Id: 64b86c4f774bb523d9a1457e Url: http://ecqi.healthit.gov/ecqms/Library/AdvancedIllnessandFrailty Version: 1.6.000 Identifier: value: 64b86c4f774bb523d9a1457e Name: AdvancedIllnessandFrailty Title: AdvancedIllnessandFrailty Status: active Experimental: false Type: system: http://terminology.hl7.org/CodeSystem/library-type code: logic-library Date: 2023-08-28T15:49:25+00:00 Publisher: National Committee for Quality Assurance Description: This library contains definitions used to exclude patients 66 and older with an indication of frailty who also meet advanced illness criteria, and patients 66 and older who are living long term in a nursing home. Related Artifacts: Dependencies Data Requirements: Type Profile MS Code Filter DeviceRequest code filter: path: code value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.118.12.1300 Observation code filter: path: code system: http://loinc.org code: 98181-1 display: Medical equipment used Condition code filter: path: code value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.113.12.1074 Encounter code filter: path: code value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1088 Observation code filter: path: code value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.113.12.1075 Encounter code filter: path: code value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1087 Encounter code filter: path: code value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1086 Encounter code filter: path: code value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1010 Encounter code filter: path: code value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1084 Encounter code filter: path: code value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1083 MedicationRequest code filter: path: code value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.196.12.1510 Observation code filter: path: code system: http://loinc.org code: 71802-3 display: Housing status Content: text/cql library AdvancedIllnessandFrailty version '1.6.000' using QICore version '4.1.1' include FHIRHelpers version '4.3.000' called FHIRHelpers include QICoreCommon version '1.5.000' called QICoreCommon include CQMCommon version '1.4.000' called Global include CumulativeMedicationDuration version '3.3.000' called CMD include Status version '1.6.000' called Status codesystem "LOINC": 'http://loinc.org' codesystem "SNOMEDCT": 'http://snomed.info/sct' valueset "Acute Inpatient": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1083' valueset "Advanced Illness": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1082' valueset "Dementia Medications": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.196.12.1510' valueset "Emergency Department Evaluation and Management Visit": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1010' valueset "Frailty Device": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.118.12.1300' valueset "Frailty Diagnosis": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.113.12.1074' valueset "Frailty Encounter": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1088' valueset "Frailty Symptom": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.113.12.1075' valueset "Nonacute Inpatient": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1084' valueset "Observation": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1086' valueset "Outpatient": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1087' code "Housing status": '71802-3' from "LOINC" display 'Housing status' code "Lives in a nursing home (finding)": '160734000' from "SNOMEDCT" display 'Lives in a nursing home (finding)' code "Medical equipment used": '98181-1' from "LOINC" display 'Medical equipment used' parameter "Measurement Period" Interval<DateTime> context Patient define "Is Age 66 or Older with Advanced Illness and Frailty": AgeInYearsAt(date from end of "Measurement Period")>= 66 and "Has Criteria Indicating Frailty" and ( "Has Two Outpatient Encounters with Advanced Illness on Different Dates of Service" or "Has Inpatient Encounter with Advanced Illness" or "Has Dementia Medications in Year Before or During Measurement Period" ) define "Is Age 66 to 80 with Advanced Illness and Frailty or Is Age 81 or Older with Frailty": ( AgeInYearsAt(date from end of "Measurement Period")in Interval[66, 80] and "Has Criteria Indicating Frailty" and ( "Has Two Outpatient Encounters with Advanced Illness on Different Dates of Service" or "Has Inpatient Encounter with Advanced Illness" or "Has Dementia Medications in Year Before or During Measurement Period" ) ) or ( AgeInYearsAt(date from end of "Measurement Period")>= 81 and "Has Criteria Indicating Frailty" ) define "Has Criteria Indicating Frailty": exists ( (([DeviceRequest: "Frailty Device"]).isDeviceOrder()) FrailtyDeviceOrder where FrailtyDeviceOrder.doNotPerform() is not true and FrailtyDeviceOrder.authoredOn.toInterval() during day of "Measurement Period" ) or exists ( (([Observation: "Medical equipment used"]).isAssessmentPerformed()) EquipmentUsed where EquipmentUsed.value as Concept in "Frailty Device" and EquipmentUsed.effective.toInterval() ends during day of "Measurement Period" ) or exists ( ([Condition: "Frailty Diagnosis"]) FrailtyDiagnosis where FrailtyDiagnosis.prevalenceInterval() overlaps "Measurement Period" ) or exists ( (([Encounter: "Frailty Encounter"]).isEncounterPerformed()) FrailtyEncounter where FrailtyEncounter.period.toInterval() overlaps "Measurement Period" ) or exists ( (([Observation: "Frailty Symptom"]).isSymptom()) FrailtySymptom where FrailtySymptom.effective.toInterval() overlaps "Measurement Period" ) define "Has Two Outpatient Encounters with Advanced Illness on Different Dates of Service": exists ( from "Outpatient Encounters with Advanced Illness" OutpatientEncounter1, "Outpatient Encounters with Advanced Illness" OutpatientEncounter2 where OutpatientEncounter2.period ends 1 day or more after day of end of OutpatientEncounter1.period return OutpatientEncounter1 ) define "Outpatient Encounters with Advanced Illness": (( [Encounter: "Outpatient"] union [Encounter: "Observation"] union [Encounter: "Emergency Department Evaluation and Management Visit"] union [Encounter: "Nonacute Inpatient"] ).isEncounterPerformed()) OutpatientEncounter where exists ((OutpatientEncounter.encounterDiagnosis()) Diagnosis where Diagnosis.code in "Advanced Illness") and OutpatientEncounter.period.toInterval() starts during day of Interval[start of "Measurement Period" - 1 year, end of "Measurement Period"] define "Has Inpatient Encounter with Advanced Illness": exists ( ( ([Encounter: "Acute Inpatient"]).isEncounterPerformed()) InpatientEncounter where exists ((InpatientEncounter.encounterDiagnosis()) Diagnosis where Diagnosis.code in "Advanced Illness") and InpatientEncounter.period.toInterval() starts during day of Interval[start of "Measurement Period" - 1 year, end of "Measurement Period"] ) define "Has Dementia Medications in Year Before or During Measurement Period": exists (( ([MedicationRequest: "Dementia Medications"]).isMedicationActive()) DementiaMedication where DementiaMedication.doNotPerform is not true and CMD."MedicationRequestPeriod" ( DementiaMedication ) overlaps Interval[start of "Measurement Period" - 1 year, end of "Measurement Period"] ) define "Is Age 66 or Older Living Long Term in a Nursing Home": AgeInYearsAt(date from end of "Measurement Period" )>= 66 and ( ( Last( (([Observation: "Housing status"]).isAssessmentPerformed()) HousingStatus where HousingStatus.effective.toInterval() ends on or before end of "Measurement Period" sort by end of effective.toInterval() asc )) LastHousingStatus where LastHousingStatus.value ~ "Lives in a nursing home (finding)" ) is not null Content: application/elm+xml Encoded data (248696 characters) Content: application/elm+json Encoded data (360368 characters)
National Committee for Quality Assurance
This library contains definitions used to exclude patients 66 and older with an indication of frailty who also meet advanced illness criteria, and patients 66 and older who are living long term in a nursing home.
Value set Emergency Department Evaluation and Management Visit
Outpatient Encounters with Advanced Illness
Has Two Outpatient Encounters with Advanced Illness on Different Dates of Service
Has Inpatient Encounter with Advanced Illness
Has Dementia Medications in Year Before or During Measurement Period
Is Age 66 or Older with Advanced Illness and Frailty
Is Age 66 to 80 with Advanced Illness and Frailty or Is Age 81 or Older with Frailty
Is Age 66 or Older Living Long Term in a Nursing Home