library HIVViralSuppressionFHIR version '0.0.001'

using QICore version '4.1.1'

include CQMCommon version '1.4.000' called CQMCommon
include FHIRHelpers version '4.3.000' called FHIRHelpers
include QICoreCommon version '1.5.000' called QICoreCommon
include SupplementalDataElements version '3.4.000' called SDE

codesystem "SNOMEDCT": 'http://snomed.info/sct'
codesystem "CPT": 'http://www.ama-assn.org/go/cpt'

valueset "Annual Wellness Visit": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240'
valueset "Face-to-Face Interaction": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1048'
valueset "HIV": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.120.12.1003'
valueset "HIV Viral Load": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.120.12.1002'
valueset "Home Healthcare Services": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016'
valueset "Office Visit": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001'
valueset "Outpatient Consultation": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1008'
valueset "Preventive Care Services Established Office Visit, 18 and Up": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025'
valueset "Preventive Care Services Initial Office Visit, 18 and Up": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023'
valueset "Preventive Care Services Other": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1030'
valueset "Preventive Care Services, Initial Office Visit, 0 to 17": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1022'
valueset "Preventive Care, Established Office Visit, 0 to 17": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1024'
valueset "Telehealth Services": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1031'
valueset "Telephone Visits": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1080'

code "Below threshold level (qualifier value)": '260988000' from "SNOMEDCT" display 'Below threshold level (qualifier value)'
code "Not detected (qualifier value)": '260415000' from "SNOMEDCT" display 'Not detected (qualifier value)'
/*code "Unlisted preventive medicine service": '99429' from "CPT" display 'Unlisted preventive medicine service'*/
  /*additional info can be found in CQLIT-368*/



parameter "Measurement Period" Interval<DateTime>

context Patient

define "Denominator":
  "Initial Population"

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

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

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

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

define "Has Active HIV Diagnosis Before or in First 90 Days of Measurement Period":
  exists ["Condition": "HIV"] HIVDx
    where QICoreCommon."ToPrevalenceInterval" ( HIVDx ) starts before day of ( start of "Measurement Period" + 90 days )

define "Initial Population":
  "Has Active HIV Diagnosis Before or in First 90 Days of Measurement Period"
    and "Has Qualifying Encounter During First 240 Days of Measurement Period"

define "Most Recent Viral Load Test During Measurement Period":
  Last(["Observation": "HIV Viral Load"] ViralLoad
      where QICoreCommon."Latest"(ViralLoad.effective) during day of "Measurement Period"
      sort by start of QICoreCommon."ToInterval"(effective)
  )

define "Has Qualifying Encounter During First 240 Days of Measurement Period":
  exists ( ["Encounter": "Office Visit"]
    union ["Encounter": "Outpatient Consultation"]
    union ["Encounter": "Annual Wellness Visit"]
    union ["Encounter": "Face-to-Face Interaction"]
    union ["Encounter": "Home Healthcare Services"]
    union ["Encounter": "Preventive Care Services Established Office Visit, 18 and Up"]
    union ["Encounter": "Preventive Care Services Initial Office Visit, 18 and Up"]
    union ["Encounter": "Preventive Care Services, Initial Office Visit, 0 to 17"]
    union ["Encounter": "Preventive Care, Established Office Visit, 0 to 17"]
    union ["Encounter": "Telephone Visits"]
    union ["Encounter": "Preventive Care Services Other"] ) QualifyingEncounter
    where QualifyingEncounter.period during day of Interval[start of "Measurement Period", start of "Measurement Period" + 240 days]

define "Numerator":
  "Most Recent Viral Load Test During Measurement Period".value < 200 '{copies}/mL'
    or "Most Recent Viral Load Test During Measurement Period".value ~ "Below threshold level (qualifier value)"
    or "Most Recent Viral Load Test During Measurement Period".value ~ "Not detected (qualifier value)"
// or "Most Recent Viral Load Test During Measurement Period".value = "Below threshold level (qualifier value)"
// or "Most Recent Viral Load Test During Measurement Period".value = "Not detected (qualifier value)"

Encoded data (116352 characters)

Encoded data (165648 characters)