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 Global (Whole world) 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 Measure Type Process 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... Improvement Notation Increased score indicates improvement 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) Initial Population ID: primary-publishablexm-initial-population Description: No description provided Criteria: Initial Population Measure Population ID: primary-publishablexm-measure-population Description: No description provided Criteria: Measure Population Measure Observation ID: primary-publishablexm-measure-observation Description: No description provided Criteria: Measure Observation 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 Population Criteria Measure Group (Rate) (ID: primary) Initial Population define "Initial Population" : "Inpatient Encounter" Encounter Definition Measure Population define "Measure Population" : "Initial Population" Definition Measure Observation define function "Measure Observation" (Encounter "Encounter" ) : duration in minutes of "Related ED Visit"(Encounter).period Definition 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: 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 Generated using version 0.4.9 of the sample-content-ig Liquid templates
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
define "SDE Payer": [Coverage: type in "Payer"] Payer return { code: Payer.type, period: Payer.period }
define "Inpatient Encounter" : ["Encounter"] Encounter where LengthInDays(Encounter.period) <= 120 and Encounter.period ends during "Measurement Period"
define "Initial Population" : "Inpatient Encounter" Encounter
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
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
define "Measure Population" : "Initial Population"
define function ToString(value AdministrativeGender): value.value
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 ToString(value uri): 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 )
define function ToString(value EncounterStatus): value.value
A term used in the measure that bears clearly definition to communicate the measure intent
HL7 International / Clinical Quality Information
An example FHIR-based publishable measure
This measure has been developed to support improvement in clinical care.
Users of this measure should be aware of...
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.
Infectious Diseases Society of America. 2012. 'Clinical Practice Guideline for the Diagnosis and Management of Group A Streptococcal Pharyngitis: 2012 Update.'
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.
Risk adjustment for this measure is performed by...
Rate aggregation for this measure is performed by...
The clinical recommendation statement for this measure is...