Clinical Quality Language Specification, published by Clinical Decision Support WG. This guide is not an authorized publication; it is the continuous build for version 1.5.3 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/cql/ and changes regularly. See the Directory of published versions
library CMS154 version '1'
/*
CMS154v1 - NQF0069
Appropriate Treatment for Children with Upper Respiratory Infection (URI)
Population criteria
Initial Patient Population =
AND: "Patient Characteristic Birthdate: birth date" >= 3 month(s) starts before start of "Measurement Period"
AND: "Patient Characteristic Birthdate: birth date" <= 18 year(s) starts before start of "Measurement Period"
AND:
OR: "Occurrence A of Diagnosis, Active: Upper Respiratory Infection" starts during
OR: "Encounter, Performed: Office Visit"
OR: "Encounter, Performed: Emergency Department Visit"
OR: "Encounter, Performed: Preventive Care- Initial Office Visit, 0 to 17"
OR: "Encounter, Performed: Preventive Care - Established Office Visit, 0 to 17"
OR: "Encounter, Performed: Hospital Observation Care - Initial"
OR: "Encounter, Performed: Face-to-Face Interaction"
during "Measurement Period"
OR:
OR: "Encounter, Performed: Office Visit"
OR: "Encounter, Performed: Emergency Department Visit"
OR: "Encounter, Performed: Preventive Care- Initial Office Visit, 0 to 17"
OR: "Encounter, Performed: Preventive Care - Established Office Visit, 0 to 17"
OR: "Encounter, Performed: Hospital Observation Care - Initial"
OR: "Encounter, Performed: Face-to-Face Interaction"
during ("Occurrence A of Diagnosis, Active: Upper Respiratory Infection" during "Measurement Period")
Denominator =
AND: "Initial Patient Population"
Denominator Exclusions =
AND:
OR: "Diagnosis, Active: Competing Conditions for Respiratory Conditions" <= 3 day(s) starts after start of "Occurrence A of Diagnosis, Active: Upper Respiratory Infection"
OR: "Medication, Active: Antibiotic Medications" <= 30 day(s) starts before or during "Occurrence A of Diagnosis, Active: Upper Respiratory Infection"
Numerator =
AND NOT: "Medication, Order: Antibiotic Medications" <= 3 day(s) starts after start of "Occurrence A of Diagnosis, Active: Upper Respiratory Infection"
Denominator Exceptions =
None
Data criteria (QDM Data Elements)
"Diagnosis, Active: Competing Conditions for Respiratory Conditions" using "Competing Conditions for Respiratory Conditions Grouping Value Set (2.16.840.1.113883.3.464.1003.102.12.1017)"
"Diagnosis, Active: Upper Respiratory Infection" using "Upper Respiratory Infection Grouping Value Set (2.16.840.1.113883.3.464.1003.102.12.1022)"
"Encounter, Performed: Emergency Department Visit" using "Emergency Department Visit Grouping Value Set (2.16.840.1.113883.3.464.1003.101.12.1010)"
"Encounter, Performed: Face-to-Face Interaction" using "Face-to-Face Interaction Grouping Value Set (2.16.840.1.113883.3.464.1003.101.12.1048)"
"Encounter, Performed: Hospital Observation Care - Initial" using "Hospital Observation Care - Initial Grouping Value Set (2.16.840.1.113883.3.464.1003.101.12.1002)"
"Encounter, Performed: Office Visit" using "Office Visit Grouping Value Set (2.16.840.1.113883.3.464.1003.101.12.1001)"
"Encounter, Performed: Preventive Care - Established Office Visit, 0 to 17" using "Preventive Care - Established Office Visit, 0 to 17 Grouping Value Set (2.16.840.1.113883.3.464.1003.101.12.1024)"
"Encounter, Performed: Preventive Care- Initial Office Visit, 0 to 17" using "Preventive Care- Initial Office Visit, 0 to 17 Grouping Value Set (2.16.840.1.113883.3.464.1003.101.12.1022)"
"Medication, Active: Antibiotic Medications" using "Antibiotic Medications Grouping Value Set (2.16.840.1.113883.3.464.1003.196.12.1001)"
"Medication, Order: Antibiotic Medications" using "Antibiotic Medications Grouping Value Set (2.16.840.1.113883.3.464.1003.196.12.1001)"
"Patient Characteristic Birthdate: birth date" using "birth date LOINC Value Set (2.16.840.1.113883.3.560.100.4)"
Reporting Stratification
None
Supplemental Data Elements
"Patient Characteristic Ethnicity: Ethnicity" using "Ethnicity CDC Value Set (2.16.840.1.114222.4.11.837)"
"Patient Characteristic Payer: Payer" using "Payer Source of Payment Typology Value Set (2.16.840.1.114222.4.11.3591)"
"Patient Characteristic Race: Race" using "Race CDC Value Set (2.16.840.1.114222.4.11.836)"
"Patient Characteristic Sex: ONC Administrative Sex" using "ONC Administrative Sex Administrative Sex Value Set (2.16.840.1.113762.1.4.1)"
// This is an episode-of-care measure, meaning that each patient may contribute multiple episodes, rather than just 1...
// Need to make sure we can handle this correctly within CQL
*/
using QUICK
valueset "Competing Conditions for Respiratory Conditions": '2.16.840.1.113883.3.464.1003.102.12.1017'
valueset "Upper Respiratory Infection": '2.16.840.1.113883.3.464.1003.102.12.1022'
valueset "Emergency Department Visit": '2.16.840.1.113883.3.464.1003.101.12.1010'
valueset "Face-to-Face Interaction": '2.16.840.1.113883.3.464.1003.101.12.1048'
valueset "Hospital Observation Care - Initial": '2.16.840.1.113883.3.464.1003.101.12.1002'
valueset "Office Visit": '2.16.840.1.113883.3.464.1003.101.12.1001'
valueset "Preventive Care - Established Office Visit, 0 to 17": '2.16.840.1.113883.3.464.1003.101.12.1024'
valueset "Preventive Care- Initial Office Visit, 0 to 17": '2.16.840.1.113883.3.464.1003.101.12.1022'
valueset "Antibiotic Medications": '2.16.840.1.113883.3.464.1003.196.12.1001'
parameter MeasurementPeriod default Interval[DateTime(2013, 1, 1, 0, 0, 0, 0), DateTime(2014, 1, 1, 0, 0, 0, 0))
context Patient
define "InDemographic":
AgeInMonthsAt(start of MeasurementPeriod) >= 3
and AgeInYearsAt(start of MeasurementPeriod) <= 18
define "ValidEncounters":
["Encounter": "Office Visit"]
union ["Encounter": "Emergency Department Visit"]
union ["Encounter": "Preventive Care- Initial Office Visit, 0 to 17"]
union ["Encounter": "Preventive Care - Established Office Visit, 0 to 17"]
union ["Encounter": "Hospital Observation Care - Initial"]
union ["Encounter": "Face-to-Face Interaction"]
define "EncountersDuringMeasurementPeriod":
"ValidEncounters" E where E."period" during MeasurementPeriod
define "URIDiagnosis":
["Condition": "Upper Respiratory Infection"]
define "ValidDiagnosis":
"URIDiagnosis" U
where exists ("EncountersDuringMeasurementPeriod" E where U."onsetDateTime" during E."period")
or exists ("ValidEncounters" E where Interval[U."onsetDateTime", U."abatementDate"] includes E."period")
define "InitialPopulation":
"ValidDiagnosis" V
where "InDemographic"
define "Denominator":
true
define "Numerator":
"ValidDiagnosis" V where not exists (["MedicationPrescription": "Antibiotic Medications"] M where M."dateWritten" occurs 3 days or less after V."onsetDateTime")
context Population
define "MeasureScore": (Count("Numerator") / Count("Denominator")) * 100