Quality Measure Implementation Guide
2.0.0 - STU 2
Quality Measure Implementation Guide
2.0.0 - STU 2
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 2.0.0 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="EXM55-FHIR"/>
<meta>
<profile
value="http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-cvmeasure"/>
<profile
value="http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-computablemeasure"/>
<profile
value="http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-shareablemeasure"/>
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<language value="en"/>
<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"><a name="metadata"> </a>Metadata</th>
</tr>
<tr>
<th scope="row" class="row-header">Title</th>
<td class="content-container">EXM55 - Median Emergency Department Visit Duration</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">Identifier</th>
<td class="content-container">55</td>
</tr>
<tr>
<th scope="row" class="row-header">Identifier</th>
<td class="content-container">urn:oid:2.16.840.1.113883.4.642.40.61.29.8</td>
</tr>
<tr>
<th scope="row" class="row-header">Effective Period</th>
<td class="content-container">2018-01-01 through 2018-12-31</td>
</tr>
<tr>
<th scope="row" class="row-header">Approval Date</th>
<td class="content-container">2019-03-08</td>
</tr>
<tr>
<th scope="row" class="row-header">Last Review Date</th>
<td class="content-container">2019-03-08</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">
Clinical Venue
=
EH
</td>
</tr>
<tr>
<th scope="row" class="row-header">Jurisdiction</th>
<td class="content-container">
<a href="http://unstats.un.org/unsd/methods/m49/m49.htm">http://unstats.un.org/unsd/methods/m49/m49.htm</a>#001
</td>
</tr>
<tr>
<th scope="row" class="row-header">Topic</th>
<td class="content-container">
Health Quality Measure Document
</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">Description</th>
<td class="content-container"><div><p>This example illustrates a continuous variable measure represented as a FHIR eCQM</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">
Continuous Variable
</td>
</tr>
<tr>
<th scope="row" class="row-header">Improvement Notation</th>
<td class="content-container">
Decreased score indicates improvement
</td>
</tr>
<tr>
<th scope="row" class="row-header">Measure Type</th>
<td class="content-container">
<a href="http://terminology.hl7.org/7.3.0/CodeSystem-measure-type.html">http://terminology.hl7.org/CodeSystem/measure-type</a>#process
</td>
</tr>
<tr>
<th scope="row" class="row-header"><a name="contents"> </a>Contents</th>
<td class="content-container">
<em><a href="#metadata">Metadata</a></em>
<br/>
<em><a href="#contents">Contents</a></em>
<br/>
<em><a href="#measure-rates">Measure Rates (Groups)</a></em>
<br/>
<em><a href="#supplemental-data">Supplemental Data</a></em>
<br/>
<em><a href="#measure-logic">Measure Logic</a></em>
<br/>
<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="measure-rates"> </a>Measure Rates (Groups)</th>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header">Measure Rate (Group) (ID: primary)</th>
</tr>
<tr>
<th scope="row" class="row-header">Initial Population</th>
<td class="content-container">
<em>ID</em>: primary-exm55-initial-population
<br/>
<em>Criteria</em>: <a href="#primary-primary-exm55-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-exm55-measure-population
<br/>
<em>Criteria</em>: <a href="#primary-primary-exm55-measure-population">Measure Population</a>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Measure Population Exclusion</th>
<td class="content-container">
<em>ID</em>: primary-exm55-measure-population-exclusion
<br/>
<em>Criteria</em>: <a href="#primary-primary-exm55-measure-population-exclusion">Measure Population Exclusion</a>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Measure Observation</th>
<td class="content-container">
<em>ID</em>: primary-exm55-measure-population-identifier
<br/>
<em>Criteria</em>: <a href="#primary-primary-exm55-measure-population-identifier">Measure Observation</a>
<br/><em>Input population</em>: measure-population-identifier
<em>Aggregate method</em>: median
</td>
</tr>
<tr>
<th scope="row" class="row-header">Stratifier</th>
<td class="content-container">
<em>Code</em>: Stratification 1
<br/>
<em>Applies to</em>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/measure-population initial-population}">Initial Population</span>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Stratifier</th>
<td class="content-container">
<em>Code</em>: Stratification 2
<br/>
<em>Applies to</em>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/measure-population initial-population}">Initial Population</span>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Stratifier</th>
<td class="content-container">
<em>Code</em>: Stratification 3
<br/>
<em>Applies to</em>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/measure-population initial-population}">Initial Population</span>
</td>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header"><a name="supplemental-data"> </a>Supplemental Data Elements</th>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header"><a name="measure-logic"> </a>Measure Logic</th>
</tr>
<tr>
<th scope="row" class="row-header">Primary Library</th>
<td class="content-container"><a href="Library-EXM55.html">EXM55 - Median Emergency Department Visit Duration Library (Example Continuous Variable Measure Library)</a></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 Rate (Group) (ID: primary)</th>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
Initial Population
</th>
</tr>
<tr>
<td>
<a name="primary-primary-exm55-initial-population"> </a>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">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</code></pre>
<a href="#exm55-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-exm55-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="#exm55-measure-population"><em>Definition</em></a>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
Measure Population Exclusion
</th>
</tr>
<tr>
<td>
<a name="primary-primary-exm55-measure-population-exclusion"> </a>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">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"</code></pre>
<a href="#exm55-measure-population-exclusion"><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-exm55-measure-population-identifier"> </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="#exm55-measure-observation"><em>Definition</em></a>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
Stratifier
</th>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Stratification 1" :
"Inpatient Encounter" Encounter
where not (Encounter.principalDiagnosis().diagnosis in "Psychiatric/Mental Health Patient")</code></pre>
<a href="#exm55-stratification-1"><em>Definition</em></a>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
Stratifier
</th>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Stratification 2" :
"Inpatient Encounter" Encounter
where Encounter.principalDiagnosis().diagnosis in "Psychiatric/Mental Health Patient"</code></pre>
<a href="#exm55-stratification-2"><em>Definition</em></a>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
Stratifier
</th>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Stratification 3" :
"Inpatient Encounter" Encounter
where Encounter.principalDiagnosis().diagnosis is null</code></pre>
<a href="#exm55-stratification-3"><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> EXMCommon</td>
</tr>
<tr>
<td>
<a name="exmcommon-lengthindays"> </a>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define fluent 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> EXMCommon</td>
</tr>
<tr>
<td>
<a name="exmcommon-principaldiagnosis"> </a>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define fluent function principalDiagnosis(encounter Encounter):
singleton from (
(encounter.claimDiagnosis()) CD
where CD.type.includesCode("Principal Diagnosis")
)</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> EXMCommon</td>
</tr>
<tr>
<td>
<a name="exmcommon-claimdiagnosis"> </a>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define fluent function claimDiagnosis(encounter Encounter):
encounter E
let
claim: ([Claim] C where C.status = 'active' and C.use = 'claim' and exists (C.item I where I.encounter.references(E))),
claimItem: (claim.item I where I.encounter.references(E))
return claim.diagnosis D where D.sequence in claimItem.diagnosisSequence</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> FHIRCommon</td>
</tr>
<tr>
<td>
<a name="fhircommon-references"> </a>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
@description: Returns true if any of the given references are to the given resource
@comment: Returns true if the `id` element of the given resource exactly equals the tail of any of the given references.
NOTE: This function assumes resources from the same source server.
*/
define fluent function references(references List<FHIR.Reference>, resource FHIR.Resource):
exists (references R where R.references(resource))</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> FHIRCommon</td>
</tr>
<tr>
<td>
<a name="fhircommon-references"> </a>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
@description: Returns true if the given reference is to the given resource
@comment: Returns true if the `id` element of the given resource exactly equals the tail of the given reference.
NOTE: This function assumes resources from the same source server.
*/
define fluent function references(reference FHIR.Reference, resource FHIR.Resource):
resource.id = Last(Split(reference.reference, '/'))</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> FHIRCommon</td>
</tr>
<tr>
<td>
<a name="fhircommon-includescode"> </a>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
@description: Returns true if the given code is in the given codeList
@comment: Returns true if the `code` is equivalent to any of the codes in the given `codeList`, false otherwise.
*/
define fluent function includesCode(codeList List<CodeableConcept>, code Concept):
exists (codeList C where C ~ code)</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 ClaimStatus): 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 Use): 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 string): 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-toconcept"> </a>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
@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
}</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-tocode"> </a>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
@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
}</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 scope="row" rowspan="2" class="row-header">
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> EXM55</td>
</tr>
<tr>
<td>
<a name="exm55-inpatient-encounter"> </a>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Inpatient Encounter" :
["Encounter"] Encounter
where Encounter.period.lengthInDays() <= 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> EXM55</td>
</tr>
<tr>
<td>
<a name="exm55-stratification-3"> </a>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Stratification 3" :
"Inpatient Encounter" Encounter
where Encounter.principalDiagnosis().diagnosis is null</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> EXM55</td>
</tr>
<tr>
<td>
<a name="exm55-stratification-2"> </a>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Stratification 2" :
"Inpatient Encounter" Encounter
where Encounter.principalDiagnosis().diagnosis in "Psychiatric/Mental Health Patient"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> EXM55</td>
</tr>
<tr>
<td>
<a name="exm55-measure-population-exclusion"> </a>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">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"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> EXM55</td>
</tr>
<tr>
<td>
<a name="exm55-stratification-1"> </a>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Stratification 1" :
"Inpatient Encounter" Encounter
where not (Encounter.principalDiagnosis().diagnosis in "Psychiatric/Mental Health Patient")</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> EXM55</td>
</tr>
<tr>
<td>
<a name="exm55-initial-population"> </a>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">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</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> EXM55</td>
</tr>
<tr>
<td>
<a name="exm55-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> EXM55</td>
</tr>
<tr>
<td>
<a name="exm55-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> EXM55</td>
</tr>
<tr>
<td>
<a name="exm55-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 colspan="2" scope="row" class="row-header"><a name="terminology"> </a>Terminology</th>
</tr>
<tr>
<th scope="row" class="row-header">Code System</th>
<td class="content-container">
<em>Description</em>: Code system Diagnosis Type
<br/>
<em>Resource</em>: <a href="http://terminology.hl7.org/7.3.0/CodeSystem-ex-diagnosistype.html">Example Diagnosis Type Codes</a>
<br/>
<em>Canonical URL</em>: <tt>http://terminology.hl7.org/CodeSystem/ex-diagnosistype</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Psychiatric/Mental Health Patient
<br/>
<em>Resource</em>: <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.299/expansion">Psychiatric/Mental Health Diagnosis</a>
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.299</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 scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Hospital Settings
<br/>
<em>Resource</em>: <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1111.126/expansion">Hospital Settings</a>
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.126</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Direct Reference Code</th>
<td class="content-container">
<em>Display</em>: Principal Diagnosis
<br/>
<em>Code</em>: principal
<br/>
<em>System</em>: <tt>http://terminology.hl7.org/CodeSystem/ex-diagnosistype</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>: FHIR model information
<br/>
<em>Resource</em>: <a href="http://hl7.org/fhir/uv/cql/STU2/Library-FHIR-ModelInfo.html">http://hl7.org/fhir/uv/cql/Library/FHIR-ModelInfo|4.0.1</a>
<br/>
<em>Canonical URL</em>: <tt>http://hl7.org/fhir/uv/cql/Library/FHIR-ModelInfo|4.0.1</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Dependency</th>
<td class="content-container">
<em>Description</em>: Library EXMCommon
<br/>
<em>Resource</em>: <a href="Library-EXMCommon.html">EXMCommon</a>
<br/>
<em>Canonical URL</em>: <tt>http://hl7.org/fhir/uv/cqm/Library/EXMCommon</tt>
</td>
</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 scope="row" class="row-header">Dependency</th>
<td class="content-container">
<em>Description</em>: Library FHIRCommon
<br/>
<em>Resource</em>: <a href="http://hl7.org/fhir/uv/cql/STU2/Library-FHIRCommon.html">http://hl7.org/fhir/uv/cql/Library/FHIRCommon|2.0.0</a>
<br/>
<em>Canonical URL</em>: <tt>http://hl7.org/fhir/uv/cql/Library/FHIRCommon|2.0.0</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>: Encounter
<br/>
<em>Profile(s)</em>:
<a href="http://hl7.org/fhir/R4/encounter.html">Encounter</a>
<br/>
<em>Must Support Elements</em>: period, type
<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, period, status, hospitalization, hospitalization.admitSource
<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>: Claim
<br/>
<em>Profile(s)</em>:
<a href="http://hl7.org/fhir/R4/claim.html">Claim</a>
<br/>
<em>Must Support Elements</em>: status, use, item
<br/>
</td>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header">Generated using version 0.5.6 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-directReferenceCode">
<valueCoding>
<system
value="http://terminology.hl7.org/CodeSystem/ex-diagnosistype"/>
<code value="principal"/>
<display value="Principal Diagnosis"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="EXM55"/>
</extension>
<extension url="name">
<valueString value="Inpatient Encounter"/>
</extension>
<extension url="statement">
<valueString
value="define "Inpatient Encounter" :
["Encounter"] Encounter
where Encounter.period.lengthInDays() <= 120
and Encounter.period ends during "Measurement Period""/>
</extension>
<extension url="displaySequence">
<valueInteger value="0"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="EXM55"/>
</extension>
<extension url="name">
<valueString value="Stratification 3"/>
</extension>
<extension url="statement">
<valueString
value="define "Stratification 3" :
"Inpatient Encounter" Encounter
where Encounter.principalDiagnosis().diagnosis is null"/>
</extension>
<extension url="displaySequence">
<valueInteger value="1"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="EXM55"/>
</extension>
<extension url="name">
<valueString value="Stratification 2"/>
</extension>
<extension url="statement">
<valueString
value="define "Stratification 2" :
"Inpatient Encounter" Encounter
where Encounter.principalDiagnosis().diagnosis in "Psychiatric/Mental Health Patient""/>
</extension>
<extension url="displaySequence">
<valueInteger value="2"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="EXM55"/>
</extension>
<extension url="name">
<valueString value="Measure Population Exclusion"/>
</extension>
<extension url="statement">
<valueString
value="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""/>
</extension>
<extension url="displaySequence">
<valueInteger value="3"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="EXM55"/>
</extension>
<extension url="name">
<valueString value="Stratification 1"/>
</extension>
<extension url="statement">
<valueString
value="define "Stratification 1" :
"Inpatient Encounter" Encounter
where not (Encounter.principalDiagnosis().diagnosis in "Psychiatric/Mental Health Patient")"/>
</extension>
<extension url="displaySequence">
<valueInteger value="4"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="EXM55"/>
</extension>
<extension url="name">
<valueString value="Initial Population"/>
</extension>
<extension url="statement">
<valueString
value="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"/>
</extension>
<extension url="displaySequence">
<valueInteger value="5"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="EXM55"/>
</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="EXMCommon"/>
</extension>
<extension url="name">
<valueString value="lengthInDays"/>
</extension>
<extension url="statement">
<valueString
value="define fluent function lengthInDays(Value Interval<DateTime> ):
difference in days between start of Value and end of Value"/>
</extension>
<extension url="displaySequence">
<valueInteger value="7"/>
</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="8"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="EXMCommon"/>
</extension>
<extension url="name">
<valueString value="principalDiagnosis"/>
</extension>
<extension url="statement">
<valueString
value="define fluent function principalDiagnosis(encounter Encounter):
singleton from (
(encounter.claimDiagnosis()) CD
where CD.type.includesCode("Principal Diagnosis")
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="9"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="EXMCommon"/>
</extension>
<extension url="name">
<valueString value="claimDiagnosis"/>
</extension>
<extension url="statement">
<valueString
value="define fluent function claimDiagnosis(encounter Encounter):
encounter E
let
claim: ([Claim] C where C.status = 'active' and C.use = 'claim' and exists (C.item I where I.encounter.references(E))),
claimItem: (claim.item I where I.encounter.references(E))
return claim.diagnosis D where D.sequence in claimItem.diagnosisSequence"/>
</extension>
<extension url="displaySequence">
<valueInteger value="10"/>
</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 ClaimStatus): value.value"/>
</extension>
<extension url="displaySequence">
<valueInteger value="11"/>
</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 Use): value.value"/>
</extension>
<extension url="displaySequence">
<valueInteger value="12"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="FHIRCommon"/>
</extension>
<extension url="name">
<valueString value="references"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Returns true if any of the given references are to the given resource
@comment: Returns true if the `id` element of the given resource exactly equals the tail of any of the given references.
NOTE: This function assumes resources from the same source server.
*/
define fluent function references(references List<FHIR.Reference>, resource FHIR.Resource):
exists (references R where R.references(resource))"/>
</extension>
<extension url="displaySequence">
<valueInteger value="13"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="FHIRCommon"/>
</extension>
<extension url="name">
<valueString value="references"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Returns true if the given reference is to the given resource
@comment: Returns true if the `id` element of the given resource exactly equals the tail of the given reference.
NOTE: This function assumes resources from the same source server.
*/
define fluent function references(reference FHIR.Reference, resource FHIR.Resource):
resource.id = Last(Split(reference.reference, '/'))"/>
</extension>
<extension url="displaySequence">
<valueInteger value="14"/>
</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 string): value.value"/>
</extension>
<extension url="displaySequence">
<valueInteger value="15"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="FHIRCommon"/>
</extension>
<extension url="name">
<valueString value="includesCode"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Returns true if the given code is in the given codeList
@comment: Returns true if the `code` is equivalent to any of the codes in the given `codeList`, false otherwise.
*/
define fluent function includesCode(codeList List<CodeableConcept>, code Concept):
exists (codeList C where C ~ code)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="16"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="FHIRHelpers"/>
</extension>
<extension url="name">
<valueString value="ToConcept"/>
</extension>
<extension url="statement">
<valueString
value="/*
@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
}"/>
</extension>
<extension url="displaySequence">
<valueInteger value="17"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="FHIRHelpers"/>
</extension>
<extension url="name">
<valueString value="ToCode"/>
</extension>
<extension url="statement">
<valueString
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
}"/>
</extension>
<extension url="displaySequence">
<valueInteger value="18"/>
</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="19"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="EXM55"/>
</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="20"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="EXM55"/>
</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="21"/>
</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="FHIR model information"/>
<resource
value="http://hl7.org/fhir/uv/cql/Library/FHIR-ModelInfo|4.0.1"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library EXMCommon"/>
<resource value="http://hl7.org/fhir/uv/cqm/Library/EXMCommon"/>
</relatedArtifact>
<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="Library FHIRCommon"/>
<resource
value="http://hl7.org/fhir/uv/cql/Library/FHIRCommon|2.0.0"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Code system Diagnosis Type"/>
<resource
value="http://terminology.hl7.org/CodeSystem/ex-diagnosistype"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Psychiatric/Mental Health Patient"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.299"/>
</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>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Hospital Settings"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.126"/>
</relatedArtifact>
<parameter>
<name value="Measurement Period"/>
<use value="in"/>
<min value="0"/>
<max value="1"/>
<type value="Period"/>
</parameter>
<parameter>
<name value="Stratification 3"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Encounter"/>
</parameter>
<parameter>
<name value="Stratification 2"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Encounter"/>
</parameter>
<parameter>
<name value="Measure Population Exclusion"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Encounter"/>
</parameter>
<parameter>
<name value="Stratification 1"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Encounter"/>
</parameter>
<parameter>
<name value="Initial Population"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Encounter"/>
</parameter>
<parameter>
<name value="Measure Population"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Encounter"/>
</parameter>
<dataRequirement>
<type value="Encounter"/>
<profile value="http://hl7.org/fhir/StructureDefinition/Encounter"/>
<mustSupport value="period"/>
<mustSupport value="type"/>
</dataRequirement>
<dataRequirement>
<type value="Encounter"/>
<profile value="http://hl7.org/fhir/StructureDefinition/Encounter"/>
<mustSupport value="type"/>
<mustSupport value="period"/>
<mustSupport value="status"/>
<mustSupport value="hospitalization"/>
<mustSupport value="hospitalization.admitSource"/>
<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="Claim"/>
<profile value="http://hl7.org/fhir/StructureDefinition/Claim"/>
<mustSupport value="status"/>
<mustSupport value="use"/>
<mustSupport value="item"/>
</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/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements">
<valueCanonical value="#effective-data-requirements"/>
</extension>
<url value="http://hl7.org/fhir/uv/cqm/Measure/EXM55-FHIR"/>
<identifier>
<use value="official"/>
<system value="http://example.org/fhir/cqi/ecqm/Measure/Identifier/exm"/>
<value value="55"/>
</identifier>
<identifier>
<system value="urn:ietf:rfc:3986"/>
<value value="urn:oid:2.16.840.1.113883.4.642.40.61.29.8"/>
</identifier>
<version value="2.0.0"/>
<name value="EXM55"/>
<title value="EXM55 - Median Emergency Department Visit Duration"/>
<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="This example illustrates a continuous variable measure represented as a FHIR eCQM"/>
<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="eh"/>
<display value="EH"/>
</coding>
</valueCodeableConcept>
</useContext>
<jurisdiction>
<coding>
<system value="http://unstats.un.org/unsd/methods/m49/m49.htm"/>
<code value="001"/>
</coding>
</jurisdiction>
<approvalDate value="2019-03-08"/>
<lastReviewDate value="2019-03-08"/>
<effectivePeriod>
<start value="2018-01-01"/>
<end value="2018-12-31"/>
</effectivePeriod>
<topic>
<coding>
<system value="http://loinc.org"/>
<code value="57024-2"/>
<display value="Health Quality Measure Document"/>
</coding>
</topic>
<library value="http://hl7.org/fhir/uv/cqm/Library/EXM55"/>
<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>
<improvementNotation>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-improvement-notation"/>
<code value="decrease"/>
<display value="Decreased 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>
<extension
url="http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.population.linkId">
<valueString value="primary-exm55-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>
<extension
url="http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.population.linkId">
<valueString value="primary-exm55-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>
<extension
url="http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.population.linkId">
<valueString value="primary-exm55-measure-population-exclusion"/>
</extension>
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="measure-population-exclusion"/>
<display value="Measure Population Exclusion"/>
</coding>
</code>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Measure Population Exclusion"/>
</criteria>
</population>
<population>
<extension
url="http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.population.linkId">
<valueString value="primary-exm55-measure-population-identifier"/>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-criteriaReference">
<valueString value="measure-population-identifier"/>
</extension>
<extension
url="http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-aggregateMethod">
<valueCode value="median"/>
</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>
<stratifier>
<extension
url="http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.stratifier.linkId">
<valueString value="primary-exm55-stratification-1"/>
</extension>
<extension
url="http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-appliesTo">
<valueCodeableConcept>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="initial-population"/>
<display value="Initial Population"/>
</coding>
</valueCodeableConcept>
</extension>
<code>
<coding>
<system value="http://example.org/stratification"/>
<code value="Stratification 1"/>
<display value="Stratification 1"/>
</coding>
</code>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Stratification 1"/>
</criteria>
</stratifier>
<stratifier>
<extension
url="http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.stratifier.linkId">
<valueString value="primary-exm55-stratificatio-2"/>
</extension>
<extension
url="http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-appliesTo">
<valueCodeableConcept>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="initial-population"/>
<display value="Initial Population"/>
</coding>
</valueCodeableConcept>
</extension>
<code>
<coding>
<system value="http://example.org/stratification"/>
<code value="Stratification 2"/>
<display value="Stratification 2"/>
</coding>
</code>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Stratification 2"/>
</criteria>
</stratifier>
<stratifier>
<extension
url="http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.stratifier.linkId">
<valueString value="primary-exm55-stratification-3"/>
</extension>
<extension
url="http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-appliesTo">
<valueCodeableConcept>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="initial-population"/>
<display value="Initial Population"/>
</coding>
</valueCodeableConcept>
</extension>
<code>
<coding>
<system value="http://example.org/stratification"/>
<code value="Stratification 3"/>
<display value="Stratification 3"/>
</coding>
</code>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Stratification 3"/>
</criteria>
</stratifier>
</group>
</Measure>
IG © 2019+ HL7 International / Clinical Quality Information.
Package hl7.fhir.uv.cqm#2.0.0 based on FHIR 4.0.1.
Generated
2026-09-02
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