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\n\n \n \n \n \n\n \n \n \n \n\n \n \n\n\n \n\n\n\n\n\n\n \n \n \n\n\n\n \n\n\n\n\n \n\n \n\n\n\n \n\n\n\n\n \n\n \n\n\n\n \n\n\n\n\n \n\n \n\n\n\n \n\n\n\n\n \n\n \n\n\n\n \n\n\n\n\n \n\n \n\n\n\n \n\n\n\n\n \n\n \n\n\n\n \n\n\n\n\n \n\n \n\n\n\n \n\n\n\n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n\n \n \n\n\n\n\n\n\n \n\n\n\n\n\n\n \n \n \n\n \n \n\n\n\n \n \n\n\n\n \n \n\n\n\n \n \n\n\n\n \n \n\n\n\n \n \n\n\n\n \n \n\n\n\n \n \n\n\n\n \n \n\n\n\n \n \n\n\n\n \n \n\n\n\n \n \n\n\n\n \n \n\n\n\n \n \n\n\n\n \n \n\n\n\n \n \n\n\n\n \n \n\n\n \n \n\n\n \n\n\n\n\n\n\n \n \n \n \n\n\n\n\n \n \n\n\n \n\n\n \n
Metadata
TitleHIV Annual Retention in CareFHIR\n
Version1.0.000
Short NameCMS1157FHIR
GUID (Version Independent)urn:uuid:03878bb8-1209-4f3f-91f6-52b655092251
GUID (Version Specific)urn:uuid:36e79353-69dd-4ca6-8d94-49fca9c67ca2
CMS Identifier1157FHIR
Effective Period2026-01-01 through 2026-12-31
Steward (Publisher)Health Resources & Services Administration
DeveloperHealth Resources & Services Administration
Description

Percentage of patients, regardless of age, with a diagnosis of Human Immunodeficiency Virus (HIV) during the first 240 days of the measurement period or before the measurement period who had at least two eligible encounters or at least one eligible encounter and one HIV viral load test that were at least 90 days apart within the measurement period

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Copyright

This measure was developed by the Health Resources and Services Administration of the U.S. Department for Health and Human Services. It is in the public domain.

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Citation of HRSA as the source of the original measure is appreciated. Any modified versions may not be represented as approved, endorsed, or authorized by HRSA or HHS. 42 U.S.C. Section 1320b-10. Users of modified versions should clearly explain how they deviate from HRSA's original measure.

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Limited proprietary coding is contained in the Measure specifications for user convenience. Users of proprietary code sets should obtain all necessary licenses from the owners of the code sets.

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CPT(R) contained in the Measure specifications is copyright 2004-2024 American Medical Association. LOINC(R) is copyright 2004-2024 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2024 International Health Terminology Standards Development Organisation. ICD-10 is copyright 2024 World Health Organization. All Rights Reserved.

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Due to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM].

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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.

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THE MEASURES AND SPECIFICATIONS ARE PROVIDED "AS IS" WITHOUT WARRANTY OF ANY KIND.

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Due to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM].

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Rationale

The HIV "continuum of care" is the process of HIV testing, linkage to HIV care, initiation of antiretroviral therapy (ART), adherence to treatment, retention in care, and virologic suppression (Gardner et al 2011). Poor retention in care is associated with lower rates of ART use (Giordano et al 2003), delayed viral suppression (Crawford et al 2014), and increased risk of mortality (Giordano et al., 2007; Mugavero et al., 2009). This measure will help providers direct their attention and quality improvement efforts towards improving retention in care.

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Clinical Recommendation Statement

"Retention in care should be routinely monitored. There are various ways to measure retention, including measures based on attended visits over a defined period of time (constancy measures) and measures based on missed visits. Both approaches are valid and independently predict survival. Missed visits and a prolonged time since the last visit are relatively easy to measure and should trigger efforts to retain or re-engage a person in care. Constancy measures (e.g., at least two visits that are at least 90 days apart over 1 year or at least one visit every 6 months over the last 2 years) can be used as clinic quality assurance measures" (Panel on Antiretroviral Guidelines for Adults and Adolescents, 2022, p. L-4).

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"Poor retention in HIV care is associated with greater risk of death. Poor retention is more common in people who use substances, have serious mental health problems, have unmet socioeconomic needs (e.g., housing, food, transportation), lack financial resources or health insurance, have schedules that complicate adherence, have been recently incarcerated, or face stigma. At the provider and health system level, low trust in providers and a poor patient-provider relationship have been associated with lower retention, as has lower satisfaction with the clinic experience. Availability of appointments and timeliness of appointments (i.e., long delay from the request for an appointment to the appointment's date) and scheduling convenience are also factors" (Panel on Antiretroviral Guidelines for Adults and Adolescents, 2022, p. L-3).

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"Recommendation 2: Systematic monitoring of retention in HIV care is recommended for all patients (II A): Retention in care is associated with improved individual health outcomes, including HIV biomarker and clinical variables, and may reduce community-level viral burden, with implications for secondary prevention. Although monitoring retention is routinely recommended, specific details, such as retention measures to be used and desired visit frequency, vary among jurisdictions and programs and should be in harmony with national and international guidelines. Many retention measures (for example, visit adherence, gaps in care, and visits per interval of time) and data sources (for example, surveillance, medical records, and administrative databases) have been used and may be applied in accordance with local resources and standards of care. As with monitoring of linkage, integration of data sources may enhance monitoring of retention" (Thompson et al., 2012, p. 4).

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Citation\n \n \n \n

Crawford, T. N., Sanderson, W. T., & Thornton, A. (2014). Impact of Poor Retention in HIV Medical Care on Time to Viral Load Suppression. Journal of the International Association of Providers of AIDS Care (JIAPAC), 13(3), 242--249. https://doi.org/10.1177/2325957413491431.

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Gardner, E. M., McLees, M. P., Steiner, J. F., Del Rio, C., & Burman, W. J. (2011). The spectrum of engagement in HIV care and its relevance to test-and-treat strategies for prevention of HIV infection. Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America, 52(6), 793--800. https://doi.org/10.1093/cid/ciq243.

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Giordano, T. P., Gifford, A. L., White, A. C., Suarez-Almazor, M. E., Rabeneck, L., Hartman, C., Backus, L. I., Mole, L. A., & Morgan, R. O. (2007). Retention in care: A challenge to survival with HIV infection. Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America, 44(11), 1493-1499. https://doi.org/10.1086/516778.

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Giordano, T. P., White, A. C., Sajja, P., Graviss, E. A., Arduino, R. C., Adu-Oppong, A., Lahart, C. J., & Visnegarwala, F. (2003). Factors associated with the use of highly active antiretroviral therapy in patients newly entering care in an urban clinic. Journal of Acquired Immune Deficiency Syndromes (JAIDS), 32(4), 399-405. https://doi.org/10.1097/00126334-200304010-00009

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Mugavero, M. J., Lin, H.-Y., Willig, J. H., Westfall, A. O., Ulett, K. B., Routman, J. S., Abroms, S., Raper, J. L., Saag, M. S., & Allison, J. J. (2009). Missed visits and mortality among patients establishing initial outpatient HIV treatment. Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America, 48(2), 248--256. https://doi.org/10.1086/595705

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Panel on Antiretroviral Guidelines for Adults and Adolescents. "Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents with HIV." Washington, DC: U.S. Department of Health and Human Services, 2022. Available at https://clinicalinfo.hiv.gov/sites/default/files/guidelines/documents/adult-adolescent-arv/guidelines-adult-adolescent-arv.pdf Updated September 21, 2022. Accessed December 15, 2022.

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Citation\n \n \n \n

Thompson, M. A., Mugavero, M. J., Amico, K. R., Cargill, V. A., Chang, L. W., Gross, R., Orrell, C., Altice, F. L., Bangsberg, D. R., Bartlett, J. G., Beckwith, C. G., Dowshen, N., Gordon, C. M., Horn, T., Kumar, P., Scott, J. D., Stirratt, M. J., Remien, R. H., Simoni, J. M., & Nachega, J. B. (2012). Guidelines for improving entry into and retention in care and antiretroviral adherence for persons with HIV: evidence-based recommendations from an International Association of Physicians in AIDS Care panel. Annals of internal medicine, 156(11), 817-294. https://doi.org/10.7326/0003-4819-156-11-201206050-00419

\n
\n \n \n \n \n \n \n \n
DefinitionMonth: To maintain consistency from year to year, this measure defines one month as equal to 30 days, three months as equal to 90 days and eight months as equal to 240 days\n
Guidance (Usage)A patient would be included in the measure numerator if they have either two eligible encounters or one eligible encounter and one viral load test at least 90 days apart from each other. The encounter or encounters that cause a patient to be included in the numerator do not need to include the encounter that caused the patient to be included in the denominator.\n\nOnly patients with an eligible encounter in the first eight months are included in this measure to allow for sufficient time to complete a second eligible encounter or viral load laboratory within the 12-month measurement period and at least 90 days after the initial encounter.\n\nThis eCQM is a patient-based measure. This measure is to be submitted a minimum of once per measurement period for patients with a diagnosis of HIV during the first eight months of the measurement period.\n\nThis FHIR-based measure has been derived from the QDM-based measure CMS1157v2. Please refer to the HL7 QI-Core Implementation Guide (https://hl7.org/fhir/us/qicore/STU6/) for more information on QI-Core and mapping recommendations from QDM to QI-Core STU 6 (https://hl7.org/fhir/us/qicore/STU6/qdm-to-qicore.html).\n
Measure Group (Rate) (ID: Group_1)
Basisboolean
Scoring\n Proportion\n\n\n
Improvement Notation\n Increased score indicates improvement\n\n\n
Type\n Process\n\n\n
Initial Population\n \n ID: InitialPopulation_1\n
\n \n \n Description:\n

All patients, regardless of age, with a diagnosis of HIV during the first 240 days of the measurement period or before the measurement period who had at least one eligible encounter during the first 240 days of the measurement period\n

\n \n \n \n \n \n Criteria: Initial Population \n \n \n \n \n \n \n
Denominator\n \n ID: Denominator_1\n
\n \n \n Description:\n

Equals Initial Population\n

\n \n \n \n \n \n Criteria: Denominator \n \n \n \n \n \n \n
Numerator\n \n ID: Numerator_1\n
\n \n \n Description:\n

Number of patients who had at least one eligible encounter and one HIV viral load test at least 90 days apart during the measurement period, or who had at least two eligible encounters at least 90 days apart during the measurement period\n

\n \n \n \n \n \n Criteria: Numerator \n \n \n \n \n \n \n
\n\n\n\n<p>For every patient evaluated by this measure also identify payer, race, ethnicity and sex</p>
Supplemental Data Elements
Supplemental Data Element\n \n ID: sde-ethnicity\n \n
\n \n \n \n \n \n Usage Code: Supplemental Data\n \n
\n \n \n \n Description: SDE Ethnicity\n\n \n \n \n
\n \n \n Logic Definition: SDE Ethnicity \n \n \n \n
Supplemental Data Element\n \n ID: sde-payer\n \n
\n \n \n \n \n \n Usage Code: Supplemental Data\n \n
\n \n \n \n Description: SDE Payer\n\n \n \n \n
\n \n \n Logic Definition: SDE Payer \n \n \n \n
Supplemental Data Element\n \n ID: sde-race\n \n
\n \n \n \n \n \n Usage Code: Supplemental Data\n \n
\n \n \n \n Description: SDE Race\n\n \n \n \n
\n \n \n Logic Definition: SDE Race \n \n \n \n
Supplemental Data Element\n \n ID: sde-sex\n \n
\n \n \n \n \n \n Usage Code: Supplemental Data\n \n
\n \n \n \n Description: SDE Sex\n\n \n \n \n
\n \n \n Logic Definition: SDE Sex \n \n \n \n
Measure Logic
Primary Libraryhttps://madie.cms.gov/Library/CMS1157FHIRHIVRetention
Contents\n Population Criteria\n
\n Logic Definitions\n
\n Terminology\n
\n Dependencies\n
\n Data Requirements\n
\n Parameters\n
\n
Population Criteria
Measure Group (Rate) (ID: Group_1)
\n \n Initial Population\n \n
\n \n \n \n \n \n \n \n 
define "Initial Population":\n  "Has Active HIV Diagnosis Starts On or Before First 240 Days of Measurement Period"\n    and "Has Qualifying Encounter During First 240 Days of Measurement Period"
\n \n \n Definition\n \n
\n \n Denominator\n \n
\n \n \n \n \n \n \n \n 
define "Denominator":\n  "Initial Population"
\n \n \n Definition\n \n
\n \n Numerator\n \n
\n \n \n \n \n \n \n \n 
define "Numerator":\n  "Has One Encounter With HIV and One Viral Load Test At Least 90 Days Apart"\n    or "Has Two Encounters With HIV At Least 90 Days Apart"
\n \n \n Definition\n \n
Logic Definitions
\n Logic Definition\n Library Name: SupplementalDataElements
\n \n \n \n \n \n \n 
define "SDE Sex":\n  case\n    when Patient.sex() = '248153007' then "Male (finding)"\n    when Patient.sex() = '248152002' then "Female (finding)"\n    else null\n  end
\n
\n Logic Definition\n Library Name: SupplementalDataElements
\n \n \n \n \n \n \n 
define "SDE Payer":\n  [USQualityCore.Coverage: type in "Payer Type"] Payer\n    return {\n      code: Payer.type,\n      period: Payer.period\n    }
\n
\n Logic Definition\n Library Name: SupplementalDataElements
\n \n \n \n \n \n \n 
define "SDE Ethnicity":\n  (Patient.ethnicity()) E\n    return Tuple {\n      codes: { E.ombCategory } union E.detailed,\n      display: E.text\n    }
\n
\n Logic Definition\n Library Name: SupplementalDataElements
\n \n \n \n \n \n \n 
define "SDE Race":\n  (Patient.race()) R\n    return Tuple {\n      codes: R.ombCategory union R.detailed,\n      display: R.text\n    }
\n
\n Logic Definition\n Library Name: CMS1157FHIRHIVRetention
\n \n \n \n \n \n \n 
define "SDE Sex":\n  SDE."SDE Sex"
\n
\n Logic Definition\n Library Name: CMS1157FHIRHIVRetention
\n \n \n \n \n \n \n 
define "Encounter During Measurement Period With HIV":\n  ( ( ["Encounter": "Office Visit"]\n      union ["Encounter": "Outpatient Consultation"]\n      union ["Encounter": "Annual Wellness Visit"]\n      union ["Encounter": "Face-to-Face Interaction"]\n      union ["Encounter": "Home Healthcare Services"]\n      union ["Encounter": "Preventive Care Services Established Office Visit, 18 and Up"]\n      union ["Encounter": "Preventive Care Services Initial Office Visit, 18 and Up"]\n      union ["Encounter": "Preventive Care Services, Initial Office Visit, 0 to 17"]\n      union ["Encounter": "Preventive Care, Established Office Visit, 0 to 17"]\n      union ["Encounter": "Telephone Visits"]\n      union ["Encounter": "Preventive Care Services Other"] ) ValidEncounter\n      with ( ["ConditionProblemsHealthConcerns": "HIV"]\n        union ["ConditionEncounterDiagnosis": "HIV"] ) HIVDiagnosis\n        such that ValidEncounter.period during day of "Measurement Period"\n          and ValidEncounter.status = 'finished'\n          and HIVDiagnosis.onset.toInterval ( ) starts on or before day of start of ValidEncounter.period\n          and HIVDiagnosis.isVerified ( )\n  )
\n
\n Logic Definition\n Library Name: CMS1157FHIRHIVRetention
\n \n \n \n \n \n \n 
define "Has One Encounter With HIV and One Viral Load Test At Least 90 Days Apart":\n  exists ( "Encounter During Measurement Period With HIV" ) EncounterWithHIV\n    with ["LaboratoryResultObservation": "HIV Viral Load Tests"] ViralLoadTest\n      such that ViralLoadTest.status in { 'final', 'amended', 'corrected' }\n        and ViralLoadTest.effective.toInterval ( ) during day of "Measurement Period"\n        and ( ( ViralLoadTest.effective.toInterval ( ) starts 90 days or more after day of end of EncounterWithHIV.period )\n            or ( EncounterWithHIV.period starts 90 days or more after day of end of ViralLoadTest.effective.toInterval ( ) )\n        )
\n
\n Logic Definition\n Library Name: CMS1157FHIRHIVRetention
\n \n \n \n \n \n \n 
define "Has Two Encounters With HIV At Least 90 Days Apart":\n  exists "Encounter During Measurement Period With HIV" EncounterWithHIV\n    with "Encounter During Measurement Period With HIV" AnotherEncounterWithHIV\n      such that EncounterWithHIV !~ AnotherEncounterWithHIV\n        and AnotherEncounterWithHIV.period starts 90 days or more after day of end of EncounterWithHIV.period
\n
\n Logic Definition\n Library Name: CMS1157FHIRHIVRetention
\n \n \n \n \n \n \n 
define "Numerator":\n  "Has One Encounter With HIV and One Viral Load Test At Least 90 Days Apart"\n    or "Has Two Encounters With HIV At Least 90 Days Apart"
\n
\n Logic Definition\n Library Name: CMS1157FHIRHIVRetention
\n \n \n \n \n \n \n 
define "Has Active HIV Diagnosis Starts On or Before First 240 Days of Measurement Period":\n  exists ( ( ["ConditionProblemsHealthConcerns": "HIV"]\n      union ["ConditionEncounterDiagnosis": "HIV"] ) HIVDx\n      where HIVDx.onset.toInterval ( ) starts on or before day of ( start of "Measurement Period" + 240 days )\n        and HIVDx.isVerified ( )\n  )
\n
\n Logic Definition\n Library Name: CMS1157FHIRHIVRetention
\n \n \n \n \n \n \n 
define "Has Qualifying Encounter During First 240 Days of Measurement Period":\n  exists ( ["Encounter": "Office Visit"]\n    union ["Encounter": "Outpatient Consultation"]\n    union ["Encounter": "Annual Wellness Visit"]\n    union ["Encounter": "Face-to-Face Interaction"]\n    union ["Encounter": "Home Healthcare Services"]\n    union ["Encounter": "Preventive Care Services Established Office Visit, 18 and Up"]\n    union ["Encounter": "Preventive Care Services Initial Office Visit, 18 and Up"]\n    union ["Encounter": "Preventive Care Services, Initial Office Visit, 0 to 17"]\n    union ["Encounter": "Preventive Care, Established Office Visit, 0 to 17"]\n    union ["Encounter": "Telephone Visits"]\n    union ["Encounter": "Preventive Care Services Other"] ) QualifyingEncounter\n    where QualifyingEncounter.period during day of Interval[start of "Measurement Period", start of "Measurement Period" + 240 days]
\n
\n Logic Definition\n Library Name: CMS1157FHIRHIVRetention
\n \n \n \n \n \n \n 
define "Initial Population":\n  "Has Active HIV Diagnosis Starts On or Before First 240 Days of Measurement Period"\n    and "Has Qualifying Encounter During First 240 Days of Measurement Period"
\n
\n Logic Definition\n Library Name: CMS1157FHIRHIVRetention
\n \n \n \n \n \n \n 
define "Denominator":\n  "Initial Population"
\n
\n Logic Definition\n Library Name: CMS1157FHIRHIVRetention
\n \n \n \n \n \n \n 
define "SDE Payer":\n  SDE."SDE Payer"
\n
\n Logic Definition\n Library Name: CMS1157FHIRHIVRetention
\n \n \n \n \n \n \n 
define "SDE Ethnicity":\n  SDE."SDE Ethnicity"
\n
\n Logic Definition\n Library Name: CMS1157FHIRHIVRetention
\n \n \n \n \n \n \n 
define "SDE Race":\n  SDE."SDE Race"
\n
\n Logic Definition\n Library Name: CMS1157FHIRHIVRetention
\n \n \n \n \n \n \n 
define fluent function isVerified(condition Choice<ConditionProblemsHealthConcerns, ConditionEncounterDiagnosis>):\n  condition.verificationStatus is not null implies ( condition.verificationStatus ~ Status."confirmed"\n      or condition.verificationStatus ~ Status."unconfirmed"\n      or condition.verificationStatus ~ Status."provisional"\n      or condition.verificationStatus ~ Status."differential"\n  )
\n
\n Logic Definition\n Library Name: FHIRHelpers
\n \n \n \n \n \n \n 
define function ToString(value string): value.value
\n
\n Logic Definition\n Library Name: FHIRHelpers
\n \n \n \n \n \n \n 
define function ToString(value uri): value.value
\n
\n Logic Definition\n Library Name: FHIRHelpers
\n \n \n \n \n \n \n 
/*\n@description: Converts the given [Period](https://hl7.org/fhir/datatypes.html#Period)\nvalue to a CQL DateTime Interval\n@comment: If the start value of the given period is unspecified, the starting\nboundary of the resulting interval will be open (meaning the start of the interval\nis unknown, as opposed to interpreted as the beginning of time).\n*/\ndefine function ToInterval(period FHIR.Period):\n    if period is null then\n        null\n    else\n        if period."start" is null then\n            Interval(period."start".value, period."end".value]\n        else\n            Interval[period."start".value, period."end".value]
\n
\n Logic Definition\n Library Name: FHIRHelpers
\n \n \n \n \n \n \n 
define function ToString(value EncounterStatus): value.value
\n
\n Logic Definition\n Library Name: FHIRHelpers
\n \n \n \n \n \n \n 
define function ToDateTime(value dateTime): value.value
\n
\n Logic Definition\n Library Name: FHIRHelpers
\n \n \n \n \n \n \n 
define function ToDateTime(value instant): value.value
\n
\n Logic Definition\n Library Name: FHIRHelpers
\n \n \n \n \n \n \n 
define function ToDate(value date): value.value
\n
\n Logic Definition\n Library Name: FHIRHelpers
\n \n \n \n \n \n \n 
/*\n@description: Converts the given FHIR [Quantity](https://hl7.org/fhir/datatypes.html#Quantity) \nvalue to a CQL Quantity\n@comment: If the given quantity has a comparator specified, a runtime error is raised. If the given quantity\nhas a system other than UCUM (i.e. `http://unitsofmeasure.org`) or CQL calendar units (i.e. `http://hl7.org/fhirpath/CodeSystem/calendar-units`)\nan error is raised. For UCUM to calendar units, the `ToCalendarUnit` function is used.\n@seealso: ToCalendarUnit\n*/\ndefine function ToQuantity(quantity FHIR.Quantity):\n    case\n        when quantity is null then null\n        when quantity.value is null then null\n        when quantity.comparator is not null then\n            Message(null, true, 'FHIRHelpers.ToQuantity.ComparatorQuantityNotSupported', 'Error', 'FHIR Quantity value has a comparator and cannot be converted to a System.Quantity value.')\n        when quantity.system is null or quantity.system.value = 'http://unitsofmeasure.org'\n              or quantity.system.value = 'http://hl7.org/fhirpath/CodeSystem/calendar-units' then\n            System.Quantity { value: quantity.value.value, unit: ToCalendarUnit(Coalesce(quantity.code.value, quantity.unit.value, '1')) }\n        else\n            Message(null, true, 'FHIRHelpers.ToQuantity.InvalidFHIRQuantity', 'Error', 'Invalid FHIR Quantity code: ' & quantity.unit.value & ' (' & quantity.system.value & '|' & quantity.code.value & ')')\n    end
\n
\n Logic Definition\n Library Name: FHIRHelpers
\n \n \n \n \n \n \n 
/*\n@description: Converts a UCUM definite duration unit to a CQL calendar duration\nunit using conversions specified in the [quantities](https://cql.hl7.org/02-authorsguide.html#quantities) \ntopic of the CQL specification.\n@comment: Note that for durations above days (or weeks), the conversion is understood to be approximate\n*/\ndefine function ToCalendarUnit(unit System.String):\n    case unit\n        when 'ms' then 'millisecond'\n        when 's' then 'second'\n        when 'min' then 'minute'\n        when 'h' then 'hour'\n        when 'd' then 'day'\n        when 'wk' then 'week'\n        when 'mo' then 'month'\n        when 'a' then 'year'\n        else unit\n    end
\n
\n Logic Definition\n Library Name: FHIRHelpers
\n \n \n \n \n \n \n 
/*\n@description: Converts the given FHIR [CodeableConcept](https://hl7.org/fhir/datatypes.html#CodeableConcept) value to a CQL Concept.\n*/\ndefine function ToConcept(concept FHIR.CodeableConcept):\n    if concept is null then\n        null\n    else\n        System.Concept {\n            codes: concept.coding C return ToCode(C),\n            display: concept.text.value\n        }
\n
\n Logic Definition\n Library Name: FHIRHelpers
\n \n \n \n \n \n \n 
/*\n@description: Converts the given FHIR [Coding](https://hl7.org/fhir/datatypes.html#Coding) value to a CQL Code.\n*/\ndefine function ToCode(coding FHIR.Coding):\n    if coding is null then\n        null\n    else\n        System.Code {\n          code: coding.code.value,\n          system: coding.system.value,\n          version: coding.version.value,\n          display: coding.display.value\n        }
\n
\n Logic Definition\n Library Name: FHIRHelpers
\n \n \n \n \n \n \n 
define function ToString(value ObservationStatus): value.value
\n
\n Logic Definition\n Library Name: FHIRCommon
\n \n \n \n \n \n \n 
/*\n@description: Returns the single extension (if present) on the given resource with the specified url.\n@comment: This function uses singleton from to ensure that a run-time exception is thrown if there\nis more than one extension on the given resource with the specified url.\n*/\ndefine fluent function ext(domainResource DomainResource, url String):\n  singleton from domainResource.exts(url)
\n
\n Logic Definition\n Library Name: FHIRCommon
\n \n \n \n \n \n \n 
/*\n@description: Returns any extensions defined on the given resource with the specified url\n*/\ndefine fluent function exts(domainResource DomainResource, url String):\n  domainResource.extension E\n    where E.url = url\n    return E
\n
\n Logic Definition\n Library Name: FHIRCommon
\n \n \n \n \n \n \n 
/*\n@description: Normalizes a value that is a choice of timing-valued types to an equivalent interval\n@comment: Normalizes a choice type of FHIR.dateTime, FHIR.Period, FHIR.Timing, FHIR.instance, FHIR.string, FHIR.Age, or FHIR.Range types\nto an equivalent interval. This selection of choice types is a superset of the majority of choice types that are used as possible\nrepresentations for timing-valued elements in FHIR, allowing this function to be used across any resource.\n\nThe input can be provided as a dateTime, Period, Timing, instant, string, Age, or Range.\nThe intent of this function is to provide a clear and concise mechanism to treat single\nelements that have multiple possible representations as intervals so that logic doesn't have to account\nfor the variability. More complex calculations (such as medication request period or dispense period\ncalculation) need specific guidance and consideration. That guidance may make use of this function, but\nthe focus of this function is on single element calculations where the semantics are unambiguous.\nIf the input is a dateTime, the result a DateTime Interval beginning and ending on that dateTime.\nIf the input is a Period, the result is a DateTime Interval.\nIf the input is a Timing, an error is raised indicating a single interval cannot be computed from a Timing.\nIf the input is an instant, the result is a DateTime Interval beginning and ending on that instant.\nIf the input is a string, an error is raised indicating a single interval cannot be computed from a string.\nIf the input is an Age, the result is a DateTime Interval beginning when the patient was the given Age,\nand ending immediately prior to when the patient was the given Age plus one year.\nIf the input is a Range, the result is a DateTime Interval beginning when the patient was the Age given\nby the low end of the Range, and ending immediately prior to when the patient was the Age given by the\nhigh end of the Range plus one year.\n\nNOTE: Due to the\ncomplexity of determining a single interval from a Timing or String type, this function will throw a run-time exception if it is used\nwith a Timing or String.\n*/\ndefine fluent function toInterval(choice Choice<FHIR.dateTime, FHIR.Period, FHIR.Timing, FHIR.instant, FHIR.string, FHIR.Age, FHIR.Range>):\n  case\n    when choice is FHIR.dateTime then\n      Interval[FHIRHelpers.ToDateTime(choice as FHIR.dateTime), FHIRHelpers.ToDateTime(choice as FHIR.dateTime)]\n    when choice is FHIR.Period then\n      FHIRHelpers.ToInterval(choice as FHIR.Period)\n    when choice is FHIR.instant then\n      Interval[FHIRHelpers.ToDateTime(choice as FHIR.instant), FHIRHelpers.ToDateTime(choice as FHIR.instant)]\n    when choice is FHIR.Age then\n      Interval[FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(choice as FHIR.Age),\n        FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(choice as FHIR.Age) + 1 year)\n    when choice is FHIR.Range then\n      Interval[FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity((choice as FHIR.Range).low),\n        FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity((choice as FHIR.Range).high) + 1 year)\n    when choice is FHIR.Timing then\n      Message(null as Interval<DateTime>, true, 'NOT_IMPLEMENTED', 'Error', 'Calculation of an interval from a Timing value is not supported')\n    when choice is FHIR.string then\n      Message(null as Interval<DateTime>, true, 'NOT_IMPLEMENTED', 'Error', 'Calculation of an interval from a String value is not supported')\n    else\n      null as Interval<DateTime>\n  end
\n
\n Logic Definition\n Library Name: FHIRCommon
\n \n \n \n \n \n \n 
/*\n@description: Returns the single extension (if present) on the given element with the specified url.\n@comment: This function uses singleton from to ensure that a run-time exception is thrown if there\nis more than one extension on the given element with the specified url.\n*/\ndefine fluent function ext(element Element, url String):\n  singleton from element.exts(url)
\n
\n Logic Definition\n Library Name: FHIRCommon
\n \n \n \n \n \n \n 
/*\n@description: Returns any extensions defined on the given element with the specified url.\n*/\ndefine fluent function exts(element Element, url String):\n  element.extension E\n    where E.url = url\n    return E
\n
\n Logic Definition\n Library Name: USCoreCommon
\n \n \n \n \n \n \n 
/*\n@description: Returns the sex element as defined for the USCore patient profile\n*/\ndefine fluent function sex(patient Patient):\n  patient.ext('http://hl7.org/fhir/us/core/StructureDefinition/us-core-sex').value as FHIR.code
\n
\n Logic Definition\n Library Name: USCoreCommon
\n \n \n \n \n \n \n 
define fluent function ethnicity(patient Patient):\n  (patient.ext('http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity')) E\n    return {\n      ombCategory: E.ext('ombCategory').value as FHIR.Coding,\n      detailed: (E.exts('detailed')) d return d.value as FHIR.Coding,\n      text: E.ext('text').value as FHIR.string\n    }
\n
\n Logic Definition\n Library Name: USCoreCommon
\n \n \n \n \n \n \n 
define fluent function race(patient Patient):\n  (patient.ext('http://hl7.org/fhir/us/core/StructureDefinition/us-core-race')) E\n    return {\n      ombCategory: (E.exts('ombCategory')) o return o.value as FHIR.Coding,\n      detailed: (E.exts('detailed')) d return d.value as FHIR.Coding,\n      text: E.ext('text').value as FHIR.string\n    }
\n
Terminology
Code System\n \n Description: Code system SNOMEDCT\n \n
\n \n \n \n \n \n \n Resource: SNOMED CT (all versions)\n
\n Canonical URL: http://snomed.info/sct\n \n
Code System\n \n Description: Code system ConditionVerificationStatusCodes\n \n
\n \n \n \n \n \n \n Resource: ConditionVerificationStatus\n
\n Canonical URL: http://terminology.hl7.org/CodeSystem/condition-ver-status\n \n
Value Set\n \n Description: Value set Office Visit\n \n
\n \n \n \n \n \n \n Resource: Office Visit\n
\n Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001\n \n
Value Set\n \n Description: Value set Outpatient Consultation\n \n
\n \n \n \n \n \n \n Resource: Outpatient Consultation\n
\n Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1008\n \n
Value Set\n \n Description: Value set Annual Wellness Visit\n \n
\n \n \n \n \n \n \n Resource: Annual Wellness Visit\n
\n Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240\n \n
Value Set\n \n Description: Value set Face-to-Face Interaction\n \n
\n \n \n \n \n \n \n Resource: Face to Face Interaction\n
\n Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.375\n \n
Value Set\n \n Description: Value set Home Healthcare Services\n \n
\n \n \n \n \n \n \n Resource: Home Healthcare Services\n
\n Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016\n \n
Value Set\n \n Description: Value set Preventive Care Services Established Office Visit, 18 and Up\n \n
\n \n \n \n \n \n \n Resource: Preventive Care Services Established Office Visit, 18 and Up\n
\n Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025\n \n
Value Set\n \n Description: Value set Preventive Care Services Initial Office Visit, 18 and Up\n \n
\n \n \n \n \n \n \n Resource: Preventive Care Services Initial Office Visit, 18 and Up\n
\n Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023\n \n
Value Set\n \n Description: Value set Preventive Care Services, Initial Office Visit, 0 to 17\n \n
\n \n \n \n \n \n \n Resource: Preventive Care Services, Initial Office Visit, 0 to 17\n
\n Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1022\n \n
Value Set\n \n Description: Value set Preventive Care, Established Office Visit, 0 to 17\n \n
\n \n \n \n \n \n \n Resource: Preventive Care, Established Office Visit, 0 to 17\n
\n Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1024\n \n
Value Set\n \n Description: Value set Telephone Visits\n \n
\n \n \n \n \n \n \n Resource: Telephone Visits\n
\n Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1080\n \n
Value Set\n \n Description: Value set Preventive Care Services Other\n \n
\n \n \n \n \n \n \n Resource: Preventive Care Services Other\n
\n Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.11.1150\n \n
Value Set\n \n Description: Value set HIV\n \n
\n \n \n \n \n \n \n Resource: HIV\n
\n Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.120.12.1003\n \n
Value Set\n \n Description: Value set HIV Viral Load Tests\n \n
\n \n \n \n \n \n \n Resource: HIV Viral Load Tests\n
\n Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.377\n \n
Value Set\n \n Description: Value set Payer Type\n \n
\n \n \n \n \n \n \n Resource: Payer Type\n
\n Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591\n \n
Direct Reference Code\n \n Display: Male (finding)\n
\n \n Code: 248153007\n
\n System: http://snomed.info/sct\n
Direct Reference Code\n \n Display: Female (finding)\n
\n \n Code: 248152002\n
\n System: http://snomed.info/sct\n
Direct Reference Code\n \n Display: confirmed\n
\n \n Code: confirmed\n
\n System: http://terminology.hl7.org/CodeSystem/condition-ver-status\n
Direct Reference Code\n \n Display: unconfirmed\n
\n \n Code: unconfirmed\n
\n System: http://terminology.hl7.org/CodeSystem/condition-ver-status\n
Direct Reference Code\n \n Display: provisional\n
\n \n Code: provisional\n
\n System: http://terminology.hl7.org/CodeSystem/condition-ver-status\n
Direct Reference Code\n \n Display: differential\n
\n \n Code: differential\n
\n System: http://terminology.hl7.org/CodeSystem/condition-ver-status\n
Dependencies
Dependency\n \n Description: USQualityCore model information\n \n
\n \n \n \n \n \n \n Resource: https://madie.cms.gov/Library/USQualityCore-ModelInfo|0.1.0-cibuild\n
\n Canonical URL: https://madie.cms.gov/Library/USQualityCore-ModelInfo|0.1.0-cibuild\n \n
Dependency\n \n Description: USCore model information\n \n
\n \n \n \n \n \n \n Resource: http://hl7.org/fhir/us/cql/Library/USCore-ModelInfo|6.1.0-derived\n
\n Canonical URL: http://hl7.org/fhir/us/cql/Library/USCore-ModelInfo|6.1.0-derived\n \n
Dependency\n \n Description: FHIR model information\n \n
\n \n \n \n \n \n \n Resource: http://hl7.org/fhir/uv/cql/Library/FHIR-ModelInfo|4.0.1\n
\n Canonical URL: http://hl7.org/fhir/uv/cql/Library/FHIR-ModelInfo|4.0.1\n \n
Dependency\n \n Description: Library SDE\n \n
\n \n \n \n \n \n \n Resource: SupplementalDataElements version: 6.1.000\n
\n Canonical URL: https://madie.cms.gov/Library/SupplementalDataElements|6.1.000\n \n
Dependency\n \n Description: Library FHIRHelpers\n \n
\n \n \n \n \n \n \n Resource: http://hl7.org/fhir/uv/cql/Library/FHIRHelpers|4.0.1\n
\n Canonical URL: http://hl7.org/fhir/uv/cql/Library/FHIRHelpers|4.0.1\n \n
Dependency\n \n Description: Library USCommon\n \n
\n \n \n \n \n \n \n Resource: http://hl7.org/fhir/us/cql/Library/USCoreCommon|2.0.0-ballot\n
\n Canonical URL: http://hl7.org/fhir/us/cql/Library/USCoreCommon|2.0.0-ballot\n \n
Dependency\n \n Description: Library FHIRCommon\n \n
\n \n \n \n \n \n \n Resource: http://hl7.org/fhir/uv/cql/Library/FHIRCommon|2.0.0\n
\n Canonical URL: http://hl7.org/fhir/uv/cql/Library/FHIRCommon|2.0.0\n \n
Dependency\n \n Description: Library Status\n \n
\n \n \n \n \n \n \n Resource: Status version: 2.1.000\n
\n Canonical URL: https://madie.cms.gov/Library/Status|2.1.000\n \n
Data Requirements
Data Requirement\n Type: Patient\n
\n \n Profile(s): \n \n http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-patient\n
\n \n \n \n Must Support Elements: ombCategory, detailed, text\n
\n \n \n
Data Requirement\n Type: Patient\n
\n \n Profile(s): \n \n Patient\n
\n \n \n \n Must Support Elements: birthDate\n
\n \n \n
Data Requirement\n Type: Encounter\n
\n \n Profile(s): \n \n Encounter\n
\n \n \n \n Must Support Elements: type, period, status\n
\n \n \n Code Filter(s): \n
\n \n \n Path: type\n
\n \n \n \n ValueSet: Office Visit\n
\n \n \n \n \n
Data Requirement\n Type: Encounter\n
\n \n Profile(s): \n \n Encounter\n
\n \n \n \n Must Support Elements: type, period, status\n
\n \n \n Code Filter(s): \n
\n \n \n Path: type\n
\n \n \n \n ValueSet: Outpatient Consultation\n
\n \n \n \n \n
Data Requirement\n Type: Encounter\n
\n \n Profile(s): \n \n Encounter\n
\n \n \n \n Must Support Elements: type, period, status\n
\n \n \n Code Filter(s): \n
\n \n \n Path: type\n
\n \n \n \n ValueSet: Annual Wellness Visit\n
\n \n \n \n \n
Data Requirement\n Type: Encounter\n
\n \n Profile(s): \n \n Encounter\n
\n \n \n \n Must Support Elements: type, period, status\n
\n \n \n Code Filter(s): \n
\n \n \n Path: type\n
\n \n \n \n ValueSet: Face to Face Interaction\n
\n \n \n \n \n
Data Requirement\n Type: Encounter\n
\n \n Profile(s): \n \n Encounter\n
\n \n \n \n Must Support Elements: type, period, status\n
\n \n \n Code Filter(s): \n
\n \n \n Path: type\n
\n \n \n \n ValueSet: Home Healthcare Services\n
\n \n \n \n \n
Data Requirement\n Type: Encounter\n
\n \n Profile(s): \n \n Encounter\n
\n \n \n \n Must Support Elements: type, period, status\n
\n \n \n Code Filter(s): \n
\n \n \n Path: type\n
\n \n \n \n ValueSet: Preventive Care Services Established Office Visit, 18 and Up\n
\n \n \n \n \n
Data Requirement\n Type: Encounter\n
\n \n Profile(s): \n \n Encounter\n
\n \n \n \n Must Support Elements: type, period, status\n
\n \n \n Code Filter(s): \n
\n \n \n Path: type\n
\n \n \n \n ValueSet: Preventive Care Services Initial Office Visit, 18 and Up\n
\n \n \n \n \n
Data Requirement\n Type: Encounter\n
\n \n Profile(s): \n \n Encounter\n
\n \n \n \n Must Support Elements: type, period, status\n
\n \n \n Code Filter(s): \n
\n \n \n Path: type\n
\n \n \n \n ValueSet: Preventive Care Services, Initial Office Visit, 0 to 17\n
\n \n \n \n \n
Data Requirement\n Type: Encounter\n
\n \n Profile(s): \n \n Encounter\n
\n \n \n \n Must Support Elements: type, period, status\n
\n \n \n Code Filter(s): \n
\n \n \n Path: type\n
\n \n \n \n ValueSet: Preventive Care, Established Office Visit, 0 to 17\n
\n \n \n \n \n
Data Requirement\n Type: Encounter\n
\n \n Profile(s): \n \n Encounter\n
\n \n \n \n Must Support Elements: type, period, status\n
\n \n \n Code Filter(s): \n
\n \n \n Path: type\n
\n \n \n \n ValueSet: Telephone Visits\n
\n \n \n \n \n
Data Requirement\n Type: Encounter\n
\n \n Profile(s): \n \n Encounter\n
\n \n \n \n Must Support Elements: type, period, status\n
\n \n \n Code Filter(s): \n
\n \n \n Path: type\n
\n \n \n \n ValueSet: Preventive Care Services Other\n
\n \n \n \n \n
Data Requirement\n Type: Condition\n
\n \n Profile(s): \n \n http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-condition-problems-health-concerns\n
\n \n \n \n Must Support Elements: code\n
\n \n \n Code Filter(s): \n
\n \n \n Path: code\n
\n \n \n \n ValueSet: HIV\n
\n \n \n \n \n
Data Requirement\n Type: Condition\n
\n \n Profile(s): \n \n http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-condition-encounter-diagnosis\n
\n \n \n \n Must Support Elements: code\n
\n \n \n Code Filter(s): \n
\n \n \n Path: code\n
\n \n \n \n ValueSet: HIV\n
\n \n \n \n \n
Data Requirement\n Type: Observation\n
\n \n Profile(s): \n \n http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-observation-lab\n
\n \n \n \n Must Support Elements: code, status, effective\n
\n \n \n Code Filter(s): \n
\n \n \n Path: code\n
\n \n \n \n ValueSet: HIV Viral Load Tests\n
\n \n \n \n \n
Data Requirement\n Type: Coverage\n
\n \n Profile(s): \n \n http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-coverage\n
\n \n \n \n Must Support Elements: type, period\n
\n \n \n Code Filter(s): \n
\n \n \n Path: type\n
\n \n \n \n ValueSet: Payer Type\n
\n \n \n \n \n
Parameters
\n\n\n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n
NameUseCard.TypeDocumentation
Measurement PeriodIn0..1Period\n
SDE SexOut0..1Coding\n
NumeratorOut0..1boolean\n
DenominatorOut0..1boolean\n
SDE PayerOut0..*Resource\n
Initial PopulationOut0..1boolean\n
SDE EthnicityOut0..1Resource\n
SDE RaceOut0..1Resource\n
\n
Generated using version 0.5.4 of the sample-content-ig Liquid templates
\n
" }, "contained" : [{ "resourceType" : "Library", "id" : "effective-data-requirements", "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode", "valueCoding" : { "system" : "http://snomed.info/sct", "code" : "248153007", "display" : "Male (finding)" } }, { "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode", "valueCoding" : { "system" : "http://snomed.info/sct", "code" : "248152002", "display" : "Female (finding)" } }, { "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode", "valueCoding" : { "system" : "http://terminology.hl7.org/CodeSystem/condition-ver-status", "code" : "confirmed", "display" : "confirmed" } }, { "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode", "valueCoding" : { "system" : "http://terminology.hl7.org/CodeSystem/condition-ver-status", "code" : "unconfirmed", "display" : "unconfirmed" } }, { "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode", "valueCoding" : { "system" : "http://terminology.hl7.org/CodeSystem/condition-ver-status", "code" : "provisional", "display" : "provisional" } }, { "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode", "valueCoding" : { "system" : "http://terminology.hl7.org/CodeSystem/condition-ver-status", "code" : "differential", "display" : "differential" } }, { "extension" : [{ "url" : "libraryName", "valueString" : "SupplementalDataElements" }, { "url" : "name", "valueString" : "SDE Sex" }, { "url" : "statement", "valueString" : "define \"SDE Sex\":\n case\n when Patient.sex() = '248153007' then \"Male (finding)\"\n when Patient.sex() = '248152002' then \"Female (finding)\"\n else null\n end" }, { "url" : "displaySequence", "valueInteger" : 0 }], "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "CMS1157FHIRHIVRetention" }, { "url" : "name", "valueString" : "SDE Sex" }, { "url" : "statement", "valueString" : "define \"SDE Sex\":\n SDE.\"SDE Sex\"" }, { "url" : "displaySequence", "valueInteger" : 1 }], "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "CMS1157FHIRHIVRetention" }, { "url" : "name", "valueString" : "Encounter During Measurement Period With HIV" }, { "url" : "statement", "valueString" : "define \"Encounter During Measurement Period With HIV\":\n ( ( [\"Encounter\": \"Office Visit\"]\n union [\"Encounter\": \"Outpatient Consultation\"]\n union [\"Encounter\": \"Annual Wellness Visit\"]\n union [\"Encounter\": \"Face-to-Face Interaction\"]\n union [\"Encounter\": \"Home Healthcare Services\"]\n union [\"Encounter\": \"Preventive Care Services Established Office Visit, 18 and Up\"]\n union [\"Encounter\": \"Preventive Care Services Initial Office Visit, 18 and Up\"]\n union [\"Encounter\": \"Preventive Care Services, Initial Office Visit, 0 to 17\"]\n union [\"Encounter\": \"Preventive Care, Established Office Visit, 0 to 17\"]\n union [\"Encounter\": \"Telephone Visits\"]\n union [\"Encounter\": \"Preventive Care Services Other\"] ) ValidEncounter\n with ( [\"ConditionProblemsHealthConcerns\": \"HIV\"]\n union [\"ConditionEncounterDiagnosis\": \"HIV\"] ) HIVDiagnosis\n such that ValidEncounter.period during day of \"Measurement Period\"\n and ValidEncounter.status = 'finished'\n and HIVDiagnosis.onset.toInterval ( ) starts on or before day of start of ValidEncounter.period\n and HIVDiagnosis.isVerified ( )\n )" }, { "url" : "displaySequence", "valueInteger" : 2 }], "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "CMS1157FHIRHIVRetention" }, { "url" : "name", "valueString" : "Has One Encounter With HIV and One Viral Load Test At Least 90 Days Apart" }, { "url" : "statement", "valueString" : "define \"Has One Encounter With HIV and One Viral Load Test At Least 90 Days Apart\":\n exists ( \"Encounter During Measurement Period With HIV\" ) EncounterWithHIV\n with [\"LaboratoryResultObservation\": \"HIV Viral Load Tests\"] ViralLoadTest\n such that ViralLoadTest.status in { 'final', 'amended', 'corrected' }\n and ViralLoadTest.effective.toInterval ( ) during day of \"Measurement Period\"\n and ( ( ViralLoadTest.effective.toInterval ( ) starts 90 days or more after day of end of EncounterWithHIV.period )\n or ( EncounterWithHIV.period starts 90 days or more after day of end of ViralLoadTest.effective.toInterval ( ) )\n )" }, { "url" : "displaySequence", "valueInteger" : 3 }], "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "CMS1157FHIRHIVRetention" }, { "url" : "name", "valueString" : "Has Two Encounters With HIV At Least 90 Days Apart" }, { "url" : "statement", "valueString" : "define \"Has Two Encounters With HIV At Least 90 Days Apart\":\n exists \"Encounter During Measurement Period With HIV\" EncounterWithHIV\n with \"Encounter During Measurement Period With HIV\" AnotherEncounterWithHIV\n such that EncounterWithHIV !~ AnotherEncounterWithHIV\n and AnotherEncounterWithHIV.period starts 90 days or more after day of end of EncounterWithHIV.period" }, { "url" : "displaySequence", "valueInteger" : 4 }], "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "CMS1157FHIRHIVRetention" }, { "url" : "name", "valueString" : "Numerator" }, { "url" : "statement", "valueString" : "define \"Numerator\":\n \"Has One Encounter With HIV and One Viral Load Test At Least 90 Days Apart\"\n or \"Has Two Encounters With HIV At Least 90 Days Apart\"" }, { "url" : "displaySequence", "valueInteger" : 5 }], "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "CMS1157FHIRHIVRetention" }, { "url" : "name", "valueString" : "Has Active HIV Diagnosis Starts On or Before First 240 Days of Measurement Period" }, { "url" : "statement", "valueString" : "define \"Has Active HIV Diagnosis Starts On or Before First 240 Days of Measurement Period\":\n exists ( ( [\"ConditionProblemsHealthConcerns\": \"HIV\"]\n union [\"ConditionEncounterDiagnosis\": \"HIV\"] ) HIVDx\n where HIVDx.onset.toInterval ( ) starts on or before day of ( start of \"Measurement Period\" + 240 days )\n and HIVDx.isVerified ( )\n )" }, { "url" : "displaySequence", "valueInteger" : 6 }], "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "CMS1157FHIRHIVRetention" }, { "url" : "name", "valueString" : "Has Qualifying Encounter During First 240 Days of Measurement Period" }, { "url" : "statement", "valueString" : "define \"Has Qualifying Encounter During First 240 Days of Measurement Period\":\n exists ( [\"Encounter\": \"Office Visit\"]\n union [\"Encounter\": \"Outpatient Consultation\"]\n union [\"Encounter\": \"Annual Wellness Visit\"]\n union [\"Encounter\": \"Face-to-Face Interaction\"]\n union [\"Encounter\": \"Home Healthcare Services\"]\n union [\"Encounter\": \"Preventive Care Services Established Office Visit, 18 and Up\"]\n union [\"Encounter\": \"Preventive Care Services Initial Office Visit, 18 and Up\"]\n union [\"Encounter\": \"Preventive Care Services, Initial Office Visit, 0 to 17\"]\n union [\"Encounter\": \"Preventive Care, Established Office Visit, 0 to 17\"]\n union [\"Encounter\": \"Telephone Visits\"]\n union [\"Encounter\": \"Preventive Care Services Other\"] ) QualifyingEncounter\n where QualifyingEncounter.period during day of Interval[start of \"Measurement Period\", start of \"Measurement Period\" + 240 days]" }, { "url" : "displaySequence", "valueInteger" : 7 }], "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "CMS1157FHIRHIVRetention" }, { "url" : "name", "valueString" : "Initial Population" }, { "url" : "statement", "valueString" : "define \"Initial Population\":\n \"Has Active HIV Diagnosis Starts On or Before First 240 Days of Measurement Period\"\n and \"Has Qualifying Encounter During First 240 Days of Measurement Period\"" }, { "url" : "displaySequence", "valueInteger" : 8 }], "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "CMS1157FHIRHIVRetention" }, { "url" : "name", "valueString" : "Denominator" }, { "url" : "statement", "valueString" : "define \"Denominator\":\n \"Initial Population\"" }, { "url" : "displaySequence", "valueInteger" : 9 }], "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "SupplementalDataElements" }, { "url" : "name", "valueString" : "SDE Payer" }, { "url" : "statement", "valueString" : "define \"SDE Payer\":\n [USQualityCore.Coverage: type in \"Payer Type\"] Payer\n return {\n code: Payer.type,\n period: Payer.period\n }" }, { "url" : "displaySequence", "valueInteger" : 10 }], "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "CMS1157FHIRHIVRetention" }, { "url" : "name", "valueString" : "SDE Payer" }, { "url" : "statement", "valueString" : "define \"SDE Payer\":\n SDE.\"SDE Payer\"" }, { "url" : "displaySequence", "valueInteger" : 11 }], "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "SupplementalDataElements" }, { "url" : "name", "valueString" : "SDE Ethnicity" }, { "url" : "statement", "valueString" : "define \"SDE Ethnicity\":\n (Patient.ethnicity()) E\n return Tuple {\n codes: { E.ombCategory } union E.detailed,\n display: E.text\n }" }, { "url" : "displaySequence", "valueInteger" : 12 }], "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "CMS1157FHIRHIVRetention" }, { "url" : "name", "valueString" : "SDE Ethnicity" }, { "url" : "statement", "valueString" : "define \"SDE Ethnicity\":\n SDE.\"SDE Ethnicity\"" }, { "url" : "displaySequence", "valueInteger" : 13 }], "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "SupplementalDataElements" }, { "url" : "name", "valueString" : "SDE Race" }, { "url" : "statement", "valueString" : "define \"SDE Race\":\n (Patient.race()) R\n return Tuple {\n codes: R.ombCategory union R.detailed,\n display: R.text\n }" }, { "url" : "displaySequence", "valueInteger" : 14 }], "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "CMS1157FHIRHIVRetention" }, { "url" : "name", "valueString" : "SDE Race" }, { "url" : "statement", "valueString" : "define \"SDE Race\":\n SDE.\"SDE Race\"" }, { "url" : "displaySequence", "valueInteger" : 15 }], "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "FHIRHelpers" }, { "url" : "name", "valueString" : "ToString" }, { "url" : "statement", "valueString" : "define function ToString(value string): value.value" }, { "url" : "displaySequence", "valueInteger" : 16 }], "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "USCoreCommon" }, { "url" : "name", "valueString" : "sex" }, { "url" : "statement", "valueString" : "/*\n@description: Returns the sex element as defined for the USCore patient profile\n*/\ndefine fluent function sex(patient Patient):\n patient.ext('http://hl7.org/fhir/us/core/StructureDefinition/us-core-sex').value as FHIR.code" }, { "url" : "displaySequence", "valueInteger" : 17 }], "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "FHIRCommon" }, { "url" : "name", "valueString" : "ext" }, { "url" : "statement", "valueString" : "/*\n@description: Returns the single extension (if present) on the given resource with the specified url.\n@comment: This function uses singleton from to ensure that a run-time exception is thrown if there\nis more than one extension on the given resource with the specified url.\n*/\ndefine fluent function ext(domainResource DomainResource, url String):\n singleton from domainResource.exts(url)" }, { "url" : "displaySequence", "valueInteger" : 18 }], "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "FHIRCommon" }, { "url" : "name", "valueString" : "exts" }, { "url" : "statement", "valueString" : "/*\n@description: Returns any extensions defined on the given resource with the specified url\n*/\ndefine fluent function exts(domainResource DomainResource, url String):\n domainResource.extension E\n where E.url = url\n return E" }, { "url" : "displaySequence", "valueInteger" : 19 }], "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "FHIRHelpers" }, { "url" : "name", "valueString" : "ToString" }, { "url" : "statement", "valueString" : "define function ToString(value uri): value.value" }, { "url" : "displaySequence", "valueInteger" : 20 }], "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "FHIRHelpers" }, { "url" : "name", "valueString" : "ToInterval" }, { "url" : "statement", "valueString" : "/*\n@description: Converts the given [Period](https://hl7.org/fhir/datatypes.html#Period)\nvalue to a CQL DateTime Interval\n@comment: If the start value of the given period is unspecified, the starting\nboundary of the resulting interval will be open (meaning the start of the interval\nis unknown, as opposed to interpreted as the beginning of time).\n*/\ndefine function ToInterval(period FHIR.Period):\n if period is null then\n null\n else\n if period.\"start\" is null then\n Interval(period.\"start\".value, period.\"end\".value]\n else\n Interval[period.\"start\".value, period.\"end\".value]" }, { "url" : "displaySequence", "valueInteger" : 21 }], "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "FHIRHelpers" }, { "url" : "name", "valueString" : "ToString" }, { "url" : "statement", "valueString" : "define function ToString(value EncounterStatus): value.value" }, { "url" : "displaySequence", "valueInteger" : 22 }], "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "FHIRCommon" }, { "url" : "name", "valueString" : "toInterval" }, { "url" : "statement", "valueString" : "/*\n@description: Normalizes a value that is a choice of timing-valued types to an equivalent interval\n@comment: Normalizes a choice type of FHIR.dateTime, FHIR.Period, FHIR.Timing, FHIR.instance, FHIR.string, FHIR.Age, or FHIR.Range types\nto an equivalent interval. This selection of choice types is a superset of the majority of choice types that are used as possible\nrepresentations for timing-valued elements in FHIR, allowing this function to be used across any resource.\n\nThe input can be provided as a dateTime, Period, Timing, instant, string, Age, or Range.\nThe intent of this function is to provide a clear and concise mechanism to treat single\nelements that have multiple possible representations as intervals so that logic doesn't have to account\nfor the variability. More complex calculations (such as medication request period or dispense period\ncalculation) need specific guidance and consideration. That guidance may make use of this function, but\nthe focus of this function is on single element calculations where the semantics are unambiguous.\nIf the input is a dateTime, the result a DateTime Interval beginning and ending on that dateTime.\nIf the input is a Period, the result is a DateTime Interval.\nIf the input is a Timing, an error is raised indicating a single interval cannot be computed from a Timing.\nIf the input is an instant, the result is a DateTime Interval beginning and ending on that instant.\nIf the input is a string, an error is raised indicating a single interval cannot be computed from a string.\nIf the input is an Age, the result is a DateTime Interval beginning when the patient was the given Age,\nand ending immediately prior to when the patient was the given Age plus one year.\nIf the input is a Range, the result is a DateTime Interval beginning when the patient was the Age given\nby the low end of the Range, and ending immediately prior to when the patient was the Age given by the\nhigh end of the Range plus one year.\n\nNOTE: Due to the\ncomplexity of determining a single interval from a Timing or String type, this function will throw a run-time exception if it is used\nwith a Timing or String.\n*/\ndefine fluent function toInterval(choice Choice):\n case\n when choice is FHIR.dateTime then\n Interval[FHIRHelpers.ToDateTime(choice as FHIR.dateTime), FHIRHelpers.ToDateTime(choice as FHIR.dateTime)]\n when choice is FHIR.Period then\n FHIRHelpers.ToInterval(choice as FHIR.Period)\n when choice is FHIR.instant then\n Interval[FHIRHelpers.ToDateTime(choice as FHIR.instant), FHIRHelpers.ToDateTime(choice as FHIR.instant)]\n when choice is FHIR.Age then\n Interval[FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(choice as FHIR.Age),\n FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(choice as FHIR.Age) + 1 year)\n when choice is FHIR.Range then\n Interval[FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity((choice as FHIR.Range).low),\n FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity((choice as FHIR.Range).high) + 1 year)\n when choice is FHIR.Timing then\n Message(null as Interval, true, 'NOT_IMPLEMENTED', 'Error', 'Calculation of an interval from a Timing value is not supported')\n when choice is FHIR.string then\n Message(null as Interval, true, 'NOT_IMPLEMENTED', 'Error', 'Calculation of an interval from a String value is not supported')\n else\n null as Interval\n end" }, { "url" : "displaySequence", "valueInteger" : 23 }], "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "FHIRHelpers" }, { "url" : "name", "valueString" : "ToDateTime" }, { "url" : "statement", "valueString" : "define function ToDateTime(value dateTime): value.value" }, { "url" : "displaySequence", "valueInteger" : 24 }], "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "FHIRHelpers" }, { "url" : "name", "valueString" : "ToDateTime" }, { "url" : "statement", "valueString" : "define function ToDateTime(value instant): value.value" }, { "url" : "displaySequence", "valueInteger" : 25 }], "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "FHIRHelpers" }, { "url" : "name", "valueString" : "ToDate" }, { "url" : "statement", "valueString" : "define function ToDate(value date): value.value" }, { "url" : "displaySequence", "valueInteger" : 26 }], "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "FHIRHelpers" }, { "url" : "name", "valueString" : "ToQuantity" }, { "url" : "statement", "valueString" : "/*\n@description: Converts the given FHIR [Quantity](https://hl7.org/fhir/datatypes.html#Quantity) \nvalue to a CQL Quantity\n@comment: If the given quantity has a comparator specified, a runtime error is raised. If the given quantity\nhas a system other than UCUM (i.e. `http://unitsofmeasure.org`) or CQL calendar units (i.e. `http://hl7.org/fhirpath/CodeSystem/calendar-units`)\nan error is raised. For UCUM to calendar units, the `ToCalendarUnit` function is used.\n@seealso: ToCalendarUnit\n*/\ndefine function ToQuantity(quantity FHIR.Quantity):\n case\n when quantity is null then null\n when quantity.value is null then null\n when quantity.comparator is not null then\n Message(null, true, 'FHIRHelpers.ToQuantity.ComparatorQuantityNotSupported', 'Error', 'FHIR Quantity value has a comparator and cannot be converted to a System.Quantity value.')\n when quantity.system is null or quantity.system.value = 'http://unitsofmeasure.org'\n or quantity.system.value = 'http://hl7.org/fhirpath/CodeSystem/calendar-units' then\n System.Quantity { value: quantity.value.value, unit: ToCalendarUnit(Coalesce(quantity.code.value, quantity.unit.value, '1')) }\n else\n Message(null, true, 'FHIRHelpers.ToQuantity.InvalidFHIRQuantity', 'Error', 'Invalid FHIR Quantity code: ' & quantity.unit.value & ' (' & quantity.system.value & '|' & quantity.code.value & ')')\n end" }, { "url" : "displaySequence", "valueInteger" : 27 }], "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "FHIRHelpers" }, { "url" : "name", "valueString" : "ToCalendarUnit" }, { "url" : "statement", "valueString" : "/*\n@description: Converts a UCUM definite duration unit to a CQL calendar duration\nunit using conversions specified in the [quantities](https://cql.hl7.org/02-authorsguide.html#quantities) \ntopic of the CQL specification.\n@comment: Note that for durations above days (or weeks), the conversion is understood to be approximate\n*/\ndefine function ToCalendarUnit(unit System.String):\n case unit\n when 'ms' then 'millisecond'\n when 's' then 'second'\n when 'min' then 'minute'\n when 'h' then 'hour'\n when 'd' then 'day'\n when 'wk' then 'week'\n when 'mo' then 'month'\n when 'a' then 'year'\n else unit\n end" }, { "url" : "displaySequence", "valueInteger" : 28 }], "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "CMS1157FHIRHIVRetention" }, { "url" : "name", "valueString" : "isVerified" }, { "url" : "statement", "valueString" : "define fluent function isVerified(condition Choice):\n condition.verificationStatus is not null implies ( condition.verificationStatus ~ Status.\"confirmed\"\n or condition.verificationStatus ~ Status.\"unconfirmed\"\n or condition.verificationStatus ~ Status.\"provisional\"\n or condition.verificationStatus ~ Status.\"differential\"\n )" }, { "url" : "displaySequence", "valueInteger" : 29 }], "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "FHIRHelpers" }, { "url" : "name", "valueString" : "ToConcept" }, { "url" : "statement", "valueString" : "/*\n@description: Converts the given FHIR [CodeableConcept](https://hl7.org/fhir/datatypes.html#CodeableConcept) value to a CQL Concept.\n*/\ndefine function ToConcept(concept FHIR.CodeableConcept):\n if concept is null then\n null\n else\n System.Concept {\n codes: concept.coding C return ToCode(C),\n display: concept.text.value\n }" }, { "url" : "displaySequence", "valueInteger" : 30 }], "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "FHIRHelpers" }, { "url" : "name", "valueString" : "ToCode" }, { "url" : "statement", "valueString" : "/*\n@description: Converts the given FHIR [Coding](https://hl7.org/fhir/datatypes.html#Coding) value to a CQL Code.\n*/\ndefine function ToCode(coding FHIR.Coding):\n if coding is null then\n null\n else\n System.Code {\n code: coding.code.value,\n system: coding.system.value,\n version: coding.version.value,\n display: coding.display.value\n }" }, { "url" : "displaySequence", "valueInteger" : 31 }], "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "FHIRHelpers" }, { "url" : "name", "valueString" : "ToString" }, { "url" : "statement", "valueString" : "define function ToString(value ObservationStatus): value.value" }, { "url" : "displaySequence", "valueInteger" : 32 }], "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "USCoreCommon" }, { "url" : "name", "valueString" : "ethnicity" }, { "url" : "statement", "valueString" : "define fluent function ethnicity(patient Patient):\n (patient.ext('http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity')) E\n return {\n ombCategory: E.ext('ombCategory').value as FHIR.Coding,\n detailed: (E.exts('detailed')) d return d.value as FHIR.Coding,\n text: E.ext('text').value as FHIR.string\n }" }, { "url" : "displaySequence", "valueInteger" : 33 }], "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "FHIRCommon" }, { "url" : "name", "valueString" : "ext" }, { "url" : "statement", "valueString" : "/*\n@description: Returns the single extension (if present) on the given element with the specified url.\n@comment: This function uses singleton from to ensure that a run-time exception is thrown if there\nis more than one extension on the given element with the specified url.\n*/\ndefine fluent function ext(element Element, url String):\n singleton from element.exts(url)" }, { "url" : "displaySequence", "valueInteger" : 34 }], "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "FHIRCommon" }, { "url" : "name", "valueString" : "exts" }, { "url" : "statement", "valueString" : "/*\n@description: Returns any extensions defined on the given element with the specified url.\n*/\ndefine fluent function exts(element Element, url String):\n element.extension E\n where E.url = url\n return E" }, { "url" : "displaySequence", "valueInteger" : 35 }], "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "USCoreCommon" }, { "url" : "name", "valueString" : "race" }, { "url" : "statement", "valueString" : "define fluent function race(patient Patient):\n (patient.ext('http://hl7.org/fhir/us/core/StructureDefinition/us-core-race')) E\n return {\n ombCategory: (E.exts('ombCategory')) o return o.value as FHIR.Coding,\n detailed: (E.exts('detailed')) d return d.value as FHIR.Coding,\n text: E.ext('text').value as FHIR.string\n }" }, { "url" : "displaySequence", "valueInteger" : 36 }], "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition" }], "name" : "EffectiveDataRequirements", "status" : "active", "type" : { "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/library-type", "code" : "module-definition" }] }, "relatedArtifact" : [{ "type" : "depends-on", "display" : "USQualityCore model information", "resource" : "https://madie.cms.gov/Library/USQualityCore-ModelInfo|0.1.0-cibuild" }, { "type" : "depends-on", "display" : "USCore model information", "resource" : "http://hl7.org/fhir/us/cql/Library/USCore-ModelInfo|6.1.0-derived" }, { "type" : "depends-on", "display" : "FHIR model information", "resource" : "http://hl7.org/fhir/uv/cql/Library/FHIR-ModelInfo|4.0.1" }, { "type" : "depends-on", "display" : "Library SDE", "resource" : "https://madie.cms.gov/Library/SupplementalDataElements|6.1.000" }, { "type" : "depends-on", "display" : "Library FHIRHelpers", "resource" : "http://hl7.org/fhir/uv/cql/Library/FHIRHelpers|4.0.1" }, { "type" : "depends-on", "display" : "Library USCommon", "resource" : "http://hl7.org/fhir/us/cql/Library/USCoreCommon|2.0.0-ballot" }, { "type" : "depends-on", "display" : "Library FHIRCommon", "resource" : "http://hl7.org/fhir/uv/cql/Library/FHIRCommon|2.0.0" }, { "type" : "depends-on", "display" : "Library Status", "resource" : "https://madie.cms.gov/Library/Status|2.1.000" }, { "type" : "depends-on", "display" : "Code system SNOMEDCT", "resource" : "http://snomed.info/sct" }, { "type" : "depends-on", "display" : "Code system ConditionVerificationStatusCodes", "resource" : "http://terminology.hl7.org/CodeSystem/condition-ver-status" }, { "type" : "depends-on", "display" : "Value set Office Visit", "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001" }, { "type" : "depends-on", "display" : "Value set Outpatient Consultation", "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1008" }, { "type" : "depends-on", "display" : "Value set Annual Wellness Visit", "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240" }, { "type" : "depends-on", "display" : "Value set Face-to-Face Interaction", "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.375" }, { "type" : "depends-on", "display" : "Value set Home Healthcare Services", "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016" }, { "type" : "depends-on", "display" : "Value set Preventive Care Services Established Office Visit, 18 and Up", "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025" }, { "type" : "depends-on", "display" : "Value set Preventive Care Services Initial Office Visit, 18 and Up", "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023" }, { "type" : "depends-on", "display" : "Value set Preventive Care Services, Initial Office Visit, 0 to 17", "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1022" }, { "type" : "depends-on", "display" : "Value set Preventive Care, Established Office Visit, 0 to 17", "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1024" }, { "type" : "depends-on", "display" : "Value set Telephone Visits", "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1080" }, { "type" : "depends-on", "display" : "Value set Preventive Care Services Other", "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.11.1150" }, { "type" : "depends-on", "display" : "Value set HIV", "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.120.12.1003" }, { "type" : "depends-on", "display" : "Value set HIV Viral Load Tests", "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.377" }, { "type" : "depends-on", "display" : "Value set Payer Type", "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591" }], "parameter" : [{ "name" : "Measurement Period", "use" : "in", "min" : 0, "max" : "1", "type" : "Period" }, { "name" : "SDE Sex", "use" : "out", "min" : 0, "max" : "1", "type" : "Coding" }, { "name" : "Numerator", "use" : "out", "min" : 0, "max" : "1", "type" : "boolean" }, { "name" : "Denominator", "use" : "out", "min" : 0, "max" : "1", "type" : "boolean" }, { "name" : "SDE Payer", "use" : "out", "min" : 0, "max" : "*", "type" : "Resource" }, { "name" : "Initial Population", "use" : "out", "min" : 0, "max" : "1", "type" : "boolean" }, { "name" : "SDE Ethnicity", "use" : "out", "min" : 0, "max" : "1", "type" : "Resource" }, { "name" : "SDE Race", "use" : "out", "min" : 0, "max" : "1", "type" : "Resource" }], "dataRequirement" : [{ "type" : "Patient", "profile" : ["http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-patient"], "mustSupport" : ["ombCategory", "detailed", "text"] }, { "type" : "Patient", "profile" : ["http://hl7.org/fhir/StructureDefinition/Patient"], "mustSupport" : ["birthDate"] }, { "type" : "Encounter", "profile" : ["http://hl7.org/fhir/StructureDefinition/Encounter"], "mustSupport" : ["type", "period", "status"], "codeFilter" : [{ "path" : "type", "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001" }] }, { "type" : "Encounter", "profile" : ["http://hl7.org/fhir/StructureDefinition/Encounter"], "mustSupport" : ["type", "period", "status"], "codeFilter" : [{ "path" : "type", "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1008" }] }, { "type" : "Encounter", "profile" : ["http://hl7.org/fhir/StructureDefinition/Encounter"], "mustSupport" : ["type", "period", "status"], "codeFilter" : [{ "path" : "type", "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240" }] }, { "type" : "Encounter", "profile" : ["http://hl7.org/fhir/StructureDefinition/Encounter"], "mustSupport" : ["type", "period", "status"], "codeFilter" : [{ "path" : "type", "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.375" }] }, { "type" : "Encounter", "profile" : ["http://hl7.org/fhir/StructureDefinition/Encounter"], "mustSupport" : ["type", "period", "status"], "codeFilter" : [{ "path" : "type", "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016" }] }, { "type" : "Encounter", "profile" : ["http://hl7.org/fhir/StructureDefinition/Encounter"], "mustSupport" : ["type", "period", "status"], "codeFilter" : [{ "path" : "type", "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025" }] }, { "type" : "Encounter", "profile" : ["http://hl7.org/fhir/StructureDefinition/Encounter"], "mustSupport" : ["type", "period", "status"], "codeFilter" : [{ "path" : "type", "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023" }] }, { "type" : "Encounter", "profile" : ["http://hl7.org/fhir/StructureDefinition/Encounter"], "mustSupport" : ["type", "period", "status"], "codeFilter" : [{ "path" : "type", "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1022" }] }, { "type" : "Encounter", "profile" : ["http://hl7.org/fhir/StructureDefinition/Encounter"], "mustSupport" : ["type", "period", "status"], "codeFilter" : [{ "path" : "type", "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1024" }] }, { "type" : "Encounter", "profile" : ["http://hl7.org/fhir/StructureDefinition/Encounter"], "mustSupport" : ["type", "period", "status"], "codeFilter" : [{ "path" : "type", "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1080" }] }, { "type" : "Encounter", "profile" : ["http://hl7.org/fhir/StructureDefinition/Encounter"], "mustSupport" : ["type", "period", "status"], "codeFilter" : [{ "path" : "type", "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.11.1150" }] }, { "type" : "Condition", "profile" : ["http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-condition-problems-health-concerns"], "mustSupport" : ["code"], "codeFilter" : [{ "path" : "code", "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.120.12.1003" }] }, { "type" : "Condition", "profile" : ["http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-condition-encounter-diagnosis"], "mustSupport" : ["code"], "codeFilter" : [{ "path" : "code", "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.120.12.1003" }] }, { "type" : "Observation", "profile" : ["http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-observation-lab"], "mustSupport" : ["code", "status", "effective"], "codeFilter" : [{ "path" : "code", "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.377" }] }, { "type" : "Coverage", "profile" : ["http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-coverage"], "mustSupport" : ["type", "period"], "codeFilter" : [{ "path" : "type", "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591" }] }] }], "extension" : [{ "id" : "supplementalDataGuidance", "extension" : [{ "url" : "guidance", "valueString" : "

For every patient evaluated by this measure also identify payer, race, ethnicity and sex

" }, { "url" : "usage", "valueCodeableConcept" : { "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage", "code" : "supplemental-data", "display" : "Supplemental Data" }], "text" : "Supplemental Data Guidance" } }], "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-supplementalDataGuidance" }, { "extension" : [{ "url" : "term", "valueString" : "Month" }, { "url" : "definition", "valueMarkdown" : "To maintain consistency from year to year, this measure defines one month as equal to 30 days, three months as equal to 90 days and eight months as equal to 240 days\n" }], "url" : "http://hl7.org/fhir/StructureDefinition/cqf-definitionTerm" }, { "url" : "http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-softwaresystem", "valueReference" : { "reference" : "Device/cqf-tooling" } }, { "url" : "http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements", "valueCanonical" : "#effective-data-requirements" }], "url" : "https://madie.cms.gov/Measure/CMS1157FHIRHIVRetention", "identifier" : [{ "use" : "usual", "type" : { "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/artifact-identifier-type", "code" : "short-name", "display" : "Short Name" }] }, "system" : "https://madie.cms.gov/measure/shortName", "value" : "CMS1157FHIR" }, { "use" : "official", "type" : { "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/artifact-identifier-type", "code" : "version-independent", "display" : "Version Independent" }] }, "system" : "urn:ietf:rfc:3986", "value" : "urn:uuid:03878bb8-1209-4f3f-91f6-52b655092251" }, { "use" : "official", "type" : { "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/artifact-identifier-type", "code" : "version-specific", "display" : "Version Specific" }] }, "system" : "urn:ietf:rfc:3986", "value" : "urn:uuid:36e79353-69dd-4ca6-8d94-49fca9c67ca2" }, { "use" : "official", "type" : { "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/artifact-identifier-type", "code" : "publisher", "display" : "Publisher" }] }, "system" : "https://madie.cms.gov/measure/cmsId", "value" : "1157FHIR", "assigner" : { "display" : "CMS" } }], "version" : "1.0.000", "name" : "CMS1157FHIRHIVRetention", "title" : "HIV Annual Retention in CareFHIR\n", "status" : "active", "experimental" : false, "date" : "2026-01-16T18:18:12+00:00", "publisher" : "Health Resources & Services Administration", "contact" : [{ "telecom" : [{ "system" : "url", "value" : " https://www.hrsa.gov/" }] }], "description" : "Percentage of patients, regardless of age, with a diagnosis of Human Immunodeficiency Virus (HIV) during the first 240 days of the measurement period or before the measurement period who had at least two eligible encounters or at least one eligible encounter and one HIV viral load test that were at least 90 days apart within the measurement period\n", "usage" : "A patient would be included in the measure numerator if they have either two eligible encounters or one eligible encounter and one viral load test at least 90 days apart from each other. The encounter or encounters that cause a patient to be included in the numerator do not need to include the encounter that caused the patient to be included in the denominator.\n\nOnly patients with an eligible encounter in the first eight months are included in this measure to allow for sufficient time to complete a second eligible encounter or viral load laboratory within the 12-month measurement period and at least 90 days after the initial encounter.\n\nThis eCQM is a patient-based measure. This measure is to be submitted a minimum of once per measurement period for patients with a diagnosis of HIV during the first eight months of the measurement period.\n\nThis FHIR-based measure has been derived from the QDM-based measure CMS1157v2. Please refer to the HL7 QI-Core Implementation Guide (https://hl7.org/fhir/us/qicore/STU6/) for more information on QI-Core and mapping recommendations from QDM to QI-Core STU 6 (https://hl7.org/fhir/us/qicore/STU6/qdm-to-qicore.html).\n", "copyright" : "This measure was developed by the Health Resources and Services Administration of the U.S. Department for Health and Human Services. It is in the public domain.\n\nCitation of HRSA as the source of the original measure is appreciated. Any modified versions may not be represented as approved, endorsed, or authorized by HRSA or HHS. 42 U.S.C. Section 1320b-10. Users of modified versions should clearly explain how they deviate from HRSA's original measure.\n\nLimited proprietary coding is contained in the Measure specifications for user convenience. Users of proprietary code sets should obtain all necessary licenses from the owners of the code sets.\n\nCPT(R) contained in the Measure specifications is copyright 2004-2024 American Medical Association. LOINC(R) is copyright 2004-2024 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT\\[R\\]) copyright 2004-2024 International Health Terminology Standards Development Organisation. ICD-10 is copyright 2024 World Health Organization. All Rights Reserved.\n\nDue to technical limitations, registered trademarks are indicated by (R) or \\[R\\] and unregistered trademarks are indicated by (TM) or \\[TM\\].\n", "effectivePeriod" : { "start" : "2026-01-01", "end" : "2026-12-31" }, "author" : [{ "name" : "Health Resources & Services Administration", "telecom" : [{ "system" : "url", "value" : " https://www.hrsa.gov/" }] }], "relatedArtifact" : [{ "type" : "citation", "citation" : "Crawford, T. N., Sanderson, W. T., \\& Thornton, A. (2014). Impact of Poor Retention in HIV Medical Care on Time to Viral Load Suppression. Journal of the International Association of Providers of AIDS Care (JIAPAC), 13(3), 242--249. https://doi.org/10.1177/2325957413491431.\n" }, { "type" : "citation", "citation" : "Gardner, E. M., McLees, M. P., Steiner, J. F., Del Rio, C., \\& Burman, W. J. (2011). The spectrum of engagement in HIV care and its relevance to test-and-treat strategies for prevention of HIV infection. Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America, 52(6), 793--800. https://doi.org/10.1093/cid/ciq243.\n" }, { "type" : "citation", "citation" : "Giordano, T. P., Gifford, A. L., White, A. C., Suarez-Almazor, M. E., Rabeneck, L., Hartman, C., Backus, L. I., Mole, L. A., \\& Morgan, R. O. (2007). Retention in care: A challenge to survival with HIV infection. Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America, 44(11), 1493-1499. https://doi.org/10.1086/516778.\n" }, { "type" : "citation", "citation" : "Giordano, T. P., White, A. C., Sajja, P., Graviss, E. A., Arduino, R. C., Adu-Oppong, A., Lahart, C. J., \\& Visnegarwala, F. (2003). Factors associated with the use of highly active antiretroviral therapy in patients newly entering care in an urban clinic. Journal of Acquired Immune Deficiency Syndromes (JAIDS), 32(4), 399-405. https://doi.org/10.1097/00126334-200304010-00009\n" }, { "type" : "citation", "citation" : "Mugavero, M. J., Lin, H.-Y., Willig, J. H., Westfall, A. O., Ulett, K. B., Routman, J. S., Abroms, S., Raper, J. L., Saag, M. S., \\& Allison, J. J. (2009). Missed visits and mortality among patients establishing initial outpatient HIV treatment. Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America, 48(2), 248--256. https://doi.org/10.1086/595705\n" }, { "type" : "citation", "citation" : "Panel on Antiretroviral Guidelines for Adults and Adolescents. \"Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents with HIV.\" Washington, DC: U.S. Department of Health and Human Services, 2022. Available at https://clinicalinfo.hiv.gov/sites/default/files/guidelines/documents/adult-adolescent-arv/guidelines-adult-adolescent-arv.pdf Updated September 21, 2022. Accessed December 15, 2022.\n" }, { "type" : "citation", "citation" : "Thompson, M. A., Mugavero, M. J., Amico, K. R., Cargill, V. A., Chang, L. W., Gross, R., Orrell, C., Altice, F. L., Bangsberg, D. R., Bartlett, J. G., Beckwith, C. G., Dowshen, N., Gordon, C. M., Horn, T., Kumar, P., Scott, J. D., Stirratt, M. J., Remien, R. H., Simoni, J. M., \\& Nachega, J. B. (2012). Guidelines for improving entry into and retention in care and antiretroviral adherence for persons with HIV: evidence-based recommendations from an International Association of Physicians in AIDS Care panel. Annals of internal medicine, 156(11), 817-294. https://doi.org/10.7326/0003-4819-156-11-201206050-00419\n" }], "library" : ["https://madie.cms.gov/Library/CMS1157FHIRHIVRetention"], "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.\n\nTHE MEASURES AND SPECIFICATIONS ARE PROVIDED \"AS IS\" WITHOUT WARRANTY OF ANY KIND.\n\nDue to technical limitations, registered trademarks are indicated by (R) or \\[R\\] and unregistered trademarks are indicated by (TM) or \\[TM\\].\n", "rationale" : "The HIV \"continuum of care\" is the process of HIV testing, linkage to HIV care, initiation of antiretroviral therapy (ART), adherence to treatment, retention in care, and virologic suppression (Gardner et al 2011). Poor retention in care is associated with lower rates of ART use (Giordano et al 2003), delayed viral suppression (Crawford et al 2014), and increased risk of mortality (Giordano et al., 2007; Mugavero et al., 2009). This measure will help providers direct their attention and quality improvement efforts towards improving retention in care.\n", "clinicalRecommendationStatement" : "\"Retention in care should be routinely monitored. There are various ways to measure retention, including measures based on attended visits over a defined period of time (constancy measures) and measures based on missed visits. Both approaches are valid and independently predict survival. Missed visits and a prolonged time since the last visit are relatively easy to measure and should trigger efforts to retain or re-engage a person in care. Constancy measures (e.g., at least two visits that are at least 90 days apart over 1 year or at least one visit every 6 months over the last 2 years) can be used as clinic quality assurance measures\" (Panel on Antiretroviral Guidelines for Adults and Adolescents, 2022, p. L-4).\n\n\"Poor retention in HIV care is associated with greater risk of death. Poor retention is more common in people who use substances, have serious mental health problems, have unmet socioeconomic needs (e.g., housing, food, transportation), lack financial resources or health insurance, have schedules that complicate adherence, have been recently incarcerated, or face stigma. At the provider and health system level, low trust in providers and a poor patient-provider relationship have been associated with lower retention, as has lower satisfaction with the clinic experience. Availability of appointments and timeliness of appointments (i.e., long delay from the request for an appointment to the appointment's date) and scheduling convenience are also factors\" (Panel on Antiretroviral Guidelines for Adults and Adolescents, 2022, p. L-3).\n\n\"Recommendation 2: Systematic monitoring of retention in HIV care is recommended for all patients (II A): Retention in care is associated with improved individual health outcomes, including HIV biomarker and clinical variables, and may reduce community-level viral burden, with implications for secondary prevention. Although monitoring retention is routinely recommended, specific details, such as retention measures to be used and desired visit frequency, vary among jurisdictions and programs and should be in harmony with national and international guidelines. Many retention measures (for example, visit adherence, gaps in care, and visits per interval of time) and data sources (for example, surveillance, medical records, and administrative databases) have been used and may be applied in accordance with local resources and standards of care. As with monitoring of linkage, integration of data sources may enhance monitoring of retention\" (Thompson et al., 2012, p. 4).\n", "group" : [{ "id" : "Group_1", "extension" : [{ "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring", "valueCodeableConcept" : { "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/measure-scoring", "code" : "proportion", "display" : "Proportion" }] } }, { "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis", "valueCode" : "boolean" }, { "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-type", "valueCodeableConcept" : { "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/measure-type", "code" : "process", "display" : "Process" }] } }, { "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-improvementNotation", "valueCodeableConcept" : { "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/measure-improvement-notation", "code" : "increase", "display" : "Increased score indicates improvement" }] } }], "population" : [{ "id" : "InitialPopulation_1", "code" : { "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/measure-population", "code" : "initial-population", "display" : "Initial Population" }] }, "description" : "All patients, regardless of age, with a diagnosis of HIV during the first 240 days of the measurement period or before the measurement period who had at least one eligible encounter during the first 240 days of the measurement period\n", "criteria" : { "language" : "text/cql-identifier", "expression" : "Initial Population" } }, { "id" : "Denominator_1", "code" : { "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/measure-population", "code" : "denominator", "display" : "Denominator" }] }, "description" : "Equals Initial Population\n", "criteria" : { "language" : "text/cql-identifier", "expression" : "Denominator" } }, { "id" : "Numerator_1", "code" : { "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/measure-population", "code" : "numerator", "display" : "Numerator" }] }, "description" : "Number of patients who had at least one eligible encounter and one HIV viral load test at least 90 days apart during the measurement period, or who had at least two eligible encounters at least 90 days apart during the measurement period\n", "criteria" : { "language" : "text/cql-identifier", "expression" : "Numerator" } }] }], "supplementalData" : [{ "id" : "sde-ethnicity", "usage" : [{ "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage", "code" : "supplemental-data" }] }], "description" : "SDE Ethnicity\n", "criteria" : { "language" : "text/cql-identifier", "expression" : "SDE Ethnicity" } }, { "id" : "sde-payer", "usage" : [{ "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage", "code" : "supplemental-data" }] }], "description" : "SDE Payer\n", "criteria" : { "language" : "text/cql-identifier", "expression" : "SDE Payer" } }, { "id" : "sde-race", "usage" : [{ "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage", "code" : "supplemental-data" }] }], "description" : "SDE Race\n", "criteria" : { "language" : "text/cql-identifier", "expression" : "SDE Race" } }, { "id" : "sde-sex", "usage" : [{ "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage", "code" : "supplemental-data" }] }], "description" : "SDE Sex\n", "criteria" : { "language" : "text/cql-identifier", "expression" : "SDE Sex" } }] }