ControllingHighBloodPressureFHIR
type: Measure
node role: treeRoot
id:
  v: ControllingHighBloodPressureFHIR
meta:
  profile:
    v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-measure-cqfm
    l: computable-measure-cqfm
text:
  status:
    v: extensions
  div:
    v: Knowledge Artifact Metadata Name (machine-readable) ControllingHighBloodPressureFHIR Title (human-readable) Controlling High Blood Pressure Status Draft Experimental false Description Percentage of patients 18-85 years of age who had a diagnosis of essential hypertension starting before and continuing into, or starting during the first six months of the measurement period, and whose most recent blood pressure was adequately controlled (<140/90 mmHg) during the measurement period Purpose Unknown Effective Period 2024-01-01..2024-12-31 Measure Steward Clinical Quality Framework Steward Contact Details http://cqframework.org Copyright This Physician Performance Measure (Measure) and related data specifications are owned and were developed by the National Committee for Quality Assurance (NCQA). NCQA is not responsible for any use of the Measure. NCQA makes no representations, warranties, or endorsement about the quality of any organization or physician that uses or reports performance measures and NCQA has no liability to anyone who relies on such measures or specifications. NCQA holds a copyright in the Measure. The Measure can be reproduced and distributed, without modification, for noncommercial purposes (e.g., use by healthcare providers in connection with their practices) without obtaining approval from NCQA. Commercial use is defined as the sale, licensing, or distribution of the Measure for commercial gain, or incorporation of the Measure into a product or service that is sold, licensed or distributed for commercial gain. All commercial uses or requests for modification must be approved by NCQA and are subject to a license at the discretion of NCQA. (C) 2012-2022 National Committee for Quality Assurance. All Rights Reserved. Limited proprietary coding is contained in the Measure specifications for user convenience. Users of proprietary code sets should obtain all necessary licenses from the owners of the code sets. NCQA disclaims all liability for use or accuracy…
contained: Library
  id:
    v: effective-data-requirements
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode
      l: cqf-directReferenceCode
    value: Coding
      type: https://loinc.org/rdf/85354-9
      system:
        v: http://loinc.org
        l: loinc.org
      code:
        v: 85354-9
      display:
        v: blood pressure
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode
      l: cqf-directReferenceCode
    value: Coding
      type: https://loinc.org/rdf/8462-4
      system:
        v: http://loinc.org
        l: loinc.org
      code:
        v: 8462-4
      display:
        v: Diastolic blood pressure
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode
      l: cqf-directReferenceCode
    value: Coding
      type: https://loinc.org/rdf/8480-6
      system:
        v: http://loinc.org
        l: loinc.org
      code:
        v: 8480-6
      display:
        v: Systolic blood pressure
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode
      l: cqf-directReferenceCode
    value: Coding
      system:
        v: http://terminology.hl7.org/CodeSystem/condition-ver-status
        l: condition-ver-status
      code:
        v: confirmed
      display:
        v: confirmed
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode
      l: cqf-directReferenceCode
    value: Coding
      system:
        v: http://terminology.hl7.org/CodeSystem/condition-clinical
        l: condition-clinical
      code:
        v: active
      display:
        v: active
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode
      l: cqf-directReferenceCode
    value: Coding
      system:
        v: http://terminology.hl7.org/CodeSystem/condition-clinical
        l: condition-clinical
      code:
        v: recurrence
      display:
        v: recurrence
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode
      l: cqf-directReferenceCode
    value: Coding
      system:
        v: http://terminology.hl7.org/CodeSystem/condition-clinical
        l: condition-clinical
      code:
        v: relapse
      display:
        v: relapse
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode
      l: cqf-directReferenceCode
    value: Coding
      type: https://loinc.org/rdf/88124-3
      system:
        v: http://loinc.org
        l: loinc.org
      code:
        v: 88124-3
      display:
        v: Food insecurity risk [HVS]
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode
      l: cqf-directReferenceCode
    value: Coding
      type: http://snomed.info/id/428361000124107
      system:
        v: http://snomed.info/sct
        l: sct
      code:
        v: 428361000124107
      display:
        v: Discharge to home for hospice care (procedure)
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode
      l: cqf-directReferenceCode
    value: Coding
      type: http://snomed.info/id/428371000124100
      system:
        v: http://snomed.info/sct
        l: sct
      code:
        v: 428371000124100
      display:
        v: Discharge to healthcare facility for hospice care (procedure)
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode
      l: cqf-directReferenceCode
    value: Coding
      type: https://loinc.org/rdf/45755-6
      system:
        v: http://loinc.org
        l: loinc.org
      code:
        v: 45755-6
      display:
        v: Hospice care [Minimum Data Set]
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode
      l: cqf-directReferenceCode
    value: Coding
      type: http://snomed.info/id/373066001
      system:
        v: http://snomed.info/sct
        l: sct
      code:
        v: 373066001
      display:
        v: Yes (qualifier value)
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode
      l: cqf-directReferenceCode
    value: Coding
      type: https://loinc.org/rdf/98181-1
      system:
        v: http://loinc.org
        l: loinc.org
      code:
        v: 98181-1
      display:
        v: Medical equipment used
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode
      l: cqf-directReferenceCode
    value: Coding
      type: https://loinc.org/rdf/71802-3
      system:
        v: http://loinc.org
        l: loinc.org
      code:
        v: 71802-3
      display:
        v: Housing status
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode
      l: cqf-directReferenceCode
    value: Coding
      type: http://snomed.info/id/160734000
      system:
        v: http://snomed.info/sct
        l: sct

v: 160734000

v: Lives in a nursing home (finding)

url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode
  l: cqf-directReferenceCode
value: Coding
  type: https://loinc.org/rdf/71007-9
  system:
    v: http://loinc.org
    l: loinc.org
  code:
    v: 71007-9
  display:
    v: Functional Assessment of Chronic Illness Therapy - Palliative Care Questionnaire (FACIT-Pal)

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: SupplementalDataElementsFHIR4
extension:
  url:
    v: name
    l: name
  value: String
    v: SDE Sex
extension:
  url:
    v: statement
    l: statement
  value: String
    v: 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
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 0
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: ControllingHighBloodPressureFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: SDE Sex
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "SDE Sex": SDE."SDE Sex"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 1
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: SurveillanceDataElementsFHIR4
extension:
  url:
    v: name
    l: name
  value: String
    v: Most recent physical home address
extension:
  url:
    v: statement
    l: statement
  value: String
    v: // Jurisdiction of residence (jurisdiction of the patient) define "Most recent physical home address": First( Patient.address A where A.use = 'home' and A.type = 'physical' sort by end of period desc )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 2
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: SurveillanceDataElementsFHIR4
extension:
  url:
    v: name
    l: name
  value: String
    v: Postal Code of Residence
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Postal Code of Residence": "Most recent physical home address".postalCode
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 3
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: ControllingHighBloodPressureFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: SDE Postal Code of Residence
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "SDE Postal Code of Residence": SurveillanceDataElements."Postal Code of Residence"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 4
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: ControllingHighBloodPressureFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Qualifying Diastolic Blood Pressure Reading
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Qualifying Diastolic Blood Pressure Reading": [Observation: "Blood pressure"] BloodPressure without ([Encounter: "Encounter Inpatient"] union [Encounter: "Emergency Department Evaluation and Management Visit"]) DisqualifyingEncounter such that Common.Latest(BloodPressure.effective) during day of DisqualifyingEncounter.period where BloodPressure.status in {'final', 'amended'} and Common.Latest(BloodPressure.effective) during "Measurement Period" and exists ( BloodPressure.component DiastolicBP where DiastolicBP.code ~ "Diastolic blood pressure" and (DiastolicBP.value as Quantity).code.value = 'mm[Hg]' )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 5
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: ControllingHighBloodPressureFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Qualifying Systolic Blood Pressure Reading
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Qualifying Systolic Blood Pressure Reading": [Observation: "Blood pressure"] BloodPressure without ([Encounter: "Encounter Inpatient"] union [Encounter: "Emergency Department Evaluation and Management Visit"]) DisqualifyingEncounter such that Common.Latest(BloodPressure.effective) during day of DisqualifyingEncounter.period where BloodPressure.status in {'final', 'amended'} and Common.Latest(BloodPressure.effective) during "Measurement Period" and exists ( BloodPressure.component SystolicBP where SystolicBP.code ~ "Systolic blood pressure" and (SystolicBP.value as Quantity).code.value = 'mm[Hg]' )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 6
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: ControllingHighBloodPressureFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Blood Pressure Days
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Blood Pressure Days": ("Qualifying Diastolic Blood Pressure Reading" DBPExam return Common.Latest(DBPExam.effective) ) intersect ("Qualifying Systolic Blood Pressure Reading" SBPExam return Common.Latest(SBPExam.effective) )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 7
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: ControllingHighBloodPressureFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Most Recent Blood Pressure Day
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Most Recent Blood Pressure Day": Max("Blood Pressure Days")
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 8
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: ControllingHighBloodPressureFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Lowest Diastolic Reading on Most Recent Blood Pressure Day
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Lowest Diastolic Reading on Most Recent Blood Pressure Day": First( "Qualifying Diastolic Blood Pressure Reading" DBPReading where Common.Earliest(DBPReading.effective) same day as "Most Recent Blood Pressure Day" return singleton from ( DBPReading.component C where C.code ~ "Diastolic blood pressure" return C.value as FHIR.Quantity ) sort ascending )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 9
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: ControllingHighBloodPressureFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Has Diastolic Blood Pressure Less Than 90
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Has Diastolic Blood Pressure Less Than 90": "Lowest Diastolic Reading on Most Recent Blood Pressure Day" < 90 'mm[Hg]'
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 10
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: ControllingHighBloodPressureFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Lowest Systolic Reading on Most Recent Blood Pressure Day
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Lowest Systolic Reading on Most Recent Blood Pressure Day": First( "Qualifying Systolic Blood Pressure Reading" SBPReading where Common.Latest(SBPReading.effective) same day as "Most Recent Blood Pressure Day" return singleton from ( SBPReading.component C where C.code ~ "Systolic blood pressure" return C.value as FHIR.Quantity ) sort ascending )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 11
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: ControllingHighBloodPressureFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Has Systolic Blood Pressure Less Than 140
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Has Systolic Blood Pressure Less Than 140": "Lowest Systolic Reading on Most Recent Blood Pressure Day" < 140 'mm[Hg]'
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 12
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: ControllingHighBloodPressureFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Numerator
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Numerator": "Has Diastolic Blood Pressure Less Than 90" and "Has Systolic Blood Pressure Less Than 140"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 13
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: ControllingHighBloodPressureFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Essential Hypertension Diagnosis
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Essential Hypertension Diagnosis": [Condition: "Essential Hypertension"] Hypertension where Hypertension.verificationStatus ~ Common."confirmed" and Common."Prevalence Period"(Hypertension) overlaps Interval[start of "Measurement Period", start of "Measurement Period" + 6 months]
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 14
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: AdultOutpatientEncountersFHIR4
extension:
  url:
    v: name
    l: name
  value: String
    v: Qualifying Encounters
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Qualifying Encounters": ( [Encounter: "Office Visit"] union [Encounter: "Annual Wellness Visit"] union [Encounter: "Preventive Care Services - Established Office Visit, 18 and Up"] union [Encounter: "Preventive Care Services - Initial Office Visit, 18 and Up"] union [Encounter: "Home Healthcare Services"] union [Encounter: "Online Assessments"] union [Encounter: "Telephone Visits"] ) ValidEncounters where FC.ToInterval(ValidEncounters.period) during "Measurement Period" and ValidEncounters.status ~ 'finished' or ValidEncounters.status ~ 'in-progress'
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 15
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: ControllingHighBloodPressureFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Initial Population
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Initial Population": AgeInYearsAt(date from end of "Measurement Period") in Interval[18, 85] and exists "Essential Hypertension Diagnosis" and exists AdultOutpatientEncounters."Qualifying Encounters"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 16
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: ControllingHighBloodPressureFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Denominator
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Denominator": "Initial Population"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 17
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: SupplementalDataElementsFHIR4
extension:
  url:
    v: name
    l: name
  value: String
    v: SDE Payer
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "SDE Payer": [Coverage: type in "Payer"] Payer return { code: Payer.type, period: Payer.period }
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 18
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: ControllingHighBloodPressureFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: SDE Payer
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "SDE Payer": SDE."SDE Payer"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 19
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: SurveillanceDataElementsFHIR4
extension:
  url:
    v: name
    l: name
  value: String
    v: State of Residence
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "State of Residence": "Most recent physical home address".state
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 20
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: ControllingHighBloodPressureFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: SDE State of Residence
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "SDE State of Residence": SurveillanceDataElements."State of Residence"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 21
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: SurveillanceDataElementsFHIR4
extension:
  url:
    v: name
    l: name
  value: String
    v: Food Insecurity Risk Status
extension:
  url:
    v: statement
    l: statement
  value: String
    v: // Jurisdiction of care (jurisdiction of the most recent encounter) // TODO: //define "Most recent address of care": // NOTE: Included in eICR // Occupational Data for Health - Past or Present Job // http://hl7.org/fhir/us/odh/StructureDefinition-odh-PastOrPresentJob.html // Observation: LOINC#11341-5, valueCodeableConcept in https://phinvads.cdc.gov/vads/ViewValueSet.action?oid=2.16.840.1.114222.4.11.7186 // Social Determinants of Health (SDOH) // http://build.fhir.org/ig/HL7/fhir-sdoh-clinicalcare/StructureDefinition-SDOHCC-ObservationScreeningResponse.html // Food insecurity risk: http://build.fhir.org/ig/HL7/fhir-sdoh-clinicalcare/Observation-SDOHCC-ObservationResponseHungerVitalSignQuestion3Example.html // Observation: LOINC#88124-3, valueCodeableConcept in https://loinc.org/LL2510-7/ (At risk, No risk) define "Food Insecurity Risk Status": First( [Observation: "Food insecurity risk [HVS]"] O sort by issued desc ).value as CodeableConcept
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 22
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: ControllingHighBloodPressureFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: SDE Food Insecurity Risk Status
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "SDE Food Insecurity Risk Status": SurveillanceDataElements."Food Insecurity Risk Status"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 23
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: SupplementalDataElementsFHIR4
extension:
  url:
    v: name
    l: name
  value: String
    v: SDE Ethnicity
extension:
  url:
    v: statement
    l: statement
  value: String
    v: 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
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 24
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: ControllingHighBloodPressureFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: SDE Ethnicity
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "SDE Ethnicity": SDE."SDE Ethnicity"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 25
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: SurveillanceDataElementsFHIR4
extension:
  url:
    v: name
    l: name
  value: String
    v: Age
extension:
  url:
    v: statement
    l: statement
  value: String
    v: // Age define "Age": AgeInYearsAt(end of "Measurement Period")
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 26
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: ControllingHighBloodPressureFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: SDE Age
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "SDE Age": SurveillanceDataElements."Age"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 27
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: HospiceFHIR4
extension:
  url:
    v: name
    l: name
  value: String
    v: Has Hospice
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Has Hospice": exists( (AC.QualifiedEncounters([Encounter: "Encounter Inpatient"])) HospiceInp where (HospiceInp.hospitalization.dischargeDisposition ~ "Discharge to home for hospice care (procedure)" or HospiceInp.hospitalization.dischargeDisposition ~ "Discharge to healthcare facility for hospice care (procedure)") and FC.ToInterval(HospiceInp.period) ends during "Measurement Period" ) or exists( (AC.QualifiedEncounters([Encounter: "Hospice Encounter"])) HospiceEnc where FC.ToInterval(HospiceEnc.period) overlaps "Measurement Period" ) or exists( (AC.QualifiedObservations([Observation: "Hospice care [Minimum Data Set]"])) HospiceObs where HospiceObs.value ~ ToConcept("Yes (qualifier value)") and FC.ToInterval(HospiceObs.effective) overlaps "Measurement Period" ) or exists( (AC.QualifiedServiceRequests([ServiceRequest: "Hospice Care Ambulatory"])) HospiceSR where FC.ToInterval(HospiceSR.authoredOn) during "Measurement Period" ) or exists( (AC.QualifiedProcedures([Procedure: "Hospice Care Ambulatory"])) HospiceProc where FC.ToInterval(HospiceProc.performed) overlaps "Measurement Period" ) or exists( (AC.QualifiedConditions([Condition: "Hospice Diagnosis"])) HospiceCareDiagnosis where FC.ToPrevalenceInterval(HospiceCareDiagnosis) overlaps "Measurement Period" )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 28
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: ControllingHighBloodPressureFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Pregnancy Or Renal Diagnosis
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Pregnancy Or Renal Diagnosis": ( [Condition: "Pregnancy"] union [Condition: "End Stage Renal Disease"] union [Condition: "Kidney Transplant Recipient"] union [Condition: "Chronic Kidney Disease, Stage 5"] ) PregnancyESRDDiagnosis where PregnancyESRDDiagnosis.verificationStatus ~ Common."confirmed" and PregnancyESRDDiagnosis.recordedDate during "Measurement Period"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 29
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: ControllingHighBloodPressureFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: End Stage Renal Disease Procedures
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "End Stage Renal Disease Procedures": ([Procedure: "Kidney Transplant"] union [Procedure: "Dialysis Services"]) ESRDProcedure where ESRDProcedure.status = 'completed' and end of Common."Normalize Interval"(ESRDProcedure.performed) on or before end of "Measurement Period"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 30
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: ControllingHighBloodPressureFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: End Stage Renal Disease Encounter
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "End Stage Renal Disease Encounter": [Encounter: "ESRD Monthly Outpatient Services"] ESRDEncounter where ESRDEncounter.status in { 'arrived', 'triaged', 'in-progress', 'onleave', 'finished' } and ESRDEncounter.period starts on or before end of "Measurement Period"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 31
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
extension:
  url:
    v: name
    l: name
  value: String
    v: Has Criteria Indicating Frailty
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Has Criteria Indicating Frailty": exists( (AC.QualifiedDeviceRequests([DeviceRequest: "Frailty Device"])) FrailtyDeviceOrder where FrailtyDeviceOrder.authoredOn during day of "Measurement Period" ) or exists( (AC.QualifiedObservations([Observation: "Medical Equipment Used"])) EquipmentUsed where EquipmentUsed.value in "Frailty Device" and FC.ToInterval(EquipmentUsed.effective) ends during day of "Measurement Period" ) or exists( (AC.QualifiedConditions([Condition: "Frailty Diagnosis"])) FrailtyDiagnosis where FC.ToPrevalenceInterval(FrailtyDiagnosis) overlaps "Measurement Period" ) or exists( (AC.QualifiedEncounters([Encounter: "Frailty Encounter"])) FrailtyEnc where FC.ToInterval(FrailtyEnc.period) overlaps "Measurement Period" ) or exists( (AC.QualifiedObservations([Observation: "Frailty Symptom"])) FrailtySymptom where FC.ToInterval(FrailtySymptom.effective) overlaps "Measurement Period" )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 32
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
extension:
  url:
    v: name
    l: name
  value: String
    v: Up To One Year Prior Including Measurement Period
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Up To One Year Prior Including Measurement Period": Interval[start of "Measurement Period" - 1 year, end of "Measurement Period"]
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 33
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
extension:
  url:
    v: name
    l: name
  value: String
    v: Outpatient Encounters With Advanced Illness
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Outpatient Encounters With Advanced Illness": ((AC.QualifiedEncounters([Encounter: "Outpatient"])) union (AC.QualifiedEncounters([Encounter: "Observation"])) union (AC.QualifiedEncounters([Encounter: "Emergency Department Visit"])) union (AC.QualifiedEncounters([Encounter: "Nonacute Inpatient"]))) OutpatientEnc with (AC.QualifiedConditions([Condition: "Advanced Illness"])) AdvanIll such that FC.ToPrevalenceInterval(AdvanIll) overlaps "Measurement Period" and FC.ToInterval(OutpatientEnc.period) overlaps "Up To One Year Prior Including Measurement Period"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 34
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
extension:
  url:
    v: name
    l: name
  value: String
    v: Has Two Outpatient Encounters With Advanced Illness on Different Dates of Service
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Has Two Outpatient Encounters With Advanced Illness on Different Dates of Service": from "Outpatient Encounters With Advanced Illness" OutpatientEncounter1, "Outpatient Encounters With Advanced Illness" OutpatientEncounter2 where OutpatientEncounter2.period ends 1 day or more after day of end of OutpatientEncounter1.period return OutpatientEncounter1
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 35
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
extension:
  url:
    v: name
    l: name
  value: String
    v: Has Inpatient Encounter With Advanced Illness
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Has Inpatient Encounter With Advanced Illness": (AC.QualifiedEncounters([Encounter: "Acute Inpatient"])) InpatientEnc with (AC.QualifiedConditions([Condition: "Advanced Illness"])) AdvanIll such that FC.ToPrevalenceInterval(AdvanIll) overlaps InpatientEnc.period and FC.ToInterval(InpatientEnc.period) overlaps "Up To One Year Prior Including Measurement Period"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 36
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
extension:
  url:
    v: name
    l: name
  value: String
    v: Has Dementia Medications In Year Before or During Measurement Period
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Has Dementia Medications In Year Before or During Measurement Period": (AC.QualifiedMedicationRequests([MedicationRequest: "Dementia Medications"])) DementiaMed where exists( DementiaMed.dosageInstruction dosage where exists( FC.ToTimingInterval(dosage.timing)) timing where timing overlaps "Up To One Year Prior Including Measurement Period")
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 37
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
extension:
  url:
    v: name
    l: name
  value: String
    v: Is Age 66 to 80 with Advanced Illness and Frailty or Is Age 81 or Older with Frailty
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Is Age 66 to 80 with Advanced Illness and Frailty or Is Age 81 or Older with Frailty": ( AgeInYearsAt(date from end of "Measurement Period") in Interval[66, 80] and "Has Criteria Indicating Frailty" and ( exists("Has Two Outpatient Encounters With Advanced Illness on Different Dates of Service") or exists("Has Inpatient Encounter With Advanced Illness") or exists("Has Dementia Medications In Year Before or During Measurement Period") ) ) or ( AgeInYearsAt(date from end of "Measurement Period") >= 81 and "Has Criteria Indicating Frailty" )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 38
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
extension:
  url:
    v: name
    l: name
  value: String
    v: Lives In A Nursing Home
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Lives In A Nursing Home": Last( (AC.QualifiedObservations([Observation: "Housing Status"])) HousingStatus where FC.ToInterval(HousingStatus.effective) ends on or before end of "Measurement Period" and HousingStatus.value ~ ToConcept("Lives In A Nursing Home (finding)") sort by issued ascending ) is not null
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 39
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
extension:
  url:
    v: name
    l: name
  value: String
    v: Is Age 66 or Older Living Long Term in a Nursing Home
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Is Age 66 or Older Living Long Term in a Nursing Home": AgeInYearsAt(date from end of "Measurement Period") >= 66 and "Lives In A Nursing Home"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 40
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: PalliativeCareFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Palliative Care in the Measurement Period
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Palliative Care in the Measurement Period": exists( (AC.QualifiedObservations([Observation: "Functional Assessment of Chronic Illness Therapy - Palliative Care Questionnaire (FACIT-Pal)"])) PalliativeObservation where FC.ToInterval(PalliativeObservation.effective) overlaps "Measurement Period" ) or exists( (AC.QualifiedConditions([Condition: "Palliative Care Diagnosis"])) PalliativeDiagnosis where FC.ToPrevalenceInterval(PalliativeDiagnosis) overlaps "Measurement Period" ) or exists( (AC.QualifiedEncounters([Encounter: "Palliative Care Encounter"])) PalliativeEncounter where FC.ToInterval(PalliativeEncounter.period) overlaps "Measurement Period" ) or exists( (AC.QualifiedProcedures([Procedure: "Palliative Care Intervention"])) PalliativeProcedure where FC.ToInterval(PalliativeProcedure.performed) overlaps "Measurement Period" )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 41
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: ControllingHighBloodPressureFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Denominator Exclusion
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Denominator Exclusion": Hospice."Has Hospice" or exists ("Pregnancy Or Renal Diagnosis") or exists ("End Stage Renal Disease Procedures") or exists ("End Stage Renal Disease Encounter") or FrailtyLTI."Is Age 66 to 80 with Advanced Illness and Frailty or Is Age 81 or Older with Frailty" or FrailtyLTI."Is Age 66 or Older Living Long Term in a Nursing Home" or PalliativeCare."Palliative Care in the Measurement Period"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 42
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: SupplementalDataElementsFHIR4
extension:
  url:
    v: name
    l: name
  value: String
    v: SDE Race
extension:
  url:
    v: statement
    l: statement
  value: String
    v: 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
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 43
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: ControllingHighBloodPressureFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: SDE Race
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "SDE Race": SDE."SDE Race"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 44
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: FHIRHelpers
extension:
  url:
    v: name
    l: name
  value: String
    v: ToString
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define function ToString(value AdministrativeGender): value.value
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 45
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: FHIRHelpers
extension:
  url:
    v: name
    l: name
  value: String
    v: ToString
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define function ToString(value AddressUse): value.value
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 46
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: FHIRHelpers
extension:
  url:
    v: name
    l: name
  value: String
    v: ToString
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define function ToString(value AddressType): value.value
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 47
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: FHIRHelpers
extension:
  url:
    v: name
    l: name
  value: String
    v: ToInterval
extension:
  url:
    v: statement
    l: statement
  value: String
    v: 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:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 48
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: FHIRHelpers
extension:
  url:
    v: name
    l: name
  value: String
    v: ToQuantity
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define function ToQuantity(quantity FHIR.Quantity): case when quantity is null then null when quantity.value is null then null when quantity.comparator is not null then Message(null, true, 'FHIRHelpers.ToQuantity.ComparatorQuantityNotSupported', 'Error', 'FHIR Quantity value has a comparator and cannot be converted to a System.Quantity value.') when quantity.system is null or quantity.system.value = 'http://unitsofmeasure.org' or quantity.system.value = 'http://hl7.org/fhirpath/CodeSystem/calendar-units' then System.Quantity { value: quantity.value.value, unit: ToCalendarUnit(Coalesce(quantity.code.value, quantity.unit.value, '1')) } else Message(null, true, 'FHIRHelpers.ToQuantity.InvalidFHIRQuantity', 'Error', 'Invalid FHIR Quantity code: ' & quantity.unit.value & ' (' & quantity.system.value & '|' & quantity.code.value & ')') end
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 49
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: FHIRHelpers
extension:
  url:
    v: name
    l: name
  value: String
    v: ToCalendarUnit
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define function ToCalendarUnit(unit System.String): case unit when 'ms' then 'millisecond' when 's' then 'second' when 'min' then 'minute' when 'h' then 'hour' when 'd' then 'day' when 'wk' then 'week' when 'mo' then 'month' when 'a' then 'year' else unit end
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 50
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: FHIRHelpers
extension:
  url:
    v: name
    l: name
  value: String
    v: ToString
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define function ToString(value ObservationStatus): value.value
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 51
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: FHIRHelpers
extension:
  url:
    v: name
    l: name
  value: String
    v: ToConcept
extension:
  url:
    v: statement
    l: statement
  value: String
    v: 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:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 52
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: FHIRHelpers
extension:
  url:
    v: name
    l: name
  value: String
    v: ToCode
extension:
  url:
    v: statement
    l: statement
  value: String
    v: 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:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 53
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: MATGlobalCommonFunctionsFHIR4
extension:
  url:
    v: name
    l: name
  value: String
    v: Prevalence Period
extension:
  url:
    v: statement
    l: statement
  value: String
    v: /* Returns an interval representing the period during which the condition was prevalent (i.e. onset to abatement) If the condition is "active", then abatement being unknown would indicate the condition is ongoing, and the ending boundary of the prevalence period is inclusive, otherwise, the abatement is considered unknown and the ending boundary of the prevalence period is exclusive. Note that when using this function it should be noted that many clinical systems do not actually capture abatement, so care should be taken when using this function to meet clinical intent. */ define function "Prevalence Period"(condition Condition ): if condition.clinicalStatus ~ "active" or condition.clinicalStatus ~ "recurrence" or condition.clinicalStatus ~ "relapse" then Interval[start of "Normalize Interval"(condition.onset), end of "Normalize Abatement"(condition)] else Interval[start of "Normalize Interval"(condition.onset), end of "Normalize Abatement"(condition))
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 54
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: MATGlobalCommonFunctionsFHIR4
extension:
  url:
    v: name
    l: name
  value: String
    v: Normalize Abatement
extension:
  url:
    v: statement
    l: statement
  value: String
    v: /** * Returns an interval representing the abatement of the given condition, if an abatement element is present, null otherwise. This function uses the semantics of Normalize Interval to interpret the abatement element. */ define function "Normalize Abatement"(condition Condition ): if condition.abatement is FHIR.dateTime then Interval[FHIRHelpers.ToDateTime(condition.abatement as FHIR.dateTime), FHIRHelpers.ToDateTime(condition.abatement as FHIR.dateTime)] else if condition.abatement is FHIR.Period then FHIRHelpers.ToInterval(condition.abatement as FHIR.Period) else if condition.abatement is FHIR.string then Message(null as Interval<DateTime>, true, '1', 'Error', 'Cannot compute an interval from a String value') else if condition.abatement is FHIR.Age then Interval[FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(condition.abatement as FHIR.Age), FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(condition.abatement as FHIR.Age) + 1 year) else if condition.abatement is FHIR.Range then Interval[FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity((condition.abatement as FHIR.Range).low), FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity((condition.abatement as FHIR.Range).high) + 1 year) else if condition.abatement is FHIR.boolean then Interval[end of "Normalize Interval"(condition.onset), condition.recordedDate) else null
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 55
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: FHIRHelpers
extension:
  url:
    v: name
    l: name
  value: String
    v: ToDateTime
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define function ToDateTime(value dateTime): value.value
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 56
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: FHIRHelpers
extension:
  url:
    v: name
    l: name
  value: String
    v: ToDate
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define function ToDate(value date): value.value
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 57
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: FHIRCommon
extension:
  url:
    v: name
    l: name
  value: String
    v: ToInterval
extension:
  url:
    v: statement
    l: statement
  value: String
    v: /* @description: Normalizes a value that is a choice of timing-valued types to an equivalent interval @comment: Normalizes a choice type of FHIR.dateTime, FHIR.Period, FHIR.Timing, FHIR.instance, FHIR.string, FHIR.Age, or FHIR.Range types to an equivalent interval. This selection of choice types is a superset of the majority of choice types that are used as possible representations for timing-valued elements in FHIR, allowing this function to be used across any resource. The input can be provided as a dateTime, Period, Timing, instant, string, Age, or Range. The intent of this function is to provide a clear and concise mechanism to treat single elements that have multiple possible representations as intervals so that logic doesn't have to account for the variability. More complex calculations (such as medication request period or dispense period calculation) need specific guidance and consideration. That guidance may make use of this function, but the focus of this function is on single element calculations where the semantics are unambiguous. If the input is a dateTime, the result a DateTime Interval beginning and ending on that dateTime. If the input is a Period, the result is a DateTime Interval. If the input is a Timing, an error is raised indicating a single interval cannot be computed from a Timing. If the input is an instant, the result is a DateTime Interval beginning and ending on that instant. If the input is a string, an error is raised indicating a single interval cannot be computed from a string. If the input is an Age, the result is a DateTime Interval beginning when the patient was the given Age, and ending immediately prior to when the patient was the given Age plus one year. If the input is a Range, the result is a DateTime Interval beginning when the patient was the Age given by the low end of the Range, and ending immediately prior to when the patient was the Age given by the high end of the Range plus one year. NOTE: Due to the complexity of dete…
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 58
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: FHIRHelpers
extension:
  url:
    v: name
    l: name
  value: String
    v: ToDateTime
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define function ToDateTime(value instant): value.value
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 59
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: FHIRHelpers
extension:
  url:
    v: name
    l: name
  value: String
    v: ToString
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define function ToString(value EncounterStatus): value.value
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 60
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: FHIRHelpers
extension:
  url:
    v: name
    l: name
  value: String
    v: ToString
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define function ToString(value uri): value.value
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 61
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: AlphoraCommon
extension:
  url:
    v: name
    l: name
  value: String
    v: QualifiedEncounters
extension:
  url:
    v: statement
    l: statement
  value: String
    v: /* Common Resource Qualifications and Negations */ define function QualifiedEncounters(value List<FHIR.Encounter>): value Encounter where ( //planned | arrived | triaged | in-progress | onleave | finished | cancelled | entered-in-error | unknown Encounter.status ~ 'arrived' or Encounter.status ~ 'in-progress' or Encounter.status ~ 'finished' or Encounter.status ~ 'onleave' or Encounter.status ~ 'triaged' )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 62
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: AlphoraCommon
extension:
  url:
    v: name
    l: name
  value: String
    v: QualifiedObservations
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define function QualifiedObservations(value List<FHIR.Observation>): value Observation where ( //registered | preliminary | final | amended | corrected | cancelled | entered-in-error | unknown Observation.status ~ 'final' or Observation.status ~ 'amended' or Observation.status ~ 'corrected' )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 63
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: AlphoraCommon
extension:
  url:
    v: name
    l: name
  value: String
    v: QualifiedServiceRequests
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define function QualifiedServiceRequests(value List<FHIR.ServiceRequest>): value ServiceRequest where ( //draft | active | on-hold | revoked | completed | entered-in-error | unknown ServiceRequest.status ~ 'active' or ServiceRequest.status ~ 'completed' and ServiceRequest.intent ~ 'order' ) and ( ServiceRequest.doNotPerform is null or ServiceRequest.doNotPerform = false )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 64
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: FHIRHelpers
extension:
  url:
    v: name
    l: name
  value: String
    v: ToString
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define function ToString(value ServiceRequestStatus): value.value
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 65
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: FHIRHelpers
extension:
  url:
    v: name
    l: name
  value: String
    v: ToString
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define function ToString(value ServiceRequestIntent): value.value
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 66
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: FHIRHelpers
extension:
  url:
    v: name
    l: name
  value: String
    v: ToBoolean
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define function ToBoolean(value boolean): value.value
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 67
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: AlphoraCommon
extension:
  url:
    v: name
    l: name
  value: String
    v: QualifiedProcedures
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define function QualifiedProcedures(value List<FHIR.Procedure>): value Procedure where ( //preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Procedure.status ~ 'completed' )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 68
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: FHIRHelpers
extension:
  url:
    v: name
    l: name
  value: String
    v: ToString
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define function ToString(value ProcedureStatus): value.value
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 69
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: AlphoraCommon
extension:
  url:
    v: name
    l: name
  value: String
    v: QualifiedConditions
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define function QualifiedConditions(value List<FHIR.Condition>): value Condition where ( FHIRHelpers.ToConcept(Condition.clinicalStatus) ~ FC."active" ) and ( FHIRHelpers.ToConcept(Condition.verificationStatus) ~ FC."confirmed" )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 70
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: FHIRCommon
extension:
  url:
    v: name
    l: name
  value: String
    v: ToPrevalenceInterval
extension:
  url:
    v: statement
    l: statement
  value: String
    v: /* @description: Returns an interval representing the normalized prevalence period of a given Condition resource. @comment: Uses the ToInterval and ToAbatementInterval functions to determine the widest potential interval from onset to abatement as specified in the given Condition. */ define function ToPrevalenceInterval(condition Condition): if condition.clinicalStatus ~ "active" or condition.clinicalStatus ~ "recurrence" or condition.clinicalStatus ~ "relapse" then Interval[start of ToInterval(condition.onset), end of ToAbatementInterval(condition)] else Interval[start of ToInterval(condition.onset), end of ToAbatementInterval(condition))
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 71
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: FHIRCommon
extension:
  url:
    v: name
    l: name
  value: String
    v: ToAbatementInterval
extension:
  url:
    v: statement
    l: statement
  value: String
    v: /* @description: Returns an interval representing the normalized Abatement of a given Condition resource. @comment: NOTE: Due to the complexity of determining an interval from a String, this function will throw a run-time exception if used with a Condition instance that has a String as the abatement value. */ define function ToAbatementInterval(condition Condition): if condition.abatement is FHIR.dateTime then Interval[FHIRHelpers.ToDateTime(condition.abatement as FHIR.dateTime), FHIRHelpers.ToDateTime(condition.abatement as FHIR.dateTime)] else if condition.abatement is FHIR.Period then FHIRHelpers.ToInterval(condition.abatement as FHIR.Period) else if condition.abatement is FHIR.string then Message(null as Interval<DateTime>, true, '1', 'Error', 'Cannot compute an interval from a String value') else if condition.abatement is FHIR.Age then Interval[FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(condition.abatement as FHIR.Age), FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(condition.abatement as FHIR.Age) + 1 year) else if condition.abatement is FHIR.Range then Interval[FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity((condition.abatement as FHIR.Range).low), FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity((condition.abatement as FHIR.Range).high) + 1 year) else if condition.abatement is FHIR.boolean then Interval[end of ToInterval(condition.onset), condition.recordedDate) else null
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 72
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: AlphoraCommon
extension:
  url:
    v: name
    l: name
  value: String
    v: QualifiedDeviceRequests
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define function QualifiedDeviceRequests(value List<FHIR.DeviceRequest>): value DeviceRequest where ( //draft | active | on-hold | revoked | completed | entered-in-error | unknown DeviceRequest.status ~ 'completed' or DeviceRequest.status ~ 'active' and DeviceRequest.intent ~ 'order' )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 73
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: FHIRHelpers
extension:
  url:
    v: name
    l: name
  value: String
    v: ToString
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define function ToString(value DeviceRequestStatus): value.value
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 74
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: FHIRHelpers
extension:
  url:
    v: name
    l: name
  value: String
    v: ToString
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define function ToString(value RequestIntent): value.value
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 75
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: FHIRHelpers
extension:
  url:
    v: name
    l: name
  value: String
    v: ToString
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define function ToString(value string): value.value
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 76
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: AlphoraCommon
extension:
  url:
    v: name
    l: name
  value: String
    v: QualifiedMedicationRequests
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define function QualifiedMedicationRequests(value List<FHIR.MedicationRequest>): value MedicationRequest where ( //active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown (MedicationRequest.status ~ 'active' or MedicationRequest.status ~ 'completed' ) and ( MedicationRequest.doNotPerform is null or MedicationRequest.doNotPerform = false ) and MedicationRequest.intent ~ 'order' )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 77
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: FHIRHelpers
extension:
  url:
    v: name
    l: name
  value: String
    v: ToString
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define function ToString(value MedicationRequestStatus): value.value
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 78
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: FHIRHelpers
extension:
  url:
    v: name
    l: name
  value: String
    v: ToString
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define function ToString(value MedicationRequestIntent): value.value
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 79
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: FHIRCommon
extension:
  url:
    v: name
    l: name
  value: String
    v: ToTimingInterval
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define function ToTimingInterval(timing FHIR.Timing): convert ( NullToEmptyInterval(ToIntervalFromList(timing.event)) union NullToEmptyInterval({ToInterval(timing.repeat.bounds as FHIR.Period)}) ) to List<Interval<DateTime>> except { null }
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 80
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: FHIRCommon
extension:
  url:
    v: name
    l: name
  value: String
    v: NullToEmptyInterval
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define function NullToEmptyInterval(value List<Interval<DateTime>>): if value is not null then value else { }
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 81
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: FHIRCommon
extension:
  url:
    v: name
    l: name
  value: String
    v: ToIntervalFromList
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define function ToIntervalFromList(value List<FHIR.dateTime>): value v return ToInterval(v)
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 82
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

v: EffectiveDataRequirements

v: active

coding:
  system:
    v: http://terminology.hl7.org/CodeSystem/library-type
    l: library-type
  code:
    v: module-definition

type:
  v: depends-on
display:
  v: Library SDE
resource:
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v: 0.1.0

v: ControllingHighBloodPressureFHIR

v: Controlling High Blood Pressure

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v: 2025-09-25T07:40:03-06:00

v: Clinical Quality Framework

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v: Percentage of patients 18-85 years of age who had a diagnosis of essential hypertension starting before and continuing into, or starting during the first six months of the measurement period, and whose most recent blood pressure was adequately controlled (<140/90 mmHg) during the measurement period

coding:
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v: Unknown

v: This Physician Performance Measure (Measure) and related data specifications are owned and were developed by the National Committee for Quality Assurance (NCQA). NCQA is not responsible for any use of the Measure. NCQA makes no representations, warranties, or endorsement about the quality of any organization or physician that uses or reports performance measures and NCQA has no liability to anyone who relies on such measures or specifications. NCQA holds a copyright in the Measure. The Measure can be reproduced and distributed, without modification, for noncommercial purposes (e.g., use by healthcare providers in connection with their practices) without obtaining approval from NCQA. Commercial use is defined as the sale, licensing, or distribution of the Measure for commercial gain, or incorporation of the Measure into a product or service that is sold, licensed or distributed for commercial gain. All commercial uses or requests for modification must be approved by NCQA and are subject to a license at the discretion of NCQA. (C) 2012-2022 National Committee for Quality Assurance. All Rights Reserved. Limited proprietary coding is contained in the Measure specifications for user convenience. Users of proprietary code sets should obtain all necessary licenses from the owners of the code sets. NCQA disclaims all liability for use or accuracy of any third-party codes contained in the specifications. CPT(R) codes, descriptions and other data are copyright 2022. American Medical Association. All rights reserved. CPT is a trademark of the American Medical Association. No fee schedules, basic units, relative values or related listings are included in CPT. The AMA assumes no liability for the data contained herein. Applicable FARS/DFARS restrictions apply to government use. LOINC(R) copyright 2004-2022 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2022 International Health Terminology Standards Development Organisat…

start:
  v: 2024-01-01
end:
  v: 2024-12-31

v: The performance Measure is not a clinical guideline and does not establish a standard of medical care, and has not been tested for all potential applications. THE MEASURE AND SPECIFICATIONS ARE PROVIDED "AS IS" WITHOUT WARRANTY OF ANY KIND. Due to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM].

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    l: measure-type
  code:
    v: outcome
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v: High blood pressure (HBP), also known as hypertension, is when the pressure in blood vessels is higher than normal (Centers for Disease Control and Prevention [CDC], 2021). The causes of hypertension are multiple and multifaceted and can be based on genetic predisposition, environmental risk factors, being overweight and obese, sodium intake, potassium intake, physical activity, and alcohol use. High blood pressure is common; according to the American Heart Association, between 2013-2016, approximately 121.5 million US adults >= 20 years of age had HBP and the prevalence of hypertension among US adults 65 and older was 77.0 percent (Virani et al., 2021). In an analysis of adults with hypertension in NHANES, the estimated age-adjusted proportion with controlled BP increased from 31.8 percent in 1999 to 53.8 percent in 2014. However, that proportion declined to 43.7 percent in 2017 to 2018 (Tsao et al., 2022). HBP, known as the “silent killer,” increases risks of heart disease and stroke which are two of the leading causes of death in the US; a person who has HBP is four times more likely to die from a stroke and three times more likely to die from heart disease (CDC, 2012). The National Center for Health Statistics reported that in 2020 there were over 670,000 deaths with HBP as a primary or contributing cause (CDC, 2022). Between 2009 and 2019 the number of deaths due to HBP rose by 65.3 percent (Tsao et al., 2022). Managing and treating HBP would reduce cardiovascular disease mortality for males and females by 30.4 percent and 38.0 percent, respectively (Patel et al., 2015). Age-adjusted death rates attributable to HBP in 2019 were more than twice as high in non-Hispanic Black males (56.7 percent) when compared to rates for non-Hispanic White males (25.7 percent) (Tsao et al., 2022). HBP costs the U.S. approximately 131 billion dollars each year, averaged over 12 years from 2003 to 2014 (Kirkland et al., 2018). A study on cost-effectiveness on treating hypertension…

v: U.S. Preventive Services Task Force (USPSTF) (2021): - The USPSTF recommends screening for hypertension in adults 18 years or older with office blood pressure measurement (OBPM). The USPSTF recommends obtaining blood pressure measurements outside of the clinical setting for diagnostic confirmation before starting treatment. This is a grade A recommendation. American College of Cardiology/American Heart Association (2017): - For adults with confirmed hypertension and known CVD or 10-year ASCVD event risk of 10 percent or higher, a blood pressure target of less than 130/80 mmHg is recommended (Level of evidence: B-R (for systolic blood pressures), Level of evidence: C-EO (for diastolic blood pressure)) - For adults with confirmed hypertension, without additional markers of increased CVD risk, a blood pressure target of less than 130/80 mmHg may be reasonable (Note: clinical trial evidence is strongest for a target blood pressure of 140/90 mmHg in this population. However, observational studies suggest that these individuals often have a high lifetime risk and would benefit from blood pressure control earlier in life) (Level of evidence: B-NR (for systolic blood pressure), Level of evidence: C-EO (for diastolic blood pressure)). American College of Physicians and the American Academy of Family Physicians (2017): - Initiate or intensify pharmacologic treatment in some adults aged 60 years or older at high cardiovascular risk, based on individualized assessment, to achieve a target systolic blood pressure of less than 140 mmHg (Grade: weak recommendation, Quality of evidence: low) - Initiate or intensify pharmacologic treatment in adults aged 60 years or older with a history of stroke or transient ischemic attack to achieve a target systolic blood pressure of less than 140 mmHg to reduce the risk of recurrent stroke (Grade: weak recommendation, Quality of evidence: moderate) American Diabetes Association (2021): - For individuals with diabetes and hypertension at higher …

coding:
  system:
    v: http://terminology.hl7.org/CodeSystem/measure-improvement-notation
    l: measure-improvement-notation
  code:
    v: decrease
  display:
    v: Lower score indicates better quality

v: In reference to the numerator element, only blood pressure readings performed by a clinician or an automated blood pressure monitor or device are acceptable for numerator compliance with this measure. This includes blood pressures taken in person by a clinician and blood pressures measured remotely by electronic monitoring devices capable of transmitting the blood pressure data to the clinician. Blood pressure readings taken by an automated blood pressure monitor or device and conveyed by the patient to the clinician are also acceptable. It is the clinician’s responsibility and discretion to confirm the automated blood pressure monitor or device used to obtain the blood pressure is considered acceptable and reliable and whether the blood pressure reading is considered accurate before documenting it in the patient’s medical record. Do not include BP readings taken during an acute inpatient stay or an ED visit. If no blood pressure is recorded during the measurement period, the patient's blood pressure is assumed 'not controlled'. If there are multiple blood pressure readings on the same day, use the lowest systolic and the lowest diastolic reading as the most recent blood pressure reading. Ranges and thresholds do not meet criteria for this measure. A distinct numeric result for both the systolic and diastolic BP reading is required for numerator compliance. This eCQM is a patient-based measure. This version of the eCQM uses QDM version 5.6. Please refer to the eCQI resource center (https://ecqi.healthit.gov/qdm) for more information on the QDM.

population:
  code:
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/measure-population
        l: measure-population
      code:
        v: initial-population
      display:
        v: Initial Population
  description:
    v: Patients 18-85 years of age who had a visit during the measurement period and diagnosis of essential hypertension
  criteria:
    language:
      v: text/cql-identifier
    expression:
      v: Initial Population
population:
  code:
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/measure-population
        l: measure-population
      code:
        v: denominator
      display:
        v: Denominator
  description:
    v: Patients 18-85 years of age who had a visit during the measurement period and diagnosis of essential hypertension
  criteria:
    language:
      v: text/cql-identifier
    expression:
      v: Denominator
population:
  code:
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/measure-population
        l: measure-population
      code:
        v: numerator
      display:
        v: Numerator
  description:
    v: Patients whose most recent blood pressure is adequately controlled (systolic blood pressure < 140 mmHg and diastolic blood pressure < 90 mmHg) during the measurement period
  criteria:
    language:
      v: text/cql-identifier
    expression:
      v: Numerator
population:
  code:
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/measure-population
        l: measure-population
      code:
        v: denominator-exclusion
      display:
        v: Denominator Exclusions
  description:
    v: Patients with ESRD or dialysis or renal transplant or pregnancy or in hospice or 66+ in nursing care or 66-80 with frailty and advanced illness or 81+ with frailty or receiving palliative care
  criteria:
    language:
      v: text/cql-identifier
    expression:
      v: Denominator Exclusion
stratifier:
  id:
    v: stratifier-ethnicity
  code:
    coding: https://loinc.org/rdf/54133-4
      system:
        v: http://loinc.org
        l: loinc.org
      code:
        v: 54133-4
      display:
        v: Ethnicity
  description:
    v: Ethnicity (CDC Value Set)
  criteria:
    language:
      v: text/cql-identifier
    expression:
      v: SDE Ethnicity
stratifier:
  id:
    v: stratifier-payer
  code:
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/coverage-class
        l: coverage-class
      code:
        v: plan
      display:
        v: SDE Payer
  description:
    v: Payer
  criteria:
    language:
      v: text/cql-identifier
    expression:
      v: SDE Payer
stratifier:
  id:
    v: stratifier-race
  code:
    coding: https://loinc.org/rdf/32624-9
      system:
        v: http://loinc.org
        l: loinc.org
      code:
        v: 32624-9
      display:
        v: SDE Race
  description:
    v: Race (CDC Value Set)
  criteria:
    language:
      v: text/cql-identifier
    expression:
      v: SDE Race
stratifier:
  id:
    v: stratifier-sex
  code:
    coding: https://loinc.org/rdf/72143-1
      system:
        v: http://loinc.org
        l: loinc.org
      code:
        v: 72143-1
      display:
        v: Sex [HL7.v3]
  description:
    v: Administrative sex
  criteria:
    language:
      v: text/cql-identifier
    expression:
      v: SDE Sex
stratifier:
  id:
    v: stratifier-age
  code:
    coding: https://loinc.org/rdf/30525-0
      system:
        v: http://loinc.org
        l: loinc.org
      code:
        v: 30525-0
      display:
        v: Age
  description:
    v: Age
  criteria:
    language:
      v: text/cql-identifier
    expression:
      v: SDE Age
stratifier:
  id:
    v: stratifier-food-insecurity-risk-status
  code:
    coding: https://loinc.org/rdf/88124-3
      system:
        v: http://loinc.org
        l: loinc.org
      code:
        v: 88124-3
      display:
        v: Food insecurity risk [HVS]
  description:
    v: Food insecurity risk status
  criteria:
    language:
      v: text/cql-identifier
    expression:
      v: SDE Food Insecurity Risk Status

id:
  v: sde-ethnicity
code:
  coding: https://loinc.org/rdf/54133-4
    system:
      v: http://loinc.org
      l: loinc.org
    code:
      v: 54133-4
    display:
      v: Ethnicity
usage:
  coding:
    system:
      v: http://terminology.hl7.org/CodeSystem/measure-data-usage
      l: measure-data-usage
    code:
      v: supplemental-data
description:
  v: Ethnicity (CDC Value Set)
criteria:
  language:
    v: text/cql-identifier
  expression:
    v: SDE Ethnicity

id:
  v: sde-payer
code:
  coding:
    system:
      v: http://terminology.hl7.org/CodeSystem/coverage-class
      l: coverage-class
    code:
      v: plan
    display:
      v: SDE Payer
usage:
  coding:
    system:
      v: http://terminology.hl7.org/CodeSystem/measure-data-usage
      l: measure-data-usage
    code:
      v: supplemental-data
description:
  v: Payer
criteria:
  language:
    v: text/cql-identifier
  expression:
    v: SDE Payer

id:
  v: sde-race
code:
  coding: https://loinc.org/rdf/32624-9
    system:
      v: http://loinc.org
      l: loinc.org
    code:
      v: 32624-9
    display:
      v: SDE Race
usage:
  coding:
    system:
      v: http://terminology.hl7.org/CodeSystem/measure-data-usage
      l: measure-data-usage
    code:
      v: supplemental-data
description:
  v: Race (CDC Value Set)
criteria:
  language:
    v: text/cql-identifier
  expression:
    v: SDE Race

id:
  v: sde-sex
code:
  coding: https://loinc.org/rdf/72143-1
    system:
      v: http://loinc.org
      l: loinc.org
    code:
      v: 72143-1
    display:
      v: Sex [HL7.v3]
usage:
  coding:
    system:
      v: http://terminology.hl7.org/CodeSystem/measure-data-usage
      l: measure-data-usage
    code:
      v: supplemental-data
description:
  v: Administrative sex
criteria:
  language:
    v: text/cql-identifier
  expression:
    v: SDE Sex

id:
  v: sde-age
code:
  coding: https://loinc.org/rdf/30525-0
    system:
      v: http://loinc.org
      l: loinc.org
    code:
      v: 30525-0
    display:
      v: Age
usage:
  coding:
    system:
      v: http://terminology.hl7.org/CodeSystem/measure-data-usage
      l: measure-data-usage
    code:
      v: supplemental-data
description:
  v: Age
criteria:
  language:
    v: text/cql-identifier
  expression:
    v: SDE Age

id:
  v: sde-state-of-residence
code:
  coding: https://loinc.org/rdf/52830-7
    system:
      v: http://loinc.org
      l: loinc.org
    code:
      v: 52830-7
    display:
      v: State, district or territory federal abbreviation
usage:
  coding:
    system:
      v: http://terminology.hl7.org/CodeSystem/measure-data-usage
      l: measure-data-usage
    code:
      v: supplemental-data
description:
  v: State of residence
criteria:
  language:
    v: text/cql-identifier
  expression:
    v: SDE State of Residence

id:
  v: sde-postal-code-of-residence
code:
  coding: https://loinc.org/rdf/45401-7
    system:
      v: http://loinc.org
      l: loinc.org
    code:
      v: 45401-7
    display:
      v: Postal code
usage:
  coding:
    system:
      v: http://terminology.hl7.org/CodeSystem/measure-data-usage
      l: measure-data-usage
    code:
      v: supplemental-data
description:
  v: Postal code of residence
criteria:
  language:
    v: text/cql-identifier
  expression:
    v: SDE Postal Code of Residence

id:
  v: sde-food-insecurity-risk-status
code:
  coding: https://loinc.org/rdf/88124-3
    system:
      v: http://loinc.org
      l: loinc.org
    code:
      v: 88124-3
    display:
      v: Food insecurity risk [HVS]
usage:
  coding:
    system:
      v: http://terminology.hl7.org/CodeSystem/measure-data-usage
      l: measure-data-usage
    code:
      v: supplemental-data
description:
  v: Food insecurity risk status
criteria:
  language:
    v: text/cql-identifier
  expression:
    v: SDE Food Insecurity Risk Status