EXM108-FHIR
type: Measure
node role: treeRoot
resource.id:
  value: EXM108-FHIR
resource.meta:
  meta.profile:
    value: http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-shareablemeasure
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    link: http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-shareablemeasure
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  meta.profile:
    value: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-proportionmeasure
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    link: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-proportionmeasure
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  meta.profile:
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    link: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-computablemeasure
resource.language:
  value: en
domain resource.text:
  narrative.status:
    value: extensions
  narrative.div: Metadata Title EXM108 - Venous Thromboembolism Prophylaxis Version 8.2.000 Identifier 108 Identifier urn:oid:2.16.840.1.113883.4.642.40.61.29.3 Effective Period 2018-01-01 through 2018-12-31 Approval Date 2019-03-08 Last Review Date 2019-03-08 Experimental true Use Context Clinical Venue = EH Jurisdiction 001 from http://unstats.un.org/unsd/methods/m49/m49.htm Topic Health Quality Measure Document Steward (Publisher) HL7 International / Clinical Quality Information Description This measure assesses the number of patients who received VTE prophylaxis or have documentation why no VTE prophylaxis was given the day of or the day after hospital admission or surgery end date for surgeries that start the day of or the day after hospital admission Copyright Measure specifications are in the Public Domain. LOINC(R) is a registered trademark of the Regenstrief Institute. This material contains SNOMED Clinical Terms(R) (SNOMED CT(C)) copyright 2004-2017 International Health Terminology Standards Development Organization. All rights reserved. Disclaimer These performance measures are not clinical guidelines and do not establish a standard of medical care, and have not been tested for all potential applications. The measures and specifications are provided without warranty Measure Basis Encounter Measure Scoring Proportion Improvement Notation Increased score indicates improvement Measure Type process from http://terminology.hl7.org/CodeSystem/measure-type Rationale Hospitalized patients at high-risk for VTE may develop an asymptomatic deep vein thrombosis (DVT), and die from pulmonary embolism (PE) even before the diagnosis is suspected. The majority of fatal events occur as sudden or abrupt death, underscoring the importance of prevention as the most critical action step for reducing death from PE (Geerts, et al, 2008). The estimated annual incidence of deep-vein thrombosis (DVT) and pulmonary embolism (PE), known collectively as venous thromboembolism (VTE), is approximately …
domain resource.contained: Library
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  resource.id:
    value: effective-data-requirements
  domain resource.extension:
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    extension.url:
      value: http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode
    extension.value coding:
      coding.system:
        value: http://terminology.hl7.org/CodeSystem/condition-clinical
      coding.code:
        value: active
  domain resource.extension:
    index: -1
    extension.url:
      value: http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode
    extension.value coding:
      coding.system:
        value: http://terminology.hl7.org/CodeSystem/condition-clinical
      coding.code:
        value: recurrence
  domain resource.extension:
    index: -1
    extension.url:
      value: http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode
    extension.value coding:
      coding.system:
        value: http://terminology.hl7.org/CodeSystem/condition-clinical
      coding.code:
        value: relapse
  domain resource.extension:
    index: -1
    extension.url:
      value: http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode
    extension.value coding:
      coding.system:
        value: http://terminology.hl7.org/CodeSystem/condition-clinical
      coding.code:
        value: inactive
  domain resource.extension:
    index: -1
    extension.url:
      value: http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode
    extension.value coding:
      coding.system:
        value: http://terminology.hl7.org/CodeSystem/condition-clinical
      coding.code:
        value: remission
  domain resource.extension:
    index: -1
    extension.url:
      value: http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode
    extension.value coding:
      coding.system:
        value: http://terminology.hl7.org/CodeSystem/condition-clinical
      coding.code:
        value: resolved
  domain resource.extension:
    index: -1
    extension.url:
      value: http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode
    extension.value coding: http://loinc.org/rdf#72136-5
      coding.system:
        value: http://loinc.org
      coding.code:
        value: 72136-5
      coding.display:
        value: Risk for venous thromboembolism
  domain resource.extension:
    index: -1
    element.extension:
      index: -1
      extension.url:
        value: libraryName
      extension.value string:
        value: SupplementalDataElements
    element.extension:
      index: -1
      extension.url:
        value: name
      extension.value string:
        value: SDE Sex
    element.extension:
      index: -1
      extension.url:
        value: statement
      extension.value string:
        value: 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
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      extension.url:
        value: displaySequence
      extension.value integer:
        value: 0
    extension.url:
      value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  domain resource.extension:
    index: -1
    element.extension:
      index: -1
      extension.url:
        value: libraryName
      extension.value string:
        value: EXM108
    element.extension:
      index: -1
      extension.url:
        value: name
      extension.value string:
        value: SDE Sex
    element.extension:
      index: -1
      extension.url:
        value: statement
      extension.value string:
        value: define "SDE Sex": SDE."SDE Sex"
    element.extension:
      index: -1
      extension.url:
        value: displaySequence
      extension.value integer:
        value: 1
    extension.url:
      value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  domain resource.extension:
    index: -1
    element.extension:
      index: -1
      extension.url:
        value: libraryName
      extension.value string:
        value: MATGlobalCommonFunctions
    element.extension:
      index: -1
      extension.url:
        value: name
      extension.value string:
        value: Inpatient Encounter
    element.extension:
      index: -1
      extension.url:
        value: statement
      extension.value string:
        value: define "Inpatient Encounter": [Encounter: "Encounter Inpatient"] EncounterInpatient where EncounterInpatient.status = 'finished' and "LengthInDays"(EncounterInpatient.period) <= 120 and EncounterInpatient.period ends during "Measurement Period"
    element.extension:
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      extension.url:
        value: displaySequence
      extension.value integer:
        value: 2
    extension.url:
      value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  domain resource.extension:
    index: -1
    element.extension:
      index: -1
      extension.url:
        value: libraryName
      extension.value string:
        value: EXM108
    element.extension:
      index: -1
      extension.url:
        value: name
      extension.value string:
        value: Admission Without VTE or Obstetrical Conditions
    element.extension:
      index: -1
      extension.url:
        value: statement
      extension.value string:
        value: define "Admission Without VTE or Obstetrical Conditions": Global."Inpatient Encounter" InpatientEncounter where not exists ( (Global.EncounterDiagnosis(InpatientEncounter)) EncounterDiagnosis where EncounterDiagnosis.code in "Obstetrics" or EncounterDiagnosis.code in "Venous Thromboembolism" or EncounterDiagnosis.code in "Obstetrics VTE" )

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extension.url:
  value: displaySequence
extension.value integer:
  value: 3

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element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: EXM108
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: // Note: added FHIRHelpers.ToDate() in R4 define "Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions": ( Global."Inpatient Encounter" InpatientEncounter where Global."CalendarAgeInYearsAt"(FHIRHelpers.ToDate(Patient.birthDate), start of InpatientEncounter.period) >= 18 ) intersect "Admission Without VTE or Obstetrical Conditions"
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  extension.url:
    value: displaySequence
  extension.value integer:
    value: 4
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

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element.extension:
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  extension.url:
    value: libraryName
  extension.value string:
    value: EXM108
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: VTE Prophylaxis by Medication Administered or Device Applied
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: // 10/29: Replaced DeviceUseStatement with Procedure with a new value set and procedure.usdCode for specifying devices define "VTE Prophylaxis by Medication Administered or Device Applied": ( ["MedicationAdministration": medication in "Low Dose Unfractionated Heparin for VTE Prophylaxis"] VTEMedication where VTEMedication.status ='completed' and VTEMedication.dosage.route in "Subcutaneous route" ) union (["MedicationAdministration": medication in "Low Molecular Weight Heparin for VTE Prophylaxis"] LMWH where LMWH.status = 'completed') union (["MedicationAdministration": medication in "Injectable Factor Xa Inhibitor for VTE Prophylaxis"] FactorXa where FactorXa.status = 'completed') union (["MedicationAdministration": medication in "Warfarin"] Warfarin where Warfarin.status = 'completed') union ( ["Procedure": "Device Application"] DeviceApplied where DeviceApplied.status = 'complete' and (DeviceApplied.usedCode in "Intermittent pneumatic compression devices (IPC)" or DeviceApplied.usedCode in"Venous foot pumps (VFP)" or DeviceApplied.usedCode in "Graduated compression stockings (GCS)" ) )
element.extension:
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  extension.url:
    value: displaySequence
  extension.value integer:
    value: 5
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

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element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: EXM108
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: Encounter With VTE Prophylaxis Received on Day of or Day After Admission or Procedure
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define "Encounter With VTE Prophylaxis Received on Day of or Day After Admission or Procedure": ( from "Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter, "VTE Prophylaxis by Medication Administered or Device Applied" VTEProphylaxis where Coalesce(Global."Normalize Interval"(VTEProphylaxis.effective), Global."Normalize Interval"(VTEProphylaxis.performed)) starts during TJC."CalendarDayOfOrDayAfter"(start of QualifyingEncounter.period) return QualifyingEncounter ) union ( from "Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter, ["Procedure": "General or Neuraxial Anesthesia"] AnesthesiaProcedure, "VTE Prophylaxis by Medication Administered or Device Applied" VTEProphylaxis where Global."Normalize Interval"(AnesthesiaProcedure.performed) ends 1 day after day of start of QualifyingEncounter.period and Coalesce(Global."Normalize Interval"(VTEProphylaxis.effective), Global."Normalize Interval"(VTEProphylaxis.performed)) starts during TJC."CalendarDayOfOrDayAfter"(end of Global."Normalize Interval"(AnesthesiaProcedure.performed)) return QualifyingEncounter )
element.extension:
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  extension.url:
    value: displaySequence
  extension.value integer:
    value: 6
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

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element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: EXM108
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: Encounter With Medication Oral Factor Xa Inhibitor Administered on Day of or Day After Admission or Procedure
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define "Encounter With Medication Oral Factor Xa Inhibitor Administered on Day of or Day After Admission or Procedure": ( from "Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter, ["MedicationAdministration": medication in "Oral Factor Xa Inhibitor for VTE Prophylaxis or VTE Treatment"] FactorXaMedication where FactorXaMedication.status = 'completed' and Global."Normalize Interval"(FactorXaMedication.effective) starts during TJC."CalendarDayOfOrDayAfter"(start of QualifyingEncounter.period) return QualifyingEncounter ) union ( from "Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter, ["Procedure": "General or Neuraxial Anesthesia"] AnesthesiaProcedure, ["MedicationAdministration": medication in "Oral Factor Xa Inhibitor for VTE Prophylaxis or VTE Treatment"] FactorXaMedication where FactorXaMedication.status = 'completed' and AnesthesiaProcedure.status = 'completed' and Global."Normalize Interval"(AnesthesiaProcedure.performed) ends 1 day after day of start of QualifyingEncounter.period and Global."Normalize Interval"(FactorXaMedication.effective) starts during TJC."CalendarDayOfOrDayAfter"(end of Global."Normalize Interval"(AnesthesiaProcedure.performed)) return QualifyingEncounter )
element.extension:
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  extension.url:
    value: displaySequence
  extension.value integer:
    value: 7
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

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element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: EXM108
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: Encounter With Prior or Present Diagnosis of Atrial Fibrillation or VTE
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define "Encounter With Prior or Present Diagnosis of Atrial Fibrillation or VTE": ( "Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter with ["Condition": code in "Atrial Fibrillation/Flutter"] AtrialFibrillation such that FHIRHelpers.ToConcept(AtrialFibrillation.clinicalStatus) in { Global."active", Global."recurrence", Global."relapse" } and Global."Normalize Interval"(AtrialFibrillation.onset) starts on or before end of QualifyingEncounter.period ) union ( "Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter where Global.EncounterDiagnosis(QualifyingEncounter).code in "Atrial Fibrillation/Flutter" ) union ( "Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter with ["Condition": code in "Venous Thromboembolism"] VTEDiagnosis such that FHIRHelpers.ToConcept(VTEDiagnosis.clinicalStatus) in { Global."inactive", Global."remission", Global."resolved" } //and VTEDiagnosis.verificationStatus = 'confirmed' and Global."Normalize Interval"(VTEDiagnosis.onset) before start of QualifyingEncounter.period )
element.extension:
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  extension.url:
    value: displaySequence
  extension.value integer:
    value: 8
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

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element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: EXM108
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: Encounter With Prior or Present Procedure of Hip or Knee Replacement Surgery
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define "Encounter With Prior or Present Procedure of Hip or Knee Replacement Surgery": "Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter with ( ["Procedure": "Hip Replacement Surgery"] union ["Procedure": "Knee Replacement Surgery"] ) HipKneeProcedure such that HipKneeProcedure.status = 'completed' and Global."Normalize Interval"(HipKneeProcedure.performed) starts on or before end of QualifyingEncounter.period
element.extension:
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  extension.url:
    value: displaySequence
  extension.value integer:
    value: 9
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

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element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: EXM108
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: Is In Low Risk for VTE or On Anticoagulant
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define "Is In Low Risk for VTE or On Anticoagulant": ( ["Observation": "Risk for venous thromboembolism"] VTERiskAssessment where VTERiskAssessment.value in "Low Risk" and VTERiskAssessment.status in {'final','amended', 'corrected'} ) union ( ["Observation": "INR"] INRLabTest where INRLabTest.value as Quantity > 3.0 and INRLabTest.status in {'final','amended', 'corrected'} return "Observation" { id: INRLabTest.id, effective: INRLabTest.issued } ) union ((( ["MedicationAdministration": "Unfractionated Heparin"] UnfractionatedHeparin where UnfractionatedHeparin.dosage.route in "Intravenous route" ) union ["MedicationAdministration": "Direct Thrombin Inhibitor"] union ["MedicationAdministration": "Glycoprotein IIb/IIIa Inhibitors"] ) AnticoagulantMedication where AnticoagulantMedication.status = 'complete' return "Observation" { id: AnticoagulantMedication.id, effective: AnticoagulantMedication.effective } )
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 10
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

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element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: EXM108
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: Low Risk for VTE or Anticoagulant Administered From Day of Start of Hospitalization To Day After Admission
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define "Low Risk for VTE or Anticoagulant Administered From Day of Start of Hospitalization To Day After Admission": "Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter with "Is In Low Risk for VTE or On Anticoagulant" VTERiskAssessment such that Global."Normalize Interval"(VTERiskAssessment.effective) starts during VTEICU."FromDayOfStartOfHospitalizationToDayAfterAdmission"(QualifyingEncounter)
element.extension:
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    value: displaySequence
  extension.value integer:
    value: 11
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

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element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: EXM108
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: Low Risk for VTE or Anticoagulant Administered on Day of or Day After Procedure
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define "Low Risk for VTE or Anticoagulant Administered on Day of or Day After Procedure": from "Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter, ["Procedure": "General or Neuraxial Anesthesia"] AnesthesiaProcedure, "Is In Low Risk for VTE or On Anticoagulant" VTERiskAssessment where Global."Normalize Interval"(AnesthesiaProcedure.performed) ends 1 day after day of start of QualifyingEncounter.period and Global."Normalize Interval"(VTERiskAssessment.effective) starts during TJC."CalendarDayOfOrDayAfter"(end of Global."Normalize Interval"(AnesthesiaProcedure.performed)) return QualifyingEncounter
element.extension:
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    value: displaySequence
  extension.value integer:
    value: 12
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

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element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: EXM108
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: Encounter With Low Risk for VTE or Anticoagulant Administered
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define "Encounter With Low Risk for VTE or Anticoagulant Administered": "Low Risk for VTE or Anticoagulant Administered From Day of Start of Hospitalization To Day After Admission" union "Low Risk for VTE or Anticoagulant Administered on Day of or Day After Procedure"
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    value: 13
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

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element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: EXM108
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: No VTE Prophylaxis Medication Administered or Ordered
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define "No VTE Prophylaxis Medication Administered or Ordered": (( ["MedicationAdministration": medication in "Low Dose Unfractionated Heparin for VTE Prophylaxis"] union ["MedicationAdministration": medication in "Low Molecular Weight Heparin for VTE Prophylaxis"] union ["MedicationAdministration": medication in "Injectable Factor Xa Inhibitor for VTE Prophylaxis"] union ["MedicationAdministration": medication in "Warfarin"] ) MedicationAdm where MedicationAdm.status = 'not-done' ) union (( ["MedicationRequest": medication in "Low Dose Unfractionated Heparin for VTE Prophylaxis"] union ["MedicationRequest": medication in "Low Molecular Weight Heparin for VTE Prophylaxis"] union ["MedicationRequest": medication in "Injectable Factor Xa Inhibitor for VTE Prophylaxis"] union ["MedicationRequest": medication in "Warfarin"] ) MedicationOrder where MedicationOrder.doNotPerform is true and MedicationOrder.status in {'completed', 'cancelled'} //11/5 discussion: all expressions for QI-Core must include a status. //Therefore, we need ServiceRequest.status = completed; and MedicationRequest.status = cancelled (or completed, since cancelled indicates it was once ordered but intentionally never filled). //So the not done issue is handled by ServiceRequest.doNotPerform = True Or MedicationRequest.doNotPerform = True )
element.extension:
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  extension.url:
    value: displaySequence
  extension.value integer:
    value: 14
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

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element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: EXM108
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: No VTE Prophylaxis Medication Due to Medical Reason From Day of Start of Hospitalization To Day After Admission
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define "No VTE Prophylaxis Medication Due to Medical Reason From Day of Start of Hospitalization To Day After Admission": "Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter with "No VTE Prophylaxis Medication Administered or Ordered" NoVTEMedication such that Coalesce(NoVTEMedication.statusReason,NoVTEMedication.reasonCode) in "Medical Reason" and Coalesce(NoVTEMedication.authoredOn, start of Global."Normalize Interval"(NoVTEMedication.effective)) during VTEICU."FromDayOfStartOfHospitalizationToDayAfterAdmission"(QualifyingEncounter)
element.extension:
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  extension.url:
    value: displaySequence
  extension.value integer:
    value: 15
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

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element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: EXM108
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: No VTE Prophylaxis Device Applied or Ordered
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define "No VTE Prophylaxis Device Applied or Ordered": (( ["ServiceRequest": "Venous foot pumps (VFP)"] union ["ServiceRequest": "Intermittent pneumatic compression devices (IPC)"] union ["ServiceRequest": "Graduated compression stockings (GCS)"] ) DeviceOrder where DeviceOrder.status = 'completed' and DeviceOrder.doNotPerform is true return {id: DeviceOrder.id, requestStatusReason: GetStatusReason(DeviceOrder), authoredOn: DeviceOrder.authoredOn} ) union ( ["Procedure": "Device Application"] DeviceApplied let DeviceNotDoneTiming: Global.GetExtension(DeviceApplied, 'qicore-recorded').value where (DeviceApplied.usedCode in "Intermittent pneumatic compression devices (IPC)" or DeviceApplied.usedCode in "Venous foot pumps (VFP)" or DeviceApplied.usedCode in "Graduated compression stockings (GCS)" ) and DeviceApplied.status = 'not-done' return {id: DeviceApplied.id, requestStatusReason: DeviceApplied.statusReason, authoredOn: DeviceNotDoneTiming} )
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 16
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: EXM108
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: No VTE Prophylaxis Device Due to Medical Reason From Day of Start of Hospitalization To Day After Admission
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define "No VTE Prophylaxis Device Due to Medical Reason From Day of Start of Hospitalization To Day After Admission": "Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter with "No VTE Prophylaxis Device Applied or Ordered" NoVTEDevice such that NoVTEDevice.requestStatusReason in "Medical Reason" and NoVTEDevice.authoredOn during VTEICU."FromDayOfStartOfHospitalizationToDayAfterAdmission"(QualifyingEncounter)
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 17
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: EXM108
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: No VTE Prophylaxis Medication Due to Medical Reason on Day of or Day After Procedure
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define "No VTE Prophylaxis Medication Due to Medical Reason on Day of or Day After Procedure": from "Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter, ["Procedure": "General or Neuraxial Anesthesia"] AnesthesiaProcedure, "No VTE Prophylaxis Medication Administered or Ordered" NoVTEMedication where Coalesce(NoVTEMedication.statusReason,NoVTEMedication.reasonCode) in "Medical Reason" and AnesthesiaProcedure.status = 'completed' and Global."Normalize Interval"(AnesthesiaProcedure.performed) ends 1 day after day of start of QualifyingEncounter.period and Coalesce(NoVTEMedication.authoredOn, start of Global."Normalize Interval"(NoVTEMedication.effective)) during TJC."CalendarDayOfOrDayAfter"(end of Global."Normalize Interval"(AnesthesiaProcedure.performed)) return QualifyingEncounter
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 18
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: EXM108
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: No VTE Prophylaxis Device Due to Medical Reason on Day of or Day After Procedure
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define "No VTE Prophylaxis Device Due to Medical Reason on Day of or Day After Procedure": from "Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter, ["Procedure": "General or Neuraxial Anesthesia"] AnesthesiaProcedure, "No VTE Prophylaxis Device Applied or Ordered" NoVTEDevice where NoVTEDevice.requestStatusReason in "Medical Reason" and AnesthesiaProcedure.status = 'completed' and Global."Normalize Interval"(AnesthesiaProcedure.performed) ends 1 day after day of start of QualifyingEncounter.period and NoVTEDevice.authoredOn during TJC."CalendarDayOfOrDayAfter"(end of Global."Normalize Interval"(AnesthesiaProcedure.performed)) return QualifyingEncounter
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 19
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: EXM108
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: Encounter With No VTE Prophylaxis Due to Medical Reason
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define "Encounter With No VTE Prophylaxis Due to Medical Reason": ( "No VTE Prophylaxis Medication Due to Medical Reason From Day of Start of Hospitalization To Day After Admission" intersect "No VTE Prophylaxis Device Due to Medical Reason From Day of Start of Hospitalization To Day After Admission" ) union ( "No VTE Prophylaxis Medication Due to Medical Reason on Day of or Day After Procedure" intersect "No VTE Prophylaxis Device Due to Medical Reason on Day of or Day After Procedure" )
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 20
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: EXM108
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: No VTE Prophylaxis Medication or Device Due to Patient Refusal
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define "No VTE Prophylaxis Medication or Device Due to Patient Refusal": ( "No VTE Prophylaxis Medication Administered or Ordered" NoVTEMedication where Coalesce(NoVTEMedication.statusReason,NoVTEMedication.reasonCode) in "Patient Refusal" ) union ("No VTE Prophylaxis Device Applied or Ordered" NoVTEDevice where NoVTEDevice.requestStatusReason in "Patient Refusal" )
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 21
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: EXM108
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: No VTE Prophylaxis Due to Patient Refusal From Day of Start of Hospitalization To Day After Admission
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define "No VTE Prophylaxis Due to Patient Refusal From Day of Start of Hospitalization To Day After Admission": "Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter with "No VTE Prophylaxis Medication or Device Due to Patient Refusal" PatientRefusal such that Coalesce(start of Global."Normalize Interval"(PatientRefusal.effective), PatientRefusal.authoredOn) during VTEICU."FromDayOfStartOfHospitalizationToDayAfterAdmission"(QualifyingEncounter)
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 22
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: EXM108
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: No VTE Prophylaxis Due to Patient Refusal on Day of or Day After Procedure
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define "No VTE Prophylaxis Due to Patient Refusal on Day of or Day After Procedure": from "Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter, ["Procedure": "General or Neuraxial Anesthesia"] AnesthesiaProcedure, "No VTE Prophylaxis Medication or Device Due to Patient Refusal" PatientRefusal where Global."Normalize Interval"(AnesthesiaProcedure.performed) ends 1 day after day of start of QualifyingEncounter.period and Coalesce(start of Global."Normalize Interval"(PatientRefusal.effective), PatientRefusal.authoredOn) during TJC."CalendarDayOfOrDayAfter"(end of Global."Normalize Interval"(AnesthesiaProcedure.performed)) return QualifyingEncounter
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 23
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: EXM108
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: Encounter With No VTE Prophylaxis Due to Patient Refusal
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define "Encounter With No VTE Prophylaxis Due to Patient Refusal": "No VTE Prophylaxis Due to Patient Refusal From Day of Start of Hospitalization To Day After Admission" union "No VTE Prophylaxis Due to Patient Refusal on Day of or Day After Procedure"
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 24
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: EXM108
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: Numerator
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define "Numerator": "Encounter With VTE Prophylaxis Received on Day of or Day After Admission or Procedure" union ( "Encounter With Medication Oral Factor Xa Inhibitor Administered on Day of or Day After Admission or Procedure" intersect ( "Encounter With Prior or Present Diagnosis of Atrial Fibrillation or VTE" union "Encounter With Prior or Present Procedure of Hip or Knee Replacement Surgery" ) ) union "Encounter With Low Risk for VTE or Anticoagulant Administered" union "Encounter With No VTE Prophylaxis Due to Medical Reason" union "Encounter With No VTE Prophylaxis Due to Patient Refusal"
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 25
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: EXM108
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: Initial Population
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define "Initial Population": "Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions"
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 26
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: EXM108
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: Denominator
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define "Denominator": "Initial Population"
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 27
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: SupplementalDataElements
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: SDE Payer
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define "SDE Payer": [Coverage: type in "Payer"] Payer return { code: Payer.type, period: Payer.period }
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 28
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: EXM108
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: SDE Payer
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define "SDE Payer": SDE."SDE Payer"
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 29
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: SupplementalDataElements
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: SDE Ethnicity
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: 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
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 30
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: EXM108
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: SDE Ethnicity
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define "SDE Ethnicity": SDE."SDE Ethnicity"
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 31
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: EXM108
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: Encounter Less Than 2 Days
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define "Encounter Less Than 2 Days": "Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter where Global."LengthInDays"(QualifyingEncounter.period)< 2
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 32
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: EXM108
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: Encounter With ICU Location Stay 1 Day or More
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define "Encounter With ICU Location Stay 1 Day or More": "Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter where exists ( QualifyingEncounter.location Location where Global.GetLocation(Location.location).type in "Intensive Care Unit" and Global."LengthInDays"(Location.period)>= 1 and Location.period starts during TJC."CalendarDayOfOrDayAfter"(start of QualifyingEncounter.period) )
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 33
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: EXM108
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: Encounter With Principal Diagnosis of Mental Disorder or Stroke
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define "Encounter With Principal Diagnosis of Mental Disorder or Stroke": "Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter where Global."PrincipalDiagnosis"(QualifyingEncounter).code in "Mental Health Diagnoses" or Global."PrincipalDiagnosis"(QualifyingEncounter).code in "Hemorrhagic Stroke" or Global."PrincipalDiagnosis"(QualifyingEncounter).code in "Ischemic Stroke"
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 34
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: EXM108
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: SCIP VTE Selected Surgery
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define "SCIP VTE Selected Surgery": ( ["Procedure": "General Surgery"] union ["Procedure": "Gynecological Surgery"] union ["Procedure": "Hip Fracture Surgery"] union ["Procedure": "Hip Replacement Surgery"] union ["Procedure": "Intracranial Neurosurgery"] union ["Procedure": "Knee Replacement Surgery"] union ["Procedure": "Urological Surgery"] ) Procedure where Procedure.status = 'completed'
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 35
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: EXM108
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: Encounter With Principal Procedure of SCIP VTE Selected Surgery
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define "Encounter With Principal Procedure of SCIP VTE Selected Surgery": from "Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter, "SCIP VTE Selected Surgery" SelectedProcedure let EncounterProcedure: Global.GetExtension(QualifyingEncounter, 'qicore-encounter-procedure') where FHIRHelpers.ToInteger(Global.GetExtension(EncounterProcedure, 'rank').value as FHIR.positiveInt) = 1 and Global.GetId(FHIRHelpers.ToString((Global.GetExtension(EncounterProcedure, 'procedure').value as FHIR.Reference).reference)) = SelectedProcedure.id and Global."Normalize Interval"(SelectedProcedure.performed) during QualifyingEncounter.period
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 36
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: EXM108
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: Intervention Comfort Measures
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define "Intervention Comfort Measures": (["ServiceRequest": "Comfort Measures"] P where P.intent = 'order' ) union (["Procedure": "Comfort Measures"] InterventionPerformed where InterventionPerformed.status in {'completed', 'in-progress'})
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 37
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: EXM108
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: Encounter With Intervention Comfort Measures From Day of Start of Hospitalization To Day After Admission
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define "Encounter With Intervention Comfort Measures From Day of Start of Hospitalization To Day After Admission": "Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter with "Intervention Comfort Measures" ComfortMeasure such that Coalesce(start of Global."Normalize Interval"(ComfortMeasure.performed), ComfortMeasure.authoredOn) during VTEICU."FromDayOfStartOfHospitalizationToDayAfterAdmission"(QualifyingEncounter)
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 38
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: EXM108
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: Encounter With Intervention Comfort Measures on Day of or Day After Procedure
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define "Encounter With Intervention Comfort Measures on Day of or Day After Procedure": from "Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter, ["Procedure": "General or Neuraxial Anesthesia"] AnesthesiaProcedure, "Intervention Comfort Measures" ComfortMeasure where AnesthesiaProcedure.status = 'completed' and Global."Normalize Interval"(AnesthesiaProcedure.performed) ends 1 day after day of start of QualifyingEncounter.period and Coalesce(start of Global."Normalize Interval"(ComfortMeasure.performed), ComfortMeasure.authoredOn) during TJC."CalendarDayOfOrDayAfter"(end of Global."Normalize Interval"(AnesthesiaProcedure.performed)) return QualifyingEncounter
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 39
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: EXM108
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: Denominator Exclusion
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define "Denominator Exclusion": "Encounter Less Than 2 Days" union "Encounter With ICU Location Stay 1 Day or More" union "Encounter With Principal Diagnosis of Mental Disorder or Stroke" union "Encounter With Principal Procedure of SCIP VTE Selected Surgery" union "Encounter With Intervention Comfort Measures From Day of Start of Hospitalization To Day After Admission" union "Encounter With Intervention Comfort Measures on Day of or Day After Procedure"
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 40
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: SupplementalDataElements
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: SDE Race
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: 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
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 41
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: EXM108
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: SDE Race
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define "SDE Race": SDE."SDE Race"
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 42
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: FHIRHelpers
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: ToString
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define function ToString(value AdministrativeGender): value.value
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 43
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: FHIRHelpers
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: ToString
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define function ToString(value EncounterStatus): value.value
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 44
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: MATGlobalCommonFunctions
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: LengthInDays
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define function "LengthInDays"(Value Interval<DateTime>): difference in days between start of Value and end of Value
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 45
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: FHIRHelpers
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: ToInterval
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: /* @description: Converts the given [Period](https://hl7.org/fhir/datatypes.html#Period) value to a CQL DateTime Interval @comment: If the start value of the given period is unspecified, the starting boundary of the resulting interval will be open (meaning the start of the interval is unknown, as opposed to interpreted as the beginning of time). */ define function ToInterval(period FHIR.Period): if period is null then null else if period."start" is null then Interval(period."start".value, period."end".value] else Interval[period."start".value, period."end".value]
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 46
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: MATGlobalCommonFunctions
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: CalendarAgeInYearsAt
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define function "CalendarAgeInYearsAt"(BirthDateTime DateTime, AsOf DateTime): years between ToDate(BirthDateTime)and ToDate(AsOf)
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 47
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: MATGlobalCommonFunctions
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: ToDate
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define function "ToDate"(Value DateTime): DateTime(year from Value, month from Value, day from Value, 0, 0, 0, 0, timezoneoffset from Value)
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 48
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: FHIRHelpers
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: ToDate
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define function ToDate(value date): value.value
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 49
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: MATGlobalCommonFunctions
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: EncounterDiagnosis
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define function "EncounterDiagnosis"(Encounter Encounter): Encounter.diagnosis D return singleton from ([Condition] C where C.id = "GetId"(D.condition.reference))
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 50
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: FHIRHelpers
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: ToString
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define function ToString(value string): value.value
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 51
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: MATGlobalCommonFunctions
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: GetId
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define function "GetId"(uri String): Last(Split(uri, '/'))
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 52
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: FHIRHelpers
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: ToConcept
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: /* @description: Converts the given FHIR [CodeableConcept](https://hl7.org/fhir/datatypes.html#CodeableConcept) value to a CQL Concept. */ define function ToConcept(concept FHIR.CodeableConcept): if concept is null then null else System.Concept { codes: concept.coding C return ToCode(C), display: concept.text.value }
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 53
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: FHIRHelpers
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: ToCode
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: /* @description: Converts the given FHIR [Coding](https://hl7.org/fhir/datatypes.html#Coding) value to a CQL Code. */ define function ToCode(coding FHIR.Coding): if coding is null then null else System.Code { code: coding.code.value, system: coding.system.value, version: coding.version.value, display: coding.display.value }
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 54
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: FHIRHelpers
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: ToString
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define function ToString(value MedicationAdministrationStatus): value.value
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 55
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: FHIRHelpers
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: ToString
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define function ToString(value ProcedureStatus): value.value
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 56
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: MATGlobalCommonFunctions
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: Normalize Interval
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: /* * * CQFMeasures Common Logic * */ define function "Normalize Interval"(choice Choice<FHIR.dateTime, FHIR.Period, FHIR.Timing, FHIR.instant, FHIR.string, FHIR.Age, FHIR.Range>): case when choice is FHIR.dateTime then Interval[FHIRHelpers.ToDateTime(choice as FHIR.dateTime), FHIRHelpers.ToDateTime(choice as FHIR.dateTime)] when choice is FHIR.Period then FHIRHelpers.ToInterval(choice as FHIR.Period) when choice is FHIR.instant then Interval[FHIRHelpers.ToDateTime(choice as FHIR.instant), FHIRHelpers.ToDateTime(choice as FHIR.instant)] when choice is FHIR.Age then Interval[FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(choice as FHIR.Age), FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(choice as FHIR.Age) + 1 year) when choice is FHIR.Range then Interval[FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity((choice as FHIR.Range).low), FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity((choice as FHIR.Range).high) + 1 year) when choice is FHIR.Timing then Message(null as Interval<DateTime>, true, '1', 'Error', 'Cannot compute a single interval from a Timing type') when choice is FHIR.string then Message(null as Interval<DateTime>, true, '1', 'Error', 'Cannot compute an interval from a String value') else null as Interval<DateTime> end
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 57
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: FHIRHelpers
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: ToDateTime
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define function ToDateTime(value dateTime): value.value
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 58
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: FHIRHelpers
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: ToDateTime
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define function ToDateTime(value instant): value.value
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 59
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: FHIRHelpers
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: ToQuantity
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: /* @description: Converts the given FHIR [Quantity](https://hl7.org/fhir/datatypes.html#Quantity) value to a CQL Quantity @comment: If the given quantity has a comparator specified, a runtime error is raised. If the given quantity has a system other than UCUM (i.e. `http://unitsofmeasure.org`) or CQL calendar units (i.e. `http://hl7.org/fhirpath/CodeSystem/calendar-units`) an error is raised. For UCUM to calendar units, the `ToCalendarUnit` function is used. @seealso: ToCalendarUnit */ define function ToQuantity(quantity FHIR.Quantity): case when quantity is null then null when quantity.value is null then null when quantity.comparator is not null then Message(null, true, 'FHIRHelpers.ToQuantity.ComparatorQuantityNotSupported', 'Error', 'FHIR Quantity value has a comparator and cannot be converted to a System.Quantity value.') when quantity.system is null or quantity.system.value = 'http://unitsofmeasure.org' or quantity.system.value = 'http://hl7.org/fhirpath/CodeSystem/calendar-units' then System.Quantity { value: quantity.value.value, unit: ToCalendarUnit(Coalesce(quantity.code.value, quantity.unit.value, '1')) } else Message(null, true, 'FHIRHelpers.ToQuantity.InvalidFHIRQuantity', 'Error', 'Invalid FHIR Quantity code: ' & quantity.unit.value & ' (' & quantity.system.value & '|' & quantity.code.value & ')') end
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 60
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: FHIRHelpers
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: ToCalendarUnit
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: /* @description: Converts a UCUM definite duration unit to a CQL calendar duration unit using conversions specified in the [quantities](https://cql.hl7.org/02-authorsguide.html#quantities) topic of the CQL specification. @comment: Note that for durations above days (or weeks), the conversion is understood to be approximate */ define function ToCalendarUnit(unit System.String): case unit when 'ms' then 'millisecond' when 's' then 'second' when 'min' then 'minute' when 'h' then 'hour' when 'd' then 'day' when 'wk' then 'week' when 'mo' then 'month' when 'a' then 'year' else unit end
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 61
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: TJCOverall
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: CalendarDayOfOrDayAfter
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define function "CalendarDayOfOrDayAfter"(StartValue DateTime ): Interval(Global."ToDate"(StartValue), Global."ToDate"(StartValue + 2 days))
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 62
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: FHIRHelpers
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: ToString
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define function ToString(value ObservationStatus): value.value
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 63
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: VTEICU
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: FromDayOfStartOfHospitalizationToDayAfterAdmission
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define function "FromDayOfStartOfHospitalizationToDayAfterAdmission"(Encounter FHIR.Encounter ): Interval[Global."ToDate"(start of Global."HospitalizationWithObservation"(Encounter)), Global."ToDate"(start of Encounter.period + 2 days))
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 64
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: MATGlobalCommonFunctions
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: HospitalizationWithObservation
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define function "HospitalizationWithObservation"(TheEncounter FHIR.Encounter): TheEncounter Visit let ObsVisit: Last([Encounter: "Observation Services"] LastObs where LastObs.period ends 1 hour or less on or before start of Visit.period sort by end of period ), VisitStart: Coalesce(start of ObsVisit.period, start of Visit.period), EDVisit: Last([Encounter: "Emergency Department Visit"] LastED where LastED.period ends 1 hour or less on or before VisitStart sort by end of period ) return Interval[Coalesce(start of EDVisit.period, VisitStart), end of Visit.period]
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 65
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: FHIRHelpers
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: ToBoolean
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define function ToBoolean(value boolean): value.value
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 66
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: FHIRHelpers
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: ToString
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define function ToString(value MedicationRequestStatus): value.value
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 67
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: FHIRHelpers
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: ToString
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define function ToString(value ServiceRequestStatus): value.value
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 68
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: EXM108
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: GetStatusReason
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: //11/5: ServiceRequest not done reason is an extension in QI-Core R4 as ServiceRequest.extension:statusReason define function GetStatusReason(requestReason ServiceRequest): Global.GetBaseExtension(requestReason, 'request-statusReason')
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 69
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: MATGlobalCommonFunctions
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: GetBaseExtension
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define function "GetBaseExtension"(domainResource DomainResource, url String): singleton from "GetBaseExtensions"(domainResource, url)
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 70
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: MATGlobalCommonFunctions
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: GetBaseExtensions
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: /* NOTE: Extensions are not the preferred approach, but are used as a way to access content that is defined by extensions but not yet surfaced in the CQL model info. */ define function "GetBaseExtensions"(domainResource DomainResource, url String): domainResource.extension E where E.url = ('http://hl7.org/fhir/StructureDefinition/' + url) return E
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 71
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: FHIRHelpers
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: ToString
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define function ToString(value uri): value.value
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 72
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: MATGlobalCommonFunctions
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: GetExtension
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define function "GetExtension"(domainResource DomainResource, url String): singleton from "GetExtensions"(domainResource, url)
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 73
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: MATGlobalCommonFunctions
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: GetExtensions
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: /* NOTE: Extensions are not the preferred approach, but are used as a way to access content that is defined by extensions but not yet surfaced in the CQL model info. */ define function "GetExtensions"(domainResource DomainResource, url String): domainResource.extension E where E.url = ('http://hl7.org/fhir/us/qicore/StructureDefinition/' + url) return E
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 74
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: MATGlobalCommonFunctions
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: GetLocation
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: // Returns the location for the given location reference define function GetLocation(reference Reference): singleton from ( [Location] L where L.id = GetId(reference.reference) )
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 75
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: MATGlobalCommonFunctions
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: PrincipalDiagnosis
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: // Returns the condition that is specified as the principal diagnosis for the encounter // TODO: BTR 2019-07-30: Shouldn't need the FHIRHelpers reference here, investigate define function "PrincipalDiagnosis"(Encounter Encounter): (singleton from (Encounter.diagnosis D where FHIRHelpers.ToInteger(D.rank) = 1)) PD return singleton from ([Condition] C where C.id = "GetId"(PD.condition.reference))
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 76
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: FHIRHelpers
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: ToInteger
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define function ToInteger(value integer): value.value
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 77
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: MATGlobalCommonFunctions
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: GetExtension
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define function "GetExtension"(element Element, url String): singleton from "GetExtensions"(element, url)
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 78
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: MATGlobalCommonFunctions
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: GetExtensions
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: /* NOTE: Extensions are not the preferred approach, but are used as a way to access content that is defined by extensions but not yet surfaced in the CQL model info. */ define function "GetExtensions"(element Element, url String): element.extension E where E.url = (url) return E
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 79
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: FHIRHelpers
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: ToString
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define function ToString(value ServiceRequestIntent): value.value
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 80
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

value: EffectiveDataRequirements

value: active

codeable concept.coding:
  index: -1
  coding.system:
    value: http://terminology.hl7.org/CodeSystem/library-type
  coding.code:
    value: module-definition

index: -1
related artifact.type:
  value: depends-on
related artifact.display:
  value: FHIR model information
related artifact.resource:
  value: http://hl7.org/fhir/uv/cql/Library/FHIR-ModelInfo|4.0.1
  link: 4.0
  link: .1

index: -1
related artifact.type:
  value: depends-on
related artifact.display:
  value: Library SDE
related artifact.resource:
  value: http://hl7.org/fhir/uv/cqm/Library/SupplementalDataElements|2.0.000
  link: 2.0
  link: .000

index: -1
related artifact.type:
  value: depends-on
related artifact.display:
  value: Library FHIRHelpers
related artifact.resource:
  value: http://hl7.org/fhir/uv/cql/Library/FHIRHelpers|4.0.1
  link: 4.0
  link: .1

index: -1
related artifact.type:
  value: depends-on
related artifact.display:
  value: Library Global
related artifact.resource:
  value: http://hl7.org/fhir/uv/cqm/Library/MATGlobalCommonFunctions|5.0.000
  link: 5.0
  link: .000

index: -1
related artifact.type:
  value: depends-on
related artifact.display:
  value: Library TJC
related artifact.resource:
  value: http://hl7.org/fhir/uv/cqm/Library/TJCOverall|4.0.000
  link: 4.0
  link: .000

index: -1
related artifact.type:
  value: depends-on
related artifact.display:
  value: Library VTEICU
related artifact.resource:
  value: http://hl7.org/fhir/uv/cqm/Library/VTEICU|5.0.000
  link: 5.0
  link: .000

index: -1
related artifact.type:
  value: depends-on
related artifact.display:
  value: Code system ConditionClinicalStatusCodes
related artifact.resource:
  value: http://terminology.hl7.org/CodeSystem/condition-clinical
  link: http://terminology.hl7.org/CodeSystem/condition-clinical

index: -1
related artifact.type:
  value: depends-on
related artifact.display:
  value: Code system LOINC
related artifact.resource:
  value: http://loinc.org
  link: http://loinc.org

index: -1
related artifact.type:
  value: depends-on
related artifact.display:
  value: Value set Encounter Inpatient
related artifact.resource:
  value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307
  link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307

index: -1
related artifact.type:
  value: depends-on
related artifact.display:
  value: Value set Obstetrics
related artifact.resource:
  value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.263
  link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.263

index: -1
related artifact.type:
  value: depends-on
related artifact.display:
  value: Value set Venous Thromboembolism
related artifact.resource:
  value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.279
  link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.279

index: -1
related artifact.type:
  value: depends-on
related artifact.display:
  value: Value set Obstetrics VTE
related artifact.resource:
  value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.264
  link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.264

index: -1
related artifact.type:
  value: depends-on
related artifact.display:
  value: Value set Low Dose Unfractionated Heparin for VTE Prophylaxis
related artifact.resource:
  value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.39
  link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.39

index: -1
related artifact.type:
  value: depends-on
related artifact.display:
  value: Value set Subcutaneous route
related artifact.resource:
  value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.223
  link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.223

index: -1
related artifact.type:
  value: depends-on
related artifact.display:
  value: Value set Low Molecular Weight Heparin for VTE Prophylaxis
related artifact.resource:
  value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.219
  link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.219

index: -1
related artifact.type:
  value: depends-on
related artifact.display:
  value: Value set Injectable Factor Xa Inhibitor for VTE Prophylaxis
related artifact.resource:
  value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.211
  link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.211

index: -1
related artifact.type:
  value: depends-on
related artifact.display:
  value: Value set Warfarin
related artifact.resource:
  value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.232
  link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.232

index: -1
related artifact.type:
  value: depends-on
related artifact.display:
  value: Value set Device Application
related artifact.resource:
  value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.48
  link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.48

index: -1
related artifact.type:
  value: depends-on
related artifact.display:
  value: Value set Intermittent pneumatic compression devices (IPC)
related artifact.resource:
  value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.214
  link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.214

index: -1
related artifact.type:
  value: depends-on
related artifact.display:
  value: Value set Venous foot pumps (VFP)
related artifact.resource:
  value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.230
  link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.230

index: -1
related artifact.type:
  value: depends-on
related artifact.display:
  value: Value set Graduated compression stockings (GCS)
related artifact.resource:
  value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.256
  link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.256

index: -1
related artifact.type:
  value: depends-on
related artifact.display:
  value: Value set General or Neuraxial Anesthesia
related artifact.resource:
  value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.1743
  link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.1743

index: -1
related artifact.type:
  value: depends-on
related artifact.display:
  value: Value set Oral Factor Xa Inhibitor for VTE Prophylaxis or VTE Treatment
related artifact.resource:
  value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.134
  link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.134

index: -1
related artifact.type:
  value: depends-on
related artifact.display:
  value: Value set Atrial Fibrillation/Flutter
related artifact.resource:
  value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.202
  link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.202

index: -1
related artifact.type:
  value: depends-on
related artifact.display:
  value: Value set Hip Replacement Surgery
related artifact.resource:
  value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.259
  link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.259

index: -1
related artifact.type:
  value: depends-on
related artifact.display:
  value: Value set Knee Replacement Surgery
related artifact.resource:
  value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.261
  link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.261

index: -1
related artifact.type:
  value: depends-on
related artifact.display:
  value: Value set Low Risk
related artifact.resource:
  value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.400
  link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.400

index: -1
related artifact.type:
  value: depends-on
related artifact.display:
  value: Value set INR
related artifact.resource:
  value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.213
  link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.213

index: -1
related artifact.type:
  value: depends-on
related artifact.display:
  value: Value set Unfractionated Heparin
related artifact.resource:
  value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.218
  link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.218

index: -1
related artifact.type:
  value: depends-on
related artifact.display:
  value: Value set Intravenous route
related artifact.resource:
  value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.222
  link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.222

index: -1
related artifact.type:
  value: depends-on
related artifact.display:
  value: Value set Direct Thrombin Inhibitor
related artifact.resource:
  value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.205
  link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.205

index: -1
related artifact.type:
  value: depends-on
related artifact.display:
  value: Value set Glycoprotein IIb/IIIa Inhibitors
related artifact.resource:
  value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.41
  link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.41

index: -1
related artifact.type:
  value: depends-on
related artifact.display:
  value: Value set Observation Services
related artifact.resource:
  value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.143
  link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.143

index: -1
related artifact.type:
  value: depends-on
related artifact.display:
  value: Value set Emergency Department Visit
related artifact.resource:
  value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292
  link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292

index: -1
related artifact.type:
  value: depends-on
related artifact.display:
  value: Value set Medical Reason
related artifact.resource:
  value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.473
  link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.473

index: -1
related artifact.type:
  value: depends-on
related artifact.display:
  value: Value set Patient Refusal
related artifact.resource:
  value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.93
  link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.93

index: -1
related artifact.type:
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related artifact.display:
  value: Value set Payer
related artifact.resource:
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  link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591

index: -1
related artifact.type:
  value: depends-on
related artifact.display:
  value: Value set Intensive Care Unit
related artifact.resource:
  value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.23
  link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.23

index: -1
related artifact.type:
  value: depends-on
related artifact.display:
  value: Value set Mental Health Diagnoses
related artifact.resource:
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  link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.105.12.1004

index: -1
related artifact.type:
  value: depends-on
related artifact.display:
  value: Value set Hemorrhagic Stroke
related artifact.resource:
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  link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.212

index: -1
related artifact.type:
  value: depends-on
related artifact.display:
  value: Value set Ischemic Stroke
related artifact.resource:
  value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.247
  link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.247

index: -1
related artifact.type:
  value: depends-on
related artifact.display:
  value: Value set General Surgery
related artifact.resource:
  value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.255
  link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.255

index: -1
related artifact.type:
  value: depends-on
related artifact.display:
  value: Value set Gynecological Surgery
related artifact.resource:
  value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.257
  link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.257

index: -1
related artifact.type:
  value: depends-on
related artifact.display:
  value: Value set Hip Fracture Surgery
related artifact.resource:
  value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.258
  link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.258

index: -1
related artifact.type:
  value: depends-on
related artifact.display:
  value: Value set Intracranial Neurosurgery
related artifact.resource:
  value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.260
  link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.260

index: -1
related artifact.type:
  value: depends-on
related artifact.display:
  value: Value set Urological Surgery
related artifact.resource:
  value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.272
  link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.272

index: -1
related artifact.type:
  value: depends-on
related artifact.display:
  value: Value set Comfort Measures
related artifact.resource:
  value: http://cts.nlm.nih.gov/fhir/ValueSet/1.3.6.1.4.1.33895.1.3.0.45
  link: http://cts.nlm.nih.gov/fhir/ValueSet/1.3.6.1.4.1.33895.1.3.0.45

index: -1
parameter definition.name:
  value: Measurement Period
parameter definition.use:
  value: in
parameter definition.min:
  value: 0
parameter definition.max:
  value: 1
parameter definition.type:
  value: Period

index: -1
parameter definition.name:
  value: SDE Sex
parameter definition.use:
  value: out
parameter definition.min:
  value: 0
parameter definition.max:
  value: 1
parameter definition.type:
  value: Coding

index: -1
parameter definition.name:
  value: Numerator
parameter definition.use:
  value: out
parameter definition.min:
  value: 0
parameter definition.max:
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  index: -1
  link: http://hl7.org/fhir/StructureDefinition/Observation
data requirement.must support:
  value: code
  index: -1
data requirement.must support:
  value: value
  index: -1
data requirement.must support:
  value: status
  index: -1
data requirement.must support:
  value: effective
  index: -1
data requirement.code filter:
  index: -1
  data requirement.code filter.path:
    value: code
  data requirement.code filter.code: http://loinc.org/rdf#72136-5
    index: -1
    coding.system:
      value: http://loinc.org
    coding.code:
      value: 72136-5
    coding.display:
      value: Risk for venous thromboembolism

index: -1
data requirement.type:
  value: Observation
data requirement.profile:
  value: http://hl7.org/fhir/StructureDefinition/Observation
  index: -1
  link: http://hl7.org/fhir/StructureDefinition/Observation
data requirement.must support:
  value: code
  index: -1
data requirement.must support:
  value: value
  index: -1
data requirement.must support:
  value: status
  index: -1
data requirement.must support:
  value: id
  index: -1
data requirement.must support:
  value: issued
  index: -1
data requirement.must support:
  value: effective
  index: -1
data requirement.code filter:
  index: -1
  data requirement.code filter.path:
    value: code
  data requirement.code filter.value set:
    value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.213
    link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.213

index: -1
data requirement.type:
  value: Medication
data requirement.profile:
  value: http://hl7.org/fhir/StructureDefinition/Medication
  index: -1
  link: http://hl7.org/fhir/StructureDefinition/Medication
data requirement.must support:
  value: id
  index: -1
data requirement.must support:
  value: code
  index: -1

index: -1
data requirement.type:
  value: MedicationRequest
data requirement.profile:
  value: http://hl7.org/fhir/StructureDefinition/MedicationRequest
  index: -1
  link: http://hl7.org/fhir/StructureDefinition/MedicationRequest
data requirement.must support:
  value: medication
  index: -1
data requirement.must support:
  value: doNotPerform
  index: -1
data requirement.must support:
  value: status
  index: -1
data requirement.code filter:
  index: -1
  data requirement.code filter.path:
    value: medication
  data requirement.code filter.value set:
    value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.39
    link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.39

index: -1
data requirement.type:
  value: MedicationRequest
data requirement.profile:
  value: http://hl7.org/fhir/StructureDefinition/MedicationRequest
  index: -1
  link: http://hl7.org/fhir/StructureDefinition/MedicationRequest
data requirement.must support:
  value: medication
  index: -1
data requirement.must support:
  value: doNotPerform
  index: -1
data requirement.must support:
  value: status
  index: -1
data requirement.code filter:
  index: -1
  data requirement.code filter.path:
    value: medication
  data requirement.code filter.value set:
    value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.219
    link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.219

index: -1
data requirement.type:
  value: MedicationRequest
data requirement.profile:
  value: http://hl7.org/fhir/StructureDefinition/MedicationRequest
  index: -1
  link: http://hl7.org/fhir/StructureDefinition/MedicationRequest
data requirement.must support:
  value: medication
  index: -1
data requirement.must support:
  value: doNotPerform
  index: -1
data requirement.must support:
  value: status
  index: -1
data requirement.code filter:
  index: -1
  data requirement.code filter.path:
    value: medication
  data requirement.code filter.value set:
    value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.211
    link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.211

index: -1
data requirement.type:
  value: MedicationRequest
data requirement.profile:
  value: http://hl7.org/fhir/StructureDefinition/MedicationRequest
  index: -1
  link: http://hl7.org/fhir/StructureDefinition/MedicationRequest
data requirement.must support:
  value: medication
  index: -1
data requirement.must support:
  value: doNotPerform
  index: -1
data requirement.must support:
  value: status
  index: -1
data requirement.code filter:
  index: -1
  data requirement.code filter.path:
    value: medication
  data requirement.code filter.value set:
    value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.232
    link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.232

index: -1
data requirement.type:
  value: ServiceRequest
data requirement.profile:
  value: http://hl7.org/fhir/StructureDefinition/ServiceRequest
  index: -1
  link: http://hl7.org/fhir/StructureDefinition/ServiceRequest
data requirement.must support:
  value: code
  index: -1
data requirement.must support:
  value: status
  index: -1
data requirement.must support:
  value: doNotPerform
  index: -1
data requirement.must support:
  value: id
  index: -1
data requirement.must support:
  value: authoredOn
  index: -1
data requirement.code filter:
  index: -1
  data requirement.code filter.path:
    value: code
  data requirement.code filter.value set:
    value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.230
    link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.230

index: -1
data requirement.type:
  value: ServiceRequest
data requirement.profile:
  value: http://hl7.org/fhir/StructureDefinition/ServiceRequest
  index: -1
  link: http://hl7.org/fhir/StructureDefinition/ServiceRequest
data requirement.must support:
  value: code
  index: -1
data requirement.must support:
  value: status
  index: -1
data requirement.must support:
  value: doNotPerform
  index: -1
data requirement.must support:
  value: id
  index: -1
data requirement.must support:
  value: authoredOn
  index: -1
data requirement.code filter:
  index: -1
  data requirement.code filter.path:
    value: code
  data requirement.code filter.value set:
    value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.214
    link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.214

index: -1
data requirement.type:
  value: ServiceRequest
data requirement.profile:
  value: http://hl7.org/fhir/StructureDefinition/ServiceRequest
  index: -1
  link: http://hl7.org/fhir/StructureDefinition/ServiceRequest
data requirement.must support:
  value: code
  index: -1
data requirement.must support:
  value: status
  index: -1
data requirement.must support:
  value: doNotPerform
  index: -1
data requirement.must support:
  value: id
  index: -1
data requirement.must support:
  value: authoredOn
  index: -1
data requirement.code filter:
  index: -1
  data requirement.code filter.path:
    value: code
  data requirement.code filter.value set:
    value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.256
    link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.256

index: -1
data requirement.type:
  value: ServiceRequest
data requirement.profile:
  value: http://hl7.org/fhir/StructureDefinition/ServiceRequest
  index: -1
  link: http://hl7.org/fhir/StructureDefinition/ServiceRequest
data requirement.must support:
  value: code
  index: -1
data requirement.must support:
  value: intent
  index: -1
data requirement.must support:
  value: status
  index: -1
data requirement.must support:
  value: doNotPerform
  index: -1
data requirement.must support:
  value: id
  index: -1
data requirement.must support:
  value: authoredOn
  index: -1
data requirement.code filter:
  index: -1
  data requirement.code filter.path:
    value: code
  data requirement.code filter.value set:
    value: http://cts.nlm.nih.gov/fhir/ValueSet/1.3.6.1.4.1.33895.1.3.0.45
    link: http://cts.nlm.nih.gov/fhir/ValueSet/1.3.6.1.4.1.33895.1.3.0.45

index: -1
data requirement.type:
  value: Coverage
data requirement.profile:
  value: http://hl7.org/fhir/StructureDefinition/Coverage
  index: -1
  link: http://hl7.org/fhir/StructureDefinition/Coverage
data requirement.must support:
  value: type
  index: -1
data requirement.must support:
  value: period
  index: -1
data requirement.code filter:
  index: -1
  data requirement.code filter.path:
    value: type
  data requirement.code filter.value set:
    value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591
    link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591

index: -1
data requirement.type:
  value: Location
data requirement.profile:
  value: http://hl7.org/fhir/StructureDefinition/Location
  index: -1
  link: http://hl7.org/fhir/StructureDefinition/Location
data requirement.must support:
  value: id
  index: -1

index: -1
extension.url:
  value: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis
extension.value code:
  value: Encounter

index: -1
extension.url:
  value: http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements
extension.value canonical:
  value: #effective-data-requirements

index: -1
identifier.use:
  value: official
identifier.system:
  value: http://example.org/fhir/cqi/ecqm/Measure/Identifier/cms
identifier.value:
  value: 108

index: -1
identifier.system:
  value: urn:ietf:rfc:3986
identifier.value:
  value: urn:oid:2.16.840.1.113883.4.642.40.61.29.3

value: 8.2.000

value: EXM108

value: EXM108 - Venous Thromboembolism Prophylaxis

value: active

value: true

value: 2025-08-13

value: HL7 International / Clinical Quality Information

index: -1
contact detail.telecom:
  index: -1
  contact point.system:
    value: url
  contact point.value:
    value: http://www.hl7.org/Special/committees/cqi

value: This measure assesses the number of patients who received VTE prophylaxis or have documentation why no VTE prophylaxis was given the day of or the day after hospital admission or surgery end date for surgeries that start the day of or the day after hospital admission

index: -1
usage context.code:
  coding.system:
    value: http://terminology.hl7.org/CodeSystem/usage-context-type
  coding.code:
    value: venue
  coding.display:
    value: Clinical Venue
usage context.value codeable concept:
  codeable concept.coding:
    index: -1
    coding.system:
      value: http://hl7.org/fhir/uv/cqm/CodeSystem/intended-venue-codes
    coding.code:
      value: eh
    coding.display:
      value: EH

index: -1
codeable concept.coding:
  index: -1
  coding.system:
    value: http://unstats.un.org/unsd/methods/m49/m49.htm
  coding.code:
    value: 001

value: Measure specifications are in the Public Domain. LOINC(R) is a registered trademark of the Regenstrief Institute. This material contains SNOMED Clinical Terms(R) (SNOMED CT(C)) copyright 2004-2017 International Health Terminology Standards Development Organization. All rights reserved.

value: 2019-03-08

value: 2019-03-08

period.start:
  value: 2018-01-01
period.end:
  value: 2018-12-31

index: -1
codeable concept.coding: http://loinc.org/rdf#57024-2
  index: -1
  coding.system:
    value: http://loinc.org
  coding.code:
    value: 57024-2
  coding.display:
    value: Health Quality Measure Document

value: http://hl7.org/fhir/uv/cqm/Library/EXM108
index: -1
link: http://hl7.org/fhir/uv/cqm/Library/EXM108

value: These performance measures are not clinical guidelines and do not establish a standard of medical care, and have not been tested for all potential applications. The measures and specifications are provided without warranty

codeable concept.coding:
  index: -1
  coding.system:
    value: http://terminology.hl7.org/CodeSystem/measure-scoring
  coding.code:
    value: proportion
  coding.display:
    value: Proportion

index: -1
codeable concept.coding:
  index: -1
  coding.system:
    value: http://terminology.hl7.org/CodeSystem/measure-type
  coding.code:
    value: process

value: Hospitalized patients at high-risk for VTE may develop an asymptomatic deep vein thrombosis (DVT), and die from pulmonary embolism (PE) even before the diagnosis is suspected. The majority of fatal events occur as sudden or abrupt death, underscoring the importance of prevention as the most critical action step for reducing death from PE (Geerts, et al, 2008). The estimated annual incidence of deep-vein thrombosis (DVT) and pulmonary embolism (PE), known collectively as venous thromboembolism (VTE), is approximately 900,000 (Geerts, et al, 2008). Approximately two-thirds of cases of DVT or PE are associated with recent hospitalization. This is consistent with the 2001 report by The Agency for Healthcare Research and Quality (AHRQ). AHRQ indicates that "the appropriate application of effective preventive measures in hospitals has major potential for improving patient safety by reducing the incidence of venous thromboembolism" (Shojania, 2001). Despite its proven effectiveness, rates of appropriate thromboprophylaxis remain low in both medical and surgical patients. A recent analysis from the ENDORSE survey, which evaluated prophylaxis rates in 17,084 major surgery patients, found that more than one third of patients at risk for VTE (38%) did not receive prophylaxis and that rates varied by surgery type (Cohen, et al., 2008). In a review of evidence-based patient safety practices, the Agency for Healthcare Research and Quality defined thromboprophylaxis against VTE as the "number one patient safety practice" for hospitalized patients (Shojania, 2001). Updated "safe practices" published by the National Quality Forum (NQF) recommend routine evaluation of hospitalized patients for risk of VTE and use of appropriate prophylaxis (National Quality Forum. National Voluntary Consensus Standards for Prevention and Care of Venous Thromboembolism, 2006). As noted by the ACCP, a vast number of randomized clinical trials provide irrefutable evidence that thromboprophylaxis reduces…

value: Failure to recognize and protect patients at risk for venous thromboembolism (VTE) increases the chances for acutely ill hospitalized patients at high risk for developing a deep vein thrombosis or dying from a pulmonary emboli. Screening all patients is the only evidence based practice in reducing incidence of disease. All hospitalized patients should be evaluated for primary VTE prophylaxis, and given appropriate prophylaxis when indicated.

codeable concept.coding:
  index: -1
  coding.system:
    value: http://terminology.hl7.org/CodeSystem/measure-improvement-notation
  coding.code:
    value: increase
  coding.display:
    value: Increased score indicates improvement

value: When low dose unfractionated heparin is administered for VTE Prophylaxis, the intended administration route for low dose unfractionated heparin is subcutaneous. Reasons for no pharmacological and no mechanical VTE prophylaxis must be explicitly documented by the MD/APN/PA or pharmacist and linked with VTE prophylaxis. Ambulation alone is not a sufficient reason for not administering VTE prophylaxis. In order for ambulation/patient ambulating to be considered as an acceptable reason, there needs to be explicit documentation, e.g., "patient out of bed and ambulating in halls - no VTE prophylaxis needed."

index: -1
element.id:
  value: group-1
element.extension:
  index: -1
  extension.url:
    value: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.linkId
  extension.value string:
    value: primary
measure.group.population:
  index: -1
  element.extension:
    index: -1
    extension.url:
      value: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.population.linkId
    extension.value string:
      value: primary-exm108-initial-population
  measure.group.population.code:
    codeable concept.coding:
      index: -1
      coding.system:
        value: http://terminology.hl7.org/CodeSystem/measure-population
      coding.code:
        value: initial-population
      coding.display:
        value: Initial Population
  measure.group.population.description:
    value: Patients age 18 and older discharged from hospital inpatient acute care without a diagnosis of venous thromboembolism (VTE) or obstetrics with a length of stay less than or equal to 120 days that ends during the measurement period
  measure.group.population.criteria:
    expression.language:
      value: text/cql-identifier
    expression.expression:
      value: Initial Population
measure.group.population:
  index: -1
  element.extension:
    index: -1
    extension.url:
      value: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.population.linkId
    extension.value string:
      value: primary-exm108-numerator
  measure.group.population.code:
    codeable concept.coding:
      index: -1
      coding.system:
        value: http://terminology.hl7.org/CodeSystem/measure-population
      coding.code:
        value: numerator
      coding.display:
        value: Numerator
  measure.group.population.description:
    value: Patients who received VTE prophylaxis: - the day of or the day after hospital admission - the day of or the day after surgery end date for surgeries that end the day of or the day after hospital admission Patients who have documentation of a reason why no VTE prophylaxis was given: - between arrival and hospital admission - the day of or the day after hospital admission - the day of or the day after surgery end date (for surgeries that end the day of or the day after hospital admission)
  measure.group.population.criteria:
    expression.language:
      value: text/cql-identifier
    expression.expression:
      value: Numerator
measure.group.population:
  index: -1
  element.extension:
    index: -1
    extension.url:
      value: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.population.linkId
    extension.value string:
      value: primary-exm108-denominator
  measure.group.population.code:
    codeable concept.coding:
      index: -1
      coding.system:
        value: http://terminology.hl7.org/CodeSystem/measure-population
      coding.code:
        value: denominator
      coding.display:
        value: Denominator
  measure.group.population.description:
    value: All patients in the initial population
  measure.group.population.criteria:
    expression.language:
      value: text/cql-identifier
    expression.expression:
      value: Denominator
measure.group.population:
  index: -1
  element.extension:
    index: -1
    extension.url:
      value: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.population.linkId
    extension.value string:
      value: primary-exm108-denominator-exclusion
  measure.group.population.code:
    codeable concept.coding:
      index: -1
      coding.system:
        value: http://terminology.hl7.org/CodeSystem/measure-population
      coding.code:
        value: denominator-exclusion
      coding.display:
        value: Denominator Exclusion
  measure.group.population.description:
    value: * Patients who have a length of stay less than 2 days * Patients with comfort measures documented anytime between arrival and the day after hospital admission * Patients with comfort measures documented by the day after surgery end date for surgeries that start the day of or the day after hospital admission * Patients who are direct admits to intensive care unit (ICU), or transferred to ICU the day of or the day after hospital admission with ICU length of stay greater than or equal to one day * Patients with a principal diagnosis of mental disorders or stroke * Patients with a principal procedure of Surgical Care Improvement Project (SCIP) VTE selected surgeries
  measure.group.population.criteria:
    expression.language:
      value: text/cql-identifier
    expression.expression:
      value: Denominator Exclusion

index: -1
element.extension:
  index: -1
  extension.url:
    value: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.supplementalData.linkId
  extension.value string:
    value: primary-sde-ethnicity
element.extension:
  index: -1
  extension.url:
    value: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-includeInReportType
  extension.value code:
    value: summary
measure.supplemental data.usage:
  index: -1
  codeable concept.coding:
    index: -1
    coding.system:
      value: http://terminology.hl7.org/CodeSystem/measure-data-usage
    coding.code:
      value: supplemental-data
measure.supplemental data.criteria:
  expression.language:
    value: text/cql-identifier
  expression.expression:
    value: SDE Ethnicity

index: -1
element.extension:
  index: -1
  extension.url:
    value: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.supplementalData.linkId
  extension.value string:
    value: primary-sde-payer
element.extension:
  index: -1
  extension.url:
    value: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-includeInReportType
  extension.value code:
    value: summary
measure.supplemental data.usage:
  index: -1
  codeable concept.coding:
    index: -1
    coding.system:
      value: http://terminology.hl7.org/CodeSystem/measure-data-usage
    coding.code:
      value: supplemental-data
measure.supplemental data.criteria:
  expression.language:
    value: text/cql-identifier
  expression.expression:
    value: SDE Payer

index: -1
element.extension:
  index: -1
  extension.url:
    value: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.supplementalData.linkId
  extension.value string:
    value: primary-sde-race
element.extension:
  index: -1
  extension.url:
    value: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-includeInReportType
  extension.value code:
    value: summary
measure.supplemental data.usage:
  index: -1
  codeable concept.coding:
    index: -1
    coding.system:
      value: http://terminology.hl7.org/CodeSystem/measure-data-usage
    coding.code:
      value: supplemental-data
measure.supplemental data.criteria:
  expression.language:
    value: text/cql-identifier
  expression.expression:
    value: SDE Race

index: -1
element.extension:
  index: -1
  extension.url:
    value: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.supplementalData.linkId
  extension.value string:
    value: primary-sde-sex
element.extension:
  index: -1
  extension.url:
    value: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-includeInReportType
  extension.value code:
    value: summary
measure.supplemental data.usage:
  index: -1
  codeable concept.coding:
    index: -1
    coding.system:
      value: http://terminology.hl7.org/CodeSystem/measure-data-usage
    coding.code:
      value: supplemental-data
measure.supplemental data.criteria:
  expression.language:
    value: text/cql-identifier
  expression.expression:
    value: SDE Sex