library HybridHospitalWideReadmissionFHIR version '0.0.001' /*This FHIR-based measure has been derived from CMS529 v4.0.0- QDM 5.6 Specifications*/ using QICore version '4.1.1' include FHIRHelpers version '4.3.000' called FHIRHelpers include SupplementalDataElements version '3.4.000' called SDE include CQMCommon version '1.4.000' called CQMCommon include QICoreCommon version '1.5.000' called QICoreCommon codesystem "LOINC:2.69": 'http://loinc.org' version '2.69' codesystem "ActCode": 'http://terminology.hl7.org/CodeSystem/v3-ActCode' codesystem "Source of Payment Typology": 'https://nahdo.org/sopt' valueset "Acute care hospital Inpatient Encounter": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.2289' valueset "Bicarbonate lab test": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.139' valueset "Body temperature": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.152' valueset "Body weight": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.159' valueset "Creatinine lab test": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.2363' valueset "Emergency Department Visit": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292' valueset "Encounter Inpatient": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307' valueset "Ethnicity": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.837' valueset "Glucose lab test": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.134' valueset "Heart Rate": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.149' valueset "Hematocrit lab test": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.114' valueset "Medicare payer": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1104.10' valueset "Observation Services": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.143' valueset "ONC Administrative Sex": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1' valueset "Oxygen Saturation by Pulse Oximetry": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.151' valueset "Payer": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591' valueset "Potassium lab test": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.117' valueset "Race": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.836' valueset "Respiratory Rate": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.130' valueset "Sodium lab test": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.119' valueset "Systolic Blood Pressure": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.163' valueset "White blood cells count lab test": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.129' code "Birth date": '21112-8' from "LOINC:2.69" display 'Birth date' code "IMP": 'IMP' from "ActCode" display 'Inpatient' code "ACUTE": 'ACUTE' from "ActCode" display 'Acute' code "NONAC": 'NONAC' from "ActCode" display 'Nonacute' code "OBSENC": 'OBSENC' from "ActCode" display 'Observation Encounter' parameter "Measurement Period" Interval default Interval[@2024-01-01T00:00:00.0, @2025-01-01T00:00:00.0) context Patient 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 "Initial Population": "Inpatient Encounters" define "Inpatient Encounters": from ["Encounter": "Encounter Inpatient"] InpatientEncounter, ["Coverage": "Medicare payer"] Payer where InpatientEncounter.status = 'finished' and ( InpatientEncounter.class ~ "IMP" or InpatientEncounter.class ~ "ACUTE" or InpatientEncounter.class ~ "NONAC" or InpatientEncounter.class ~ "OBSENC" ) and InpatientEncounter.hospitalizationWithObservationLengthofStay ( ) < 365 and InpatientEncounter.period ends during "Measurement Period" and AgeInYearsAt(date from start of InpatientEncounter.period) >= 65 return InpatientEncounter define "Results": flatten { // First physical exams (vital signs) "FirstPhysicalExamWithEncounterId"([Observation: "Heart Rate"], 'FirstHeartRate'), "FirstPhysicalExamWithEncounterId"([Observation: "Systolic Blood Pressure"], 'FirstSystolicBP'), "FirstPhysicalExamWithEncounterId"([Observation: "Respiratory Rate"], 'FirstRespRate'), "FirstPhysicalExamWithEncounterId"([Observation: "Body temperature"], 'FirstTemperature'), "FirstPhysicalExamWithEncounterId"([Observation: "Oxygen Saturation by Pulse Oximetry"], 'FirstO2Saturation'), // First weight using lab test timing "FirstPhysicalExamWithEncounterIdUsingLabTiming"([Observation: "Body weight"], 'FirstWeight'), //First lab tests "FirstLabTestWithEncounterId"([Observation: "Hematocrit lab test"], 'FirstHematocrit'), "FirstLabTestWithEncounterId"([Observation: "White blood cells count lab test"], 'FirstWhiteBloodCell'), "FirstLabTestWithEncounterId"([Observation: "Potassium lab test"], 'FirstPotassium'), "FirstLabTestWithEncounterId"([Observation: "Sodium lab test"], 'FirstSodium'), "FirstLabTestWithEncounterId"([Observation: "Bicarbonate lab test"], 'FirstBicarbonate'), "FirstLabTestWithEncounterId"([Observation: "Creatinine lab test"], 'FirstCreatinine'), "FirstLabTestWithEncounterId"([Observation: "Glucose lab test"], 'FirstGlucose') } define function "FirstPhysicalExamWithEncounterId"(ExamList List, CCDE String): "Inpatient Encounters" Encounter let firstexam: First(ExamList Exam where start of QICoreCommon."ToInterval"(Exam.effective) is not null and start of QICoreCommon."ToInterval"(Exam.effective) during Interval[start of Encounter.period - 1440 minutes, start of Encounter.period + 120 minutes] and Exam.status in { 'final', 'amended', 'preliminary' } and Exam.value is not null sort by start of QICoreCommon."ToInterval"(effective) ) return '\r\n' & CCDE & ',' & Encounter.id & ',' & ( ToString(firstexam.value as Quantity) ) & ',' & ToString(start of QICoreCommon."ToInterval"(firstexam.effective)) define function "FirstPhysicalExamWithEncounterIdUsingLabTiming"(ExamList List, CCDE String): "Inpatient Encounters" Encounter let firstexamwithlabtiming: First(ExamList Exam where start of QICoreCommon."ToInterval"(Exam.effective) is not null and start of QICoreCommon."ToInterval"(Exam.effective) during Interval[start of Encounter.period - 1440 minutes, start of Encounter.period + 1440 minutes] and Exam.status in { 'final', 'amended', 'preliminary' } and Exam.value is not null sort by start of QICoreCommon."ToInterval"(effective) ) return '\r\n' & CCDE & ',' & Encounter.id & ',' & ( ToString(firstexamwithlabtiming.value as Quantity) ) & ',' & ToString(start of QICoreCommon."ToInterval"(firstexamwithlabtiming.effective)) define function "FirstLabTestWithEncounterId"(LabList List, CCDE String): "Inpatient Encounters" Encounter let firstlab: First(LabList Lab where Lab.issued is not null and Lab.issued during Interval[start of Encounter.period - 1440 minutes, start of Encounter.period + 1440 minutes] and Lab.status in { 'final', 'amended', 'preliminary' } and Lab.value is not null sort by issued ) return '\r\n' & CCDE & ',' & Encounter.id & ',' & ( ToString(firstlab.value as Quantity) ) & ',' & ToString(firstlab.issued)