/***Population Criteria***/


define "Initial Population":
  exists "Dementia Encounter During Measurement Period"
    and ( Count("Qualifying Encounter During Measurement Period") >= 2 )

/***Population Criteria***/


define "Initial Population":
  exists "Dementia Encounter During Measurement Period"
    and ( Count("Qualifying Encounter During Measurement Period") >= 2 )

define "Denominator":
  "Initial Population"

define "Numerator":
  exists "Assessment of Cognition Using Standardized Tools or Alternate Methods"

define "Denominator Exceptions":
  exists "Patient Reason for Not Performing Assessment of Cognition Using Standardized Tools or Alternate Methods"

define "SDE Sex":
  case
    when Patient.sex = '248153007' then "Male (finding)"
    when Patient.sex = '248152002' then "Female (finding)"
    else null
  end

define "SDE Payer":
  [Coverage: type in "Payer Type"] Payer
    return {
      code: Payer.type,
      period: Payer.period
    }

define "SDE Ethnicity":
  Patient.ethnicity E
    return Tuple {
      codes: { E.ombCategory } union E.detailed,
      display: E.text
    }

define "SDE Race":
  Patient.race R
    return Tuple {
      codes: R.ombCategory union R.detailed,
      display: R.text
    }

/*
@description: Returns an interval representing the normalized prevalence period of a given Condition.
@comment: Uses the ToInterval and ToAbatementInterval functions to determine the widest potential interval from
onset to abatement as specified in the given Condition. If the condition is active, or has an abatement date the resulting 
interval will have a closed ending boundary. Otherwise, the resulting interval will have an open ending boundary.
*/
define fluent function prevalenceInterval(condition Choice<"ConditionEncounterDiagnosis", "ConditionProblemsHealthConcerns">):
if condition.clinicalStatus ~ "active"
  or condition.clinicalStatus ~ "recurrence"
  or condition.clinicalStatus ~ "relapse" then
  Interval[start of condition.onset.toInterval(), end of condition.abatementInterval()]
else
    (end of condition.abatementInterval()) abatementDate
    return if abatementDate is null then
      Interval[start of condition.onset.toInterval(), abatementDate)
    else
      Interval[start of condition.onset.toInterval(), abatementDate]

/*
@description: Normalizes a value that is a choice of timing-valued types to an equivalent interval
@comment: Normalizes a choice type of DateTime, Quanitty, Interval<DateTime>, or Interval<Quantity> types
to an equivalent interval. This selection of choice types is a superset of the majority of choice types that are used as possible
representations for timing-valued elements in QICore, allowing this function to be used across any resource.
The input can be provided as a DateTime, Quantity, Interval<DateTime> or Interval<Quantity>.
The intent of this function is to provide a clear and concise mechanism to treat single
elements that have multiple possible representations as intervals so that logic doesn't have to account
for the variability. More complex calculations (such as medication request period or dispense period
calculation) need specific guidance and consideration. That guidance may make use of this function, but
the focus of this function is on single element calculations where the semantics are unambiguous.
If the input is a DateTime, the result a DateTime Interval beginning and ending on that DateTime.
If the input is a Quantity, the quantity is expected to be a calendar-duration interpreted as an Age,
and the result is a DateTime Interval beginning on the Date the patient turned that age and ending immediately before one year later.
If the input is a DateTime Interval, the result is the input.
If the input is a Quantity Interval, the quantities are expected to be calendar-durations interpreted as an Age, and the result
is a DateTime Interval beginning on the date the patient turned the age given as the start of the quantity interval, and ending
immediately before one year later than the date the patient turned the age given as the end of the quantity interval.
If the input is a Timing, an error will be thrown indicating that Timing calculations are not implemented. Any other input will reslt in a null DateTime Interval
*/
define fluent function toInterval(choice Choice<DateTime, Quantity, Interval<DateTime>, Interval<Quantity>, Timing>):
  case
	  when choice is DateTime then
    	Interval[choice as DateTime, choice as DateTime]
		when choice is Interval<DateTime> then
  		choice as Interval<DateTime>
		when choice is Quantity then
		  Interval[Patient.birthDate + (choice as Quantity),
			  Patient.birthDate + (choice as Quantity) + 1 year)
		when choice is Interval<Quantity> then
		  Interval[Patient.birthDate + (choice.low as Quantity),
			  Patient.birthDate + (choice.high as Quantity) + 1 year)
		when choice is Timing then
      Message(null, true, 'NOT_IMPLEMENTED', 'Error', 'Calculation of an interval from a Timing value is not supported') as Interval<DateTime>
		else
			null as Interval<DateTime>
	end

/*
@description: Returns an interval representing the normalized abatement of a given Condition.
@comment: If the abatement element of the Condition is represented as a DateTime, the result
is an interval beginning and ending on that DateTime.
If the abatement is represented as a Quantity, the quantity is expected to be a calendar-duration and is interpreted as the age of the patient. The
result is an interval from the date the patient turned that age to immediately before one year later.
If the abatement is represented as a Quantity Interval, the quantities are expected to be calendar-durations and are interpreted as an age range during
which the abatement occurred. The result is an interval from the date the patient turned the starting age of the quantity interval, and ending immediately
before one year later than the date the patient turned the ending age of the quantity interval.
*/
define fluent function abatementInterval(condition Choice<"ConditionEncounterDiagnosis", "ConditionProblemsHealthConcerns">):
	if condition.abatement is DateTime then
	  Interval[condition.abatement as DateTime, condition.abatement as DateTime]
	else if condition.abatement is Quantity then
		Interval[Patient.birthDate + (condition.abatement as Quantity),
			Patient.birthDate + (condition.abatement as Quantity) + 1 year)
	else if condition.abatement is Interval<Quantity> then
	  Interval[Patient.birthDate + (condition.abatement.low as Quantity),
		  Patient.birthDate + (condition.abatement.high as Quantity) + 1 year)
	else if condition.abatement is Interval<DateTime> then
	  Interval[condition.abatement.low, condition.abatement.high)
	else null as Interval<DateTime>

define "SDE Sex":
  SDE."SDE Sex"

define "Encounter to Assess Cognition":
  ( ["Encounter": "Psych Visit Diagnostic Evaluation"]
    union ["Encounter": "Nursing Facility Visit"]
    union ["Encounter": "Care Services in Long Term Residential Facility"]
    union ["Encounter": "Home Healthcare Services"]
    union ["Encounter": "Psych Visit Psychotherapy"]
    union ["Encounter": "Behavioral or Neuropsych Assessment"]
    union ["Encounter": "Occupational Therapy Evaluation"]
    union ["Encounter": "Office Visit"]
    union ["Encounter": "Outpatient Consultation"] ) EncounterAssessCognition
    where EncounterAssessCognition.period during day of "Measurement Period"
      and EncounterAssessCognition.status ~ 'finished'

define "Dementia Encounter During Measurement Period":
  "Encounter to Assess Cognition" EncounterAssessCognition
    with ( [ConditionProblemsHealthConcerns: "Dementia & Mental Degenerations"]
      union [ConditionEncounterDiagnosis: "Dementia & Mental Degenerations"] ) Dementia
      such that EncounterAssessCognition.period during day of "Measurement Period"
        and Dementia.prevalenceInterval ( ) overlaps day of EncounterAssessCognition.period
        and ( Dementia.abatement is null
            or end of Dementia.abatement.toInterval ( ) after day of end of "Measurement Period"
        )
        and Dementia.isVerified ( )

/***Definitions***/


define "Assessment of Cognition Using Standardized Tools or Alternate Methods":
  ( ["ObservationScreeningAssessment": "Standardized Tools for Assessment of Cognition"]
    union ["ObservationScreeningAssessment": "Cognitive Assessment"] ) CognitiveAssessment
    with "Dementia Encounter During Measurement Period" EncounterDementia
      such that CognitiveAssessment.effective.toInterval ( ) starts 12 months or less on or before day of end of EncounterDementia.period
    where CognitiveAssessment.value is not null
      and CognitiveAssessment.status in { 'final', 'amended', 'corrected' }

define "Numerator":
  exists "Assessment of Cognition Using Standardized Tools or Alternate Methods"

define "Qualifying Encounter During Measurement Period":
  ( "Encounter to Assess Cognition"
    union ["Encounter": "Patient Provider Interaction"] ) ValidEncounter
    where ValidEncounter.period during day of "Measurement Period"
      and ValidEncounter.status = 'finished'

/***Population Criteria***/


define "Initial Population":
  exists "Dementia Encounter During Measurement Period"
    and ( Count("Qualifying Encounter During Measurement Period") >= 2 )

define "Denominator":
  "Initial Population"

define "SDE Payer":
  SDE."SDE Payer"

/***Population Criteria***/


define "Initial Population":
  exists "Dementia Encounter During Measurement Period"
    and ( Count("Qualifying Encounter During Measurement Period") >= 2 )

define "SDE Ethnicity":
  SDE."SDE Ethnicity"

define "SDE Race":
  SDE."SDE Race"

define "Patient Reason for Not Performing Assessment of Cognition Using Standardized Tools or Alternate Methods":
  ( [ObservationCancelled: code in "Standardized Tools for Assessment of Cognition"]
    union [ObservationCancelled: code in "Cognitive Assessment"] ) NoCognitiveAssessment
    with "Dementia Encounter During Measurement Period" EncounterDementia
      such that NoCognitiveAssessment.issued during day of EncounterDementia.period
    where NoCognitiveAssessment.notDoneReason in "Patient Reason"

define "Denominator Exceptions":
  exists "Patient Reason for Not Performing Assessment of Cognition Using Standardized Tools or Alternate Methods"

define fluent function isVerified(condition Choice<ConditionEncounterDiagnosis, ConditionProblemsHealthConcerns>):
  condition.verificationStatus is not null implies ( condition.verificationStatus ~ QICoreCommon."confirmed"
      or condition.verificationStatus ~ QICoreCommon."unconfirmed"
      or condition.verificationStatus ~ QICoreCommon."provisional"
      or condition.verificationStatus ~ QICoreCommon."differential"
  )

define function ToString(value uri): value.value

/*
@description: Converts the given [Period](https://hl7.org/fhir/datatypes.html#Period)
value to a CQL DateTime Interval
@comment: If the start value of the given period is unspecified, the starting
boundary of the resulting interval will be open (meaning the start of the interval
is unknown, as opposed to interpreted as the beginning of time).
*/
define function ToInterval(period FHIR.Period):
    if period is null then
        null
    else
        if period."start" is null then
            Interval(period."start".value, period."end".value]
        else
            Interval[period."start".value, period."end".value]

/*
@description: Converts the given FHIR [Coding](https://hl7.org/fhir/datatypes.html#Coding) value to a CQL Code.
*/
define function ToCode(coding FHIR.Coding):
    if coding is null then
        null
    else
        System.Code {
          code: coding.code.value,
          system: coding.system.value,
          version: coding.version.value,
          display: coding.display.value
        }