Quality Measure Implementation Guide
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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-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-cqm/ and changes regularly. See the Directory of published versions

Measure: EXM Publishable Measure (Experimental)

Official URL: http://hl7.org/fhir/uv/cqm/Measure/measure-publishable-exm Version: 2.0.0
Standards status: Informative Active as of 2025-08-13 Computable Name: PublishableMeasureEXM
Other Identifiers: Short Name (use: usual, ), UUID:11873bc9-ca0a-4cf3-b8f2-605a950aac74 (use: official, ), UUID:b366f29b-347f-464e-8064-c83842d825c7 (use: official, ), Endorser (use: official, ), Publisher (use: official, ), OID:2.16.840.1.113883.4.642.40.61.29.23

Usage: Clinical Venue: EC

Copyright/Legal: Example Copyright Statement

An example FHIR-based publishable measure

Metadata
Title EXM Publishable Measure
Version 2.0.0
Short Name EXM-123
GUID (Version Independent) urn:uuid:11873bc9-ca0a-4cf3-b8f2-605a950aac74
GUID (Version Specific) urn:uuid:b366f29b-347f-464e-8064-c83842d825c7
CMS Identifier CMS-123
NQF Identifier NQF-123
Identifier urn:oid:2.16.840.1.113883.4.642.40.61.29.23
Effective Period 2018-01-01 + 1 year(s)
Approval Date 2019-02-17
Last Review Date 2019-02-17
Experimental true
Use Context Clinical Venue = EC
Jurisdiction 001 from http://unstats.un.org/unsd/methods/m49/m49.htm
Topic Health Quality Measure Document
Steward (Publisher) HL7 International / Clinical Quality Information
Developer Example Measure Content Developer
Description

An example FHIR-based publishable measure

Purpose

This measure has been developed to support improvement in clinical care.

Copyright

Example Copyright Statement

Disclaimer

Example disclaimer

Measure Basis Encounter
Measure Scoring Continuous Variable
Improvement Notation Increased score indicates improvement
Measure Type process from http://terminology.hl7.org/CodeSystem/measure-type
Risk Adjustment Risk adjustment for this measure is performed by...
Rate Aggregation Rate aggregation for this measure is performed by...
Rationale

The rationale of this measure is to...

Clinical Recommendation Statement

The clinical recommendation statement for this measure is...

Citation

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.

Content URL: https://pubmed.ncbi.nlm.nih.gov/16278359/
Document: null @ https://pubmed.ncbi.nlm.nih.gov/16278359/
Citation

Infectious Diseases Society of America. 2012. 'Clinical Practice Guideline for the Diagnosis and Management of Group A Streptococcal Pharyngitis: 2012 Update.'

Content URL: https://pubmed.ncbi.nlm.nih.gov/23091044/
Document: null @ https://pubmed.ncbi.nlm.nih.gov/23091044/
Citation

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.

Content URL: https://pubmed.ncbi.nlm.nih.gov/19739972/
Document: null @ https://pubmed.ncbi.nlm.nih.gov/19739972/
Citation

Example citation to draft publication

Content URL: http://example.org/publications/1234
Document: null @ http://example.org/publications/1234
Guidance (Usage) Users of this measure should be aware of...
Measure Group (Rate) (ID: primary)
Supplemental Data Elements
Supplemental Data Element ID: sde-ethnicity
Usage Code: Supplemental Data
Description: No description provided
Logic Definition: SDE Ethnicity
Supplemental Data Element ID: sde-race
Usage Code: Supplemental Data
Description: No description provided
Logic Definition: SDE Race
Supplemental Data Element ID: sde-payer
Usage Code: Supplemental Data
Description: No description provided
Logic Definition: SDE Payer
Supplemental Data Element ID: sde-sex
Usage Code: Supplemental Data
Description: No description provided
Logic Definition: SDE Sex
Measure Logic
Primary Library Example Publishable Library
Contents Population Criteria
Logic Definitions
Terminology
Dependencies
Data Requirements
Parameters
Population Criteria
Measure Group (Rate) (ID: primary)
Logic Definitions
Logic Definition Library Name: EXMPublishableLibrary
define "SDE Sex":
  case
    when Patient.gender = 'male' then Code { code: 'M', system: 'http://hl7.org/fhir/v3/AdministrativeGender', display: 'Male' }
    when Patient.gender = 'female' then Code { code: 'F', system: 'http://hl7.org/fhir/v3/AdministrativeGender', display: 'Female' }
    else null
  end
Logic Definition Library Name: EXMPublishableLibrary
define "SDE Payer":
    [Coverage: type in "Payer"] Payer
      return {
        code: Payer.type,
        period: Payer.period
      }
Logic Definition Library Name: EXMPublishableLibrary
define "Inpatient Encounter" :
  ["Encounter"] Encounter
    where LengthInDays(Encounter.period) <= 120
      and Encounter.period ends during "Measurement Period"
Logic Definition Library Name: EXMPublishableLibrary
define "Initial Population" :
  "Inpatient Encounter" Encounter
Logic Definition Library Name: EXMPublishableLibrary
define "SDE Ethnicity":
  (flatten (
    Patient.extension Extension
      where Extension.url = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity'
        return Extension.extension
  )) E
    where E.url = 'ombCategory'
      or E.url = 'detailed'
    return E.value as Coding
Logic Definition Library Name: EXMPublishableLibrary
define "SDE Race":
  (flatten (
    Patient.extension Extension
      where Extension.url = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-race'
        return Extension.extension
  )) E
    where E.url = 'ombCategory'
      or E.url = 'detailed'
    return E.value as Coding
Logic Definition Library Name: EXMPublishableLibrary
define "Measure Population" :
  "Initial Population"
Logic Definition Library Name: EXMPublishableLibrary
define function "LengthInDays"(Value Interval<DateTime>):
	difference in days between start of Value and end of Value
Logic Definition Library Name: EXMPublishableLibrary
define function "Measure Observation" (Encounter "Encounter" ) :
  duration in minutes of "Related ED Visit"(Encounter).period
Logic Definition Library Name: EXMPublishableLibrary
//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 )
Logic Definition Library Name: FHIRHelpers
define function ToString(value AdministrativeGender): value.value
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
define function ToString(value uri): value.value
Logic Definition Library Name: FHIRHelpers
define function ToString(value EncounterStatus): value.value
Terminology
Value Set Description: Value set Payer
Resource: Payer Type
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591
Value Set Description: Value set 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
Dependencies
Dependency Description: FHIR model information
Resource: http://hl7.org/fhir/uv/cql/Library/FHIR-ModelInfo|4.0.1
Canonical URL: http://hl7.org/fhir/uv/cql/Library/FHIR-ModelInfo|4.0.1
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: Patient
Profile(s): Patient
Must Support Elements: url, extension, value
Data Requirement Type: Coverage
Profile(s): Coverage
Must Support Elements: type, period
Code Filter(s):
Path: type
ValueSet: Payer Type
Data Requirement Type: Encounter
Profile(s): Encounter
Must Support Elements: type, status, period
Code Filter(s):
Path: type
ValueSet: Emergency Department Visit
Data Requirement Type: Encounter
Profile(s): Encounter
Must Support Elements: period
Parameters
Name Use Card. Type Documentation
Measurement Period In 0..1 Period
SDE Sex Out 0..1 Coding
SDE Payer Out 0..* Resource
Initial Population Out 0..* Encounter
SDE Ethnicity Out 0..* Coding
SDE Race Out 0..* Coding
Measure Population Out 0..* Encounter
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