Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented - Quality Measure Implementation Guide v1.0.0

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 1.0.0 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: Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented (Experimental)

Official URL: http://hl7.org/fhir/uv/cqm/Measure/HBPComponent				Version: 0.0.001
Standards status: Informative				Computable Name: HBPComponent
Other Identifiers: Version Independent: Uniform Resource Identifier (URI)#http://example.org/fhir/us/cqm/Measure/HBPComponent (use: official, ), Version Specific: Uniform Resource Identifier (URI)#http://example.org/fhir/us/cqm/Measure/22v11 (use: official, ), Short Name: High Blood Pressure Screening (use: usual, ), OID:2.16.840.1.113883.4.642.40.61.29.11
Usage:Clinical Venue: EC

This is an example only.

Metadata
Title	Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented
Version	0.0.001
Short Name	High Blood Pressure Screening
GUID (Version Independent)	http://example.org/fhir/us/cqm/Measure/HBPComponent
GUID (Version Specific)	http://example.org/fhir/us/cqm/Measure/22v11
Identifier	urn:oid:2.16.840.1.113883.4.642.40.61.29.11
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 an example only.
Measure Basis	Encounter
Measure Scoring	Proportion
Measure Type	Process
Improvement Notation	Increased score indicates improvement
Measure Group (Rate) (ID: primary)
Initial Population	ID: primary-hbpcomponent-initial-population Description: No description provided Criteria: Initial Population
Denominator	ID: primary-hbpcomponent-denominator Description: No description provided Criteria: Denominator
Denominator Exclusion	ID: primary-hbpcomponent-denominator-exclusion Description: No description provided Criteria: Denominator Exclusions
Denominator Exception	ID: primary-hbpcomponent-denominator-exception Description: No description provided Criteria: Denominator Exceptions
Numerator	ID: primary-hbpcomponent-numerator Description: No description provided Criteria: Numerator
Supplemental Data Guidance	This guidance provides instructions on how to collect and report supplemental data elements for this measure.
Supplemental Data Elements
Supplemental Data Element	ID: cd02ebb6-a0bf-4196-90f9-80f2a8a79bbf Usage Code: Supplemental Data Description: No description provided Logic Definition: SDE Ethnicity
Supplemental Data Element	ID: a67a3fc7-cedd-4d78-b7b0-4718fa7f3e2b Usage Code: Supplemental Data Description: No description provided Logic Definition: SDE Payer
Supplemental Data Element	ID: 3dc8840d-cc30-44af-a233-3b2b6c602060 Usage Code: Supplemental Data Description: No description provided Logic Definition: SDE Race
Supplemental Data Element	ID: 5a4e95aa-f8b3-400f-89b3-02555a361251 Usage Code: Supplemental Data Description: No description provided Logic Definition: SDE Sex
Measure Logic
Primary Library	HBP 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": "Qualifying Encounter During Measurement Period" QualifyingEncounter with [Patient] BirthDate such that Global."CalendarAgeInYearsAt" ( FHIRHelpers.ToDate ( BirthDate.birthDate ), start of "Measurement Period" ) >= 18` Definition
Denominator
Denominator	`define "Denominator": "Initial Population"` Definition
Denominator Exclusion
Denominator Exclusion	`define "Denominator Exclusions": "Qualifying Encounter During Measurement Period" QualifyingEncounter with [Condition: "Diagnosis of Hypertension"] Hypertension such that Global."Prevalence Period" ( Hypertension ) overlaps before QualifyingEncounter.period` Definition
Denominator Exception
Denominator Exception	`define "Denominator Exceptions": "Encounter with Medical Reason for Not Obtaining or Patient Declined Blood Pressure Measurement" union "Encounter with Order for Hypertension Follow Up Declined by Patient"` Definition
Numerator
Numerator	define "Numerator": "Encounter with Normal Blood Pressure Reading" union ( "Encounter with Prehypertensive Blood Pressure Reading" intersect ( ( "Encounter with Order for Intervention for Hypertension" intersect "Encounter with Order for Follow Up Within One Year" ) union "Encounter with Referral to Alternate Provider for High Blood Pressure Reading" ) ) union ( "Encounter with First Hypertensive Reading" intersect ( ( "Encounter with Order for Intervention for Hypertension" intersect "Encounter with Order for Follow Up Within 4 Weeks" ) union "Encounter with Referral to Alternate Provider for High Blood Pressure Reading" ) ) union ( "Encounter with Second Hypertensive Reading" intersect ( ( "Encounter with Order for Intervention for Hypertension" intersect ( "Encounter with Order for Laboratory Test for Hypertension" union "Encounter with Order for Electrocardiogram for Hypertension" union "Encounter with Order for Hypertension Medication" ) ) union "Encounter with Referral to Alternate Provider for High Blood Pressure Reading" ) ) Definition
Logic Definitions
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: 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: HBPComponent
Logic Definition	`define "SDE Sex": SDE."SDE Sex"`
Logic Definition	Library Name: HBPComponent
Logic Definition	`define "Qualifying Encounter During Measurement Period": [Encounter: "Encounter to Screen for Blood Pressure"] ValidEncounter where ValidEncounter.period during "Measurement Period"`
Logic Definition	Library Name: HBPComponent
Logic Definition	define "Encounter with Normal Blood Pressure Reading": "Qualifying Encounter During Measurement Period" QualifyingEncounter let EncounterLastSystolicBP: Last([Observation: "Systolic blood pressure"] SystolicBP where SystolicBP.effective during QualifyingEncounter.period sort by effective ), EncounterLastDiastolicBP: Last([Observation: "Diastolic blood pressure"] DiastolicBP where DiastolicBP.effective during QualifyingEncounter.period sort by effective ) where EncounterLastSystolicBP.value included in Interval[1 'mm[Hg]', 120 'mm[Hg]' ) and EncounterLastDiastolicBP.value included in Interval[1 'mm[Hg]', 80 'mm[Hg]' )
Logic Definition	Library Name: HBPComponent
Logic Definition	define "Encounter with Prehypertensive Blood Pressure Reading": "Qualifying Encounter During Measurement Period" QualifyingEncounter let EncounterLastSystolicBP: Last([Observation: "Systolic blood pressure"] SystolicBP where SystolicBP.effective during QualifyingEncounter.period sort by effective ), EncounterLastDiastolicBP: Last([Observation: "Diastolic blood pressure"] DiastolicBP where DiastolicBP.effective during QualifyingEncounter.period sort by effective ) where EncounterLastSystolicBP.value included in Interval[1 'mm[Hg]', 140 'mm[Hg]' ) and EncounterLastDiastolicBP.value included in Interval[1 'mm[Hg]', 90 'mm[Hg]' ) and ( EncounterLastSystolicBP.value >= 120 'mm[Hg]' or EncounterLastDiastolicBP.value >= 80 'mm[Hg]' )
Logic Definition	Library Name: HBPComponent
Logic Definition	define "Encounter with Order for Intervention for Hypertension": "Qualifying Encounter During Measurement Period" QualifyingEncounter with ( [ServiceRequest: "Lifestyle Recommendation"] union [ServiceRequest: "Weight Reduction Recommended"] union [ServiceRequest: "Dietary Recommendations"] union [ServiceRequest: "Recommendation to Increase Physical Activity"] union [ServiceRequest: "Referral or Counseling for Alcohol Consumption"] ) HighBloodPressureIntervention such that HighBloodPressureIntervention.authoredOn same day as start of QualifyingEncounter.period
Logic Definition	Library Name: HBPComponent
Logic Definition	`define "Encounter with Order for Follow Up Within One Year": "Qualifying Encounter During Measurement Period" QualifyingEncounter with [ServiceRequest: "Follow Up Within One Year"] FollowupOneYear such that FollowupOneYear.authoredOn same day as start of QualifyingEncounter.period`
Logic Definition	Library Name: HBPComponent
Logic Definition	`define "Encounter with Referral to Alternate Provider for High Blood Pressure Reading": "Qualifying Encounter During Measurement Period" QualifyingEncounter with [ServiceRequest: "Referral to Primary Care or Alternate Provider"] Referral such that Referral.authoredOn same day as start of QualifyingEncounter.period and Referral.reasonCode in "Finding of Elevated Blood Pressure or Hypertension"`
Logic Definition	Library Name: HBPComponent
Logic Definition	define "Encounter with High Blood Pressure Reading": "Qualifying Encounter During Measurement Period" QualifyingEncounter let EncounterLastSystolicBP: Last([Observation: "Systolic blood pressure"] SystolicBP where SystolicBP.effective during QualifyingEncounter.period sort by effective ), EncounterLastDiastolicBP: Last([Observation: "Diastolic blood pressure"] DiastolicBP where DiastolicBP.effective during QualifyingEncounter.period sort by effective ) where EncounterLastSystolicBP.value > 0 'mm[Hg]' and EncounterLastDiastolicBP.value > 0 'mm[Hg]' and ( EncounterLastSystolicBP.value >= 140 'mm[Hg]' or EncounterLastDiastolicBP.value >= 90 'mm[Hg]' )
Logic Definition	Library Name: HBPComponent
Logic Definition	define "Encounter with High Blood Pressure Reading Within Year Prior": "Qualifying Encounter During Measurement Period" QualifyingEncounter let EncounterLastSystolicBP: Last([Observation: "Systolic blood pressure"] SystolicBP where SystolicBP.effective 1 year or less before start of QualifyingEncounter.period sort by effective ), EncounterLastDiastolicBP: Last([Observation: "Diastolic blood pressure"] DiastolicBP where DiastolicBP.effective 1 year or less before start of QualifyingEncounter.period sort by effective ) where EncounterLastSystolicBP.value > 0 'mm[Hg]' and EncounterLastDiastolicBP.value > 0 'mm[Hg]' and ( EncounterLastSystolicBP.value >= 140 'mm[Hg]' or EncounterLastDiastolicBP.value >= 90 'mm[Hg]' )
Logic Definition	Library Name: HBPComponent
Logic Definition	`define "Encounter with First Hypertensive Reading": "Encounter with High Blood Pressure Reading" except "Encounter with High Blood Pressure Reading Within Year Prior"`
Logic Definition	Library Name: HBPComponent
Logic Definition	`define "Encounter with Order for Follow Up Within 4 Weeks": "Qualifying Encounter During Measurement Period" QualifyingEncounter with [ServiceRequest: "Follow Up Within 4 Weeks"] Followup4Weeks such that Followup4Weeks.authoredOn same day as start of QualifyingEncounter.period`
Logic Definition	Library Name: HBPComponent
Logic Definition	`define "Encounter with Second Hypertensive Reading": "Encounter with High Blood Pressure Reading" intersect "Encounter with High Blood Pressure Reading Within Year Prior"`
Logic Definition	Library Name: HBPComponent
Logic Definition	`define "Encounter with Order for Laboratory Test for Hypertension": "Qualifying Encounter During Measurement Period" QualifyingEncounter with [ServiceRequest: "Laboratory Tests for Hypertension"] HypertensionLabs such that HypertensionLabs.authoredOn same day as start of QualifyingEncounter.period`
Logic Definition	Library Name: HBPComponent
Logic Definition	`define "Encounter with Order for Electrocardiogram for Hypertension": "Qualifying Encounter During Measurement Period" QualifyingEncounter with ( [ServiceRequest: "12 lead EKG panel"] union [ServiceRequest: "EKG study"] ) ECG such that ECG.authoredOn same day as start of QualifyingEncounter.period`
Logic Definition	Library Name: HBPComponent
Logic Definition	`define "Encounter with Order for Hypertension Medication": "Qualifying Encounter During Measurement Period" QualifyingEncounter with [MedicationRequest: "Pharmacologic Therapy for Hypertension"] AntihypertensiveMedication such that AntihypertensiveMedication.authoredOn same day as start of QualifyingEncounter.period`
Logic Definition	Library Name: HBPComponent
Logic Definition	define "Numerator": "Encounter with Normal Blood Pressure Reading" union ( "Encounter with Prehypertensive Blood Pressure Reading" intersect ( ( "Encounter with Order for Intervention for Hypertension" intersect "Encounter with Order for Follow Up Within One Year" ) union "Encounter with Referral to Alternate Provider for High Blood Pressure Reading" ) ) union ( "Encounter with First Hypertensive Reading" intersect ( ( "Encounter with Order for Intervention for Hypertension" intersect "Encounter with Order for Follow Up Within 4 Weeks" ) union "Encounter with Referral to Alternate Provider for High Blood Pressure Reading" ) ) union ( "Encounter with Second Hypertensive Reading" intersect ( ( "Encounter with Order for Intervention for Hypertension" intersect ( "Encounter with Order for Laboratory Test for Hypertension" union "Encounter with Order for Electrocardiogram for Hypertension" union "Encounter with Order for Hypertension Medication" ) ) union "Encounter with Referral to Alternate Provider for High Blood Pressure Reading" ) )
Logic Definition	Library Name: HBPComponent
Logic Definition	`define "Initial Population": "Qualifying Encounter During Measurement Period" QualifyingEncounter with [Patient] BirthDate such that Global."CalendarAgeInYearsAt" ( FHIRHelpers.ToDate ( BirthDate.birthDate ), start of "Measurement Period" ) >= 18`
Logic Definition	Library Name: HBPComponent
Logic Definition	`define "Denominator": "Initial Population"`
Logic Definition	Library Name: HBPComponent
Logic Definition	`define "SDE Payer": SDE."SDE Payer"`
Logic Definition	Library Name: HBPComponent
Logic Definition	`define "SDE Ethnicity": SDE."SDE Ethnicity"`
Logic Definition	Library Name: HBPComponent
Logic Definition	`define "Denominator Exclusions": "Qualifying Encounter During Measurement Period" QualifyingEncounter with [Condition: "Diagnosis of Hypertension"] Hypertension such that Global."Prevalence Period" ( Hypertension ) overlaps before QualifyingEncounter.period`
Logic Definition	Library Name: HBPComponent
Logic Definition	`define "SDE Race": SDE."SDE Race"`
Logic Definition	Library Name: HBPComponent
Logic Definition	define "Encounter with Medical Reason for Not Obtaining or Patient Declined Blood Pressure Measurement": "Qualifying Encounter During Measurement Period" QualifyingEncounter with ( [Observation: "Systolic blood pressure"] union [Observation: "Diastolic blood pressure"] ) NoBPScreen such that ( NoBPScreen.code in "Medical Reason" or NoBPScreen.code in "Patient Declined" ) and NoBPScreen.effective same day as start of QualifyingEncounter.period and "Not Done"(NoBPScreen) and NoBPScreen.status = 'final'
Logic Definition	Library Name: HBPComponent
Logic Definition	define "Encounter with Order for Hypertension Follow Up Declined by Patient": "Qualifying Encounter During Measurement Period" QualifyingEncounter with ( [ServiceRequest: "12 lead EKG panel"] union [ServiceRequest: "EKG study"] union [ServiceRequest: "Follow Up Within One Year"] union [ServiceRequest: "Follow Up Within 4 Weeks"] union [ServiceRequest: "Referral to Primary Care or Alternate Provider"] union [ServiceRequest: "Lifestyle Recommendation"] union [ServiceRequest: "Weight Reduction Recommended"] union [ServiceRequest: "Dietary Recommendations"] union [ServiceRequest: "Recommendation to Increase Physical Activity"] union [ServiceRequest: "Referral or Counseling for Alcohol Consumption"] union [ServiceRequest: "Laboratory Tests for Hypertension"] union [MedicationRequest: "Pharmacologic Therapy for Hypertension"] ) NoFollowUpOrdered such that NoFollowUpOrdered.doNotPerform is true and NoFollowUpOrdered.code in "Patient Declined" and NoFollowUpOrdered.authoredOn same day as start of QualifyingEncounter.period
Logic Definition	Library Name: HBPComponent
Logic Definition	`define "Denominator Exceptions": "Encounter with Medical Reason for Not Obtaining or Patient Declined Blood Pressure Measurement" union "Encounter with Order for Hypertension Follow Up Declined by Patient"`
Logic Definition	Library Name: HBPComponent
Logic Definition	`define function "Not Done"(res DomainResource ): if ( res R where ( "GetModiferExtension"(R, 'http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDone').value = true ) ) is not null then true else false`
Logic Definition	Library Name: HBPComponent
Logic Definition	`define function "GetModiferExtension"(res DomainResource, url String ): singleton from "GetModifierExtensions"(res, url)`
Logic Definition	Library Name: HBPComponent
Logic Definition	`define function "GetModifierExtensions"(res DomainResource, url String ): res.modifierExtension E where E.url = ( url ) return E`
Logic Definition	Library Name: FHIRHelpers
Logic Definition	`define function ToString(value AdministrativeGender): 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 ToDateTime(value dateTime): value.value`
Logic Definition	Library Name: FHIRHelpers
Logic Definition	`define function ToDateTime(value instant): value.value`
Logic Definition	Library Name: FHIRHelpers
Logic Definition	`/* @description: Converts the given FHIR [Range](https://hl7.org/fhir/datatypes.html#Range) value to a CQL Interval of Quantity */ define function ToInterval(range FHIR.Range): if range is null then null else Interval[ToQuantity(range.low), ToQuantity(range.high)]`
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	`/* @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 string): value.value`
Logic Definition	Library Name: FHIRHelpers
Logic Definition	`define function ToDate(value date): value.value`
Logic Definition	Library Name: FHIRHelpers
Logic Definition	`define function ToString(value uri): value.value`
Logic Definition	Library Name: FHIRHelpers
Logic Definition	`define function ToBoolean(value boolean): value.value`
Logic Definition	Library Name: FHIRHelpers
Logic Definition	`define function ToString(value ObservationStatus): value.value`
Terminology
Code System	Description: Code system LOINC Resource: Logical Observation Identifiers, Names and Codes (LOINC) Canonical URL: `http://loinc.org`
Value Set	Description: Value set Encounter to Screen for Blood Pressure Resource: Encounter to Screen for Blood Pressure Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1920`
Value Set	Description: Value set Lifestyle Recommendation Resource: Lifestyle Recommendation Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1581`
Value Set	Description: Value set Weight Reduction Recommended Resource: Weight Reduction Recommended Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1510`
Value Set	Description: Value set Dietary Recommendations Resource: Dietary Recommendations Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1515`
Value Set	Description: Value set Recommendation to Increase Physical Activity Resource: Recommendation to Increase Physical Activity Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1518`
Value Set	Description: Value set Referral or Counseling for Alcohol Consumption Resource: Referral or Counseling for Alcohol Consumption Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1583`
Value Set	Description: Value set Follow Up Within One Year Resource: Follow Up Within One Year Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1579`
Value Set	Description: Value set Referral to Primary Care or Alternate Provider Resource: Referral to Primary Care or Alternate Provider Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1580`
Value Set	Description: Value set Finding of Elevated Blood Pressure or Hypertension Resource: Finding of Elevated Blood Pressure or Hypertension Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1047.514`
Value Set	Description: Value set Follow Up Within 4 Weeks Resource: Follow Up Within 4 Weeks Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1578`
Value Set	Description: Value set Laboratory Tests for Hypertension Resource: Laboratory Tests for Hypertension Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1482`
Value Set	Description: Value set Pharmacologic Therapy for Hypertension Resource: Pharmacologic Therapy for Hypertension Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.1577`
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 Diagnosis of Hypertension Resource: Diagnosis of Hypertension Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.263`
Value Set	Description: Value set Medical Reason Resource: Medical Reason Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1007`
Value Set	Description: Value set Patient Declined Resource: Patient Declined Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1582`
Direct Reference Code	Display: Systolic blood pressure Code: 8480-6 System: `http://loinc.org`
Direct Reference Code	Display: Diastolic blood pressure Code: 8462-4 System: `http://loinc.org`
Direct Reference Code	Display: 12 lead EKG panel Code: 34534-8 System: `http://loinc.org`
Direct Reference Code	Display: EKG study Code: 11524-6 System: `http://loinc.org`
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`
Data Requirements
Data Requirement	Type: Patient Profile(s): Patient Must Support Elements: birthDate, url, extension, value
Data Requirement	Type: Encounter Profile(s): Encounter Must Support Elements: type, period Code Filter(s): Path: type ValueSet: Encounter to Screen for Blood Pressure
Data Requirement	Type: Observation Profile(s): Observation Must Support Elements: code, effective, status, value Code Filter(s): Path: code Code(s): LOINC 8480-6: Systolic blood pressure
Data Requirement	Type: Observation Profile(s): Observation Must Support Elements: code, effective, status, value Code Filter(s): Path: code Code(s): LOINC 8462-4: Diastolic blood pressure
Data Requirement	Type: ServiceRequest Profile(s): ServiceRequest Must Support Elements: code, authoredOn Code Filter(s): Path: code Code(s): LOINC 34534-8: 12 lead EKG panel
Data Requirement	Type: ServiceRequest Profile(s): ServiceRequest Must Support Elements: code, authoredOn Code Filter(s): Path: code Code(s): LOINC 11524-6: EKG study
Data Requirement	Type: ServiceRequest Profile(s): ServiceRequest Must Support Elements: code, authoredOn Code Filter(s): Path: code ValueSet: Follow Up Within One Year
Data Requirement	Type: ServiceRequest Profile(s): ServiceRequest Must Support Elements: code, authoredOn Code Filter(s): Path: code ValueSet: Follow Up Within 4 Weeks
Data Requirement	Type: ServiceRequest Profile(s): ServiceRequest Must Support Elements: code, authoredOn, reasonCode Code Filter(s): Path: code ValueSet: Referral to Primary Care or Alternate Provider
Data Requirement	Type: ServiceRequest Profile(s): ServiceRequest Must Support Elements: code, authoredOn Code Filter(s): Path: code ValueSet: Lifestyle Recommendation
Data Requirement	Type: ServiceRequest Profile(s): ServiceRequest Must Support Elements: code, authoredOn Code Filter(s): Path: code ValueSet: Weight Reduction Recommended
Data Requirement	Type: ServiceRequest Profile(s): ServiceRequest Must Support Elements: code, authoredOn Code Filter(s): Path: code ValueSet: Dietary Recommendations
Data Requirement	Type: ServiceRequest Profile(s): ServiceRequest Must Support Elements: code, authoredOn Code Filter(s): Path: code ValueSet: Recommendation to Increase Physical Activity
Data Requirement	Type: ServiceRequest Profile(s): ServiceRequest Must Support Elements: code, authoredOn Code Filter(s): Path: code ValueSet: Referral or Counseling for Alcohol Consumption
Data Requirement	Type: ServiceRequest Profile(s): ServiceRequest Must Support Elements: code, authoredOn Code Filter(s): Path: code ValueSet: Laboratory Tests for Hypertension
Data Requirement	Type: MedicationRequest Profile(s): MedicationRequest Must Support Elements: medication, authoredOn Code Filter(s): Path: medication ValueSet: Pharmacologic Therapy for Hypertension
Data Requirement	Type: MedicationRequest Profile(s): MedicationRequest Must Support Elements: medication.reference, authoredOn
Data Requirement	Type: Medication Profile(s): Medication Must Support Elements: id, code
Data Requirement	Type: Coverage Profile(s): Coverage Must Support Elements: type, period Code Filter(s): Path: type ValueSet: Payer Type
Data Requirement	Type: Condition Profile(s): Condition Must Support Elements: code Code Filter(s): Path: code ValueSet: Diagnosis of Hypertension
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