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

Immunizations

FHIR defines several immunization-related resources for tracking a patient’s immunization information, including Immunization and ImmunizationRecommendation.

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

NOTE: The Immunization resources represent immunization information as recorded in an Immunization Information System. For immunizations administered as part of clinical workflow, use the medication resources instead.

NOTE: The US Quality Core ImmunizationEvaluation and ImmunizationRecommendation profiles are marked with an asterisk in the US Quality Core profile list, meaning they are not part of that guide’s conformance expectations. Immunization and Immunization Not Done, used below, are in scope.

Immunization performed

US Quality Core defines the US Quality Core Immunization profile to represent an immunization administered to a patient, characterized by the vaccineCode element, which identifies the specific vaccine product using standardized terminology.

define "Polio Immunizations":
  [USQualityCore.Immunization: "Inactivated Polio Vaccine (IPV)"] PolioVaccination
    where PolioVaccination.status = 'completed'

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

Immunization not performed

US Quality Core defines the US Quality Core Immunization Not Done profile to document the reason an immunization was not administered, also characterized by vaccineCode. The profile fixes status to not-done, so that element need not be tested. See Negation Patterns.

define "Reason for No Polio Immunization":
  [USQualityCore.ImmunizationNotDone: "Inactivated Polio Vaccine (IPV)"] PolioVaccination
    where PolioVaccination.statusReason in "Medical Reason For Not Providing Treatment"
      or PolioVaccination.statusReason in "Patient Declined"

Where the statement is that no vaccine in a value set was administered, rather than that one specific vaccine was not, the value set is carried on the vaccineCode element through the notDoneValueSet extension. vaccineCode() in USQualityCoreCommon returns the negated activity extent in either form; see Extent of negation.