Preventive Care Services-Initial Office Visit, 18 and Up",
          "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023"
        },
        {
          "type" : "depends-on",
          "display" : "Value set Payer",
          "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"
        },
        {
          "type" : "depends-on",
          "display" : "Value set Medical Reason",
          "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1007"
        }
      ],
      "parameter" : [
        {
          "name" : "Measurement Period",
          "use" : "in",
          "min" : 0,
          "max" : "1",
          "type" : "Period"
        },
        {
          "name" : "Numerator 3",
          "use" : "out",
          "min" : 0,
          "max" : "1",
          "type" : "boolean"
        },
        {
          "name" : "Denominator Exceptions 1",
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          "min" : 0,
          "max" : "1",
          "type" : "boolean"
        },
        {
          "name" : "Numerator 1",
          "use" : "out",
          "min" : 0,
          "max" : "1",
          "type" : "boolean"
        },
        {
          "name" : "Numerator 2",
          "use" : "out",
          "min" : 0,
          "max" : "1",
          "type" : "boolean"
        },
        {
          "name" : "SDE Race",
          "use" : "out",
          "min" : 0,
          "max" : "*",
          "type" : "Coding"
        },
        {
          "name" : "SDE Sex",
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          "max" : "1",
          "type" : "Coding"
        },
        {
          "name" : "Denominator 3",
          "use" : "out",
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          "max" : "1",
          "type" : "boolean"
        },
        {
          "name" : "Denominator 2",
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          "max" : "1",
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        },
        {
          "name" : "SDE Payer",
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          "max" : "*",
          "type" : "Resource"
        },
        {
          "name" : "Initial Population",
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        },
        {
          "name" : "SDE Ethnicity",
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          "min" : 0,
          "max" : "*",
          "type" : "Coding"
        },
        {
          "name" : "Denominator Exceptions 2",
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          "max" : "1",
          "type" : "boolean"
        },
        {
          "name" : "Denominator Exceptions 3",
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          "max" : "1",
          "type" : "boolean"
        },
        {
          "name" : "Denominator 1",
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      ],
      "dataRequirement" : [
        {
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          ],
          "mustSupport" : [
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            "birthDate",
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        },
        {
          "type" : "Encounter",
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          "mustSupport" : [
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          "codeFilter" : [
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              "path" : "type",
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          ]
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        },
        {
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        },
        {
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        },
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          "profile" : [
            "http://hl7.org/fhir/StructureDefinition/Condition"
          ],
          "mustSupport" : [
            "clinicalStatus"
          ]
        },
        {
          "type" : "Procedure",
          "profile" : [
            "http://hl7.org/fhir/StructureDefinition/Procedure"
          ],
          "mustSupport" : [
            "code",
            "statusReason",
            "performed",
            "status"
          ],
          "codeFilter" : [
            {
              "path" : "code",
              "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.509"
            }
          ]
        }
      ]
    }
  ],
  "extension" : [
    {
      "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis",
      "valueCode" : "boolean"
    },
    {
      "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-softwaresystem",
      "valueReference" : {
        "reference" : "Device/software-system-example"
      }
    },
    {
      "id" : "effective-data-requirements",
      "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-effectiveDataRequirements",
      "valueReference" : {
        "reference" : "#effective-data-requirements"
      }
    }
  ],
  "url" : "http://hl7.org/fhir/us/cqfmeasures/Measure/TSCComponent",
  "version" : "0.0.001",
  "name" : "TSCComponent",
  "title" : "Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention",
  "status" : "draft",
  "experimental" : true,
  "date" : "2022-02-22T11:37:04-06:00",
  "publisher" : "Clinical Quality Information WG",
  "contact" : [
    {
      "telecom" : [
        {
          "system" : "url",
          "value" : "http://www.hl7.org/Special/committees/cqi"
        }
      ]
    }
  ],
  "description" : "This is an example only.",
  "jurisdiction" : [
    {
      "coding" : [
        {
          "system" : "urn:iso:std:iso:3166",
          "code" : "US"
        }
      ]
    }
  ],
  "effectivePeriod" : {
    "start" : "2022-01-01",
    "end" : "2022-12-31"
  },
  "library" : [
    "http://ecqi.healthit.gov/ecqms/Library/TSCComponent"
  ],
  "scoring" : {
    "coding" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/measure-scoring",
        "code" : "proportion",
        "display" : "Proportion"
      }
    ]
  },
  "type" : [
    {
      "coding" : [
        {
          "system" : "http://terminology.hl7.org/CodeSystem/measure-type",
          "code" : "process"
        }
      ]
    }
  ],
  "improvementNotation" : {
    "coding" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/measure-improvement-notation",
        "code" : "increase"
      }
    ]
  },
  "group" : [
    {
      "id" : "group-1",
      "code" : {
        "text" : "Group 1"
      },
      "population" : [
        {
          "id" : "1DE7294A-72AE-42D1-A2A6-BCAE23DBA8A6",
          "code" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                "code" : "initial-population",
                "display" : "Initial Population"
              }
            ]
          },
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Initial Population"
          }
        },
        {
          "id" : "0F57D23C-C2AA-4CE1-9E20-33DAE1F2B145",
          "code" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                "code" : "denominator",
                "display" : "Denominator"
              }
            ]
          },
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Denominator 1"
          }
        },
        {
          "id" : "570F7624-72EC-4CFC-9137-F48E476D77DC",
          "code" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                "code" : "denominator-exception",
                "display" : "Denominator Exception"
              }
            ]
          },
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Denominator Exceptions 1"
          }
        },
        {
          "id" : "20577EB7-3FE9-43D2-B918-A8C7AE5E0E91",
          "code" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                "code" : "numerator",
                "display" : "Numerator"
              }
            ]
          },
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Numerator 1"
          }
        }
      ]
    },
    {
      "id" : "group-2",
      "code" : {
        "text" : "Group 2"
      },
      "population" : [
        {
          "id" : "DD346C87-5D2B-4319-B41D-7BF64ADF95D0",
          "code" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                "code" : "initial-population",
                "display" : "Initial Population"
              }
            ]
          },
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Initial Population"
          }
        },
        {
          "id" : "A1FAA872-5C94-4F2B-A355-8E3A3390369C",
          "code" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                "code" : "denominator",
                "display" : "Denominator"
              }
            ]
          },
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Denominator 2"
          }
        },
        {
          "id" : "3AE470CD-37DF-492D-A3A4-365BAF744C5A",
          "code" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                "code" : "denominator-exception",
                "display" : "Denominator Exception"
              }
            ]
          },
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Denominator Exceptions 2"
          }
        },
        {
          "id" : "B1F8B729-7BBD-4616-B39C-E90444B7884C",
          "code" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                "code" : "numerator",
                "display" : "Numerator"
              }
            ]
          },
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Numerator 2"
          }
        }
      ]
    },
    {
      "id" : "group-3",
      "code" : {
        "text" : "Group 3"
      },
      "population" : [
        {
          "id" : "EA2696EE-326B-490A-82B5-E4D8FC581E77",
          "code" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                "code" : "initial-population",
                "display" : "Initial Population"
              }
            ]
          },
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Initial Population"
          }
        },
        {
          "id" : "D346BB79-EFD1-4DB1-902A-36F027BE75E9",
          "code" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                "code" : "denominator",
                "display" : "Denominator"
              }
            ]
          },
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Denominator 3"
          }
        },
        {
          "id" : "6BBFE753-2072-4848-B189-0E5B44BE1F52",
          "code" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                "code" : "denominator-exception",
                "display" : "Denominator Exception"
              }
            ]
          },
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Denominator Exceptions 3"
          }
        },
        {
          "id" : "F8E22F0F-7307-4BED-9295-648803772928",
          "code" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                "code" : "numerator",
                "display" : "Numerator"
              }
            ]
          },
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Numerator 3"
          }
        }
      ]
    }
  ],
  "supplementalData" : [
    {
      "id" : "fe7bab72-cc69-44bb-a678-473b24811e67",
      "usage" : [
        {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
              "code" : "supplemental-data"
            }
          ]
        }
      ],
      "criteria" : {
        "language" : "text/cql-identifier",
        "expression" : "SDE Ethnicity"
      }
    },
    {
      "id" : "2486f84d-df90-489b-8f5c-e55cdcfb361e",
      "usage" : [
        {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
              "code" : "supplemental-data"
            }
          ]
        }
      ],
      "criteria" : {
        "language" : "text/cql-identifier",
        "expression" : "SDE Payer"
      }
    },
    {
      "id" : "bb0949c4-1f7b-4ce2-a988-c2e60f1a0079",
      "usage" : [
        {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
              "code" : "supplemental-data"
            }
          ]
        }
      ],
      "criteria" : {
        "language" : "text/cql-identifier",
        "expression" : "SDE Race"
      }
    },
    {
      "id" : "742028bc-5aa5-4a5b-927d-be1908e10aaf",
      "usage" : [
        {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
              "code" : "supplemental-data"
            }
          ]
        }
      ],
      "criteria" : {
        "language" : "text/cql-identifier",
        "expression" : "SDE Sex"
      }
    }
  ]
}