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

## Library: SafeUseofOpioidsConcurrentPrescribingFHIR

Official URL: http://ecqi.healthit.gov/ecqms/Library/SafeUseofOpioidsConcurrentPrescribingFHIR | Version: 0.1.000
Active as of 2023-08-18 | Computable Name: SafeUseofOpioidsConcurrentPrescribingFHIR
Other Identifiers: https://madie.cms.gov/login#SafeUseofOpioidsConcurrentPrescribingFHIR (use: official, )
Usage:Program: EH/CAH

SafeUseofOpioidsConcurrentPrescribingFHIR

Id: | SafeUseofOpioidsConcurrentPrescribingFHIR
Url: | http://ecqi.healthit.gov/ecqms/Library/SafeUseofOpioidsConcurrentPrescribingFHIR
Version: | 0.1.000
Identifier: | value: SafeUseofOpioidsConcurrentPrescribingFHIR
Name: | SafeUseofOpioidsConcurrentPrescribingFHIR
Title: | SafeUseofOpioidsConcurrentPrescribingFHIR
Status: | active
Experimental: | false
Type: | system: http://terminology.hl7.org/CodeSystem/library-type code: logic-library
Date: | 2023-08-18T15:25:34+00:00
Description: | SafeUseofOpioidsConcurrentPrescribingFHIR
Use Context: |
code | value | display
--- | --- | ---
program | eh-cah | EH/CAH
Related Artifacts: | Dependencies
Data Requirements: |
Type | Profile | MS | Code Filter
--- | --- | --- | ---
Patient | http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient |  |
Patient | http://hl7.org/fhir/Patient | ;;;; |
Encounter | http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter | ;;;; | code filter: path: type value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307
Patient | http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient |  |
Encounter | http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter | ;;;; | code filter: path: type value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307
MedicationRequest | http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest | ; | code filter: path: medication value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.165
MedicationRequest | http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest | ; | code filter: path: medication value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.165
MedicationRequest | http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest | ; | code filter: path: medication value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1125.1
MedicationRequest | http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest | ;;;;;;; | code filter: path: medication value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1125.1
Encounter | http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter | ;;;; | code filter: path: type value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307
MedicationRequest | http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest | ;;;;;;; | code filter: path: medication value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1125.1
Encounter | http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter | ;;;; | code filter: path: type value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307
Encounter | http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter | ;;;; | code filter: path: type value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307
Coverage | http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-coverage | ;; | code filter: path: type value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591
uri | http://hl7.org/fhir/uri | ; |
Patient | http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient | ;; |
Patient | http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient | ;; |
Condition | http://hl7.org/fhir/Condition | ; |
Condition | http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition | ;; |
ServiceRequest | http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest | ; | code filter: path: code value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1.1579
Procedure | http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure | ; | code filter: path: code value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1.1579
Patient | http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient |  |
Encounter | http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter | ;;;; | code filter: path: type value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.143
Encounter | http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter | ;;;; | code filter: path: type value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292
Encounter | http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter | ;;;; | code filter: path: type value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.143
Encounter | http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter | ;;;; | code filter: path: type value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292
Condition | http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition | ; | code filter: path: code value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.161
Patient | http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient | ;; |
Patient | http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient | ;; |
Coverage | http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-coverage | ;; | code filter: path: type value set: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591
Patient | http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient | ;; |
Patient | http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient | ;; |
Content: text/cql
    library SafeUseofOpioidsConcurrentPrescribingFHIR version '0.1.000'

    using QICore version '4.1.1'

    include CQMCommon version '1.4.000' called CQMCommon
    include FHIRHelpers version '4.3.000' called FHIRHelpers
    include Hospice version '6.7.000' called Hospice
    include QICoreCommon version '1.5.000' called QICoreCommon
    include SupplementalDataElements version '3.4.000' called SDE

    codesystem "LOINC": 'http://loinc.org'

    valueset "All Primary and Secondary Cancer": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.161'
    valueset "Discharge To Acute Care Facility": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.87'
    valueset "Encounter Inpatient": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307'
    valueset "Hospice Care Referral or Admission": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1116.365'
    valueset "Palliative or Hospice Care": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1.1579'
    valueset "Patient Expired": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.309'
    valueset "Schedule II & III Opioid Medications": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.165'
    valueset "Schedule IV Benzodiazepines": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1125.1'

    code "Birth date": '21112-8' from "LOINC" display 'Birth date'

    parameter "Measurement Period" Interval<DateTime>

    context Patient

    define "Initial Population":
      "Inpatient Encounters with an Opioid or Benzodiazepine at Discharge"

    define "Denominator":
      "Initial Population"

    define "Denominator Exclusion":
      /*Excludes encounters of patients with cancer or who are receiving palliative or hospice care at the time of the encounter*/

      "Inpatient Encounters with an Opioid or Benzodiazepine at Discharge" InpatientEncounter
        where exists ( [Condition: "All Primary and Secondary Cancer"] Cancer
            where ( Cancer.isProblemListItem ( )
                or Cancer.isHealthConcern ( )
            )
              and Cancer.isActive ( )
              and Cancer.prevalenceInterval ( ) overlaps InpatientEncounter.period
        )
          or exists ( ( InpatientEncounter.encounterDiagnosis ( ) ) InpatientEncounterDiagnosis
              where InpatientEncounterDiagnosis.code in "All Primary and Secondary Cancer"
          )
          or exists ( "Intervention Palliative or Hospice Care" PalliativeOrHospiceCare
              where Coalesce(PalliativeOrHospiceCare.performed.toInterval(), PalliativeOrHospiceCare.authoredOn.toInterval()) during day of CQMCommon."HospitalizationWithObservation" ( InpatientEncounter )
          )
          or ( InpatientEncounter.hospitalization.dischargeDisposition in "Discharge To Acute Care Facility"
              or InpatientEncounter.hospitalization.dischargeDisposition in "Hospice Care Referral or Admission"
              or InpatientEncounter.hospitalization.dischargeDisposition in "Patient Expired"
          )

    define "Numerator":
      /*Encounters of patients prescribed two or more opioids or an opioid and benzodiazepine at discharge.*/

      ( "Inpatient Encounter with Age Greater than or Equal to 18" InpatientEncounter
          where ( Count("Opioid at Discharge" Opioids
                return distinct Opioids.medication
            ) >= 2
          )
      )
        union ( "Inpatient Encounter with Age Greater than or Equal to 18" InpatientEncounter
            with "Opioid at Discharge" OpioidsDischarge
              such that OpioidsDischarge.authoredOn during InpatientEncounter.period
            with "Benzodiazepine at Discharge" BenzodiazepinesDischarge
              such that BenzodiazepinesDischarge.authoredOn during day of InpatientEncounter.period
        )

    define "Benzodiazepine at Discharge":
      ( [MedicationRequest: medication in "Schedule IV Benzodiazepines"] BenzoMedications
        where ( BenzoMedications.isCommunity ( )
            or BenzoMedications.isDischarge ( )
        ) ) BenzodiazepineDischargeMedication
        where BenzodiazepineDischargeMedication.status in { 'active', 'completed' }
          and BenzodiazepineDischargeMedication.intent = 'order'

    define "Inpatient Encounter with Age Greater than or Equal to 18":
      CQMCommon."Inpatient Encounter" InpatientHospitalEncounter
        where AgeInYearsAt(date from start of InpatientHospitalEncounter.period) >= 18

    define "Inpatient Encounters with an Opioid or Benzodiazepine at Discharge":
      "Inpatient Encounter with Age Greater than or Equal to 18" InpatientEncounter
        with ( "Opioid at Discharge"
          union "Benzodiazepine at Discharge" ) OpioidOrBenzodiazepineAtDischarge
          such that OpioidOrBenzodiazepineAtDischarge.authoredOn during day of InpatientEncounter.period

    define "Intervention Palliative or Hospice Care":
      [ServiceRequest: "Palliative or Hospice Care"]
        union [Procedure: "Palliative or Hospice Care"]

    define "Opioid at Discharge":
      ( [MedicationRequest: "Schedule II & III Opioid Medications"] OpioidMedications
        where ( OpioidMedications.isCommunity ( )
            or OpioidMedications.isDischarge ( )
        ) ) OpioidDischargeMedication
        where OpioidDischargeMedication.status in { 'active', 'completed' }
          and OpioidDischargeMedication.intent = 'order'

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

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

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

    define "SDE Sex":
      SDE."SDE Sex"
Content: application/elm+xml
    Encoded data (136148 characters)
Content: application/elm+json
    Encoded data (190988 characters)