Metadata Title EXMRatio - Example Ratio Measure Library Version 4.0.0 Identifier EXMRatio Identifier urn:oid:2.16.840.1.113883.4.642.40.61.28.22 Approval Date 2019-08-03 Last Review Date 2019-08-03 Experimental true Jurisdiction Global (Whole world) Steward (Publisher) HL7 International / Clinical Quality Information Description This library is used as an example in the FHIR Quality Measure Implementation Guide Type Logic Library Parameter Name: Patient Use: Out Min Cardinality: 0 Max Cardinality: 1 Type: Patient Parameter Name: Qualifying Encounters Use: Out Min Cardinality: 0 Max Cardinality: * Type: Encounter Parameter Name: Initial Population Use: Out Min Cardinality: 0 Max Cardinality: * Type: Encounter Parameter Name: Denominator Use: Out Min Cardinality: 0 Max Cardinality: * Type: Encounter Parameter Name: Numerator Use: Out Min Cardinality: 0 Max Cardinality: * Type: Encounter Parameter Name: Falls with Major Injury Use: Out Min Cardinality: 0 Max Cardinality: * Type: Observation Data Requirement Type: Patient Profile(s): Patient Data Requirement Type: Encounter Profile(s): Encounter Must Support Elements: type Code Filter(s): Path: type ValueSet: http://example.org/fhir/ValueSet/inpatient Data Requirement Type: Observation Profile(s): Observation Must Support Elements: code, effective Code Filter(s): Path: code ValueSet: http://example.org/fhir/ValueSet/fall Library Content CQL Content /*#xD; Measures the number of inpatient falls with major injury per 1000 patient days.#xD; #xD; “Patient days” are to be calculated such that:#xD; Sum actual hours for all patients, whether in-patient, ED or observation, and divide by 24.#xD; #xD; The approach we envision is starting from an encounter-based eCQM with numerator#xD; and denominator observations to arrive at the following:#xD; #xD; Patient A has a 10 day inpatient encounter. On day 1 she fell 9 times. No more falls in that stay.#xD; #xD; Patient B has a 2 day inpatient encounter. On day 2 he fell 1 time. No other falls in that stay#xD; #xD; Result: 10 falls/12 days = 833/1000 patient days#xD; #xD; Answer: There are multiple considerations involved in the representation of falls with major injury,#xD; this example does not address those considerations, focusing only on the overall structure#xD; of the measure and the final calculation.#xD; #xD; This measure can be represented as an encounter-based ratio measure, with:#xD; #xD; Numerator Observation: Count(Falls with Major Injury)#xD; Denominator Observation: Sum(Encounter Days)#xD; #xD; This does result in a ratio, but there isn't mechanism in the current FHIR measure#xD; to specify that the ratio should be converted to "per 1000 days".#xD; #xD; To support that aspect, we are proposing a scoringUnit extension of the Quality Measure IG#xD; to state the expected units of a ratio measure.#xD; #xD; This is submitted as a tracker to the quality measure IG here:#xD; https://jira.hl7.org/browse/FHIR-30506#xD; #xD; The included EXMRatioFHIRv603-Artifacts.zip is an export of this measure expressed#xD; in the MAT which includes everything but the proprosed scoringUnit extension. That#xD; extension is proposed for inclusion in the May 2021 ballot of the quality measure ig#xD; and is not supported by the MAT at this time.#xD; */#xD; library EXMRatio#xD; #xD; using FHIR version '4.0.1'#xD; #xD; include hl7.fhir.uv.cql.FHIRHelpers version '4.0.1' called FHIRHelpers#xD; #xD; include MATGlobalCommonFunctions version '5.0.000' called Global#xD; #xD; valueset "Inpatient": 'http://example.org/fhir/ValueSet/inpatient'#xD; valueset "Fall": 'http://example.org/fhir/ValueSet/fall'#xD; #xD; context Patient#xD; #xD; define "Initial Population":#xD; "Qualifying Encounters"#xD; #xD; define "Denominator":#xD; "Initial Population"#xD; #xD; define "Numerator":#xD; "Initial Population"#xD; #xD; define "Qualifying Encounters":#xD; ["Encounter": "Inpatient"]#xD; #xD; define "Falls with Major Injury":#xD; ["Observation": "Fall"]#xD; #xD; define function "Denominator Observation"(Encounter "Encounter"):#xD; duration in hours of Global.Hospitalization(Encounter) / 24#xD; #xD; define function "Numerator Observation"(Encounter "Encounter"):#xD; Count(#xD; "Falls with Major Injury" Falls#xD; where Global."Normalize Interval"(Falls.effective) during Encounter.period#xD; )#xD; ELM XML Content Encoded data (21956 characters) ELM JSON Content Encoded data (36248 characters) Generated using version 0.4.9 of the sample-content-ig Liquid templates
EXMRatio - Example Ratio Measure Library
HL7 International / Clinical Quality Information
This library is used as an example in the FHIR Quality Measure Implementation Guide