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

## : SafeUseofOpioidsConcurrentPrescribingFHIR - XML Representation

Active as of 2023-08-18

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    <Library xmlns="http://hl7.org/fhir">
      <id value="SafeUseofOpioidsConcurrentPrescribingFHIR"/>
      <meta>
        <profile
                 value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-library-cqfm"/>
      </meta>
      <language value="en"/>
      <text>
        <status value="extensions"/>
        <div xmlns="http://www.w3.org/1999/xhtml">
        <table class="grid dict">

                <tr>
                    <th scope="row"><b>Id: </b></th>
                    <td style="padding-left: 4px;">SafeUseofOpioidsConcurrentPrescribingFHIR</td>
                </tr>

                <tr>
                    <th scope="row"><b>Url: </b></th>
                    <td style="padding-left: 4px;">http://ecqi.healthit.gov/ecqms/Library/SafeUseofOpioidsConcurrentPrescribingFHIR</td>
                </tr>

                <tr>
                    <th scope="row"><b>Version: </b></th>
                    <td style="padding-left: 4px;">0.1.000</td>
                </tr>

                <tr>
                    <th scope="row"><b>Identifier: </b></th>
                    <td style="padding-left: 4px;">

                            <p style="margin-bottom: 5px;">
                                <b>value: </b> <span>SafeUseofOpioidsConcurrentPrescribingFHIR</span>
                            </p>

                    </td>
                </tr>

                <tr>
                    <th scope="row"><b>Name: </b></th>
                    <td style="padding-left: 4px;">SafeUseofOpioidsConcurrentPrescribingFHIR</td>
                </tr>

                <tr>
                    <th scope="row"><b>Title: </b></th>
                    <td style="padding-left: 4px;">SafeUseofOpioidsConcurrentPrescribingFHIR</td>
                </tr>

                <tr>
                    <th scope="row"><b>Status: </b></th>
                    <td style="padding-left: 4px;">active</td>
                </tr>

                <tr>
                    <th scope="row"><b>Experimental: </b></th>
                    <td style="padding-left: 4px;">false</td>
                </tr>

                <tr>
                    <th scope="row"><b>Type: </b></th>
                    <td style="padding-left: 4px;">

                                    <p style="margin-bottom: 5px;">
                                        <b>system: </b> <span>http://terminology.hl7.org/CodeSystem/library-type</span>
                                    </p>

                                    <p style="margin-bottom: 5px;">
                                        <b>code: </b> <span>logic-library</span>
                                    </p>

                    </td>
                </tr>

                <tr>
                    <th scope="row"><b>Date: </b></th>
                    <td style="padding-left: 4px;">2023-08-18T15:25:34+00:00</td>
                </tr>

                <tr>
                    <th scope="row"><b>Description: </b></th>
                    <td style="padding-left: 4px;">SafeUseofOpioidsConcurrentPrescribingFHIR</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><th><b>display</b></th></tr>

                                <tr>
                                    <td>program</td>
                                    <td>eh-cah</td>
                                    <td>EH/CAH</td>
                                </tr>

                        </table>
                    </td>
                </tr>

                <tr>
                    <th scope="row"><b>Related Artifacts: </b></th>
                    <td style="padding-left: 4px;">

                            <p><b>Dependencies</b></p>
                            <ul>

                                    <li/>

                                    <li/>

                                    <li/>

                                    <li/>

                                    <li/>

                                    <li/>

                                    <li/>

                                    <li/>

                                    <li/>

                                    <li/>

                                    <li/>

                                    <li/>

                                    <li/>

                                    <li/>

                            </ul>

                    </td>
                </tr>

                <tr>
                    <th scope="row"><b>Data Requirements:</b></th>
                    <td style="padding-left: 4px;">
                        <table class="grid-dict">
                            <tr><th><b>Type</b></th><th><b>Profile</b></th><th><b>MS</b></th><th><b>Code Filter</b></th></tr>

                                <tr>
                                    <th>Patient</th>
                                    <th>http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient</th>
                                    <th/>
                                    <th>

                                    </th>
                                </tr>

                                <tr>
                                    <th>Patient</th>
                                    <th>http://hl7.org/fhir/Patient</th>
                                    <th>;;;;</th>
                                    <th>

                                    </th>
                                </tr>

                                <tr>
                                    <th>Encounter</th>
                                    <th>http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter</th>
                                    <th>;;;;</th>
                                    <th>

                                            <b>code filter: </b>

                                                <br/>

                                                <span style="padding-left: 4px;">
                              <b>path: </b><span>type</span>
                          </span>

                                                    <br/>

                                                <span style="padding-left: 4px;">
                              <b>value set: </b><span>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307</span>
                          </span>

                                    </th>
                                </tr>

                                <tr>
                                    <th>Patient</th>
                                    <th>http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient</th>
                                    <th/>
                                    <th>

                                    </th>
                                </tr>

                                <tr>
                                    <th>Encounter</th>
                                    <th>http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter</th>
                                    <th>;;;;</th>
                                    <th>

                                            <b>code filter: </b>

                                                <br/>

                                                <span style="padding-left: 4px;">
                              <b>path: </b><span>type</span>
                          </span>

                                                    <br/>

                                                <span style="padding-left: 4px;">
                              <b>value set: </b><span>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307</span>
                          </span>

                                    </th>
                                </tr>

                                <tr>
                                    <th>MedicationRequest</th>
                                    <th>http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest</th>
                                    <th>;</th>
                                    <th>

                                            <b>code filter: </b>

                                                <br/>

                                                <span style="padding-left: 4px;">
                              <b>path: </b><span>medication</span>
                          </span>

                                                    <br/>

                                                <span style="padding-left: 4px;">
                              <b>value set: </b><span>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.165</span>
                          </span>

                                    </th>
                                </tr>

                                <tr>
                                    <th>MedicationRequest</th>
                                    <th>http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest</th>
                                    <th>;</th>
                                    <th>

                                            <b>code filter: </b>

                                                <br/>

                                                <span style="padding-left: 4px;">
                              <b>path: </b><span>medication</span>
                          </span>

                                                    <br/>

                                                <span style="padding-left: 4px;">
                              <b>value set: </b><span>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.165</span>
                          </span>

                                    </th>
                                </tr>

                                <tr>
                                    <th>MedicationRequest</th>
                                    <th>http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest</th>
                                    <th>;</th>
                                    <th>

                                            <b>code filter: </b>

                                                <br/>

                                                <span style="padding-left: 4px;">
                              <b>path: </b><span>medication</span>
                          </span>

                                                    <br/>

                                                <span style="padding-left: 4px;">
                              <b>value set: </b><span>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1125.1</span>
                          </span>

                                    </th>
                                </tr>

                                <tr>
                                    <th>MedicationRequest</th>
                                    <th>http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest</th>
                                    <th>;;;;;;;</th>
                                    <th>

                                            <b>code filter: </b>

                                                <br/>

                                                <span style="padding-left: 4px;">
                              <b>path: </b><span>medication</span>
                          </span>

                                                    <br/>

                                                <span style="padding-left: 4px;">
                              <b>value set: </b><span>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1125.1</span>
                          </span>

                                    </th>
                                </tr>

                                <tr>
                                    <th>Encounter</th>
                                    <th>http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter</th>
                                    <th>;;;;</th>
                                    <th>

                                            <b>code filter: </b>

                                                <br/>

                                                <span style="padding-left: 4px;">
                              <b>path: </b><span>type</span>
                          </span>

                                                    <br/>

                                                <span style="padding-left: 4px;">
                              <b>value set: </b><span>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307</span>
                          </span>

                                    </th>
                                </tr>

                                <tr>
                                    <th>MedicationRequest</th>
                                    <th>http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest</th>
                                    <th>;;;;;;;</th>
                                    <th>

                                            <b>code filter: </b>

                                                <br/>

                                                <span style="padding-left: 4px;">
                              <b>path: </b><span>medication</span>
                          </span>

                                                    <br/>

                                                <span style="padding-left: 4px;">
                              <b>value set: </b><span>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1125.1</span>
                          </span>

                                    </th>
                                </tr>

                                <tr>
                                    <th>Encounter</th>
                                    <th>http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter</th>
                                    <th>;;;;</th>
                                    <th>

                                            <b>code filter: </b>

                                                <br/>

                                                <span style="padding-left: 4px;">
                              <b>path: </b><span>type</span>
                          </span>

                                                    <br/>

                                                <span style="padding-left: 4px;">
                              <b>value set: </b><span>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307</span>
                          </span>

                                    </th>
                                </tr>

                                <tr>
                                    <th>Encounter</th>
                                    <th>http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter</th>
                                    <th>;;;;</th>
                                    <th>

                                            <b>code filter: </b>

                                                <br/>

                                                <span style="padding-left: 4px;">
                              <b>path: </b><span>type</span>
                          </span>

                                                    <br/>

                                                <span style="padding-left: 4px;">
                              <b>value set: </b><span>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307</span>
                          </span>

                                    </th>
                                </tr>

                                <tr>
                                    <th>Coverage</th>
                                    <th>http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-coverage</th>
                                    <th>;;</th>
                                    <th>

                                            <b>code filter: </b>

                                                <br/>

                                                <span style="padding-left: 4px;">
                              <b>path: </b><span>type</span>
                          </span>

                                                    <br/>

                                                <span style="padding-left: 4px;">
                              <b>value set: </b><span>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591</span>
                          </span>

                                    </th>
                                </tr>

                                <tr>
                                    <th>uri</th>
                                    <th>http://hl7.org/fhir/uri</th>
                                    <th>;</th>
                                    <th>

                                    </th>
                                </tr>

                                <tr>
                                    <th>Patient</th>
                                    <th>http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient</th>
                                    <th>;;</th>
                                    <th>

                                    </th>
                                </tr>

                                <tr>
                                    <th>Patient</th>
                                    <th>http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient</th>
                                    <th>;;</th>
                                    <th>

                                    </th>
                                </tr>

                                <tr>
                                    <th>Condition</th>
                                    <th>http://hl7.org/fhir/Condition</th>
                                    <th>;</th>
                                    <th>

                                    </th>
                                </tr>

                                <tr>
                                    <th>Condition</th>
                                    <th>http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition</th>
                                    <th>;;</th>
                                    <th>

                                    </th>
                                </tr>

                                <tr>
                                    <th>ServiceRequest</th>
                                    <th>http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest</th>
                                    <th>;</th>
                                    <th>

                                            <b>code filter: </b>

                                                <br/>

                                                <span style="padding-left: 4px;">
                              <b>path: </b><span>code</span>
                          </span>

                                                    <br/>

                                                <span style="padding-left: 4px;">
                              <b>value set: </b><span>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1.1579</span>
                          </span>

                                    </th>
                                </tr>

                                <tr>
                                    <th>Procedure</th>
                                    <th>http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure</th>
                                    <th>;</th>
                                    <th>

                                            <b>code filter: </b>

                                                <br/>

                                                <span style="padding-left: 4px;">
                              <b>path: </b><span>code</span>
                          </span>

                                                    <br/>

                                                <span style="padding-left: 4px;">
                              <b>value set: </b><span>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1.1579</span>
                          </span>

                                    </th>
                                </tr>

                                <tr>
                                    <th>Patient</th>
                                    <th>http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient</th>
                                    <th/>
                                    <th>

                                    </th>
                                </tr>

                                <tr>
                                    <th>Encounter</th>
                                    <th>http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter</th>
                                    <th>;;;;</th>
                                    <th>

                                            <b>code filter: </b>

                                                <br/>

                                                <span style="padding-left: 4px;">
                              <b>path: </b><span>type</span>
                          </span>

                                                    <br/>

                                                <span style="padding-left: 4px;">
                              <b>value set: </b><span>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.143</span>
                          </span>

                                    </th>
                                </tr>

                                <tr>
                                    <th>Encounter</th>
                                    <th>http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter</th>
                                    <th>;;;;</th>
                                    <th>

                                            <b>code filter: </b>

                                                <br/>

                                                <span style="padding-left: 4px;">
                              <b>path: </b><span>type</span>
                          </span>

                                                    <br/>

                                                <span style="padding-left: 4px;">
                              <b>value set: </b><span>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292</span>
                          </span>

                                    </th>
                                </tr>

                                <tr>
                                    <th>Encounter</th>
                                    <th>http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter</th>
                                    <th>;;;;</th>
                                    <th>

                                            <b>code filter: </b>

                                                <br/>

                                                <span style="padding-left: 4px;">
                              <b>path: </b><span>type</span>
                          </span>

                                                    <br/>

                                                <span style="padding-left: 4px;">
                              <b>value set: </b><span>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.143</span>
                          </span>

                                    </th>
                                </tr>

                                <tr>
                                    <th>Encounter</th>
                                    <th>http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter</th>
                                    <th>;;;;</th>
                                    <th>

                                            <b>code filter: </b>

                                                <br/>

                                                <span style="padding-left: 4px;">
                              <b>path: </b><span>type</span>
                          </span>

                                                    <br/>

                                                <span style="padding-left: 4px;">
                              <b>value set: </b><span>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292</span>
                          </span>

                                    </th>
                                </tr>

                                <tr>
                                    <th>Condition</th>
                                    <th>http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition</th>
                                    <th>;</th>
                                    <th>

                                            <b>code filter: </b>

                                                <br/>

                                                <span style="padding-left: 4px;">
                              <b>path: </b><span>code</span>
                          </span>

                                                    <br/>

                                                <span style="padding-left: 4px;">
                              <b>value set: </b><span>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.161</span>
                          </span>

                                    </th>
                                </tr>

                                <tr>
                                    <th>Patient</th>
                                    <th>http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient</th>
                                    <th>;;</th>
                                    <th>

                                    </th>
                                </tr>

                                <tr>
                                    <th>Patient</th>
                                    <th>http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient</th>
                                    <th>;;</th>
                                    <th>

                                    </th>
                                </tr>

                                <tr>
                                    <th>Coverage</th>
                                    <th>http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-coverage</th>
                                    <th>;;</th>
                                    <th>

                                            <b>code filter: </b>

                                                <br/>

                                                <span style="padding-left: 4px;">
                              <b>path: </b><span>type</span>
                          </span>

                                                    <br/>

                                                <span style="padding-left: 4px;">
                              <b>value set: </b><span>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591</span>
                          </span>

                                    </th>
                                </tr>

                                <tr>
                                    <th>Patient</th>
                                    <th>http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient</th>
                                    <th>;;</th>
                                    <th>

                                    </th>
                                </tr>

                                <tr>
                                    <th>Patient</th>
                                    <th>http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient</th>
                                    <th>;;</th>
                                    <th>

                                    </th>
                                </tr>

                        </table>
                    </td>
                </tr>

                    <tr>
                        <td colspan="2">
                            <table>
                                <tr><th><a id="cql-content"><b>Content: </b></a> text/cql</th></tr>
                                <tr><td><pre><code class="language-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 &quot;LOINC&quot;: 'http://loinc.org'

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

    code &quot;Birth date&quot;: '21112-8' from &quot;LOINC&quot; display 'Birth date'

    parameter &quot;Measurement Period&quot; Interval&lt;DateTime&gt;

    context Patient

    define &quot;Initial Population&quot;:
      &quot;Inpatient Encounters with an Opioid or Benzodiazepine at Discharge&quot;

    define &quot;Denominator&quot;:
      &quot;Initial Population&quot;

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

      &quot;Inpatient Encounters with an Opioid or Benzodiazepine at Discharge&quot; InpatientEncounter
        where exists ( [Condition: &quot;All Primary and Secondary Cancer&quot;] 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 &quot;All Primary and Secondary Cancer&quot;
          )
          or exists ( &quot;Intervention Palliative or Hospice Care&quot; PalliativeOrHospiceCare
              where Coalesce(PalliativeOrHospiceCare.performed.toInterval(), PalliativeOrHospiceCare.authoredOn.toInterval()) during day of CQMCommon.&quot;HospitalizationWithObservation&quot; ( InpatientEncounter )
          )
          or ( InpatientEncounter.hospitalization.dischargeDisposition in &quot;Discharge To Acute Care Facility&quot;
              or InpatientEncounter.hospitalization.dischargeDisposition in &quot;Hospice Care Referral or Admission&quot;
              or InpatientEncounter.hospitalization.dischargeDisposition in &quot;Patient Expired&quot;
          )

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

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

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

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

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

    define &quot;Intervention Palliative or Hospice Care&quot;:
      [ServiceRequest: &quot;Palliative or Hospice Care&quot;]
        union [Procedure: &quot;Palliative or Hospice Care&quot;]

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

    define &quot;SDE Ethnicity&quot;:
      SDE.&quot;SDE Ethnicity&quot;

    define &quot;SDE Payer&quot;:
      SDE.&quot;SDE Payer&quot;

    define &quot;SDE Race&quot;:
      SDE.&quot;SDE Race&quot;

    define &quot;SDE Sex&quot;:
      SDE.&quot;SDE Sex&quot;</code></pre></td></tr>
                            </table>
                        </td>
                    </tr>

                    <tr>
                        <td colspan="2">
                            <table>
                                <tr><th><b>Content: </b> application/elm+xml</th></tr>
                                <tr><td><pre><code>Encoded data (136148 characters)</code></pre></td></tr>
                            </table>
                        </td>
                    </tr>

                    <tr>
                        <td colspan="2">
                            <table>
                                <tr><th><b>Content: </b> application/elm+json</th></tr>
                                <tr><td><pre><code>Encoded data (190988 characters)</code></pre></td></tr>
                            </table>
                        </td>
                    </tr>

        </table>
    </div>
      </text>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-softwaresystem">
        <valueReference>
          <reference value="Device/cqf-tooling"/>
        </valueReference>
      </extension>
      <url
           value="http://ecqi.healthit.gov/ecqms/Library/SafeUseofOpioidsConcurrentPrescribingFHIR"/>
      <identifier>
        <use value="official"/>
        <system value="https://madie.cms.gov/login"/>
        <value value="SafeUseofOpioidsConcurrentPrescribingFHIR"/>
      </identifier>
      <version value="0.1.000"/>
      <name value="SafeUseofOpioidsConcurrentPrescribingFHIR"/>
      <title value="SafeUseofOpioidsConcurrentPrescribingFHIR"/>
      <status value="active"/>
      <experimental value="false"/>
      <type>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/library-type"/>
          <code value="logic-library"/>
        </coding>
      </type>
      <date value="2023-08-18T15:25:34+00:00"/>
      <description value="SafeUseofOpioidsConcurrentPrescribingFHIR"/>
      <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>
      <relatedArtifact id="21112-8">
        <display value="Birth date"/>
        <url value="http://loinc.org"/>
        <document>
          <url value="http://loinc.org"/>
        </document>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="QICore model information"/>
        <resource value="http://hl7.org/fhir/Library/QICore-ModelInfo"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Library CQMCommon"/>
        <resource
                  value="http://ecqi.healthit.gov/ecqms/Library/CQMCommon|1.4.000"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Library FHIRHelpers"/>
        <resource
                  value="http://ecqi.healthit.gov/ecqms/Library/FHIRHelpers|4.3.000"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Library Hospice"/>
        <resource value="http://ecqi.healthit.gov/ecqms/Library/Hospice|6.7.000"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Library QICoreCommon"/>
        <resource
                  value="http://ecqi.healthit.gov/ecqms/Library/QICoreCommon|1.5.000"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Library SDE"/>
        <resource
                  value="http://ecqi.healthit.gov/ecqms/Library/SupplementalDataElements|3.4.000"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Code system LOINC"/>
        <resource value="http://loinc.org"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Code system MedicationRequestCategory"/>
        <resource
                  value="http://terminology.hl7.org/CodeSystem/medicationrequest-category"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Code system ConditionCategory"/>
        <resource
                  value="http://terminology.hl7.org/CodeSystem/condition-category"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Code system USCoreConditionCategoryExtensionCodes"/>
        <resource
                  value="http://hl7.org/fhir/us/core/CodeSystem/condition-category"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Code system ConditionClinicalStatusCodes"/>
        <resource
                  value="http://terminology.hl7.org/CodeSystem/condition-clinical"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Code system AdministrativeGender"/>
        <resource value="http://hl7.org/fhir/v3/AdministrativeGender"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set All Primary and Secondary Cancer"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.161"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Discharge To Acute Care Facility"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.87"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Encounter Inpatient"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Hospice Care Referral or Admission"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1116.365"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Palliative or Hospice Care"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1.1579"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Patient Expired"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.309"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Schedule II &amp; III Opioid Medications"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.165"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Schedule IV Benzodiazepines"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1125.1"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Observation Services"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.143"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Emergency Department Visit"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Payer Type"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"/>
      </relatedArtifact>
      <parameter>
        <name value="Measurement Period"/>
        <use value="in"/>
        <min value="0"/>
        <max value="1"/>
        <type value="Period"/>
      </parameter>
      <parameter>
        <name value="Patient"/>
        <use value="out"/>
        <min value="0"/>
        <max value="1"/>
        <type value="Resource"/>
      </parameter>
      <parameter>
        <name value="Inpatient Encounter with Age Greater than or Equal to 18"/>
        <use value="out"/>
        <min value="0"/>
        <max value="*"/>
        <type value="Resource"/>
      </parameter>
      <parameter>
        <name value="Opioid at Discharge"/>
        <use value="out"/>
        <min value="0"/>
        <max value="*"/>
        <type value="Resource"/>
      </parameter>
      <parameter>
        <name value="Benzodiazepine at Discharge"/>
        <use value="out"/>
        <min value="0"/>
        <max value="*"/>
        <type value="Resource"/>
      </parameter>
      <parameter>
        <name
              value="Inpatient Encounters with an Opioid or Benzodiazepine at Discharge"/>
        <use value="out"/>
        <min value="0"/>
        <max value="*"/>
        <type value="Resource"/>
      </parameter>
      <parameter>
        <name value="Initial Population"/>
        <use value="out"/>
        <min value="0"/>
        <max value="*"/>
        <type value="Resource"/>
      </parameter>
      <parameter>
        <name value="Denominator"/>
        <use value="out"/>
        <min value="0"/>
        <max value="*"/>
        <type value="Resource"/>
      </parameter>
      <parameter>
        <name value="Intervention Palliative or Hospice Care"/>
        <use value="out"/>
        <min value="0"/>
        <max value="*"/>
        <type value="Resource"/>
      </parameter>
      <parameter>
        <name value="Denominator Exclusion"/>
        <use value="out"/>
        <min value="0"/>
        <max value="*"/>
        <type value="Resource"/>
      </parameter>
      <parameter>
        <name value="Numerator"/>
        <use value="out"/>
        <min value="0"/>
        <max value="*"/>
        <type value="Resource"/>
      </parameter>
      <parameter>
        <name value="SDE Ethnicity"/>
        <use value="out"/>
        <min value="0"/>
        <max value="1"/>
        <type value="Resource"/>
      </parameter>
      <parameter>
        <name value="SDE Payer"/>
        <use value="out"/>
        <min value="0"/>
        <max value="*"/>
        <type value="Resource"/>
      </parameter>
      <parameter>
        <name value="SDE Race"/>
        <use value="out"/>
        <min value="0"/>
        <max value="1"/>
        <type value="Resource"/>
      </parameter>
      <parameter>
        <name value="SDE Sex"/>
        <use value="out"/>
        <min value="0"/>
        <max value="1"/>
        <type value="Coding"/>
      </parameter>
      <dataRequirement>
        <type value="Patient"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"/>
        <mustSupport value="ethnicity"/>
        <mustSupport value="race"/>
      </dataRequirement>
      <dataRequirement>
        <type value="Encounter"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"/>
        <mustSupport value="type"/>
        <mustSupport value="status"/>
        <mustSupport value="status.value"/>
        <mustSupport value="period"/>
        <mustSupport value="condition"/>
        <mustSupport value="condition.reference"/>
        <mustSupport value="condition.reference.value"/>
        <mustSupport value="hospitalization"/>
        <mustSupport value="hospitalization.dischargeDisposition"/>
        <codeFilter>
          <path value="type"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.143"/>
        </codeFilter>
        <codeFilter>
          <path value="status.value"/>
          <code>
            <code value="finished"/>
          </code>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Encounter"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"/>
        <mustSupport value="type"/>
        <mustSupport value="status"/>
        <mustSupport value="status.value"/>
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        <mustSupport value="condition"/>
        <mustSupport value="condition.reference"/>
        <mustSupport value="condition.reference.value"/>
        <mustSupport value="hospitalization"/>
        <mustSupport value="hospitalization.dischargeDisposition"/>
        <codeFilter>
          <path value="type"/>
          <valueSet
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        <codeFilter>
          <path value="status.value"/>
          <code>
            <code value="finished"/>
          </code>
        </codeFilter>
        <dateFilter>
          <path value="period"/>
          <valuePeriod>
            <extension url="http://hl7.org/fhir/uv/crmi-analysisException">
              <valueString
                           value="Error attempting to determine filter value: toFhirValue not implemented for Subtract"/>
            </extension>
          </valuePeriod>
        </dateFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Encounter"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"/>
        <mustSupport value="type"/>
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        <mustSupport value="condition"/>
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        <mustSupport value="hospitalization"/>
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          <code>
            <code value="finished"/>
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        <dateFilter>
          <path value="period"/>
          <valuePeriod>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/cqf-expression">
              <valueExpression>
                <language value="text/cql-identifier"/>
                <expression value="Measurement Period"/>
              </valueExpression>
            </extension>
          </valuePeriod>
        </dateFilter>
      </dataRequirement>
      <dataRequirement id="16">
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        <profile
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        <mustSupport value="status"/>
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        <mustSupport value="condition"/>
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        <mustSupport value="hospitalization"/>
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        <codeFilter>
          <path value="status.value"/>
          <code>
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        <dateFilter>
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          <valuePeriod>
            <extension
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              <valueExpression>
                <language value="text/cql-identifier"/>
                <expression value="Measurement Period"/>
              </valueExpression>
            </extension>
          </valuePeriod>
        </dateFilter>
      </dataRequirement>
      <dataRequirement>
        <extension
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          <extension url="targetId">
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          <extension url="targetProperty">
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        <type value="Medication"/>
        <profile
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        <mustSupport value="id"/>
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      <dataRequirement id="G10002">
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        <profile
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        <mustSupport value="medication"/>
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      <dataRequirement>
        <type value="MedicationRequest"/>
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          <path value="intent.value"/>
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            <code value="order"/>
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      </dataRequirement>
      <dataRequirement>
        <extension
                   url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-relatedRequirement">
          <extension url="targetId">
            <valueString value="16"/>
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          <extension url="targetProperty">
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        <type value="MedicationRequest"/>
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        <codeFilter>
          <path value="intent.value"/>
          <code>
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        <type value="ServiceRequest"/>
        <profile
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          <path value="code"/>
          <valueSet
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      <dataRequirement>
        <type value="Condition"/>
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      <dataRequirement>
        <type value="Coverage"/>
        <profile
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        <mustSupport value="type"/>
        <mustSupport value="period"/>
        <codeFilter>
          <path value="type"/>
          <valueSet
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      <content>
        <contentType value="text/cql"/>
        <data
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      <content>
        <contentType value="application/elm+xml"/>
        <data
              value=" "/>
      </content>
    </Library>