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

: EXM Publishable Measure - JSON Representation

Active as of 2022-02-22

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{
  "resourceType" : "Measure",
  "id" : "measure-publishable-exm",
  "meta" : {
    "profile" : [
      🔗 "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/publishable-measure-cqfm"🔗 ,
      "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-measure-cqfm"
    ]
  },
  "text" : {
    "status" : "extensions",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b style=\"color: maroon\">Exception generating Narrative: unexpected non-end of element null::a  at line 288 column 37</b></p></div>"
  },
  "contained" : [
    {
      "resourceType" : "Library",
      "id" : "effective-data-requirements",
      "extension" : [
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "EXMPublishableLibrary"
            },
            {
              "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" : 0
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "EXMPublishableLibrary"
            },
            {
              "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" : 1
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "EXMPublishableLibrary"
            },
            {
              "url" : "name",
              "valueString" : "Inpatient Encounter"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Inpatient Encounter\" :   [\"Encounter\"] Encounter     where LengthInDays(Encounter.period) <= 120       and Encounter.period ends during \"Measurement Period\""
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 2
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "EXMPublishableLibrary"
            },
            {
              "url" : "name",
              "valueString" : "Initial Population"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Initial Population\" :   \"Inpatient Encounter\" Encounter"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 3
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "EXMPublishableLibrary"
            },
            {
              "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" : 4
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "EXMPublishableLibrary"
            },
            {
              "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" : 5
            }
          ],
          "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" : "2022-02-22T10:37:03-07:00",
      "relatedArtifact" : [
        {
          "type" : "depends-on",
          "display" : "Library FHIRHelpers",
          "resource" : "http://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1"
        },
        {
          "type" : "depends-on",
          "display" : "Value set Payer",
          "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"
        }
      ],
      "parameter" : [
        {
          "name" : "Measurement Period",
          "use" : "in",
          "min" : 0,
          "max" : "1",
          "type" : "Period"
        },
        {
          "name" : "SDE Sex",
          "use" : "out",
          "min" : 0,
          "max" : "1",
          "type" : "Coding"
        },
        {
          "name" : "SDE Payer",
          "use" : "out",
          "min" : 0,
          "max" : "*",
          "type" : "Resource"
        },
        {
          "name" : "Initial Population",
          "use" : "out",
          "min" : 0,
          "max" : "*",
          "type" : "Encounter"
        },
        {
          "name" : "SDE Ethnicity",
          "use" : "out",
          "min" : 0,
          "max" : "*",
          "type" : "Coding"
        },
        {
          "name" : "SDE Race",
          "use" : "out",
          "min" : 0,
          "max" : "*",
          "type" : "Coding"
        }
      ],
      "dataRequirement" : [
        {
          "type" : "Patient",
          "profile" : [
            🔗 "http://hl7.org/fhir/StructureDefinition/Patient"
          ],
          "mustSupport" : [
            "extension",
            "value",
            "url"
          ]
        },
        {
          "type" : "Encounter",
          "profile" : [
            🔗 "http://hl7.org/fhir/StructureDefinition/Encounter"
          ],
          "mustSupport" : [
            "period"
          ]
        },
        {
          "type" : "Coverage",
          "profile" : [
            🔗 "http://hl7.org/fhir/StructureDefinition/Coverage"
          ],
          "mustSupport" : [
            "period",
            "type"
          ],
          "codeFilter" : [
            {
              "path" : "type",
              "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"
            }
          ]
        }
      ]
    }
  ],
  "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"
      }
    },
    {
      "id" : "effective-data-requirements",
      "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-effectiveDataRequirements",
      "valueReference" : {
        "reference" : "#effective-data-requirements"
      }
    },
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
      "valueCode" : "cqi"
    }
  ],
  "url" : "http://example.org/fhir/measures/publishable-measure-exm",
  "identifier" : [
    {
      "use" : "usual",
      "type" : {
        "coding" : [
          {
            "system" : "http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type",
            "code" : "short-name"
          }
        ]
      },
      "system" : "http://example.org/fhir/cqi/ecqm/Measure/Identifier/exm",
      "value" : "EXM-123"
    },
    {
      "use" : "official",
      "type" : {
        "coding" : [
          {
            "system" : "http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type",
            "code" : "version-independent"
          }
        ]
      },
      "system" : "urn:ietf:rfc:3986",
      "value" : "urn:uuid:11873bc9-ca0a-4cf3-b8f2-605a950aac74"
    },
    {
      "use" : "official",
      "type" : {
        "coding" : [
          {
            "system" : "http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type",
            "code" : "version-specific"
          }
        ]
      },
      "system" : "urn:ietf:rfc:3986",
      "value" : "urn:uuid:b366f29b-347f-464e-8064-c83842d825c7"
    },
    {
      "use" : "official",
      "type" : {
        "coding" : [
          {
            "system" : "http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type",
            "code" : "endorser"
          }
        ]
      },
      "system" : "http://example.org/fhir/cqi/ecqm/Measure/Identifier/nqf",
      "value" : "NQF-123",
      "assigner" : {
        "display" : "NQF"
      }
    },
    {
      "use" : "official",
      "type" : {
        "coding" : [
          {
            "system" : "http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type",
            "code" : "publisher"
          }
        ]
      },
      "system" : "http://example.org/fhir/cqi/ecqm/Measure/Identifier/cms",
      "value" : "CMS-123",
      "assigner" : {
        "display" : "CMS"
      }
    }
  ],
  "version" : "5.0.0-ballot",
  "name" : "PublishableMeasureEXM",
  "title" : "EXM Publishable Measure",
  "status" : "active",
  "experimental" : true,
  "date" : "2022-02-22",
  "publisher" : "HL7 International / Clinical Quality Information",
  "contact" : [
    {
      "telecom" : [
        {
          "system" : "url",
          "value" : "http://www.hl7.org/Special/committees/cqi"
        }
      ]
    }
  ],
  "description" : "An example FHIR-based publishable measure",
  "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" : "ep-ec"
          }
        ],
        "text" : "eligible-provider"
      }
    }
  ],
  "jurisdiction" : [
    {
      "coding" : [
        {
          "system" : "urn:iso:std:iso:3166",
          "code" : "US"
        }
      ]
    }
  ],
  "purpose" : "The purpose of this measure is to...",
  "usage" : "Users of this measure should be aware of...",
  "copyright" : "Example Copyright Statement",
  "approvalDate" : "2019-02-17",
  "lastReviewDate" : "2019-02-17",
  "effectivePeriod" : {
    "extension" : [
      {
        "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-effectivePeriodAnchor",
        "valueDateTime" : "2018-01-01"
      },
      {
        "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-effectivePeriodDuration",
        "valueDuration" : {
          "value" : 1,
          "system" : "http://unitsofmeasure.org",
          "code" : "a"
        }
      }
    ],
    "start" : "2018-01-01",
    "end" : "2018-12-31"
  },
  "topic" : [
    {
      "coding" : [
        {
          "system" : "http://loinc.org",
          "code" : "57024-2"
        }
      ],
      "text" : "Health Quality Measure Document"
    }
  ],
  "author" : [
    {
      "name" : "Example Measure Content Developer"
    }
  ],
  "relatedArtifact" : [
    {
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-isPrimaryCitation",
          "valueBoolean" : true
        }
      ],
      "type" : "citation",
      "citation" : "Linder, J.A., D.W. Bates, G.M. Lee, J.A. Finkelstein. 2005. \"Antibiotic treatment       of children with sore throat.\" JAMA 294(18):2315-2322.",
      "url" : "https://pubmed.ncbi.nlm.nih.gov/16278359/",
      "document" : {
        "url" : "https://pubmed.ncbi.nlm.nih.gov/16278359/"
      }
    },
    {
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-isPrimaryCitation",
          "valueBoolean" : true
        }
      ],
      "type" : "citation",
      "citation" : "Infectious Diseases Society of America. 2012. \"Clinical Practice Guideline for the Diagnosis and Management of Group A Streptococcal Pharyngitis: 2012 Update.\"",
      "url" : "https://pubmed.ncbi.nlm.nih.gov/23091044/",
      "document" : {
        "url" : "https://pubmed.ncbi.nlm.nih.gov/23091044/"
      }
    },
    {
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-isPrimaryCitation",
          "valueBoolean" : true
        }
      ],
      "type" : "citation",
      "citation" : "Roberts, R.R., B. Hota, I. Ahmad, et al. \"Hospital and Societal Costs of Antimicrobial-Resistant Infections in a Chicago Teaching Hospital: Implications for Antibiotic Stewardship.\" Clin Infect Dis. Oct 2009; 49(8):1175-84.",
      "url" : "https://pubmed.ncbi.nlm.nih.gov/19739972/",
      "document" : {
        "url" : "https://pubmed.ncbi.nlm.nih.gov/19739972/"
      }
    },
    {
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-publicationStatus",
          "valueCode" : "draft"
        },
        {
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-publicationDate",
          "valueDate" : "2019-01-01"
        }
      ],
      "type" : "citation",
      "citation" : "Example citation to draft publication",
      "url" : "http://example.org/publications/1234",
      "document" : {
        "url" : "http://example.org/publications/1234"
      }
    }
  ],
  "library" : [
    🔗 "http://hl7.org/fhir/us/cqfmeasures/Library/EXMPublishableLibrary"
  ],
  "disclaimer" : "Example disclaimer",
  "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"
        }
      ]
    }
  ],
  "riskAdjustment" : "Risk adjustment for this measure is performed by...",
  "rateAggregation" : "Rate aggregation for this measure is performed by...",
  "rationale" : "Rationale for this measure is...",
  "clinicalRecommendationStatement" : "The clinical recommendation statement for this measure is...",
  "improvementNotation" : {
    "coding" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/measure-improvement-notation",
        "code" : "increase",
        "display" : "Increased score indicates improvement"
      }
    ]
  },
  "_definition" : [
    {
      "extension" : [
        {
          "extension" : [
            {
              "url" : "term",
              "valueString" : "Term"
            },
            {
              "url" : "definition",
              "valueMarkdown" : "A term used in the measure that bears clearly definition to communicate the measure intent"
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-definitionTerm"
        }
      ]
    }
  ],
  "group" : [
    {
      "id" : "group-1",
      "population" : [
        {
          "id" : "initial-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"
          }
        },
        {
          "id" : "numerator",
          "code" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                "code" : "numerator",
                "display" : "Numerator"
              }
            ]
          },
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Numerator"
          }
        },
        {
          "id" : "denominator",
          "code" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                "code" : "denominator",
                "display" : "Denominator"
              }
            ]
          },
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Denominator"
          }
        }
      ]
    }
  ],
  "supplementalData" : [
    {
      "id" : "sde-ethnicity",
      "usage" : [
        {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
              "code" : "supplemental-data"
            }
          ]
        }
      ],
      "criteria" : {
        "language" : "text/cql-identifier",
        "expression" : "SDE Ethnicity"
      }
    },
    {
      "id" : "sde-race",
      "usage" : [
        {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
              "code" : "supplemental-data"
            }
          ]
        }
      ],
      "criteria" : {
        "language" : "text/cql-identifier",
        "expression" : "SDE Race"
      }
    },
    {
      "id" : "sde-payer",
      "usage" : [
        {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
              "code" : "supplemental-data"
            }
          ]
        }
      ],
      "criteria" : {
        "language" : "text/cql-identifier",
        "expression" : "SDE Payer"
      }
    },
    {
      "id" : "sde-sex",
      "usage" : [
        {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
              "code" : "supplemental-data"
            }
          ]
        }
      ],
      "criteria" : {
        "language" : "text/cql-identifier",
        "expression" : "SDE Sex"
      }
    }
  ]
}