WHO Antenatal Care Guideline Implementation Guide
0.3.0 - CI Build
WHO Antenatal Care Guideline Implementation Guide
0.3.0 - CI Build
WHO Antenatal Care Guideline Implementation Guide, published by World Health Organization (WHO). This guide is not an authorized publication; it is the continuous build for version 0.3.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/WorldHealthOrganization/smart-anc/ and changes regularly. See the Directory of published versions
| Draft as of 2023-03-13 |
<Measure xmlns="http://hl7.org/fhir">
<id value="ANCIND03"/>
<meta>
<profile
value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-measure-cqfm"/>
</meta>
<text>
<status value="extensions"/>
<div xmlns="http://www.w3.org/1999/xhtml">
<table class="grid dict">
<tr>
<th scope="row"><b>Id: </b></th>
<td style="padding-left: 4px;">ANCIND03</td>
</tr>
<tr>
<th scope="row"><b>Url: </b></th>
<td style="padding-left: 4px;"><a href="Measure-ANCIND03.html">ANC.IND.03 Percentage of pregnant women screened for syphilis during ANC</a></td>
</tr>
<tr>
<th scope="row"><b>Version: </b></th>
<td style="padding-left: 4px;">0.3.0</td>
</tr>
<tr>
<th scope="row"><b>Name: </b></th>
<td style="padding-left: 4px;">ANCIND03</td>
</tr>
<tr>
<th scope="row"><b>Title: </b></th>
<td style="padding-left: 4px;">ANC.IND.03 Percentage of pregnant women screened for syphilis during ANC</td>
</tr>
<tr>
<th scope="row"><b>Status: </b></th>
<td style="padding-left: 4px;">draft</td>
</tr>
<tr>
<th scope="row"><b>Experimental: </b></th>
<td style="padding-left: 4px;">false</td>
</tr>
<tr>
<th scope="row"><b>Scoring: </b></th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<b>system: </b> <span><a href="http://terminology.hl7.org/5.5.0/CodeSystem-measure-scoring.html">MeasureScoring</a></span>
</p>
<p style="margin-bottom: 5px;">
<b>code: </b> <span>proportion</span>
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Improvement Notation: </b></th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<b>system: </b> <span><a href="http://terminology.hl7.org/5.5.0/CodeSystem-measure-improvement-notation.html">MeasureImprovementNotation</a></span>
</p>
<p style="margin-bottom: 5px;">
<b>code: </b> <span>increase</span>
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Type: </b></th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<b>system: </b> <span><a href="http://terminology.hl7.org/5.5.0/CodeSystem-measure-type.html">MeasureType</a></span>
</p>
<p style="margin-bottom: 5px;">
<b>code: </b> <span>process</span>
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Date: </b></th>
<td style="padding-left: 4px;">2023-03-13 22:32:10-0600</td>
</tr>
<tr>
<th scope="row"><b>Publisher: </b></th>
<td style="padding-left: 4px;">World Health Organization (WHO)</td>
</tr>
<tr>
<th scope="row"><b>Description: </b></th>
<td style="padding-left: 4px;">Percentage of pregnant women screened for syphilis during ANC</td>
</tr>
<tr>
<th scope="row"><b>Jurisdiction: </b></th>
<td style="padding-left: 25px;">001</td>
</tr>
<tr>
<th scope="row"><b>Libraries: </b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr><td><a href="Library-ANCIND03.html">ANC.IND.03 Percentage of pregnant women screened for syphilis during ANC</a></td></tr>
</table>
</td>
</tr>
</table>
</div>
</text>
<contained>
<Library>
<id value="effective-data-requirements"/>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
<valueCoding>
<system
value="http://ohie.org/CodeSystem/iso-8601-derived-periods"/>
<code value="P10Y--P14Y"/>
<display value="10-14 years"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
<valueCoding>
<system
value="http://ohie.org/CodeSystem/iso-8601-derived-periods"/>
<code value="P15Y--P19Y"/>
<display value="15-19 years"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
<valueCoding>
<system
value="http://ohie.org/CodeSystem/iso-8601-derived-periods"/>
<code value="P20Y--P9999Y"/>
<display value="20+ years"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="ANCDataElements"/>
</extension>
<extension url="name">
<valueString value="Syphilis test result"/>
</extension>
<extension url="statement">
<valueString
value="/*
@dataElement: ANC.B9.DE107 Syphilis test result
@activity: ANC.B9. Conduct laboratory tests and imaging
@description: Syphilis test result
*/
define "Syphilis test result":
[Observation: Cx."Syphilis test result"] O
where O.status in { 'final', 'amended', 'corrected' }
and Coalesce(WC.ModifierExtension(O, 'who-notDone').value, false) is false"/>
</extension>
<extension url="displaySequence">
<valueInteger value="0"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="ANCBaseDataElements"/>
</extension>
<extension url="name">
<valueString value="Antenatal care case"/>
</extension>
<extension url="statement">
<valueString
value="/*
define "Pregnant":
"Pregnancy" is not null
or "Pregnancy status" in BCx."Pregnancy status - pregnant"
define "Pregnancy status":
FHIRHelpers.ToConcept(
Last(
[Observation: BCx."Pregnancy status"] O
where O.status = 'final'
sort by FHIRHelpers.ToDateTime(effective as FHIR.dateTime)
).value
)
*/
define "Antenatal care case":
["EpisodeOfCare": type in BCx."Antenatal care case"]"/>
</extension>
<extension url="displaySequence">
<valueInteger value="1"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="ANCBaseDataElements"/>
</extension>
<extension url="name">
<valueString value="Pregnancy"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Most recent antenatal care case
*/
define "Pregnancy":
First(
"Antenatal care case" E
sort by start of period descending
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="2"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="ANCIND03"/>
</extension>
<extension url="name">
<valueString value="Numerator"/>
</extension>
<extension url="statement">
<valueString
value="/*
Numerator: Percentage of pregnant women screened for syphilis during ANC
Numerator Computation: COUNT of number of women who had at least one syphilis test result recorded during pregnancy
*/
define Numerator:
exists (
PatientData."Syphilis test result" T
where T.issued during BaseData."Pregnancy".period
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="3"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="ANCBaseDataElements"/>
</extension>
<extension url="name">
<valueString value="Antenatal care contact"/>
</extension>
<extension url="statement">
<valueString
value="define "Antenatal care contact":
["Encounter": type in BCx."Antenatal care contact"]"/>
</extension>
<extension url="displaySequence">
<valueInteger value="4"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="ANCIND03"/>
</extension>
<extension url="name">
<valueString value="Contact Number Category Stratifier"/>
</extension>
<extension url="statement">
<valueString
value="/*
Disaggregation: Contact number categories: (1, 2–3, 4–8, 9+)
*If the woman had multiple syphilis tests done during pregnancy, use the contact number of the first test result recorded
*/
define "Contact Number Category Stratifier":
First(
PatientData."Syphilis test result" T
let TC: First(BaseData."Antenatal care contact" C where T.issued during C.period)
where T.issued during BaseData."Pregnancy".period
return { issued: T.issued, contactNumber: AC.Extension(TC, 'contactNumber').value as FHIR.integer }
sort by issued
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="5"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="ANCStratifiers"/>
</extension>
<extension url="name">
<valueString value="By Age"/>
</extension>
<extension url="statement">
<valueString
value="/*
By Patient Age as of the start of the Measurement Period
Age (10-14, 15-19, 20+)
*/
define "By Age":
case
when AgeInYearsAt(start of "Measurement Period") in Interval[10, 14] then "P10Y--P14Y"
when AgeInYearsAt(start of "Measurement Period") in Interval[15, 19] then "P15Y--P19Y"
when AgeInYearsAt(start of "Measurement Period") >= 20 then "P20Y--P9999Y"
else null
end"/>
</extension>
<extension url="displaySequence">
<valueInteger value="6"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="ANCIND03"/>
</extension>
<extension url="name">
<valueString value="Age Stratifier"/>
</extension>
<extension url="statement">
<valueString
value="/*
Disaggregation: Age (10-14, 15-19, 20+)
*/
define "Age Stratifier":
Stratifiers."By Age""/>
</extension>
<extension url="displaySequence">
<valueInteger value="7"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="ANCDataElements"/>
</extension>
<extension url="name">
<valueString value="Reason for closing ANC record"/>
</extension>
<extension url="statement">
<valueString
value="/*
@dataElement: ANC.End.1 Reason for closing ANC record
@activity: ANC.End End
@description: Select the reason why you are closing the woman's ANC record
*/
define "Reason for closing ANC record":
[Observation: Cx."Reason for closing ANC record"] O
where O.status in { 'final', 'amended', 'corrected' }
and Coalesce(WC.ModifierExtension(O, 'who-notDone').value, false) is false"/>
</extension>
<extension url="displaySequence">
<valueInteger value="8"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="ANCIND03"/>
</extension>
<extension url="name">
<valueString value="Denominator"/>
</extension>
<extension url="statement">
<valueString
value="/*
Denominator: Total number of antenatal clients with a first contact
Denominator Computation: COUNT of all women whose records were closed (ANC
close form) in the last reporting period due to any of the reasons below:
» live birth
» stillbirth
» miscarriage
» abortion
» woman died
» lost to follow-up
» moved away
*/
define Denominator:
exists (
PatientData."Reason for closing ANC record" R
where FC.ToInterval(R.effective) during "Measurement Period"
and R.value as FHIR.CodeableConcept in Stratifiers."Qualifying Reason for closing ANC record Choices"
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="9"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="ANCStratifiers"/>
</extension>
<extension url="name">
<valueString value="By Education Level"/>
</extension>
<extension url="statement">
<valueString
value="/*
By Patient Education Level (none, don't know, primary, secondary, higher)
*/
define "By Education Level":
Patient.extension E
where E.url = 'http://fhir.org/guides/who/anc-cds/StructureDefinition/educationlevel'
return E.value as CodeableConcept"/>
</extension>
<extension url="displaySequence">
<valueInteger value="10"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="ANCIND03"/>
</extension>
<extension url="name">
<valueString value="Education Level Stratifier"/>
</extension>
<extension url="statement">
<valueString
value="/*
Disaggregation: Education Level (none, don't know, primary, secondary, higher)
*/
define "Education Level Stratifier":
Stratifiers."By Education Level""/>
</extension>
<extension url="displaySequence">
<valueInteger value="11"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="ANCIND03"/>
</extension>
<extension url="name">
<valueString value="Initial Population"/>
</extension>
<extension url="statement">
<valueString
value="/*
Initial population: Antenatal clients
*/
define "Initial Population":
exists (BaseData."Antenatal care case")"/>
</extension>
<extension url="displaySequence">
<valueInteger value="12"/>
</extension>
</extension>
<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="Library PatientData"/>
<resource
value="http://fhir.org/guides/who/anc-cds/Library/ANCDataElements"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library Cx"/>
<resource
value="http://fhir.org/guides/who/anc-cds/Library/ANCConcepts"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library FHIRHelpers"/>
<resource
value="http://fhir.org/guides/who/anc-cds/Library/FHIRHelpers|4.0.1"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library WC"/>
<resource
value="http://fhir.org/guides/who/anc-cds/Library/WHOCommon"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library BaseData"/>
<resource
value="http://fhir.org/guides/who/anc-cds/Library/ANCBaseDataElements"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library BCx"/>
<resource
value="http://fhir.org/guides/who/anc-cds/Library/ANCBaseConcepts"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library AC"/>
<resource
value="http://fhir.org/guides/who/anc-cds/Library/ANCCommon"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library Stratifiers"/>
<resource
value="http://fhir.org/guides/who/anc-cds/Library/ANCStratifiers"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library FC"/>
<resource
value="http://fhir.org/guides/who/anc-cds/Library/FHIRCommon"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Code system ISO-8601-Derived Periods"/>
<resource
value="http://ohie.org/CodeSystem/iso-8601-derived-periods"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Syphilis test result"/>
<resource
value="http://fhir.org/guides/who/anc-cds/ValueSet/anc-b9-de107"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Antenatal care case"/>
<resource
value="http://fhir.org/guides/who/anc-cds/ValueSet/antenatal-care-case"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Antenatal care contact"/>
<resource
value="http://fhir.org/guides/who/anc-cds/ValueSet/antenatal-care-contact"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Reason for closing ANC record"/>
<resource
value="http://fhir.org/guides/who/anc-cds/ValueSet/anc-end-1"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display
value="Value set Qualifying Reason for closing ANC record Choices"/>
<resource
value="http://fhir.org/guides/who/anc-cds/ValueSet/qualifying-reason-for-closing-anc-record-choices"/>
</relatedArtifact>
<parameter>
<name value="Measurement Period"/>
<use value="in"/>
<min value="0"/>
<max value="1"/>
<type value="Period"/>
</parameter>
<parameter>
<name value="Numerator"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="boolean"/>
</parameter>
<parameter>
<name value="Contact Number Category Stratifier"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="Resource"/>
</parameter>
<parameter>
<name value="Age Stratifier"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="Coding"/>
</parameter>
<parameter>
<name value="Denominator"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="boolean"/>
</parameter>
<parameter>
<name value="Education Level Stratifier"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="CodeableConcept"/>
</parameter>
<parameter>
<name value="Initial Population"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="boolean"/>
</parameter>
<dataRequirement>
<type value="Observation"/>
<profile value="http://hl7.org/fhir/StructureDefinition/Observation"/>
<mustSupport value="code"/>
<mustSupport value="status"/>
<mustSupport value="issued"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://fhir.org/guides/who/anc-cds/ValueSet/anc-b9-de107"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Observation"/>
<profile value="http://hl7.org/fhir/StructureDefinition/Observation"/>
<mustSupport value="code"/>
<mustSupport value="status"/>
<mustSupport value="effective"/>
<mustSupport value="value"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://fhir.org/guides/who/anc-cds/ValueSet/anc-end-1"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="EpisodeOfCare"/>
<profile
value="http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"/>
<mustSupport value="type"/>
<codeFilter>
<path value="type"/>
<valueSet
value="http://fhir.org/guides/who/anc-cds/ValueSet/antenatal-care-case"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Encounter"/>
<profile value="http://hl7.org/fhir/StructureDefinition/Encounter"/>
<mustSupport value="type"/>
<mustSupport value="period"/>
<codeFilter>
<path value="type"/>
<valueSet
value="http://fhir.org/guides/who/anc-cds/ValueSet/antenatal-care-contact"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Patient"/>
<profile value="http://hl7.org/fhir/StructureDefinition/Patient"/>
<mustSupport value="url"/>
<mustSupport value="value"/>
</dataRequirement>
</Library>
</contained>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-softwaresystem">
<valueReference>🔗
<reference value="Device/cqf-tooling"/>
</valueReference>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-softwaresystem">
<valueReference>🔗
<reference value="Device/cqf-tooling"/>
</valueReference>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-effectiveDataRequirements" id="effective-data-requirements">
<valueReference>
<reference value="#effective-data-requirements"/>
</valueReference>
</extension>
<url value="http://fhir.org/guides/who/anc-cds/Measure/ANCIND03"/>
<version value="0.3.0"/>
<name value="ANCIND03"/>
<title
value="ANC.IND.03 Percentage of pregnant women screened for syphilis during ANC"/>
<status value="draft"/>
<experimental value="false"/>
<date value="2023-03-13T22:32:10-06:00"/>
<publisher value="World Health Organization (WHO)"/>
<contact>
<telecom>
<system value="url"/>
<value value="https://www.who.int"/>
</telecom>
</contact>
<description
value="Percentage of pregnant women screened for syphilis during ANC"/>
<jurisdiction>
<coding>
<system value="http://unstats.un.org/unsd/methods/m49/m49.htm"/>
<code value="001"/>
</coding>
</jurisdiction>
<library value="http://fhir.org/guides/who/anc-cds/Library/ANCIND03"/>
<scoring>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/measure-scoring"/>
<code value="proportion"/>
</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="increase"/>
</coding>
</improvementNotation>
<group id="group-1">
<population id="initial-population">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="initial-population"/>
</coding>
</code>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Initial Population"/>
</criteria>
</population>
<population id="denominator">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="denominator"/>
</coding>
</code>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Denominator"/>
</criteria>
</population>
<population id="numerator">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="numerator"/>
</coding>
</code>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Numerator"/>
</criteria>
</population>
<stratifier id="by-age">
<criteria>
<language value="text/cql-identifier"/>
<expression value="Age Stratifier"/>
</criteria>
</stratifier>
<stratifier id="by-education-level">
<criteria>
<expression value="Education Level Stratifier"/>
</criteria>
</stratifier>
<stratifier id="by-contact-number-category">
<criteria>
<language value="text/cql-identifier"/>
<expression value="Contact Number Category Stratifier"/>
</criteria>
</stratifier>
</group>
</Measure>
IG © 2019+ World Health Organization (WHO). Package who.fhir.anc-cds#0.3.0 based on FHIR 4.0.1. Generated 2024-04-09
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