http://fhir.org/guides/cqf/aphl/chronic-ds/Measure/DiabetesHemoglobinA1cHbA1cPoorControl9FHIR
type: Measure
node role: treeRoot
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) DiabetesHemoglobinA1cHbA1cPoorControl9FHIR Title (human-readable) Diabetes: Hemoglobin A1c (HbA1c) Poor Control (> 9%)FHIR Status Draft Experimental false Description Percentage of patients 18-75 years of age with diabetes who had hemoglobin A1c > 9.0% 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) 2012-2020 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) contained in the Measure specifications is copyright 2004-2020 American Medical Ass…
contained: Library
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      system:
        v: http://terminology.hl7.org/CodeSystem/observation-category
        l: observation-category
      code:
        v: laboratory
      display:
        v: laboratory
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode
      l: cqf-directReferenceCode
    value: Coding
      system:
        v: http://www.ama-assn.org/go/cpt
        l: cpt
      code:
        v: 97802
      display:
        v: Medical nutrition therapy; initial assessment and intervention, individual, face-to-face with the patient, each 15 minutes
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode
      l: cqf-directReferenceCode
    value: Coding
      system:
        v: http://www.ama-assn.org/go/cpt
        l: cpt
      code:
        v: 97803
      display:
        v: Medical nutrition therapy; re-assessment and intervention, individual, face-to-face with the patient, each 15 minutes
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode
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    value: Coding
      system:
        v: http://www.ama-assn.org/go/cpt
        l: cpt
      code:
        v: 97804
      display:
        v: Medical nutrition therapy; group (2 or more individual(s)), each 30 minutes
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode
      l: cqf-directReferenceCode
    value: Coding
      system:
        v: http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets
        l: HCPCSReleaseCodeSets
      code:
        v: G0270
      display:
        v: Medical nutrition therapy; reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition or treatment regimen (including additional hours needed for renal disease), individual, face to face with the patient, each 15 minutes
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode
      l: cqf-directReferenceCode
    value: Coding
      system:
        v: http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets
        l: HCPCSReleaseCodeSets
      code:
        v: G0271
      display:
        v: Medical nutrition therapy, reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition, or treatment regimen (including additional hours needed for renal disease), group (2 or more individuals), each 30 minutes
  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
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    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
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    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
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    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
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    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/71802-3
      system:
        v: http://loinc.org
        l: loinc.org
      code:
        v: 71802-3
      display:
        v: Housing status

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
  code:
    v: 160734000
  display:
    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/98181-1
  system:
    v: http://loinc.org
    l: loinc.org
  code:
    v: 98181-1
  display:
    v: Medical equipment used

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
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
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
extension:
  url:
    v: name
    l: name
  value: String
    v: Has HbA1c Lab Test
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Has HbA1c Lab Test": (AC.LaboratoryObservation([Observation: "HbA1c Laboratory Test"]))
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
extension:
  url:
    v: name
    l: name
  value: String
    v: Most Recent HbA1c Lab Test
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Most Recent HbA1c Lab Test": AC.MostRecent("Has HbA1c Lab Test" HbA1cTest where FC.ToInterval(HbA1cTest.effective) during "Measurement Period")
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
extension:
  url:
    v: name
    l: name
  value: String
    v: Has Most Recent HbA1c Without Result
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Has Most Recent HbA1c Without Result": ("Most Recent HbA1c Lab Test" is not null) and ("Most Recent HbA1c Lab Test".value is null)
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
extension:
  url:
    v: name
    l: name
  value: String
    v: Has Most Recent Elevated HbA1c
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Has Most Recent Elevated HbA1c": "Most Recent HbA1c Lab Test".value >= 9 '%'
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
extension:
  url:
    v: name
    l: name
  value: String
    v: Has No Record Of HbA1c
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Has No Record Of HbA1c": not exists("Has HbA1c Lab Test")
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
extension:
  url:
    v: name
    l: name
  value: String
    v: Numerator
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Numerator": "Has Most Recent HbA1c Without Result" or "Has Most Recent Elevated HbA1c" or "Has No Record Of HbA1c"
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
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: "Nutrition Services"] union [Encounter: "Medical nutrition therapy; initial assessment and intervention, individual, face-to-face with the patient, each 15 minutes"] union [Encounter: "Medical nutrition therapy; re-assessment and intervention, individual, face-to-face with the patient, each 15 minutes"] union [Encounter: "Medical nutrition therapy; group (2 or more individual(s)), each 30 minutes"] union [Encounter: "Medical nutrition therapy; reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition or treatment regimen (including additional hours needed for renal disease), individual, face to face with the patient, each 15 minutes"] union [Encounter: "Medical nutrition therapy, reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition, or treatment regimen (including additional hours needed for renal disease), group (2 or more individuals), each 30 minutes"] union [Encounter: "Telephone Visits"] ) ValidEncounters where ValidEncounters.period during "Measurement Period" and ValidEncounters.status ~ 'finished'
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
extension:
  url:
    v: name
    l: name
  value: String
    v: Initial Population
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Initial Population": AgeInYearsAt(end of "Measurement Period") in Interval[18, 75] and exists("Qualifying Encounters") and exists( (AC.QualifiedConditions([Condition: "Diabetes"])) Diabetes where FC.ToPrevalenceInterval(Diabetes) overlaps "Measurement Period" )
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
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: 13
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: 14
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: 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: 15
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: 16
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: 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: 17
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: 18
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: 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: 19
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: 20
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: 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: 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: 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: 22
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: 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: 23
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: 24
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: 25
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: 26
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: 27
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: 28
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: 29
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: 30
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: 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 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: 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: Is Age 66 or Older with Advanced Illness and Frailty
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Is Age 66 or Older with Advanced Illness and Frailty": AgeInYearsAt(date from end of "Measurement Period") >= 66 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") )
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
    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: 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: Denominator Exclusions
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Denominator Exclusions": Hospice."Has Hospice" or Frailty."Is Age 66 or Older Living Long Term in a Nursing Home" or Frailty."Is Age 66 or Older with Advanced Illness and Frailty" or PalliativeCare."Palliative Care in the Measurement Period"
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
    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: 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: 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: 37
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: 38
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: 39
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: 40
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: 41
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: MostRecent
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define function MostRecent(observations List<Observation>): Last( observations O sort by start of FC.ToInterval(effective) )
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: AlphoraCommon
extension:
  url:
    v: name
    l: name
  value: String
    v: LaboratoryObservation
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define function LaboratoryObservation(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' and exists(Observation.category ObservationCategory where ( ObservationCategory ) ~ "laboratory" or (ObservationCategory) is null) )
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: 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: 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: 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: 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: 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: 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: 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: 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: 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: 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: 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: 49
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: 50
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: 51
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: 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: 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: 53
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: 54
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: 55
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: 56
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: 57
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: 58
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: 59
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: 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 ServiceRequestStatus): 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: 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: 62
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: 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: 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: 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 ProcedureStatus): 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: 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: 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: 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: 67
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: 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 string): 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: 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: 70
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: 71
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: 72
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: 73
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: 74
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: 75
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:
  v: http://fhir.org/guides/cqf/aphl/chronic-ds/Library/SupplementalDataElementsFHIR4|2.0.000
  l: http://fhir.org/guides/cqf/aphl/chronic-ds/Library/SupplementalDataElementsFHIR4

type:
  v: depends-on
display:
  v: Library FHIRHelpers
resource:
  v: http://fhir.org/guides/cqf/aphl/chronic-ds/Library/FHIRHelpers|4.1.000
  l: http://fhir.org/guides/cqf/aphl/chronic-ds/Library/FHIRHelpers

type:
  v: depends-on
display:
  v: Library SurveillanceDataElements
resource:
  v: http://fhir.org/guides/cqf/aphl/chronic-ds/Library/SurveillanceDataElementsFHIR4|1.0.000
  l: http://fhir.org/guides/cqf/aphl/chronic-ds/Library/SurveillanceDataElementsFHIR4

type:
  v: depends-on
display:
  v: Library AC
resource:
  v: http://fhir.org/guides/cqf/aphl/chronic-ds/Library/AlphoraCommon
  l: AlphoraCommon

type:
  v: depends-on
display:
  v: Library FC
resource:
  v: http://fhir.org/guides/cqf/aphl/chronic-ds/Library/FHIRCommon|1.1.000
  l: http://fhir.org/guides/cqf/aphl/chronic-ds/Library/FHIRCommon

type:
  v: depends-on
display:
  v: Library Common
resource:
  v: http://fhir.org/guides/cqf/aphl/chronic-ds/Library/MATGlobalCommonFunctionsFHIR4|6.0.000
  l: http://fhir.org/guides/cqf/aphl/chronic-ds/Library/MATGlobalCommonFunctionsFHIR4

type:
  v: depends-on
display:
  v: Library Hospice
resource:
  v: http://fhir.org/guides/cqf/aphl/chronic-ds/Library/HospiceFHIR4|2.0.000
  l: http://fhir.org/guides/cqf/aphl/chronic-ds/Library/HospiceFHIR4

type:
  v: depends-on
display:
  v: Library Frailty
resource:
  v: http://fhir.org/guides/cqf/aphl/chronic-ds/Library/AdvancedIllnessandFrailtyExclusionECQMFHIR4|5.12.000

type:
  v: depends-on
display:
  v: Library PalliativeCare
resource:
  v: http://fhir.org/guides/cqf/aphl/chronic-ds/Library/PalliativeCareFHIR
  l: PalliativeCareFHIR

type:
  v: depends-on
display:
  v: Code system ObservationCategoryCodes
resource:
  v: http://terminology.hl7.org/CodeSystem/observation-category
  l: observation-category

type:
  v: depends-on
display:
  v: Code system CPT
resource:
  v: http://www.ama-assn.org/go/cpt
  l: cpt

type:
  v: depends-on
display:
  v: Code system HCPCS
resource:
  v: http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets
  l: HCPCSReleaseCodeSets

type:
  v: depends-on
display:
  v: Code system ConditionClinicalStatusCodes
resource:
  v: http://terminology.hl7.org/CodeSystem/condition-clinical
  l: condition-clinical

type:
  v: depends-on
display:
  v: Code system ConditionVerificationStatusCodes
resource:
  v: http://terminology.hl7.org/CodeSystem/condition-ver-status
  l: condition-ver-status

type:
  v: depends-on
display:
  v: Code system LOINC
resource:
  v: http://loinc.org
  l: loinc.org

type:
  v: depends-on
display:
  v: Code system SNOMEDCT
resource:
  v: http://snomed.info/sct
  l: sct

type:
  v: depends-on
display:
  v: Value set HbA1c Laboratory Test
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1013
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1013

type:
  v: depends-on
display:
  v: Value set Office Visit
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001

type:
  v: depends-on
display:
  v: Value set Annual Wellness Visit
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240

type:
  v: depends-on
display:
  v: Value set Preventive Care Services - Established Office Visit, 18 and Up
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025

type:
  v: depends-on
display:
  v: Value set Preventive Care Services - Initial Office Visit, 18 and Up
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023

type:
  v: depends-on
display:
  v: Value set Home Healthcare Services
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016

type:
  v: depends-on
display:
  v: Value set Nutrition Services
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1006
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1006

type:
  v: depends-on
display:
  v: Value set Telephone Visits
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1080
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1080

type:
  v: depends-on
display:
  v: Value set Diabetes
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  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1083
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1083

type:
  v: Encounter
profile:
  v: http://hl7.org/fhir/StructureDefinition/Encounter
  l: Encounter
must support:
  v: type
must support:
  v: period
must support:
  v: status
code filter:
  path:
    v: type
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1090
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1090

type:
  v: Condition
profile:
  v: http://hl7.org/fhir/StructureDefinition/Condition
  l: Condition
must support:
  v: code
must support:
  v: clinicalStatus
must support:
  v: verificationStatus
code filter:
  path:
    v: code
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.103.12.1001
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.103.12.1001

type:
  v: Condition
profile:
  v: http://hl7.org/fhir/StructureDefinition/Condition
  l: Condition
must support:
  v: code
must support:
  v: clinicalStatus
must support:
  v: verificationStatus
code filter:
  path:
    v: code
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1165
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1165

type:
  v: Condition
profile:
  v: http://hl7.org/fhir/StructureDefinition/Condition
  l: Condition
must support:
  v: code
must support:
  v: clinicalStatus
must support:
  v: verificationStatus
code filter:
  path:
    v: code
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.113.12.1074
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.113.12.1074

type:
  v: Condition
profile:
  v: http://hl7.org/fhir/StructureDefinition/Condition
  l: Condition
must support:
  v: code
must support:
  v: clinicalStatus
must support:
  v: verificationStatus
code filter:
  path:
    v: code
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1082
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1082

type:
  v: Condition
profile:
  v: http://hl7.org/fhir/StructureDefinition/Condition
  l: Condition
must support:
  v: code
must support:
  v: clinicalStatus
must support:
  v: verificationStatus
code filter:
  path:
    v: code
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1167
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1167

type:
  v: Coverage
profile:
  v: http://hl7.org/fhir/StructureDefinition/Coverage
  l: Coverage
must support:
  v: type
must support:
  v: period
code filter:
  path:
    v: type
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591

type:
  v: ServiceRequest
profile:
  v: http://hl7.org/fhir/StructureDefinition/ServiceRequest
  l: ServiceRequest
must support:
  v: code
must support:
  v: authoredOn
must support:
  v: status
must support:
  v: intent
must support:
  v: doNotPerform
code filter:
  path:
    v: code
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.15
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.15

type:
  v: Procedure
profile:
  v: http://hl7.org/fhir/StructureDefinition/Procedure
  l: Procedure
must support:
  v: code
must support:
  v: performed
must support:
  v: status
code filter:
  path:
    v: code
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.15
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.15

type:
  v: Procedure
profile:
  v: http://hl7.org/fhir/StructureDefinition/Procedure
  l: Procedure
must support:
  v: code
must support:
  v: performed
must support:
  v: status
code filter:
  path:
    v: code
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1135
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1135

type:
  v: DeviceRequest
profile:
  v: http://hl7.org/fhir/StructureDefinition/DeviceRequest
  l: DeviceRequest
must support:
  v: code
must support:
  v: status
must support:
  v: intent
must support:
  v: authoredOn
code filter:
  path:
    v: code
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.118.12.1300
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.118.12.1300

type:
  v: MedicationRequest
profile:
  v: http://hl7.org/fhir/StructureDefinition/MedicationRequest
  l: MedicationRequest
must support:
  v: medication
must support:
  v: status
must support:
  v: doNotPerform
must support:
  v: intent
must support:
  v: dosageInstruction
code filter:
  path:
    v: medication
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.196.12.1510
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.196.12.1510

type:
  v: MedicationRequest
profile:
  v: http://hl7.org/fhir/StructureDefinition/MedicationRequest
  l: MedicationRequest
must support:
  v: medication.reference
must support:
  v: status
must support:
  v: doNotPerform
must support:
  v: intent
must support:
  v: dosageInstruction

type:
  v: Medication
profile:
  v: http://hl7.org/fhir/StructureDefinition/Medication
  l: Medication
must support:
  v: id
must support:
  v: code

id:
  v: cqf-tooling
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-softwaresystem
  l: cqfm-softwaresystem
value: Reference
  l: cqf-tooling
  reference:
    v: Device/cqf-tooling

url:
  v: http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements
  l: crmi-effectiveDataRequirements
value: Canonical
  v: #effective-data-requirements
  l: effective-data-requirements

use:
  v: usual
system:
  v: short-name
  l: short-name
value:
  v: CMS122v11

use:
  v: official
system:
  v: publisher
  l: publisher
value:
  v: 001

use:
  v: official
system:
  v: http://hl7.org/fhir/cqi/ecqm/Measure/Identifier/guid
  l: guid

v: 0.1.0

v: Diabetes: Hemoglobin A1c (HbA1c) Poor Control (> 9%)FHIR

v: draft

v: false

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

v: Clinical Quality Framework

telecom:
  system:
    v: url
  value:
    v: http://cqframework.org

v: Percentage of patients 18-75 years of age with diabetes who had hemoglobin A1c > 9.0% during the measurement period

coding:
  system:
    v: http://unstats.un.org/unsd/methods/m49/m49.htm
    l: m49.htm
  code:
    v: 001

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) 2012-2020 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) contained in the Measure specifications is copyright 2004-2020 American Medical Association. LOINC(R) copyright 2004-2020 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2020 International Health Terminology Standards Development Organisation. ICD-10 copyright 2020 World Health Organization. All Rights Reserved.

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].

coding:
  system:
    v: http://terminology.hl7.org/CodeSystem/measure-scoring
    l: measure-scoring
  code:
    v: proportion
  display:
    v: Proportion

coding:
  system:
    v: http://terminology.hl7.org/CodeSystem/measure-type
    l: measure-type
  code:
    v: outcome
  display:
    v: intermediateOutcome

v: Diabetes is the seventh leading cause of death in the United States. In 2017, diabetes affected approximately 34 million Americans (10.5 percent of the U.S. population) and killed approximately 84,000 people (Centers for Disease Control and Prevention [CDC], 2020a). Diabetes is a long-lasting disease marked by high blood glucose levels, resulting from the body's inability to produce or use insulin properly (CDC, 2020a). People with diabetes are at increased risk of serious health complications including vision loss, heart disease, stroke, kidney damage, and amputation of feet or legs (CDC, 2018). In 2017, diabetes cost the U.S. an estimated $327 billion: $237 billion in direct medical costs and $90 billion in reduced productivity. This is a 34 percent increase from the estimated $245 billion spent on diabetes in 2012 (American Diabetes Association [ADA], 2018). Controlling A1c blood levels helps reduce the risk of microvascular complications (eye, kidney and nerve diseases) (ADA, 2020).

v: American Diabetes Association (2020): - An A1C goal for many nonpregnant adults of <7% (53 mmol/mol) is appropriate. (Level of evidence: A) - On the basis of provider judgement and patient preference, achievement of lower A1C goals (such as <6.5%) may be acceptable if this can be achieved safely without significant hypoglycemia or other adverse effects of treatment. (Level of evidence: C) - Less stringent A1C goals (such as <8% [64 mmol/mol]) may be appropriate for patients with a history of severe hypoglycemia, limited life expectancy, advanced microvascular or macrovascular complications, extensive comorbid conditions, or long-standing diabetes in whom the goal is difficult to achieve despite diabetes self-management education, appropriate glucose monitoring, and effective doses of multiple glucose-lowering agents including insulin. (Level of evidence: B)

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: If the HbA1c test result is in the medical record, the test can be used to determine numerator compliance. Only patients with a diagnosis of Type 1 or Type 2 diabetes should be included in the denominator of this measure; patients with a diagnosis of secondary diabetes due to another condition should not be included. This eCQM is a patient-based measure. This version of the eCQM uses QDM version 5.5. 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: Seen patients between 18 and 75 years of age with an active diabetes diagnosis
  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: Seen patients between 18 and 75 years of age with an active diabetes diagnosis
  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 HbA1c > 9%
  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 in hospice or long term care, or with advanced illness or frailty
  criteria:
    language:
      v: text/cql-identifier
    expression:
      v: Denominator Exclusions
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