Cervical Cancer Screening - Quality Measure Implementation Guide v1.0.1-cibuild

Quality Measure Implementation Guide, published by HL7 International / Clinical Quality Information. This guide is not an authorized publication; it is the continuous build for version 1.0.1-cibuild built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-cqm/ and changes regularly. See the Directory of published versions

Measure: Cervical Cancer Screening (Experimental)

Official URL: http://hl7.org/fhir/uv/cqm/Measure/CCSComponent				Version: 0.0.001
Standards status: Informative				Computable Name: CCSComponent
Other Identifiers: Version Independent: Uniform Resource Identifier (URI)#http://example.org/fhir/us/cqm/Measure/CCSComponent (use: official, ), Version Specific: Uniform Resource Identifier (URI)#http://example.org/fhir/us/cqm/Measure/130v10 (use: official, ), Short Name: Colorectal Cancer Screening (use: usual, ), OID:2.16.840.1.113883.4.642.40.61.29.2
Usage:Clinical Venue: EC

This is only an example.

Metadata
Title	Cervical Cancer Screening
Version	0.0.001
Short Name	Colorectal Cancer Screening
GUID (Version Independent)	http://example.org/fhir/us/cqm/Measure/CCSComponent
GUID (Version Specific)	http://example.org/fhir/us/cqm/Measure/130v10
Identifier	urn:oid:2.16.840.1.113883.4.642.40.61.29.2
Effective Period	2022-01-01 through 2022-12-31
Experimental	true
Use Context	Clinical Venue = EC
Jurisdiction	Global (Whole world)
Steward (Publisher)	HL7 International / Clinical Quality Information
Description	This is only an example.
Measure Basis	boolean
Measure Scoring	Proportion
Measure Type	Process
Improvement Notation	Increased score indicates improvement
Measure Group (Rate) (ID: primary)
Initial Population	ID: primary-ccscomponent-initial-population Description: No description provided Criteria: Initial Population
Denominator	ID: primary-ccscomponent-denominator Description: No description provided Criteria: Denominator
Denominator Exclusion	ID: primary-ccscomponent-denominator-exclusion Description: No description provided Criteria: Denominator Exclusion
Numerator	ID: primary-ccscomponent-numerator Description: No description provided Criteria: Numerator
Supplemental Data Elements
Supplemental Data Element	ID: 4d3fff25-29d7-4e61-9fdd-a02a85c1472f Usage Code: Supplemental Data Description: No description provided Logic Definition: SDE Ethnicity
Supplemental Data Element	ID: 4732f9d3-e4c9-4a24-ab3c-9247a55d73ef Usage Code: Supplemental Data Description: No description provided Logic Definition: SDE Payer
Supplemental Data Element	ID: 523c2619-71c6-4e60-83f8-3d8eeef75398 Usage Code: Supplemental Data Description: No description provided Logic Definition: SDE Race
Supplemental Data Element	ID: 336d1356-61a7-4220-9635-ffc50b90af2f Usage Code: Supplemental Data Description: No description provided Logic Definition: SDE Sex
Measure Logic
Primary Library	CCS Component Library
Contents	Population Criteria Logic Definitions Terminology Dependencies Data Requirements
Population Criteria
Measure Group (Rate) (ID: primary)
Initial Population
Initial Population	`define "Initial Population": Global."CalendarAgeInYearsAt" ( FHIRHelpers.ToDate ( Patient.birthDate ), start of "Measurement Period" ) in Interval[50, 75] and exists AdultOutpatientEncounters."Qualifying Encounters"` Definition
Denominator
Denominator	`define "Denominator": "Initial Population"` Definition
Denominator Exclusion
Denominator Exclusion	`define "Denominator Exclusion": Hospice."Has Hospice" or exists "Malignant Neoplasm" or exists "Total Colectomy Performed" or Frailty."Advanced Illness and Frailty Exclusion Not Including Over Age 80" and Frailty."Long Term Care Periods Longer Than 90 Consecutive Days"` Definition
Numerator
Numerator	`define "Numerator": exists "Colonoscopy Performed" or exists "Fecal Occult Blood Test Performed" or exists "Flexible Sigmoidoscopy Performed" or exists "Fecal Immunochemical Test DNA" or exists "CT Colonography Performed"` Definition
Logic Definitions
Logic Definition	Library Name: AdultOutpatientEncounters
Logic Definition	`define "Qualifying Encounters": ( [Encounter: "Office Visit"] union [Encounter: "Annual Wellness Visit"] union [Encounter: "Preventive Care Services - Established Office Visit, 18 and Up"] union [Encounter: "Preventive Care Services-Initial Office Visit, 18 and Up"] union [Encounter: "Home Healthcare Services"] ) ValidEncounter where ValidEncounter.period during "Measurement Period" and ValidEncounter.status = 'finished'`
Logic Definition	Library Name: Hospice
Logic Definition	define "Has Hospice": exists ( [Encounter: "Encounter Inpatient"] DischargeHospice where DischargeHospice.status = 'finished' and ( DischargeHospice.hospitalization.dischargeDisposition ~ "Discharge to home for hospice care (procedure)" or DischargeHospice.hospitalization.dischargeDisposition ~ "Discharge to healthcare facility for hospice care (procedure)" ) and DischargeHospice.period ends during "Measurement Period" ) or exists ( [ServiceRequest: "Hospice care ambulatory"] HospiceOrder where HospiceOrder.intent = 'order' and HospiceOrder.authoredOn in "Measurement Period" ) or exists ( [Procedure: "Hospice care ambulatory"] HospicePerformed where HospicePerformed.status = 'completed' and Global."Normalize Interval"(HospicePerformed.performed) overlaps "Measurement Period" )
Logic Definition	Library Name: AdvancedIllnessandFrailtyExclusion
Logic Definition	define "Has Criteria Indicating Frailty": //Ask Bryn about devices exists ( [DeviceRequest: "Frailty Device"] FrailtyDeviceOrder where FrailtyDeviceOrder.authoredOn during "Measurement Period" ) // DeviceUseStatement has a known issue with the publication tooling // so it is removed to allow this IG to publish until that is fixed //or exists ( [DeviceUseStatement: "Frailty Device"] FrailtyDeviceUse // where Global."Normalize Interval"(FrailtyDeviceUse.timing) overlaps "Measurement Period" //) or exists ( [Condition: "Frailty Diagnosis"] FrailtyDiagnosis where Global."Prevalence Period"(FrailtyDiagnosis) overlaps "Measurement Period" ) or exists ( [Encounter: "Frailty Encounter"] FrailtyEncounter where FrailtyEncounter.period overlaps "Measurement Period" ) or exists ( [Observation: "Frailty Symptom"] FrailtySymptomObservation where Global."Normalize Interval"(FrailtySymptomObservation.effective) overlaps "Measurement Period" )
Logic Definition	Library Name: AdvancedIllnessandFrailtyExclusion
Logic Definition	define "Outpatient Encounters with Advanced Illness": ( [Encounter: "Outpatient"] union [Encounter: "Observation"] union [Encounter: "ED"] union [Encounter: "Nonacute Inpatient"] ) OutpatientEncounter with [Condition: "Advanced Illness"] AdvancedIllnessDiagnosis such that exists ( OutpatientEncounter.diagnosis.condition EncounterDiagnosis where EndsWith(EncounterDiagnosis.reference, AdvancedIllnessDiagnosis.id) ) and OutpatientEncounter.period starts 2 years or less on or before end of "Measurement Period"
Logic Definition	Library Name: AdvancedIllnessandFrailtyExclusion
Logic Definition	define "Inpatient Encounter with Advanced Illness": [Encounter: "Acute Inpatient"] InpatientEncounter with [Condition: "Advanced Illness"] AdvancedIllnessDiagnosis such that exists ( InpatientEncounter.diagnosis.condition EncounterDiagnosis where EndsWith(EncounterDiagnosis.reference, AdvancedIllnessDiagnosis.id) ) and InpatientEncounter.period starts 2 years or less on or before end of "Measurement Period"
Logic Definition	Library Name: AdvancedIllnessandFrailtyExclusion
Logic Definition	`define "Dementia Medications In Year Before or During Measurement Period": ["MedicationDispense": "Dementia Medications"] DementiaMed where DementiaMed.whenHandedOver during Interval[ ( start of "Measurement Period" - 1 year ), end of "Measurement Period" ]`
Logic Definition	Library Name: AdvancedIllnessandFrailtyExclusion
Logic Definition	define "Advanced Illness and Frailty Exclusion Not Including Over Age 80": //If the measure does NOT include populations age 80 and older, then use this logic: Global."CalendarAgeInYearsAt"(FHIRHelpers.ToDate(Patient.birthDate), start of "Measurement Period")>= 65 and "Has Criteria Indicating Frailty" and ( Count("Outpatient Encounters with Advanced Illness")>= 2 or exists ( "Inpatient Encounter with Advanced Illness" ) or exists "Dementia Medications In Year Before or During Measurement Period" )
Logic Definition	Library Name: AdvancedIllnessandFrailtyExclusion
Logic Definition	`// start here define "Long Term Care Periods During Measurement Period": ( [Encounter: "Care Services in Long-Term Residential Facility"] union [Encounter: "Nursing Facility Visit"] ) LongTermFacilityEncounter where LongTermFacilityEncounter.period overlaps "Measurement Period" return LongTermFacilityEncounter.period intersect "Measurement Period"`
Logic Definition	Library Name: AdvancedIllnessandFrailtyExclusion
Logic Definition	`define "Long Term Care Periods Longer Than 90 Consecutive Days": exists ( "Long Term Care Periods During Measurement Period" LongTermCareDuringMP where duration in days of LongTermCareDuringMP > 90 )`
Logic Definition	Library Name: SupplementalDataElements
Logic Definition	`define "SDE Sex": case when Patient.gender = 'male' then Code { code: 'M', system: 'http://hl7.org/fhir/v3/AdministrativeGender', display: 'Male' } when Patient.gender = 'female' then Code { code: 'F', system: 'http://hl7.org/fhir/v3/AdministrativeGender', display: 'Female' } else null end`
Logic Definition	Library Name: SupplementalDataElements
Logic Definition	`define "SDE Payer": [Coverage: type in "Payer"] Payer return { code: Payer.type, period: Payer.period }`
Logic Definition	Library Name: SupplementalDataElements
Logic Definition	`define "SDE Ethnicity": (flatten ( Patient.extension Extension where Extension.url = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity' return Extension.extension )) E where E.url = 'ombCategory' or E.url = 'detailed' return E.value as Coding`
Logic Definition	Library Name: SupplementalDataElements
Logic Definition	`define "SDE Race": (flatten ( Patient.extension Extension where Extension.url = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-race' return Extension.extension )) E where E.url = 'ombCategory' or E.url = 'detailed' return E.value as Coding`
Logic Definition	Library Name: CCSComponent
Logic Definition	`define "SDE Sex": SDE."SDE Sex"`
Logic Definition	Library Name: CCSComponent
Logic Definition	`define "Colonoscopy Performed": [Procedure: "Colonoscopy"] Colonoscopy where Colonoscopy.status = 'completed' and Global."Normalize Interval" ( Colonoscopy.performed ) ends 10 years or less on or before end of "Measurement Period"`
Logic Definition	Library Name: CCSComponent
Logic Definition	`define "Fecal Occult Blood Test Performed": [Observation: "Fecal Occult Blood Test (FOBT)"] FecalOccultResult where FecalOccultResult.status in { 'final', 'amended', 'corrected', 'preliminary' } and FecalOccultResult.value is not null and Global."Normalize Interval" ( FecalOccultResult.effective ) during day of "Measurement Period"`
Logic Definition	Library Name: CCSComponent
Logic Definition	`define "Flexible Sigmoidoscopy Performed": [Procedure: "Flexible Sigmoidoscopy"] FlexibleSigmoidoscopy where FlexibleSigmoidoscopy.status = 'completed' and Global."Normalize Interval" ( FlexibleSigmoidoscopy.performed ) ends 5 years or less on or before end of "Measurement Period"`
Logic Definition	Library Name: CCSComponent
Logic Definition	`define "Fecal Immunochemical Test DNA": [Observation: "FIT DNA"] FitDNA where FitDNA.status in { 'final', 'amended', 'corrected', 'preliminary' } and FitDNA.value is not null and Global."Normalize Interval" ( FitDNA.effective ) occurs 3 years or less on or before day of end of "Measurement Period"`
Logic Definition	Library Name: CCSComponent
Logic Definition	`define "CT Colonography Performed": [Procedure: "CT Colonography"] Colonography where Colonography.status = 'completed' and Global."Normalize Interval" ( Colonography.performed ) ends 5 years or less on or before end of "Measurement Period"`
Logic Definition	Library Name: CCSComponent
Logic Definition	`define "Numerator": exists "Colonoscopy Performed" or exists "Fecal Occult Blood Test Performed" or exists "Flexible Sigmoidoscopy Performed" or exists "Fecal Immunochemical Test DNA" or exists "CT Colonography Performed"`
Logic Definition	Library Name: CCSComponent
Logic Definition	`define "Initial Population": Global."CalendarAgeInYearsAt" ( FHIRHelpers.ToDate ( Patient.birthDate ), start of "Measurement Period" ) in Interval[50, 75] and exists AdultOutpatientEncounters."Qualifying Encounters"`
Logic Definition	Library Name: CCSComponent
Logic Definition	`define "Denominator": "Initial Population"`
Logic Definition	Library Name: CCSComponent
Logic Definition	`define "SDE Payer": SDE."SDE Payer"`
Logic Definition	Library Name: CCSComponent
Logic Definition	`define "SDE Ethnicity": SDE."SDE Ethnicity"`
Logic Definition	Library Name: CCSComponent
Logic Definition	`define "Malignant Neoplasm": [Condition: "Malignant Neoplasm of Colon"] ColorectalCancer where Global."Prevalence Period" ( ColorectalCancer ) starts on or before end of "Measurement Period"`
Logic Definition	Library Name: CCSComponent
Logic Definition	`define "Total Colectomy Performed": [Procedure: "Total Colectomy"] Colectomy where Colectomy.status = 'completed' and Global."Normalize Interval" ( Colectomy.performed ) starts on or before end of "Measurement Period"`
Logic Definition	Library Name: CCSComponent
Logic Definition	`define "Denominator Exclusion": Hospice."Has Hospice" or exists "Malignant Neoplasm" or exists "Total Colectomy Performed" or Frailty."Advanced Illness and Frailty Exclusion Not Including Over Age 80" and Frailty."Long Term Care Periods Longer Than 90 Consecutive Days"`
Logic Definition	Library Name: CCSComponent
Logic Definition	`define "SDE Race": SDE."SDE Race"`
Logic Definition	Library Name: MATGlobalCommonFunctions
Logic Definition	`define function "CalendarAgeInYearsAt"(BirthDateTime DateTime, AsOf DateTime): years between ToDate(BirthDateTime)and ToDate(AsOf)`
Logic Definition	Library Name: MATGlobalCommonFunctions
Logic Definition	`define function "ToDate"(Value DateTime): DateTime(year from Value, month from Value, day from Value, 0, 0, 0, 0, timezoneoffset from Value)`
Logic Definition	Library Name: MATGlobalCommonFunctions
Logic Definition	`define function "Prevalence Period"(condition Condition): Interval[start of "Normalize Interval"(condition.onset), end of "Normalize Abatement"(condition))`
Logic Definition	Library Name: MATGlobalCommonFunctions
Logic Definition	define function "Normalize Abatement"(condition Condition): if condition.abatement is FHIR.dateTime then Interval[FHIRHelpers.ToDateTime(condition.abatement as FHIR.dateTime), FHIRHelpers.ToDateTime(condition.abatement as FHIR.dateTime)] else if condition.abatement is FHIR.Period then FHIRHelpers.ToInterval(condition.abatement as FHIR.Period) else if condition.abatement is FHIR.string then Message(null as Interval<DateTime>, true, '1', 'Error', 'Cannot compute an interval from a String value') else if condition.abatement is FHIR.Age then Interval[FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(condition.abatement as FHIR.Age), FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(condition.abatement as FHIR.Age) + 1 year) else if condition.abatement is FHIR.Range then Interval[FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity((condition.abatement as FHIR.Range).low), FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity((condition.abatement as FHIR.Range).high) + 1 year) else if condition.abatement is FHIR.boolean then Interval[end of "Normalize Interval"(condition.onset), condition.recordedDate) else null
Logic Definition	Library Name: FHIRHelpers
Logic Definition	`define function ToString(value AdministrativeGender): value.value`
Logic Definition	Library Name: FHIRHelpers
Logic Definition	`define function ToString(value ProcedureStatus): value.value`
Logic Definition	Library Name: FHIRHelpers
Logic Definition	`define function ToString(value ObservationStatus): value.value`
Logic Definition	Library Name: FHIRHelpers
Logic Definition	`define function ToDate(value date): value.value`
Logic Definition	Library Name: FHIRHelpers
Logic Definition	/* @description: Converts the given [Period](https://hl7.org/fhir/datatypes.html#Period) value to a CQL DateTime Interval @comment: If the start value of the given period is unspecified, the starting boundary of the resulting interval will be open (meaning the start of the interval is unknown, as opposed to interpreted as the beginning of time). */ define function ToInterval(period FHIR.Period): if period is null then null else if period."start" is null then Interval(period."start".value, period."end".value] else Interval[period."start".value, period."end".value]
Logic Definition	Library Name: FHIRHelpers
Logic Definition	`define function ToString(value EncounterStatus): value.value`
Logic Definition	Library Name: FHIRHelpers
Logic Definition	`define function ToString(value uri): value.value`
Logic Definition	Library Name: FHIRHelpers
Logic Definition	`/* @description: Converts the given FHIR [CodeableConcept](https://hl7.org/fhir/datatypes.html#CodeableConcept) value to a CQL Concept. */ define function ToConcept(concept FHIR.CodeableConcept): if concept is null then null else System.Concept { codes: concept.coding C return ToCode(C), display: concept.text.value }`
Logic Definition	Library Name: FHIRHelpers
Logic Definition	`/* @description: Converts the given FHIR [Coding](https://hl7.org/fhir/datatypes.html#Coding) value to a CQL Code. */ define function ToCode(coding FHIR.Coding): if coding is null then null else System.Code { code: coding.code.value, system: coding.system.value, version: coding.version.value, display: coding.display.value }`
Logic Definition	Library Name: FHIRHelpers
Logic Definition	`define function ToString(value ServiceRequestIntent): value.value`
Logic Definition	Library Name: FHIRHelpers
Logic Definition	`define function ToDateTime(value dateTime): value.value`
Logic Definition	Library Name: FHIRHelpers
Logic Definition	/* @description: Converts the given FHIR [Quantity](https://hl7.org/fhir/datatypes.html#Quantity) value to a CQL Quantity @comment: If the given quantity has a comparator specified, a runtime error is raised. If the given quantity has a system other than UCUM (i.e. `http://unitsofmeasure.org`) or CQL calendar units (i.e. `http://hl7.org/fhirpath/CodeSystem/calendar-units`) an error is raised. For UCUM to calendar units, the `ToCalendarUnit` function is used. @seealso: ToCalendarUnit */ define function ToQuantity(quantity FHIR.Quantity): case when quantity is null then null when quantity.value is null then null when quantity.comparator is not null then Message(null, true, 'FHIRHelpers.ToQuantity.ComparatorQuantityNotSupported', 'Error', 'FHIR Quantity value has a comparator and cannot be converted to a System.Quantity value.') when quantity.system is null or quantity.system.value = 'http://unitsofmeasure.org' or quantity.system.value = 'http://hl7.org/fhirpath/CodeSystem/calendar-units' then System.Quantity { value: quantity.value.value, unit: ToCalendarUnit(Coalesce(quantity.code.value, quantity.unit.value, '1')) } else Message(null, true, 'FHIRHelpers.ToQuantity.InvalidFHIRQuantity', 'Error', 'Invalid FHIR Quantity code: ' & quantity.unit.value & ' (' & quantity.system.value & '\|' & quantity.code.value & ')') end
Logic Definition	Library Name: FHIRHelpers
Logic Definition	/* @description: Converts a UCUM definite duration unit to a CQL calendar duration unit using conversions specified in the [quantities](https://cql.hl7.org/02-authorsguide.html#quantities) topic of the CQL specification. @comment: Note that for durations above days (or weeks), the conversion is understood to be approximate */ define function ToCalendarUnit(unit System.String): case unit when 'ms' then 'millisecond' when 's' then 'second' when 'min' then 'minute' when 'h' then 'hour' when 'd' then 'day' when 'wk' then 'week' when 'mo' then 'month' when 'a' then 'year' else unit end
Logic Definition	Library Name: FHIRHelpers
Logic Definition	`define function ToString(value string): value.value`
Terminology
Code System	Description: Code system SNOMEDCT:2017-09 Resource: `http://snomed.info/sct\|http://snomed.info/sct/731000124108/version/201709` Canonical URL: `http://snomed.info/sct\|http://snomed.info/sct/731000124108/version/201709`
Value Set	Description: Value set Colonoscopy Resource: Colonoscopy Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1020`
Value Set	Description: Value set Fecal Occult Blood Test (FOBT) Resource: Fecal Occult Blood Test (FOBT) Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1011`
Value Set	Description: Value set Flexible Sigmoidoscopy Resource: Flexible Sigmoidoscopy Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1010`
Value Set	Description: Value set FIT DNA Resource: sDNA FIT Test Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1039`
Value Set	Description: Value set CT Colonography Resource: CT Colonography Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1038`
Value Set	Description: Value set Office Visit Resource: Office Visit Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001`
Value Set	Description: Value set Annual Wellness Visit Resource: Annual Wellness Visit Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240`
Value Set	Description: Value set Preventive Care Services - Established Office Visit, 18 and Up Resource: Preventive Care Services Established Office Visit, 18 and Up Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025`
Value Set	Description: Value set Preventive Care Services-Initial Office Visit, 18 and Up Resource: Preventive Care Services Initial Office Visit, 18 and Up Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023`
Value Set	Description: Value set Home Healthcare Services Resource: Home Healthcare Services Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016`
Value Set	Description: Value set Payer Resource: Payer Type Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591`
Value Set	Description: Value set Encounter Inpatient Resource: Encounter Inpatient Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307`
Value Set	Description: Value set Hospice care ambulatory Resource: Hospice Care Ambulatory Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.15`
Value Set	Description: Value set Malignant Neoplasm of Colon Resource: Malignant Neoplasm of Colon Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1001`
Value Set	Description: Value set Total Colectomy Resource: Total Colectomy Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1019`
Value Set	Description: Value set Frailty Device Resource: Frailty Device Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.118.12.1300`
Value Set	Description: Value set Frailty Diagnosis Resource: Frailty Diagnosis Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.113.12.1074`
Value Set	Description: Value set Frailty Encounter Resource: Frailty Encounter Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1088`
Value Set	Description: Value set Frailty Symptom Resource: Frailty Symptom Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.113.12.1075`
Value Set	Description: Value set Outpatient Resource: Outpatient Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1087`
Value Set	Description: Value set Observation Resource: Observation Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1086`
Value Set	Description: Value set ED Resource: ED Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1085`
Value Set	Description: Value set Nonacute Inpatient Resource: Nonacute Inpatient Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1084`
Value Set	Description: Value set Advanced Illness Resource: Advanced Illness Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1082`
Value Set	Description: Value set Acute Inpatient Resource: Acute Inpatient Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1083`
Value Set	Description: Value set Dementia Medications Resource: Dementia Medications Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.196.12.1510`
Value Set	Description: Value set Care Services in Long-Term Residential Facility Resource: Care Services in Long Term Residential Facility Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1014`
Value Set	Description: Value set Nursing Facility Visit Resource: Nursing Facility Visit Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1012`
Direct Reference Code	Display: Discharge to home for hospice care (procedure) Code: 428361000124107 System: `http://snomed.info/sct`
Direct Reference Code	Display: Discharge to healthcare facility for hospice care (procedure) Code: 428371000124100 System: `http://snomed.info/sct`
Dependencies
Dependency	Description: Library SDE Resource: Supplemental Data Elementsversion: null2.0.000) Canonical URL: `http://hl7.org/fhir/uv/cqm/Library/SupplementalDataElements\|2.0.000`
Dependency	Description: Library FHIRHelpers Resource: http://hl7.org/fhir/uv/cql/Library/FHIRHelpers\|4.0.1 Canonical URL: `http://hl7.org/fhir/uv/cql/Library/FHIRHelpers\|4.0.1`
Dependency	Description: Library Global Resource: MAT Global Common Functions FHIR Libraryversion: null5.0.000) Canonical URL: `http://hl7.org/fhir/uv/cqm/Library/MATGlobalCommonFunctions\|5.0.000`
Dependency	Description: Library AdultOutpatientEncounters Resource: Adult Outpatient Encounters Common Libraryversion: null2.0.000) Canonical URL: `http://hl7.org/fhir/uv/cqm/Library/AdultOutpatientEncounters\|2.0.000`
Dependency	Description: Library Hospice Resource: Hospice FHIR Libraryversion: null2.0.000) Canonical URL: `http://hl7.org/fhir/uv/cqm/Library/Hospice\|2.0.000`
Dependency	Description: Library Frailty Resource: Advanced Illness and Frailty Exclusion Libraryversion: null5.12.000) Canonical URL: `http://hl7.org/fhir/uv/cqm/Library/AdvancedIllnessandFrailtyExclusion\|5.12.000`
Data Requirements
Data Requirement	Type: Patient Profile(s): Patient Must Support Elements: url, extension, value
Data Requirement	Type: Procedure Profile(s): Procedure Must Support Elements: code, status, performed Code Filter(s): Path: code ValueSet: Colonoscopy
Data Requirement	Type: Procedure Profile(s): Procedure Must Support Elements: code, status, performed Code Filter(s): Path: code ValueSet: Flexible Sigmoidoscopy
Data Requirement	Type: Procedure Profile(s): Procedure Must Support Elements: code, status, performed Code Filter(s): Path: code ValueSet: CT Colonography
Data Requirement	Type: Procedure Profile(s): Procedure Must Support Elements: code, status, performed Code Filter(s): Path: code ValueSet: Hospice Care Ambulatory
Data Requirement	Type: Procedure Profile(s): Procedure Must Support Elements: code, status, performed Code Filter(s): Path: code ValueSet: Total Colectomy
Data Requirement	Type: Observation Profile(s): Observation Must Support Elements: code, status, value, effective Code Filter(s): Path: code ValueSet: Fecal Occult Blood Test (FOBT)
Data Requirement	Type: Observation Profile(s): Observation Must Support Elements: code, status, value, effective Code Filter(s): Path: code ValueSet: sDNA FIT Test
Data Requirement	Type: Observation Profile(s): Observation Must Support Elements: code, effective Code Filter(s): Path: code ValueSet: Frailty Symptom
Data Requirement	Type: Encounter Profile(s): Encounter Must Support Elements: type, period, status, diagnosis Code Filter(s): Path: type ValueSet: Office Visit
Data Requirement	Type: Encounter Profile(s): Encounter Must Support Elements: type, period, status, diagnosis Code Filter(s): Path: type ValueSet: Annual Wellness Visit
Data Requirement	Type: Encounter Profile(s): Encounter Must Support Elements: type, period, status, diagnosis Code Filter(s): Path: type ValueSet: Preventive Care Services Established Office Visit, 18 and Up
Data Requirement	Type: Encounter Profile(s): Encounter Must Support Elements: type, period, status, diagnosis Code Filter(s): Path: type ValueSet: Preventive Care Services Initial Office Visit, 18 and Up
Data Requirement	Type: Encounter Profile(s): Encounter Must Support Elements: type, period, status, diagnosis Code Filter(s): Path: type ValueSet: Home Healthcare Services
Data Requirement	Type: Encounter Profile(s): Encounter Must Support Elements: type, status, hospitalization, hospitalization.dischargeDisposition, period, diagnosis Code Filter(s): Path: type ValueSet: Encounter Inpatient
Data Requirement	Type: Encounter Profile(s): Encounter Must Support Elements: type, period, status, diagnosis Code Filter(s): Path: type ValueSet: Frailty Encounter
Data Requirement	Type: Encounter Profile(s): Encounter Must Support Elements: type, period, status, diagnosis Code Filter(s): Path: type ValueSet: Outpatient
Data Requirement	Type: Encounter Profile(s): Encounter Must Support Elements: type, period, status, diagnosis Code Filter(s): Path: type ValueSet: Observation
Data Requirement	Type: Encounter Profile(s): Encounter Must Support Elements: type, period, status, diagnosis Code Filter(s): Path: type ValueSet: ED
Data Requirement	Type: Encounter Profile(s): Encounter Must Support Elements: type, period, status, diagnosis Code Filter(s): Path: type ValueSet: Nonacute Inpatient
Data Requirement	Type: Encounter Profile(s): Encounter Must Support Elements: type, diagnosis, period, status Code Filter(s): Path: type ValueSet: Acute Inpatient
Data Requirement	Type: Encounter Profile(s): Encounter Must Support Elements: type, period, status, diagnosis Code Filter(s): Path: type ValueSet: Care Services in Long Term Residential Facility
Data Requirement	Type: Encounter Profile(s): Encounter Must Support Elements: type, period, status, diagnosis Code Filter(s): Path: type ValueSet: Nursing Facility Visit
Data Requirement	Type: Coverage Profile(s): Coverage Must Support Elements: type, period Code Filter(s): Path: type ValueSet: Payer Type
Data Requirement	Type: ServiceRequest Profile(s): ServiceRequest Must Support Elements: code, intent, authoredOn Code Filter(s): Path: code ValueSet: Hospice Care Ambulatory
Data Requirement	Type: Condition Profile(s): Condition Must Support Elements: code Code Filter(s): Path: code ValueSet: Malignant Neoplasm of Colon
Data Requirement	Type: Condition Profile(s): Condition Must Support Elements: code Code Filter(s): Path: code ValueSet: Frailty Diagnosis
Data Requirement	Type: Condition Profile(s): Condition Must Support Elements: code, id Code Filter(s): Path: code ValueSet: Advanced Illness
Data Requirement	Type: DeviceRequest Profile(s): DeviceRequest Must Support Elements: code, authoredOn Code Filter(s): Path: code ValueSet: Frailty Device
Data Requirement	Type: MedicationDispense Profile(s): MedicationDispense Must Support Elements: medication, whenHandedOver Code Filter(s): Path: medication ValueSet: Dementia Medications
Data Requirement	Type: MedicationDispense Profile(s): MedicationDispense Must Support Elements: medication.reference, whenHandedOver
Data Requirement	Type: Medication Profile(s): Medication Must Support Elements: id, code
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