Quality Measure Implementation Guide (STU3 Ballot)
2.1.0 - ballot

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

: EXM Measure - XML Representation

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<Measure xmlns="http://hl7.org/fhir">
  <id value="measure-exm"/>
  <meta>
    <profile
             value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/proportion-measure-cqfm"/>
    <profile
             value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-measure-cqfm"/>
  </meta>
  <text>
    <status value="extensions"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
    <table class="grid dict">
        
        <tr>
            <th scope="row"><b>Id: </b></th>
            <td style="padding-left: 4px;">measure-exm</td>
        </tr>
        
        
        <tr>
            <th scope="row"><b>Url: </b></th>
            <td style="padding-left: 4px;">http://hl7.org/fhir/us/cqfmeasures/Measure/measure-exm</td>
        </tr>
        
        
        <tr>
            <th scope="row"><b>Version: </b></th>
            <td style="padding-left: 4px;">2.0.0</td>
        </tr>
        
        
        <tr>
            <th scope="row"><b>Identifier: </b></th>
            <td style="padding-left: 4px;">
                
                
                <p style="margin-bottom: 5px;">
                    <b>value: </b> <span>EXM</span>
                </p>
                
            </td>
        </tr>
        
        
        <tr>
            <th scope="row"><b>Name: </b></th>
            <td style="padding-left: 4px;">MeasureEXM</td>
        </tr>
        
        
        <tr>
            <th scope="row"><b>Title: </b></th>
            <td style="padding-left: 4px;">EXM Measure</td>
        </tr>
        
        
        
        <tr>
            <th scope="row"><b>Status: </b></th>
            <td style="padding-left: 4px;">active</td>
        </tr>
        
        
        <tr>
            <th scope="row"><b>Experimental: </b></th>
            <td style="padding-left: 4px;">true</td>
        </tr>
        
        
        <tr>
            <th scope="row"><b>Scoring: </b></th>
            <td style="padding-left: 4px;">
                
                    
                        
                        <p style="margin-bottom: 5px;">
                            <b>system: </b> <span>http://terminology.hl7.org/CodeSystem/measure-scoring</span>
                        </p>
                        
                        
                        <p style="margin-bottom: 5px;">
                            <b>code: </b> <span>proportion</span>
                        </p>
                        
                        
                        <p style="margin-bottom: 5px;">
                            <b>display: </b> <span>Proportion</span>
                        </p>
                        
                    
                
                
            </td>
        </tr>
        
        
        <tr>
            <th scope="row"><b>Improvement Notation: </b></th>
            <td style="padding-left: 4px;">
                
                    
                        
                        <p style="margin-bottom: 5px;">
                            <b>system: </b> <span>http://terminology.hl7.org/CodeSystem/measure-improvement-notation</span>
                        </p>
                        
                        
                        <p style="margin-bottom: 5px;">
                            <b>code: </b> <span>increase</span>
                        </p>
                        
                        
                        <p style="margin-bottom: 5px;">
                            <b>display: </b> <span>Increased score indicates improvement</span>
                        </p>
                        
                    
                
                
            </td>
        </tr>
        
        
        <tr>
            <th scope="row"><b>Type: </b></th>
            <td style="padding-left: 4px;">
                
                    
                        
                        <p style="margin-bottom: 5px;">
                            <b>system: </b> <span>http://terminology.hl7.org/CodeSystem/measure-type</span>
                        </p>
                        
                        
                        <p style="margin-bottom: 5px;">
                            <b>code: </b> <span>process</span>
                        </p>
                        
                        
                    
                
                
            </td>
        </tr>
        
        
        
        <tr>
            <th scope="row"><b>Date: </b></th>
            <td style="padding-left: 4px;">2021-04-03</td>
        </tr>
        
        
        <tr>
            <th scope="row"><b>Publisher: </b></th>
            <td style="padding-left: 4px;">Clinical Quality Information WG</td>
        </tr>
        
        
        <tr>
            <th scope="row"><b>Description: </b></th>
            <td style="padding-left: 4px;">An example FHIR-based measure</td>
        </tr>
        
        
        
        
        <tr>
            <th scope="row"><b>Parameters: </b></th>
            <td style="padding-left: 4px;">
                <table class="grid-dict">
                    <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>
                    
                    <tr>
                        <td>Measurement Period</td>
                        <td>in</td>
                        <td>0</td>
                        <td>1</td>
                        <td>Period</td>
                    </tr>
                    
                    <tr>
                        <td>SDE Sex</td>
                        <td>out</td>
                        <td>0</td>
                        <td>1</td>
                        <td>Coding</td>
                    </tr>
                    
                    <tr>
                        <td>Stratifier 3</td>
                        <td>out</td>
                        <td>0</td>
                        <td>*</td>
                        <td>Encounter</td>
                    </tr>
                    
                    <tr>
                        <td>Inpatient Encounter</td>
                        <td>out</td>
                        <td>0</td>
                        <td>*</td>
                        <td>Encounter</td>
                    </tr>
                    
                    <tr>
                        <td>Stratifier 4</td>
                        <td>out</td>
                        <td>0</td>
                        <td>*</td>
                        <td>Encounter</td>
                    </tr>
                    
                    <tr>
                        <td>SDE Payer</td>
                        <td>out</td>
                        <td>0</td>
                        <td>*</td>
                        <td>Any</td>
                    </tr>
                    
                    <tr>
                        <td>Initial Population</td>
                        <td>out</td>
                        <td>0</td>
                        <td>*</td>
                        <td>Encounter</td>
                    </tr>
                    
                    <tr>
                        <td>SDE Ethnicity</td>
                        <td>out</td>
                        <td>0</td>
                        <td>*</td>
                        <td>Coding</td>
                    </tr>
                    
                    <tr>
                        <td>Patient</td>
                        <td>out</td>
                        <td>0</td>
                        <td>1</td>
                        <td>Patient</td>
                    </tr>
                    
                    <tr>
                        <td>SDE Race</td>
                        <td>out</td>
                        <td>0</td>
                        <td>*</td>
                        <td>Coding</td>
                    </tr>
                    
                    <tr>
                        <td>Stratifier 1</td>
                        <td>out</td>
                        <td>0</td>
                        <td>*</td>
                        <td>Encounter</td>
                    </tr>
                    
                    <tr>
                        <td>Stratifier 2</td>
                        <td>out</td>
                        <td>0</td>
                        <td>*</td>
                        <td>Encounter</td>
                    </tr>
                    
                </table>
            </td>
        </tr>
        
        
        <tr>
          <th scope="row"><b>Data Requirements: </b></th>
          <td style="padding-left: 4px;">
                <table class="grid-dict">
                    <tr><th><b>type</b></th><th><b>path</b></th><th><b>valueSet or system</b></th><th><b>code</b></th></tr>
                    
                        <tr>
                            <td>Encounter</td>
                            <td></td>
                            
                            
                        </tr>
                    
                        <tr>
                            <td>Condition</td>
                            <td>id</td>
                            
                            
                        </tr>
                    
                        <tr>
                            <td>Coverage</td>
                            <td>type</td>
                            
                                <td>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591</td>
                                <td></td>
                            
                            
                        </tr>
                    
                        <tr>
                            <td>Patient</td>
                            <td></td>
                            
                            
                        </tr>
                    
                </table>
          </td>
        </tr>
        
        
        <tr>
          <th scope="row"><b>Direct Reference Codes: </b></th>
          <td style="padding-left: 4px;">
                <table class="grid-dict">
                    <tr><th><b>display</b></th><th><b>code</b></th><th><b>system</b></th></tr>
                    
                        <tr>
                            <td>Billing</td>
                            <td>billing</td>
                            <td></td>
                        </tr>
                    
                </table>
          </td>
        </tr>
        
        
            <tr>
                <th scope="row"><b>Supplemental Data: </b></th>
                <td style="padding-left: 4px;">
                    <table class="grid-dict">
                        <tr><th><b>expression</b></th><th><b>system</b></th></tr>
                        
                        <tr>
                            <td>SDE Ethnicity</td>
                            <td>http://terminology.hl7.org/CodeSystem/measure-data-usage</td>
                        </tr>
                        
                        <tr>
                            <td>SDE Race</td>
                            <td>http://terminology.hl7.org/CodeSystem/measure-data-usage</td>
                        </tr>
                        
                        <tr>
                            <td>SDE Payer</td>
                            <td>http://terminology.hl7.org/CodeSystem/measure-data-usage</td>
                        </tr>
                        
                        <tr>
                            <td>SDE Sex</td>
                            <td>http://terminology.hl7.org/CodeSystem/measure-data-usage</td>
                        </tr>
                        
                    </table>
                </td>
            </tr>
        
        
        <tr>
            <th scope="row"><b>Use Context: </b></th>
            <td style="padding-left: 4px;">
                <table class="grid-dict">
                    <tr><th><b>code</b></th><th><b>value</b></th></tr>
                    
                      <tr>
                        <td>program</td>
                        <td>eligible-provider</td>
                      </tr>
                    
                </table>
            </td>
        </tr>
        
        
        <tr>
            <th scope="row"><b>Jurisdiction: </b></th>
            <td style="padding-left: 25px;">US</td>
        </tr>
        
        
        <tr>
            <th scope="row"><b>Topic: </b></th>
            <td style="padding-left: 25px;">57024-2</td>
        </tr>
        
        
        <tr>
            <th scope="row"><b>Purpose: </b></th>
            <td style="padding-left: 4px;">The purpose of this measure is to...</td>
        </tr>
        
        
        <tr>
            <th scope="row"><b>Usage: </b></th>
            <td style="padding-left: 4px;">Users of this measure should be aware of...</td>
        </tr>
        
        
        <tr>
            <th scope="row"><b>Copyright: </b></th>
            <td style="padding-left: 25px;">Example Copyright Statement</td>
        </tr>
        
        
        <tr>
            <th scope="row"><b>Disclaimer: </b></th>
            <td style="padding-left: 25px;">Example disclaimer</td>
        </tr>
        
        
        <tr>
            <th scope="row"><b>Approval Date: </b></th>
            <td style="padding-left: 4px;">2019-02-17</td>
        </tr>
        
        
        <tr>
            <th scope="row"><b>Last Review Date: </b></th>
            <td style="padding-left: 4px;">2019-02-17</td>
        </tr>
        
        
        <tr>
            <th scope="row"><b>Effective Period: </b></th>
            <td style="padding-left: 4px;">2018-01-01..2018-12-31</td>
        </tr>
        
        
        <tr>
          <th scope="row"><b>Related Artifacts: </b></th>
          <td style="padding-left: 4px;">
            
            
            
            <p><b>Dependencies</b></p>
            <ul>
              
                <li>http://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1</li>
              
                <li>http://terminology.hl7.org/CodeSystem/diagnosis-role</li>
              
                <li>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591</li>
              
                <li>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.299</li>
              
            </ul>
            
            
            
            
            
          </td>
        </tr>
        
        
        
        
        
        <tr>
          <th scope="row"><b>Logic Definitions: </b></th>
          <td style="padding-left: 4px;">
            
                <table class="grid-dict">
                    <tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>
                    <tr>
                        
                            <td>EXMLogic</td>
                        
                        
                            <td>SDE Sex</td>
                        
                        
                    </tr>
                </table>
                
                    <pre><code class="language-cql">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</code></pre>
                
                <br/><br/>
            
                <table class="grid-dict">
                    <tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>
                    <tr>
                        
                            <td>EXMLogic</td>
                        
                        
                            <td>Stratifier 3</td>
                        
                        
                    </tr>
                </table>
                
                    <pre><code class="language-cql">define "Stratifier 3" :
  "Inpatient Encounter" Encounter
    where PrincipalDiagnosis(Encounter) is null</code></pre>
                
                <br/><br/>
            
                <table class="grid-dict">
                    <tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>
                    <tr>
                        
                            <td>EXMLogic</td>
                        
                        
                            <td>Inpatient Encounter</td>
                        
                        
                    </tr>
                </table>
                
                    <pre><code class="language-cql">define "Inpatient Encounter" :
  ["Encounter"] Encounter
    where LengthInDays(Encounter.period) &lt;= 120
      and Encounter.period ends during "Measurement Period"</code></pre>
                
                <br/><br/>
            
                <table class="grid-dict">
                    <tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>
                    <tr>
                        
                            <td>EXMLogic</td>
                        
                        
                            <td>Stratifier 4</td>
                        
                        
                    </tr>
                </table>
                
                    <pre><code class="language-cql">define "Stratifier 4" :
  "Inpatient Encounter" Encounter
    where PrincipalDiagnosis(Encounter) is null</code></pre>
                
                <br/><br/>
            
                <table class="grid-dict">
                    <tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>
                    <tr>
                        
                            <td>EXMLogic</td>
                        
                        
                            <td>SDE Payer</td>
                        
                        
                    </tr>
                </table>
                
                    <pre><code class="language-cql">define "SDE Payer":
    [Coverage: type in "Payer"] Payer
      return {
        code: Payer.type,
        period: Payer.period
      }</code></pre>
                
                <br/><br/>
            
                <table class="grid-dict">
                    <tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>
                    <tr>
                        
                            <td>EXMLogic</td>
                        
                        
                            <td>Initial Population</td>
                        
                        
                    </tr>
                </table>
                
                    <pre><code class="language-cql">define "Initial Population" :
  "Inpatient Encounter" Encounter</code></pre>
                
                <br/><br/>
            
                <table class="grid-dict">
                    <tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>
                    <tr>
                        
                            <td>EXMLogic</td>
                        
                        
                            <td>SDE Ethnicity</td>
                        
                        
                    </tr>
                </table>
                
                    <pre><code class="language-cql">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</code></pre>
                
                <br/><br/>
            
                <table class="grid-dict">
                    <tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>
                    <tr>
                        
                            <td>EXMLogic</td>
                        
                        
                            <td>SDE Race</td>
                        
                        
                    </tr>
                </table>
                
                    <pre><code class="language-cql">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</code></pre>
                
                <br/><br/>
            
                <table class="grid-dict">
                    <tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>
                    <tr>
                        
                            <td>EXMLogic</td>
                        
                        
                            <td>Stratifier 1</td>
                        
                        
                    </tr>
                </table>
                
                    <pre><code class="language-cql">define "Stratifier 1" :
  "Inpatient Encounter" Encounter
    where not (PrincipalDiagnosis(Encounter).code in "Psychiatric/Mental Health Patient")</code></pre>
                
                <br/><br/>
            
                <table class="grid-dict">
                    <tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>
                    <tr>
                        
                            <td>EXMLogic</td>
                        
                        
                            <td>Stratifier 2</td>
                        
                        
                    </tr>
                </table>
                
                    <pre><code class="language-cql">define "Stratifier 2" :
  "Inpatient Encounter" Encounter
    where PrincipalDiagnosis(Encounter).code in "Psychiatric/Mental Health Patient"</code></pre>
                
                <br/><br/>
            
          </td>
        </tr>
        
    </table>
</div>
  </text>
  <extension
             url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-artifactComment">
    <extension url="type">
      <valueCode value="documentation"/>
    </extension>
    <extension url="text">
      <valueString value="This illustrates an example comment"/>
    </extension>
  </extension>
  <extension
             url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis">
    <valueCode value="Encounter"/>
  </extension>
  <extension
             url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-allocation">
    <valueMarkdown value="Additional guidance for allocation"/>
  </extension>
  <extension
             url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-parameter">
    <valueParameterDefinition>
      <name value="Measurement Period"/>
      <use value="in"/>
      <min value="0"/>
      <max value="1"/>
      <type value="Period"/>
    </valueParameterDefinition>
  </extension>
  <extension
             url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-parameter">
    <valueParameterDefinition>
      <name value="SDE Sex"/>
      <use value="out"/>
      <min value="0"/>
      <max value="1"/>
      <type value="Coding"/>
    </valueParameterDefinition>
  </extension>
  <extension
             url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-parameter">
    <valueParameterDefinition>
      <name value="Stratifier 3"/>
      <use value="out"/>
      <min value="0"/>
      <max value="*"/>
      <type value="Encounter"/>
    </valueParameterDefinition>
  </extension>
  <extension
             url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-parameter">
    <valueParameterDefinition>
      <name value="Inpatient Encounter"/>
      <use value="out"/>
      <min value="0"/>
      <max value="*"/>
      <type value="Encounter"/>
    </valueParameterDefinition>
  </extension>
  <extension
             url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-parameter">
    <valueParameterDefinition>
      <name value="Stratifier 4"/>
      <use value="out"/>
      <min value="0"/>
      <max value="*"/>
      <type value="Encounter"/>
    </valueParameterDefinition>
  </extension>
  <extension
             url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-parameter">
    <valueParameterDefinition>
      <name value="SDE Payer"/>
      <use value="out"/>
      <min value="0"/>
      <max value="*"/>
      <type value="Any"/>
    </valueParameterDefinition>
  </extension>
  <extension
             url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-parameter">
    <valueParameterDefinition>
      <name value="Initial Population"/>
      <use value="out"/>
      <min value="0"/>
      <max value="*"/>
      <type value="Encounter"/>
    </valueParameterDefinition>
  </extension>
  <extension
             url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-parameter">
    <valueParameterDefinition>
      <name value="SDE Ethnicity"/>
      <use value="out"/>
      <min value="0"/>
      <max value="*"/>
      <type value="Coding"/>
    </valueParameterDefinition>
  </extension>
  <extension
             url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-parameter">
    <valueParameterDefinition>
      <name value="Patient"/>
      <use value="out"/>
      <min value="0"/>
      <max value="1"/>
      <type value="Patient"/>
    </valueParameterDefinition>
  </extension>
  <extension
             url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-parameter">
    <valueParameterDefinition>
      <name value="SDE Race"/>
      <use value="out"/>
      <min value="0"/>
      <max value="*"/>
      <type value="Coding"/>
    </valueParameterDefinition>
  </extension>
  <extension
             url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-parameter">
    <valueParameterDefinition>
      <name value="Stratifier 1"/>
      <use value="out"/>
      <min value="0"/>
      <max value="*"/>
      <type value="Encounter"/>
    </valueParameterDefinition>
  </extension>
  <extension
             url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-parameter">
    <valueParameterDefinition>
      <name value="Stratifier 2"/>
      <use value="out"/>
      <min value="0"/>
      <max value="*"/>
      <type value="Encounter"/>
    </valueParameterDefinition>
  </extension>
  <extension
             url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-dataRequirement">
    <valueDataRequirement>
      <type value="Encounter"/>
      <profile value="http://hl7.org/fhir/StructureDefinition/Encounter"/>
    </valueDataRequirement>
  </extension>
  <extension
             url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-dataRequirement">
    <valueDataRequirement>
      <type value="Condition"/>
      <profile value="http://hl7.org/fhir/StructureDefinition/Condition"/>
      <codeFilter>
        <path value="id"/>
      </codeFilter>
    </valueDataRequirement>
  </extension>
  <extension
             url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-dataRequirement">
    <valueDataRequirement>
      <type value="Coverage"/>
      <profile value="http://hl7.org/fhir/StructureDefinition/Coverage"/>
      <codeFilter>
        <path value="type"/>
        <valueSet
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"/>
      </codeFilter>
    </valueDataRequirement>
  </extension>
  <extension
             url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-dataRequirement">
    <valueDataRequirement>
      <type value="Patient"/>
      <profile value="http://hl7.org/fhir/StructureDefinition/Patient"/>
    </valueDataRequirement>
  </extension>
  <extension
             url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
    <valueCoding>
      <system value="http://terminology.hl7.org/CodeSystem/diagnosis-role"/>
      <code value="billing"/>
      <display value="Billing"/>
    </valueCoding>
  </extension>
  <extension
             url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
    <extension url="libraryName">
      <valueString value="EXMLogic"/>
    </extension>
    <extension url="name">
      <valueString value="SDE Sex"/>
    </extension>
    <extension url="statement">
      <valueString
                   value="define &quot;SDE Sex&quot;:
  case
    when Patient.gender = &#39;male&#39; then Code { code: &#39;M&#39;, system: &#39;http://hl7.org/fhir/v3/AdministrativeGender&#39;, display: &#39;Male&#39; }
    when Patient.gender = &#39;female&#39; then Code { code: &#39;F&#39;, system: &#39;http://hl7.org/fhir/v3/AdministrativeGender&#39;, display: &#39;Female&#39; }
    else null
  end"/>
    </extension>
    <extension url="displaySequence">
      <valueInteger value="0"/>
    </extension>
  </extension>
  <extension
             url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
    <extension url="libraryName">
      <valueString value="EXMLogic"/>
    </extension>
    <extension url="name">
      <valueString value="Stratifier 3"/>
    </extension>
    <extension url="statement">
      <valueString
                   value="define &quot;Stratifier 3&quot; :
  &quot;Inpatient Encounter&quot; Encounter
    where PrincipalDiagnosis(Encounter) is null"/>
    </extension>
    <extension url="displaySequence">
      <valueInteger value="1"/>
    </extension>
  </extension>
  <extension
             url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
    <extension url="libraryName">
      <valueString value="EXMLogic"/>
    </extension>
    <extension url="name">
      <valueString value="Inpatient Encounter"/>
    </extension>
    <extension url="statement">
      <valueString
                   value="define &quot;Inpatient Encounter&quot; :
  [&quot;Encounter&quot;] Encounter
    where LengthInDays(Encounter.period) &lt;= 120
      and Encounter.period ends during &quot;Measurement Period&quot;"/>
    </extension>
    <extension url="displaySequence">
      <valueInteger value="2"/>
    </extension>
  </extension>
  <extension
             url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
    <extension url="libraryName">
      <valueString value="EXMLogic"/>
    </extension>
    <extension url="name">
      <valueString value="Stratifier 4"/>
    </extension>
    <extension url="statement">
      <valueString
                   value="define &quot;Stratifier 4&quot; :
  &quot;Inpatient Encounter&quot; Encounter
    where PrincipalDiagnosis(Encounter) is null"/>
    </extension>
    <extension url="displaySequence">
      <valueInteger value="3"/>
    </extension>
  </extension>
  <extension
             url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
    <extension url="libraryName">
      <valueString value="EXMLogic"/>
    </extension>
    <extension url="name">
      <valueString value="SDE Payer"/>
    </extension>
    <extension url="statement">
      <valueString
                   value="define &quot;SDE Payer&quot;:
    [Coverage: type in &quot;Payer&quot;] Payer
      return {
        code: Payer.type,
        period: Payer.period
      }"/>
    </extension>
    <extension url="displaySequence">
      <valueInteger value="4"/>
    </extension>
  </extension>
  <extension
             url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
    <extension url="libraryName">
      <valueString value="EXMLogic"/>
    </extension>
    <extension url="name">
      <valueString value="Initial Population"/>
    </extension>
    <extension url="statement">
      <valueString
                   value="define &quot;Initial Population&quot; :
  &quot;Inpatient Encounter&quot; Encounter"/>
    </extension>
    <extension url="displaySequence">
      <valueInteger value="5"/>
    </extension>
  </extension>
  <extension
             url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
    <extension url="libraryName">
      <valueString value="EXMLogic"/>
    </extension>
    <extension url="name">
      <valueString value="SDE Ethnicity"/>
    </extension>
    <extension url="statement">
      <valueString
                   value="define &quot;SDE Ethnicity&quot;:
  (flatten (
    Patient.extension Extension
      where Extension.url = &#39;http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity&#39;
        return Extension.extension
  )) E
    where E.url = &#39;ombCategory&#39;
      or E.url = &#39;detailed&#39;
    return E.value as Coding"/>
    </extension>
    <extension url="displaySequence">
      <valueInteger value="6"/>
    </extension>
  </extension>
  <extension
             url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
    <extension url="libraryName">
      <valueString value="EXMLogic"/>
    </extension>
    <extension url="name">
      <valueString value="SDE Race"/>
    </extension>
    <extension url="statement">
      <valueString
                   value="define &quot;SDE Race&quot;:
  (flatten (
    Patient.extension Extension
      where Extension.url = &#39;http://hl7.org/fhir/us/core/StructureDefinition/us-core-race&#39;
        return Extension.extension
  )) E
    where E.url = &#39;ombCategory&#39;
      or E.url = &#39;detailed&#39;
    return E.value as Coding"/>
    </extension>
    <extension url="displaySequence">
      <valueInteger value="7"/>
    </extension>
  </extension>
  <extension
             url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
    <extension url="libraryName">
      <valueString value="EXMLogic"/>
    </extension>
    <extension url="name">
      <valueString value="Stratifier 1"/>
    </extension>
    <extension url="statement">
      <valueString
                   value="define &quot;Stratifier 1&quot; :
  &quot;Inpatient Encounter&quot; Encounter
    where not (PrincipalDiagnosis(Encounter).code in &quot;Psychiatric/Mental Health Patient&quot;)"/>
    </extension>
    <extension url="displaySequence">
      <valueInteger value="8"/>
    </extension>
  </extension>
  <extension
             url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
    <extension url="libraryName">
      <valueString value="EXMLogic"/>
    </extension>
    <extension url="name">
      <valueString value="Stratifier 2"/>
    </extension>
    <extension url="statement">
      <valueString
                   value="define &quot;Stratifier 2&quot; :
  &quot;Inpatient Encounter&quot; Encounter
    where PrincipalDiagnosis(Encounter).code in &quot;Psychiatric/Mental Health Patient&quot;"/>
    </extension>
    <extension url="displaySequence">
      <valueInteger value="9"/>
    </extension>
  </extension>
  <url value="http://hl7.org/fhir/us/cqfmeasures/Measure/measure-exm"/>
  <identifier>
    <system value="http://example.org/fhir/cqi/ecqm/Measure/Identifier/exm"/>
    <value value="EXM"/>
  </identifier>
  <version value="2.0.0"/>
  <name value="MeasureEXM"/>
  <title value="EXM Measure"/>
  <status value="active"/>
  <experimental value="true"/>
  <date value="2021-04-03"/>
  <publisher value="Clinical Quality Information WG"/>
  <contact>
    <telecom>
      <system value="url"/>
      <value value="http://www.hl7.org/Special/committees/cqi/index.cfm"/>
    </telecom>
  </contact>
  <description value="An example FHIR-based measure"/>
  <useContext>
    <code>
      <system value="http://terminology.hl7.org/CodeSystem/usage-context-type"/>
      <code value="program"/>
    </code>
    <valueCodeableConcept>
      <text value="eligible-provider"/>
    </valueCodeableConcept>
  </useContext>
  <jurisdiction>
    <coding>
      <system value="urn:iso:std:iso:3166"/>
      <code value="US"/>
    </coding>
  </jurisdiction>
  <purpose value="The purpose of this measure is to..."/>
  <usage value="Users of this measure should be aware of..."/>
  <copyright value="Example Copyright Statement"/>
  <approvalDate value="2019-02-17"/>
  <lastReviewDate value="2019-02-17"/>
  <effectivePeriod>
    <extension
               url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-effectivePeriodAnchor">
      <valueDateTime value="2018-01-01"/>
    </extension>
    <extension
               url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-effectivePeriodDuration">
      <valueDuration>
        <value value="1"/>
        <system value="http://unitsofmeasure.org"/>
        <code value="a"/>
      </valueDuration>
    </extension>
    <start value="2018-01-01"/>
    <end value="2018-12-31"/>
  </effectivePeriod>
  <topic>
    <coding>
      <system value="http://loinc.org"/>
      <code value="57024-2"/>
    </coding>
    <text value="Health Quality Measure Document"/>
  </topic>
  <author>
    <name value="Example Measure Content Developer"/>
  </author>
  <relatedArtifact>
    <type value="depends-on"/>
    <display value="Library FHIRHelpers"/>
    <resource
              value="http://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1"/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="depends-on"/>
    <display value="Code system Diagnosis Role"/>
    <resource value="http://terminology.hl7.org/CodeSystem/diagnosis-role"/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="depends-on"/>
    <display value="Value set Payer"/>
    <resource
              value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="depends-on"/>
    <display value="Value set Psychiatric/Mental Health Patient"/>
    <resource
              value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.299"/>
  </relatedArtifact>
  <library value="http://hl7.org/fhir/us/cqfmeasures/Library/EXMLogic"/>
  <disclaimer value="Example disclaimer"/>
  <scoring>
    <coding>
      <system value="http://terminology.hl7.org/CodeSystem/measure-scoring"/>
      <code value="proportion"/>
      <display value="Proportion"/>
    </coding>
  </scoring>
  <type>
    <coding>
      <system value="http://terminology.hl7.org/CodeSystem/measure-type"/>
      <code value="process"/>
    </coding>
  </type>
  <riskAdjustment value="Risk adjustment for this measure is performed by..."/>
  <rateAggregation value="Rate aggregation for this measure is performed by..."/>
  <rationale value="Rationale for this measure is..."/>
  <clinicalRecommendationStatement
                                   value="The clinical recommendation statement for this measure is..."/>
  <improvementNotation>
    <coding>
      <system
              value="http://terminology.hl7.org/CodeSystem/measure-improvement-notation"/>
      <code value="increase"/>
      <display value="Increased score indicates improvement"/>
    </coding>
  </improvementNotation>
  <definition>
    <extension
               url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-definitionTerm">
      <extension url="term">
        <valueString value="Term"/>
      </extension>
      <extension url="definition">
        <valueMarkdown
                       value="A term used in the measure that bears clearly definition to communicate the measure intent"/>
      </extension>
    </extension>
  </definition>
  <guidance
            value="Additional guidance provided to help communicate the intent of the measure"/>
  <group id="group-1">
    <code>
      <coding>
        <display value="group-1"/>
      </coding>
    </code>
    <population id="initial-population-1">
      <code>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/measure-population"/>
          <code value="initial-population"/>
          <display value="Initial Population"/>
        </coding>
      </code>
      <criteria>
        <language value="text/cql.identifier"/>
        <expression value="Initial Population"/>
      </criteria>
    </population>
    <population id="numerator">
      <code>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/measure-population"/>
          <code value="numerator"/>
          <display value="Numerator"/>
        </coding>
      </code>
      <criteria>
        <language value="text/cql.identifier"/>
        <expression value="Numerator"/>
      </criteria>
    </population>
    <population id="denominator">
      <code>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/measure-population"/>
          <code value="denominator"/>
          <display value="Denominator"/>
        </coding>
      </code>
      <criteria>
        <language value="text/cql.identifier"/>
        <expression value="Denominator"/>
      </criteria>
    </population>
    <stratifier id="stratifier-1">
      <code>
        <text value="Stratifier 1"/>
      </code>
      <criteria>
        <language value="text/cql.identifier"/>
        <expression value="Stratifier 1"/>
      </criteria>
    </stratifier>
    <stratifier id="stratifier-2">
      <code>
        <text value="Stratifier 2"/>
      </code>
      <criteria>
        <language value="text/cql.identifier"/>
        <expression value="Stratifier 2"/>
      </criteria>
    </stratifier>
    <stratifier id="stratifier-3">
      <code>
        <text value="Stratifier 3"/>
      </code>
      <criteria>
        <language value="text/cql.identifier"/>
        <expression value="Stratifier 3"/>
      </criteria>
    </stratifier>
    <stratifier id="stratifier-4">
      <code>
        <text value="Stratifier 4"/>
      </code>
      <criteria>
        <language value="text/cql.identifier"/>
        <expression value="Stratifier 4"/>
      </criteria>
    </stratifier>
  </group>
  <supplementalData id="sde-ethnicity">
    <usage>
      <coding>
        <system value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
        <code value="supplemental-data"/>
      </coding>
    </usage>
    <criteria>
      <language value="text/cql.identifier"/>
      <expression value="SDE Ethnicity"/>
    </criteria>
  </supplementalData>
  <supplementalData id="sde-race">
    <usage>
      <coding>
        <system value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
        <code value="supplemental-data"/>
      </coding>
    </usage>
    <criteria>
      <language value="text/cql.identifier"/>
      <expression value="SDE Race"/>
    </criteria>
  </supplementalData>
  <supplementalData id="sde-payer">
    <usage>
      <coding>
        <system value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
        <code value="supplemental-data"/>
      </coding>
    </usage>
    <criteria>
      <language value="text/cql.identifier"/>
      <expression value="SDE Payer"/>
    </criteria>
  </supplementalData>
  <supplementalData id="sde-sex">
    <usage>
      <coding>
        <system value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
        <code value="supplemental-data"/>
      </coding>
    </usage>
    <criteria>
      <language value="text/cql.identifier"/>
      <expression value="SDE Sex"/>
    </criteria>
  </supplementalData>
</Measure>