WHO Antenatal Care Guideline Implementation Guide
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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

: ANC.IND.10 Percentage of pregnant women with an ultrasound scan before 24 weeks - JSON Representation

Draft as of 2023-03-13

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{
  "resourceType" : "Measure",
  "id" : "ANCIND10",
  "meta" : {
    "profile" : [
      🔗 "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-measure-cqfm"
    ]
  },
  "text" : {
    "status" : "extensions",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n    <table class=\"grid dict\">\n        \n        <tr>\n            <th scope=\"row\"><b>Id: </b></th>\n            <td style=\"padding-left: 4px;\">ANCIND10</td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Url: </b></th>\n            <td style=\"padding-left: 4px;\"><a href=\"Measure-ANCIND10.html\">ANC.IND.10 Percentage of pregnant women with an ultrasound scan before 24\u202fweeks</a></td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Version: </b></th>\n            <td style=\"padding-left: 4px;\">0.3.0</td>\n        </tr>\n        \n        \n        \n        <tr>\n            <th scope=\"row\"><b>Name: </b></th>\n            <td style=\"padding-left: 4px;\">ANCIND10</td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Title: </b></th>\n            <td style=\"padding-left: 4px;\">ANC.IND.10 Percentage of pregnant women with an ultrasound scan before 24\u202fweeks</td>\n        </tr>\n        \n        \n        \n        <tr>\n            <th scope=\"row\"><b>Status: </b></th>\n            <td style=\"padding-left: 4px;\">draft</td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Experimental: </b></th>\n            <td style=\"padding-left: 4px;\">false</td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Scoring: </b></th>\n            <td style=\"padding-left: 4px;\">\n                \n                    \n                        \n                        <p style=\"margin-bottom: 5px;\">\n                            <b>system: </b> <span><a href=\"http://hl7.org/fhir/R4/codesystem-measure-scoring.html\">http://terminology.hl7.org/CodeSystem/measure-scoring</a></span>\n                        </p>\n                        \n                        \n                        <p style=\"margin-bottom: 5px;\">\n                            <b>code: </b> <span>proportion</span>\n                        </p>\n                        \n                        \n                    \n                \n                \n            </td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Improvement Notation: </b></th>\n            <td style=\"padding-left: 4px;\">\n                \n                    \n                        \n                        <p style=\"margin-bottom: 5px;\">\n                            <b>system: </b> <span><a href=\"http://hl7.org/fhir/R4/codesystem-measure-improvement-notation.html\">http://terminology.hl7.org/CodeSystem/measure-improvement-notation</a></span>\n                        </p>\n                        \n                        \n                        <p style=\"margin-bottom: 5px;\">\n                            <b>code: </b> <span>increase</span>\n                        </p>\n                        \n                        \n                    \n                \n                \n            </td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Type: </b></th>\n            <td style=\"padding-left: 4px;\">\n                \n                    \n                        \n                        <p style=\"margin-bottom: 5px;\">\n                            <b>system: </b> <span><a href=\"http://hl7.org/fhir/R4/codesystem-measure-type.html\">http://terminology.hl7.org/CodeSystem/measure-type</a></span>\n                        </p>\n                        \n                        \n                        <p style=\"margin-bottom: 5px;\">\n                            <b>code: </b> <span>process</span>\n                        </p>\n                        \n                        \n                    \n                \n                \n            </td>\n        </tr>\n        \n        \n        \n        <tr>\n            <th scope=\"row\"><b>Date: </b></th>\n            <td style=\"padding-left: 4px;\">2023-03-13 22:32:10-0600</td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Publisher: </b></th>\n            <td style=\"padding-left: 4px;\">World Health Organization (WHO)</td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Description: </b></th>\n            <td style=\"padding-left: 4px;\">Percentage of pregnant women with an ultrasound scan before 24\u202fweeks</td>\n        </tr>\n        \n        \n        \n        \n        \n        \n        \n        \n        \n        <tr>\n            <th scope=\"row\"><b>Jurisdiction: </b></th>\n            <td style=\"padding-left: 25px;\">001</td>\n        </tr>\n        \n        \n        \n        \n        \n        \n        \n        \n        \n        \n        \n        \n        \n\n        \n        <tr>\n          <th scope=\"row\"><b>Libraries: </b></th>\n          <td style=\"padding-left: 4px;\">\n            <table class=\"grid-dict\">\n              \n                <tr><td><a href=\"Library-ANCIND10.html\">ANC.IND.10 Percentage of pregnant women with an ultrasound scan before 24\u202fweeks</a></td></tr>\n              \n            </table>\n          </td>\n        </tr>\n        \n\n        \n    </table>\n</div>"
  },
  "contained" : [
    {
      "resourceType" : "Library",
      "id" : "effective-data-requirements",
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
          "valueCoding" : {
            "system" : "http://ohie.org/CodeSystem/iso-8601-derived-periods",
            "code" : "P10Y--P14Y",
            "display" : "10-14 years"
          }
        },
        {
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
          "valueCoding" : {
            "system" : "http://ohie.org/CodeSystem/iso-8601-derived-periods",
            "code" : "P15Y--P19Y",
            "display" : "15-19 years"
          }
        },
        {
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
          "valueCoding" : {
            "system" : "http://ohie.org/CodeSystem/iso-8601-derived-periods",
            "code" : "P20Y--P9999Y",
            "display" : "20+ years"
          }
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "ANCDataElements"
            },
            {
              "url" : "name",
              "valueString" : "Ultrasound scan conducted"
            },
            {
              "url" : "statement",
              "valueString" : "/*\n  @dataElement: ANC.B9.DE3 Ultrasound scan conducted\n  @activity: ANC.B6. Collect woman's profile and history\n  @description: Whether an ultrasound scan was conducted during a specific contact\n*/\ndefine \"Ultrasound scan conducted\":\n  [Procedure: Cx.\"Ultrasound scan conducted\"] P\n    where P.status in { 'preparation', 'in-progress', 'on-hold', 'completed' }"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 0
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "ANCBaseDataElements"
            },
            {
              "url" : "name",
              "valueString" : "Antenatal care case"
            },
            {
              "url" : "statement",
              "valueString" : "/*\ndefine \"Pregnant\":\n  \"Pregnancy\" is not null\n    or \"Pregnancy status\" in BCx.\"Pregnancy status - pregnant\"\n\ndefine \"Pregnancy status\":\n  FHIRHelpers.ToConcept(\n    Last(\n      [Observation: BCx.\"Pregnancy status\"] O\n        where O.status = 'final'\n        sort by FHIRHelpers.ToDateTime(effective as FHIR.dateTime)\n    ).value\n  )\n*/\ndefine \"Antenatal care case\":\n  [\"EpisodeOfCare\": type in BCx.\"Antenatal care case\"]"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 1
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "ANCBaseDataElements"
            },
            {
              "url" : "name",
              "valueString" : "Pregnancy"
            },
            {
              "url" : "statement",
              "valueString" : "/*\n@description: Most recent antenatal care case\n*/\ndefine \"Pregnancy\":\n  First(\n    \"Antenatal care case\" E\n\t\t  sort by start of period descending\n\t)"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 2
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "ANCIND10"
            },
            {
              "url" : "name",
              "valueString" : "Numerator"
            },
            {
              "url" : "statement",
              "valueString" : "/*\nNumerator: Number of pregnant women who received ultrasound scan before 24\u202fweeks\u00a0\nNumerator Computation: COUNT of all women who had an ultrasound scan done before 24\u202fweeks gestational age\u00a0\n*/\ndefine Numerator:\n  exists (\n    PatientData.\"Ultrasound scan conducted\" P\n      where FC.ToInterval(P.performed) during Interval[start of BaseData.\"Pregnancy\".period, start of BaseData.\"Pregnancy\".period + 24 weeks]\n    )"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 3
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "ANCStratifiers"
            },
            {
              "url" : "name",
              "valueString" : "By Age"
            },
            {
              "url" : "statement",
              "valueString" : "/*\nBy Patient Age as of the start of the Measurement Period\nAge (10-14, 15-19, 20+)\n*/\ndefine \"By Age\":\n  case\n    when AgeInYearsAt(start of \"Measurement Period\") in Interval[10, 14] then \"P10Y--P14Y\"\n    when AgeInYearsAt(start of \"Measurement Period\") in Interval[15, 19] then \"P15Y--P19Y\"\n    when AgeInYearsAt(start of \"Measurement Period\") >= 20 then \"P20Y--P9999Y\"\n    else null\n  end"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 4
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "ANCIND10"
            },
            {
              "url" : "name",
              "valueString" : "Age Stratifier"
            },
            {
              "url" : "statement",
              "valueString" : "/*\nDisaggregation: Age (10-14, 15-19, 20+)\n*/\ndefine \"Age Stratifier\":\n  Stratifiers.\"By Age\""
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 5
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "ANCDataElements"
            },
            {
              "url" : "name",
              "valueString" : "Gestational age"
            },
            {
              "url" : "statement",
              "valueString" : "/*\n  @dataElement: ANC.B6.DE17 Gestational age\n  @activity: ANC.B6. Collect woman's profile and history\n  @description: Gestational age in weeks and/or days depending on the source of gestational age\n*/\ndefine \"Gestational age\":\n  [Observation: Cx.\"Gestational age\"] O\n    where O.status in { 'final', 'amended', 'corrected' }\n      and Coalesce(WC.ModifierExtension(O, 'who-notDone').value, false) is false"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 6
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
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          "extension" : [
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              "url" : "libraryName",
              "valueString" : "ANCIND10"
            },
            {
              "url" : "name",
              "valueString" : "Denominator"
            },
            {
              "url" : "statement",
              "valueString" : "/*\nDenominator: Total number of antenatal clients with gestational age equal to 24\u202fweeks\nDenominator Computation: COUNT of all pregnant women who reached 24\u202fweeks gestational age in the past calendar month\u00a0\n*/\ndefine Denominator:\n  exists (\n    PatientData.\"Gestational age\" GA\n      where FC.ToInterval(GA.effective) during \"Measurement Period\"\n        and GA.value = 24 weeks\n  )"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 7
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "ANCStratifiers"
            },
            {
              "url" : "name",
              "valueString" : "By Education Level"
            },
            {
              "url" : "statement",
              "valueString" : "/*\nBy Patient Education Level (none, don't know, primary, secondary, higher)\n*/\ndefine \"By Education Level\":\n  Patient.extension E\n    where E.url = 'http://fhir.org/guides/who/anc-cds/StructureDefinition/educationlevel'\n    return E.value as CodeableConcept"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 8
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "ANCIND10"
            },
            {
              "url" : "name",
              "valueString" : "Education Level Stratifier"
            },
            {
              "url" : "statement",
              "valueString" : "/*\nDisaggregation: Education Level (none, don't know, primary, secondary, higher)\n*/\ndefine \"Education Level Stratifier\":\n  Stratifiers.\"By Education Level\""
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 9
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "ANCIND10"
            },
            {
              "url" : "name",
              "valueString" : "Initial Population"
            },
            {
              "url" : "statement",
              "valueString" : "/*\nInitial population: Antenatal clients\n*/\ndefine \"Initial Population\":\n  exists (BaseData.\"Antenatal care case\")"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 10
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        }
      ],
      "status" : "active",
      "type" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/library-type",
            "code" : "module-definition"
          }
        ]
      },
      "relatedArtifact" : [
        {
          "type" : "depends-on",
          "display" : "Library PatientData",
          "resource" : "http://fhir.org/guides/who/anc-cds/Library/ANCDataElements"
        },
        {
          "type" : "depends-on",
          "display" : "Library Cx",
          "resource" : "http://fhir.org/guides/who/anc-cds/Library/ANCConcepts"
        },
        {
          "type" : "depends-on",
          "display" : "Library FHIRHelpers",
          "resource" : "http://fhir.org/guides/who/anc-cds/Library/FHIRHelpers|4.0.1"
        },
        {
          "type" : "depends-on",
          "display" : "Library FC",
          "resource" : "http://fhir.org/guides/who/anc-cds/Library/FHIRCommon"
        },
        {
          "type" : "depends-on",
          "display" : "Library BaseData",
          "resource" : "http://fhir.org/guides/who/anc-cds/Library/ANCBaseDataElements"
        },
        {
          "type" : "depends-on",
          "display" : "Library BCx",
          "resource" : "http://fhir.org/guides/who/anc-cds/Library/ANCBaseConcepts"
        },
        {
          "type" : "depends-on",
          "display" : "Library Stratifiers",
          "resource" : "http://fhir.org/guides/who/anc-cds/Library/ANCStratifiers"
        },
        {
          "type" : "depends-on",
          "display" : "Library WC",
          "resource" : "http://fhir.org/guides/who/anc-cds/Library/WHOCommon"
        },
        {
          "type" : "depends-on",
          "display" : "Code system ISO-8601-Derived Periods",
          "resource" : "http://ohie.org/CodeSystem/iso-8601-derived-periods"
        },
        {
          "type" : "depends-on",
          "display" : "Value set Ultrasound scan conducted",
          "resource" : "http://fhir.org/guides/who/anc-cds/ValueSet/anc-b9-de3"
        },
        {
          "type" : "depends-on",
          "display" : "Value set Antenatal care case",
          "resource" : "http://fhir.org/guides/who/anc-cds/ValueSet/antenatal-care-case"
        },
        {
          "type" : "depends-on",
          "display" : "Value set Gestational age",
          "resource" : "http://fhir.org/guides/who/anc-cds/ValueSet/anc-b6-de17"
        }
      ],
      "parameter" : [
        {
          "name" : "Measurement Period",
          "use" : "in",
          "min" : 0,
          "max" : "1",
          "type" : "Period"
        },
        {
          "name" : "Numerator",
          "use" : "out",
          "min" : 0,
          "max" : "1",
          "type" : "boolean"
        },
        {
          "name" : "Age Stratifier",
          "use" : "out",
          "min" : 0,
          "max" : "1",
          "type" : "Coding"
        },
        {
          "name" : "Denominator",
          "use" : "out",
          "min" : 0,
          "max" : "1",
          "type" : "boolean"
        },
        {
          "name" : "Education Level Stratifier",
          "use" : "out",
          "min" : 0,
          "max" : "*",
          "type" : "CodeableConcept"
        },
        {
          "name" : "Initial Population",
          "use" : "out",
          "min" : 0,
          "max" : "1",
          "type" : "boolean"
        }
      ],
      "dataRequirement" : [
        {
          "type" : "Procedure",
          "profile" : [
            🔗 "http://hl7.org/fhir/StructureDefinition/Procedure"
          ],
          "mustSupport" : [
            "code",
            "status",
            "performed"
          ],
          "codeFilter" : [
            {
              "path" : "code",
              "valueSet" : "http://fhir.org/guides/who/anc-cds/ValueSet/anc-b9-de3"
            }
          ]
        },
        {
          "type" : "EpisodeOfCare",
          "profile" : [
            🔗 "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
          ],
          "mustSupport" : [
            "type"
          ],
          "codeFilter" : [
            {
              "path" : "type",
              "valueSet" : "http://fhir.org/guides/who/anc-cds/ValueSet/antenatal-care-case"
            }
          ]
        },
        {
          "type" : "Patient",
          "profile" : [
            🔗 "http://hl7.org/fhir/StructureDefinition/Patient"
          ],
          "mustSupport" : [
            "url",
            "value"
          ]
        },
        {
          "type" : "Observation",
          "profile" : [
            🔗 "http://hl7.org/fhir/StructureDefinition/Observation"
          ],
          "mustSupport" : [
            "code",
            "status",
            "effective",
            "value"
          ],
          "codeFilter" : [
            {
              "path" : "code",
              "valueSet" : "http://fhir.org/guides/who/anc-cds/ValueSet/anc-b6-de17"
            }
          ]
        }
      ]
    }
  ],
  "extension" : [
    {
      "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-softwaresystem",
      "valueReference" : {
        🔗 "reference" : "Device/cqf-tooling"
      }
    },
    {
      "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-softwaresystem",
      "valueReference" : {
        🔗 "reference" : "Device/cqf-tooling"
      }
    },
    {
      "id" : "effective-data-requirements",
      "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-effectiveDataRequirements",
      "valueReference" : {
        "reference" : "#effective-data-requirements"
      }
    }
  ],
  "url" : "http://fhir.org/guides/who/anc-cds/Measure/ANCIND10",
  "version" : "0.3.0",
  "name" : "ANCIND10",
  "title" : "ANC.IND.10 Percentage of pregnant women with an ultrasound scan before 24\u202fweeks",
  "status" : "draft",
  "experimental" : false,
  "date" : "2023-03-13T22:32:10-06:00",
  "publisher" : "World Health Organization (WHO)",
  "contact" : [
    {
      "telecom" : [
        {
          "system" : "url",
          "value" : "https://www.who.int"
        }
      ]
    }
  ],
  "description" : "Percentage of pregnant women with an ultrasound scan before 24\u202fweeks",
  "jurisdiction" : [
    {
      "coding" : [
        {
          "system" : "http://unstats.un.org/unsd/methods/m49/m49.htm",
          "code" : "001"
        }
      ]
    }
  ],
  "library" : [
    🔗 "http://fhir.org/guides/who/anc-cds/Library/ANCIND10"
  ],
  "scoring" : {
    "coding" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/measure-scoring",
        "code" : "proportion"
      }
    ]
  },
  "type" : [
    {
      "coding" : [
        {
          "system" : "http://terminology.hl7.org/CodeSystem/measure-type",
          "code" : "process"
        }
      ]
    }
  ],
  "improvementNotation" : {
    "coding" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/measure-improvement-notation",
        "code" : "increase"
      }
    ]
  },
  "group" : [
    {
      "id" : "group-1",
      "population" : [
        {
          "id" : "initial-population",
          "code" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                "code" : "initial-population"
              }
            ]
          },
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Initial Population"
          }
        },
        {
          "id" : "denominator",
          "code" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                "code" : "denominator"
              }
            ]
          },
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Denominator"
          }
        },
        {
          "id" : "numerator",
          "code" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                "code" : "numerator"
              }
            ]
          },
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Numerator"
          }
        }
      ],
      "stratifier" : [
        {
          "id" : "by-age",
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Age Stratifier"
          }
        },
        {
          "id" : "by-education-level",
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Education Level Stratifier"
          }
        }
      ]
    }
  ]
}