{
  "resourceType": "Measure",
  "id": "measure-EXM55-FHIR",
  "contained": [
    {
      "resourceType": "Library",
      "id": "EXM55",
      "extension": [
        {
          "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
          "valueCode": "cqi"
        }
      ],
      "url": "http://hl7.org/fhir/uv/cqm/Library/EXM55",
      "identifier": [
        {
          "use": "official",
          "system": "http://example.org/fhir/cqi/ecqm/Library/Identifier",
          "value": "EXM55"
        }
      ],
      "version": "5.0.0",
      "name": "EXM55",
      "title": "EXM55 - Median Emergency Department Visit Duration Library (Example Continuous Variable Measure Library)",
      "status": "active",
      "experimental": true,
      "type": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/library-type",
            "code": "logic-library"
          }
        ]
      },
      "date": "2019-09-03",
      "publisher": "HL7 International / Clinical Quality Information",
      "contact": [
        {
          "telecom": [
            {
              "system": "url",
              "value": "http://www.hl7.org/Special/committees/cqi"
            }
          ]
        }
      ],
      "description": "This library is used as an example in the FHIR Continuous Variable Measure example",
      "jurisdiction": [
        {
          "coding": [
            {
              "system": "http://unstats.un.org/unsd/methods/m49/m49.htm",
              "code": "001"
            }
          ]
        }
      ],
      "approvalDate": "2019-08-03",
      "lastReviewDate": "2019-08-03",
      "relatedArtifact": [
        {
          "type": "depends-on",
          "display": "FHIR model information",
          "resource": "http://hl7.org/fhir/uv/cql/Library/FHIR-ModelInfo|4.0.1"
        },
        {
          "type": "depends-on",
          "display": "Library FHIRHelpers",
          "resource": "http://hl7.org/fhir/uv/cql/Library/FHIRHelpers|4.0.1"
        }
      ],
      "parameter": [
        {
          "name": "Measurement Period",
          "use": "in",
          "min": 0,
          "max": "1",
          "type": "Period"
        },
        {
          "name": "Patient",
          "use": "out",
          "min": 0,
          "max": "1",
          "type": "Patient"
        },
        {
          "name": "Inpatient Encounter",
          "use": "out",
          "min": 0,
          "max": "*",
          "type": "Encounter"
        },
        {
          "name": "Initial Population",
          "use": "out",
          "min": 0,
          "max": "*",
          "type": "Encounter"
        },
        {
          "name": "Measure Population",
          "use": "out",
          "min": 0,
          "max": "*",
          "type": "Encounter"
        },
        {
          "name": "Measure Population Exclusion",
          "use": "out",
          "min": 0,
          "max": "*",
          "type": "Encounter"
        },
        {
          "name": "Stratification 1",
          "use": "out",
          "min": 0,
          "max": "*",
          "type": "Encounter"
        },
        {
          "name": "Stratification 2",
          "use": "out",
          "min": 0,
          "max": "*",
          "type": "Encounter"
        },
        {
          "name": "Stratification 3",
          "use": "out",
          "min": 0,
          "max": "*",
          "type": "Encounter"
        }
      ],
      "dataRequirement": [
        {
          "type": "Patient",
          "profile": [
            "http://hl7.org/fhir/StructureDefinition/Patient"
          ]
        },
        {
          "type": "Encounter",
          "profile": [
            "http://hl7.org/fhir/StructureDefinition/Encounter"
          ],
          "mustSupport": [
            "period",
            "use",
            "rank",
            "rank.value",
            "condition",
            "condition.reference"
          ]
        },
        {
          "type": "Encounter",
          "profile": [
            "http://hl7.org/fhir/StructureDefinition/Encounter"
          ],
          "mustSupport": [
            "type",
            "status",
            "period",
            "use",
            "rank",
            "rank.value",
            "condition",
            "condition.reference",
            "hospitalization",
            "hospitalization.admitSource"
          ]
        },
        {
          "type": "Condition",
          "profile": [
            "http://hl7.org/fhir/StructureDefinition/Condition"
          ],
          "mustSupport": [
            "id"
          ],
          "codeFilter": [
            {
              "path": "id"
            }
          ]
        }
      ],
      "content": [
        {
          "contentType": "text/cql",
          "data": "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"
        }
      ]
    }
  ],
  "extension": [
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
      "valueCode": "cqi"
    }
  ],
  "url": "http://hl7.org/fhir/uv/cqm/Measure/measure-EXM55-FHIR",
  "identifier": [
    {
      "use": "official",
      "system": "http://example.org/fhir/cqi/ecqm/Measure/Identifier/exm",
      "value": "55"
    }
  ],
  "version": "5.0.0",
  "name": "EXM55",
  "title": "EXM55 - Median Emergency Department Visit Duration",
  "status": "active",
  "experimental": true,
  "date": "2025-08-13",
  "publisher": "HL7 International / Clinical Quality Information",
  "contact": [
    {
      "telecom": [
        {
          "system": "url",
          "value": "http://www.hl7.org/Special/committees/cqi"
        }
      ]
    }
  ],
  "description": "This example illustrates a continuous variable measure represented as a FHIR eCQM",
  "useContext": [
    {
      "code": {
        "system": "http://terminology.hl7.org/CodeSystem/usage-context-type",
        "code": "venue",
        "display": "Clinical Venue"
      },
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "http://hl7.org/fhir/uv/cqm/CodeSystem/intended-venue-codes",
            "code": "eh",
            "display": "EH"
          }
        ]
      }
    }
  ],
  "jurisdiction": [
    {
      "coding": [
        {
          "system": "http://unstats.un.org/unsd/methods/m49/m49.htm",
          "code": "001"
        }
      ]
    }
  ],
  "approvalDate": "2019-03-08",
  "lastReviewDate": "2019-03-08",
  "effectivePeriod": {
    "start": "2018-01-01",
    "end": "2018-12-31"
  },
  "library": [
    "#EXM55"
  ],
  "group": [
    {
      "id": "group-1",
      "type": [
        {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/measure-type",
              "code": "process"
            }
          ]
        }
      ],
      "basis": "Encounter",
      "scoring": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/measure-scoring",
            "code": "continuous-variable",
            "display": "Continuous Variable"
          }
        ]
      },
      "improvementNotation": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/measure-improvement-notation",
            "code": "decrease",
            "display": "Decreased score indicates improvement"
          }
        ]
      },
      "population": [
        {
          "linkId": "primary-exm55-initial-population",
          "code": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                "code": "initial-population",
                "display": "Initial Population"
              }
            ]
          },
          "criteria": {
            "language": "text/cql-identifier",
            "expression": "Initial Population"
          }
        },
        {
          "linkId": "primary-exm55-measure-population",
          "code": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                "code": "measure-population",
                "display": "Measure Population"
              }
            ]
          },
          "criteria": {
            "language": "text/cql-identifier",
            "expression": "Measure Population"
          }
        },
        {
          "linkId": "primary-exm55-measure-population-exclusion",
          "code": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                "code": "measure-population-exclusion",
                "display": "Measure Population Exclusion"
              }
            ]
          },
          "criteria": {
            "language": "text/cql-identifier",
            "expression": "Measure Population Exclusion"
          }
        },
        {
          "linkId": "primary-exm55-measure-population-identifier",
          "code": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                "code": "measure-observation",
                "display": "Measure Observation"
              }
            ]
          },
          "criteria": {
            "language": "text/cql-identifier",
            "expression": "Measure Observation"
          },
          "inputPopulationId": "measure-population-identifier",
          "aggregateMethod": {
            "coding": [
              {
                "system": "http://hl7.org/fhir/CodeSystem/measure-aggregate-method",
                "code": "median",
                "display": "Median"
              }
            ]
          }
        }
      ],
      "stratifier": [
        {
          "linkId": "primary-exm55-stratification-1",
          "code": {
            "coding": [
              {
                "system": "http://example.org/stratification",
                "code": "Stratification 1",
                "display": "Stratification 1"
              }
            ]
          },
          "criteria": {
            "language": "text/cql-identifier",
            "expression": "Stratification 1"
          }
        },
        {
          "linkId": "primary-exm55-stratification-2",
          "code": {
            "coding": [
              {
                "system": "http://example.org/stratification",
                "code": "Stratification 2",
                "display": "Stratification 2"
              }
            ]
          },
          "criteria": {
            "language": "text/cql-identifier",
            "expression": "Stratification 2"
          }
        },
        {
          "linkId": "primary-exm55-stratification-3",
          "code": {
            "coding": [
              {
                "system": "http://example.org/stratification",
                "code": "Stratification 3",
                "display": "Stratification 3"
              }
            ]
          },
          "criteria": {
            "language": "text/cql-identifier",
            "expression": "Stratification 3"
          }
        }
      ]
    }
  ]
}