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

: Median ED Visit Duration - JSON Representation

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{
  "resourceType" : "Measure",
  "id" : "measure-exm55-FHIR",
  "meta" : {
    "profile" : [
      "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cv-measure-cqfm",
      "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-measure-cqfm"
    ]
  },
  "text" : {
    "status" : "extensions",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n    <table class=\"grid dict\">\n        \n        <tr>\n            <th scope=\"row\"><b>Id: </b></th>\n            <td style=\"padding-left: 4px;\">measure-exm55-FHIR</td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Url: </b></th>\n            <td style=\"padding-left: 4px;\">http://hl7.org/fhir/us/cqfmeasures/Measure/measure-exm55-FHIR</td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Version: </b></th>\n            <td style=\"padding-left: 4px;\">5.0.0</td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Identifier: </b></th>\n            <td style=\"padding-left: 4px;\">\n                \n                \n                <p style=\"margin-bottom: 5px;\">\n                    <b>value: </b> <span>55</span>\n                </p>\n                \n            </td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Name: </b></th>\n            <td style=\"padding-left: 4px;\">EXM55</td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Title: </b></th>\n            <td style=\"padding-left: 4px;\">Median ED Visit Duration</td>\n        </tr>\n        \n        \n        \n        <tr>\n            <th scope=\"row\"><b>Status: </b></th>\n            <td style=\"padding-left: 4px;\">active</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>http://terminology.hl7.org/CodeSystem/measure-scoring</span>\n                        </p>\n                        \n                        \n                        <p style=\"margin-bottom: 5px;\">\n                            <b>code: </b> <span>continuous-variable</span>\n                        </p>\n                        \n                        \n                        <p style=\"margin-bottom: 5px;\">\n                            <b>display: </b> <span>Continuous Variable</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>http://terminology.hl7.org/CodeSystem/measure-improvement-notation</span>\n                        </p>\n                        \n                        \n                        <p style=\"margin-bottom: 5px;\">\n                            <b>code: </b> <span>decrease</span>\n                        </p>\n                        \n                        \n                        <p style=\"margin-bottom: 5px;\">\n                            <b>display: </b> <span>Decreased score indicates improvement</span>\n                        </p>\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>http://terminology.hl7.org/CodeSystem/measure-type</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;\">2021-04-03</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;\">This example illustrates a continuous variable measure represented as a FHIR eCQM</td>\n        </tr>\n        \n        \n        \n        \n        <tr>\n            <th scope=\"row\"><b>Parameters: </b></th>\n            <td style=\"padding-left: 4px;\">\n                <table class=\"grid-dict\">\n                    <tr><th><b>name</b></th><th><b>use</b></th><th><b>min</b></th><th><b>max</b></th><th><b>type</b></th></tr>\n                    \n                    <tr>\n                        <td>Measurement Period</td>\n                        <td>in</td>\n                        <td>0</td>\n                        <td>1</td>\n                        <td>Period</td>\n                    </tr>\n                    \n                    <tr>\n                        <td>Stratification 3</td>\n                        <td>out</td>\n                        <td>0</td>\n                        <td>*</td>\n                        <td>Encounter</td>\n                    </tr>\n                    \n                    <tr>\n                        <td>Inpatient Encounter</td>\n                        <td>out</td>\n                        <td>0</td>\n                        <td>*</td>\n                        <td>Encounter</td>\n                    </tr>\n                    \n                    <tr>\n                        <td>Stratification 2</td>\n                        <td>out</td>\n                        <td>0</td>\n                        <td>*</td>\n                        <td>Encounter</td>\n                    </tr>\n                    \n                    <tr>\n                        <td>Measure Population Exclusion</td>\n                        <td>out</td>\n                        <td>0</td>\n                        <td>*</td>\n                        <td>Encounter</td>\n                    </tr>\n                    \n                    <tr>\n                        <td>Stratification 1</td>\n                        <td>out</td>\n                        <td>0</td>\n                        <td>*</td>\n                        <td>Encounter</td>\n                    </tr>\n                    \n                    <tr>\n                        <td>Initial Population</td>\n                        <td>out</td>\n                        <td>0</td>\n                        <td>*</td>\n                        <td>Encounter</td>\n                    </tr>\n                    \n                    <tr>\n                        <td>Measure Population</td>\n                        <td>out</td>\n                        <td>0</td>\n                        <td>*</td>\n                        <td>Encounter</td>\n                    </tr>\n                    \n                </table>\n            </td>\n        </tr>\n        \n        \n        <tr>\n          <th scope=\"row\"><b>Data Requirements: </b></th>\n          <td style=\"padding-left: 4px;\">\n                <table class=\"grid-dict\">\n                    <tr><th><b>type</b></th><th><b>path</b></th><th><b>valueSet or system</b></th><th><b>code</b></th></tr>\n                    \n                        <tr>\n                            <td>Encounter</td>\n                            <td></td>\n                            \n                            \n                        </tr>\n                    \n                        <tr>\n                            <td>Condition</td>\n                            <td>id</td>\n                            \n                            \n                        </tr>\n                    \n                        <tr>\n                            <td>Encounter</td>\n                            <td>type</td>\n                            \n                                <td>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292</td>\n                                <td></td>\n                            \n                            \n                        </tr>\n                    \n                        <tr>\n                            <td>Encounter</td>\n                            <td>type</td>\n                            \n                                <td>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292</td>\n                                <td></td>\n                            \n                            \n                        </tr>\n                    \n                </table>\n          </td>\n        </tr>\n        \n        \n        <tr>\n          <th scope=\"row\"><b>Direct Reference Codes: </b></th>\n          <td style=\"padding-left: 4px;\">\n                <table class=\"grid-dict\">\n                    <tr><th><b>display</b></th><th><b>code</b></th><th><b>system</b></th></tr>\n                    \n                        <tr>\n                            <td>Billing</td>\n                            <td>billing</td>\n                            <td></td>\n                        </tr>\n                    \n                </table>\n          </td>\n        </tr>\n        \n        \n        \n        <tr>\n            <th scope=\"row\"><b>Use Context: </b></th>\n            <td style=\"padding-left: 4px;\">\n                <table class=\"grid-dict\">\n                    <tr><th><b>code</b></th><th><b>value</b></th></tr>\n                    \n                      <tr>\n                        <td>program</td>\n                        <td></td>\n                      </tr>\n                    \n                </table>\n            </td>\n        </tr>\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        <tr>\n            <th scope=\"row\"><b>Topic: </b></th>\n            <td style=\"padding-left: 25px;\">57024-2</td>\n        </tr>\n        \n        \n        \n        \n        \n        \n        <tr>\n            <th scope=\"row\"><b>Approval Date: </b></th>\n            <td style=\"padding-left: 4px;\">2019-03-08</td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Last Review Date: </b></th>\n            <td style=\"padding-left: 4px;\">2019-03-08</td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Effective Period: </b></th>\n            <td style=\"padding-left: 4px;\">2018-01-01..2018-12-31</td>\n        </tr>\n        \n        \n        <tr>\n          <th scope=\"row\"><b>Related Artifacts: </b></th>\n          <td style=\"padding-left: 4px;\">\n            \n            \n            \n            <p><b>Dependencies</b></p>\n            <ul>\n              \n                <li>http://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1</li>\n              \n                <li>http://terminology.hl7.org/CodeSystem/diagnosis-role</li>\n              \n                <li>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.299</li>\n              \n                <li>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292</li>\n              \n                <li>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.126</li>\n              \n            </ul>\n            \n            \n            \n            \n            \n          </td>\n        </tr>\n        \n        \n        \n        \n        \n        <tr>\n          <th scope=\"row\"><b>Logic Definitions: </b></th>\n          <td style=\"padding-left: 4px;\">\n            \n                <table class=\"grid-dict\">\n                    <tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>\n                    <tr>\n                        \n                            <td>EXM55</td>\n                        \n                        \n                            <td>Stratification 3</td>\n                        \n                        \n                    </tr>\n                </table>\n                \n                    <pre><code class=\"language-cql\">define \"Stratification 3\" :\n  \"Inpatient Encounter\" Encounter\n    where PrincipalDiagnosis(Encounter) is null</code></pre>\n                \n                <br/><br/>\n            \n                <table class=\"grid-dict\">\n                    <tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>\n                    <tr>\n                        \n                            <td>EXM55</td>\n                        \n                        \n                            <td>Inpatient Encounter</td>\n                        \n                        \n                    </tr>\n                </table>\n                \n                    <pre><code class=\"language-cql\">define \"Inpatient Encounter\" :\n  [\"Encounter\"] Encounter\n    where LengthInDays(Encounter.period) &lt;= 120\n      and Encounter.period ends during \"Measurement Period\"</code></pre>\n                \n                <br/><br/>\n            \n                <table class=\"grid-dict\">\n                    <tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>\n                    <tr>\n                        \n                            <td>EXM55</td>\n                        \n                        \n                            <td>Stratification 2</td>\n                        \n                        \n                    </tr>\n                </table>\n                \n                    <pre><code class=\"language-cql\">define \"Stratification 2\" :\n  \"Inpatient Encounter\" Encounter\n    where PrincipalDiagnosis(Encounter).code in \"Psychiatric/Mental Health Patient\"</code></pre>\n                \n                <br/><br/>\n            \n                <table class=\"grid-dict\">\n                    <tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>\n                    <tr>\n                        \n                            <td>EXM55</td>\n                        \n                        \n                            <td>Measure Population Exclusion</td>\n                        \n                        \n                    </tr>\n                </table>\n                \n                    <pre><code class=\"language-cql\">define \"Measure Population Exclusion\" :\n  \"Inpatient Encounter\" Encounter\n    with [\"Encounter\" : \"Emergency Department Visit\"] ED\n      such that ED.period ends 1 hour or less before start of Encounter.period\n        and ED.status = 'finished'\n        and ED.hospitalization.admitSource in \"Hospital Settings\"</code></pre>\n                \n                <br/><br/>\n            \n                <table class=\"grid-dict\">\n                    <tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>\n                    <tr>\n                        \n                            <td>EXM55</td>\n                        \n                        \n                            <td>Stratification 1</td>\n                        \n                        \n                    </tr>\n                </table>\n                \n                    <pre><code class=\"language-cql\">define \"Stratification 1\" :\n  \"Inpatient Encounter\" Encounter\n    where not (PrincipalDiagnosis(Encounter).code in \"Psychiatric/Mental Health Patient\")</code></pre>\n                \n                <br/><br/>\n            \n                <table class=\"grid-dict\">\n                    <tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>\n                    <tr>\n                        \n                            <td>EXM55</td>\n                        \n                        \n                            <td>Initial Population</td>\n                        \n                        \n                    </tr>\n                </table>\n                \n                    <pre><code class=\"language-cql\">define \"Initial Population\" :\n  \"Inpatient Encounter\" Encounter\n    with [\"Encounter\" : \"Emergency Department Visit\"] ED\n     such that ED.status = 'finished'\n       and ED.period ends 1 hour or less before start of Encounter.period</code></pre>\n                \n                <br/><br/>\n            \n                <table class=\"grid-dict\">\n                    <tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>\n                    <tr>\n                        \n                            <td>EXM55</td>\n                        \n                        \n                            <td>Measure Population</td>\n                        \n                        \n                    </tr>\n                </table>\n                \n                    <pre><code class=\"language-cql\">define \"Measure Population\" :\n  \"Initial Population\"</code></pre>\n                \n                <br/><br/>\n            \n          </td>\n        </tr>\n        \n    </table>\n</div>"
  },
  "extension" : [
    {
      "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis",
      "valueCode" : "Encounter"
    },
    {
      "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-softwaresystem",
      "valueReference" : {
        "reference" : "Device/software-system-example"
      }
    },
    {
      "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-parameter",
      "valueParameterDefinition" : {
        "name" : "Measurement Period",
        "use" : "in",
        "min" : 0,
        "max" : "1",
        "type" : "Period"
      }
    },
    {
      "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-parameter",
      "valueParameterDefinition" : {
        "name" : "Stratification 3",
        "use" : "out",
        "min" : 0,
        "max" : "*",
        "type" : "Encounter"
      }
    },
    {
      "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-parameter",
      "valueParameterDefinition" : {
        "name" : "Inpatient Encounter",
        "use" : "out",
        "min" : 0,
        "max" : "*",
        "type" : "Encounter"
      }
    },
    {
      "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-parameter",
      "valueParameterDefinition" : {
        "name" : "Stratification 2",
        "use" : "out",
        "min" : 0,
        "max" : "*",
        "type" : "Encounter"
      }
    },
    {
      "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-parameter",
      "valueParameterDefinition" : {
        "name" : "Measure Population Exclusion",
        "use" : "out",
        "min" : 0,
        "max" : "*",
        "type" : "Encounter"
      }
    },
    {
      "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-parameter",
      "valueParameterDefinition" : {
        "name" : "Stratification 1",
        "use" : "out",
        "min" : 0,
        "max" : "*",
        "type" : "Encounter"
      }
    },
    {
      "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-parameter",
      "valueParameterDefinition" : {
        "name" : "Initial Population",
        "use" : "out",
        "min" : 0,
        "max" : "*",
        "type" : "Encounter"
      }
    },
    {
      "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-parameter",
      "valueParameterDefinition" : {
        "name" : "Measure Population",
        "use" : "out",
        "min" : 0,
        "max" : "*",
        "type" : "Encounter"
      }
    },
    {
      "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-dataRequirement",
      "valueDataRequirement" : {
        "type" : "Encounter",
        "profile" : [
          "http://hl7.org/fhir/StructureDefinition/Encounter"
        ]
      }
    },
    {
      "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-dataRequirement",
      "valueDataRequirement" : {
        "type" : "Condition",
        "profile" : [
          "http://hl7.org/fhir/StructureDefinition/Condition"
        ],
        "codeFilter" : [
          {
            "path" : "id"
          }
        ]
      }
    },
    {
      "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-dataRequirement",
      "valueDataRequirement" : {
        "type" : "Encounter",
        "profile" : [
          "http://hl7.org/fhir/StructureDefinition/Encounter"
        ],
        "codeFilter" : [
          {
            "path" : "type",
            "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292"
          }
        ]
      }
    },
    {
      "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-dataRequirement",
      "valueDataRequirement" : {
        "type" : "Encounter",
        "profile" : [
          "http://hl7.org/fhir/StructureDefinition/Encounter"
        ],
        "codeFilter" : [
          {
            "path" : "type",
            "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292"
          }
        ]
      }
    },
    {
      "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
      "valueCoding" : {
        "system" : "http://terminology.hl7.org/CodeSystem/diagnosis-role",
        "code" : "billing",
        "display" : "Billing"
      }
    },
    {
      "extension" : [
        {
          "url" : "libraryName",
          "valueString" : "EXM55"
        },
        {
          "url" : "name",
          "valueString" : "Stratification 3"
        },
        {
          "url" : "statement",
          "valueString" : "define \"Stratification 3\" :\n  \"Inpatient Encounter\" Encounter\n    where PrincipalDiagnosis(Encounter) is null"
        },
        {
          "url" : "displaySequence",
          "valueInteger" : 0
        }
      ],
      "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
    },
    {
      "extension" : [
        {
          "url" : "libraryName",
          "valueString" : "EXM55"
        },
        {
          "url" : "name",
          "valueString" : "Inpatient Encounter"
        },
        {
          "url" : "statement",
          "valueString" : "define \"Inpatient Encounter\" :\n  [\"Encounter\"] Encounter\n    where LengthInDays(Encounter.period) <= 120\n      and Encounter.period ends during \"Measurement Period\""
        },
        {
          "url" : "displaySequence",
          "valueInteger" : 1
        }
      ],
      "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
    },
    {
      "extension" : [
        {
          "url" : "libraryName",
          "valueString" : "EXM55"
        },
        {
          "url" : "name",
          "valueString" : "Stratification 2"
        },
        {
          "url" : "statement",
          "valueString" : "define \"Stratification 2\" :\n  \"Inpatient Encounter\" Encounter\n    where PrincipalDiagnosis(Encounter).code in \"Psychiatric/Mental Health Patient\""
        },
        {
          "url" : "displaySequence",
          "valueInteger" : 2
        }
      ],
      "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
    },
    {
      "extension" : [
        {
          "url" : "libraryName",
          "valueString" : "EXM55"
        },
        {
          "url" : "name",
          "valueString" : "Measure Population Exclusion"
        },
        {
          "url" : "statement",
          "valueString" : "define \"Measure Population Exclusion\" :\n  \"Inpatient Encounter\" Encounter\n    with [\"Encounter\" : \"Emergency Department Visit\"] ED\n      such that ED.period ends 1 hour or less before start of Encounter.period\n        and ED.status = 'finished'\n        and ED.hospitalization.admitSource in \"Hospital Settings\""
        },
        {
          "url" : "displaySequence",
          "valueInteger" : 3
        }
      ],
      "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
    },
    {
      "extension" : [
        {
          "url" : "libraryName",
          "valueString" : "EXM55"
        },
        {
          "url" : "name",
          "valueString" : "Stratification 1"
        },
        {
          "url" : "statement",
          "valueString" : "define \"Stratification 1\" :\n  \"Inpatient Encounter\" Encounter\n    where not (PrincipalDiagnosis(Encounter).code in \"Psychiatric/Mental Health Patient\")"
        },
        {
          "url" : "displaySequence",
          "valueInteger" : 4
        }
      ],
      "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
    },
    {
      "extension" : [
        {
          "url" : "libraryName",
          "valueString" : "EXM55"
        },
        {
          "url" : "name",
          "valueString" : "Initial Population"
        },
        {
          "url" : "statement",
          "valueString" : "define \"Initial Population\" :\n  \"Inpatient Encounter\" Encounter\n    with [\"Encounter\" : \"Emergency Department Visit\"] ED\n     such that ED.status = 'finished'\n       and ED.period ends 1 hour or less before start of Encounter.period"
        },
        {
          "url" : "displaySequence",
          "valueInteger" : 5
        }
      ],
      "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
    },
    {
      "extension" : [
        {
          "url" : "libraryName",
          "valueString" : "EXM55"
        },
        {
          "url" : "name",
          "valueString" : "Measure Population"
        },
        {
          "url" : "statement",
          "valueString" : "define \"Measure Population\" :\n  \"Initial Population\""
        },
        {
          "url" : "displaySequence",
          "valueInteger" : 6
        }
      ],
      "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
    }
  ],
  "url" : "http://hl7.org/fhir/us/cqfmeasures/Measure/measure-exm55-FHIR",
  "identifier" : [
    {
      "use" : "official",
      "system" : "http://example.org/fhir/cqi/ecqm/Measure/Identifier/exm",
      "value" : "55"
    }
  ],
  "version" : "5.0.0",
  "name" : "EXM55",
  "title" : "Median ED Visit Duration",
  "status" : "active",
  "experimental" : true,
  "date" : "2021-04-03",
  "publisher" : "Clinical Quality Information WG",
  "contact" : [
    {
      "telecom" : [
        {
          "system" : "url",
          "value" : "http://www.hl7.org/Special/committees/cqi/index.cfm"
        }
      ]
    }
  ],
  "description" : "This example illustrates a continuous variable measure represented as a FHIR eCQM",
  "useContext" : [
    {
      "code" : {
        "system" : "http://terminology.hl7.org/CodeSystem/usage-context-type",
        "code" : "program"
      },
      "valueCodeableConcept" : {
        "coding" : [
          {
            "system" : "http://hl7.org/fhir/us/cqfmeasures/CodeSystem/quality-programs",
            "code" : "eh-cah",
            "display" : "EH/CAH"
          }
        ]
      }
    }
  ],
  "jurisdiction" : [
    {
      "coding" : [
        {
          "system" : "urn:iso:std:iso:3166",
          "code" : "US"
        }
      ]
    }
  ],
  "approvalDate" : "2019-03-08",
  "lastReviewDate" : "2019-03-08",
  "effectivePeriod" : {
    "start" : "2018-01-01",
    "end" : "2018-12-31"
  },
  "topic" : [
    {
      "coding" : [
        {
          "system" : "http://loinc.org",
          "code" : "57024-2",
          "display" : "Health Quality Measure Document"
        }
      ]
    }
  ],
  "relatedArtifact" : [
    {
      "type" : "depends-on",
      "display" : "Library FHIRHelpers",
      "resource" : "http://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1"
    },
    {
      "type" : "depends-on",
      "display" : "Code system Diagnosis Role",
      "resource" : "http://terminology.hl7.org/CodeSystem/diagnosis-role"
    },
    {
      "type" : "depends-on",
      "display" : "Value set Psychiatric/Mental Health Patient",
      "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.299"
    },
    {
      "type" : "depends-on",
      "display" : "Value set Emergency Department Visit",
      "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292"
    },
    {
      "type" : "depends-on",
      "display" : "Value set Hospital Settings",
      "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.126"
    }
  ],
  "library" : [
    "http://hl7.org/fhir/us/cqfmeasures/Library/EXM55"
  ],
  "scoring" : {
    "coding" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/measure-scoring",
        "code" : "continuous-variable",
        "display" : "Continuous Variable"
      }
    ]
  },
  "type" : [
    {
      "coding" : [
        {
          "system" : "http://terminology.hl7.org/CodeSystem/measure-type",
          "code" : "process"
        }
      ]
    }
  ],
  "improvementNotation" : {
    "coding" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/measure-improvement-notation",
        "code" : "decrease",
        "display" : "Decreased score indicates improvement"
      }
    ]
  },
  "group" : [
    {
      "population" : [
        {
          "code" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                "code" : "initial-population",
                "display" : "Initial Population"
              }
            ]
          },
          "criteria" : {
            "language" : "text/cql.identifier",
            "expression" : "Initial Population"
          }
        },
        {
          "code" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                "code" : "measure-population",
                "display" : "Measure Population"
              }
            ]
          },
          "criteria" : {
            "language" : "text/cql.identifier",
            "expression" : "Measure Population"
          }
        },
        {
          "code" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                "code" : "measure-population-exclusion",
                "display" : "Measure Population Exclusion"
              }
            ]
          },
          "criteria" : {
            "language" : "text/cql.identifier",
            "expression" : "Measure Population Exclusion"
          }
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-criteriaReference",
              "valueString" : "measure-population-identifier"
            },
            {
              "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-aggregateMethod",
              "valueCode" : "median"
            }
          ],
          "code" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                "code" : "measure-observation",
                "display" : "Measure Observation"
              }
            ]
          },
          "criteria" : {
            "language" : "text/cql.identifier",
            "expression" : "Measure Observation"
          }
        }
      ],
      "stratifier" : [
        {
          "code" : {
            "coding" : [
              {
                "display" : "Stratification 1"
              }
            ]
          },
          "criteria" : {
            "language" : "text/cql.identifier",
            "expression" : "Stratification 1"
          }
        },
        {
          "code" : {
            "coding" : [
              {
                "display" : "Stratification 2"
              }
            ]
          },
          "criteria" : {
            "language" : "text/cql.identifier",
            "expression" : "Stratification 2"
          }
        },
        {
          "code" : {
            "coding" : [
              {
                "display" : "Stratification 3"
              }
            ]
          },
          "criteria" : {
            "language" : "text/cql.identifier",
            "expression" : "Stratification 3"
          }
        }
      ]
    }
  ]
}