Metadata Title EXM55 - Median Emergency Department Visit Duration Version 5.0.0 Identifier 55 Identifier urn:oid:2.16.840.1.113883.4.642.40.61.29.8 Effective Period 2018-01-01 through 2018-12-31 Approval Date 2019-03-08 Last Review Date 2019-03-08 Experimental true Use Context Clinical Venue = EH Jurisdiction Global (Whole world) Topic Health Quality Measure Document Steward (Publisher) HL7 International / Clinical Quality Information Description This example illustrates a continuous variable measure represented as a FHIR eCQM Measure Basis Encounter Measure Scoring Continuous Variable Measure Type Process Improvement Notation Decreased score indicates improvement Measure Group (Rate) (ID: primary) Initial Population ID: primary-exm55-initial-population Description: No description provided Criteria: Initial Population Measure Population ID: primary-exm55-measure-population Description: No description provided Criteria: Measure Population Measure Population Exclusion ID: primary-exm55-measure-population-exclusion Description: No description provided Criteria: Measure Population Exclusion Measure Observation ID: primary-exm55-measure-population-identifier Description: No description provided Criteria: Measure Observation Input Population: measure-population-identifier AggregateMethod: median Stratifier Code: Stratification 1 Stratifier Code: Stratification 2 Stratifier Code: Stratification 3 Measure Logic Primary Library EXM55 - Median Emergency Department Visit Duration Library (Example Continuous Variable Measure Library) Contents Population Criteria Logic Definitions Terminology Dependencies Data Requirements Population Criteria Measure Group (Rate) (ID: primary) Initial Population define "Initial Population" : "Inpatient Encounter" Encounter with ["Encounter" : "Emergency Department Visit"] ED such that ED.status = 'finished' and ED.period ends 1 hour or less before start of Encounter.period Definition Measure Population define "Measure Population" : "Initial Population" Definition Measure Population Exclusion define "Measure Population Exclusion" : "Inpatient Encounter" Encounter with ["Encounter" : "Emergency Department Visit"] ED such that ED.period ends 1 hour or less before start of Encounter.period and ED.status = 'finished' and ED.hospitalization.admitSource in "Hospital Settings" Definition Measure Observation define function "Measure Observation" (Encounter "Encounter" ) : duration in minutes of "Related ED Visit"(Encounter).period Definition Stratifier define "Stratification 1" : "Inpatient Encounter" Encounter where not (PrincipalDiagnosis(Encounter).code in "Psychiatric/Mental Health Patient") Definition Stratifier define "Stratification 2" : "Inpatient Encounter" Encounter where PrincipalDiagnosis(Encounter).code in "Psychiatric/Mental Health Patient" Definition Stratifier define "Stratification 3" : "Inpatient Encounter" Encounter where PrincipalDiagnosis(Encounter) is null Definition Logic Definitions Logic Definition Library Name: FHIRHelpers /* @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 /* @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 /* @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 define function ToString(value string): value.value Logic Definition Library Name: FHIRHelpers define function ToString(value EncounterStatus): value.value Logic Definition Library Name: EXM55 define "Inpatient Encounter" : ["Encounter"] Encounter where LengthInDays(Encounter.period) <= 120 and Encounter.period ends during "Measurement Period" Logic Definition Library Name: EXM55 define "Stratification 3" : "Inpatient Encounter" Encounter where PrincipalDiagnosis(Encounter) is null Logic Definition Library Name: EXM55 define "Stratification 2" : "Inpatient Encounter" Encounter where PrincipalDiagnosis(Encounter).code in "Psychiatric/Mental Health Patient" Logic Definition Library Name: EXM55 define "Measure Population Exclusion" : "Inpatient Encounter" Encounter with ["Encounter" : "Emergency Department Visit"] ED such that ED.period ends 1 hour or less before start of Encounter.period and ED.status = 'finished' and ED.hospitalization.admitSource in "Hospital Settings" Logic Definition Library Name: EXM55 define "Stratification 1" : "Inpatient Encounter" Encounter where not (PrincipalDiagnosis(Encounter).code in "Psychiatric/Mental Health Patient") Logic Definition Library Name: EXM55 define "Initial Population" : "Inpatient Encounter" Encounter with ["Encounter" : "Emergency Department Visit"] ED such that ED.status = 'finished' and ED.period ends 1 hour or less before start of Encounter.period Logic Definition Library Name: EXM55 define "Measure Population" : "Initial Population" Logic Definition Library Name: EXM55 define function "LengthInDays"(Value Interval<DateTime>): difference in days between start of Value and end of Value Logic Definition Library Name: EXM55 define function "PrincipalDiagnosis"(Encounter Encounter): (singleton from (Encounter.diagnosis D where D.use ~ ToConcept("Billing") and D.rank.value = 1)) PD return singleton from ([Condition: id in "GetId"(PD.condition.reference)]) Logic Definition Library Name: EXM55 define function "GetId"(uri String): Last(Split(uri, '/')) Logic Definition Library Name: EXM55 define function "Measure Observation" (Encounter "Encounter" ) : duration in minutes of "Related ED Visit"(Encounter).period Logic Definition Library Name: EXM55 //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 ) Terminology Code System Description: Code system Diagnosis Role Resource: Diagnosis Role Canonical URL: http://terminology.hl7.org/CodeSystem/diagnosis-role Value Set Description: Value set Psychiatric/Mental Health Patient Resource: Psychiatric/Mental Health Diagnosis Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.299 Value Set Description: Value set Emergency Department Visit Resource: Emergency Department Visit Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292 Value Set Description: Value set Hospital Settings Resource: Hospital Settings Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.126 Direct Reference Code Display: Billing Code: billing System: http://terminology.hl7.org/CodeSystem/diagnosis-role Dependencies 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 Data Requirements Data Requirement Type: Encounter Profile(s): Encounter Must Support Elements: period, use, rank, rank.value, condition, condition.reference Data Requirement Type: Encounter Profile(s): Encounter Must Support Elements: type, period, status, hospitalization, hospitalization.admitSource, use, rank, rank.value, condition, condition.reference Code Filter(s): Path: type ValueSet: Emergency Department Visit Data Requirement Type: Condition Profile(s): Condition Must Support Elements: id Code Filter(s): Path: id Generated using version 0.4.9 of the sample-content-ig Liquid templates
define "Inpatient Encounter" : ["Encounter"] Encounter where LengthInDays(Encounter.period) <= 120 and Encounter.period ends during "Measurement Period"
define "Stratification 3" : "Inpatient Encounter" Encounter where PrincipalDiagnosis(Encounter) is null
define "Stratification 2" : "Inpatient Encounter" Encounter where PrincipalDiagnosis(Encounter).code in "Psychiatric/Mental Health Patient"
define "Measure Population Exclusion" : "Inpatient Encounter" Encounter with ["Encounter" : "Emergency Department Visit"] ED such that ED.period ends 1 hour or less before start of Encounter.period and ED.status = 'finished' and ED.hospitalization.admitSource in "Hospital Settings"
define "Stratification 1" : "Inpatient Encounter" Encounter where not (PrincipalDiagnosis(Encounter).code in "Psychiatric/Mental Health Patient")
define "Initial Population" : "Inpatient Encounter" Encounter with ["Encounter" : "Emergency Department Visit"] ED such that ED.status = 'finished' and ED.period ends 1 hour or less before start of Encounter.period
define "Measure Population" : "Initial Population"
define function "LengthInDays"(Value Interval<DateTime>): difference in days between start of Value and end of 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]
define function "PrincipalDiagnosis"(Encounter Encounter): (singleton from (Encounter.diagnosis D where D.use ~ ToConcept("Billing") and D.rank.value = 1)) PD return singleton from ([Condition: id in "GetId"(PD.condition.reference)])
/* @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 }
/* @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 }
define function "GetId"(uri String): Last(Split(uri, '/'))
define function ToString(value string): value.value
define function ToString(value EncounterStatus): value.value
define function "Measure Observation" (Encounter "Encounter" ) : duration in minutes of "Related ED Visit"(Encounter).period
//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 )
Value set Psychiatric/Mental Health Patient
EXM55 - Median Emergency Department Visit Duration
HL7 International / Clinical Quality Information
This example illustrates a continuous variable measure represented as a FHIR eCQM