CMS FHIR Quality Measure Development IG, published by Centers for Medicare & Medicaid Services (CMS). This guide is not an authorized publication; it is the continuous build for version 0.8.0-cibuild built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/cqframework/cms-qmd/ and changes regularly. See the Directory of published versions

Communication

FHIR uses the Communication resource for information transmitted from a sender to a receiver, about or with the patient.

The US CQL implementation guide does not publish a Communication patterns page, so this page is the primary source for communication patterns; see the Pattern Index for the full list of available patterns.

NOTE: The US Quality Core Communication and Communication Not Done profiles are both marked with an asterisk in the US Quality Core profile list, meaning they are not part of that guide’s conformance expectations; neither carries a USCDI+ Quality flagged data element.

Communication

The US Quality Core Communication profile is characterized by the topic element.

Where measure intent is patient education or another clinical action — training or counseling that verifies the patient’s comprehension or aims to change their mental state — the Procedure profile is the correct choice instead, since that is “an action that is being or was performed on a patient”.

define "Lab Results Communicated":
  [USQualityCore.Communication: "Informing health care professional of test result (procedure)"] LabReport
    where LabReport.topic ~ "Laboratory test result abnormal (situation)"
      and LabReport.status = 'completed'
      and exists (LabReport.reasonCode Reason
        where Reason ~ "Serum potassium level above reference range (finding)")

The profile does not fix status, so the expression must account for every value relevant to measure intent.

topic and reasonCode above are compared against direct-reference codes rather than value sets, so the equivalent operator is used; see Use of terminologies and the Codes topic in the Using CQL With FHIR IG.

Communication Not Done

US Quality Core defines the US Quality Core Communication Not Done profile to document the reason a communication did not occur, also characterized by topic. The profile fixes status to not-done, so that element need not — and must not — be tested for any other value. See Negation Patterns.

define "Medication Not Available Communication":
  [USQualityCore.CommunicationNotDone] Update
    where exists (Update.category Category
        where Category ~ "Informing health care professional (procedure)")
      and Update.topic() ~ "Medication not available (finding)"
      and exists (Update.reasonCode Reason
        where Reason ~ "Medication not available (finding)")

topic() is the accessor for the negated activity extent, defined in USQualityCoreCommon; it returns the topic whether it was recorded as a code or as a reference to a value set through the notDoneValueSet extension. See Extent of negation.

NOTE: A direct-reference code cannot currently be used as the terminology target in the retrieve of a negation profile. Either place the code in a single-code value set, or filter outside the retrieve using the activity-extent accessor as above. See Negation in CQL in US Quality Core.