eCQM QICore Content Implementation Guide
2023.0.0 - CI Build
eCQM QICore Content Implementation Guide
2023.0.0 - CI Build
eCQM QICore Content Implementation Guide, published by cqframework. This guide is not an authorized publication; it is the continuous build for version 2023.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/cqframework/ecqm-content-qicore-2023/ and changes regularly. See the Directory of published versions
| Draft as of 2023-08-08 |
<Measure xmlns="http://hl7.org/fhir">
<id value="SevereObstetricComplicationsFHIR"/>
<meta>
<profile
value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-measure-cqfm"/>
<profile
value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/publishable-measure-cqfm"/>
<profile
value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/executable-measure-cqfm"/>
</meta>
<text>
<status value="extensions"/>
<div xmlns="http://www.w3.org/1999/xhtml">
<table class="grid dict">
<tr>
<th scope="row"><b>Title: </b></th>
<td style="padding-left: 4px;">Severe Obstetric ComplicationsFHIR</td>
</tr>
<tr>
<th scope="row"><b>Id: </b></th>
<td style="padding-left: 4px;">SevereObstetricComplicationsFHIR</td>
</tr>
<tr>
<th scope="row"><b>Download cql: </b></th>
<td style="padding-left: 4px;"><a href="Library-SevereObstetricComplicationsFHIR.cql">SevereObstetricComplicationsFHIR.cql</a></td>
</tr>
<tr>
<th scope="row"><b>Version: </b></th>
<td style="padding-left: 4px;">0.0.007</td>
</tr>
<tr>
<th scope="row"><b>Url: </b></th>
<td style="padding-left: 4px;"><a href="Measure-SevereObstetricComplicationsFHIR.html">Severe Obstetric ComplicationsFHIR</a></td>
</tr>
<tr>
<th scope="row">
<b>
short-name identifier:
</b>
</th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<span>CMS1028FHIR</span>
</p>
</td>
</tr>
<tr>
<th scope="row">
<b>
version-independent identifier:
</b>
</th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<span>urn:uuid:6cf03fe2-b962-4f83-ac37-26d7477183c7</span>
</p>
</td>
</tr>
<tr>
<th scope="row">
<b>
version-specific identifier:
</b>
</th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<span>urn:uuid:2c92808482ead7c5018384daff512547</span>
</p>
</td>
</tr>
<tr>
<th scope="row">
<b>
publisher (CMS) identifier:
</b>
</th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<span>1028FHIR</span>
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Effective Period: </b></th>
<td style="padding-left: 4px;">2024-01-01
..2024-12-31</td>
</tr>
<tr>
<th scope="row"><b>Status: </b></th>
<td style="padding-left: 4px;">draft</td>
</tr>
<tr>
<th scope="row"><b>Date: </b></th>
<td style="padding-left: 4px;">2023-08-08 18:35:06+0000</td>
</tr>
<tr>
<th scope="row"><b>Approval Date: </b></th>
<td style="padding-left: 4px;">2023-08-21</td>
</tr>
<tr>
<th scope="row"><b>Last Review Date: </b></th>
<td style="padding-left: 4px;">2023-08-21</td>
</tr>
<tr>
<th scope="row"><b>Name: </b></th>
<td style="padding-left: 4px;">SevereObstetricComplicationsFHIR</td>
</tr>
<tr>
<th scope="row"><b>Publisher: </b></th>
<td style="padding-left: 4px;">The Joint Commission</td>
</tr>
<tr>
<th scope="row"><b>Author: </b></th>
<td style="padding-left: 4px;">The Joint Commission: <a href="https://www.jointcommission.org/">https://www.jointcommission.org/</a>, Centers for Medicare & Medicaid Services (CMS): <a href="https://www.cms.gov/">https://www.cms.gov/</a>, Yale New Haven Health Service Corporation/ Center for Outcomes Research and Evaluation: <a href="https://medicine.yale.edu/core/">https://medicine.yale.edu/core/</a></td>
</tr>
<tr>
<th scope="row"><b>Description: </b></th>
<td style="padding-left: 4px;"><div><p>Patients with severe obstetric complications which occur during the inpatient delivery hospitalization</p>
</div></td>
</tr>
<tr>
<th scope="row"><b>Use Context: </b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr>
<th><b>code</b></th>
<th><b>value</b></th>
</tr>
<tr>
<td>program</td>
<td/>
</tr>
</table>
</td>
</tr>
<tr>
<th scope="row"><b>Purpose: </b></th>
<td style="padding-left: 4px;"><div><p>UNKNOWN</p>
</div></td>
</tr>
<tr>
<th scope="row"><b>Copyright: </b></th>
<td style="padding-left: 4px;"><div><p>Measure specifications are in the Public Domain.</p>
<p>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.</p>
</div></td>
</tr>
<tr>
<th scope="row"><b>Disclaimer: </b></th>
<td style="padding-left: 4px;"><div><p>These performance measures are not clinical guidelines and do not establish a standard of medical care, and have not been tested for all potential applications. The measures and specifications are provided without warranty.</p>
</div></td>
</tr>
<tr>
<th scope="row"><b>Risk Adjustment Factor: </b></th>
<td style="padding-left: 4px;">
<p>
Risk Variable Lab and Physical Exam Results
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Risk Adjustment Factor: </b></th>
<td style="padding-left: 4px;">
<p>
Risk Variable Anemia
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Risk Adjustment Factor: </b></th>
<td style="padding-left: 4px;">
<p>
Risk Variable Asthma
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Risk Adjustment Factor: </b></th>
<td style="padding-left: 4px;">
<p>
Risk Variable Autoimmune Disease
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Risk Adjustment Factor: </b></th>
<td style="padding-left: 4px;">
<p>
Risk Variable Bariatric Surgery
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Risk Adjustment Factor: </b></th>
<td style="padding-left: 4px;">
<p>
Risk Variable Bleeding Disorder
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Risk Adjustment Factor: </b></th>
<td style="padding-left: 4px;">
<p>
Risk Variable Morbid Obesity
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Risk Adjustment Factor: </b></th>
<td style="padding-left: 4px;">
<p>
Risk Variable Cardiac Disease
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Risk Adjustment Factor: </b></th>
<td style="padding-left: 4px;">
<p>
Risk Variable Economic Housing Instability
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Risk Adjustment Factor: </b></th>
<td style="padding-left: 4px;">
<p>
Risk Variable Gastrointestinal Disease
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Risk Adjustment Factor: </b></th>
<td style="padding-left: 4px;">
<p>
Risk Variable Gestational Diabetes
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Risk Adjustment Factor: </b></th>
<td style="padding-left: 4px;">
<p>
Risk Variable HIV
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Risk Adjustment Factor: </b></th>
<td style="padding-left: 4px;">
<p>
Risk Variable Hypertension
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Risk Adjustment Factor: </b></th>
<td style="padding-left: 4px;">
<p>
Risk Variable Long Term Anticoagulant Use
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Risk Adjustment Factor: </b></th>
<td style="padding-left: 4px;">
<p>
Risk Variable Mental Health Disorder
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Risk Adjustment Factor: </b></th>
<td style="padding-left: 4px;">
<p>
Risk Variable Multiple Pregnancy
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Risk Adjustment Factor: </b></th>
<td style="padding-left: 4px;">
<p>
Risk Variable Neuromuscular
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Risk Adjustment Factor: </b></th>
<td style="padding-left: 4px;">
<p>
Risk Variable Obstetrical VTE
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Risk Adjustment Factor: </b></th>
<td style="padding-left: 4px;">
<p>
Risk Variable Placenta Previa
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Risk Adjustment Factor: </b></th>
<td style="padding-left: 4px;">
<p>
Risk Variable Placental Abruption
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Risk Adjustment Factor: </b></th>
<td style="padding-left: 4px;">
<p>
Risk Variable Placental Accreta Spectrum
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Risk Adjustment Factor: </b></th>
<td style="padding-left: 4px;">
<p>
Risk Variable Preexisting Diabetes
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Risk Adjustment Factor: </b></th>
<td style="padding-left: 4px;">
<p>
Risk Variable Previous Cesarean
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Risk Adjustment Factor: </b></th>
<td style="padding-left: 4px;">
<p>
Risk Variable Pulmonary Hypertension
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Risk Adjustment Factor: </b></th>
<td style="padding-left: 4px;">
<p>
Risk Variable Renal Disease
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Risk Adjustment Factor: </b></th>
<td style="padding-left: 4px;">
<p>
Risk Variable Severe Preeclampsia
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Risk Adjustment Factor: </b></th>
<td style="padding-left: 4px;">
<p>
Risk Variable Substance Abuse
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Risk Adjustment Factor: </b></th>
<td style="padding-left: 4px;">
<p>
Risk Variable Thyrotoxicosis
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Risk Adjustment Factor: </b></th>
<td style="padding-left: 4px;">
<p>
Risk Variable Other Preeclampsia
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Risk Adjustment Factor: </b></th>
<td style="padding-left: 4px;">
<p>
Risk Variable Preterm Birth
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Risk Adjustment Factor: </b></th>
<td style="padding-left: 4px;">
<p>
Risk Variable First Hematocrit Lab Test
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Risk Adjustment Factor: </b></th>
<td style="padding-left: 4px;">
<p>
Risk Variable First White Blood Cell Count Lab Test
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Risk Adjustment Factor: </b></th>
<td style="padding-left: 4px;">
<p>
Risk Variable Heart Rate
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Risk Adjustment Factor: </b></th>
<td style="padding-left: 4px;">
<p>
Risk Variable Systolic Blood Pressure
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Rationale: </b></th>
<td style="padding-left: 4px;"><div><p>The United States (US) experiences higher rates of maternal morbidity and mortality than most other developed countries. These rates have continued to trend upward in recent decades (CDC, n.d.). Research indicates that the overall rate of severe maternal morbidity (SMM) increased by almost 200% between 1993 and 2014 to 144 per 10,000 delivery hospitalizations (CDC, n.d.), with more than 25,000 women per year experiencing obstetric complications (U.S. Department of Health and Human Services, 2020). Recent maternal mortality data from 2018 reveal that 658 women in the US died from maternal causes, resulting in a rate of 17.4 deaths per 100,000 live births, with 77% of the deaths attributed to direct obstetric causes like hemorrhage, preeclampsia, obstetric embolism, and other complications (Hoyert & Minino, 2018). 144 per 10,000 women hospitalized for delivery have experienced SMM, including hemorrhage, embolism, hypertension, stroke, and other serious complications (CDC,2020). Racial and ethnic disparities for Black women and Hispanic women are at a significantly higher risk for developing these complications than are Non-Hispanic White women (Leonard et al., 2019). Increasing rates of SMM are resulting in increased healthcare costs, longer hospitalization stays and impacts on a woman's health.</p>
<p>There is limited national evaluation of hospitals' performance on maternal morbidity and mortality although SMM is widely used at the population level. SMM is linked to maternal mortality, varies significantly among hospitals, and has significant racial/ethnic and urban/rural disparities. SMM is a cost driver for both Medicaid and commercial plans. This measure is important as it will assist in the discovery and understanding of SMM patterns which can lead to improvements in the safety and quality of maternal care necessary to reduce SMM rates.</p>
</div></td>
</tr>
<tr>
<th scope="row"><b>Clinical recommendation statement: </b></th>
<td style="padding-left: 4px;"><div><p>Healthy People 2030 Measure (MICH-05): Reduce severe maternal complications identified during delivery hospitalizations</p>
<p>The American College of Obstetricians and Gynecologists (the College) and the Society for Maternal-Fetal Medicine (SMFM) recommend identifying potential cases of severe maternal morbidity for further review, with a focus on outcomes and complications, and consider this an important step toward promoting safe obstetric care.</p>
</div></td>
</tr>
<tr>
<th scope="row"><b>Guidance (Usage): </b></th>
<td style="padding-left: 4px;">This measure allows for 3 approaches to determine gestational age (GA) in the following order of precedence:
1. The GA is calculated using the American College of Obstetricians and Gynecologists ReVITALize guidelines.*
2. The GA is obtained from a discrete field in the electronic health record. This option is only used when the calculated GA is not available.
3. The GA is based on ICD10 or SNOMED codes indicative of weeks gestation. This option is only used when results from items #1 and #2 (see above) are not available.
Wherever gestational age is mentioned, relative to the delivery, the intent is to capture the last estimated gestational age prior to or at the time of delivery.
*ACOG ReVITALize Guidelines for Calculating Gestational Age:
Gestational Age = (280-(Estimated Due Date minus Reference Date))/7
--Estimated Due Date (EDD): The best obstetrical EDD is determined by last menstrual period if confirmed by early ultrasound or no ultrasound performed, or early ultrasound if no known last menstrual period or the ultrasound is not consistent with last menstrual period, or known date of fertilization (e.g., assisted reproductive technology)
--Reference Date is the date on which you are trying to determine gestational age. For purposes of this eCQM, Reference Date would be the Date of Delivery.
Note however the calculation may yield a non-whole number and gestational age should be rounded off to the nearest completed week. For example, an infant born on the 5th day of the 36th week (35 weeks and 5/7 days) is at a gestational age of 35 weeks, not 36 weeks.
Definition:
For this measure, specifications are modeled after the nationally available and adopted CDC definition for Severe Maternal Morbidity (SMM) with the addition of maternal mortality. At times, we may refer to the CDC indicators of morbidity as SMM, but the outcome of the measure, which includes morbidity and mortality, is referred to as Severe Obstetric Complications (SOC).
This eCQM is an episode-based measure. An episode is defined as each inpatient hospitalization or encounter that ends during the measurement period.
This FHIR-based measure has been derived from the QDM-based measure CMS1028v2.
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).</td>
</tr>
<tr>
<th scope="row"><b>Population Criteria: </b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr>
<th><b>638907ab4ba3d47c885c02fd</b></th>
</tr>
<tr>
<td>Initial Population:</td>
<td>Inpatient hospitalizations for patients age greater than or equal to 8 years and less than 65 admitted to the hospital for inpatient acute care who undergo a delivery procedure with a discharge date that ends during the measurement period</td>
</tr>
<tr>
<td>Denominator:</td>
<td>Inpatient hospitalizations for patients delivering stillborn or live birth with greater than or equal to 20 weeks, 0 days gestation completed</td>
</tr>
<tr>
<td>Denominator Exclusion:</td>
<td>Inpatient hospitalizations for patients with confirmed diagnosis of COVID with COVID-related respiratory condition or patients with confirmed diagnosis of COVID with COVID-related respiratory procedure</td>
</tr>
<tr>
<td>Numerator:</td>
<td>Inpatient hospitalizations for patients with severe obstetric complications (not present on admission that occur during the current delivery encounter) including the following:
- Severe maternal morbidity diagnoses (see list below)
- Severe maternal morbidity procedures (see list below)
- Discharge disposition of expired
Please note that present on admission codes may be those entered by coding staff, extracted from billing/claims data.
Severe Maternal Morbidity Diagnoses:
- Cardiac
Acute heart failure
Acute myocardial infarction
Aortic aneurysm
Cardiac arrest/ventricular fibrillation
Heart failure/arrest during procedure or surgery
- Hemorrhage
Disseminated intravascular coagulation
Shock
- Renal
Acute renal failure
- Respiratory
Adult respiratory distress syndrome
Pulmonary edema
- Sepsis
- Other OB
Air and thrombotic embolism
Amniotic fluid embolism
Eclampsia
Severe anesthesia complications
- Other Medical
Puerperal cerebrovascular disorder
Sickle cell disease with crisis
Severe Maternal Morbidity Procedures:
- Blood transfusion
- Conversion of cardiac rhythm
- Hysterectomy
- Temporary tracheostomy
- Ventilation</td>
</tr>
<tr>
<td>Numerator Exclusion:</td>
<td>None</td>
</tr>
<tr>
<td>Denominator Exception:</td>
<td>None</td>
</tr>
<tr><b>Stratifier Criteria: </b></tr>
<tr>
<td>:</td>
<td>Stratum1: Delivery hospitalizations with severe obstetric complications excluding hospitalizations where transfusion was the only severe obstetric complication.
Additionally, this measure will be stratified by race and ethnicity after measure submission.</td>
</tr>
<tr>
<td>:</td>
<td>None</td>
</tr>
</table>
</td>
</tr>
<tr>
<th scope="row">
<b> Supplemental Data Guidance
: </b></th>
<td style="padding-left: 4px;"> Patient's Ethnicity:
Hispanic or Latino
Not Hispanic or Latino Patient's Payer:
Categories of types of health care payer entities as defined by the US Public Health Data Consortium SOP code system Patient's Race:
Native Hawaiian or Other Pacific Islander
Asian
American Indian or Alaska Native
Other Race
White
Black or African American Patient's Sex:
Gender identity restricted to only Male and Female used in administrative situations requiring a restriction to these two categories.
This definition establishes a variable of CGA (Calculated Gestational Age). CGA is a supplemental data element to store the calculated gestational age result from the "calculatedGestationalAge" function. The data element enables the capturing and saving of the CGA for data analysis post data receipt. Hospitals do not need to submit any additional data to comply with this definition.
</td>
</tr>
<tr>
<th scope="row">
<b> Risk Adjustment Variable Guidance
: </b></th>
<td style="padding-left: 4px;"> The Severe Obstetric Complications Risk Adjustment Methodology Report is available on the eCQI Resource Center (https://ecqi.healthit.gov).
Lab and Physical Exam Results:
Report the first resulted value 24 hours prior to start of encounter and before time of delivery in UCUM units specified:
- Heart rate: {beats}/min
- Systolic blood pressure: mm[Hg]
- White blood cell count: 10*3/uL
- Hematocrit: %
The Severe Obstetric Complications Risk Adjustment Methodology Report is available on the eCQI Resource Center (https://ecqi.healthit.gov).
Pre-existing conditions and variables must be present on admission:. Please note that present on admission codes may be those entered by coding staff, extracted from billing/claims data.
The Severe Obstetric Complications Risk Adjustment Methodology Report is available on the eCQI Resource Center (https://ecqi.healthit.gov).
Pre-existing conditions and variables must be present on admission:. Please note that present on admission codes may be those entered by coding staff, extracted from billing/claims data. The Severe Obstetric Complications Risk Adjustment Methodology Report is available on the eCQI Resource Center (https://ecqi.healthit.gov).
Pre-existing conditions and variables must be present on admission:. Please note that present on admission codes may be those entered by coding staff, extracted from billing/claims data. The Severe Obstetric Complications Risk Adjustment Methodology Report is available on the eCQI Resource Center (https://ecqi.healthit.gov).
Pre-existing conditions and variables must be present on admission:. Please note that present on admission codes may be those entered by coding staff, extracted from billing/claims data. The Severe Obstetric Complications Risk Adjustment Methodology Report is available on the eCQI Resource Center (https://ecqi.healthit.gov).
Pre-existing conditions and variables must be present on admission:. Please note that present on admission codes may be those entered by coding staff, extracted from billing/claims data. The Severe Obstetric Complications Risk Adjustment Methodology Report is available on the eCQI Resource Center (https://ecqi.healthit.gov).
Pre-existing conditions and variables must be present on admission:. Please note that present on admission codes may be those entered by coding staff, extracted from billing/claims data. The Severe Obstetric Complications Risk Adjustment Methodology Report is available on the eCQI Resource Center (https://ecqi.healthit.gov).
Pre-existing conditions and variables must be present on admission:. Please note that present on admission codes may be those entered by coding staff, extracted from billing/claims data. The Severe Obstetric Complications Risk Adjustment Methodology Report is available on the eCQI Resource Center (https://ecqi.healthit.gov).
Pre-existing conditions and variables must be present on admission:. Please note that present on admission codes may be those entered by coding staff, extracted from billing/claims data. The Severe Obstetric Complications Risk Adjustment Methodology Report is available on the eCQI Resource Center (https://ecqi.healthit.gov).
Pre-existing conditions and variables must be present on admission:. Please note that present on admission codes may be those entered by coding staff, extracted from billing/claims data. The Severe Obstetric Complications Risk Adjustment Methodology Report is available on the eCQI Resource Center (https://ecqi.healthit.gov).
Pre-existing conditions and variables must be present on admission:. Please note that present on admission codes may be those entered by coding staff, extracted from billing/claims data. The Severe Obstetric Complications Risk Adjustment Methodology Report is available on the eCQI Resource Center (https://ecqi.healthit.gov).
Pre-existing conditions and variables must be present on admission:. Please note that present on admission codes may be those entered by coding staff, extracted from billing/claims data. The Severe Obstetric Complications Risk Adjustment Methodology Report is available on the eCQI Resource Center (https://ecqi.healthit.gov).
Pre-existing conditions and variables must be present on admission:. Please note that present on admission codes may be those entered by coding staff, extracted from billing/claims data. The Severe Obstetric Complications Risk Adjustment Methodology Report is available on the eCQI Resource Center (https://ecqi.healthit.gov).
Pre-existing conditions and variables must be present on admission:. Please note that present on admission codes may be those entered by coding staff, extracted from billing/claims data. The Severe Obstetric Complications Risk Adjustment Methodology Report is available on the eCQI Resource Center (https://ecqi.healthit.gov).
Pre-existing conditions and variables must be present on admission:. Please note that present on admission codes may be those entered by coding staff, extracted from billing/claims data. The Severe Obstetric Complications Risk Adjustment Methodology Report is available on the eCQI Resource Center (https://ecqi.healthit.gov).
Pre-existing conditions and variables must be present on admission:. Please note that present on admission codes may be those entered by coding staff, extracted from billing/claims data. The Severe Obstetric Complications Risk Adjustment Methodology Report is available on the eCQI Resource Center (https://ecqi.healthit.gov).
Pre-existing conditions and variables must be present on admission:. Please note that present on admission codes may be those entered by coding staff, extracted from billing/claims data. The Severe Obstetric Complications Risk Adjustment Methodology Report is available on the eCQI Resource Center (https://ecqi.healthit.gov).
Pre-existing conditions and variables must be present on admission:. Please note that present on admission codes may be those entered by coding staff, extracted from billing/claims data. The Severe Obstetric Complications Risk Adjustment Methodology Report is available on the eCQI Resource Center (https://ecqi.healthit.gov).
Pre-existing conditions and variables must be present on admission:. Please note that present on admission codes may be those entered by coding staff, extracted from billing/claims data. The Severe Obstetric Complications Risk Adjustment Methodology Report is available on the eCQI Resource Center (https://ecqi.healthit.gov).
Pre-existing conditions and variables must be present on admission:. Please note that present on admission codes may be those entered by coding staff, extracted from billing/claims data. The Severe Obstetric Complications Risk Adjustment Methodology Report is available on the eCQI Resource Center (https://ecqi.healthit.gov).
Pre-existing conditions and variables must be present on admission:. Please note that present on admission codes may be those entered by coding staff, extracted from billing/claims data. The Severe Obstetric Complications Risk Adjustment Methodology Report is available on the eCQI Resource Center (https://ecqi.healthit.gov).
Pre-existing conditions and variables must be present on admission:. Please note that present on admission codes may be those entered by coding staff, extracted from billing/claims data. The Severe Obstetric Complications Risk Adjustment Methodology Report is available on the eCQI Resource Center (https://ecqi.healthit.gov).
Pre-existing conditions and variables must be present on admission:. Please note that present on admission codes may be those entered by coding staff, extracted from billing/claims data. The Severe Obstetric Complications Risk Adjustment Methodology Report is available on the eCQI Resource Center (https://ecqi.healthit.gov).
Pre-existing conditions and variables must be present on admission:. Please note that present on admission codes may be those entered by coding staff, extracted from billing/claims data. The Severe Obstetric Complications Risk Adjustment Methodology Report is available on the eCQI Resource Center (https://ecqi.healthit.gov).
Pre-existing conditions and variables must be present on admission:. Please note that present on admission codes may be those entered by coding staff, extracted from billing/claims data. The Severe Obstetric Complications Risk Adjustment Methodology Report is available on the eCQI Resource Center (https://ecqi.healthit.gov).
Pre-existing conditions and variables must be present on admission:. Please note that present on admission codes may be those entered by coding staff, extracted from billing/claims data. The Severe Obstetric Complications Risk Adjustment Methodology Report is available on the eCQI Resource Center (https://ecqi.healthit.gov).
Pre-existing conditions and variables must be present on admission:. Please note that present on admission codes may be those entered by coding staff, extracted from billing/claims data. The Severe Obstetric Complications Risk Adjustment Methodology Report is available on the eCQI Resource Center (https://ecqi.healthit.gov).
Pre-existing conditions and variables must be present on admission:. Please note that present on admission codes may be those entered by coding staff, extracted from billing/claims data. The Severe Obstetric Complications Risk Adjustment Methodology Report is available on the eCQI Resource Center (https://ecqi.healthit.gov).
Pre-existing conditions and variables must be present on admission:. Please note that present on admission codes may be those entered by coding staff, extracted from billing/claims data. The Severe Obstetric Complications Risk Adjustment Methodology Report is available on the eCQI Resource Center (https://ecqi.healthit.gov).
Pre-existing conditions and variables must be present on admission:. Please note that present on admission codes may be those entered by coding staff, extracted from billing/claims data. </td>
</tr>
<tr>
<th scope="row"><b> Supplemental Data Elements: </b></th>
<td style="padding-left: 4px;">
SDE Ethnicity
SDE Payer
SDE Race
SDE Sex
Variable Calculated Gestational Age
</td>
</tr>
<tr>
<th scope="row"><b>Libraries: </b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr>
<td><a href="Library-SevereObstetricComplicationsFHIR.html">SevereObstetricComplicationsFHIR</a></td>
</tr>
</table>
</td>
</tr>
<tr>
<th scope="row"><b>Related Artifact Dependencies: </b></th>
<td style="padding-left: 4px;">
<li><code>Library/PCMaternal|5.10.000</code></li>
<li><code>Library/FHIRHelpers|4.3.000</code></li>
<li><code>Library/QICoreCommon|1.5.000</code></li>
<li><code>Library/CQMCommon|1.4.000</code></li>
<li><code>Library/QICoreCommon|1.5.000</code></li>
<li><code>Library/FHIRHelpers|4.3.000</code></li>
<li><code>Library/QICoreCommon|1.5.000</code></li>
<li><code>Library/SupplementalDataElements|3.4.000</code></li>
<li><code>Library/FHIRHelpers|4.3.000</code></li>
<li><a href="http://tx.fhir.org/r4/ValueSet/x-loinc2.82">LOINC</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.666.5.307/expansion">Encounter Inpatient</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1045.59/expansion">Delivery Procedures</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1111.143/expansion">Observation Services</a></li>
<li><a href="https://tx.fhir.org/r4/ValueSet/2.16.840.1.113762.1.4.1029.369-20210611">ED Visit and OB Triage</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1045.26/expansion">Estimated Gestational Age at Delivery</a></li>
<li><a href="https://tx.fhir.org/r4/ValueSet/2.16.840.1.113762.1.4.1110.67-20230217">20 to 42 Plus Weeks Gestation</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.271/expansion">Asthma</a></li>
<li><a href="https://tx.fhir.org/r4/ValueSet/2.16.840.1.113762.1.4.1110.63-20220127">Present On Admission is Yes or Exempt</a></li>
<li><a href="https://tx.fhir.org/r4/ValueSet/2.16.840.1.113762.1.4.1029.320-20220127">Substance Abuse</a></li>
<li><a href="https://tx.fhir.org/r4/ValueSet/2.16.840.1.113762.1.4.1029.302-20220127">Placenta Accreta</a></li>
<li><a href="https://tx.fhir.org/r4/ValueSet/2.16.840.1.113762.1.4.1029.308-20220127">Neuromuscular Disease</a></li>
<li><a href="https://tx.fhir.org/r4/ValueSet/2.16.840.1.113762.1.4.1029.335-20220127">Renal Disease</a></li>
<li><a href="https://tx.fhir.org/r4/ValueSet/2.16.840.1.113762.1.4.1029.338-20220127">Gastrointestinal Disease</a></li>
<li><a href="https://tx.fhir.org/r4/ValueSet/2.16.840.1.113762.1.4.1029.332-20220127">Hypertension</a></li>
<li><a href="https://tx.fhir.org/r4/ValueSet/2.16.840.1.113762.1.4.1029.299-20220127">Preterm Birth</a></li>
<li><a href="https://tx.fhir.org/r4/ValueSet/2.16.840.1.113762.1.4.1029.281-20220127">Pulmonary Hypertension</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.114222.4.11.3591/expansion">Payer</a></li>
<li><a href="https://tx.fhir.org/r4/ValueSet/2.16.840.1.113762.1.4.1029.296-20220127">Thyrotoxicosis</a></li>
<li><a href="https://tx.fhir.org/r4/ValueSet/2.16.840.1.113762.1.4.1029.329-20220127">Mild or Moderate Preeclampsia</a></li>
<li><a href="https://tx.fhir.org/r4/ValueSet/2.16.840.1.113762.1.4.1029.292-20220127">Economic Housing Instability</a></li>
<li><a href="https://tx.fhir.org/r4/ValueSet/2.16.840.1.113762.1.4.1029.305-20220127">Placental Abruption</a></li>
<li><a href="https://tx.fhir.org/r4/ValueSet/2.16.840.1.113762.1.4.1029.373-20220127">COVID 19 Confirmed</a></li>
<li><a href="https://tx.fhir.org/r4/ValueSet/2.16.840.1.113762.1.4.1029.376-20220127">Respiratory Conditions Related to COVID 19</a></li>
<li><a href="https://tx.fhir.org/r4/ValueSet/2.16.840.1.113762.1.4.1029.379-20220127">Respiratory Support Procedures Related to COVID 19</a></li>
<li><a href="https://tx.fhir.org/r4/ValueSet/2.16.840.1.113762.1.4.1029.272-20220127">HIV in Pregnancy Childbirth and Puerperium</a></li>
<li><a href="https://tx.fhir.org/r4/ValueSet/2.16.840.1.113762.1.4.1029.290-20220127">Morbid or Severe Obesity</a></li>
<li><a href="https://tx.fhir.org/r4/ValueSet/2.16.840.1.113762.1.4.1029.275-20220127">Preexisting Diabetes</a></li>
<li><a href="https://tx.fhir.org/r4/ValueSet/2.16.840.1.113762.1.4.1029.314-20220127">Mental Health Disorder</a></li>
<li><a href="https://tx.fhir.org/r4/ValueSet/2.16.840.1.113762.1.4.1029.363-20220127">Venous Thromboembolism in Pregnancy</a></li>
<li><a href="https://tx.fhir.org/r4/ValueSet/2.16.840.1.113762.1.4.1029.311-20220127">Autoimmune Disease</a></li>
<li><a href="https://tx.fhir.org/r4/ValueSet/2.16.840.1.113762.1.4.1029.317-20220127">Bariatric Surgery</a></li>
<li><a href="https://tx.fhir.org/r4/ValueSet/2.16.840.1.113762.1.4.1029.278-20220316">Previous Cesarean</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1110.35/expansion">Placenta Previa</a></li>
<li><a href="https://tx.fhir.org/r4/ValueSet/2.16.840.1.113762.1.4.1029.269-20220127">Gestational Diabetes</a></li>
<li><a href="https://tx.fhir.org/r4/ValueSet/2.16.840.1.113762.1.4.1029.255-20220127">Severe Maternal Morbidity Diagnoses</a></li>
<li><a href="https://tx.fhir.org/r4/ValueSet/2.16.840.1.113762.1.4.1029.370-20220127">Present on Admission is No or Unable To Determine</a></li>
<li><a href="https://tx.fhir.org/r4/ValueSet/2.16.840.1.113762.1.4.1029.256-20230218">Severe Maternal Morbidity Procedures</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.309/expansion">Patient Expired</a></li>
<li><a href="https://tx.fhir.org/r4/ValueSet/2.16.840.1.113762.1.4.1029.213-20220127">Blood Transfusion</a></li>
<li><a href="https://tx.fhir.org/r4/ValueSet/2.16.840.1.113762.1.4.1029.287-20220127">Bleeding Disorder</a></li>
<li><a href="https://tx.fhir.org/r4/ValueSet/2.16.840.1.113762.1.4.1029.284-20220127">Multiple Pregnancy</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1045.129/expansion">White blood cells count lab test</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1045.114/expansion">Hematocrit lab test</a></li>
<li><a href="https://tx.fhir.org/r4/ValueSet/2.16.840.1.113762.1.4.1029.323-20220127">Anemia</a></li>
<li><a href="https://tx.fhir.org/r4/ValueSet/2.16.840.1.113762.1.4.1029.327-20220127">Severe Preeclampsia</a></li>
<li><a href="https://tx.fhir.org/r4/ValueSet/2.16.840.1.113762.1.4.1029.341-20220127">Cardiac Disease</a></li>
<li><a href="https://tx.fhir.org/r4/ValueSet/2.16.840.1.113762.1.4.1029.366-20220127">Long Term Anticoagulant Use</a></li>
</td>
</tr>
<tr>
<th scope="row"><b>Parameters:</b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr>
<th><b>name</b></th>
<th><b>use</b></th>
<th><b>min</b></th>
<th><b>max</b></th>
<th><b>type</b></th>
</tr>
<tr>
<td>Measurement Period</td>
<td>In</td>
<td>0</td>
<td>1</td>
<td>Period</td>
</tr>
<tr>
<td>Risk Variable Systolic Blood Pressure</td>
<td>Out</td>
<td>0</td>
<td>1</td>
<td>Resource</td>
</tr>
<tr>
<td>Risk Variable Asthma</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Risk Variable Substance Abuse</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Risk Variable Placental Accreta Spectrum</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Risk Variable Neuromuscular</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Risk Variable Renal Disease</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Risk Variable Gastrointestinal Disease</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Risk Variable Hypertension</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Risk Variable Preterm Birth</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Risk Variable Pulmonary Hypertension</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Variable Calculated Gestational Age</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>SDE Payer</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Risk Variable Thyrotoxicosis</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Risk Variable Other Preeclampsia</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Initial Population</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Risk Variable Economic Housing Instability</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Risk Variable Placental Abruption</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Denominator Exclusion</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Risk Variable HIV</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Risk Variable Morbid Obesity</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Risk Variable Preexisting Diabetes</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Risk Variable Heart Rate</td>
<td>Out</td>
<td>0</td>
<td>1</td>
<td>Resource</td>
</tr>
<tr>
<td>Risk Variable Mental Health Disorder</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Risk Variable Obstetrical VTE</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Risk Variable Autoimmune Disease</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Risk Variable Bariatric Surgery</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Risk Variable Previous Cesarean</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>SDE Race</td>
<td>Out</td>
<td>0</td>
<td>1</td>
<td>Resource</td>
</tr>
<tr>
<td>Risk Variable Placenta Previa</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>SDE Sex</td>
<td>Out</td>
<td>0</td>
<td>1</td>
<td>Coding</td>
</tr>
<tr>
<td>Risk Variable Gestational Diabetes</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Numerator</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Stratum 1</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Risk Variable Bleeding Disorder</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Risk Variable Multiple Pregnancy</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Risk Variable First White Blood Cell Count Lab Test</td>
<td>Out</td>
<td>0</td>
<td>1</td>
<td>Resource</td>
</tr>
<tr>
<td>Denominator</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Risk Variable First Hematocrit Lab Test</td>
<td>Out</td>
<td>0</td>
<td>1</td>
<td>Resource</td>
</tr>
<tr>
<td>SDE Ethnicity</td>
<td>Out</td>
<td>0</td>
<td>1</td>
<td>Resource</td>
</tr>
<tr>
<td>Risk Variable Anemia</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Risk Variable Severe Preeclampsia</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Risk Variable Cardiac Disease</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Risk Variable Long Term Anticoagulant Use</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
</table>
</td>
</tr>
<tr>
<th scope="row"><b>DataRequirements:</b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr>
<th><b>Type</b></th>
<th><b>Elements</b></th>
<th><b>Valueset Name</b></th>
<th><b>Valueset</b></th>
</tr>
<tr>
<td>Patient(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-patient.html">QICorePatient</a>)</td>
<td>
</td>
<td>
</td>
<td/>
</tr>
<tr>
<td>Encounter(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html">QICoreEncounter</a>)</td>
<td>
type
status
status.value
period
</td>
<td>
Encounter Inpatient
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.666.5.307/expansion">Encounter Inpatient</a></td>
</tr>
<tr>
<td>Encounter(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html">QICoreEncounter</a>)</td>
<td>
type
period
status
status.value
</td>
<td>
Observation Services
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1111.143/expansion">Observation Services</a></td>
</tr>
<tr>
<td>Encounter(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html">QICoreEncounter</a>)</td>
<td>
type
period
status
status.value
</td>
<td>
ED Visit and OB Triage
</td>
<td><a href="https://tx.fhir.org/r4/ValueSet/2.16.840.1.113762.1.4.1029.369-20210611">ED Visit and OB Triage</a></td>
</tr>
<tr>
<td>Encounter(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html">QICoreEncounter</a>)</td>
<td>
type
period
status
status.value
</td>
<td>
Observation Services
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1111.143/expansion">Observation Services</a></td>
</tr>
<tr>
<td>Encounter(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html">QICoreEncounter</a>)</td>
<td>
type
period
status
status.value
</td>
<td>
ED Visit and OB Triage
</td>
<td><a href="https://tx.fhir.org/r4/ValueSet/2.16.840.1.113762.1.4.1029.369-20210611">ED Visit and OB Triage</a></td>
</tr>
<tr>
<td>Procedure(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html">QICoreProcedure</a>)</td>
<td>
code
status
status.value
performed
</td>
<td>
Delivery Procedures
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1045.59/expansion">Delivery Procedures</a></td>
</tr>
<tr>
<td>Encounter(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html">QICoreEncounter</a>)</td>
<td>
type
status
status.value
period
</td>
<td>
Encounter Inpatient
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.666.5.307/expansion">Encounter Inpatient</a></td>
</tr>
<tr>
<td>Patient(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-patient.html">QICorePatient</a>)</td>
<td>
</td>
<td>
</td>
<td/>
</tr>
<tr>
<td>Patient(<code>http://hl7.org/fhir/Patient</code>)</td>
<td>
birthDate
birthDate.value
gender
gender.value
</td>
<td>
</td>
<td/>
</tr>
<tr>
<td>Observation(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-observation.html">QICoreObservation</a>)</td>
<td>
code
value
status
status.value
effective
</td>
<td>
</td>
<td/>
</tr>
<tr>
<td>Observation(<code>http://hl7.org/fhir/Observation</code>)</td>
<td>
value
</td>
<td>
</td>
<td/>
</tr>
<tr>
<td>Observation(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-observation.html">QICoreObservation</a>)</td>
<td>
code
value
status
status.value
effective
</td>
<td>
</td>
<td/>
</tr>
<tr>
<td>Observation(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-observation.html">QICoreObservation</a>)</td>
<td>
code
value
status
status.value
effective
</td>
<td>
Estimated Gestational Age at Delivery
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1045.26/expansion">Estimated Gestational Age at Delivery</a></td>
</tr>
<tr>
<td>Condition(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-condition.html">QICoreCondition</a>)</td>
<td>
id
id.value
</td>
<td>
</td>
<td/>
</tr>
<tr>
<td>uri(<code>http://hl7.org/fhir/uri</code>)</td>
<td>
value
</td>
<td>
</td>
<td/>
</tr>
<tr>
<td>string(<code>http://hl7.org/fhir/string</code>)</td>
<td>
value
</td>
<td>
</td>
<td/>
</tr>
<tr>
<td>Observation(<a href="http://hl7.org/fhir/R4/bp.html">Observation Blood Pressure Profile</a>)</td>
<td>
effective
status
status.value
component
</td>
<td>
</td>
<td/>
</tr>
<tr>
<td>(<code>http://hl7.org/fhir/Observation.Component</code>)</td>
<td>
value
</td>
<td>
</td>
<td/>
</tr>
<tr>
<td>Condition(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-condition.html">QICoreCondition</a>)</td>
<td>
id
id.value
</td>
<td>
</td>
<td/>
</tr>
<tr>
<td>Reference(<code>http://hl7.org/fhir/Reference</code>)</td>
<td>
reference
reference.value
</td>
<td>
</td>
<td/>
</tr>
<tr>
<td>Coverage(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-coverage.html">QICoreCoverage</a>)</td>
<td>
type
period
</td>
<td>
Payer Type
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.114222.4.11.3591/expansion">Payer</a></td>
</tr>
<tr>
<td>Procedure(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html">QICoreProcedure</a>)</td>
<td>
code
status
status.value
performed
</td>
<td>
Respiratory Support Procedures Related to COVID 19
</td>
<td><a href="https://tx.fhir.org/r4/ValueSet/2.16.840.1.113762.1.4.1029.379-20220127">Respiratory Support Procedures Related to COVID 19</a></td>
</tr>
<tr>
<td>Observation(<a href="http://hl7.org/fhir/R4/heartrate.html">Observation Heart Rate Profile</a>)</td>
<td>
effective
status
status.value
value
</td>
<td>
</td>
<td/>
</tr>
<tr>
<td>Patient(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-patient.html">QICorePatient</a>)</td>
<td>
</td>
<td>
</td>
<td/>
</tr>
<tr>
<td>Patient(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-patient.html">QICorePatient</a>)</td>
<td>
url
extension
</td>
<td>
</td>
<td/>
</tr>
<tr>
<td>Patient(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-patient.html">QICorePatient</a>)</td>
<td>
url
extension
</td>
<td>
</td>
<td/>
</tr>
<tr>
<td>Procedure(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html">QICoreProcedure</a>)</td>
<td>
code
status
status.value
performed
</td>
<td>
Severe Maternal Morbidity Procedures
</td>
<td><a href="https://tx.fhir.org/r4/ValueSet/2.16.840.1.113762.1.4.1029.256-20230218">Severe Maternal Morbidity Procedures</a></td>
</tr>
<tr>
<td>Procedure(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html">QICoreProcedure</a>)</td>
<td>
code
status
status.value
performed
</td>
<td>
Blood Transfusion
</td>
<td><a href="https://tx.fhir.org/r4/ValueSet/2.16.840.1.113762.1.4.1029.213-20220127">Blood Transfusion</a></td>
</tr>
<tr>
<td>Observation(<a href="http://hl7.org/fhir/us/core/STU3.1.1/StructureDefinition-us-core-observation-lab.html">US Core Laboratory Result Observation Profile</a>)</td>
<td>
code
issued
issued.value
status
status.value
value
</td>
<td>
White blood cells count lab test
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1045.129/expansion">White blood cells count lab test</a></td>
</tr>
<tr>
<td>Observation(<a href="http://hl7.org/fhir/us/core/STU3.1.1/StructureDefinition-us-core-observation-lab.html">US Core Laboratory Result Observation Profile</a>)</td>
<td>
code
issued
issued.value
status
status.value
value
</td>
<td>
Hematocrit lab test
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1045.114/expansion">Hematocrit lab test</a></td>
</tr>
<tr>
<td>Patient(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-patient.html">QICorePatient</a>)</td>
<td>
url
extension
</td>
<td>
</td>
<td/>
</tr>
<tr>
<td>Patient(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-patient.html">QICorePatient</a>)</td>
<td>
url
extension
</td>
<td>
</td>
<td/>
</tr>
<tr>
<td>Coverage(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-coverage.html">QICoreCoverage</a>)</td>
<td>
type
period
</td>
<td>
Payer Type
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.114222.4.11.3591/expansion">Payer</a></td>
</tr>
<tr>
<td>Patient(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-patient.html">QICorePatient</a>)</td>
<td>
url
extension
</td>
<td>
</td>
<td/>
</tr>
<tr>
<td>Patient(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-patient.html">QICorePatient</a>)</td>
<td>
url
extension
</td>
<td>
</td>
<td/>
</tr>
</table>
</td>
</tr>
<tr>
<th scope="row"><b>Direct Reference Codes:</b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr>
<th><b>display</b></th>
<th><b>code</b></th>
<th><b>system</b></th>
</tr>
<tr>
<td>Date and time of obstetric delivery</td>
<td>93857-1</td>
<td><a href="https://loinc.org/">http://loinc.org</a></td>
</tr>
<tr>
<td>Delivery date Estimated</td>
<td>11778-8</td>
<td><a href="https://loinc.org/">http://loinc.org</a></td>
</tr>
</table>
</td>
</tr>
<tr>
<th scope="row"><b>Logic Definitions:</b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr>
<th><b>Group</b></th>
<th><b>Scoring</b></th>
<th><b>Population Criteria</b></th>
<th><b>Expression</b></th>
</tr>
<tr>
<td> 638907ab4ba3d47c885c02fd </td>
<td>
<b>Group scoring:</b>
<span> proportion </span>
</td>
<tr>
<td/>
<td/>
<td>Initial Population</td>
<td>
<pre><code class="language-cql">define "Initial Population":
PCMaternal."Delivery Encounter with Age Range"</code></pre>
</td>
</tr>
<tr>
<td/>
<td/>
<td>Denominator</td>
<td>
<pre><code class="language-cql">define "Denominator":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation"</code></pre>
</td>
</tr>
<tr>
<td/>
<td/>
<td>Denominator Exclusion</td>
<td>
<pre><code class="language-cql">define "Denominator Exclusion":
"Delivery Encounters with COVID and Respiratory Condition or Procedure"</code></pre>
</td>
</tr>
<tr>
<td/>
<td/>
<td>Numerator</td>
<td>
<pre><code class="language-cql">define "Numerator":
"Delivery Encounters with Severe Obstetric Complications"</code></pre>
</td>
</tr>
<tr>
<td/>
<td/>
<td>Numerator Exclusion</td>
<td>
None
</td>
</tr>
<tr>
<td/>
<td/>
<td>Denominator Exception</td>
<td>
None
</td>
</tr>
<tr>
<td/>
<td/>
<td/>
<td>
<pre><code class="language-cql"/></pre>
</td>
</tr>
<tr>
<td/>
<td/>
<td/>
<td>
None
</td>
</tr>
</tr>
</table>
<table class="grid-dict">
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>PCMaternal</td>
<td>Encounter with Age Range</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Encounter with Age Range":
["Encounter": "Encounter Inpatient"] EncounterInpatient
where EncounterInpatient.status = 'finished'
and AgeInYearsAt(date from start of EncounterInpatient.period) in Interval[ 8, 65 )
and EncounterInpatient.period ends during day of "Measurement Period"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>PCMaternal</td>
<td>Delivery Encounter with Age Range</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Delivery Encounter with Age Range":
"Encounter with Age Range" EncounterWithAge
with ["Procedure": "Delivery Procedures"] DeliveryProcedure
such that DeliveryProcedure.status = 'completed'
and DeliveryProcedure.performed.toInterval ( ) starts during day of EncounterWithAge.hospitalizationWithEDOBTriageObservation ()</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Delivery Encounters with Calculated Gestational Age Greater than or Equal to 20 Weeks</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Delivery Encounters with Calculated Gestational Age Greater than or Equal to 20 Weeks":
PCMaternal."Delivery Encounter with Age Range" DeliveryEncounter
where DeliveryEncounter.calculatedGestationalAge ( ) >= 20</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Delivery Encounters with Estimated Gestational Age Assessment Greater than or Equal to 20 Weeks</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Delivery Encounters with Estimated Gestational Age Assessment Greater than or Equal to 20 Weeks":
PCMaternal."Delivery Encounter with Age Range" DeliveryEncounter
where DeliveryEncounter.calculatedGestationalAge ( ) is null
and ( DeliveryEncounter.lastEstimatedGestationalAge ( ) >= 20 weeks )</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Delivery Encounters with Gestational Age Greater than or Equal to 20 Weeks Based on Coding</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Delivery Encounters with Gestational Age Greater than or Equal to 20 Weeks Based on Coding":
PCMaternal."Delivery Encounter with Age Range" DeliveryEncounter
let CGA: DeliveryEncounter.calculatedGestationalAge ( ),
EGA: DeliveryEncounter.lastEstimatedGestationalAge ( )
where CGA is null
and EGA is null
and exists ( ( DeliveryEncounter.encounterDiagnosis ( ) ) EncounterDiagnosis
where EncounterDiagnosis.code in "20 to 42 Plus Weeks Gestation"
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Delivery Encounters At Greater than or Equal to 20 Weeks Gestation</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation":
"Delivery Encounters with Calculated Gestational Age Greater than or Equal to 20 Weeks"
union "Delivery Encounters with Estimated Gestational Age Assessment Greater than or Equal to 20 Weeks"
union "Delivery Encounters with Gestational Age Greater than or Equal to 20 Weeks Based on Coding"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Risk Variable Systolic Blood Pressure</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">//First resulted value 24 hours prior to start of encounter and before time of delivery
//Report systolic blood pressure as mm[Hg]
define "Risk Variable Systolic Blood Pressure":
First(from
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" Encounter,
["observation-bp"] BP
where BP.effective.earliest() during Interval[start of Encounter.hospitalizationWithEDOBTriageObservation() - 1440 minutes, Encounter.lastTimeOfDelivery())
and BP.status in { 'final', 'amended', 'corrected' }
return {
EncounterId: Encounter.id,
FirstResult: BP.SystolicBP.value as Quantity,
Timing: BP.effective.earliest()
}
sort by Timing
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Risk Variable Asthma</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Risk Variable Asthma":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where exists ( TwentyWeeksPlusEncounter.diagnosis EncounterDiagnoses
where EncounterDiagnoses.condition.getCondition ( ).code in "Acute or Persistent Asthma"
and ( EncounterDiagnoses.diagnosisPresentOnAdmission in "Present On Admission is Yes or Exempt" )
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Risk Variable Substance Abuse</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Risk Variable Substance Abuse":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where exists ( TwentyWeeksPlusEncounter.diagnosis EncounterDiagnoses
where EncounterDiagnoses.condition.getCondition ( ).code in "Substance Abuse"
and ( EncounterDiagnoses.diagnosisPresentOnAdmission in "Present On Admission is Yes or Exempt" )
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Risk Variable Placental Accreta Spectrum</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Risk Variable Placental Accreta Spectrum":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where exists ( TwentyWeeksPlusEncounter.diagnosis EncounterDiagnoses
where EncounterDiagnoses.condition.getCondition ( ).code in "Placental Accreta Spectrum"
and ( EncounterDiagnoses.diagnosisPresentOnAdmission in "Present On Admission is Yes or Exempt" )
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Risk Variable Neuromuscular</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Risk Variable Neuromuscular":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where exists ( TwentyWeeksPlusEncounter.diagnosis EncounterDiagnoses
where EncounterDiagnoses.condition.getCondition ( ).code in "Neuromuscular Disease"
and ( EncounterDiagnoses.diagnosisPresentOnAdmission in "Present On Admission is Yes or Exempt" )
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Risk Variable Renal Disease</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Risk Variable Renal Disease":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where exists ( TwentyWeeksPlusEncounter.diagnosis EncounterDiagnoses
where EncounterDiagnoses.condition.getCondition ( ).code in "Renal Disease"
and ( EncounterDiagnoses.diagnosisPresentOnAdmission in "Present On Admission is Yes or Exempt" )
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Risk Variable Gastrointestinal Disease</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Risk Variable Gastrointestinal Disease":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where exists ( TwentyWeeksPlusEncounter.diagnosis EncounterDiagnoses
where EncounterDiagnoses.condition.getCondition ( ).code in "Gastrointestinal Disease"
and ( EncounterDiagnoses.diagnosisPresentOnAdmission in "Present On Admission is Yes or Exempt" )
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Risk Variable Hypertension</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Risk Variable Hypertension":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where exists ( TwentyWeeksPlusEncounter.diagnosis EncounterDiagnoses
where EncounterDiagnoses.condition.getCondition ( ).code in "Hypertension"
and ( EncounterDiagnoses.diagnosisPresentOnAdmission in "Present On Admission is Yes or Exempt" )
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Risk Variable Preterm Birth</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Risk Variable Preterm Birth":
/* CGA = Calculated Gestational Age. EGA = Estimated Gestational Age. */
( PCMaternal."Delivery Encounter with Age Range" DeliveryEncounter
let CGA: DeliveryEncounter.calculatedGestationalAge ( ),
EGA: DeliveryEncounter.lastEstimatedGestationalAge ( )
where CGA in Interval[20, 36]
or ( CGA is null
and ( EGA >= 20 weeks
and EGA <= 36 weeks
)
)
)
union ( PCMaternal."Delivery Encounter with Age Range" DeliveryEncounter
let CGA: DeliveryEncounter.calculatedGestationalAge ( ),
EGA: DeliveryEncounter.lastEstimatedGestationalAge ( )
where CGA is null
and EGA is null
and exists ( DeliveryEncounter.diagnosis DeliveryEncounterDiagnoses
where DeliveryEncounterDiagnoses.condition.getCondition ( ).code in "Preterm Birth"
and ( DeliveryEncounterDiagnoses.diagnosisPresentOnAdmission in "Present On Admission is Yes or Exempt" )
)
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Risk Variable Pulmonary Hypertension</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Risk Variable Pulmonary Hypertension":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where exists ( TwentyWeeksPlusEncounter.diagnosis EncounterDiagnoses
where EncounterDiagnoses.condition.getCondition ( ).code in "Pulmonary Hypertension"
and ( EncounterDiagnoses.diagnosisPresentOnAdmission in "Present On Admission is Yes or Exempt" )
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>PCMaternal</td>
<td>Variable Calculated Gestational Age</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Variable Calculated Gestational Age":
//This definition establishes a variable of CGA (Calculated Gestational Age) for all patients for the sole purpose of displaying the Calculated Gestational Age. This definition is not used in the measure logic.
"Delivery Encounter with Age Range" QualifyingEncounter
let CGA: QualifyingEncounter.calculatedGestationalAge()
// return { QualifyingEncounter, CGA }
return {
EncounterID: QualifyingEncounter.id,
CalculatedCGA: CGA
}</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Variable Calculated Gestational Age</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Variable Calculated Gestational Age":
//This definition establishes a variable of CGA (Calculated Gestational Age). CGA is a supplemental data element to store the calculated gestational age result from the "CalculatedGestationalAge" function. The data element enables the capturing and saving of the CGA for data analysis post data receipt. Hospitals do not need to submit any additional data to comply with this definition.
PCMaternal."Variable Calculated Gestational Age"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SupplementalDataElements</td>
<td>SDE Payer</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "SDE Payer":
[Coverage: type in "Payer Type"] Payer
return {
code: Payer.type,
period: Payer.period
}</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>SDE Payer</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "SDE Payer":
SDE."SDE Payer"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Risk Variable Thyrotoxicosis</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Risk Variable Thyrotoxicosis":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where exists ( TwentyWeeksPlusEncounter.diagnosis EncounterDiagnoses
where EncounterDiagnoses.condition.getCondition ( ).code in "Thyrotoxicosis"
and ( EncounterDiagnoses.diagnosisPresentOnAdmission in "Present On Admission is Yes or Exempt" )
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Risk Variable Other Preeclampsia</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Risk Variable Other Preeclampsia":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where exists ( TwentyWeeksPlusEncounter.diagnosis EncounterDiagnoses
where EncounterDiagnoses.condition.getCondition ( ).code in "Mild or Moderate Preeclampsia"
and ( EncounterDiagnoses.diagnosisPresentOnAdmission in "Present On Admission is Yes or Exempt" )
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Initial Population</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Initial Population":
PCMaternal."Delivery Encounter with Age Range"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Risk Variable Economic Housing Instability</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Risk Variable Economic Housing Instability":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where exists ( TwentyWeeksPlusEncounter.diagnosis EncounterDiagnoses
where EncounterDiagnoses.condition.getCondition ( ).code in "Economic Housing Instability"
and ( EncounterDiagnoses.diagnosisPresentOnAdmission in "Present On Admission is Yes or Exempt" )
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Risk Variable Placental Abruption</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Risk Variable Placental Abruption":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where exists ( TwentyWeeksPlusEncounter.diagnosis EncounterDiagnoses
where EncounterDiagnoses.condition.getCondition ( ).code in "Placental Abruption"
and ( EncounterDiagnoses.diagnosisPresentOnAdmission in "Present On Admission is Yes or Exempt" )
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Delivery Encounters with COVID and Respiratory Condition or Procedure</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Delivery Encounters with COVID and Respiratory Condition or Procedure":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where exists ( ( TwentyWeeksPlusEncounter.encounterDiagnosis ( ) ) EncounterDiagnosis
where EncounterDiagnosis.code in "COVID 19 Confirmed"
)
and ( exists ( ( TwentyWeeksPlusEncounter.encounterDiagnosis ( ) ) EncounterDiagnosis
where EncounterDiagnosis.code in "Respiratory Conditions Related to COVID 19"
)
or exists ( ["Procedure": "Respiratory Support Procedures Related to COVID 19"] EncounterProcedures
where EncounterProcedures.status = 'completed'
and EncounterProcedures.performed.toInterval ( ) starts during day of TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation ( )
)
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Denominator Exclusion</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Denominator Exclusion":
"Delivery Encounters with COVID and Respiratory Condition or Procedure"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Risk Variable HIV</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Risk Variable HIV":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where exists ( TwentyWeeksPlusEncounter.diagnosis EncounterDiagnoses
where EncounterDiagnoses.condition.getCondition ( ).code in "HIV in Pregnancy Childbirth and Puerperium"
and ( EncounterDiagnoses.diagnosisPresentOnAdmission in "Present On Admission is Yes or Exempt" )
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Risk Variable Morbid Obesity</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Risk Variable Morbid Obesity":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where exists ( TwentyWeeksPlusEncounter.diagnosis EncounterDiagnoses
where EncounterDiagnoses.condition.getCondition ( ).code in "Morbid or Severe Obesity"
and ( EncounterDiagnoses.diagnosisPresentOnAdmission in "Present On Admission is Yes or Exempt" )
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Risk Variable Preexisting Diabetes</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Risk Variable Preexisting Diabetes":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where exists ( TwentyWeeksPlusEncounter.diagnosis EncounterDiagnoses
where EncounterDiagnoses.condition.getCondition ( ).code in "Preexisting Diabetes"
and ( EncounterDiagnoses.diagnosisPresentOnAdmission in "Present On Admission is Yes or Exempt" )
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Risk Variable Heart Rate</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">//First resulted value 24 hours prior to start of encounter and before time of delivery
//Report heart rate as beats/min
define "Risk Variable Heart Rate":
First(from
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" Encounter,
["observation-heartrate"] HeartRate
where HeartRate.effective.earliest() during Interval[start of Encounter.hospitalizationWithEDOBTriageObservation() - 1440 minutes, Encounter.lastTimeOfDelivery())
and HeartRate.status in { 'final', 'amended', 'corrected' }
return {
EncounterId: Encounter.id,
FirstResult: HeartRate.value as Quantity,
Timing: HeartRate.effective.earliest()
}
sort by Timing
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Risk Variable Mental Health Disorder</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Risk Variable Mental Health Disorder":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where exists ( TwentyWeeksPlusEncounter.diagnosis EncounterDiagnoses
where EncounterDiagnoses.condition.getCondition ( ).code in "Mental Health Disorder"
and ( EncounterDiagnoses.diagnosisPresentOnAdmission in "Present On Admission is Yes or Exempt" )
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Risk Variable Obstetrical VTE</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Risk Variable Obstetrical VTE":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where exists ( TwentyWeeksPlusEncounter.diagnosis EncounterDiagnoses
where EncounterDiagnoses.condition.getCondition ( ).code in "Venous Thromboembolism in Pregnancy"
and ( EncounterDiagnoses.diagnosisPresentOnAdmission in "Present On Admission is Yes or Exempt" )
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Risk Variable Autoimmune Disease</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Risk Variable Autoimmune Disease":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where exists ( TwentyWeeksPlusEncounter.diagnosis EncounterDiagnoses
where EncounterDiagnoses.condition.getCondition ( ).code in "Autoimmune Disease"
and ( EncounterDiagnoses.diagnosisPresentOnAdmission in "Present On Admission is Yes or Exempt" )
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Risk Variable Bariatric Surgery</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Risk Variable Bariatric Surgery":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where exists ( TwentyWeeksPlusEncounter.diagnosis EncounterDiagnoses
where EncounterDiagnoses.condition.getCondition ( ).code in "Bariatric Surgery"
and ( EncounterDiagnoses.diagnosisPresentOnAdmission in "Present On Admission is Yes or Exempt" )
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Risk Variable Previous Cesarean</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Risk Variable Previous Cesarean":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where exists ( TwentyWeeksPlusEncounter.diagnosis EncounterDiagnoses
where EncounterDiagnoses.condition.getCondition ( ).code in "Previous Cesarean"
and ( EncounterDiagnoses.diagnosisPresentOnAdmission in "Present On Admission is Yes or Exempt" )
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SupplementalDataElements</td>
<td>SDE Race</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "SDE Race":
Patient.race R
return Tuple {
codes: R.ombCategory union R.detailed,
display: R.text
}</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>SDE Race</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "SDE Race":
SDE."SDE Race"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Risk Variable Placenta Previa</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Risk Variable Placenta Previa":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where exists ( TwentyWeeksPlusEncounter.diagnosis EncounterDiagnoses
where EncounterDiagnoses.condition.getCondition ( ).code in "Placenta Previa"
and ( EncounterDiagnoses.diagnosisPresentOnAdmission in "Present On Admission is Yes or Exempt" )
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SupplementalDataElements</td>
<td>SDE Sex</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">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</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>SDE Sex</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "SDE Sex":
SDE."SDE Sex"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Risk Variable Gestational Diabetes</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Risk Variable Gestational Diabetes":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where exists ( TwentyWeeksPlusEncounter.diagnosis EncounterDiagnoses
where EncounterDiagnoses.condition.getCondition ( ).code in "Gestational Diabetes"
and ( EncounterDiagnoses.diagnosisPresentOnAdmission in "Present On Admission is Yes or Exempt" )
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Delivery Encounters with Severe Obstetric Complications Diagnosis or Procedure Excluding Blood Transfusion</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Delivery Encounters with Severe Obstetric Complications Diagnosis or Procedure Excluding Blood Transfusion":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where exists ( TwentyWeeksPlusEncounter.diagnosis EncounterDiagnoses
where EncounterDiagnoses.condition.getCondition ( ).code in "Severe Maternal Morbidity Diagnoses"
and EncounterDiagnoses.diagnosisPresentOnAdmission in "Present on Admission is No or Unable To Determine"
)
//EncounterDiagnoses.diagnosisPresentOnAdmission ~ 'N')
or exists ( ["Procedure": "Severe Maternal Morbidity Procedures"] EncounterProcedures
where EncounterProcedures.status = 'completed'
and EncounterProcedures.performed.toInterval ( ) starts during day of TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation ( )
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Delivery Encounters with Expiration</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Delivery Encounters with Expiration":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where TwentyWeeksPlusEncounter.hospitalization.dischargeDisposition in "Patient Expired"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Delivery Encounters with Blood Transfusion</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Delivery Encounters with Blood Transfusion":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
with ["Procedure": "Blood Transfusion"] BloodTransfusion
such that BloodTransfusion.status = 'completed'
and BloodTransfusion.performed.toInterval ( ) starts during day of TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation ( )</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Delivery Encounters with Severe Obstetric Complications</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Delivery Encounters with Severe Obstetric Complications":
"Delivery Encounters with Severe Obstetric Complications Diagnosis or Procedure Excluding Blood Transfusion"
union "Delivery Encounters with Expiration"
union "Delivery Encounters with Blood Transfusion"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Numerator</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Numerator":
"Delivery Encounters with Severe Obstetric Complications"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Stratification Encounter</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Stratification Encounter":
"Numerator"
except "Denominator Exclusion"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions":
"Delivery Encounters with Severe Obstetric Complications Diagnosis or Procedure Excluding Blood Transfusion"
union "Delivery Encounters with Expiration"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Stratum 1</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Stratum 1":
//This logic identifies a subset of the numerator population with severe obstetric complications excluding cases where transfusion was the only severe obstetric complication.
"Stratification Encounter"
intersect "Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Risk Variable Bleeding Disorder</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Risk Variable Bleeding Disorder":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where exists ( TwentyWeeksPlusEncounter.diagnosis EncounterDiagnoses
where EncounterDiagnoses.condition.getCondition ( ).code in "Bleeding Disorder"
and ( EncounterDiagnoses.diagnosisPresentOnAdmission in "Present On Admission is Yes or Exempt" )
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Risk Variable Multiple Pregnancy</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Risk Variable Multiple Pregnancy":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where exists ( TwentyWeeksPlusEncounter.diagnosis EncounterDiagnoses
where EncounterDiagnoses.condition.getCondition ( ).code in "Multiple Pregnancy"
and ( EncounterDiagnoses.diagnosisPresentOnAdmission in "Present On Admission is Yes or Exempt" )
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Risk Variable First White Blood Cell Count Lab Test</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">//First resulted value 24 hours prior to start of encounter and before time of delivery
//Report white blood cell count as 10*3/uL
define "Risk Variable First White Blood Cell Count Lab Test":
First(from
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" Encounter,
["USCoreLaboratoryResultObservationProfile": "White blood cells count lab test"] WBC
where WBC.issued during Interval[start of Encounter.hospitalizationWithEDOBTriageObservation() - 1440 minutes, Encounter.lastTimeOfDelivery())
and WBC.status in { 'final', 'amended', 'corrected' }
return {
EncounterId: Encounter.id,
FirstResult: WBC.value as Quantity,
Timing: WBC.issued
}
sort by Timing
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Denominator</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Denominator":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Risk Variable First Hematocrit Lab Test</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">//First resulted value 24 hours prior to start of encounter and before time of delivery
//Report hematocrit as %
define "Risk Variable First Hematocrit Lab Test":
First(from
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" Encounter,
["USCoreLaboratoryResultObservationProfile": "Hematocrit lab test"] Hematocrit
where Hematocrit.issued during Interval[start of Encounter.hospitalizationWithEDOBTriageObservation() - 1440 minutes, Encounter.lastTimeOfDelivery())
and Hematocrit.status in { 'final', 'amended', 'corrected' }
return {
EncounterId: Encounter.id,
FirstResult: Hematocrit.value as Quantity,
Timing: Hematocrit.issued
}
sort by Timing
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SupplementalDataElements</td>
<td>SDE Ethnicity</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "SDE Ethnicity":
Patient.ethnicity E
return Tuple {
codes: { E.ombCategory } union E.detailed,
display: E.text
}</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>SDE Ethnicity</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "SDE Ethnicity":
SDE."SDE Ethnicity"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Risk Variable Anemia</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Risk Variable Anemia":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where exists ( TwentyWeeksPlusEncounter.diagnosis EncounterDiagnoses
where EncounterDiagnoses.condition.getCondition ( ).code in "Anemia"
and ( EncounterDiagnoses.diagnosisPresentOnAdmission in "Present On Admission is Yes or Exempt" )
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Risk Variable Severe Preeclampsia</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Risk Variable Severe Preeclampsia":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where exists ( TwentyWeeksPlusEncounter.diagnosis EncounterDiagnoses
where EncounterDiagnoses.condition.getCondition ( ).code in "Severe Preeclampsia"
and ( EncounterDiagnoses.diagnosisPresentOnAdmission in "Present On Admission is Yes or Exempt" )
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Risk Variable Cardiac Disease</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Risk Variable Cardiac Disease":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where exists ( TwentyWeeksPlusEncounter.diagnosis EncounterDiagnoses
where EncounterDiagnoses.condition.getCondition ( ).code in "Cardiac Disease"
and ( EncounterDiagnoses.diagnosisPresentOnAdmission in "Present On Admission is Yes or Exempt" )
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Risk Variable Long Term Anticoagulant Use</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Risk Variable Long Term Anticoagulant Use":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where exists ( TwentyWeeksPlusEncounter.diagnosis EncounterDiagnoses
where EncounterDiagnoses.condition.getCondition ( ).code in "Long Term Anticoagulant Use"
and ( EncounterDiagnoses.diagnosisPresentOnAdmission in "Present On Admission is Yes or Exempt" )
)</code></pre>
</td>
</tr>
</table>
</td>
</tr>
</table>
</div>
</text>
<contained>
<Library>
<id value="effective-data-requirements"/>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
<valueCoding>
<system value="http://loinc.org"/>
<code value="93857-1"/>
<display value="Date and time of obstetric delivery"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
<valueCoding>
<system value="http://loinc.org"/>
<code value="11778-8"/>
<display value="Delivery date Estimated"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="PCMaternal"/>
</extension>
<extension url="name">
<valueString value="Encounter with Age Range"/>
</extension>
<extension url="statement">
<valueString
value="define "Encounter with Age Range":
["Encounter": "Encounter Inpatient"] EncounterInpatient
where EncounterInpatient.status = 'finished'
and AgeInYearsAt(date from start of EncounterInpatient.period) in Interval[ 8, 65 )
and EncounterInpatient.period ends during day of "Measurement Period""/>
</extension>
<extension url="displaySequence">
<valueInteger value="0"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="PCMaternal"/>
</extension>
<extension url="name">
<valueString value="Delivery Encounter with Age Range"/>
</extension>
<extension url="statement">
<valueString
value="define "Delivery Encounter with Age Range":
"Encounter with Age Range" EncounterWithAge
with ["Procedure": "Delivery Procedures"] DeliveryProcedure
such that DeliveryProcedure.status = 'completed'
and DeliveryProcedure.performed.toInterval ( ) starts during day of EncounterWithAge.hospitalizationWithEDOBTriageObservation ()"/>
</extension>
<extension url="displaySequence">
<valueInteger value="1"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString
value="Delivery Encounters with Calculated Gestational Age Greater than or Equal to 20 Weeks"/>
</extension>
<extension url="statement">
<valueString
value="define "Delivery Encounters with Calculated Gestational Age Greater than or Equal to 20 Weeks":
PCMaternal."Delivery Encounter with Age Range" DeliveryEncounter
where DeliveryEncounter.calculatedGestationalAge ( ) >= 20"/>
</extension>
<extension url="displaySequence">
<valueInteger value="2"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString
value="Delivery Encounters with Estimated Gestational Age Assessment Greater than or Equal to 20 Weeks"/>
</extension>
<extension url="statement">
<valueString
value="define "Delivery Encounters with Estimated Gestational Age Assessment Greater than or Equal to 20 Weeks":
PCMaternal."Delivery Encounter with Age Range" DeliveryEncounter
where DeliveryEncounter.calculatedGestationalAge ( ) is null
and ( DeliveryEncounter.lastEstimatedGestationalAge ( ) >= 20 weeks )"/>
</extension>
<extension url="displaySequence">
<valueInteger value="3"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString
value="Delivery Encounters with Gestational Age Greater than or Equal to 20 Weeks Based on Coding"/>
</extension>
<extension url="statement">
<valueString
value="define "Delivery Encounters with Gestational Age Greater than or Equal to 20 Weeks Based on Coding":
PCMaternal."Delivery Encounter with Age Range" DeliveryEncounter
let CGA: DeliveryEncounter.calculatedGestationalAge ( ),
EGA: DeliveryEncounter.lastEstimatedGestationalAge ( )
where CGA is null
and EGA is null
and exists ( ( DeliveryEncounter.encounterDiagnosis ( ) ) EncounterDiagnosis
where EncounterDiagnosis.code in "20 to 42 Plus Weeks Gestation"
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="4"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString
value="Delivery Encounters At Greater than or Equal to 20 Weeks Gestation"/>
</extension>
<extension url="statement">
<valueString
value="define "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation":
"Delivery Encounters with Calculated Gestational Age Greater than or Equal to 20 Weeks"
union "Delivery Encounters with Estimated Gestational Age Assessment Greater than or Equal to 20 Weeks"
union "Delivery Encounters with Gestational Age Greater than or Equal to 20 Weeks Based on Coding""/>
</extension>
<extension url="displaySequence">
<valueInteger value="5"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Risk Variable Systolic Blood Pressure"/>
</extension>
<extension url="statement">
<valueString
value="//First resulted value 24 hours prior to start of encounter and before time of delivery
//Report systolic blood pressure as mm[Hg]
define "Risk Variable Systolic Blood Pressure":
First(from
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" Encounter,
["observation-bp"] BP
where BP.effective.earliest() during Interval[start of Encounter.hospitalizationWithEDOBTriageObservation() - 1440 minutes, Encounter.lastTimeOfDelivery())
and BP.status in { 'final', 'amended', 'corrected' }
return {
EncounterId: Encounter.id,
FirstResult: BP.SystolicBP.value as Quantity,
Timing: BP.effective.earliest()
}
sort by Timing
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="6"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Risk Variable Asthma"/>
</extension>
<extension url="statement">
<valueString
value="define "Risk Variable Asthma":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where exists ( TwentyWeeksPlusEncounter.diagnosis EncounterDiagnoses
where EncounterDiagnoses.condition.getCondition ( ).code in "Acute or Persistent Asthma"
and ( EncounterDiagnoses.diagnosisPresentOnAdmission in "Present On Admission is Yes or Exempt" )
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="7"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Risk Variable Substance Abuse"/>
</extension>
<extension url="statement">
<valueString
value="define "Risk Variable Substance Abuse":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where exists ( TwentyWeeksPlusEncounter.diagnosis EncounterDiagnoses
where EncounterDiagnoses.condition.getCondition ( ).code in "Substance Abuse"
and ( EncounterDiagnoses.diagnosisPresentOnAdmission in "Present On Admission is Yes or Exempt" )
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="8"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Risk Variable Placental Accreta Spectrum"/>
</extension>
<extension url="statement">
<valueString
value="define "Risk Variable Placental Accreta Spectrum":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where exists ( TwentyWeeksPlusEncounter.diagnosis EncounterDiagnoses
where EncounterDiagnoses.condition.getCondition ( ).code in "Placental Accreta Spectrum"
and ( EncounterDiagnoses.diagnosisPresentOnAdmission in "Present On Admission is Yes or Exempt" )
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="9"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Risk Variable Neuromuscular"/>
</extension>
<extension url="statement">
<valueString
value="define "Risk Variable Neuromuscular":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where exists ( TwentyWeeksPlusEncounter.diagnosis EncounterDiagnoses
where EncounterDiagnoses.condition.getCondition ( ).code in "Neuromuscular Disease"
and ( EncounterDiagnoses.diagnosisPresentOnAdmission in "Present On Admission is Yes or Exempt" )
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="10"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Risk Variable Renal Disease"/>
</extension>
<extension url="statement">
<valueString
value="define "Risk Variable Renal Disease":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where exists ( TwentyWeeksPlusEncounter.diagnosis EncounterDiagnoses
where EncounterDiagnoses.condition.getCondition ( ).code in "Renal Disease"
and ( EncounterDiagnoses.diagnosisPresentOnAdmission in "Present On Admission is Yes or Exempt" )
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="11"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Risk Variable Gastrointestinal Disease"/>
</extension>
<extension url="statement">
<valueString
value="define "Risk Variable Gastrointestinal Disease":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where exists ( TwentyWeeksPlusEncounter.diagnosis EncounterDiagnoses
where EncounterDiagnoses.condition.getCondition ( ).code in "Gastrointestinal Disease"
and ( EncounterDiagnoses.diagnosisPresentOnAdmission in "Present On Admission is Yes or Exempt" )
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="12"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Risk Variable Hypertension"/>
</extension>
<extension url="statement">
<valueString
value="define "Risk Variable Hypertension":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where exists ( TwentyWeeksPlusEncounter.diagnosis EncounterDiagnoses
where EncounterDiagnoses.condition.getCondition ( ).code in "Hypertension"
and ( EncounterDiagnoses.diagnosisPresentOnAdmission in "Present On Admission is Yes or Exempt" )
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="13"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Risk Variable Preterm Birth"/>
</extension>
<extension url="statement">
<valueString
value="define "Risk Variable Preterm Birth":
/* CGA = Calculated Gestational Age. EGA = Estimated Gestational Age. */
( PCMaternal."Delivery Encounter with Age Range" DeliveryEncounter
let CGA: DeliveryEncounter.calculatedGestationalAge ( ),
EGA: DeliveryEncounter.lastEstimatedGestationalAge ( )
where CGA in Interval[20, 36]
or ( CGA is null
and ( EGA >= 20 weeks
and EGA <= 36 weeks
)
)
)
union ( PCMaternal."Delivery Encounter with Age Range" DeliveryEncounter
let CGA: DeliveryEncounter.calculatedGestationalAge ( ),
EGA: DeliveryEncounter.lastEstimatedGestationalAge ( )
where CGA is null
and EGA is null
and exists ( DeliveryEncounter.diagnosis DeliveryEncounterDiagnoses
where DeliveryEncounterDiagnoses.condition.getCondition ( ).code in "Preterm Birth"
and ( DeliveryEncounterDiagnoses.diagnosisPresentOnAdmission in "Present On Admission is Yes or Exempt" )
)
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="14"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Risk Variable Pulmonary Hypertension"/>
</extension>
<extension url="statement">
<valueString
value="define "Risk Variable Pulmonary Hypertension":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where exists ( TwentyWeeksPlusEncounter.diagnosis EncounterDiagnoses
where EncounterDiagnoses.condition.getCondition ( ).code in "Pulmonary Hypertension"
and ( EncounterDiagnoses.diagnosisPresentOnAdmission in "Present On Admission is Yes or Exempt" )
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="15"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="PCMaternal"/>
</extension>
<extension url="name">
<valueString value="Variable Calculated Gestational Age"/>
</extension>
<extension url="statement">
<valueString
value="define "Variable Calculated Gestational Age":
//This definition establishes a variable of CGA (Calculated Gestational Age) for all patients for the sole purpose of displaying the Calculated Gestational Age. This definition is not used in the measure logic.
"Delivery Encounter with Age Range" QualifyingEncounter
let CGA: QualifyingEncounter.calculatedGestationalAge()
// return { QualifyingEncounter, CGA }
return {
EncounterID: QualifyingEncounter.id,
CalculatedCGA: CGA
}"/>
</extension>
<extension url="displaySequence">
<valueInteger value="16"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Variable Calculated Gestational Age"/>
</extension>
<extension url="statement">
<valueString
value="define "Variable Calculated Gestational Age":
//This definition establishes a variable of CGA (Calculated Gestational Age). CGA is a supplemental data element to store the calculated gestational age result from the "CalculatedGestationalAge" function. The data element enables the capturing and saving of the CGA for data analysis post data receipt. Hospitals do not need to submit any additional data to comply with this definition.
PCMaternal."Variable Calculated Gestational Age""/>
</extension>
<extension url="displaySequence">
<valueInteger value="17"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SupplementalDataElements"/>
</extension>
<extension url="name">
<valueString value="SDE Payer"/>
</extension>
<extension url="statement">
<valueString
value="define "SDE Payer":
[Coverage: type in "Payer Type"] Payer
return {
code: Payer.type,
period: Payer.period
}"/>
</extension>
<extension url="displaySequence">
<valueInteger value="18"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="SDE Payer"/>
</extension>
<extension url="statement">
<valueString
value="define "SDE Payer":
SDE."SDE Payer""/>
</extension>
<extension url="displaySequence">
<valueInteger value="19"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Risk Variable Thyrotoxicosis"/>
</extension>
<extension url="statement">
<valueString
value="define "Risk Variable Thyrotoxicosis":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where exists ( TwentyWeeksPlusEncounter.diagnosis EncounterDiagnoses
where EncounterDiagnoses.condition.getCondition ( ).code in "Thyrotoxicosis"
and ( EncounterDiagnoses.diagnosisPresentOnAdmission in "Present On Admission is Yes or Exempt" )
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="20"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Risk Variable Other Preeclampsia"/>
</extension>
<extension url="statement">
<valueString
value="define "Risk Variable Other Preeclampsia":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where exists ( TwentyWeeksPlusEncounter.diagnosis EncounterDiagnoses
where EncounterDiagnoses.condition.getCondition ( ).code in "Mild or Moderate Preeclampsia"
and ( EncounterDiagnoses.diagnosisPresentOnAdmission in "Present On Admission is Yes or Exempt" )
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="21"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Initial Population"/>
</extension>
<extension url="statement">
<valueString
value="define "Initial Population":
PCMaternal."Delivery Encounter with Age Range""/>
</extension>
<extension url="displaySequence">
<valueInteger value="22"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Risk Variable Economic Housing Instability"/>
</extension>
<extension url="statement">
<valueString
value="define "Risk Variable Economic Housing Instability":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where exists ( TwentyWeeksPlusEncounter.diagnosis EncounterDiagnoses
where EncounterDiagnoses.condition.getCondition ( ).code in "Economic Housing Instability"
and ( EncounterDiagnoses.diagnosisPresentOnAdmission in "Present On Admission is Yes or Exempt" )
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="23"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Risk Variable Placental Abruption"/>
</extension>
<extension url="statement">
<valueString
value="define "Risk Variable Placental Abruption":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where exists ( TwentyWeeksPlusEncounter.diagnosis EncounterDiagnoses
where EncounterDiagnoses.condition.getCondition ( ).code in "Placental Abruption"
and ( EncounterDiagnoses.diagnosisPresentOnAdmission in "Present On Admission is Yes or Exempt" )
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="24"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString
value="Delivery Encounters with COVID and Respiratory Condition or Procedure"/>
</extension>
<extension url="statement">
<valueString
value="define "Delivery Encounters with COVID and Respiratory Condition or Procedure":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where exists ( ( TwentyWeeksPlusEncounter.encounterDiagnosis ( ) ) EncounterDiagnosis
where EncounterDiagnosis.code in "COVID 19 Confirmed"
)
and ( exists ( ( TwentyWeeksPlusEncounter.encounterDiagnosis ( ) ) EncounterDiagnosis
where EncounterDiagnosis.code in "Respiratory Conditions Related to COVID 19"
)
or exists ( ["Procedure": "Respiratory Support Procedures Related to COVID 19"] EncounterProcedures
where EncounterProcedures.status = 'completed'
and EncounterProcedures.performed.toInterval ( ) starts during day of TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation ( )
)
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="25"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Denominator Exclusion"/>
</extension>
<extension url="statement">
<valueString
value="define "Denominator Exclusion":
"Delivery Encounters with COVID and Respiratory Condition or Procedure""/>
</extension>
<extension url="displaySequence">
<valueInteger value="26"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Risk Variable HIV"/>
</extension>
<extension url="statement">
<valueString
value="define "Risk Variable HIV":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where exists ( TwentyWeeksPlusEncounter.diagnosis EncounterDiagnoses
where EncounterDiagnoses.condition.getCondition ( ).code in "HIV in Pregnancy Childbirth and Puerperium"
and ( EncounterDiagnoses.diagnosisPresentOnAdmission in "Present On Admission is Yes or Exempt" )
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="27"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Risk Variable Morbid Obesity"/>
</extension>
<extension url="statement">
<valueString
value="define "Risk Variable Morbid Obesity":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where exists ( TwentyWeeksPlusEncounter.diagnosis EncounterDiagnoses
where EncounterDiagnoses.condition.getCondition ( ).code in "Morbid or Severe Obesity"
and ( EncounterDiagnoses.diagnosisPresentOnAdmission in "Present On Admission is Yes or Exempt" )
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="28"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Risk Variable Preexisting Diabetes"/>
</extension>
<extension url="statement">
<valueString
value="define "Risk Variable Preexisting Diabetes":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where exists ( TwentyWeeksPlusEncounter.diagnosis EncounterDiagnoses
where EncounterDiagnoses.condition.getCondition ( ).code in "Preexisting Diabetes"
and ( EncounterDiagnoses.diagnosisPresentOnAdmission in "Present On Admission is Yes or Exempt" )
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="29"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Risk Variable Heart Rate"/>
</extension>
<extension url="statement">
<valueString
value="//First resulted value 24 hours prior to start of encounter and before time of delivery
//Report heart rate as beats/min
define "Risk Variable Heart Rate":
First(from
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" Encounter,
["observation-heartrate"] HeartRate
where HeartRate.effective.earliest() during Interval[start of Encounter.hospitalizationWithEDOBTriageObservation() - 1440 minutes, Encounter.lastTimeOfDelivery())
and HeartRate.status in { 'final', 'amended', 'corrected' }
return {
EncounterId: Encounter.id,
FirstResult: HeartRate.value as Quantity,
Timing: HeartRate.effective.earliest()
}
sort by Timing
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="30"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Risk Variable Mental Health Disorder"/>
</extension>
<extension url="statement">
<valueString
value="define "Risk Variable Mental Health Disorder":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where exists ( TwentyWeeksPlusEncounter.diagnosis EncounterDiagnoses
where EncounterDiagnoses.condition.getCondition ( ).code in "Mental Health Disorder"
and ( EncounterDiagnoses.diagnosisPresentOnAdmission in "Present On Admission is Yes or Exempt" )
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="31"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Risk Variable Obstetrical VTE"/>
</extension>
<extension url="statement">
<valueString
value="define "Risk Variable Obstetrical VTE":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where exists ( TwentyWeeksPlusEncounter.diagnosis EncounterDiagnoses
where EncounterDiagnoses.condition.getCondition ( ).code in "Venous Thromboembolism in Pregnancy"
and ( EncounterDiagnoses.diagnosisPresentOnAdmission in "Present On Admission is Yes or Exempt" )
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="32"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Risk Variable Autoimmune Disease"/>
</extension>
<extension url="statement">
<valueString
value="define "Risk Variable Autoimmune Disease":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where exists ( TwentyWeeksPlusEncounter.diagnosis EncounterDiagnoses
where EncounterDiagnoses.condition.getCondition ( ).code in "Autoimmune Disease"
and ( EncounterDiagnoses.diagnosisPresentOnAdmission in "Present On Admission is Yes or Exempt" )
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="33"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Risk Variable Bariatric Surgery"/>
</extension>
<extension url="statement">
<valueString
value="define "Risk Variable Bariatric Surgery":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where exists ( TwentyWeeksPlusEncounter.diagnosis EncounterDiagnoses
where EncounterDiagnoses.condition.getCondition ( ).code in "Bariatric Surgery"
and ( EncounterDiagnoses.diagnosisPresentOnAdmission in "Present On Admission is Yes or Exempt" )
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="34"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Risk Variable Previous Cesarean"/>
</extension>
<extension url="statement">
<valueString
value="define "Risk Variable Previous Cesarean":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where exists ( TwentyWeeksPlusEncounter.diagnosis EncounterDiagnoses
where EncounterDiagnoses.condition.getCondition ( ).code in "Previous Cesarean"
and ( EncounterDiagnoses.diagnosisPresentOnAdmission in "Present On Admission is Yes or Exempt" )
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="35"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SupplementalDataElements"/>
</extension>
<extension url="name">
<valueString value="SDE Race"/>
</extension>
<extension url="statement">
<valueString
value="define "SDE Race":
Patient.race R
return Tuple {
codes: R.ombCategory union R.detailed,
display: R.text
}"/>
</extension>
<extension url="displaySequence">
<valueInteger value="36"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="SDE Race"/>
</extension>
<extension url="statement">
<valueString
value="define "SDE Race":
SDE."SDE Race""/>
</extension>
<extension url="displaySequence">
<valueInteger value="37"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Risk Variable Placenta Previa"/>
</extension>
<extension url="statement">
<valueString
value="define "Risk Variable Placenta Previa":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where exists ( TwentyWeeksPlusEncounter.diagnosis EncounterDiagnoses
where EncounterDiagnoses.condition.getCondition ( ).code in "Placenta Previa"
and ( EncounterDiagnoses.diagnosisPresentOnAdmission in "Present On Admission is Yes or Exempt" )
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="38"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SupplementalDataElements"/>
</extension>
<extension url="name">
<valueString value="SDE Sex"/>
</extension>
<extension url="statement">
<valueString
value="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>
<extension url="displaySequence">
<valueInteger value="39"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="SDE Sex"/>
</extension>
<extension url="statement">
<valueString
value="define "SDE Sex":
SDE."SDE Sex""/>
</extension>
<extension url="displaySequence">
<valueInteger value="40"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Risk Variable Gestational Diabetes"/>
</extension>
<extension url="statement">
<valueString
value="define "Risk Variable Gestational Diabetes":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where exists ( TwentyWeeksPlusEncounter.diagnosis EncounterDiagnoses
where EncounterDiagnoses.condition.getCondition ( ).code in "Gestational Diabetes"
and ( EncounterDiagnoses.diagnosisPresentOnAdmission in "Present On Admission is Yes or Exempt" )
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="41"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString
value="Delivery Encounters with Severe Obstetric Complications Diagnosis or Procedure Excluding Blood Transfusion"/>
</extension>
<extension url="statement">
<valueString
value="define "Delivery Encounters with Severe Obstetric Complications Diagnosis or Procedure Excluding Blood Transfusion":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where exists ( TwentyWeeksPlusEncounter.diagnosis EncounterDiagnoses
where EncounterDiagnoses.condition.getCondition ( ).code in "Severe Maternal Morbidity Diagnoses"
and EncounterDiagnoses.diagnosisPresentOnAdmission in "Present on Admission is No or Unable To Determine"
)
//EncounterDiagnoses.diagnosisPresentOnAdmission ~ 'N')
or exists ( ["Procedure": "Severe Maternal Morbidity Procedures"] EncounterProcedures
where EncounterProcedures.status = 'completed'
and EncounterProcedures.performed.toInterval ( ) starts during day of TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation ( )
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="42"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Delivery Encounters with Expiration"/>
</extension>
<extension url="statement">
<valueString
value="define "Delivery Encounters with Expiration":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where TwentyWeeksPlusEncounter.hospitalization.dischargeDisposition in "Patient Expired""/>
</extension>
<extension url="displaySequence">
<valueInteger value="43"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Delivery Encounters with Blood Transfusion"/>
</extension>
<extension url="statement">
<valueString
value="define "Delivery Encounters with Blood Transfusion":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
with ["Procedure": "Blood Transfusion"] BloodTransfusion
such that BloodTransfusion.status = 'completed'
and BloodTransfusion.performed.toInterval ( ) starts during day of TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation ( )"/>
</extension>
<extension url="displaySequence">
<valueInteger value="44"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString
value="Delivery Encounters with Severe Obstetric Complications"/>
</extension>
<extension url="statement">
<valueString
value="define "Delivery Encounters with Severe Obstetric Complications":
"Delivery Encounters with Severe Obstetric Complications Diagnosis or Procedure Excluding Blood Transfusion"
union "Delivery Encounters with Expiration"
union "Delivery Encounters with Blood Transfusion""/>
</extension>
<extension url="displaySequence">
<valueInteger value="45"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Numerator"/>
</extension>
<extension url="statement">
<valueString
value="define "Numerator":
"Delivery Encounters with Severe Obstetric Complications""/>
</extension>
<extension url="displaySequence">
<valueInteger value="46"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Stratification Encounter"/>
</extension>
<extension url="statement">
<valueString
value="define "Stratification Encounter":
"Numerator"
except "Denominator Exclusion""/>
</extension>
<extension url="displaySequence">
<valueInteger value="47"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString
value="Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions"/>
</extension>
<extension url="statement">
<valueString
value="define "Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions":
"Delivery Encounters with Severe Obstetric Complications Diagnosis or Procedure Excluding Blood Transfusion"
union "Delivery Encounters with Expiration""/>
</extension>
<extension url="displaySequence">
<valueInteger value="48"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Stratum 1"/>
</extension>
<extension url="statement">
<valueString
value="define "Stratum 1":
//This logic identifies a subset of the numerator population with severe obstetric complications excluding cases where transfusion was the only severe obstetric complication.
"Stratification Encounter"
intersect "Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions""/>
</extension>
<extension url="displaySequence">
<valueInteger value="49"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Risk Variable Bleeding Disorder"/>
</extension>
<extension url="statement">
<valueString
value="define "Risk Variable Bleeding Disorder":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where exists ( TwentyWeeksPlusEncounter.diagnosis EncounterDiagnoses
where EncounterDiagnoses.condition.getCondition ( ).code in "Bleeding Disorder"
and ( EncounterDiagnoses.diagnosisPresentOnAdmission in "Present On Admission is Yes or Exempt" )
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="50"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Risk Variable Multiple Pregnancy"/>
</extension>
<extension url="statement">
<valueString
value="define "Risk Variable Multiple Pregnancy":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where exists ( TwentyWeeksPlusEncounter.diagnosis EncounterDiagnoses
where EncounterDiagnoses.condition.getCondition ( ).code in "Multiple Pregnancy"
and ( EncounterDiagnoses.diagnosisPresentOnAdmission in "Present On Admission is Yes or Exempt" )
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="51"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString
value="Risk Variable First White Blood Cell Count Lab Test"/>
</extension>
<extension url="statement">
<valueString
value="//First resulted value 24 hours prior to start of encounter and before time of delivery
//Report white blood cell count as 10*3/uL
define "Risk Variable First White Blood Cell Count Lab Test":
First(from
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" Encounter,
["USCoreLaboratoryResultObservationProfile": "White blood cells count lab test"] WBC
where WBC.issued during Interval[start of Encounter.hospitalizationWithEDOBTriageObservation() - 1440 minutes, Encounter.lastTimeOfDelivery())
and WBC.status in { 'final', 'amended', 'corrected' }
return {
EncounterId: Encounter.id,
FirstResult: WBC.value as Quantity,
Timing: WBC.issued
}
sort by Timing
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="52"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Denominator"/>
</extension>
<extension url="statement">
<valueString
value="define "Denominator":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation""/>
</extension>
<extension url="displaySequence">
<valueInteger value="53"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Risk Variable First Hematocrit Lab Test"/>
</extension>
<extension url="statement">
<valueString
value="//First resulted value 24 hours prior to start of encounter and before time of delivery
//Report hematocrit as %
define "Risk Variable First Hematocrit Lab Test":
First(from
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" Encounter,
["USCoreLaboratoryResultObservationProfile": "Hematocrit lab test"] Hematocrit
where Hematocrit.issued during Interval[start of Encounter.hospitalizationWithEDOBTriageObservation() - 1440 minutes, Encounter.lastTimeOfDelivery())
and Hematocrit.status in { 'final', 'amended', 'corrected' }
return {
EncounterId: Encounter.id,
FirstResult: Hematocrit.value as Quantity,
Timing: Hematocrit.issued
}
sort by Timing
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="54"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SupplementalDataElements"/>
</extension>
<extension url="name">
<valueString value="SDE Ethnicity"/>
</extension>
<extension url="statement">
<valueString
value="define "SDE Ethnicity":
Patient.ethnicity E
return Tuple {
codes: { E.ombCategory } union E.detailed,
display: E.text
}"/>
</extension>
<extension url="displaySequence">
<valueInteger value="55"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="SDE Ethnicity"/>
</extension>
<extension url="statement">
<valueString
value="define "SDE Ethnicity":
SDE."SDE Ethnicity""/>
</extension>
<extension url="displaySequence">
<valueInteger value="56"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Risk Variable Anemia"/>
</extension>
<extension url="statement">
<valueString
value="define "Risk Variable Anemia":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where exists ( TwentyWeeksPlusEncounter.diagnosis EncounterDiagnoses
where EncounterDiagnoses.condition.getCondition ( ).code in "Anemia"
and ( EncounterDiagnoses.diagnosisPresentOnAdmission in "Present On Admission is Yes or Exempt" )
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="57"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Risk Variable Severe Preeclampsia"/>
</extension>
<extension url="statement">
<valueString
value="define "Risk Variable Severe Preeclampsia":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where exists ( TwentyWeeksPlusEncounter.diagnosis EncounterDiagnoses
where EncounterDiagnoses.condition.getCondition ( ).code in "Severe Preeclampsia"
and ( EncounterDiagnoses.diagnosisPresentOnAdmission in "Present On Admission is Yes or Exempt" )
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="58"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Risk Variable Cardiac Disease"/>
</extension>
<extension url="statement">
<valueString
value="define "Risk Variable Cardiac Disease":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where exists ( TwentyWeeksPlusEncounter.diagnosis EncounterDiagnoses
where EncounterDiagnoses.condition.getCondition ( ).code in "Cardiac Disease"
and ( EncounterDiagnoses.diagnosisPresentOnAdmission in "Present On Admission is Yes or Exempt" )
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="59"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Risk Variable Long Term Anticoagulant Use"/>
</extension>
<extension url="statement">
<valueString
value="define "Risk Variable Long Term Anticoagulant Use":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where exists ( TwentyWeeksPlusEncounter.diagnosis EncounterDiagnoses
where EncounterDiagnoses.condition.getCondition ( ).code in "Long Term Anticoagulant Use"
and ( EncounterDiagnoses.diagnosisPresentOnAdmission in "Present On Admission is Yes or Exempt" )
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="60"/>
</extension>
</extension>
<status value="active"/>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/library-type"/>
<code value="module-definition"/>
</coding>
</type>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library PCMaternal"/>
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<type value="Patient"/>
<profile value="http://hl7.org/fhir/Patient"/>
<mustSupport value="birthDate"/>
<mustSupport value="birthDate.value"/>
<mustSupport value="gender"/>
<mustSupport value="gender.value"/>
</dataRequirement>
<dataRequirement>
<type value="Observation"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation"/>
<mustSupport value="code"/>
<mustSupport value="value"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="effective"/>
<codeFilter>
<path value="code"/>
<code>
<system value="http://loinc.org"/>
<code value="93857-1"/>
<display value="Date and time of obstetric delivery"/>
</code>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Observation"/>
<profile value="http://hl7.org/fhir/Observation"/>
<mustSupport value="value"/>
</dataRequirement>
<dataRequirement>
<type value="Observation"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation"/>
<mustSupport value="code"/>
<mustSupport value="value"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="effective"/>
<codeFilter>
<path value="code"/>
<code>
<system value="http://loinc.org"/>
<code value="11778-8"/>
<display value="Delivery date Estimated"/>
</code>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Observation"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation"/>
<mustSupport value="code"/>
<mustSupport value="value"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="effective"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.26"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Condition"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition"/>
<mustSupport value="id"/>
<mustSupport value="id.value"/>
</dataRequirement>
<dataRequirement>
<type value="uri"/>
<profile value="http://hl7.org/fhir/uri"/>
<mustSupport value="value"/>
</dataRequirement>
<dataRequirement>
<type value="string"/>
<profile value="http://hl7.org/fhir/string"/>
<mustSupport value="value"/>
</dataRequirement>
<dataRequirement>
<type value="Observation"/>
<profile value="http://hl7.org/fhir/StructureDefinition/bp"/>
<mustSupport value="effective"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="component"/>
</dataRequirement>
<dataRequirement>
<profile value="http://hl7.org/fhir/Observation.Component"/>
<mustSupport value="value"/>
</dataRequirement>
<dataRequirement>
<type value="Condition"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition"/>
<mustSupport value="id"/>
<mustSupport value="id.value"/>
</dataRequirement>
<dataRequirement>
<type value="Reference"/>
<profile value="http://hl7.org/fhir/Reference"/>
<mustSupport value="reference"/>
<mustSupport value="reference.value"/>
</dataRequirement>
<dataRequirement>
<type value="Coverage"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-coverage"/>
<mustSupport value="type"/>
<mustSupport value="period"/>
<codeFilter>
<path value="type"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Procedure"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure"/>
<mustSupport value="code"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="performed"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.379"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Observation"/>
<profile value="http://hl7.org/fhir/StructureDefinition/heartrate"/>
<mustSupport value="effective"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="value"/>
</dataRequirement>
<dataRequirement>
<type value="Patient"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"/>
</dataRequirement>
<dataRequirement>
<type value="Patient"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"/>
<mustSupport value="url"/>
<mustSupport value="extension"/>
</dataRequirement>
<dataRequirement>
<type value="Patient"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"/>
<mustSupport value="url"/>
<mustSupport value="extension"/>
</dataRequirement>
<dataRequirement>
<type value="Procedure"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure"/>
<mustSupport value="code"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="performed"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.256"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Procedure"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure"/>
<mustSupport value="code"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="performed"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.213"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Observation"/>
<profile
value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab"/>
<mustSupport value="code"/>
<mustSupport value="issued"/>
<mustSupport value="issued.value"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="value"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.129"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Observation"/>
<profile
value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab"/>
<mustSupport value="code"/>
<mustSupport value="issued"/>
<mustSupport value="issued.value"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="value"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.114"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Patient"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"/>
<mustSupport value="url"/>
<mustSupport value="extension"/>
</dataRequirement>
<dataRequirement>
<type value="Patient"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"/>
<mustSupport value="url"/>
<mustSupport value="extension"/>
</dataRequirement>
<dataRequirement>
<type value="Coverage"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-coverage"/>
<mustSupport value="type"/>
<mustSupport value="period"/>
<codeFilter>
<path value="type"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Patient"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"/>
<mustSupport value="url"/>
<mustSupport value="extension"/>
</dataRequirement>
<dataRequirement>
<type value="Patient"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"/>
<mustSupport value="url"/>
<mustSupport value="extension"/>
</dataRequirement>
</Library>
</contained>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-supplementalDataGuidance" id="supplementalDataGuidance">
<extension url="guidance">
<valueString
value="Patient's Ethnicity:
Hispanic or Latino
Not Hispanic or Latino Patient's Payer:
Categories of types of health care payer entities as defined by the US Public Health Data Consortium SOP code system Patient's Race:
Native Hawaiian or Other Pacific Islander
Asian
American Indian or Alaska Native
Other Race
White
Black or African American Patient's Sex:
Gender identity restricted to only Male and Female used in administrative situations requiring a restriction to these two categories.
This definition establishes a variable of CGA (Calculated Gestational Age). CGA is a supplemental data element to store the calculated gestational age result from the "calculatedGestationalAge" function. The data element enables the capturing and saving of the CGA for data analysis post data receipt. Hospitals do not need to submit any additional data to comply with this definition.
"/>
</extension>
<extension url="usage">
<valueCodeableConcept>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="supplemental-data"/>
<display value="Supplemental Data"/>
</coding>
<text value="Supplemental Data Guidance"/>
</valueCodeableConcept>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-supplementalDataGuidance" id="riskAdjustmentVariableGuidance">
<extension url="guidance">
<valueString
value="The Severe Obstetric Complications Risk Adjustment Methodology Report is available on the eCQI Resource Center (https://ecqi.healthit.gov).
Lab and Physical Exam Results:
Report the first resulted value 24 hours prior to start of encounter and before time of delivery in UCUM units specified:
- Heart rate: {beats}/min
- Systolic blood pressure: mm[Hg]
- White blood cell count: 10*3/uL
- Hematocrit: %
The Severe Obstetric Complications Risk Adjustment Methodology Report is available on the eCQI Resource Center (https://ecqi.healthit.gov).
Pre-existing conditions and variables must be present on admission:. Please note that present on admission codes may be those entered by coding staff, extracted from billing/claims data.
The Severe Obstetric Complications Risk Adjustment Methodology Report is available on the eCQI Resource Center (https://ecqi.healthit.gov).
Pre-existing conditions and variables must be present on admission:. Please note that present on admission codes may be those entered by coding staff, extracted from billing/claims data. The Severe Obstetric Complications Risk Adjustment Methodology Report is available on the eCQI Resource Center (https://ecqi.healthit.gov).
Pre-existing conditions and variables must be present on admission:. Please note that present on admission codes may be those entered by coding staff, extracted from billing/claims data. The Severe Obstetric Complications Risk Adjustment Methodology Report is available on the eCQI Resource Center (https://ecqi.healthit.gov).
Pre-existing conditions and variables must be present on admission:. Please note that present on admission codes may be those entered by coding staff, extracted from billing/claims data. The Severe Obstetric Complications Risk Adjustment Methodology Report is available on the eCQI Resource Center (https://ecqi.healthit.gov).
Pre-existing conditions and variables must be present on admission:. Please note that present on admission codes may be those entered by coding staff, extracted from billing/claims data. The Severe Obstetric Complications Risk Adjustment Methodology Report is available on the eCQI Resource Center (https://ecqi.healthit.gov).
Pre-existing conditions and variables must be present on admission:. Please note that present on admission codes may be those entered by coding staff, extracted from billing/claims data. The Severe Obstetric Complications Risk Adjustment Methodology Report is available on the eCQI Resource Center (https://ecqi.healthit.gov).
Pre-existing conditions and variables must be present on admission:. Please note that present on admission codes may be those entered by coding staff, extracted from billing/claims data. The Severe Obstetric Complications Risk Adjustment Methodology Report is available on the eCQI Resource Center (https://ecqi.healthit.gov).
Pre-existing conditions and variables must be present on admission:. Please note that present on admission codes may be those entered by coding staff, extracted from billing/claims data. The Severe Obstetric Complications Risk Adjustment Methodology Report is available on the eCQI Resource Center (https://ecqi.healthit.gov).
Pre-existing conditions and variables must be present on admission:. Please note that present on admission codes may be those entered by coding staff, extracted from billing/claims data. The Severe Obstetric Complications Risk Adjustment Methodology Report is available on the eCQI Resource Center (https://ecqi.healthit.gov).
Pre-existing conditions and variables must be present on admission:. Please note that present on admission codes may be those entered by coding staff, extracted from billing/claims data. The Severe Obstetric Complications Risk Adjustment Methodology Report is available on the eCQI Resource Center (https://ecqi.healthit.gov).
Pre-existing conditions and variables must be present on admission:. Please note that present on admission codes may be those entered by coding staff, extracted from billing/claims data. The Severe Obstetric Complications Risk Adjustment Methodology Report is available on the eCQI Resource Center (https://ecqi.healthit.gov).
Pre-existing conditions and variables must be present on admission:. Please note that present on admission codes may be those entered by coding staff, extracted from billing/claims data. The Severe Obstetric Complications Risk Adjustment Methodology Report is available on the eCQI Resource Center (https://ecqi.healthit.gov).
Pre-existing conditions and variables must be present on admission:. Please note that present on admission codes may be those entered by coding staff, extracted from billing/claims data. The Severe Obstetric Complications Risk Adjustment Methodology Report is available on the eCQI Resource Center (https://ecqi.healthit.gov).
Pre-existing conditions and variables must be present on admission:. Please note that present on admission codes may be those entered by coding staff, extracted from billing/claims data. The Severe Obstetric Complications Risk Adjustment Methodology Report is available on the eCQI Resource Center (https://ecqi.healthit.gov).
Pre-existing conditions and variables must be present on admission:. Please note that present on admission codes may be those entered by coding staff, extracted from billing/claims data. The Severe Obstetric Complications Risk Adjustment Methodology Report is available on the eCQI Resource Center (https://ecqi.healthit.gov).
Pre-existing conditions and variables must be present on admission:. Please note that present on admission codes may be those entered by coding staff, extracted from billing/claims data. The Severe Obstetric Complications Risk Adjustment Methodology Report is available on the eCQI Resource Center (https://ecqi.healthit.gov).
Pre-existing conditions and variables must be present on admission:. Please note that present on admission codes may be those entered by coding staff, extracted from billing/claims data. The Severe Obstetric Complications Risk Adjustment Methodology Report is available on the eCQI Resource Center (https://ecqi.healthit.gov).
Pre-existing conditions and variables must be present on admission:. Please note that present on admission codes may be those entered by coding staff, extracted from billing/claims data. The Severe Obstetric Complications Risk Adjustment Methodology Report is available on the eCQI Resource Center (https://ecqi.healthit.gov).
Pre-existing conditions and variables must be present on admission:. Please note that present on admission codes may be those entered by coding staff, extracted from billing/claims data. The Severe Obstetric Complications Risk Adjustment Methodology Report is available on the eCQI Resource Center (https://ecqi.healthit.gov).
Pre-existing conditions and variables must be present on admission:. Please note that present on admission codes may be those entered by coding staff, extracted from billing/claims data. The Severe Obstetric Complications Risk Adjustment Methodology Report is available on the eCQI Resource Center (https://ecqi.healthit.gov).
Pre-existing conditions and variables must be present on admission:. Please note that present on admission codes may be those entered by coding staff, extracted from billing/claims data. The Severe Obstetric Complications Risk Adjustment Methodology Report is available on the eCQI Resource Center (https://ecqi.healthit.gov).
Pre-existing conditions and variables must be present on admission:. Please note that present on admission codes may be those entered by coding staff, extracted from billing/claims data. The Severe Obstetric Complications Risk Adjustment Methodology Report is available on the eCQI Resource Center (https://ecqi.healthit.gov).
Pre-existing conditions and variables must be present on admission:. Please note that present on admission codes may be those entered by coding staff, extracted from billing/claims data. The Severe Obstetric Complications Risk Adjustment Methodology Report is available on the eCQI Resource Center (https://ecqi.healthit.gov).
Pre-existing conditions and variables must be present on admission:. Please note that present on admission codes may be those entered by coding staff, extracted from billing/claims data. The Severe Obstetric Complications Risk Adjustment Methodology Report is available on the eCQI Resource Center (https://ecqi.healthit.gov).
Pre-existing conditions and variables must be present on admission:. Please note that present on admission codes may be those entered by coding staff, extracted from billing/claims data. The Severe Obstetric Complications Risk Adjustment Methodology Report is available on the eCQI Resource Center (https://ecqi.healthit.gov).
Pre-existing conditions and variables must be present on admission:. Please note that present on admission codes may be those entered by coding staff, extracted from billing/claims data. The Severe Obstetric Complications Risk Adjustment Methodology Report is available on the eCQI Resource Center (https://ecqi.healthit.gov).
Pre-existing conditions and variables must be present on admission:. Please note that present on admission codes may be those entered by coding staff, extracted from billing/claims data. The Severe Obstetric Complications Risk Adjustment Methodology Report is available on the eCQI Resource Center (https://ecqi.healthit.gov).
Pre-existing conditions and variables must be present on admission:. Please note that present on admission codes may be those entered by coding staff, extracted from billing/claims data. The Severe Obstetric Complications Risk Adjustment Methodology Report is available on the eCQI Resource Center (https://ecqi.healthit.gov).
Pre-existing conditions and variables must be present on admission:. Please note that present on admission codes may be those entered by coding staff, extracted from billing/claims data. "/>
</extension>
<extension url="usage">
<valueCodeableConcept>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
<display value="Risk Adjustment Factor"/>
</coding>
<text value="Risk Adjustment Variable Guidance"/>
</valueCodeableConcept>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-effectiveDataRequirements">
<valueReference>
<reference value="#effective-data-requirements"/>
</valueReference>
</extension>
<url
value="http://ecqi.healthit.gov/ecqms/Measure/SevereObstetricComplicationsFHIR"/>
<identifier>
<use value="usual"/>
<type>
<coding>
<system
value="http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type"/>
<code value="short-name"/>
</coding>
</type>
<system value="https://madie.cms.gov/measure/shortName"/>
<value value="CMS1028FHIR"/>
</identifier>
<identifier>
<use value="official"/>
<type>
<coding>
<system
value="http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type"/>
<code value="version-independent"/>
</coding>
</type>
<system value="urn:ietf:rfc:3986"/>
<value value="urn:uuid:6cf03fe2-b962-4f83-ac37-26d7477183c7"/>
</identifier>
<identifier>
<use value="official"/>
<type>
<coding>
<system
value="http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type"/>
<code value="version-specific"/>
</coding>
</type>
<system value="urn:ietf:rfc:3986"/>
<value value="urn:uuid:2c92808482ead7c5018384daff512547"/>
</identifier>
<identifier>
<use value="official"/>
<type>
<coding>
<system
value="http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type"/>
<code value="publisher"/>
</coding>
</type>
<system value="https://madie.cms.gov/measure/cmsId"/>
<value value="1028FHIR"/>
<assigner>
<display value="CMS"/>
</assigner>
</identifier>
<version value="0.0.007"/>
<name value="SevereObstetricComplicationsFHIR"/>
<title value="Severe Obstetric ComplicationsFHIR"/>
<status value="draft"/>
<experimental value="false"/>
<date value="2023-08-08T18:35:06+00:00"/>
<publisher value="The Joint Commission"/>
<contact>
<telecom>
<system value="url"/>
<value value="https://www.jointcommission.org/"/>
</telecom>
</contact>
<description
value="Patients with severe obstetric complications which occur during the inpatient delivery hospitalization"/>
<useContext>
<code>
<system
value="http://terminology.hl7.org/CodeSystem/usage-context-type"/>
<code value="program"/>
</code>
<valueCodeableConcept>
<coding>
<system
value="http://hl7.org/fhir/us/cqfmeasures/CodeSystem/quality-programs"/>
<code value="eh-cah"/>
<display value="EH/CAH"/>
</coding>
</valueCodeableConcept>
</useContext>
<purpose value="UNKNOWN"/>
<usage
value="This measure allows for 3 approaches to determine gestational age (GA) in the following order of precedence:
1. The GA is calculated using the American College of Obstetricians and Gynecologists ReVITALize guidelines.*
2. The GA is obtained from a discrete field in the electronic health record. This option is only used when the calculated GA is not available.
3. The GA is based on ICD10 or SNOMED codes indicative of weeks gestation. This option is only used when results from items #1 and #2 (see above) are not available.
Wherever gestational age is mentioned, relative to the delivery, the intent is to capture the last estimated gestational age prior to or at the time of delivery.
*ACOG ReVITALize Guidelines for Calculating Gestational Age:
Gestational Age = (280-(Estimated Due Date minus Reference Date))/7
--Estimated Due Date (EDD): The best obstetrical EDD is determined by last menstrual period if confirmed by early ultrasound or no ultrasound performed, or early ultrasound if no known last menstrual period or the ultrasound is not consistent with last menstrual period, or known date of fertilization (e.g., assisted reproductive technology)
--Reference Date is the date on which you are trying to determine gestational age. For purposes of this eCQM, Reference Date would be the Date of Delivery.
Note however the calculation may yield a non-whole number and gestational age should be rounded off to the nearest completed week. For example, an infant born on the 5th day of the 36th week (35 weeks and 5/7 days) is at a gestational age of 35 weeks, not 36 weeks.
Definition:
For this measure, specifications are modeled after the nationally available and adopted CDC definition for Severe Maternal Morbidity (SMM) with the addition of maternal mortality. At times, we may refer to the CDC indicators of morbidity as SMM, but the outcome of the measure, which includes morbidity and mortality, is referred to as Severe Obstetric Complications (SOC).
This eCQM is an episode-based measure. An episode is defined as each inpatient hospitalization or encounter that ends during the measurement period.
This FHIR-based measure has been derived from the QDM-based measure CMS1028v2.
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)."/>
<copyright
value="Measure specifications are in the Public Domain.
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."/>
<approvalDate value="2023-08-21"/>
<lastReviewDate value="2023-08-21"/>
<effectivePeriod>
<start value="2024-01-01"/>
<end value="2024-12-31"/>
</effectivePeriod>
<author>
<name value="The Joint Commission"/>
<telecom>
<system value="url"/>
<value value="https://www.jointcommission.org/"/>
</telecom>
</author>
<author>
<name value="Centers for Medicare & Medicaid Services (CMS)"/>
<telecom>
<system value="url"/>
<value value="https://www.cms.gov/"/>
</telecom>
</author>
<author>
<name
value="Yale New Haven Health Service Corporation/ Center for Outcomes Research and Evaluation"/>
<telecom>
<system value="url"/>
<value value="https://medicine.yale.edu/core/"/>
</telecom>
</author>
<library
value="http://ecqi.healthit.gov/ecqms/Library/SevereObstetricComplicationsFHIR"/>
<disclaimer
value="These performance measures are not clinical guidelines and do not establish a standard of medical care, and have not been tested for all potential applications. The measures and specifications are provided without warranty."/>
<rationale
value="The United States (US) experiences higher rates of maternal morbidity and mortality than most other developed countries. These rates have continued to trend upward in recent decades (CDC, n.d.). Research indicates that the overall rate of severe maternal morbidity (SMM) increased by almost 200% between 1993 and 2014 to 144 per 10,000 delivery hospitalizations (CDC, n.d.), with more than 25,000 women per year experiencing obstetric complications (U.S. Department of Health and Human Services, 2020). Recent maternal mortality data from 2018 reveal that 658 women in the US died from maternal causes, resulting in a rate of 17.4 deaths per 100,000 live births, with 77% of the deaths attributed to direct obstetric causes like hemorrhage, preeclampsia, obstetric embolism, and other complications (Hoyert & Minino, 2018). 144 per 10,000 women hospitalized for delivery have experienced SMM, including hemorrhage, embolism, hypertension, stroke, and other serious complications (CDC,2020). Racial and ethnic disparities for Black women and Hispanic women are at a significantly higher risk for developing these complications than are Non-Hispanic White women (Leonard et al., 2019). Increasing rates of SMM are resulting in increased healthcare costs, longer hospitalization stays and impacts on a woman's health.
There is limited national evaluation of hospitals' performance on maternal morbidity and mortality although SMM is widely used at the population level. SMM is linked to maternal mortality, varies significantly among hospitals, and has significant racial/ethnic and urban/rural disparities. SMM is a cost driver for both Medicaid and commercial plans. This measure is important as it will assist in the discovery and understanding of SMM patterns which can lead to improvements in the safety and quality of maternal care necessary to reduce SMM rates."/>
<clinicalRecommendationStatement
value="Healthy People 2030 Measure (MICH-05): Reduce severe maternal complications identified during delivery hospitalizations
The American College of Obstetricians and Gynecologists (the College) and the Society for Maternal-Fetal Medicine (SMFM) recommend identifying potential cases of severe maternal morbidity for further review, with a focus on outcomes and complications, and consider this an important step toward promoting safe obstetric care."/>
<group id="638907ab4ba3d47c885c02fd">
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring">
<valueCodeableConcept>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-scoring"/>
<code value="proportion"/>
<display value="Proportion"/>
</coding>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis">
<valueCode value="Encounter"/>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-type">
<valueCodeableConcept>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/measure-type"/>
<code value="outcome"/>
<display value="Outcome"/>
</coding>
</valueCodeableConcept>
</extension>
<population id="8D56845B-BA26-4F6A-8D23-BBFD696C9450">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="initial-population"/>
<display value="Initial Population"/>
</coding>
</code>
<description
value="Inpatient hospitalizations for patients age greater than or equal to 8 years and less than 65 admitted to the hospital for inpatient acute care who undergo a delivery procedure with a discharge date that ends during the measurement period"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Initial Population"/>
</criteria>
</population>
<population id="8542DE86-6114-4575-9A2B-D09A0FA7C671">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="denominator"/>
<display value="Denominator"/>
</coding>
</code>
<description
value="Inpatient hospitalizations for patients delivering stillborn or live birth with greater than or equal to 20 weeks, 0 days gestation completed"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Denominator"/>
</criteria>
</population>
<population id="16605347-8AF3-47AA-B230-65B7208909B9">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="denominator-exclusion"/>
<display value="Denominator Exclusion"/>
</coding>
</code>
<description
value="Inpatient hospitalizations for patients with confirmed diagnosis of COVID with COVID-related respiratory condition or patients with confirmed diagnosis of COVID with COVID-related respiratory procedure"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Denominator Exclusion"/>
</criteria>
</population>
<population id="05AD3648-8C60-4938-96C4-82385B9C4F91">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="numerator"/>
<display value="Numerator"/>
</coding>
</code>
<description
value="Inpatient hospitalizations for patients with severe obstetric complications (not present on admission that occur during the current delivery encounter) including the following:
- Severe maternal morbidity diagnoses (see list below)
- Severe maternal morbidity procedures (see list below)
- Discharge disposition of expired
Please note that present on admission codes may be those entered by coding staff, extracted from billing/claims data.
Severe Maternal Morbidity Diagnoses:
- Cardiac
Acute heart failure
Acute myocardial infarction
Aortic aneurysm
Cardiac arrest/ventricular fibrillation
Heart failure/arrest during procedure or surgery
- Hemorrhage
Disseminated intravascular coagulation
Shock
- Renal
Acute renal failure
- Respiratory
Adult respiratory distress syndrome
Pulmonary edema
- Sepsis
- Other OB
Air and thrombotic embolism
Amniotic fluid embolism
Eclampsia
Severe anesthesia complications
- Other Medical
Puerperal cerebrovascular disorder
Sickle cell disease with crisis
Severe Maternal Morbidity Procedures:
- Blood transfusion
- Conversion of cardiac rhythm
- Hysterectomy
- Temporary tracheostomy
- Ventilation"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Numerator"/>
</criteria>
</population>
<population id="e29f29ee-889e-4314-983c-e0ddc189a16c">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="numerator-exclusion"/>
<display value="Numerator Exclusion"/>
</coding>
</code>
<criteria>
<language value="text/cql-identifier"/>
</criteria>
</population>
<population id="f2f492ff-b304-4d26-9df1-69162493ddc1">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="denominator-exception"/>
<display value="Denominator Exception"/>
</coding>
</code>
<criteria>
<language value="text/cql-identifier"/>
</criteria>
</population>
<stratifier id="75faa812-7f77-45d4-bed1-a5d92837e8f4">
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo">
<valueCodeableConcept>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="initial-population"/>
<display value="Initial Population"/>
</coding>
</valueCodeableConcept>
</extension>
<description
value="Stratum1: Delivery hospitalizations with severe obstetric complications excluding hospitalizations where transfusion was the only severe obstetric complication.
Additionally, this measure will be stratified by race and ethnicity after measure submission."/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Stratum 1"/>
</criteria>
</stratifier>
<stratifier id="f08626ef-90df-4c81-9651-f6206e05d480">
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo">
<valueCodeableConcept>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="initial-population"/>
<display value="Initial Population"/>
</coding>
</valueCodeableConcept>
</extension>
<criteria>
<language value="text/cql-identifier"/>
</criteria>
</stratifier>
</group>
<supplementalData id="sde-ethnicity">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="supplemental-data"/>
</coding>
</usage>
<description value="SDE Ethnicity"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="SDE Ethnicity"/>
</criteria>
</supplementalData>
<supplementalData id="sde-payer">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="supplemental-data"/>
</coding>
</usage>
<description value="SDE Payer"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="SDE Payer"/>
</criteria>
</supplementalData>
<supplementalData id="sde-race">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="supplemental-data"/>
</coding>
</usage>
<description value="SDE Race"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="SDE Race"/>
</criteria>
</supplementalData>
<supplementalData id="sde-sex">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="supplemental-data"/>
</coding>
</usage>
<description value="SDE Sex"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="SDE Sex"/>
</criteria>
</supplementalData>
<supplementalData id="variable-calculated-gestational-age">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="supplemental-data"/>
</coding>
</usage>
<description value="Variable Calculated Gestational Age"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Variable Calculated Gestational Age"/>
</criteria>
</supplementalData>
<supplementalData id="risk-variable-lab-and-physical-exam-results">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
</coding>
</usage>
<description value="Risk Variable Lab and Physical Exam Results"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Risk Variable Lab and Physical Exam Results"/>
</criteria>
</supplementalData>
<supplementalData id="risk-variable-anemia">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
</coding>
</usage>
<description value="Risk Variable Anemia"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Risk Variable Anemia"/>
</criteria>
</supplementalData>
<supplementalData id="risk-variable-asthma">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
</coding>
</usage>
<description value="Risk Variable Asthma"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Risk Variable Asthma"/>
</criteria>
</supplementalData>
<supplementalData id="risk-variable-autoimmune-disease">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
</coding>
</usage>
<description value="Risk Variable Autoimmune Disease"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Risk Variable Autoimmune Disease"/>
</criteria>
</supplementalData>
<supplementalData id="risk-variable-bariatric-surgery">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
</coding>
</usage>
<description value="Risk Variable Bariatric Surgery"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Risk Variable Bariatric Surgery"/>
</criteria>
</supplementalData>
<supplementalData id="risk-variable-bleeding-disorder">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
</coding>
</usage>
<description value="Risk Variable Bleeding Disorder"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Risk Variable Bleeding Disorder"/>
</criteria>
</supplementalData>
<supplementalData id="risk-variable-morbid-obesity">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
</coding>
</usage>
<description value="Risk Variable Morbid Obesity"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Risk Variable Morbid Obesity"/>
</criteria>
</supplementalData>
<supplementalData id="risk-variable-cardiac-disease">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
</coding>
</usage>
<description value="Risk Variable Cardiac Disease"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Risk Variable Cardiac Disease"/>
</criteria>
</supplementalData>
<supplementalData id="risk-variable-economic-housing-instability">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
</coding>
</usage>
<description value="Risk Variable Economic Housing Instability"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Risk Variable Economic Housing Instability"/>
</criteria>
</supplementalData>
<supplementalData id="risk-variable-gastrointestinal-disease">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
</coding>
</usage>
<description value="Risk Variable Gastrointestinal Disease"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Risk Variable Gastrointestinal Disease"/>
</criteria>
</supplementalData>
<supplementalData id="risk-variable-gestational-diabetes">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
</coding>
</usage>
<description value="Risk Variable Gestational Diabetes"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Risk Variable Gestational Diabetes"/>
</criteria>
</supplementalData>
<supplementalData id="risk-variable-hiv">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
</coding>
</usage>
<description value="Risk Variable HIV"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Risk Variable HIV"/>
</criteria>
</supplementalData>
<supplementalData id="risk-variable-hypertension">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
</coding>
</usage>
<description value="Risk Variable Hypertension"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Risk Variable Hypertension"/>
</criteria>
</supplementalData>
<supplementalData id="risk-variable-long-term-anticoagulant-use">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
</coding>
</usage>
<description value="Risk Variable Long Term Anticoagulant Use"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Risk Variable Long Term Anticoagulant Use"/>
</criteria>
</supplementalData>
<supplementalData id="risk-variable-mental-health-disorder">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
</coding>
</usage>
<description value="Risk Variable Mental Health Disorder"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Risk Variable Mental Health Disorder"/>
</criteria>
</supplementalData>
<supplementalData id="risk-variable-multiple-pregnancy">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
</coding>
</usage>
<description value="Risk Variable Multiple Pregnancy"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Risk Variable Multiple Pregnancy"/>
</criteria>
</supplementalData>
<supplementalData id="risk-variable-neuromuscular">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
</coding>
</usage>
<description value="Risk Variable Neuromuscular"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Risk Variable Neuromuscular"/>
</criteria>
</supplementalData>
<supplementalData id="risk-variable-obstetrical-vte">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
</coding>
</usage>
<description value="Risk Variable Obstetrical VTE"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Risk Variable Obstetrical VTE"/>
</criteria>
</supplementalData>
<supplementalData id="risk-variable-placenta-previa">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
</coding>
</usage>
<description value="Risk Variable Placenta Previa"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Risk Variable Placenta Previa"/>
</criteria>
</supplementalData>
<supplementalData id="risk-variable-placental-abruption">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
</coding>
</usage>
<description value="Risk Variable Placental Abruption"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Risk Variable Placental Abruption"/>
</criteria>
</supplementalData>
<supplementalData id="risk-variable-placental-accreta-spectrum">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
</coding>
</usage>
<description value="Risk Variable Placental Accreta Spectrum"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Risk Variable Placental Accreta Spectrum"/>
</criteria>
</supplementalData>
<supplementalData id="risk-variable-preexisting-diabetes">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
</coding>
</usage>
<description value="Risk Variable Preexisting Diabetes"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Risk Variable Preexisting Diabetes"/>
</criteria>
</supplementalData>
<supplementalData id="risk-variable-previous-cesarean">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
</coding>
</usage>
<description value="Risk Variable Previous Cesarean"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Risk Variable Previous Cesarean"/>
</criteria>
</supplementalData>
<supplementalData id="risk-variable-pulmonary-hypertension">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
</coding>
</usage>
<description value="Risk Variable Pulmonary Hypertension"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Risk Variable Pulmonary Hypertension"/>
</criteria>
</supplementalData>
<supplementalData id="risk-variable-renal-disease">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
</coding>
</usage>
<description value="Risk Variable Renal Disease"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Risk Variable Renal Disease"/>
</criteria>
</supplementalData>
<supplementalData id="risk-variable-severe-preeclampsia">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
</coding>
</usage>
<description value="Risk Variable Severe Preeclampsia"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Risk Variable Severe Preeclampsia"/>
</criteria>
</supplementalData>
<supplementalData id="risk-variable-substance-abuse">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
</coding>
</usage>
<description value="Risk Variable Substance Abuse"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Risk Variable Substance Abuse"/>
</criteria>
</supplementalData>
<supplementalData id="risk-variable-thyrotoxicosis">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
</coding>
</usage>
<description value="Risk Variable Thyrotoxicosis"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Risk Variable Thyrotoxicosis"/>
</criteria>
</supplementalData>
<supplementalData id="risk-variable-other-preeclampsia">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
</coding>
</usage>
<description value="Risk Variable Other Preeclampsia"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Risk Variable Other Preeclampsia"/>
</criteria>
</supplementalData>
<supplementalData id="risk-variable-preterm-birth">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
</coding>
</usage>
<description value="Risk Variable Preterm Birth"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Risk Variable Preterm Birth"/>
</criteria>
</supplementalData>
<supplementalData id="risk-variable-first-hematocrit-lab-test">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
</coding>
</usage>
<description value="Risk Variable First Hematocrit Lab Test"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Risk Variable First Hematocrit Lab Test"/>
</criteria>
</supplementalData>
<supplementalData id="risk-variable-first-white-blood-cell-count-lab-test">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
</coding>
</usage>
<description value="Risk Variable First White Blood Cell Count Lab Test"/>
<criteria>
<language value="text/cql-identifier"/>
<expression
value="Risk Variable First White Blood Cell Count Lab Test"/>
</criteria>
</supplementalData>
<supplementalData id="risk-variable-heart-rate">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
</coding>
</usage>
<description value="Risk Variable Heart Rate"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Risk Variable Heart Rate"/>
</criteria>
</supplementalData>
<supplementalData id="risk-variable-systolic-blood-pressure">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
</coding>
</usage>
<description value="Risk Variable Systolic Blood Pressure"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Risk Variable Systolic Blood Pressure"/>
</criteria>
</supplementalData>
</Measure>
IG © 2023+ cqframework. Package gov.healthit.ecqi.ecqms#2023.0.0 based on FHIR 4.0.1. Generated 2026-05-13
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