DepressionRemissionatTwelveMonthsFHIR
type: Measure
node role: treeRoot
id:
  v: DepressionRemissionatTwelveMonthsFHIR
meta:
  profile:
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    l: computable-measure-cqfm
  profile:
    v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/publishable-measure-cqfm
    l: publishable-measure-cqfm
  profile:
    v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/executable-measure-cqfm
    l: executable-measure-cqfm
text:
  status:
    v: extensions
  div:
    v: Title: Depression Remission at Twelve MonthsFHIR Id: DepressionRemissionatTwelveMonthsFHIR Download cql: DepressionRemissionatTwelveMonthsFHIR.cql Version: 0.0.001 Url: Depression Remission at Twelve MonthsFHIR short-name identifier: CMS159FHIR version-independent identifier: urn:uuid:5df972fb-27e0-4b59-b5f8-b041e6ffc947 version-specific identifier: urn:uuid:2c928084808a9589018094b0efb804a6 endorser (NQF) identifier: 0710e publisher (CMS) identifier: 159FHIR Effective Period: 2024-01-01 ..2024-12-31 Status: draft Date: 2023-08-28 17:12:47+0000 Approval Date: 2023-08-28 Last Review Date: 2023-08-28 Name: DepressionRemissionatTwelveMonthsFHIR Publisher: MN Community Measurement Author: Telligen: https://www.telligen.com/ Description: The percentage of adolescent patients 12 to 17 years of age and adult patients 18 years of age or older with major depression or dysthymia who reached remission 12 months (+/- 60 days) after an index event Use Context: code value program Purpose: UNKNOWN Copyright: Copyright MN Community Measurement, 2023. All rights reserved. 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. Mathematica disclaims all liability for use or accuracy of any third party codes contained in the specifications. CPT(R) contained in the Measure specifications is copyright 2004-2022 American Medical Association. LOINC(R) copyright 2004-2022 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2022 International Health Terminology Standards Development Organisation. ICD-10 copyright 2022 World Health Organization. All Rights Reserved. Disclaimer: The performance measure is not a clinical guideline and does not establish a standard of medical care, and has not been tested for all potential applications. THE MEASURES AND SPECIFICATIONS ARE PROVIDED “AS IS” WITHOUT WARRANTY O…
contained: Library
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    v: effective-data-requirements
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    url:
      v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode
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    value: Coding
      system:
        v: http://terminology.hl7.org/CodeSystem/condition-clinical
        l: condition-clinical
      code:
        v: active
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    url:
      v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode
      l: cqfm-directReferenceCode
    value: Coding
      system:
        v: http://terminology.hl7.org/CodeSystem/condition-clinical
        l: condition-clinical
      code:
        v: recurrence
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      v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode
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      system:
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      code:
        v: relapse
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      v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode
      l: cqfm-directReferenceCode
    value: Coding
      system:
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      code:
        v: unconfirmed
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    url:
      v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode
      l: cqfm-directReferenceCode
    value: Coding
      system:
        v: http://terminology.hl7.org/CodeSystem/condition-ver-status
        l: condition-ver-status
      code:
        v: refuted
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    url:
      v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode
      l: cqfm-directReferenceCode
    value: Coding
      system:
        v: http://terminology.hl7.org/CodeSystem/condition-ver-status
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      code:
        v: entered-in-error
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    url:
      v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode
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    value: Coding
      type: http://snomed.info/id/428361000124107
      system:
        v: http://snomed.info/sct
        l: sct
      code:
        v: 428361000124107
      display:
        v: Discharge to home for hospice care (procedure)
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      v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode
      l: cqfm-directReferenceCode
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      type: http://snomed.info/id/428371000124100
      system:
        v: http://snomed.info/sct
        l: sct
      code:
        v: 428371000124100
      display:
        v: Discharge to healthcare facility for hospice care (procedure)
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    url:
      v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode
      l: cqfm-directReferenceCode
    value: Coding
      type: https://loinc.org/rdf/45755-6
      system:
        v: http://loinc.org
        l: loinc.org
      code:
        v: 45755-6
      display:
        v: Hospice care [Minimum Data Set]
  extension:
    url:
      v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode
      l: cqfm-directReferenceCode
    value: Coding
      type: http://snomed.info/id/373066001
      system:
        v: http://snomed.info/sct
        l: sct
      code:
        v: 373066001
      display:
        v: Yes (qualifier value)
  extension:
    url:
      v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode
      l: cqfm-directReferenceCode
    value: Coding
      type: https://loinc.org/rdf/71007-9
      system:
        v: http://loinc.org
        l: loinc.org
      code:
        v: 71007-9
      display:
        v: Functional Assessment of Chronic Illness Therapy - Palliative Care Questionnaire (FACIT-Pal)
  extension:
    extension:
      url:
        v: libraryName
        l: libraryName
      value: String
        v: SupplementalDataElements
    extension:
      url:
        v: name
        l: name
      value: String
        v: SDE Sex
    extension:
      url:
        v: statement
        l: statement
      value: String
        v: define "SDE Sex": case when Patient.gender = 'male' then Code { code: 'M', system: 'http://hl7.org/fhir/v3/AdministrativeGender', display: 'Male' } when Patient.gender = 'female' then Code { code: 'F', system: 'http://hl7.org/fhir/v3/AdministrativeGender', display: 'Female' } else null end
    extension:
      url:
        v: displaySequence
        l: displaySequence
      value: Integer
        v: 0
    url:
      v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
      l: cqfm-logicDefinition
  extension:
    extension:
      url:
        v: libraryName
        l: libraryName
      value: String
        v: DepressionRemissionatTwelveMonthsFHIR
    extension:
      url:
        v: name
        l: name
      value: String
        v: SDE Sex
    extension:
      url:
        v: statement
        l: statement
      value: String
        v: define "SDE Sex": SDE."SDE Sex"
    extension:
      url:
        v: displaySequence
        l: displaySequence
      value: Integer
        v: 1
    url:
      v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
      l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: DepressionRemissionatTwelveMonthsFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Depression Assessments Greater than 9
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Depression Assessments Greater than 9": [Observation: "PHQ 9 and PHQ 9M Tools"] DepressionAssessment where DepressionAssessment.value > 9 and DepressionAssessment.status in { 'final', 'amended', 'corrected' }
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 2
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: DepressionRemissionatTwelveMonthsFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Depression Diagnoses
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Depression Diagnoses": ( [Condition: "Major Depression Including Remission"] union [Condition: "Dysthymia"] ) Depression where Depression.isActive ( ) and not ( Depression.verificationStatus ~ QICoreCommon."unconfirmed" or Depression.verificationStatus ~ QICoreCommon."refuted" or Depression.verificationStatus ~ QICoreCommon."entered-in-error" )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 3
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: DepressionRemissionatTwelveMonthsFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Denominator Identification Period
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Denominator Identification Period": Interval[start of "Measurement Period" - 14 months, start of "Measurement Period" - 2 months )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 4
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: DepressionRemissionatTwelveMonthsFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Depression Encounter
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Depression Encounter": [Encounter: "Contact or Office Visit"] ValidEncounter with "Depression Diagnoses" Depression such that ValidEncounter.period overlaps Depression.prevalenceInterval ( ) and ValidEncounter.period ends during "Denominator Identification Period" and ValidEncounter.status = 'finished'
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 5
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: DepressionRemissionatTwelveMonthsFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Index Depression Assessment
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Index Depression Assessment": First("Depression Assessments Greater than 9" DepressionAssessment with "Depression Encounter" DepressionEncounter such that DepressionAssessment.effective.toInterval() during day of Interval[ToDate((start of DepressionEncounter.period) - 7 days), end of DepressionEncounter.period] sort by start of effective.toInterval() )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 6
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: DepressionRemissionatTwelveMonthsFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Measure Assessment Period
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Measure Assessment Period": "Index Depression Assessment" FirstIndexAssessment let YearAfterIndexAssessment: date from start of FirstIndexAssessment.effective.toInterval ( ) + 12 months return Interval[YearAfterIndexAssessment - 60 days, YearAfterIndexAssessment + 60 days]
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 7
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: DepressionRemissionatTwelveMonthsFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Numerator
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Numerator": Last([Observation: "PHQ 9 and PHQ 9M Tools"] DepressionAssessment where ToDate(start of DepressionAssessment.effective.toInterval()) during "Measure Assessment Period" and DepressionAssessment.status in { 'final', 'amended', 'corrected' } sort by start of effective.toInterval() ).value < 5
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 8
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: DepressionRemissionatTwelveMonthsFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Stratification 2
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Stratification 2": "Index Depression Assessment" IndexAssessment return AgeInYearsAt(date from start of IndexAssessment.effective.toInterval()) >= 18
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 9
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: DepressionRemissionatTwelveMonthsFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Stratification 1
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Stratification 1": "Index Depression Assessment" IndexAssessment return AgeInYearsAt(date from start of IndexAssessment.effective.toInterval()) in Interval[12, 17]
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 10
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: DepressionRemissionatTwelveMonthsFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Initial Population
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Initial Population": AgeInYearsAt(start of("Index Depression Assessment".effective.toInterval())) >= 12
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 11
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: DepressionRemissionatTwelveMonthsFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Denominator
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Denominator": "Initial Population"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 12
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: SupplementalDataElements
extension:
  url:
    v: name
    l: name
  value: String
    v: SDE Payer
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "SDE Payer": [Coverage: type in "Payer Type"] Payer return { code: Payer.type, period: Payer.period }
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 13
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: DepressionRemissionatTwelveMonthsFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: SDE Payer
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "SDE Payer": SDE."SDE Payer"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 14
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: SupplementalDataElements
extension:
  url:
    v: name
    l: name
  value: String
    v: SDE Ethnicity
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "SDE Ethnicity": Patient.ethnicity E return Tuple { codes: { E.ombCategory } union E.detailed, display: E.text }
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 15
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: DepressionRemissionatTwelveMonthsFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: SDE Ethnicity
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "SDE Ethnicity": SDE."SDE Ethnicity"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 16
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: DepressionRemissionatTwelveMonthsFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Has Hospice Services in the Measure Assessment Period
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Has Hospice Services in the Measure Assessment Period": exists ( [Encounter: "Encounter Inpatient"] InpatientEncounter where ( InpatientEncounter.hospitalization.dischargeDisposition ~ "Discharge to home for hospice care (procedure)" or InpatientEncounter.hospitalization.dischargeDisposition ~ "Discharge to healthcare facility for hospice care (procedure)" ) and InpatientEncounter.period ends during day of Interval[start of "Denominator Identification Period", end of "Measure Assessment Period"] and InpatientEncounter.status = 'finished' ) or exists ( [Encounter: "Hospice Encounter"] HospiceEncounter where HospiceEncounter.period overlaps day of Interval[start of "Denominator Identification Period", end of "Measure Assessment Period"] and not ( HospiceEncounter.status in { 'cancelled', 'entered-in-error', 'unknown' } ) ) or exists ( [Observation: "Hospice care [Minimum Data Set]"] HospiceAssessment where HospiceAssessment.value ~ "Yes (qualifier value)" and HospiceAssessment.effective.toInterval ( ) overlaps day of Interval[start of "Denominator Identification Period", end of "Measure Assessment Period"] and HospiceAssessment.status in { 'final', 'amended', 'corrected' } ) or exists ( [ServiceRequest: code in "Hospice Care Ambulatory"] HospiceOrder where HospiceOrder.authoredOn during day of Interval[start of "Denominator Identification Period", end of "Measure Assessment Period"] and HospiceOrder.status in { 'active', 'completed' } and HospiceOrder.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' } ) or exists ( [Procedure: "Hospice Care Ambulatory"] HospicePerformed where HospicePerformed.performed.toInterval ( ) overlaps day of Interval[start of "Denominator Identification Period", end of "Measure Assessment Period"] and not ( HospicePerformed.status in { 'not-done', 'entered-in-error', 'unknown' } ) ) or exists ( [Condition: "Hospice Diagnosis"] HospiceCareDiagnosis where HospiceCareDiagnosis.prevalenceInterval ( ) …
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 17
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: DepressionRemissionatTwelveMonthsFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Has Palliative Care in the Measure Assessment Period
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Has Palliative Care in the Measure Assessment Period": exists ( [Observation: "Functional Assessment of Chronic Illness Therapy - Palliative Care Questionnaire (FACIT-Pal)"] PalliativeAssessment where PalliativeAssessment.effective.toInterval ( ) overlaps Interval[start of "Denominator Identification Period", end of "Measure Assessment Period"] and PalliativeAssessment.status in { 'final', 'amended', 'corrected' } ) or exists ( [Condition: "Palliative Care Diagnosis"] PalliativeDiagnosis where PalliativeDiagnosis.prevalenceInterval ( ) overlaps Interval[start of "Denominator Identification Period", end of "Measure Assessment Period"] and PalliativeDiagnosis.isActive ( ) and not ( PalliativeDiagnosis.verificationStatus ~ QICoreCommon."unconfirmed" or PalliativeDiagnosis.verificationStatus ~ QICoreCommon."refuted" or PalliativeDiagnosis.verificationStatus ~ QICoreCommon."entered-in-error" ) ) or exists ( [Encounter: "Palliative Care Encounter"] PalliativeEncounter where PalliativeEncounter.period overlaps Interval[start of "Denominator Identification Period", end of "Measure Assessment Period"] and PalliativeEncounter.status = 'finished' ) or exists ( [Procedure: "Palliative Care Intervention"] PalliativeIntervention where PalliativeIntervention.performed.toInterval ( ) overlaps Interval[start of "Denominator Identification Period", end of "Measure Assessment Period"] and not ( PalliativeIntervention.status in { 'not-done', 'entered-in-error', 'unknown' } ) )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 18
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: DepressionRemissionatTwelveMonthsFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Patient Expired
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Patient Expired": Patient.deceased on or before end of "Measure Assessment Period"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 19
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: DepressionRemissionatTwelveMonthsFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Has Mental Health Disorder Diagnoses
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Has Mental Health Disorder Diagnoses": exists ( ( [Condition: "Bipolar Disorder"] union [Condition: "Personality Disorder Emotionally Labile"] union [Condition: "Schizophrenia or Psychotic Disorder"] union [Condition: "Pervasive Developmental Disorder"] ) MentalHealthDisorderDiagnoses where ToDate(start of MentalHealthDisorderDiagnoses.prevalenceInterval()) on or before end of "Measure Assessment Period" and MentalHealthDisorderDiagnoses.isActive ( ) and not ( MentalHealthDisorderDiagnoses.verificationStatus ~ QICoreCommon."unconfirmed" or MentalHealthDisorderDiagnoses.verificationStatus ~ QICoreCommon."refuted" or MentalHealthDisorderDiagnoses.verificationStatus ~ QICoreCommon."entered-in-error" ) )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 20
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: DepressionRemissionatTwelveMonthsFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Denominator Exclusions
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Denominator Exclusions": "Has Hospice Services in the Measure Assessment Period" or "Has Palliative Care in the Measure Assessment Period" or "Patient Expired" or "Has Mental Health Disorder Diagnoses"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 21
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: SupplementalDataElements
extension:
  url:
    v: name
    l: name
  value: String
    v: SDE Race
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "SDE Race": Patient.race R return Tuple { codes: R.ombCategory union R.detailed, display: R.text }
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 22
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: DepressionRemissionatTwelveMonthsFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: SDE Race
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "SDE Race": SDE."SDE Race"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 23
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

v: active

coding:
  system:
    v: http://terminology.hl7.org/CodeSystem/library-type
    l: library-type
  code:
    v: module-definition

type:
  v: depends-on
display:
  v: Library SDE
resource:
  v: Library/SupplementalDataElements|3.4.000
  l: http://ecqi.healthit.gov/ecqms/Library/SupplementalDataElements

type:
  v: depends-on
display:
  v: Library FHIRHelpers
resource:
  v: Library/FHIRHelpers|4.3.000
  l: http://ecqi.healthit.gov/ecqms/Library/FHIRHelpers

type:
  v: depends-on
display:
  v: Library QICoreCommon
resource:
  v: Library/QICoreCommon|1.5.000
  l: http://ecqi.healthit.gov/ecqms/Library/QICoreCommon

type:
  v: depends-on
display:
  v: Library FHIRHelpers
resource:
  v: Library/FHIRHelpers|4.3.000
  l: http://ecqi.healthit.gov/ecqms/Library/FHIRHelpers

type:
  v: depends-on
display:
  v: Library FHIRHelpers
resource:
  v: Library/FHIRHelpers|4.3.000
  l: http://ecqi.healthit.gov/ecqms/Library/FHIRHelpers

type:
  v: depends-on
display:
  v: Code system ConditionClinicalStatusCodes
resource:
  v: http://terminology.hl7.org/CodeSystem/condition-clinical
  l: condition-clinical

type:
  v: depends-on
display:
  v: Code system ConditionVerificationStatusCodes
resource:
  v: http://terminology.hl7.org/CodeSystem/condition-ver-status
  l: condition-ver-status

type:
  v: depends-on
display:
  v: Code system SNOMEDCT
resource:
  v: http://snomed.info/sct
  l: sct

type:
  v: depends-on
display:
  v: Code system LOINC
resource:
  v: http://loinc.org
  l: loinc.org

type:
  v: depends-on
display:
  v: Value set PHQ 9 and PHQ 9M Tools
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.67.1.101.1.263
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.67.1.101.1.263

type:
  v: depends-on
display:
  v: Value set Contact or Office Visit
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1080.5
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1080.5

type:
  v: depends-on
display:
  v: Value set Major Depression Including Remission
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.113883.3.67.1.101.3.2444
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.113883.3.67.1.101.3.2444

type:
  v: depends-on
display:
  v: Value set Dysthymia
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.67.1.101.1.254
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.67.1.101.1.254

type:
  v: depends-on
display:
  v: Value set Payer Type
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591

type:
  v: depends-on
display:
  v: Value set Encounter Inpatient
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307

type:
  v: depends-on
display:
  v: Value set Hospice Encounter
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1003
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1003

type:
  v: depends-on
display:
  v: Value set Hospice Care Ambulatory
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1584
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1584

type:
  v: depends-on
display:
  v: Value set Hospice Diagnosis
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1165
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1165

type:
  v: depends-on
display:
  v: Value set Palliative Care Diagnosis
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1167
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1167

type:
  v: depends-on
display:
  v: Value set Palliative Care Encounter
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1090
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1090

type:
  v: depends-on
display:
  v: Value set Palliative Care Intervention
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1135
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1135

type:
  v: depends-on
display:
  v: Value set Bipolar Disorder
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.67.1.101.1.128
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.67.1.101.1.128

type:
  v: depends-on
display:
  v: Value set Personality Disorder Emotionally Labile
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.67.1.101.1.246
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.67.1.101.1.246

type:
  v: depends-on
display:
  v: Value set Schizophrenia or Psychotic Disorder
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.105.12.1104
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.105.12.1104

type:
  v: depends-on
display:
  v: Value set Pervasive Developmental Disorder
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.105.12.1152
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.105.12.1152

name:
  v: Measurement Period
use:
  v: in
min:
  v: 0
max:
  v: 1
type:
  v: Period

name:
  v: SDE Sex
use:
  v: out
min:
  v: 0
max:
  v: 1
type:
  v: Coding

name:
  v: Numerator
use:
  v: out
min:
  v: 0
max:
  v: 1
type:
  v: boolean

name:
  v: Stratification 2
use:
  v: out
min:
  v: 0
max:
  v: 1
type:
  v: boolean

name:
  v: Stratification 1
use:
  v: out
min:
  v: 0
max:
  v: 1
type:
  v: boolean

name:
  v: Denominator
use:
  v: out
min:
  v: 0
max:
  v: 1
type:
  v: boolean

name:
  v: SDE Payer
use:
  v: out
min:
  v: 0
max:
  v: *
type:
  v: Resource

name:
  v: Initial Population
use:
  v: out
min:
  v: 0
max:
  v: 1
type:
  v: boolean

name:
  v: SDE Ethnicity
use:
  v: out
min:
  v: 0
max:
  v: 1
type:
  v: Resource

name:
  v: Denominator Exclusions
use:
  v: out
min:
  v: 0
max:
  v: 1
type:
  v: boolean

name:
  v: SDE Race
use:
  v: out
min:
  v: 0
max:
  v: 1
type:
  v: Resource

type:
  v: Patient
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient
  l: qicore-patient

type:
  v: Patient
profile:
  v: http://hl7.org/fhir/Patient
  l: Patient
must support:
  v: gender
must support:
  v: gender.value
must support:
  v: birthDate
must support:
  v: birthDate.value
must support:
  v: deceased

type:
  v: Patient
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient
  l: qicore-patient

type:
  v: Observation
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation
  l: qicore-observation
must support:
  v: code
must support:
  v: value
must support:
  v: status
must support:
  v: status.value
must support:
  v: effective
code filter:
  path:
    v: code
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.67.1.101.1.263
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.67.1.101.1.263

type:
  v: Condition
profile:
  v: http://hl7.org/fhir/Condition
  l: Condition
must support:
  v: clinicalStatus

type:
  v: Condition
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition
  l: qicore-condition
must support:
  v: code
code filter:
  path:
    v: code
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.113883.3.67.1.101.3.2444
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.113883.3.67.1.101.3.2444

type:
  v: Condition
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition
  l: qicore-condition
must support:
  v: code
code filter:
  path:
    v: code
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.67.1.101.1.254
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.67.1.101.1.254

type:
  v: Encounter
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
  l: qicore-encounter
must support:
  v: type
must support:
  v: period
must support:
  v: status
must support:
  v: status.value
code filter:
  path:
    v: type
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1080.5
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1080.5

type:
  v: Observation
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation
  l: qicore-observation
must support:
  v: code
must support:
  v: value
must support:
  v: status
must support:
  v: status.value
must support:
  v: effective
code filter:
  path:
    v: code
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.67.1.101.1.263
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.67.1.101.1.263

type:
  v: Observation
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation
  l: qicore-observation
must support:
  v: code
must support:
  v: effective
must support:
  v: status
must support:
  v: status.value
code filter:
  path:
    v: code
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.67.1.101.1.263
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.67.1.101.1.263

type:
  v: Observation
profile:
  v: http://hl7.org/fhir/Observation
  l: Observation
must support:
  v: value
must support:
  v: effective

type:
  v: Patient
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient
  l: qicore-patient

type:
  v: Coverage
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-coverage
  l: qicore-coverage
must support:
  v: type
must support:
  v: period
code filter:
  path:
    v: type
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591

type:
  v: uri
profile:
  v: http://hl7.org/fhir/uri
  l: uri
must support:
  v: value

type:
  v: Patient
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient
  l: qicore-patient
must support:
  v: url
must support:
  v: extension

type:
  v: Patient
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient
  l: qicore-patient
must support:
  v: url
must support:
  v: extension

type:
  v: Encounter
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
  l: qicore-encounter
must support:
  v: type
must support:
  v: hospitalization
must support:
  v: hospitalization.dischargeDisposition
must support:
  v: period
must support:
  v: status
must support:
  v: status.value
code filter:
  path:
    v: type
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307

type:
  v: Encounter
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
  l: qicore-encounter
must support:
  v: type
must support:
  v: period
must support:
  v: status
must support:
  v: status.value
code filter:
  path:
    v: type
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1003
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1003

type:
  v: Observation
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation
  l: qicore-observation
must support:
  v: code
must support:
  v: value
must support:
  v: effective
must support:
  v: status
must support:
  v: status.value
code filter:
  path:
    v: code
  code: https://loinc.org/rdf/45755-6
    system:
      v: http://loinc.org
      l: loinc.org
    code:
      v: 45755-6
    display:
      v: Hospice care [Minimum Data Set]

type:
  v: ServiceRequest
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest
  l: qicore-servicerequest
must support:
  v: code
must support:
  v: authoredOn
must support:
  v: authoredOn.value
must support:
  v: status
must support:
  v: status.value
must support:
  v: intent
must support:
  v: intent.value
code filter:
  path:
    v: code
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1584
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1584

type:
  v: Procedure
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure
  l: qicore-procedure
must support:
  v: code
must support:
  v: performed
must support:
  v: status
must support:
  v: status.value
code filter:
  path:
    v: code
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1584
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1584

type:
  v: Condition
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition
  l: qicore-condition
must support:
  v: code
must support:
  v: verificationStatus
code filter:
  path:
    v: code
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1165
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1165

type:
  v: Observation
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation
  l: qicore-observation
must support:
  v: code
must support:
  v: effective
must support:
  v: status
must support:
  v: status.value
code filter:
  path:
    v: code
  code: https://loinc.org/rdf/71007-9
    system:
      v: http://loinc.org
      l: loinc.org
    code:
      v: 71007-9
    display:
      v: Functional Assessment of Chronic Illness Therapy - Palliative Care Questionnaire (FACIT-Pal)

type:
  v: Condition
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition
  l: qicore-condition
must support:
  v: code
must support:
  v: verificationStatus
code filter:
  path:
    v: code
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1167
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1167

type:
  v: Encounter
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
  l: qicore-encounter
must support:
  v: type
must support:
  v: period
must support:
  v: status
must support:
  v: status.value
code filter:
  path:
    v: type
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1090
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1090

type:
  v: Procedure
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure
  l: qicore-procedure
must support:
  v: code
must support:
  v: performed
must support:
  v: status
must support:
  v: status.value
code filter:
  path:
    v: code
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1135
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1135

type:
  v: Condition
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition
  l: qicore-condition
must support:
  v: code
code filter:
  path:
    v: code
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.67.1.101.1.128
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.67.1.101.1.128

type:
  v: Condition
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition
  l: qicore-condition
must support:
  v: code
code filter:
  path:
    v: code
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.67.1.101.1.246
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.67.1.101.1.246

type:
  v: Condition
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition
  l: qicore-condition
must support:
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v: 0.0.001

v: DepressionRemissionatTwelveMonthsFHIR

v: Depression Remission at Twelve MonthsFHIR

v: draft

v: false

v: 2023-08-28T17:12:47+00:00

v: MN Community Measurement

telecom:
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  value:
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v: The percentage of adolescent patients 12 to 17 years of age and adult patients 18 years of age or older with major depression or dysthymia who reached remission 12 months (+/- 60 days) after an index event

code:
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v: UNKNOWN

v: When an index assessment is conducted with PHQ-9M, the follow-up assessment can use either a PHQ-9M or PHQ-9. This eCQM is a patient-based measure. This FHIR-based measure has been derived from the QDM-based measure: CMS159v12. Please refer to the HL7 QI-Core Implementation Guide (http://hl7.org/fhir/us/qicore/index.html) for more information on QI-Core and mapping recommendations from QDM to QI-Core 4.1.1 (http://hl7.org/fhir/us/qicore/qdm-to-qicore.html).

v: Copyright MN Community Measurement, 2023. All rights reserved. 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. Mathematica disclaims all liability for use or accuracy of any third party codes contained in the specifications. CPT(R) contained in the Measure specifications is copyright 2004-2022 American Medical Association. LOINC(R) copyright 2004-2022 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2022 International Health Terminology Standards Development Organisation. ICD-10 copyright 2022 World Health Organization. All Rights Reserved.

v: 2023-08-28

v: 2023-08-28

start:
  v: 2024-01-01
end:
  v: 2024-12-31

name:
  v: Telligen
telecom:
  system:
    v: url
  value:
    v: https://www.telligen.com/

v: The performance measure is not a clinical guideline and does not establish a standard of medical care, and has not been tested for all potential applications. THE MEASURES AND SPECIFICATIONS ARE PROVIDED “AS IS” WITHOUT WARRANTY OF ANY KIND. Due to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM].

v: Adults: Depression is a common and treatable mental disorder. During 2013-2016, 8.1% of American adults age 20 and over had depression in a given 2 week period. Women (10.4%) were almost twice as likely as men (5.5%) to have had depression. The prevalence of depression among adults decreased as family income levels increased. About 80% of adults with depression reported at least some difficulty with work, home, or social activities because of their depression symptoms (Brody, Pratt, and Hughes, 2018). Depression is a risk factor for development of chronic illnesses such as diabetes and coronary heart disease and adversely affects the course, complications and management of chronic medical illness. Both maladaptive health risk behaviors and psychobiological factors associated with depression may explain depression's negative effect on outcomes of chronic illness (Katon, 2011). Adolescents and Adults: The Centers for Disease Control and Prevention states that during 2009-2012 an estimated 7.6% of the U.S. population aged 12 and over had depression, including 3% of Americans with severe depressive symptoms. Almost 43% of persons with severe depressive symptoms reported serious difficulties in work, home and social activities, yet only 35% reported having contact with a mental health professional in the past year (Pratt and Brody, 2014). Depression is associated with higher mortality rates in all age groups. Depression is also a leading cause of medical disability, and depressed people lose 5.6 hours of productive work every week when they are depressed, 50% of which is due to absenteeism and short-term disability (Stewart et al., 2003). Adolescents: In 2014, an estimated 2.8 million adolescents age 12 to 17 in the United States had at least one major depressive episode (MDE) in the past year (Center for Behavioral Health Statistics and Quality, 2015). The 2013 Youth Risk Behavior Survey of students grades 9 to 12 indicated that during the past 12 months 39.1% (F) and 2…

v: Adults: Recommendations and algorithm notations supporting depression outcomes and duration of treatment according to Institute for Clinical Systems Improvement Health Care Guideline (Trangle et al., 2016): Recommendation: Clinicians should establish and maintain follow-up with patients. Appropriate, reliable follow-up is highly correlated with improved response and remission scores. It is also correlated with the improved safety and efficacy of medications and helps prevent relapse (Trangle et al., 2016). Proactive follow-up contacts (in person, telephone) based on the collaborative care model have been shown to significantly lower depression severity (Unutzer et al., 2002). In the available clinical effectiveness trials conducted in real clinical practice settings, even the addition of a care manager leads to modest remission rates (Trivedi et al., 2006; Unutzer et al., 2002). Interventions are critical to educating the patient regarding the importance of preventing relapse, safety and efficacy of medications, and management of potential side effects. Establish and maintain initial follow-up contact intervals (office, phone, other) (Hunkeler et al., 2000; Simon et al., 2000). The Patient Health Questionnaire-9 (PHQ-9) is an effective monitoring and management tool, and should be used routinely for subsequent visits to monitor treatment outcomes and severity. It can also help the clinician decide if/how to modify the treatment plan (Duffy et al., 2008; Lowe et al., 2004). Using a measurement-based approach to depression care, PHQ-9 results and side effect evaluation should be combined with treatment algorithms to drive patients toward remission. A five-point drop in PHQ-9 score is considered the minimal clinically significant difference (Trivedi, 2009). The goals of treatment should be to achieve remission, reduce relapse and recurrence, and return to previous level of occupational and psychosocial function. If using a PHQ-9 tool, remission translates to PHQ-9 scor…

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    v: Adolescent patients 12 to 17 years of age and adult patients 18 years of age and older with a diagnosis of major depression or dysthymia and an initial PHQ-9 or PHQ-9M score greater than nine during the index event. Patients may be assessed using PHQ-9 or PHQ-9M on the same date or up to 7 days prior to the encounter (index event).
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