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

## : DRCommunicationWithPhysicianManagingDiabetesFHIR - XML Representation

Active as of 2023-08-14

Raw xml | Download

    <Library xmlns="http://hl7.org/fhir">
      <id value="DRCommunicationWithPhysicianManagingDiabetesFHIR"/>
      <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;">DRCommunicationWithPhysicianManagingDiabetesFHIR</td>
                </tr>

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

                <tr>
                    <th scope="row"><b>Version: </b></th>
                    <td style="padding-left: 4px;">0.0.004</td>
                </tr>

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

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

                    </td>
                </tr>

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

                <tr>
                    <th scope="row"><b>Title: </b></th>
                    <td style="padding-left: 4px;">DRCommunicationWithPhysicianManagingDiabetesFHIR</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;">2023-08-14T15:19:06+00:00</td>
                </tr>

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

                                    <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/2.16.840.1.113883.3.464.1003.101.12.1001</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/2.16.840.1.113883.3.526.3.1285</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/2.16.840.1.113883.3.464.1003.101.12.1008</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/2.16.840.1.113883.3.464.1003.101.12.1014</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/2.16.840.1.113883.3.464.1003.101.12.1012</span>
                          </span>

                                    </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>

                                            <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/2.16.840.1.113883.3.526.3.327</span>
                          </span>

                                    </th>
                                </tr>

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

                                            <b>code filter: </b>

                                                <br/>

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

                                                    <br/>

                                                <span style="padding-left: 4px;">
                              <b>value set: </b><span>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1283</span>
                          </span>

                                    </th>
                                </tr>

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

                                            <b>code filter: </b>

                                                <br/>

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

                                                    <br/>

                                                <span style="padding-left: 4px;">
                              <b>value set: </b><span>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.2.1391</span>
                          </span>

                                    </th>
                                </tr>

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

                                            <b>code filter: </b>

                                                <br/>

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

                                                    <br/>

                                                <span style="padding-left: 4px;">
                              <b>value set: </b><span>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1320</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>Patient</th>
                                    <th>http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient</th>
                                    <th/>
                                    <th>

                                    </th>
                                </tr>

                                <tr>
                                    <th>Observation</th>
                                    <th>http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation</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/2.16.840.1.113883.3.526.3.1251</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>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>Communication</th>
                                    <th>http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-communicationnotdone</th>
                                    <th>;</th>
                                    <th>

                                            <b>code filter: </b>

                                                <br/>

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

                                                    <br/>

                                                <span style="padding-left: 4px;">
                              <b>value set: </b><span>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1283</span>
                          </span>

                                    </th>
                                </tr>

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

                                            <b>code filter: </b>

                                                <br/>

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

                                                    <br/>

                                                <span style="padding-left: 4px;">
                              <b>value set: </b><span>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1283</span>
                          </span>

                                    </th>
                                </tr>

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

                                            <b>code filter: </b>

                                                <br/>

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

                                                    <br/>

                                                <span style="padding-left: 4px;">
                              <b>value set: </b><span>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.2.1391</span>
                          </span>

                                    </th>
                                </tr>

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

                                            <b>code filter: </b>

                                                <br/>

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

                                                    <br/>

                                                <span style="padding-left: 4px;">
                              <b>value set: </b><span>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.2.1391</span>
                          </span>

                                    </th>
                                </tr>

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

                                            <b>code filter: </b>

                                                <br/>

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

                                                    <br/>

                                                <span style="padding-left: 4px;">
                              <b>value set: </b><span>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1320</span>
                          </span>

                                    </th>
                                </tr>

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

                                            <b>code filter: </b>

                                                <br/>

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

                                                    <br/>

                                                <span style="padding-left: 4px;">
                              <b>value set: </b><span>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1320</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>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 DRCommunicationWithPhysicianManagingDiabetesFHIR version '0.0.004'

    using QICore version '4.1.1'

    /*This spec aligns with AU2022/PY2023 QDM version*/

    /*
    Notes:
    -This spec aligns with AU2022/PY2023 QDM version
    - Per BonnieMat-1455 and ticket  https://github.com/cqframework/cql-execution/issues/296
    --https://oncprojectracking.healthit.gov/support/browse/CQLIT-371 (formerly BonnieMat-1420)
    --surrounding negation with QI-Core 4.1.1 DRC are not supported as resource filters and must be replaced with valueset or used on unfiltered resource in predicate
    --cardinality issues surrounding negation coding to be addressed in future execution engine update
    */

    include FHIRHelpers version '4.3.000' called FHIRHelpers
    include SupplementalDataElements version '3.4.000' called SDE
    include QICoreCommon version '1.5.000' called QICoreCommon

    codesystem &quot;SNOMEDCT&quot;: 'http://snomed.info/sct'
    codesystem &quot;ActCode&quot;: 'http://terminology.hl7.org/CodeSystem/v3-ActCode'

    valueset &quot;Care Services in Long-Term Residential Facility&quot;: 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1014'
    valueset &quot;Diabetic Retinopathy&quot;: 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.327'
    valueset &quot;Level of Severity of Retinopathy Findings&quot;: 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1283'
    valueset &quot;Macular Edema Findings Present&quot;: 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1320'
    valueset &quot;Macular Exam&quot;: 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1251'
    valueset &quot;Medical Reason&quot;: 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1007'
    valueset &quot;Nursing Facility Visit&quot;: 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1012'
    valueset &quot;Office Visit&quot;: 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001'
    valueset &quot;Ophthalmological Services&quot;: 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1285'
    valueset &quot;Outpatient Consultation&quot;: 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1008'
    valueset &quot;Patient Reason&quot;: 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1008'
    valueset &quot;Macular edema absent (situation)&quot;: 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.2.1391'

    code &quot;Healthcare professional (occupation)&quot;: '223366009' from &quot;SNOMEDCT&quot; display 'Healthcare professional (occupation)'
    code &quot;Medical practitioner (occupation)&quot;: '158965000' from &quot;SNOMEDCT&quot; display 'Medical practitioner (occupation)'
    code &quot;Ophthalmologist (occupation)&quot;: '422234006' from &quot;SNOMEDCT&quot; display 'Ophthalmologist (occupation)'
    code &quot;Optometrist (occupation)&quot;: '28229004' from &quot;SNOMEDCT&quot; display 'Optometrist (occupation)'
    code &quot;Physician (occupation)&quot;: '309343006' from &quot;SNOMEDCT&quot; display 'Physician (occupation)'
    code &quot;virtual&quot;: 'VR' from &quot;ActCode&quot; display 'virtual'
    // code &quot;Macular edema absent (situation)&quot;: '428341000124108' from &quot;SNOMEDCT&quot; display 'Macular edema absent (situation)'

    code &quot;AMB&quot;: 'AMB' from &quot;ActCode&quot; display 'Ambulatory'

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

    context Patient

    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;

    define &quot;Initial Population&quot;:
      AgeInYearsAt(date from start of &quot;Measurement Period&quot;) &gt;= 18
        and exists &quot;Diabetic Retinopathy Encounter&quot;

    define &quot;Denominator&quot;:
      &quot;Initial Population&quot;
        and exists &quot;Macular Exam Performed&quot;

    define &quot;Numerator&quot;:
      exists &quot;Level of Severity of Retinopathy Findings Communicated&quot;
        and ( exists &quot;Macular Edema Absence Communicated&quot;
            or exists &quot;Macular Edema Presence Communicated&quot;
        )

    define &quot;Denominator Exceptions&quot;:
      exists &quot;Medical or Patient Reason for Not Communicating Level of Severity of Retinopathy&quot;
        or exists &quot;Medical or Patient Reason for Not Communicating Absence of Macular Edema&quot;
        or exists &quot;Medical or Patient Reason for Not Communicating Presence of Macular Edema&quot;

    define &quot;Qualifying Encounter During Measurement Period&quot;:
      ( [&quot;Encounter&quot;: &quot;Office Visit&quot;]
        union [&quot;Encounter&quot;: &quot;Ophthalmological Services&quot;]
        union [&quot;Encounter&quot;: &quot;Outpatient Consultation&quot;]
        union [&quot;Encounter&quot;: &quot;Care Services in Long-Term Residential Facility&quot;]
        union [&quot;Encounter&quot;: &quot;Nursing Facility Visit&quot;] ) QualifyingEncounter
        where QualifyingEncounter.period during &quot;Measurement Period&quot;
          and QualifyingEncounter.status = 'finished'
          and QualifyingEncounter.class !~ &quot;virtual&quot;

    define &quot;Diabetic Retinopathy Encounter&quot;:
      &quot;Qualifying Encounter During Measurement Period&quot; ValidQualifyingEncounter
        with [&quot;Condition&quot;: &quot;Diabetic Retinopathy&quot;] DiabeticRetinopathy
          such that DiabeticRetinopathy.prevalenceInterval ( ) overlaps ValidQualifyingEncounter.period
            and DiabeticRetinopathy.isActive ( )
            and not ( DiabeticRetinopathy.verificationStatus ~ QICoreCommon.&quot;unconfirmed&quot;
                or DiabeticRetinopathy.verificationStatus ~ QICoreCommon.&quot;refuted&quot;
                or DiabeticRetinopathy.verificationStatus ~ QICoreCommon.&quot;entered-in-error&quot;
            )

    define &quot;Macular Exam Performed&quot;:
      [&quot;Observation&quot;: &quot;Macular Exam&quot;] MacularExam
        with &quot;Diabetic Retinopathy Encounter&quot; EncounterDiabeticRetinopathy
          such that MacularExam.effective.toInterval ( ) during EncounterDiabeticRetinopathy.period
        where MacularExam.value is not null
          and MacularExam.status in { 'final', 'amended', 'corrected', 'preliminary' }

    define &quot;Results of Dilated Macular or Fundus Exam Communicated&quot;:
      exists &quot;Level of Severity of Retinopathy Findings Communicated&quot;
        and ( exists &quot;Macular Edema Absence Communicated&quot;
            or exists &quot;Macular Edema Presence Communicated&quot;
        )

    define &quot;Level of Severity of Retinopathy Findings Communicated&quot;:
      [&quot;Communication&quot;: &quot;Level of Severity of Retinopathy Findings&quot;] LevelOfSeverityCommunicated
        with &quot;Diabetic Retinopathy Encounter&quot; EncounterDiabeticRetinopathy
          such that LevelOfSeverityCommunicated.sent after start of EncounterDiabeticRetinopathy.period
        where LevelOfSeverityCommunicated.status = 'completed'

    define &quot;Macular Edema Absence Communicated&quot;:
      [&quot;Communication&quot;: &quot;Macular edema absent (situation)&quot;] MacularEdemaAbsentCommunicated
        with &quot;Diabetic Retinopathy Encounter&quot; EncounterDiabeticRetinopathy
          such that MacularEdemaAbsentCommunicated.sent after start of EncounterDiabeticRetinopathy.period
        where MacularEdemaAbsentCommunicated.status = 'completed'

    define &quot;Macular Edema Presence Communicated&quot;:
      [&quot;Communication&quot;: &quot;Macular Edema Findings Present&quot;] MacularEdemaPresentCommunicated
        with &quot;Diabetic Retinopathy Encounter&quot; EncounterDiabeticRetinopathy
          such that MacularEdemaPresentCommunicated.sent after start of EncounterDiabeticRetinopathy.period
        where MacularEdemaPresentCommunicated.status = 'completed'

    define &quot;Medical or Patient Reason for Not Communicating Level of Severity of Retinopathy&quot;:
      [CommunicationNotDone: &quot;Level of Severity of Retinopathy Findings&quot;] LevelOfSeverityNotCommunicated
        with &quot;Diabetic Retinopathy Encounter&quot; EncounterDiabeticRetinopathy
          such that LevelOfSeverityNotCommunicated.recorded during EncounterDiabeticRetinopathy.period
        where ( LevelOfSeverityNotCommunicated.statusReason in &quot;Medical Reason&quot;
            or LevelOfSeverityNotCommunicated.statusReason in &quot;Patient Reason&quot;
        )

    define &quot;Medical or Patient Reason for Not Communicating Presence of Macular Edema&quot;:
      [CommunicationNotDone: &quot;Macular Edema Findings Present&quot;] MacularEdemaPresentNotCommunicated
        with &quot;Diabetic Retinopathy Encounter&quot; EncounterDiabeticRetinopathy
          such that MacularEdemaPresentNotCommunicated.recorded during EncounterDiabeticRetinopathy.period
        where ( MacularEdemaPresentNotCommunicated.statusReason in &quot;Medical Reason&quot;
            or MacularEdemaPresentNotCommunicated.statusReason in &quot;Patient Reason&quot;
        )

    /* Note:
    below definition workaround for
    https://oncprojectracking.healthit.gov/support/browse/CQLIT-371. Using value set workaround has been applied for now
    but when QI Core STU 5 gets in the tool, it may be reverted back to a DRC */

    define &quot;Medical or Patient Reason for Not Communicating Absence of Macular Edema&quot;:
      [CommunicationNotDone: &quot;Macular edema absent (situation)&quot;] MacularEdemaAbsentNotCommunicated
        with &quot;Diabetic Retinopathy Encounter&quot; EncounterDiabeticRetinopathy
          such that MacularEdemaAbsentNotCommunicated.recorded during EncounterDiabeticRetinopathy.period
        where ( MacularEdemaAbsentNotCommunicated.statusReason in &quot;Medical Reason&quot;
            or MacularEdemaAbsentNotCommunicated.statusReason in &quot;Patient Reason&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 (181644 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 (257468 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/DRCommunicationWithPhysicianManagingDiabetesFHIR"/>
      <identifier>
        <use value="official"/>
        <system value="https://madie.cms.gov/login"/>
        <value value="DRCommunicationWithPhysicianManagingDiabetesFHIR"/>
      </identifier>
      <version value="0.0.004"/>
      <name value="DRCommunicationWithPhysicianManagingDiabetesFHIR"/>
      <title value="DRCommunicationWithPhysicianManagingDiabetesFHIR"/>
      <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="2023-08-14T15:19:06+00:00"/>
      <description value="DRCommunicationWithPhysicianManagingDiabetesFHIR"/>
      <relatedArtifact id="223366009">
        <display value="Healthcare professional (occupation)"/>
        <url value="http://snomed.info/sct"/>
        <document>
          <url value="http://snomed.info/sct"/>
        </document>
      </relatedArtifact>
      <relatedArtifact id="158965000">
        <display value="Medical practitioner (occupation)"/>
        <url value="http://snomed.info/sct"/>
        <document>
          <url value="http://snomed.info/sct"/>
        </document>
      </relatedArtifact>
      <relatedArtifact id="422234006">
        <display value="Ophthalmologist (occupation)"/>
        <url value="http://snomed.info/sct"/>
        <document>
          <url value="http://snomed.info/sct"/>
        </document>
      </relatedArtifact>
      <relatedArtifact id="28229004">
        <display value="Optometrist (occupation)"/>
        <url value="http://snomed.info/sct"/>
        <document>
          <url value="http://snomed.info/sct"/>
        </document>
      </relatedArtifact>
      <relatedArtifact id="309343006">
        <display value="Physician (occupation)"/>
        <url value="http://snomed.info/sct"/>
        <document>
          <url value="http://snomed.info/sct"/>
        </document>
      </relatedArtifact>
      <relatedArtifact id="VR">
        <display value="virtual"/>
        <url value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
        <document>
          <url value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
        </document>
      </relatedArtifact>
      <relatedArtifact id="AMB">
        <display value="AMB"/>
        <url value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
        <document>
          <url value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
        </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 FHIRHelpers"/>
        <resource
                  value="http://ecqi.healthit.gov/ecqms/Library/FHIRHelpers|4.3.000"/>
      </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="Library QICoreCommon"/>
        <resource
                  value="http://ecqi.healthit.gov/ecqms/Library/QICoreCommon|1.5.000"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Code system SNOMEDCT"/>
        <resource value="http://snomed.info/sct"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Code system ActCode"/>
        <resource value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
      </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="Code system ConditionClinicalStatusCodes"/>
        <resource
                  value="http://terminology.hl7.org/CodeSystem/condition-clinical"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Code system ConditionVerificationStatusCodes"/>
        <resource
                  value="http://terminology.hl7.org/CodeSystem/condition-ver-status"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display
                 value="Value set Care Services in Long-Term Residential Facility"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1014"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Diabetic Retinopathy"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.327"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Level of Severity of Retinopathy Findings"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1283"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Macular Edema Findings Present"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1320"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Macular Exam"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1251"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Medical Reason"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1007"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Nursing Facility Visit"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1012"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Office Visit"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Ophthalmological Services"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1285"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Outpatient Consultation"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1008"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Patient Reason"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1008"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Macular edema absent (situation)"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.2.1391"/>
      </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="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>
      <parameter>
        <name value="Qualifying Encounter During Measurement Period"/>
        <use value="out"/>
        <min value="0"/>
        <max value="*"/>
        <type value="Resource"/>
      </parameter>
      <parameter>
        <name value="Diabetic Retinopathy Encounter"/>
        <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="1"/>
        <type value="boolean"/>
      </parameter>
      <parameter>
        <name value="Macular Exam Performed"/>
        <use value="out"/>
        <min value="0"/>
        <max value="*"/>
        <type value="Resource"/>
      </parameter>
      <parameter>
        <name value="Denominator"/>
        <use value="out"/>
        <min value="0"/>
        <max value="1"/>
        <type value="boolean"/>
      </parameter>
      <parameter>
        <name value="Level of Severity of Retinopathy Findings Communicated"/>
        <use value="out"/>
        <min value="0"/>
        <max value="*"/>
        <type value="Resource"/>
      </parameter>
      <parameter>
        <name value="Macular Edema Absence Communicated"/>
        <use value="out"/>
        <min value="0"/>
        <max value="*"/>
        <type value="Resource"/>
      </parameter>
      <parameter>
        <name value="Macular Edema Presence Communicated"/>
        <use value="out"/>
        <min value="0"/>
        <max value="*"/>
        <type value="Resource"/>
      </parameter>
      <parameter>
        <name value="Numerator"/>
        <use value="out"/>
        <min value="0"/>
        <max value="1"/>
        <type value="boolean"/>
      </parameter>
      <parameter>
        <name
              value="Medical or Patient Reason for Not Communicating Level of Severity of Retinopathy"/>
        <use value="out"/>
        <min value="0"/>
        <max value="*"/>
        <type value="Resource"/>
      </parameter>
      <parameter>
        <name
              value="Medical or Patient Reason for Not Communicating Absence of Macular Edema"/>
        <use value="out"/>
        <min value="0"/>
        <max value="*"/>
        <type value="Resource"/>
      </parameter>
      <parameter>
        <name
              value="Medical or Patient Reason for Not Communicating Presence of Macular Edema"/>
        <use value="out"/>
        <min value="0"/>
        <max value="*"/>
        <type value="Resource"/>
      </parameter>
      <parameter>
        <name value="Denominator Exceptions"/>
        <use value="out"/>
        <min value="0"/>
        <max value="1"/>
        <type value="boolean"/>
      </parameter>
      <parameter>
        <name value="Results of Dilated Macular or Fundus Exam Communicated"/>
        <use value="out"/>
        <min value="0"/>
        <max value="1"/>
        <type value="boolean"/>
      </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="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="Encounter"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"/>
        <mustSupport value="type"/>
        <mustSupport value="period"/>
        <mustSupport value="status"/>
        <mustSupport value="status.value"/>
        <mustSupport value="class"/>
        <codeFilter>
          <path value="type"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Encounter"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"/>
        <mustSupport value="type"/>
        <mustSupport value="period"/>
        <mustSupport value="status"/>
        <mustSupport value="status.value"/>
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          <path value="type"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1285"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Encounter"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"/>
        <mustSupport value="type"/>
        <mustSupport value="period"/>
        <mustSupport value="status"/>
        <mustSupport value="status.value"/>
        <mustSupport value="class"/>
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          <path value="type"/>
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                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1008"/>
        </codeFilter>
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      <dataRequirement>
        <type value="Encounter"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"/>
        <mustSupport value="type"/>
        <mustSupport value="period"/>
        <mustSupport value="status"/>
        <mustSupport value="status.value"/>
        <mustSupport value="class"/>
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          <path value="type"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1014"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Encounter"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"/>
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        <mustSupport value="period"/>
        <mustSupport value="status"/>
        <mustSupport value="status.value"/>
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          <path value="type"/>
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                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1012"/>
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      </dataRequirement>
      <dataRequirement>
        <type value="Condition"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition"/>
        <mustSupport value="code"/>
        <mustSupport value="verificationStatus"/>
        <codeFilter>
          <path value="code"/>
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                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.327"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Observation"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation"/>
        <mustSupport value="code"/>
        <mustSupport value="effective"/>
        <mustSupport value="value"/>
        <mustSupport value="status"/>
        <mustSupport value="status.value"/>
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        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Communication"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-communication"/>
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          <path value="reasonCode"/>
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                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1283"/>
        </codeFilter>
        <codeFilter>
          <path value="status.value"/>
          <code>
            <code value="completed"/>
          </code>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Communication"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-communication"/>
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        <mustSupport value="sent"/>
        <mustSupport value="sent.value"/>
        <mustSupport value="status"/>
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          <path value="reasonCode"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.2.1391"/>
        </codeFilter>
        <codeFilter>
          <path value="status.value"/>
          <code>
            <code value="completed"/>
          </code>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Communication"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-communication"/>
        <mustSupport value="reasonCode"/>
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        <mustSupport value="sent.value"/>
        <mustSupport value="status"/>
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        <codeFilter>
          <path value="reasonCode"/>
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