eCQM QICore Content Implementation Guide
2023.0.0 - CI Build
eCQM QICore Content Implementation Guide
2023.0.0 - CI Build
eCQM QICore Content Implementation Guide, published by cqframework. This guide is not an authorized publication; it is the continuous build for version 2023.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/cqframework/ecqm-content-qicore-2023/ and changes regularly. See the Directory of published versions
| Draft as of 2023-10-27 |
<Measure xmlns="http://hl7.org/fhir">
<id value="HIVSTITestingFHIR"/>
<meta>
<profile
value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-measure-cqfm"/>
<profile
value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/publishable-measure-cqfm"/>
<profile
value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/executable-measure-cqfm"/>
</meta>
<text>
<status value="extensions"/>
<div xmlns="http://www.w3.org/1999/xhtml">
<table class="grid dict">
<tr>
<th scope="row"><b>Title: </b></th>
<td style="padding-left: 4px;">Sexually Transmitted Infection (STI) Testing for People with HIVFHIR</td>
</tr>
<tr>
<th scope="row"><b>Id: </b></th>
<td style="padding-left: 4px;">HIVSTITestingFHIR</td>
</tr>
<tr>
<th scope="row"><b>Download cql: </b></th>
<td style="padding-left: 4px;"><a href="Library-HIVSTITestingFHIR.cql">HIVSTITestingFHIR.cql</a></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>Url: </b></th>
<td style="padding-left: 4px;"><a href="Measure-HIVSTITestingFHIR.html">Sexually Transmitted Infection (STI) Testing for People with HIVFHIR</a></td>
</tr>
<tr>
<th scope="row">
<b>
short-name identifier:
</b>
</th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<span>CMS1188FHIR</span>
</p>
</td>
</tr>
<tr>
<th scope="row">
<b>
version-independent identifier:
</b>
</th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<span>urn:uuid:6f66ca77-1a2c-489c-b0d8-730da6e5a763</span>
</p>
</td>
</tr>
<tr>
<th scope="row">
<b>
version-specific identifier:
</b>
</th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<span>urn:uuid:2c92808287dd6f640188b07c4a8a1f35</span>
</p>
</td>
</tr>
<tr>
<th scope="row">
<b>
publisher (CMS) identifier:
</b>
</th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<span>1188FHIR</span>
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Effective Period: </b></th>
<td style="padding-left: 4px;">2024-01-01
..2024-12-31</td>
</tr>
<tr>
<th scope="row"><b>Status: </b></th>
<td style="padding-left: 4px;">draft</td>
</tr>
<tr>
<th scope="row"><b>Date: </b></th>
<td style="padding-left: 4px;">2023-10-27 08:12:32+0000</td>
</tr>
<tr>
<th scope="row"><b>Approval Date: </b></th>
<td style="padding-left: 4px;">2023-08-11</td>
</tr>
<tr>
<th scope="row"><b>Last Review Date: </b></th>
<td style="padding-left: 4px;">2023-08-11</td>
</tr>
<tr>
<th scope="row"><b>Name: </b></th>
<td style="padding-left: 4px;">HIVSTITestingFHIR</td>
</tr>
<tr>
<th scope="row"><b>Publisher: </b></th>
<td style="padding-left: 4px;">Health Resources & Services Administration</td>
</tr>
<tr>
<th scope="row"><b>Author: </b></th>
<td style="padding-left: 4px;">Health Resources & Services Administration: <a href=" https://www.hrsa.gov/"> https://www.hrsa.gov/</a></td>
</tr>
<tr>
<th scope="row"><b>Description: </b></th>
<td style="padding-left: 4px;"><div><p>Percentage of patients 13 years of age and older with a diagnosis of HIV who had tests for syphilis, gonorrhea, and chlamydia performed within the measurement period</p>
</div></td>
</tr>
<tr>
<th scope="row"><b>Use Context: </b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr>
<th><b>code</b></th>
<th><b>value</b></th>
</tr>
<tr>
<td>program</td>
<td/>
</tr>
</table>
</td>
</tr>
<tr>
<th scope="row"><b>Purpose: </b></th>
<td style="padding-left: 4px;"><div><p>UNKNOWN</p>
</div></td>
</tr>
<tr>
<th scope="row"><b>Copyright: </b></th>
<td style="padding-left: 4px;"><div><p>This measure was developed by the Health Resources & Services Administration (HRSA) of the U.S. Department of Health & Human Services (HHS). It is in the public domain.</p>
<p>Citation of HRSA as the source of the original measure is appreciated. Any modified versions may not be represented as approved, endorsed, or authorized by HRSA or HHS. 42 U.S.C. Section 1320b-10. Users of modified versions should clearly explain how they deviate from HRSA's original measure.</p>
<p>Limited proprietary coding is contained in the Measure specifications for user convenience. Users of proprietary code sets should obtain all necessary licenses from the owners of the code sets.</p>
<p>CPT(R) contained in the Measure specifications is copyright 2004-2022 American Medical Association. LOINC(R) is copyright 2004-2022 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2022 International Health Terminology Standards Development Organisation. ICD-10 is copyright 2022 World Health Organization. All Rights Reserved.</p>
<p>Due to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM].</p>
</div></td>
</tr>
<tr>
<th scope="row"><b>Disclaimer: </b></th>
<td style="padding-left: 4px;"><div><p>These performance measures are not clinical guidelines and do not establish a standard of medical care, and have not been tested for all potential applications.</p>
<p>THE MEASURES AND SPECIFICATIONS ARE PROVIDED "AS IS" WITHOUT WARRANTY OF ANY KIND.</p>
<p>Due to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM].</p>
</div></td>
</tr>
<tr>
<th scope="row"><b>Rationale: </b></th>
<td style="padding-left: 4px;"><div><p>The rates of syphilis, gonorrhea, and chlamydia cases per 100,000 in the United States have steadily risen over the last decade and increased 11.2%, 5.9%, and 2.8%, respectively, from 2018 to 2019 (DHHS, 2021). People with HIV are at an increased risk of bacterial sexually transmitted infections (STIs), including chlamydia, gonorrhea, and syphilis (CDC, 2004). However, early detection and treatment of bacterial STIs in people with HIV can lead to a reduction in HIV transmission (CDC, 2004). Despite guidelines for at least annual screening among sexually active persons with HIV, only an estimated 55% received a syphilis test in the past year, 23% received a gonorrhea test in the past year, and 24% received a chlamydia test in the past year based on a nationally-representative survey of adults with HIV receiving medical care in the United States (Flagg et al., 2015). This measure will help providers focus their attention and quality improvement efforts towards testing and treating sexually transmitted infections in patients with HIV, thus reducing the complications to long-term syphilis infection and reducing STI incidence (Patel et al., 2012).</p>
</div></td>
</tr>
<tr>
<th scope="row"><b>Clinical recommendation statement: </b></th>
<td style="padding-left: 4px;"><div><p>"Routine serologic screening for syphilis is recommended at least annually for all persons with HIV infection who are sexually active, with more frequent screening (i.e., every 3-6 months) for those who have multiple or anonymous partners" (Panel on Opportunistic Infections in Adults and Adolescents with HIV, 2022, p. Y-3).</p>
<p>"Patients undergoing screening or treatment for syphilis also should be evaluated for other sexually transmitted diseases such as chlamydia and gonorrhea at anatomic sites of exposure in men and for chlamydia, gonorrhea, and trichomonas in women" (Panel on Opportunistic Infections in Adults and Adolescents with HIV, 2022, p. Y-3).</p>
<p>"The USPSTF recommends screening for syphilis in persons who are at increased risk for infection. When deciding which persons to screen for syphilis, clinicians should consider the prevalence of infection in the communities they serve, as well as other sociodemographic and behavioral factors that may be associated with increased risk of syphilis infection. For example, prevalence of syphilis is higher in men, men who have sex with men, persons with HIV infection, young adults, and persons with a history of incarceration, sex work, or military service…. Optimal screening frequency for persons who are at increased risk for syphilis infection is not well established. Men who have sex with men or persons with HIV infection may benefit from screening at least annually or more frequently (e.g., every 3 to 6 months) if they continue to be at high risk" (USPSTF, 2022, p. 1244-1246).</p>
<p>"At the initial HIV care visit, providers should screen all sexually active persons for syphilis, gonorrhea, and chlamydia, and perform screening for these infections at least annually during the course of HIV care. Specific testing includes syphilis serology and [a nucleic acid amplification test] NAAT for N. gonorrhoeae and C. trachomatis at the anatomic site of exposure" (Workowski et al., 2021, p. 26).</p>
</div></td>
</tr>
<tr>
<th scope="row"><b>Guidance (Usage): </b></th>
<td style="padding-left: 4px;">This eCQM is a patient-based measure.
This FHIR-based measure has been derived from the QDM-based measure: CMS1188v1.
Please refer to the HL7 QI-Core Implementation Guide (http://hl7.org/fhir/us/qicore/index.html) for more information on QI-Core and mapping recommendations from QDM to QI-Core 4.1.1 (http://hl7.org/fhir/us/qicore/qdm-to-qicore.html).</td>
</tr>
<tr>
<th scope="row"><b>Population Criteria: </b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr>
<th><b>64998bd84c79454c026f7483</b></th>
</tr>
<tr>
<td>Initial Population:</td>
<td>All patients 13 years of age and older at the start of the measurement period with a diagnosis of HIV before the end of the measurement period with an eligible encounter during the measurement period</td>
</tr>
<tr>
<td>Denominator:</td>
<td>Equals Initial Population</td>
</tr>
<tr>
<td>Denominator Exclusion:</td>
<td>None</td>
</tr>
<tr>
<td>Numerator:</td>
<td>Patients who were tested for each of the following at least once during the measurement period: syphilis, gonorrhea, and chlamydia</td>
</tr>
<tr>
<td>Numerator Exclusion:</td>
<td>None</td>
</tr>
<tr>
<td>Denominator Exception:</td>
<td>None</td>
</tr>
</table>
</td>
</tr>
<tr>
<th scope="row"><b>Libraries: </b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr>
<td><a href="Library-HIVSTITestingFHIR.html">HIVSTITestingFHIR</a></td>
</tr>
</table>
</td>
</tr>
<tr>
<th scope="row"><b>Related Artifact Dependencies: </b></th>
<td style="padding-left: 4px;">
<li><a href="Library-FHIRHelpers.html">FHIRHelpers</a> version: 4.3.000</li>
<li><a href="Library-QICoreCommon.html">QICoreCommon</a> version: 1.5.000</li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.110.12.1052/expansion">Chlamydia Screening</a></li>
<li><a href="https://tx.fhir.org/r4/ValueSet/2.16.840.1.113762.1.4.1258.1-20250208">Gonorrhea Screening</a></li>
<li><a href="https://tx.fhir.org/r4/ValueSet/2.16.840.1.113762.1.4.1166.117-20230708">Syphilis Tests</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1001/expansion">Office Visit</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1008/expansion">Outpatient Consultation</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1240/expansion">Annual Wellness Visit</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1048/expansion">Face-to-Face Interaction</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1016/expansion">Home Healthcare Services</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1025/expansion">Preventive Care Services - Established Office Visit, 18 and Up</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1023/expansion">Preventive Care Services-Initial Office Visit, 18 and Up</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1022/expansion">Preventive Care Services, Initial Office Visit, 0 to 17</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1024/expansion">Preventive Care, Established Office Visit, 0 to 17</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1080/expansion">Telephone Visits</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.11.1150/expansion">Preventive Care Services - Other</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.120.12.1003/expansion">HIV</a></li>
</td>
</tr>
<tr>
<th scope="row"><b>Parameters:</b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr>
<th><b>name</b></th>
<th><b>use</b></th>
<th><b>min</b></th>
<th><b>max</b></th>
<th><b>type</b></th>
</tr>
<tr>
<td>Measurement Period</td>
<td>In</td>
<td>0</td>
<td>1</td>
<td>Period</td>
</tr>
<tr>
<td>Numerator</td>
<td>Out</td>
<td>0</td>
<td>1</td>
<td>boolean</td>
</tr>
<tr>
<td>Denominator</td>
<td>Out</td>
<td>0</td>
<td>1</td>
<td>boolean</td>
</tr>
<tr>
<td>Initial Population</td>
<td>Out</td>
<td>0</td>
<td>1</td>
<td>boolean</td>
</tr>
</table>
</td>
</tr>
<tr>
<th scope="row"><b>DataRequirements:</b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr>
<th><b>Type</b></th>
<th><b>Elements</b></th>
<th><b>Valueset Name</b></th>
<th><b>Valueset</b></th>
</tr>
<tr>
<td>Patient(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-patient.html">QICorePatient</a>)</td>
<td>
</td>
<td>
</td>
<td/>
</tr>
<tr>
<td>Observation(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-observation.html">QICoreObservation</a>)</td>
<td>
code
value
effective
</td>
<td>
Chlamydia Screening
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.110.12.1052/expansion">Chlamydia Screening</a></td>
</tr>
<tr>
<td>Observation(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-observation.html">QICoreObservation</a>)</td>
<td>
code
value
effective
</td>
<td>
Gonorrhea Screening
</td>
<td><a href="https://tx.fhir.org/r4/ValueSet/2.16.840.1.113762.1.4.1258.1-20250208">Gonorrhea Screening</a></td>
</tr>
<tr>
<td>Observation(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-observation.html">QICoreObservation</a>)</td>
<td>
code
value
effective
</td>
<td>
Syphilis Tests
</td>
<td><a href="https://tx.fhir.org/r4/ValueSet/2.16.840.1.113762.1.4.1166.117-20230708">Syphilis Tests</a></td>
</tr>
<tr>
<td>Encounter(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html">QICoreEncounter</a>)</td>
<td>
type
period
</td>
<td>
Office Visit
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1001/expansion">Office Visit</a></td>
</tr>
<tr>
<td>Encounter(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html">QICoreEncounter</a>)</td>
<td>
type
period
</td>
<td>
Outpatient Consultation
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1008/expansion">Outpatient Consultation</a></td>
</tr>
<tr>
<td>Encounter(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html">QICoreEncounter</a>)</td>
<td>
type
period
</td>
<td>
Annual Wellness Visit
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1240/expansion">Annual Wellness Visit</a></td>
</tr>
<tr>
<td>Encounter(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html">QICoreEncounter</a>)</td>
<td>
type
period
</td>
<td>
Face-to-Face Interaction
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1048/expansion">Face-to-Face Interaction</a></td>
</tr>
<tr>
<td>Encounter(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html">QICoreEncounter</a>)</td>
<td>
type
period
</td>
<td>
Home Healthcare Services
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1016/expansion">Home Healthcare Services</a></td>
</tr>
<tr>
<td>Encounter(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html">QICoreEncounter</a>)</td>
<td>
type
period
</td>
<td>
Preventive Care Services Established Office Visit, 18 and Up
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1025/expansion">Preventive Care Services - Established Office Visit, 18 and Up</a></td>
</tr>
<tr>
<td>Encounter(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html">QICoreEncounter</a>)</td>
<td>
type
period
</td>
<td>
Preventive Care Services Initial Office Visit, 18 and Up
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1023/expansion">Preventive Care Services-Initial Office Visit, 18 and Up</a></td>
</tr>
<tr>
<td>Encounter(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html">QICoreEncounter</a>)</td>
<td>
type
period
</td>
<td>
Preventive Care Services, Initial Office Visit, 0 to 17
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1022/expansion">Preventive Care Services, Initial Office Visit, 0 to 17</a></td>
</tr>
<tr>
<td>Encounter(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html">QICoreEncounter</a>)</td>
<td>
type
period
</td>
<td>
Preventive Care, Established Office Visit, 0 to 17
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1024/expansion">Preventive Care, Established Office Visit, 0 to 17</a></td>
</tr>
<tr>
<td>Encounter(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html">QICoreEncounter</a>)</td>
<td>
type
period
</td>
<td>
Telephone Visits
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1080/expansion">Telephone Visits</a></td>
</tr>
<tr>
<td>Encounter(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html">QICoreEncounter</a>)</td>
<td>
type
period
</td>
<td>
Preventive Care Services - Other
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.11.1150/expansion">Preventive Care Services - Other</a></td>
</tr>
<tr>
<td>Condition(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-condition.html">QICoreCondition</a>)</td>
<td>
code
</td>
<td>
HIV
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.120.12.1003/expansion">HIV</a></td>
</tr>
</table>
</td>
</tr>
<tr>
<th scope="row"><b>Logic Definitions:</b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr>
<th><b>Group</b></th>
<th><b>Scoring</b></th>
<th><b>Population Criteria</b></th>
<th><b>Expression</b></th>
</tr>
<tr>
<td> 64998bd84c79454c026f7483 </td>
<td>
<b>Group scoring:</b>
<span> proportion </span>
</td>
<tr>
<td/>
<td/>
<td>Initial Population</td>
<td>
<pre><code class="language-cql">define "Initial Population":
AgeInYearsAt(date from start of "Measurement Period") >= 13
and "Has Qualifying Encounter During Measurement Period"
and "Has HIV Diagnosis Before End of Measurement Period"</code></pre>
</td>
</tr>
<tr>
<td/>
<td/>
<td>Denominator</td>
<td>
<pre><code class="language-cql">define "Denominator":
"Initial Population"</code></pre>
</td>
</tr>
<tr>
<td/>
<td/>
<td>Denominator Exclusion</td>
<td>
None
</td>
</tr>
<tr>
<td/>
<td/>
<td>Numerator</td>
<td>
<pre><code class="language-cql">define "Numerator":
"Has Chlamydia Testing"
and "Has Gonorrhea Testing"
and "Has Syphilis Testing"</code></pre>
</td>
</tr>
<tr>
<td/>
<td/>
<td>Numerator Exclusion</td>
<td>
None
</td>
</tr>
<tr>
<td/>
<td/>
<td>Denominator Exception</td>
<td>
None
</td>
</tr>
</tr>
</table>
<table class="grid-dict">
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>HIVSTITestingFHIR</td>
<td>Has Chlamydia Testing</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Has Chlamydia Testing":
exists ["Observation": "Chlamydia Screening"] ChlamydiaTest
where ChlamydiaTest.value is not null
and QICoreCommon."Latest" ( ChlamydiaTest.effective ) during day of "Measurement Period"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>HIVSTITestingFHIR</td>
<td>Has Gonorrhea Testing</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Has Gonorrhea Testing":
exists ["Observation": "Gonorrhea Screening"] GonorrheaTest
where GonorrheaTest.value is not null
and QICoreCommon."Latest" ( GonorrheaTest.effective ) during day of "Measurement Period"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>HIVSTITestingFHIR</td>
<td>Has Syphilis Testing</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Has Syphilis Testing":
exists ["Observation": "Syphilis Tests"] SyphilisTest
where SyphilisTest.value is not null
and QICoreCommon."Latest" ( SyphilisTest.effective ) during day of "Measurement Period"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>HIVSTITestingFHIR</td>
<td>Numerator</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Numerator":
"Has Chlamydia Testing"
and "Has Gonorrhea Testing"
and "Has Syphilis Testing"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>HIVSTITestingFHIR</td>
<td>Has Qualifying Encounter During Measurement Period</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Has Qualifying Encounter During Measurement Period":
exists ( ( ["Encounter": "Office Visit"]
union ["Encounter": "Outpatient Consultation"]
union ["Encounter": "Annual Wellness Visit"]
union ["Encounter": "Face-to-Face Interaction"]
union ["Encounter": "Home Healthcare Services"]
union ["Encounter": "Preventive Care Services Established Office Visit, 18 and Up"]
union ["Encounter": "Preventive Care Services Initial Office Visit, 18 and Up"]
union ["Encounter": "Preventive Care Services, Initial Office Visit, 0 to 17"]
union ["Encounter": "Preventive Care, Established Office Visit, 0 to 17"]
union ["Encounter": "Telephone Visits"]
union ["Encounter": "Preventive Care Services - Other"] ) QualifyingEncounter
where QualifyingEncounter.period during day of "Measurement Period"
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>HIVSTITestingFHIR</td>
<td>Has HIV Diagnosis Before End of Measurement Period</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Has HIV Diagnosis Before End of Measurement Period":
exists ["Condition": "HIV"] HIVDx
where QICoreCommon."ToPrevalenceInterval" ( HIVDx ) starts on or before day of end of "Measurement Period"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>HIVSTITestingFHIR</td>
<td>Initial Population</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Initial Population":
AgeInYearsAt(date from start of "Measurement Period") >= 13
and "Has Qualifying Encounter During Measurement Period"
and "Has HIV Diagnosis Before End of Measurement Period"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>HIVSTITestingFHIR</td>
<td>Denominator</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Denominator":
"Initial Population"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>QICoreCommon</td>
<td>Latest</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">/*
@description: Given an interval, returns the ending point if the interval has an ending boundary specified,
otherwise, returns the starting point
@deprecated: This function is deprecated. Use the fluent function `latest()` instead
*/
define function "Latest"(choice Choice<DateTime, Quantity, Interval<DateTime>, Interval<Quantity>> ):
(choice.toInterval()) period
return
if (HasEnd(period)) then end of period
else start of period</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>QICoreCommon</td>
<td>toInterval</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">/*
@description: Normalizes a value that is a choice of timing-valued types to an equivalent interval
@comment: Normalizes a choice type of DateTime, Quanitty, Interval<DateTime>, or Interval<Quantity> types
to an equivalent interval. This selection of choice types is a superset of the majority of choice types that are used as possible
representations for timing-valued elements in QICore, allowing this function to be used across any resource.
The input can be provided as a DateTime, Quantity, Interval<DateTime> or Interval<Quantity>.
The intent of this function is to provide a clear and concise mechanism to treat single
elements that have multiple possible representations as intervals so that logic doesn't have to account
for the variability. More complex calculations (such as medication request period or dispense period
calculation) need specific guidance and consideration. That guidance may make use of this function, but
the focus of this function is on single element calculations where the semantics are unambiguous.
If the input is a DateTime, the result a DateTime Interval beginning and ending on that DateTime.
If the input is a Quantity, the quantity is expected to be a calendar-duration interpreted as an Age,
and the result is a DateTime Interval beginning on the Date the patient turned that age and ending immediately before one year later.
If the input is a DateTime Interval, the result is the input.
If the input is a Quantity Interval, the quantities are expected to be calendar-durations interpreted as an Age, and the result
is a DateTime Interval beginning on the date the patient turned the age given as the start of the quantity interval, and ending
immediately before one year later than the date the patient turned the age given as the end of the quantity interval.
Any other input will reslt in a null DateTime Interval
*/
define fluent function toInterval(choice Choice<DateTime, Quantity, Interval<DateTime>, Interval<Quantity>>):
case
when choice is DateTime then
Interval[choice as DateTime, choice as DateTime]
when choice is Interval<DateTime> then
choice as Interval<DateTime>
when choice is Quantity then
Interval[Patient.birthDate + (choice as Quantity),
Patient.birthDate + (choice as Quantity) + 1 year)
when choice is Interval<Quantity> then
Interval[Patient.birthDate + (choice.low as Quantity),
Patient.birthDate + (choice.high as Quantity) + 1 year)
else
null as Interval<DateTime>
end</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>QICoreCommon</td>
<td>ToPrevalenceInterval</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">/*
@description: Returns an interval representing the normalized prevalence period of a given Condition.
@comment: Uses the ToInterval and ToAbatementInterval functions to determine the widest potential interval from
onset to abatement as specified in the given Condition. If the condition is active, the resulting interval will have
a closed ending boundary. If the condition is not active, the resulting interval will have an open ending boundary.
@deprecated: This function is deprecated. Use the `prevalenceInterval()` fluent function instead
*/
define function ToPrevalenceInterval(condition Condition):
if condition.clinicalStatus ~ "active"
or condition.clinicalStatus ~ "recurrence"
or condition.clinicalStatus ~ "relapse" then
Interval[start of ToInterval(condition.onset), end of ToAbatementInterval(condition)]
else
Interval[start of ToInterval(condition.onset), end of ToAbatementInterval(condition))</code></pre>
</td>
</tr>
</table>
</td>
</tr>
</table>
</div>
</text>
<contained>
<Library>
<id value="effective-data-requirements"/>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="HIVSTITestingFHIR"/>
</extension>
<extension url="name">
<valueString value="Has Chlamydia Testing"/>
</extension>
<extension url="statement">
<valueString
value="define "Has Chlamydia Testing":
exists ["Observation": "Chlamydia Screening"] ChlamydiaTest
where ChlamydiaTest.value is not null
and QICoreCommon."Latest" ( ChlamydiaTest.effective ) during day of "Measurement Period""/>
</extension>
<extension url="displaySequence">
<valueInteger value="0"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="HIVSTITestingFHIR"/>
</extension>
<extension url="name">
<valueString value="Has Gonorrhea Testing"/>
</extension>
<extension url="statement">
<valueString
value="define "Has Gonorrhea Testing":
exists ["Observation": "Gonorrhea Screening"] GonorrheaTest
where GonorrheaTest.value is not null
and QICoreCommon."Latest" ( GonorrheaTest.effective ) during day of "Measurement Period""/>
</extension>
<extension url="displaySequence">
<valueInteger value="1"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="HIVSTITestingFHIR"/>
</extension>
<extension url="name">
<valueString value="Has Syphilis Testing"/>
</extension>
<extension url="statement">
<valueString
value="define "Has Syphilis Testing":
exists ["Observation": "Syphilis Tests"] SyphilisTest
where SyphilisTest.value is not null
and QICoreCommon."Latest" ( SyphilisTest.effective ) during day of "Measurement Period""/>
</extension>
<extension url="displaySequence">
<valueInteger value="2"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="HIVSTITestingFHIR"/>
</extension>
<extension url="name">
<valueString value="Numerator"/>
</extension>
<extension url="statement">
<valueString
value="define "Numerator":
"Has Chlamydia Testing"
and "Has Gonorrhea Testing"
and "Has Syphilis Testing""/>
</extension>
<extension url="displaySequence">
<valueInteger value="3"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="HIVSTITestingFHIR"/>
</extension>
<extension url="name">
<valueString
value="Has Qualifying Encounter During Measurement Period"/>
</extension>
<extension url="statement">
<valueString
value="define "Has Qualifying Encounter During Measurement Period":
exists ( ( ["Encounter": "Office Visit"]
union ["Encounter": "Outpatient Consultation"]
union ["Encounter": "Annual Wellness Visit"]
union ["Encounter": "Face-to-Face Interaction"]
union ["Encounter": "Home Healthcare Services"]
union ["Encounter": "Preventive Care Services Established Office Visit, 18 and Up"]
union ["Encounter": "Preventive Care Services Initial Office Visit, 18 and Up"]
union ["Encounter": "Preventive Care Services, Initial Office Visit, 0 to 17"]
union ["Encounter": "Preventive Care, Established Office Visit, 0 to 17"]
union ["Encounter": "Telephone Visits"]
union ["Encounter": "Preventive Care Services - Other"] ) QualifyingEncounter
where QualifyingEncounter.period during day of "Measurement Period"
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="4"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="HIVSTITestingFHIR"/>
</extension>
<extension url="name">
<valueString
value="Has HIV Diagnosis Before End of Measurement Period"/>
</extension>
<extension url="statement">
<valueString
value="define "Has HIV Diagnosis Before End of Measurement Period":
exists ["Condition": "HIV"] HIVDx
where QICoreCommon."ToPrevalenceInterval" ( HIVDx ) starts on or before day of end of "Measurement Period""/>
</extension>
<extension url="displaySequence">
<valueInteger value="5"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="HIVSTITestingFHIR"/>
</extension>
<extension url="name">
<valueString value="Initial Population"/>
</extension>
<extension url="statement">
<valueString
value="define "Initial Population":
AgeInYearsAt(date from start of "Measurement Period") >= 13
and "Has Qualifying Encounter During Measurement Period"
and "Has HIV Diagnosis Before End of Measurement Period""/>
</extension>
<extension url="displaySequence">
<valueInteger value="6"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="HIVSTITestingFHIR"/>
</extension>
<extension url="name">
<valueString value="Denominator"/>
</extension>
<extension url="statement">
<valueString
value="define "Denominator":
"Initial Population""/>
</extension>
<extension url="displaySequence">
<valueInteger value="7"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="QICoreCommon"/>
</extension>
<extension url="name">
<valueString value="Latest"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Given an interval, returns the ending point if the interval has an ending boundary specified,
otherwise, returns the starting point
@deprecated: This function is deprecated. Use the fluent function `latest()` instead
*/
define function "Latest"(choice Choice<DateTime, Quantity, Interval<DateTime>, Interval<Quantity>> ):
(choice.toInterval()) period
return
if (HasEnd(period)) then end of period
else start of period"/>
</extension>
<extension url="displaySequence">
<valueInteger value="8"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="QICoreCommon"/>
</extension>
<extension url="name">
<valueString value="toInterval"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Normalizes a value that is a choice of timing-valued types to an equivalent interval
@comment: Normalizes a choice type of DateTime, Quanitty, Interval<DateTime>, or Interval<Quantity> types
to an equivalent interval. This selection of choice types is a superset of the majority of choice types that are used as possible
representations for timing-valued elements in QICore, allowing this function to be used across any resource.
The input can be provided as a DateTime, Quantity, Interval<DateTime> or Interval<Quantity>.
The intent of this function is to provide a clear and concise mechanism to treat single
elements that have multiple possible representations as intervals so that logic doesn't have to account
for the variability. More complex calculations (such as medication request period or dispense period
calculation) need specific guidance and consideration. That guidance may make use of this function, but
the focus of this function is on single element calculations where the semantics are unambiguous.
If the input is a DateTime, the result a DateTime Interval beginning and ending on that DateTime.
If the input is a Quantity, the quantity is expected to be a calendar-duration interpreted as an Age,
and the result is a DateTime Interval beginning on the Date the patient turned that age and ending immediately before one year later.
If the input is a DateTime Interval, the result is the input.
If the input is a Quantity Interval, the quantities are expected to be calendar-durations interpreted as an Age, and the result
is a DateTime Interval beginning on the date the patient turned the age given as the start of the quantity interval, and ending
immediately before one year later than the date the patient turned the age given as the end of the quantity interval.
Any other input will reslt in a null DateTime Interval
*/
define fluent function toInterval(choice Choice<DateTime, Quantity, Interval<DateTime>, Interval<Quantity>>):
case
when choice is DateTime then
Interval[choice as DateTime, choice as DateTime]
when choice is Interval<DateTime> then
choice as Interval<DateTime>
when choice is Quantity then
Interval[Patient.birthDate + (choice as Quantity),
Patient.birthDate + (choice as Quantity) + 1 year)
when choice is Interval<Quantity> then
Interval[Patient.birthDate + (choice.low as Quantity),
Patient.birthDate + (choice.high as Quantity) + 1 year)
else
null as Interval<DateTime>
end"/>
</extension>
<extension url="displaySequence">
<valueInteger value="9"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="QICoreCommon"/>
</extension>
<extension url="name">
<valueString value="ToPrevalenceInterval"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Returns an interval representing the normalized prevalence period of a given Condition.
@comment: Uses the ToInterval and ToAbatementInterval functions to determine the widest potential interval from
onset to abatement as specified in the given Condition. If the condition is active, the resulting interval will have
a closed ending boundary. If the condition is not active, the resulting interval will have an open ending boundary.
@deprecated: This function is deprecated. Use the `prevalenceInterval()` fluent function instead
*/
define function ToPrevalenceInterval(condition Condition):
if condition.clinicalStatus ~ "active"
or condition.clinicalStatus ~ "recurrence"
or condition.clinicalStatus ~ "relapse" then
Interval[start of ToInterval(condition.onset), end of ToAbatementInterval(condition)]
else
Interval[start of ToInterval(condition.onset), end of ToAbatementInterval(condition))"/>
</extension>
<extension url="displaySequence">
<valueInteger value="10"/>
</extension>
</extension>
<status value="active"/>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/library-type"/>
<code value="module-definition"/>
</coding>
</type>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library FHIRHelpers"/>
<resource
value="http://ecqi.healthit.gov/ecqms/Library/FHIRHelpers|4.3.000"/>
</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="Value set Chlamydia Screening"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1052"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Gonorrhea Screening"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1258.1"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Syphilis Tests"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1166.117"/>
</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 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 Annual Wellness Visit"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Face-to-Face Interaction"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1048"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Home Healthcare Services"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display
value="Value set Preventive Care Services Established Office Visit, 18 and Up"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display
value="Value set Preventive Care Services Initial Office Visit, 18 and Up"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display
value="Value set Preventive Care Services, Initial Office Visit, 0 to 17"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1022"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display
value="Value set Preventive Care, Established Office Visit, 0 to 17"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1024"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Telephone Visits"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1080"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Preventive Care Services - Other"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.11.1150"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set HIV"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.120.12.1003"/>
</relatedArtifact>
<parameter>
<name value="Measurement Period"/>
<use value="in"/>
<min value="0"/>
<max value="1"/>
<type value="Period"/>
</parameter>
<parameter>
<name value="Numerator"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="boolean"/>
</parameter>
<parameter>
<name value="Denominator"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="boolean"/>
</parameter>
<parameter>
<name value="Initial Population"/>
<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"/>
</dataRequirement>
<dataRequirement>
<type value="Observation"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation"/>
<mustSupport value="code"/>
<mustSupport value="value"/>
<mustSupport value="effective"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1052"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Observation"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation"/>
<mustSupport value="code"/>
<mustSupport value="value"/>
<mustSupport value="effective"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1258.1"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
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<mustSupport value="value"/>
<mustSupport value="effective"/>
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<mustSupport value="period"/>
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<type value="Condition"/>
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<mustSupport value="code"/>
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<path value="code"/>
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</Library>
</contained>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-softwaresystem">
<valueReference>
<reference value="Device/cqf-tooling"/>
</valueReference>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-effectiveDataRequirements" id="effective-data-requirements">
<valueReference>
<reference value="#effective-data-requirements"/>
</valueReference>
</extension>
<url value="http://ecqi.healthit.gov/ecqms/Measure/HIVSTITestingFHIR"/>
<identifier>
<use value="usual"/>
<type>
<coding>
<system
value="http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type"/>
<code value="short-name"/>
</coding>
</type>
<system value="https://madie.cms.gov/measure/shortName"/>
<value value="CMS1188FHIR"/>
</identifier>
<identifier>
<use value="official"/>
<type>
<coding>
<system
value="http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type"/>
<code value="version-independent"/>
</coding>
</type>
<system value="urn:ietf:rfc:3986"/>
<value value="urn:uuid:6f66ca77-1a2c-489c-b0d8-730da6e5a763"/>
</identifier>
<identifier>
<use value="official"/>
<type>
<coding>
<system
value="http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type"/>
<code value="version-specific"/>
</coding>
</type>
<system value="urn:ietf:rfc:3986"/>
<value value="urn:uuid:2c92808287dd6f640188b07c4a8a1f35"/>
</identifier>
<identifier>
<use value="official"/>
<type>
<coding>
<system
value="http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type"/>
<code value="publisher"/>
</coding>
</type>
<system value="https://madie.cms.gov/measure/cmsId"/>
<value value="1188FHIR"/>
<assigner>
<display value="CMS"/>
</assigner>
</identifier>
<version value="0.1.000"/>
<name value="HIVSTITestingFHIR"/>
<title
value="Sexually Transmitted Infection (STI) Testing for People with HIVFHIR"/>
<status value="draft"/>
<experimental value="false"/>
<date value="2023-10-27T08:12:32+00:00"/>
<publisher value="Health Resources & Services Administration"/>
<contact>
<telecom>
<system value="url"/>
<value value=" https://www.hrsa.gov/"/>
</telecom>
</contact>
<description
value="Percentage of patients 13 years of age and older with a diagnosis of HIV who had tests for syphilis, gonorrhea, and chlamydia performed within the measurement period"/>
<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="ep-ec"/>
<display value="EP/EC"/>
</coding>
</valueCodeableConcept>
</useContext>
<purpose value="UNKNOWN"/>
<usage
value="This eCQM is a patient-based measure.
This FHIR-based measure has been derived from the QDM-based measure: CMS1188v1.
Please refer to the HL7 QI-Core Implementation Guide (http://hl7.org/fhir/us/qicore/index.html) for more information on QI-Core and mapping recommendations from QDM to QI-Core 4.1.1 (http://hl7.org/fhir/us/qicore/qdm-to-qicore.html)."/>
<copyright
value="This measure was developed by the Health Resources & Services Administration (HRSA) of the U.S. Department of Health & Human Services (HHS). It is in the public domain.
Citation of HRSA as the source of the original measure is appreciated. Any modified versions may not be represented as approved, endorsed, or authorized by HRSA or HHS. 42 U.S.C. Section 1320b-10. Users of modified versions should clearly explain how they deviate from HRSA's original measure.
Limited proprietary coding is contained in the Measure specifications for user convenience. Users of proprietary code sets should obtain all necessary licenses from the owners of the code sets.
CPT(R) contained in the Measure specifications is copyright 2004-2022 American Medical Association. LOINC(R) is copyright 2004-2022 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2022 International Health Terminology Standards Development Organisation. ICD-10 is copyright 2022 World Health Organization. All Rights Reserved.
Due to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM]."/>
<approvalDate value="2023-08-11"/>
<lastReviewDate value="2023-08-11"/>
<effectivePeriod>
<start value="2024-01-01"/>
<end value="2024-12-31"/>
</effectivePeriod>
<author>
<name value="Health Resources & Services Administration"/>
<telecom>
<system value="url"/>
<value value=" https://www.hrsa.gov/"/>
</telecom>
</author>
<library value="http://ecqi.healthit.gov/ecqms/Library/HIVSTITestingFHIR"/>
<disclaimer
value="These performance measures are not clinical guidelines and do not establish a standard of medical care, and have not been tested for all potential applications.
THE MEASURES AND SPECIFICATIONS ARE PROVIDED "AS IS" WITHOUT WARRANTY OF ANY KIND.
Due to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM]."/>
<rationale
value="The rates of syphilis, gonorrhea, and chlamydia cases per 100,000 in the United States have steadily risen over the last decade and increased 11.2%, 5.9%, and 2.8%, respectively, from 2018 to 2019 (DHHS, 2021). People with HIV are at an increased risk of bacterial sexually transmitted infections (STIs), including chlamydia, gonorrhea, and syphilis (CDC, 2004). However, early detection and treatment of bacterial STIs in people with HIV can lead to a reduction in HIV transmission (CDC, 2004). Despite guidelines for at least annual screening among sexually active persons with HIV, only an estimated 55% received a syphilis test in the past year, 23% received a gonorrhea test in the past year, and 24% received a chlamydia test in the past year based on a nationally-representative survey of adults with HIV receiving medical care in the United States (Flagg et al., 2015). This measure will help providers focus their attention and quality improvement efforts towards testing and treating sexually transmitted infections in patients with HIV, thus reducing the complications to long-term syphilis infection and reducing STI incidence (Patel et al., 2012)."/>
<clinicalRecommendationStatement
value=""Routine serologic screening for syphilis is recommended at least annually for all persons with HIV infection who are sexually active, with more frequent screening (i.e., every 3-6 months) for those who have multiple or anonymous partners" (Panel on Opportunistic Infections in Adults and Adolescents with HIV, 2022, p. Y-3).
"Patients undergoing screening or treatment for syphilis also should be evaluated for other sexually transmitted diseases such as chlamydia and gonorrhea at anatomic sites of exposure in men and for chlamydia, gonorrhea, and trichomonas in women" (Panel on Opportunistic Infections in Adults and Adolescents with HIV, 2022, p. Y-3).
"The USPSTF recommends screening for syphilis in persons who are at increased risk for infection. When deciding which persons to screen for syphilis, clinicians should consider the prevalence of infection in the communities they serve, as well as other sociodemographic and behavioral factors that may be associated with increased risk of syphilis infection. For example, prevalence of syphilis is higher in men, men who have sex with men, persons with HIV infection, young adults, and persons with a history of incarceration, sex work, or military service…. Optimal screening frequency for persons who are at increased risk for syphilis infection is not well established. Men who have sex with men or persons with HIV infection may benefit from screening at least annually or more frequently (e.g., every 3 to 6 months) if they continue to be at high risk" (USPSTF, 2022, p. 1244-1246).
"At the initial HIV care visit, providers should screen all sexually active persons for syphilis, gonorrhea, and chlamydia, and perform screening for these infections at least annually during the course of HIV care. Specific testing includes syphilis serology and [a nucleic acid amplification test] NAAT for N. gonorrhoeae and C. trachomatis at the anatomic site of exposure" (Workowski et al., 2021, p. 26)."/>
<group id="64998bd84c79454c026f7483">
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring">
<valueCodeableConcept>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-scoring"/>
<code value="proportion"/>
<display value="Proportion"/>
</coding>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis">
<valueCode value="boolean"/>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-type">
<valueCodeableConcept>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/measure-type"/>
<code value="process"/>
<display value="Process"/>
</coding>
</valueCodeableConcept>
</extension>
<population id="250DDEF3-2C5A-44DA-BFB9-69734554ACF4">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="initial-population"/>
<display value="Initial Population"/>
</coding>
</code>
<description
value="All patients 13 years of age and older at the start of the measurement period with a diagnosis of HIV before the end of the measurement period with an eligible encounter during the measurement period"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Initial Population"/>
</criteria>
</population>
<population id="10249168-FCAB-4E5C-AE8E-3D94C9E5BEE7">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="denominator"/>
<display value="Denominator"/>
</coding>
</code>
<description value="Equals Initial Population"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Denominator"/>
</criteria>
</population>
<population id="5e85b046-832f-4cea-9d3c-f7d35dda4faf">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="denominator-exclusion"/>
<display value="Denominator Exclusion"/>
</coding>
</code>
<criteria>
<language value="text/cql-identifier"/>
</criteria>
</population>
<population id="3C47B2A0-999A-43F1-AF6E-359AC843FD67">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="numerator"/>
<display value="Numerator"/>
</coding>
</code>
<description
value="Patients who were tested for each of the following at least once during the measurement period: syphilis, gonorrhea, and chlamydia"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Numerator"/>
</criteria>
</population>
<population id="192f31c2-58e6-4192-8d4d-eb0dc07a1cfd">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="numerator-exclusion"/>
<display value="Numerator Exclusion"/>
</coding>
</code>
<criteria>
<language value="text/cql-identifier"/>
</criteria>
</population>
<population id="3e946d98-08c5-4a41-a3fc-cba39eaabda7">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="denominator-exception"/>
<display value="Denominator Exception"/>
</coding>
</code>
<criteria>
<language value="text/cql-identifier"/>
</criteria>
</population>
</group>
</Measure>
IG © 2023+ cqframework. Package gov.healthit.ecqi.ecqms#2023.0.0 based on FHIR 4.0.1. Generated 2026-05-13
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