KidneyHealthEvaluationFHIR
type: Measure
node role: treeRoot
id:
  v: KidneyHealthEvaluationFHIR
meta:
  profile:
    v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-measure-cqfm
    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: Kidney Health EvaluationFHIR Id: KidneyHealthEvaluationFHIR Download cql: KidneyHealthEvaluationFHIR.cql Version: 0.0.005 Url: Kidney Health EvaluationFHIR short-name identifier: CMS951FHIR version-independent identifier: urn:uuid:e66e345d-d892-4fe2-84a7-748433b6e0a6 version-specific identifier: urn:uuid:2c928085806c39a2018085f3251705e4 publisher (CMS) identifier: 951FHIR Effective Period: 2024-01-01 ..2024-12-31 Status: draft Date: 2023-10-27 08:12:32+0000 Approval Date: 2023-08-14 Last Review Date: 2023-08-14 Name: KidneyHealthEvaluationFHIR Publisher: National Kidney Foundation Author: National Kidney Foundation: www.kidney.org Description: Percentage of patients aged 18-75 years with a diagnosis of diabetes who received a kidney health evaluation defined by an Estimated Glomerular Filtration Rate (eGFR) AND Urine Albumin-Creatinine Ratio (uACR) within the measurement period Purpose: UNKNOWN Copyright: Copyright 2022 National Kidney Foundation. All Rights Reserved. Disclaimer: Physician Performance Measures (Measures) and related data specifications developed by the National Kidney Foundation (NKF) are intended to facilitate quality improvement activities by health care professionals. These Measures are intended to assist health care professionals in enhancing quality of care. These Measures are not clinical guidelines and do not establish a standard of medical care and have not been tested for all potential applications. NKF encourages testing and evaluation of its Measures. Measures are subject to review and may be revised or rescinded at any time by NKF. The measures may not be altered without prior written approval from NKF. The measures, while copyrighted, can be reproduced and distributed, without modification, for noncommercial purposes. Commercial use is defined as the sale, license, or distribution of the measures for commercial gain, or incorporation of the measures into a product or service that is sold, licensed, or distributed for commercial g…
contained: Library
  id:
    v: effective-data-requirements
  extension:
    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: active
  extension:
    url:
      v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode
      l: cqfm-directReferenceCode
    value: Coding
      system:
        v: http://terminology.hl7.org/CodeSystem/v3-ActCode
        l: v3-ActCode
      code:
        v: AMB
      display:
        v: Ambulatory
  extension:
    url:
      v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode
      l: cqfm-directReferenceCode
    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)
  extension:
    url:
      v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode
      l: cqfm-directReferenceCode
    value: Coding
      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)
  extension:
    url:
      v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode
      l: cqfm-directReferenceCode
    value: Coding
      system:
        v: http://terminology.hl7.org/CodeSystem/observation-category
        l: observation-category
      code:
        v: survey
      display:
        v: survey
  extension:
    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: KidneyHealthEvaluationFHIR
    extension:
      url:
        v: name
        l: name
      value: String
        v: Has Kidney Panel Performed During Measurement Period
    extension:
      url:
        v: statement
        l: statement
      value: String
        v: define "Has Kidney Panel Performed During Measurement Period": exists ( ["Observation": "Estimated Glomerular Filtration Rate"] eGFRTest where QICoreCommon."ToInterval" ( eGFRTest.effective ) during "Measurement Period" and eGFRTest.value is not null and eGFRTest.status in { 'final', 'amended', 'corrected' } ) and exists ( ["Observation": "Urine Albumin Creatinine Ratio"] uACRTest where QICoreCommon."ToInterval" ( uACRTest.effective ) during "Measurement Period" and uACRTest.value is not null and uACRTest.status in { 'final', 'amended', 'corrected' } )
    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: KidneyHealthEvaluationFHIR
    extension:
      url:
        v: name
        l: name
      value: String
        v: Numerator
    extension:
      url:
        v: statement
        l: statement
      value: String
        v: define "Numerator": "Has Kidney Panel Performed During Measurement Period"
    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:
    extension:
      url:
        v: libraryName
        l: libraryName
      value: String
        v: KidneyHealthEvaluationFHIR
    extension:
      url:
        v: name
        l: name
      value: String
        v: Has Active Diabetes Overlaps Measurement Period
    extension:
      url:
        v: statement
        l: statement
      value: String
        v: define "Has Active Diabetes Overlaps Measurement Period": exists ( ["Condition": "Diabetes"] Diabetes where QICoreCommon."ToPrevalenceInterval" ( Diabetes ) overlaps "Measurement Period" and Diabetes.clinicalStatus ~ "active" )
    extension:
      url:
        v: displaySequence
        l: displaySequence
      value: Integer
        v: 2

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: KidneyHealthEvaluationFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Has Outpatient Visit During Measurement Period
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Has Outpatient Visit During Measurement Period": exists ( ( ["Encounter": "Annual Wellness Visit"] union ["Encounter": "Home Healthcare Services"] union ["Encounter": "Office Visit"] union ["Encounter": "Outpatient Consultation"] union ["Encounter": "Preventive Care Services Established Office Visit, 18 and Up"] union ["Encounter": "Preventive Care Services Initial Office Visit, 18 and Up"] union ["Encounter": "Telephone Visits"] ) ValidEncounter where ValidEncounter.period during "Measurement Period" and ValidEncounter.class ~ "AMB" and ValidEncounter.status = 'finished' )
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: KidneyHealthEvaluationFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Initial Population
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Initial Population": AgeInYearsAt(date from start of "Measurement Period") in Interval[18, 75] and "Has Active Diabetes Overlaps Measurement Period" and "Has Outpatient Visit During Measurement Period"
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: KidneyHealthEvaluationFHIR
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: 5
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: KidneyHealthEvaluationFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Has CKD Stage 5 or ESRD Diagnosis Overlaps Measurement Period
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Has CKD Stage 5 or ESRD Diagnosis Overlaps Measurement Period": ( ["Condition": "Chronic Kidney Disease, Stage 5"] union ["Condition": "End Stage Renal Disease"] ) CKDOrESRD where QICoreCommon."ToPrevalenceInterval" ( CKDOrESRD ) overlaps "Measurement Period" and CKDOrESRD.clinicalStatus ~ "active"
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: Hospice
extension:
  url:
    v: name
    l: name
  value: String
    v: Has Hospice Services
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Has Hospice Services": exists ((([Encounter: "Encounter Inpatient"]).isEncounterPerformed()) 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.toInterval() ends during day of "Measurement Period" ) or exists ((([Encounter: "Hospice Encounter"]).isEncounterPerformed()) HospiceEncounter where HospiceEncounter.period.toInterval() overlaps day of "Measurement Period" ) or exists ((([Observation: "Hospice care [Minimum Data Set]"]).isAssessmentPerformed()) HospiceAssessment where HospiceAssessment.value ~ "Yes (qualifier value)" and HospiceAssessment.effective.toInterval() overlaps day of "Measurement Period" ) or exists ((([ServiceRequest: "Hospice Care Ambulatory"]).isInterventionOrder()) HospiceOrder where HospiceOrder.authoredOn.toInterval() during day of "Measurement Period" ) or exists ((([Procedure: "Hospice Care Ambulatory"]).isInterventionPerformed()) HospicePerformed where HospicePerformed.performed.toInterval() overlaps day of "Measurement Period" ) or exists (([Condition: "Hospice Diagnosis"]) HospiceCareDiagnosis where HospiceCareDiagnosis.prevalenceInterval() overlaps day of "Measurement Period" )
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: PalliativeCare
extension:
  url:
    v: name
    l: name
  value: String
    v: Has Palliative Care in the Measurement Period
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Has Palliative Care in the Measurement Period": exists ((([Observation: "Functional Assessment of Chronic Illness Therapy - Palliative Care Questionnaire (FACIT-Pal)"]).isAssessmentPerformed()) PalliativeAssessment where PalliativeAssessment.effective.toInterval() overlaps day of "Measurement Period" ) or exists ([Condition: "Palliative Care Diagnosis"] PalliativeDiagnosis where PalliativeDiagnosis.prevalenceInterval() overlaps day of "Measurement Period" ) or exists ((([Encounter: "Palliative Care Encounter"]).isEncounterPerformed()) PalliativeEncounter where PalliativeEncounter.period.toInterval() overlaps day of "Measurement Period" ) or exists ((([Procedure: "Palliative Care Intervention"]).isInterventionPerformed()) PalliativeIntervention where PalliativeIntervention.performed.toInterval() overlaps day of "Measurement Period" )
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: KidneyHealthEvaluationFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Denominator Exclusions
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Denominator Exclusions": exists "Has CKD Stage 5 or ESRD Diagnosis Overlaps Measurement Period" or Hospice."Has Hospice Services" or PalliativeCare."Has Palliative Care in the Measurement Period"
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: QICoreCommon
extension:
  url:
    v: name
    l: name
  value: String
    v: ToInterval
extension:
  url:
    v: statement
    l: statement
  value: String
    v: /* @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. Any other input will reslt in a null DateTime Interval @deprecated: This function is deprecated. Use the fluent function `toInterval()` instead */ define function ToInterval(choice Choice<DateTim…
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: QICoreCommon
extension:
  url:
    v: name
    l: name
  value: String
    v: ToPrevalenceInterval
extension:
  url:
    v: statement
    l: statement
  value: String
    v: /* @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, the resulting interval will have a closed ending boundary. If the condition is not active, the resulting interval will have an open ending boundary. @deprecated: This function is deprecated. Use the `prevalenceInterval()` fluent function instead */ define function ToPrevalenceInterval(condition Condition): if condition.clinicalStatus ~ "active" or condition.clinicalStatus ~ "recurrence" or condition.clinicalStatus ~ "relapse" then Interval[start of ToInterval(condition.onset), end of ToAbatementInterval(condition)] else Interval[start of ToInterval(condition.onset), end of ToAbatementInterval(condition))
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: Status
extension:
  url:
    v: name
    l: name
  value: String
    v: isEncounterPerformed
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define fluent function isEncounterPerformed(Enc List<Encounter>): Enc E where E.status in {'finished', 'arrived', 'triaged', 'in-progress', 'onleave'}
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: QICoreCommon
extension:
  url:
    v: name
    l: name
  value: String
    v: toInterval
extension:
  url:
    v: statement
    l: statement
  value: String
    v: /* @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. Any other input will reslt in a null DateTime Interval */ define fluent function toInterval(choice Choice<DateTime, Quantity, Interval<DateTime>, Interval<Quantity>>): case when choice is DateTim…
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: Status
extension:
  url:
    v: name
    l: name
  value: String
    v: isAssessmentPerformed
extension:
  url:
    v: statement
    l: statement
  value: String
    v: //Similar but different from QICoreCommon.isSurvey, which does not have status constraints define fluent function isAssessmentPerformed(Obs List<Observation>): Obs O where O.status in { 'final', 'amended', 'corrected' } and exists ( O.category ObservationCategory where ( ObservationCategory ) ~ "survey" )
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: FHIRHelpers
extension:
  url:
    v: name
    l: name
  value: String
    v: ToConcept
extension:
  url:
    v: statement
    l: statement
  value: String
    v: /* @description: Converts the given FHIR [CodeableConcept](https://hl7.org/fhir/datatypes.html#CodeableConcept) value to a CQL Concept. */ define function ToConcept(concept FHIR.CodeableConcept): if concept is null then null else System.Concept { codes: concept.coding C return ToCode(C), display: concept.text.value }
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: Status
extension:
  url:
    v: name
    l: name
  value: String
    v: isInterventionOrder
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define fluent function isInterventionOrder(ServiceRequest List<ServiceRequest>): ServiceRequest S where S.status in { 'active', 'completed' } and S.intent = 'order'
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: Status
extension:
  url:
    v: name
    l: name
  value: String
    v: isInterventionPerformed
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define fluent function isInterventionPerformed(Proc List<Procedure>): Proc P where P.status ~ 'completed'
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: QICoreCommon
extension:
  url:
    v: name
    l: name
  value: String
    v: prevalenceInterval
extension:
  url:
    v: statement
    l: statement
  value: String
    v: /* @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, the resulting interval will have a closed ending boundary. If the condition is not active, the resulting interval will have an open ending boundary. */ define fluent function prevalenceInterval(condition Condition): if condition.clinicalStatus ~ "active" or condition.clinicalStatus ~ "recurrence" or condition.clinicalStatus ~ "relapse" then Interval[start of condition.onset.toInterval(), end of condition.abatementInterval()] else Interval[start of condition.onset.toInterval(), end of condition.abatementInterval())
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 18
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 QICoreCommon
resource:
  v: http://ecqi.healthit.gov/ecqms/Library/QICoreCommon|1.5.000
  l: http://ecqi.healthit.gov/ecqms/Library/QICoreCommon

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

type:
  v: depends-on
display:
  v: Library Hospice
resource:
  v: http://ecqi.healthit.gov/ecqms/Library/Hospice|6.7.000
  l: http://ecqi.healthit.gov/ecqms/Library/Hospice

type:
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      v: http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type
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    code:
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system:
  v: urn:ietf:rfc:3986
  l: 3986

use:
  v: official
type:
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      l: identifier-type
    code:
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system:
  v: urn:ietf:rfc:3986
  l: 3986

use:
  v: official
type:
  coding:
    system:
      v: http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type
      l: identifier-type
    code:
      v: publisher
system:
  v: https://madie.cms.gov/measure/cmsId
  l: cmsId
value:
  v: 951FHIR
assigner:
  display:
    v: CMS

v: 0.0.005

v: KidneyHealthEvaluationFHIR

v: Kidney Health EvaluationFHIR

v: draft

v: false

v: 2023-10-27T08:12:32+00:00

v: National Kidney Foundation

telecom:
  system:
    v: url
  value:
    v: www.kidney.org

v: Percentage of patients aged 18-75 years with a diagnosis of diabetes who received a kidney health evaluation defined by an Estimated Glomerular Filtration Rate (eGFR) AND Urine Albumin-Creatinine Ratio (uACR) within the measurement period

v: UNKNOWN

v: This measure assesses performance of a comprehensive kidney evaluation in adults aged 18-75. This measure does not preclude or discourage the use of regular laboratory testing for CKD in patients outside of the age range (patients under 18 years and those over 75 years of age). This eCQM is a patient-based measure. This FHIR-based measure has been derived from the QDM-based measure: CMS951v1. 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 2022 National Kidney Foundation. All Rights Reserved.

v: 2023-08-14

v: 2023-08-14

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

name:
  v: National Kidney Foundation
telecom:
  system:
    v: url
  value:
    v: www.kidney.org

v: Physician Performance Measures (Measures) and related data specifications developed by the National Kidney Foundation (NKF) are intended to facilitate quality improvement activities by health care professionals. These Measures are intended to assist health care professionals in enhancing quality of care. These Measures are not clinical guidelines and do not establish a standard of medical care and have not been tested for all potential applications. NKF encourages testing and evaluation of its Measures. Measures are subject to review and may be revised or rescinded at any time by NKF. The measures may not be altered without prior written approval from NKF. The measures, while copyrighted, can be reproduced and distributed, without modification, for noncommercial purposes. Commercial use is defined as the sale, license, or distribution of the measures for commercial gain, or incorporation of the measures into a product or service that is sold, licensed, or distributed for commercial gain. Commercial uses of the measures require a license agreement between the user and NKF. Neither NKF nor its members shall be responsible for any use of the measures. THESE MEASURES AND SPECIFICATIONS ARE PROVIDED "AS IS" WITHOUT WARRANTY OF ANY KIND. Limited proprietary coding is contained in the Measure specifications for convenience. Users of the proprietary code sets should obtain all necessary licenses from the owners of these code sets. CPT(R) contained in the Measure specifications is copyright 2004-2021 American Medical Association. LOINC(R) is copyright 2004-2021 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2021 International Health Terminology Standards Development Organisation. ICD-10 is copyright 2021 World Health Organization. All Rights Reserved. The PCPI’s and AMA’s significant past efforts and contributions to the development and updating of the measure are acknowledged. Due to technical limitations, registere…

v: Chronic Kidney Disease (CKD) is a major driver of morbidity, mortality and high healthcare costs in the United States. Currently, 37 million American adults have CKD and millions of others are at increased risk (NKF, 2019), with an estimated population prevalence growing to nearly 17% among Americans aged 30 years and older by the year 2030 (Saran, 2019; Hoerger, 2015). Total Medicare spending in 2016 on both CKD and ESRD was over $114 billion, comprising 23% of total Medicare fee-for-service spending overall with costs increasing exponentially with advancing CKD (Saran, 2019; Nichols, 2020). In the US from 2002-2016, the burden of CKD, defined as years of life lost, years living with disability, disability-adjusted life years, and deaths, outpaced changes in the burden of disease for other conditions (Bowe, 2018). Patients with CKD are readmitted to the hospital more frequently than those without diagnosed CKD (Saran, 2019). CKD is the 9th leading cause of death in the US and is the fastest growing non-communicable disease in terms of in burden largely due to death (Hoerger, 2015; Bowe, 2018). This public health issue is driven largely by the impact of diabetes—the most common comorbid risk factor for CKD (Saran, 2019; Bowe, 2018). The intent of this process measure is to improve rates of guideline-concordant kidney health evaluation in patients with diabetes to more consistently identify and potentially treat or delay progression of CKD in this high-risk population. Annual kidney health evaluation in patients with diabetes to determine risk of CKD using estimated glomerular filtration rate (eGFR) and urine albumin creatinine ratio (uACR) is recommended by clinical practice guidelines (ADA, 2022; NKF, 2007; NKF, 2012) and has been a focus of various local and national health care quality improvement initiatives, including Healthy People 2020 (United States Renal Data System, 2018). However, performance of these tests in patients with diabetes remains low, with rate…

v: The following evidence statements are quoted verbatim from the referenced clinical guidelines and other sources, where applicable: At least once a year, assess urinary albumin (e.g., spot urinary albumin-to-creatinine ratio) and estimated glomerular filtration rate in patients with type 1 diabetes with duration of >= 5 years, in all patients with type 2 diabetes, and in all patients with comorbid hypertension. B (American Diabetes Association Professional Practice Committee, 2019) Patients with diabetes should be screened annually for Diabetic Kidney Disease (DKD). Initial screening should commence: - 5 years after the diagnosis of type 1 diabetes; (A) or - From diagnosis of type 2 diabetes. (B) Screening should include: - Measurements of urinary albumin-creatinine ratio (ACR) in a spot urine sample; (B) - Measurement of serum creatinine and estimation of GFR. (B) (National Kidney Foundation [NKF], 2007; NKF, 2012)

id:
  v: 638500824ba3d47c885c02a8
extension:
  url:
    v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring
    l: cqfm-scoring
  value: CodeableConcept
    coding:
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        v: http://terminology.hl7.org/CodeSystem/measure-scoring
        l: measure-scoring
      code:
        v: proportion
      display:
        v: Proportion
extension:
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    v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis
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extension:
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    l: cqfm-type
  value: CodeableConcept
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/measure-type
        l: measure-type
      code:
        v: process
      display:
        v: Process
population:
  code:
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/measure-population
        l: measure-population
      code:
        v: initial-population
      display:
        v: Initial Population
  description:
    v: All patients aged 18-75 years with a diagnosis of diabetes at the start of the measurement period with a visit during the measurement period
  criteria:
    language:
      v: text/cql-identifier
    expression:
      v: Initial Population
population:
  code:
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/measure-population
        l: measure-population
      code:
        v: denominator
      display:
        v: Denominator
  description:
    v: Equals Initial Population
  criteria:
    language:
      v: text/cql-identifier
    expression:
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population:
  code:
    coding:
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        v: http://terminology.hl7.org/CodeSystem/measure-population
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      code:
        v: denominator-exclusion
      display:
        v: Denominator Exclusion
  description:
    v: Patients with a diagnosis of End Stage Renal Disease (ESRD); Patients with a diagnosis of Chronic Kidney Disease (CKD) Stage 5; Patients who have an order for or are receiving hospice or palliative care
  criteria:
    language:
      v: text/cql-identifier
    expression:
      v: Denominator Exclusions
population:
  code:
    coding:
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        v: http://terminology.hl7.org/CodeSystem/measure-population
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        v: denominator-exception
      display:
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      display:
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  description:
    v: Patients who received a kidney health evaluation defined by an Estimated Glomerular Filtration Rate (eGFR) AND Urine Albumin-Creatinine Ratio (uACR) within the measurement period
  criteria:
    language:
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    expression:
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population:
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      code:
        v: numerator-exclusion
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