Quality Measure Implementation Guide
1.0.0 - STU 1
Quality Measure Implementation Guide
1.0.0 - STU 1
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
| Page standards status: Informative |
<Measure xmlns="http://hl7.org/fhir">
<id value="measure-publishable-exm"/>
<meta>
<profile
value="http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-publishablemeasure"/>
<profile
value="http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-computablemeasure"/>
</meta>
<text>
<status value="extensions"/>
<div xmlns="http://www.w3.org/1999/xhtml">
<table class="narrative-table">
<tbody>
<tr>
<th colspan="2" scope="row" class="row-header">Metadata</th>
</tr>
<tr>
<th scope="row" class="row-header">Title</th>
<td class="content-container">EXM Publishable Measure</td>
</tr>
<tr>
<th scope="row" class="row-header">Version</th>
<td class="content-container">2.0.0</td>
</tr>
<tr>
<th scope="row" class="row-header">Short Name</th>
<td class="content-container">EXM-123</td>
</tr>
<tr>
<th scope="row" class="row-header">GUID (Version Independent)</th>
<td class="content-container">urn:uuid:11873bc9-ca0a-4cf3-b8f2-605a950aac74</td>
</tr>
<tr>
<th scope="row" class="row-header">GUID (Version Specific)</th>
<td class="content-container">urn:uuid:b366f29b-347f-464e-8064-c83842d825c7</td>
</tr>
<tr>
<th scope="row" class="row-header">CMS Identifier</th>
<td class="content-container">CMS-123</td>
</tr>
<tr>
<th scope="row" class="row-header">NQF Identifier</th>
<td class="content-container">NQF-123</td>
</tr>
<tr>
<th scope="row" class="row-header">Identifier</th>
<td class="content-container">urn:oid:2.16.840.1.113883.4.642.40.61.29.23</td>
</tr>
<tr>
<th scope="row" class="row-header">Effective Period</th>
<td class="content-container">2018-01-01 + 1 year(s)</td>
</tr>
<tr>
<th scope="row" class="row-header">Approval Date</th>
<td class="content-container">2019-02-17</td>
</tr>
<tr>
<th scope="row" class="row-header">Last Review Date</th>
<td class="content-container">2019-02-17</td>
</tr>
<tr>
<th scope="row" class="row-header">Experimental</th>
<td class="content-container">true</td>
</tr>
<tr>
<th scope="row" class="row-header">Use Context</th>
<td class="content-container"><span title="{http://terminology.hl7.org/CodeSystem/usage-context-type venue}">Clinical Venue</span> = <span title="Codes:{http://hl7.org/fhir/uv/cqm/CodeSystem/intended-venue-codes ec}">EC</span></td>
</tr>
<tr>
<th scope="row" class="row-header">Jurisdiction</th>
<td class="content-container"><span title="Codes:{http://unstats.un.org/unsd/methods/m49/m49.htm 001}">Global (Whole world)</span></td>
</tr>
<tr>
<th scope="row" class="row-header">Topic</th>
<td class="content-container"><span title="Codes:{http://loinc.org 57024-2}">Health Quality Measure Document</span></td>
</tr>
<tr>
<th scope="row" class="row-header">Steward (Publisher)</th>
<td class="content-container">HL7 International / Clinical Quality Information</td>
</tr>
<tr>
<th scope="row" class="row-header">Developer</th>
<td class="content-container">Example Measure Content Developer</td>
</tr>
<tr>
<th scope="row" class="row-header">Description</th>
<td class="content-container"><div><p>An example FHIR-based publishable measure</p>
</div></td>
</tr>
<tr>
<th scope="row" class="row-header">Purpose</th>
<td class="content-container"><div><p>This measure has been developed to support improvement in clinical care.</p>
</div></td>
</tr>
<tr>
<th scope="row" class="row-header">Copyright</th>
<td class="content-container"><div><p>Example Copyright Statement</p>
</div></td>
</tr>
<tr>
<th scope="row" class="row-header">Disclaimer</th>
<td class="content-container"><div><p>Example disclaimer</p>
</div></td>
</tr>
<tr>
<th scope="row" class="row-header">Measure Basis</th>
<td class="content-container">Encounter</td>
</tr>
<tr>
<th scope="row" class="row-header">Measure Scoring</th>
<td class="content-container"><span title="Codes:{http://terminology.hl7.org/CodeSystem/measure-scoring continuous-variable}">Continuous Variable</span></td>
</tr>
<tr>
<th scope="row" class="row-header">Measure Type</th>
<td class="content-container"><span title="Codes:{http://terminology.hl7.org/CodeSystem/measure-type process}">Process</span></td>
</tr>
<tr>
<th scope="row" class="row-header">Risk Adjustment</th>
<td class="content-container">Risk adjustment for this measure is performed by...</td>
</tr>
<tr>
<th scope="row" class="row-header">Rate Aggregation</th>
<td class="content-container">Rate aggregation for this measure is performed by...</td>
</tr>
<tr>
<th scope="row" class="row-header">Rationale</th>
<td class="content-container"><div><p>The rationale of this measure is to...</p>
</div></td>
</tr>
<tr>
<th scope="row" class="row-header">Clinical Recommendation Statement</th>
<td class="content-container"><div><p>The clinical recommendation statement for this measure is...</p>
</div></td>
</tr>
<tr>
<th scope="row" class="row-header">Improvement Notation</th>
<td class="content-container"><span title="Codes:{http://terminology.hl7.org/CodeSystem/measure-improvement-notation increase}">Increased score indicates improvement</span></td>
</tr>
<tr>
<th scope="row" class="row-header">Citation</th>
<td class="content-container">
<div><p>Linder, J.A., D.W. Bates, G.M. Lee, J.A. Finkelstein. 2005. 'Antibiotic treatment of children with sore throat.' JAMA 294(18):2315-2322.</p>
</div>
<em>Content URL</em>: <a href="https://pubmed.ncbi.nlm.nih.gov/16278359/">https://pubmed.ncbi.nlm.nih.gov/16278359/</a>
<br/>
<em>Document</em>: null @ https://pubmed.ncbi.nlm.nih.gov/16278359/
</td>
</tr>
<tr>
<th scope="row" class="row-header">Citation</th>
<td class="content-container">
<div><p>Infectious Diseases Society of America. 2012. 'Clinical Practice Guideline for the Diagnosis and Management of Group A Streptococcal Pharyngitis: 2012 Update.'</p>
</div>
<em>Content URL</em>: <a href="https://pubmed.ncbi.nlm.nih.gov/23091044/">https://pubmed.ncbi.nlm.nih.gov/23091044/</a>
<br/>
<em>Document</em>: null @ https://pubmed.ncbi.nlm.nih.gov/23091044/
</td>
</tr>
<tr>
<th scope="row" class="row-header">Citation</th>
<td class="content-container">
<div><p>Roberts, R.R., B. Hota, I. Ahmad, et al. 'Hospital and Societal Costs of Antimicrobial-Resistant Infections in a Chicago Teaching Hospital: Implications for Antibiotic Stewardship.' Clin Infect Dis. Oct 2009; 49(8):1175-84.</p>
</div>
<em>Content URL</em>: <a href="https://pubmed.ncbi.nlm.nih.gov/19739972/">https://pubmed.ncbi.nlm.nih.gov/19739972/</a>
<br/>
<em>Document</em>: null @ https://pubmed.ncbi.nlm.nih.gov/19739972/
</td>
</tr>
<tr>
<th scope="row" class="row-header">Citation</th>
<td class="content-container">
<div><p>Example citation to draft publication</p>
</div>
<em>Content URL</em>: <a href="http://example.org/publications/1234">http://example.org/publications/1234</a>
<br/>
<em>Document</em>: null @ http://example.org/publications/1234
</td>
</tr>
<tr>
<th scope="row" class="row-header">Guidance (Usage)</th>
<td class="content-container">Users of this measure should be aware of...</td>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header">Measure Group (Rate) (ID: primary)</th>
</tr>
<tr>
<th scope="row" class="row-header">Initial Population</th>
<td class="content-container">
<em>ID</em>: primary-publishablexm-initial-population
<br/>
<em>Description</em>: No description provided
<em>Criteria</em>: <a href="#primary-primary-publishablexm-initial-population">Initial Population</a>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Measure Population</th>
<td class="content-container">
<em>ID</em>: primary-publishablexm-measure-population
<br/>
<em>Description</em>: No description provided
<em>Criteria</em>: <a href="#primary-primary-publishablexm-measure-population">Measure Population</a>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Measure Observation</th>
<td class="content-container">
<em>ID</em>: primary-publishablexm-measure-observation
<br/>
<em>Description</em>: No description provided
<em>Criteria</em>: <a href="#primary-primary-publishablexm-measure-observation">Measure Observation</a>
</td>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header">Supplemental Data Elements</th>
</tr>
<tr>
<th scope="row" class="row-header">Supplemental Data Element</th>
<td class="content-container">
<em>ID</em>: sde-ethnicity
<br/>
<em>Usage Code</em>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/measure-data-usage supplemental-data}">Supplemental Data</span>
<br/>
<em>Description</em>: No description provided
<br/>
<em>Logic Definition</em>: <a href="#exmpublishablelibrary-sde-ethnicity">SDE Ethnicity</a>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Supplemental Data Element</th>
<td class="content-container">
<em>ID</em>: sde-race
<br/>
<em>Usage Code</em>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/measure-data-usage supplemental-data}">Supplemental Data</span>
<br/>
<em>Description</em>: No description provided
<br/>
<em>Logic Definition</em>: <a href="#exmpublishablelibrary-sde-race">SDE Race</a>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Supplemental Data Element</th>
<td class="content-container">
<em>ID</em>: sde-payer
<br/>
<em>Usage Code</em>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/measure-data-usage supplemental-data}">Supplemental Data</span>
<br/>
<em>Description</em>: No description provided
<br/>
<em>Logic Definition</em>: <a href="#exmpublishablelibrary-sde-payer">SDE Payer</a>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Supplemental Data Element</th>
<td class="content-container">
<em>ID</em>: sde-sex
<br/>
<em>Usage Code</em>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/measure-data-usage supplemental-data}">Supplemental Data</span>
<br/>
<em>Description</em>: No description provided
<br/>
<em>Logic Definition</em>: <a href="#exmpublishablelibrary-sde-sex">SDE Sex</a>
</td>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header">Measure Logic</th>
</tr>
<tr>
<th scope="row" class="row-header">Primary Library</th>
<td class="content-container"><a href="Library-EXMPublishableLibrary.html">Example Publishable Library</a></td>
</tr>
<tr>
<th scope="row" class="row-header">Contents</th>
<td class="content-container">
<em><a href="#population-criteria">Population Criteria</a></em>
<br/>
<em><a href="#definitions">Logic Definitions</a></em>
<br/>
<em><a href="#terminology">Terminology</a></em>
<br/>
<em><a href="#dependencies">Dependencies</a></em>
<br/>
<em><a href="#data-requirements">Data Requirements</a></em>
<br/>
</td>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header"><a name="population-criteria"> </a>Population Criteria</th>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header">Measure Group (Rate) (ID: primary)</th>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
Initial Population
</th>
</tr>
<tr>
<td>
<a name="primary-primary-publishablexm-initial-population"> </a>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Initial Population" : "Inpatient Encounter" Encounter</code></pre>
<a href="#exmpublishablelibrary-initial-population"><em>Definition</em></a>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
Measure Population
</th>
</tr>
<tr>
<td>
<a name="primary-primary-publishablexm-measure-population"> </a>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Measure Population" : "Initial Population"</code></pre>
<a href="#exmpublishablelibrary-measure-population"><em>Definition</em></a>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
Measure Observation
</th>
</tr>
<tr>
<td>
<a name="primary-primary-publishablexm-measure-observation"> </a>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define function "Measure Observation" (Encounter "Encounter" ) : duration in minutes of "Related ED Visit"(Encounter).period</code></pre>
<a href="#exmpublishablelibrary-measure-observation"><em>Definition</em></a>
</td>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header"><a name="definitions"> </a>Logic Definitions</th>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> EXMPublishableLibrary</td>
</tr>
<tr>
<td>
<a name="exmpublishablelibrary-sde-sex"> </a>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">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</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> EXMPublishableLibrary</td>
</tr>
<tr>
<td>
<a name="exmpublishablelibrary-sde-payer"> </a>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "SDE Payer": [Coverage: type in "Payer"] Payer return { code: Payer.type, period: Payer.period }</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> EXMPublishableLibrary</td>
</tr>
<tr>
<td>
<a name="exmpublishablelibrary-inpatient-encounter"> </a>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Inpatient Encounter" : ["Encounter"] Encounter where LengthInDays(Encounter.period) <= 120 and Encounter.period ends during "Measurement Period"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> EXMPublishableLibrary</td>
</tr>
<tr>
<td>
<a name="exmpublishablelibrary-initial-population"> </a>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Initial Population" : "Inpatient Encounter" Encounter</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> EXMPublishableLibrary</td>
</tr>
<tr>
<td>
<a name="exmpublishablelibrary-sde-ethnicity"> </a>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">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</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> EXMPublishableLibrary</td>
</tr>
<tr>
<td>
<a name="exmpublishablelibrary-sde-race"> </a>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">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</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> EXMPublishableLibrary</td>
</tr>
<tr>
<td>
<a name="exmpublishablelibrary-measure-population"> </a>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Measure Population" : "Initial Population"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> EXMPublishableLibrary</td>
</tr>
<tr>
<td>
<a name="exmpublishablelibrary-lengthindays"> </a>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define function "LengthInDays"(Value Interval<DateTime>): difference in days between start of Value and end of Value</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> EXMPublishableLibrary</td>
</tr>
<tr>
<td>
<a name="exmpublishablelibrary-measure-observation"> </a>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define function "Measure Observation" (Encounter "Encounter" ) : duration in minutes of "Related ED Visit"(Encounter).period</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> EXMPublishableLibrary</td>
</tr>
<tr>
<td>
<a name="exmpublishablelibrary-related-ed-visit"> </a>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">//Measure Observation define function "Related ED Visit" (Encounter "Encounter" ) : Last(["Encounter" : "Emergency Department Visit"] ED where ED.status = 'finished' and ED.period ends 1 hour or less before start of Encounter.period sort by start of period )</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> FHIRHelpers</td>
</tr>
<tr>
<td>
<a name="fhirhelpers-tostring"> </a>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define function ToString(value AdministrativeGender): value.value</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> FHIRHelpers</td>
</tr>
<tr>
<td>
<a name="fhirhelpers-tointerval"> </a>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/* @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]</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> FHIRHelpers</td>
</tr>
<tr>
<td>
<a name="fhirhelpers-tostring"> </a>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define function ToString(value uri): value.value</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> FHIRHelpers</td>
</tr>
<tr>
<td>
<a name="fhirhelpers-tostring"> </a>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define function ToString(value EncounterStatus): value.value</code></pre>
</td>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header"><a name="terminology"> </a>Terminology</th>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Payer
<br/>
<em>Resource</em>: <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.114222.4.11.3591/expansion">Payer Type</a>
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Emergency Department Visit
<br/>
<em>Resource</em>: <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.292/expansion">Emergency Department Visit</a>
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292</tt>
</td>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header"><a name="dependencies"> </a>Dependencies</th>
</tr>
<tr>
<th scope="row" class="row-header">Dependency</th>
<td class="content-container">
<em>Description</em>: Library FHIRHelpers
<br/>
<em>Resource</em>: <a href="http://hl7.org/fhir/uv/cql/STU2/Library-FHIRHelpers.html">http://hl7.org/fhir/uv/cql/Library/FHIRHelpers|4.0.1</a>
<br/>
<em>Canonical URL</em>: <tt>http://hl7.org/fhir/uv/cql/Library/FHIRHelpers|4.0.1</tt>
</td>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header"><a name="data-requirements"> </a>Data Requirements</th>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Patient
<br/>
<em>Profile(s)</em>:
<a href="http://hl7.org/fhir/R4/patient.html">Patient</a>
<br/>
<em>Must Support Elements</em>: url, extension, value
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Coverage
<br/>
<em>Profile(s)</em>:
<a href="http://hl7.org/fhir/R4/coverage.html">Coverage</a>
<br/>
<em>Must Support Elements</em>: type, period
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: type</span>
<br/>
<span class="tab-one"><em>ValueSet</em>:</span> <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.114222.4.11.3591/expansion">Payer Type</a>
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Encounter
<br/>
<em>Profile(s)</em>:
<a href="http://hl7.org/fhir/R4/encounter.html">Encounter</a>
<br/>
<em>Must Support Elements</em>: type, status, period
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: type</span>
<br/>
<span class="tab-one"><em>ValueSet</em>:</span> <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.292/expansion">Emergency Department Visit</a>
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Encounter
<br/>
<em>Profile(s)</em>:
<a href="http://hl7.org/fhir/R4/encounter.html">Encounter</a>
<br/>
<em>Must Support Elements</em>: period
<br/>
</td>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header">Generated using version 0.4.9 of the sample-content-ig Liquid templates</th>
</tr>
</tbody>
</table>
</div>
</text>
<contained>
<Library>
<id value="effective-data-requirements"/>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="EXMPublishableLibrary"/>
</extension>
<extension url="name">
<valueString value="SDE Sex"/>
</extension>
<extension url="statement">
<valueString
value="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"/>
</extension>
<extension url="displaySequence">
<valueInteger value="0"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="EXMPublishableLibrary"/>
</extension>
<extension url="name">
<valueString value="SDE Payer"/>
</extension>
<extension url="statement">
<valueString
value="define "SDE Payer": [Coverage: type in "Payer"] Payer return { code: Payer.type, period: Payer.period }"/>
</extension>
<extension url="displaySequence">
<valueInteger value="1"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="EXMPublishableLibrary"/>
</extension>
<extension url="name">
<valueString value="Inpatient Encounter"/>
</extension>
<extension url="statement">
<valueString
value="define "Inpatient Encounter" : ["Encounter"] Encounter where LengthInDays(Encounter.period) <= 120 and Encounter.period ends during "Measurement Period""/>
</extension>
<extension url="displaySequence">
<valueInteger value="2"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="EXMPublishableLibrary"/>
</extension>
<extension url="name">
<valueString value="Initial Population"/>
</extension>
<extension url="statement">
<valueString
value="define "Initial Population" : "Inpatient Encounter" Encounter"/>
</extension>
<extension url="displaySequence">
<valueInteger value="3"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="EXMPublishableLibrary"/>
</extension>
<extension url="name">
<valueString value="SDE Ethnicity"/>
</extension>
<extension url="statement">
<valueString
value="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"/>
</extension>
<extension url="displaySequence">
<valueInteger value="4"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="EXMPublishableLibrary"/>
</extension>
<extension url="name">
<valueString value="SDE Race"/>
</extension>
<extension url="statement">
<valueString
value="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"/>
</extension>
<extension url="displaySequence">
<valueInteger value="5"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="EXMPublishableLibrary"/>
</extension>
<extension url="name">
<valueString value="Measure Population"/>
</extension>
<extension url="statement">
<valueString
value="define "Measure Population" : "Initial Population""/>
</extension>
<extension url="displaySequence">
<valueInteger value="6"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="FHIRHelpers"/>
</extension>
<extension url="name">
<valueString value="ToString"/>
</extension>
<extension url="statement">
<valueString
value="define function ToString(value AdministrativeGender): value.value"/>
</extension>
<extension url="displaySequence">
<valueInteger value="7"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="EXMPublishableLibrary"/>
</extension>
<extension url="name">
<valueString value="LengthInDays"/>
</extension>
<extension url="statement">
<valueString
value="define function "LengthInDays"(Value Interval<DateTime>): difference in days between start of Value and end of Value"/>
</extension>
<extension url="displaySequence">
<valueInteger value="8"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="FHIRHelpers"/>
</extension>
<extension url="name">
<valueString value="ToInterval"/>
</extension>
<extension url="statement">
<valueString
value="/* @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]"/>
</extension>
<extension url="displaySequence">
<valueInteger value="9"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="FHIRHelpers"/>
</extension>
<extension url="name">
<valueString value="ToString"/>
</extension>
<extension url="statement">
<valueString
value="define function ToString(value uri): value.value"/>
</extension>
<extension url="displaySequence">
<valueInteger value="10"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="EXMPublishableLibrary"/>
</extension>
<extension url="name">
<valueString value="Measure Observation"/>
</extension>
<extension url="statement">
<valueString
value="define function "Measure Observation" (Encounter "Encounter" ) : duration in minutes of "Related ED Visit"(Encounter).period"/>
</extension>
<extension url="displaySequence">
<valueInteger value="11"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="EXMPublishableLibrary"/>
</extension>
<extension url="name">
<valueString value="Related ED Visit"/>
</extension>
<extension url="statement">
<valueString
value="//Measure Observation define function "Related ED Visit" (Encounter "Encounter" ) : Last(["Encounter" : "Emergency Department Visit"] ED where ED.status = 'finished' and ED.period ends 1 hour or less before start of Encounter.period sort by start of period )"/>
</extension>
<extension url="displaySequence">
<valueInteger value="12"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="FHIRHelpers"/>
</extension>
<extension url="name">
<valueString value="ToString"/>
</extension>
<extension url="statement">
<valueString
value="define function ToString(value EncounterStatus): value.value"/>
</extension>
<extension url="displaySequence">
<valueInteger value="13"/>
</extension>
</extension>
<name value="EffectiveDataRequirements"/>
<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://hl7.org/fhir/uv/cql/Library/FHIRHelpers|4.0.1"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Payer"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Emergency Department Visit"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292"/>
</relatedArtifact>
<parameter>
<name value="Measurement Period"/>
<use value="in"/>
<min value="0"/>
<max value="1"/>
<type value="Period"/>
</parameter>
<parameter>
<name value="SDE Sex"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="Coding"/>
</parameter>
<parameter>
<name value="SDE Payer"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Resource"/>
</parameter>
<parameter>
<name value="Initial Population"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Encounter"/>
</parameter>
<parameter>
<name value="SDE Ethnicity"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Coding"/>
</parameter>
<parameter>
<name value="SDE Race"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Coding"/>
</parameter>
<parameter>
<name value="Measure Population"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Encounter"/>
</parameter>
<dataRequirement>
<type value="Patient"/>
<profile value="http://hl7.org/fhir/StructureDefinition/Patient"/>
<mustSupport value="url"/>
<mustSupport value="extension"/>
<mustSupport value="value"/>
</dataRequirement>
<dataRequirement>
<type value="Coverage"/>
<profile value="http://hl7.org/fhir/StructureDefinition/Coverage"/>
<mustSupport value="type"/>
<mustSupport value="period"/>
<codeFilter>
<path value="type"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Encounter"/>
<profile value="http://hl7.org/fhir/StructureDefinition/Encounter"/>
<mustSupport value="type"/>
<mustSupport value="status"/>
<mustSupport value="period"/>
<codeFilter>
<path value="type"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Encounter"/>
<profile value="http://hl7.org/fhir/StructureDefinition/Encounter"/>
<mustSupport value="period"/>
</dataRequirement>
</Library>
</contained>
<extension
url="http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis">
<valueCode value="Encounter"/>
</extension>
<extension
url="http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-softwaresystem">
<valueReference>🔗
<reference value="Device/software-system-example"/>
</valueReference>
</extension>
<extension
url="http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.term">
<extension url="code">
<valueCodeableConcept>
<coding>
<system value="http://example.org/fhir/CodeSystem/measure-terms"/>
<code value="example-term-code"/>
<display value="Example Term Display"/>
</coding>
</valueCodeableConcept>
</extension>
<extension url="definition">
<valueMarkdown
value="A term used in the measure that bears clearly definition to communicate the measure intent"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements" id="effective-data-requirements">
<valueCanonical value="#effective-data-requirements"/>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
<valueCode value="cqi"/>
</extension>
<url value="http://hl7.org/fhir/uv/cqm/Measure/measure-publishable-exm"/>
<identifier>
<use value="usual"/>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/artifact-identifier-type"/>
<code value="short-name"/>
</coding>
</type>
<system value="http://example.org/fhir/cqi/ecqm/Measure/Identifier/exm"/>
<value value="EXM-123"/>
</identifier>
<identifier>
<use value="official"/>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/artifact-identifier-type"/>
<code value="version-independent"/>
</coding>
</type>
<system value="urn:ietf:rfc:3986"/>
<value value="urn:uuid:11873bc9-ca0a-4cf3-b8f2-605a950aac74"/>
</identifier>
<identifier>
<use value="official"/>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/artifact-identifier-type"/>
<code value="version-specific"/>
</coding>
</type>
<system value="urn:ietf:rfc:3986"/>
<value value="urn:uuid:b366f29b-347f-464e-8064-c83842d825c7"/>
</identifier>
<identifier>
<use value="official"/>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/artifact-identifier-type"/>
<code value="endorser"/>
</coding>
</type>
<system value="http://example.org/fhir/cqi/ecqm/Measure/Identifier/nqf"/>
<value value="NQF-123"/>
<assigner>
<display value="NQF"/>
</assigner>
</identifier>
<identifier>
<use value="official"/>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/artifact-identifier-type"/>
<code value="publisher"/>
</coding>
</type>
<system value="http://example.org/fhir/cqi/ecqm/Measure/Identifier/cms"/>
<value value="CMS-123"/>
<assigner>
<display value="CMS"/>
</assigner>
</identifier>
<identifier>
<system value="urn:ietf:rfc:3986"/>
<value value="urn:oid:2.16.840.1.113883.4.642.40.61.29.23"/>
</identifier>
<version value="2.0.0"/>
<name value="PublishableMeasureEXM"/>
<title value="EXM Publishable Measure"/>
<status value="active"/>
<experimental value="true"/>
<date value="2025-08-13"/>
<publisher value="HL7 International / Clinical Quality Information"/>
<contact>
<telecom>
<system value="url"/>
<value value="http://www.hl7.org/Special/committees/cqi"/>
</telecom>
</contact>
<description value="An example FHIR-based publishable measure"/>
<useContext>
<code>
<system
value="http://terminology.hl7.org/CodeSystem/usage-context-type"/>
<code value="venue"/>
<display value="Clinical Venue"/>
</code>
<valueCodeableConcept>
<coding>
<system
value="http://hl7.org/fhir/uv/cqm/CodeSystem/intended-venue-codes"/>
<code value="ec"/>
<display value="EC"/>
</coding>
</valueCodeableConcept>
</useContext>
<jurisdiction>
<coding>
<system value="http://unstats.un.org/unsd/methods/m49/m49.htm"/>
<code value="001"/>
</coding>
</jurisdiction>
<purpose
value="This measure has been developed to support improvement in clinical care."/>
<usage value="Users of this measure should be aware of..."/>
<copyright value="Example Copyright Statement"/>
<approvalDate value="2019-02-17"/>
<lastReviewDate value="2019-02-17"/>
<effectivePeriod>
<extension
url="http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-effectivePeriodAnchor">
<valueDateTime value="2018-01-01"/>
</extension>
<extension
url="http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-effectivePeriodDuration">
<valueDuration>
<value value="1"/>
<system value="http://unitsofmeasure.org"/>
<code value="a"/>
</valueDuration>
</extension>
<start value="2018-01-01"/>
<end value="2018-12-31"/>
</effectivePeriod>
<topic>
<coding>
<system value="http://loinc.org"/>
<code value="57024-2"/>
</coding>
<text value="Health Quality Measure Document"/>
</topic>
<author>
<name value="Example Measure Content Developer"/>
</author>
<relatedArtifact>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-isPrimaryCitation">
<valueBoolean value="true"/>
</extension>
<type value="citation"/>
<citation
value="Linder, J.A., D.W. Bates, G.M. Lee, J.A. Finkelstein. 2005. 'Antibiotic treatment of children with sore throat.' JAMA 294(18):2315-2322."/>
<url value="https://pubmed.ncbi.nlm.nih.gov/16278359/"/>
<document>
<url value="https://pubmed.ncbi.nlm.nih.gov/16278359/"/>
</document>
</relatedArtifact>
<relatedArtifact>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-isPrimaryCitation">
<valueBoolean value="true"/>
</extension>
<type value="citation"/>
<citation
value="Infectious Diseases Society of America. 2012. 'Clinical Practice Guideline for the Diagnosis and Management of Group A Streptococcal Pharyngitis: 2012 Update.'"/>
<url value="https://pubmed.ncbi.nlm.nih.gov/23091044/"/>
<document>
<url value="https://pubmed.ncbi.nlm.nih.gov/23091044/"/>
</document>
</relatedArtifact>
<relatedArtifact>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-isPrimaryCitation">
<valueBoolean value="true"/>
</extension>
<type value="citation"/>
<citation
value="Roberts, R.R., B. Hota, I. Ahmad, et al. 'Hospital and Societal Costs of Antimicrobial-Resistant Infections in a Chicago Teaching Hospital: Implications for Antibiotic Stewardship.' Clin Infect Dis. Oct 2009; 49(8):1175-84."/>
<url value="https://pubmed.ncbi.nlm.nih.gov/19739972/"/>
<document>
<url value="https://pubmed.ncbi.nlm.nih.gov/19739972/"/>
</document>
</relatedArtifact>
<relatedArtifact>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-publicationStatus">
<valueCode value="draft"/>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-publicationDate">
<valueDate value="2019-01-01"/>
</extension>
<type value="citation"/>
<citation value="Example citation to draft publication"/>
<url value="http://example.org/publications/1234"/>
<document>
<url value="http://example.org/publications/1234"/>
</document>
</relatedArtifact>
<library value="http://hl7.org/fhir/uv/cqm/Library/EXMPublishableLibrary"/>
<disclaimer value="Example disclaimer"/>
<scoring>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/measure-scoring"/>
<code value="continuous-variable"/>
<display value="Continuous Variable"/>
</coding>
</scoring>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/measure-type"/>
<code value="process"/>
</coding>
</type>
<riskAdjustment
value="Risk adjustment for this measure is performed by..."/>
<rateAggregation
value="Rate aggregation for this measure is performed by..."/>
<rationale value="The rationale of this measure is to..."/>
<clinicalRecommendationStatement
value="The clinical recommendation statement for this measure is..."/>
<improvementNotation>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-improvement-notation"/>
<code value="increase"/>
<display value="Increased score indicates improvement"/>
</coding>
</improvementNotation>
<group id="group-1">
<extension
url="http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.linkId">
<valueString value="primary"/>
</extension>
<population id="initial-population">
<extension
url="http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.population.linkId">
<valueString value="primary-publishablexm-initial-population"/>
</extension>
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="initial-population"/>
<display value="Initial Population"/>
</coding>
</code>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Initial Population"/>
</criteria>
</population>
<population id="measure-population">
<extension
url="http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.population.linkId">
<valueString value="primary-publishablexm-measure-population"/>
</extension>
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="measure-population"/>
<display value="Measure Population"/>
</coding>
</code>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Measure Population"/>
</criteria>
</population>
<population id="measure-observation">
<extension
url="http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.population.linkId">
<valueString value="primary-publishablexm-measure-observation"/>
</extension>
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="measure-observation"/>
<display value="Measure Observation"/>
</coding>
</code>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Measure Observation"/>
</criteria>
</population>
</group>
<supplementalData id="sde-ethnicity">
<extension
url="http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.supplementalData.linkId">
<valueString value="primary-sde-ethnicity"/>
</extension>
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="supplemental-data"/>
</coding>
</usage>
<criteria>
<language value="text/cql-identifier"/>
<expression value="SDE Ethnicity"/>
</criteria>
</supplementalData>
<supplementalData id="sde-race">
<extension
url="http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.supplementalData.linkId">
<valueString value="primary-sde-race"/>
</extension>
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="supplemental-data"/>
</coding>
</usage>
<criteria>
<language value="text/cql-identifier"/>
<expression value="SDE Race"/>
</criteria>
</supplementalData>
<supplementalData id="sde-payer">
<extension
url="http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.supplementalData.linkId">
<valueString value="primary-sde-payer"/>
</extension>
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="supplemental-data"/>
</coding>
</usage>
<criteria>
<language value="text/cql-identifier"/>
<expression value="SDE Payer"/>
</criteria>
</supplementalData>
<supplementalData id="sde-sex">
<extension
url="http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.supplementalData.linkId">
<valueString value="primary-sde-sex"/>
</extension>
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="supplemental-data"/>
</coding>
</usage>
<criteria>
<language value="text/cql-identifier"/>
<expression value="SDE Sex"/>
</criteria>
</supplementalData>
</Measure>
IG © 2019+ HL7 International / Clinical Quality Information. Package hl7.fhir.uv.cqm#1.0.0 based on FHIR 4.0.1. Generated 2025-08-27
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