ControllingHighBloodPressureFHIR
type: Measure
node role: treeRoot
id:
  v: ControllingHighBloodPressureFHIR
meta:
  profile:
    v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-measure-cqfm
    l: computable-measure-cqfm
  profile:
    v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/publishable-measure-cqfm
    l: publishable-measure-cqfm
  profile:
    v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/executable-measure-cqfm
    l: executable-measure-cqfm
text:
  status:
    v: extensions
  div:
    v: Metadata Title Controlling High Blood PressureFHIR Version 0.1.000 Short Name CMS165FHIR GUID (Version Independent) urn:uuid:9017d914-6748-45a9-bff1-8392ed644a7b GUID (Version Specific) urn:uuid:f573fb8f-4907-4ed7-bc04-09d9a3f36268 CMS Identifier 165FHIR Effective Period 2025-01-01 through 2025-12-31 Status Draft Steward (Publisher) National Committee for Quality Assurance Developer National Committee for Quality Assurance Description Percentage of patients 18-85 years of age who had a diagnosis of essential hypertension starting before and continuing into, or starting during the first six months of the measurement period, and whose most recent blood pressure was adequately controlled (<140/90 mmHg) during the measurement period 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) 2012-2024 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 obt…
contained: Library
  id:
    v: effective-data-requirements
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode
      l: cqf-directReferenceCode
    value: Coding
      system:
        v: http://hl7.org/fhir/administrative-gender
        l: administrative-gender
      code:
        v: M
      display:
        v: Male
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode
      l: cqf-directReferenceCode
    value: Coding
      system:
        v: http://hl7.org/fhir/administrative-gender
        l: administrative-gender
      code:
        v: F
      display:
        v: Female
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode
      l: cqf-directReferenceCode
    value: Coding
      type: https://loinc.org/rdf/8480-6
      system:
        v: http://loinc.org
        l: loinc.org
      code:
        v: 8480-6
      display:
        v: Systolic blood pressure
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode
      l: cqf-directReferenceCode
    value: Coding
      type: https://loinc.org/rdf/8462-4
      system:
        v: http://loinc.org
        l: loinc.org
      code:
        v: 8462-4
      display:
        v: Diastolic blood pressure
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode
      l: cqf-directReferenceCode
    value: Coding
      system:
        v: http://terminology.hl7.org/CodeSystem/condition-clinical
        l: condition-clinical
      code:
        v: active
      display:
        v: Active
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode
      l: cqf-directReferenceCode
    value: Coding
      system:
        v: http://terminology.hl7.org/CodeSystem/condition-clinical
        l: condition-clinical
      code:
        v: recurrence
      display:
        v: Recurrence
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode
      l: cqf-directReferenceCode
    value: Coding
      system:
        v: http://terminology.hl7.org/CodeSystem/condition-clinical
        l: condition-clinical
      code:
        v: relapse
      display:
        v: Relapse
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode
      l: cqf-directReferenceCode
    value: Coding
      type: 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
      system:
        v: http://terminology.hl7.org/CodeSystem/observation-category
        l: observation-category
      code:
        v: survey
      display:
        v: survey
  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/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: https://loinc.org/rdf/98181-1
      system:
        v: http://loinc.org
        l: loinc.org
      code:
        v: 98181-1
      display:
        v: Medical equipment used
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode
      l: cqf-directReferenceCode
    value: Coding
      type: https://loinc.org/rdf/71802-3
      system:
        v: http://loinc.org
        l: loinc.org
      code:
        v: 71802-3
      display:
        v: Housing status
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode
      l: cqf-directReferenceCode
    value: Coding

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/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: SupplementalDataElements
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 "M" when Patient.gender = 'female' then "F" else null end
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 0
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

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

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: ControllingHighBloodPressureFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Qualifying Systolic Blood Pressure Reading
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Qualifying Systolic Blood Pressure Reading": ( ( ["observation-bp"] ).isObservationBP ( ) ) BloodPressure where ( not ( ( BloodPressure.encounter.getEncounter ( ) ).class.code in { 'EMER', 'IMP', 'ACUTE', 'NONAC', 'PRENC', 'SS' } ) ) and BloodPressure.effective.latest ( ) during day of "Measurement Period"
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: ControllingHighBloodPressureFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Qualifying Diastolic Blood Pressure Reading
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Qualifying Diastolic Blood Pressure Reading": ( ( ["observation-bp"] ).isObservationBP ( ) ) BloodPressure where ( not ( ( BloodPressure.encounter.getEncounter ( ) ).class.code in { 'EMER', 'IMP', 'ACUTE', 'NONAC', 'PRENC', 'SS' } ) ) and BloodPressure.effective.latest ( ) during day of "Measurement Period"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 3
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: ControllingHighBloodPressureFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Blood Pressure Days
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Blood Pressure Days": ( "Qualifying Diastolic Blood Pressure Reading" DBPExam return date from DBPExam.effective.latest ( ) ) intersect ( "Qualifying Systolic Blood Pressure Reading" SBPExam return date from SBPExam.effective.latest ( ) )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 4
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: ControllingHighBloodPressureFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Most Recent Blood Pressure Day
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Most Recent Blood Pressure Day": Last("Blood Pressure Days" BPDays sort asc )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 5
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: ControllingHighBloodPressureFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Lowest Systolic Reading on Most Recent Blood Pressure Day
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Lowest Systolic Reading on Most Recent Blood Pressure Day": First("Qualifying Systolic Blood Pressure Reading" SBPReading where SBPReading.effective.latest() same day as "Most Recent Blood Pressure Day" return singleton from(SBPReading.component SBPComponent where SBPComponent.code ~ "Systolic blood pressure" return SBPComponent.value as Quantity ) sort asc )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 6
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: ControllingHighBloodPressureFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Has Systolic Blood Pressure Less Than 140
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Has Systolic Blood Pressure Less Than 140": "Lowest Systolic Reading on Most Recent Blood Pressure Day" < 140 'mm[Hg]'
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 7
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: ControllingHighBloodPressureFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Lowest Diastolic Reading on Most Recent Blood Pressure Day
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Lowest Diastolic Reading on Most Recent Blood Pressure Day": First("Qualifying Diastolic Blood Pressure Reading" DBPReading where DBPReading.effective.latest() same day as "Most Recent Blood Pressure Day" return singleton from(DBPReading.component DBPComponent where DBPComponent.code ~ "Diastolic blood pressure" return DBPComponent.value as Quantity ) sort asc )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 8
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: ControllingHighBloodPressureFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Has Diastolic Blood Pressure Less Than 90
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Has Diastolic Blood Pressure Less Than 90": "Lowest Diastolic Reading on Most Recent Blood Pressure Day" < 90 'mm[Hg]'
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 9
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: ControllingHighBloodPressureFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Numerator
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Numerator": "Has Systolic Blood Pressure Less Than 140" and "Has Diastolic Blood Pressure Less Than 90"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 10
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: ControllingHighBloodPressureFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Essential Hypertension Diagnosis
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Essential Hypertension Diagnosis": ( [Condition: "Essential Hypertension"] ) Hypertension where Hypertension.prevalenceInterval ( ) overlaps Interval[start of "Measurement Period", start of "Measurement Period" + 6 months )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 11
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: AdultOutpatientEncounters
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: "Virtual Encounter"] union [Encounter: "Telephone Visits"] ).isEncounterPerformed() ) ValidEncounter where ValidEncounter.period.toInterval() during day of "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
    v: ControllingHighBloodPressureFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Initial Population
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Initial Population": AgeInYearsAt(date from end of "Measurement Period" ) in Interval[18, 85] and exists "Essential Hypertension Diagnosis" and exists AdultOutpatientEncounters."Qualifying Encounters"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 13
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: ControllingHighBloodPressureFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Denominator
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Denominator": "Initial Population"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 14
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: SupplementalDataElements
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 Type"] Payer return { code: Payer.type, period: Payer.period }
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 15
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: ControllingHighBloodPressureFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: 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: 16
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: SupplementalDataElements
extension:
  url:
    v: name
    l: name
  value: String
    v: SDE Ethnicity
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "SDE Ethnicity": Patient.ethnicity E return Tuple { codes: { E.ombCategory } union E.detailed, display: E.text }
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: ControllingHighBloodPressureFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: SDE Ethnicity
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "SDE Ethnicity": SDE."SDE Ethnicity"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 18
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: Hospice
extension:
  url:
    v: name
    l: name
  value: String
    v: Has Hospice Services
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Has Hospice Services": exists ((([Encounter: "Encounter Inpatient"]).isEncounterPerformed()) InpatientEncounter where (InpatientEncounter.hospitalization.dischargeDisposition ~ "Discharge to home for hospice care (procedure)" or InpatientEncounter.hospitalization.dischargeDisposition ~ "Discharge to healthcare facility for hospice care (procedure)" ) and InpatientEncounter.period.toInterval() ends during day of "Measurement Period" ) or exists ((([Encounter: "Hospice Encounter"]).isEncounterPerformed()) HospiceEncounter where HospiceEncounter.period.toInterval() overlaps day of "Measurement Period" ) or exists ((([Observation: "Hospice care [Minimum Data Set]"]).isAssessmentPerformed()) HospiceAssessment where HospiceAssessment.value ~ "Yes (qualifier value)" and HospiceAssessment.effective.toInterval() overlaps day of "Measurement Period" ) or exists ((([ServiceRequest: "Hospice Care Ambulatory"]).isInterventionOrder()) HospiceOrder where HospiceOrder.authoredOn.toInterval() during day of "Measurement Period" // and HospiceOrder.doNotPerform is not true // https://oncprojectracking.healthit.gov/support/browse/CQLIT-447 ) or exists ((([Procedure: "Hospice Care Ambulatory"]).isInterventionPerformed()) HospicePerformed where HospicePerformed.performed.toInterval() overlaps day of "Measurement Period" ) or exists (([Condition: "Hospice Diagnosis"]) HospiceCareDiagnosis where HospiceCareDiagnosis.prevalenceInterval() overlaps day of "Measurement Period" )
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: ControllingHighBloodPressureFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Pregnancy or Renal Diagnosis
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Pregnancy or Renal Diagnosis": ( [Condition: "Pregnancy"] union [Condition: "End Stage Renal Disease"] union [Condition: "Kidney Transplant Recipient"] union [Condition: "Chronic Kidney Disease, Stage 5"] ) PregnancyESRDDiagnosis where PregnancyESRDDiagnosis.prevalenceInterval ( ) overlaps "Measurement Period"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 20
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: ControllingHighBloodPressureFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: End Stage Renal Disease Procedures
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "End Stage Renal Disease Procedures": ( ( [Procedure: "Kidney Transplant"] union [Procedure: "Dialysis Services"] ).isProcedurePerformed ( ) ) ESRDProcedure where ESRDProcedure.performed.toInterval ( ) ends on or before end of "Measurement Period"
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: ControllingHighBloodPressureFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: End Stage Renal Disease Encounter
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "End Stage Renal Disease Encounter": ( ( [Encounter: "ESRD Monthly Outpatient Services"] ).isEncounterPerformed ( ) ) ESRDEncounter where ESRDEncounter.period.toInterval ( ) starts on or before 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
    v: AdvancedIllnessandFrailty
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 ( (([DeviceRequest: "Frailty Device"]).isDeviceOrder()) FrailtyDeviceOrder where FrailtyDeviceOrder.doNotPerform() is not true and FrailtyDeviceOrder.authoredOn.toInterval() during day of "Measurement Period" ) or exists ( (([Observation: "Medical equipment used"]).isAssessmentPerformed()) EquipmentUsed where EquipmentUsed.value as Concept in "Frailty Device" and EquipmentUsed.effective.toInterval() ends during day of "Measurement Period" ) or exists ( ([Condition: "Frailty Diagnosis"]) FrailtyDiagnosis where FrailtyDiagnosis.prevalenceInterval() overlaps day of "Measurement Period" ) or exists ( (([Encounter: "Frailty Encounter"]).isEncounterPerformed()) FrailtyEncounter where FrailtyEncounter.period.toInterval() overlaps day of "Measurement Period" ) or exists ( (([Observation: "Frailty Symptom"]).isSymptom()) FrailtySymptom where FrailtySymptom.effective.toInterval() overlaps day of "Measurement Period" )
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: AdvancedIllnessandFrailty
extension:
  url:
    v: name
    l: name
  value: String
    v: Has Advanced Illness in Year Before or During Measurement Period
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Has Advanced Illness in Year Before or During Measurement Period": exists ([Condition: "Advanced Illness"] AdvancedIllnessDiagnosis where AdvancedIllnessDiagnosis.prevalenceInterval() starts during day of Interval[start of "Measurement Period" - 1 year, end of "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
    v: AdvancedIllnessandFrailty
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": exists (( ([MedicationRequest: medication in "Dementia Medications"]).isMedicationActive()) DementiaMedication // https://oncprojectracking.healthit.gov/support/browse/CQLIT-449 where DementiaMedication.medicationRequestPeriod() overlaps day of Interval[start of "Measurement Period" - 1 year, end of "Measurement Period"] // and DementiaMedication.doNotPerform is not true // https://oncprojectracking.healthit.gov/support/browse/CQLIT-447 )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 25
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: AdvancedIllnessandFrailty
extension:
  url:
    v: name
    l: name
  value: String
    v: Is Age 66 to 80 with Advanced Illness and Frailty or Is Age 81 or Older with Frailty
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Is Age 66 to 80 with Advanced Illness and Frailty or Is Age 81 or Older with Frailty": ( AgeInYearsAt(date from end of "Measurement Period")in Interval[66, 80] and "Has Criteria Indicating Frailty" and ( "Has Advanced Illness in Year Before or During Measurement Period" or "Has Dementia Medications in Year Before or During Measurement Period" ) ) or ( AgeInYearsAt(date from end of "Measurement Period")>= 81 and "Has Criteria Indicating Frailty" )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 26
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: AdvancedIllnessandFrailty
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 ( ( Last( (([Observation: "Housing status"]).isAssessmentPerformed()) HousingStatus where HousingStatus.effective.toInterval() ends on or before day of end of "Measurement Period" sort by end of effective.toInterval() asc )) LastHousingStatus where LastHousingStatus.value ~ "Lives in a nursing home (finding)" ) is not null
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 27
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: PalliativeCare
extension:
  url:
    v: name
    l: name
  value: String
    v: Has Palliative Care in the Measurement Period
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Has Palliative Care in the Measurement Period": exists ((([Observation: "Functional Assessment of Chronic Illness Therapy - Palliative Care Questionnaire (FACIT-Pal)"]).isAssessmentPerformed()) PalliativeAssessment where PalliativeAssessment.effective.toInterval() overlaps day of "Measurement Period" ) or exists ([Condition: "Palliative Care Diagnosis"] PalliativeDiagnosis where PalliativeDiagnosis.prevalenceInterval() overlaps day of "Measurement Period" ) or exists ((([Encounter: "Palliative Care Encounter"]).isEncounterPerformed()) PalliativeEncounter where PalliativeEncounter.period.toInterval() overlaps day of "Measurement Period" ) or exists ((([Procedure: "Palliative Care Intervention"]).isInterventionPerformed()) PalliativeIntervention where PalliativeIntervention.performed.toInterval() overlaps day 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
    v: ControllingHighBloodPressureFHIR
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 Services" or exists ( "Pregnancy or Renal Diagnosis" ) or exists ( "End Stage Renal Disease Procedures" ) or exists ( "End Stage Renal Disease Encounter" ) or AIFrailLTCF."Is Age 66 to 80 with Advanced Illness and Frailty or Is Age 81 or Older with Frailty" or AIFrailLTCF."Is Age 66 or Older Living Long Term in a Nursing Home" or PalliativeCare."Has Palliative Care in the Measurement Period"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 29
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: SupplementalDataElements
extension:
  url:
    v: name
    l: name
  value: String
    v: SDE Race
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "SDE Race": Patient.race R return Tuple { codes: R.ombCategory union R.detailed, display: R.text }
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 30
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: ControllingHighBloodPressureFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: 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: 31
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: Status
extension:
  url:
    v: name
    l: name
  value: String
    v: isObservationBP
extension:
  url:
    v: statement
    l: statement
  value: String
    v: //Observation Vital Signs define fluent function isObservationBP(Obs List<"QICore.observation-bp">): Obs O where O.status in { 'final', 'amended', 'corrected' }
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
    v: ControllingHighBloodPressureFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: getEncounter
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define fluent function getEncounter(reference Reference): singleton from ( [Encounter] E where E.id = reference.reference.getId ( ) )
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: QICoreCommon
extension:
  url:
    v: name
    l: name
  value: String
    v: getId
extension:
  url:
    v: statement
    l: statement
  value: String
    v: /* @description: Returns the tail of the given uri (i.e. everything after the last slash in the URI). @comment: This function can be used to determine the logical id of a given resource. It can be used in a single-server environment to trace references. However, this function does not attempt to resolve or distinguish the base of the given url, and so cannot be used safely in multi-server environments. */ define fluent function getId(uri String): Last(Split(uri, '/'))
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
    v: QICoreCommon
extension:
  url:
    v: name
    l: name
  value: String
    v: prevalenceInterval
extension:
  url:
    v: statement
    l: statement
  value: String
    v: /* @description: Returns an interval representing the normalized prevalence period of a given Condition. @comment: Uses the ToInterval and ToAbatementInterval functions to determine the widest potential interval from onset to abatement as specified in the given Condition. If the condition is active, or has an abatement date the resulting interval will have a closed ending boundary. Otherwise, the resulting interval will have an open ending boundary. */ define fluent function prevalenceInterval(condition Condition): if condition.clinicalStatus ~ "active" or condition.clinicalStatus ~ "recurrence" or condition.clinicalStatus ~ "relapse" then Interval[start of condition.onset.toInterval(), end of condition.abatementInterval()] else (end of condition.abatementInterval()) abatementDate return if abatementDate is null then Interval[start of condition.onset.toInterval(), abatementDate) else Interval[start of condition.onset.toInterval(), abatementDate]
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: QICoreCommon
extension:
  url:
    v: name
    l: name
  value: String
    v: abatementInterval
extension:
  url:
    v: statement
    l: statement
  value: String
    v: /* @description: Returns an interval representing the normalized abatement of a given Condition. @comment: If the abatement element of the Condition is represented as a DateTime, the result is an interval beginning and ending on that DateTime. If the abatement is represented as a Quantity, the quantity is expected to be a calendar-duration and is interpreted as the age of the patient. The result is an interval from the date the patient turned that age to immediately before one year later. If the abatement is represented as a Quantity Interval, the quantities are expected to be calendar-durations and are interpreted as an age range during which the abatement occurred. The result is an interval from the date the patient turned the starting age of the quantity interval, and ending immediately before one year later than the date the patient turned the ending age of the quantity interval. */ define fluent function abatementInterval(condition Condition): if condition.abatement is DateTime then Interval[condition.abatement as DateTime, condition.abatement as DateTime] else if condition.abatement is Quantity then Interval[Patient.birthDate + (condition.abatement as Quantity), Patient.birthDate + (condition.abatement as Quantity) + 1 year) else if condition.abatement is Interval<Quantity> then Interval[Patient.birthDate + (condition.abatement.low as Quantity), Patient.birthDate + (condition.abatement.high as Quantity) + 1 year) else if condition.abatement is Interval<DateTime> then Interval[condition.abatement.low, condition.abatement.high) else null as Interval<DateTime>
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
    v: Status
extension:
  url:
    v: name
    l: name
  value: String
    v: isEncounterPerformed
extension:
  url:
    v: statement
    l: statement
  value: String
    v: //Encounter, Performed //General usage unless required otherwise by measure intent (e.g., follow-up encounters) define fluent function isEncounterPerformed(Enc List<Encounter>): Enc E where E.status in {'finished', 'arrived', 'triaged', 'in-progress', 'onleave'}
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: QICoreCommon
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 DateTime, Quanitty, Interval<DateTime>, or Interval<Quantity> 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 QICore, allowing this function to be used across any resource. The input can be provided as a DateTime, Quantity, Interval<DateTime> or Interval<Quantity>. 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 Quantity, the quantity is expected to be a calendar-duration interpreted as an Age, and the result is a DateTime Interval beginning on the Date the patient turned that age and ending immediately before one year later. If the input is a DateTime Interval, the result is the input. If the input is a Quantity Interval, the quantities are expected to be calendar-durations interpreted as an Age, and the result is a DateTime Interval beginning on the date the patient turned the age given as the start of the quantity interval, and ending immediately before one year later than the date the patient turned the age given as the end of the quantity interval. If the input is a Timing, an error will be thrown indicating that Timing calculations are not implemented. Any other input will reslt in a null DateTime Interval */ define fluent function toInter…
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: ToInterval
extension:
  url:
    v: statement
    l: statement
  value: String
    v: /* @description: Converts the given [Period](https://hl7.org/fhir/datatypes.html#Period) value to a CQL DateTime Interval @comment: If the start value of the given period is unspecified, the starting boundary of the resulting interval will be open (meaning the start of the interval is unknown, as opposed to interpreted as the beginning of time). */ 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: 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 uri): 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: ToCode
extension:
  url:
    v: statement
    l: statement
  value: String
    v: /* @description: Converts the given FHIR [Coding](https://hl7.org/fhir/datatypes.html#Coding) value to a CQL Code. */ 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: 41
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: Status
extension:
  url:
    v: name
    l: name
  value: String
    v: isAssessmentPerformed
extension:
  url:
    v: statement
    l: statement
  value: String
    v: //This library contains functions that are based on QDM 5.6 to QICore 4.1.1 March 2023 (https://github.com/cqframework/CQL-Formatting-and-Usage-Wiki/wiki/Authoring-Patterns---QICore-v4.1.1). The functions may appear similar to some QICoreCommon functions but different in that they have constraints that are relevant for measures authored by NCQA. //Assessment, Performed define fluent function isAssessmentPerformed(Obs List<Observation>): Obs O where O.status in { 'final', 'amended', 'corrected' } and exists ( O.category ObservationCategory where ( ObservationCategory ) ~ "survey" )
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: FHIRHelpers
extension:
  url:
    v: name
    l: name
  value: String
    v: ToConcept
extension:
  url:
    v: statement
    l: statement
  value: String
    v: /* @description: Converts the given FHIR [CodeableConcept](https://hl7.org/fhir/datatypes.html#CodeableConcept) value to a CQL Concept. */ 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: 43
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: Status
extension:
  url:
    v: name
    l: name
  value: String
    v: isInterventionOrder
extension:
  url:
    v: statement
    l: statement
  value: String
    v: //Intervention, Order: active and completed only define fluent function isInterventionOrder(ServiceRequest List<ServiceRequest>): ServiceRequest S where S.status in { 'active', 'completed' } and S.intent = 'order'
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: Status
extension:
  url:
    v: name
    l: name
  value: String
    v: isInterventionPerformed
extension:
  url:
    v: statement
    l: statement
  value: String
    v: //Intervention, Performed define fluent function isInterventionPerformed(Proc List<Procedure>): Proc P where P.status ~ 'completed'
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: Status
extension:
  url:
    v: name
    l: name
  value: String
    v: isProcedurePerformed
extension:
  url:
    v: statement
    l: statement
  value: String
    v: //Procedure, Performed define fluent function isProcedurePerformed(Proc List<Procedure>): Proc P where P.status ~ 'completed'
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: Status
extension:
  url:
    v: name
    l: name
  value: String
    v: isDeviceOrder
extension:
  url:
    v: statement
    l: statement
  value: String
    v: //Device, Order - Personal Use Devices: active and completed only define fluent function isDeviceOrder(DeviceRequest List<DeviceRequest>): DeviceRequest D where D.status in { 'active', 'completed' } and D.intent = 'order'
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: QICoreCommon
extension:
  url:
    v: name
    l: name
  value: String
    v: doNotPerform
extension:
  url:
    v: statement
    l: statement
  value: String
    v: /* @description: Returns true if the given DeviceRequest is a negation (i.e. do not perform this order) */ define fluent function doNotPerform(deviceRequest DeviceRequest): singleton from ( deviceRequest.modifierExtension E where E.url = 'http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-doNotPerform' return E.value as Boolean )
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: Status
extension:
  url:
    v: name
    l: name
  value: String
    v: isSymptom
extension:
  url:
    v: statement
    l: statement
  value: String
    v: //Symptom define fluent function isSymptom(Obs List<Observation>): Obs O where O.status in { 'preliminary', 'final', 'amended', 'corrected' }
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: Status
extension:
  url:
    v: name
    l: name
  value: String
    v: isMedicationActive
extension:
  url:
    v: statement
    l: statement
  value: String
    v: //Medication, Active define fluent function isMedicationActive(MedicationRequest List<MedicationRequest>): MedicationRequest M where M.status = 'active' and M.intent = 'order'
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: CumulativeMedicationDuration
extension:
  url:
    v: name
    l: name
  value: String
    v: medicationRequestPeriod
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define fluent function medicationRequestPeriod(Request "MedicationRequest"): Request R let dosage: singleton from R.dosageInstruction, doseAndRate: singleton from dosage.doseAndRate, timing: dosage.timing, frequency: Coalesce(timing.repeat.frequencyMax, timing.repeat.frequency), period: Quantity(timing.repeat.period, timing.repeat.periodUnit), doseRange: doseAndRate.dose, doseQuantity: doseAndRate.dose, dose: Coalesce(end of doseRange, doseQuantity), dosesPerDay: Coalesce(ToDaily(frequency, period), Count(timing.repeat.timeOfDay), 1.0), boundsPeriod: timing.repeat.bounds as Interval<DateTime>, daysSupply: (convert R.dispenseRequest.expectedSupplyDuration to days).value, quantity: R.dispenseRequest.quantity, refills: Coalesce(R.dispenseRequest.numberOfRepeatsAllowed, 0), startDate: Coalesce( date from start of boundsPeriod, date from R.authoredOn, date from start of R.dispenseRequest.validityPeriod ), totalDaysSupplied: Coalesce(daysSupply, quantity.value / (dose.value * dosesPerDay)) * (1 + refills) return if startDate is not null and totalDaysSupplied is not null then Interval[startDate, startDate + Quantity(totalDaysSupplied - 1, 'day') ] else if startDate is not null and boundsPeriod."high" is not null then Interval[startDate, date from end of boundsPeriod] else null
extension:
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    v: displaySequence
    l: displaySequence
  value: Integer
    v: 51
url:
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  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: CumulativeMedicationDuration
extension:
  url:
    v: name
    l: name
  value: String
    v: Quantity
extension:
  url:
    v: statement
    l: statement
  value: String
    v: /**********************************************************************/ /* Functions in this region are copied from opioid-mme-r4 */ /**********************************************************************/ define function Quantity(value Decimal, unit String): if value is not null then System.Quantity { value: value, unit: unit } else null
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 52
url:
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  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: CumulativeMedicationDuration
extension:
  url:
    v: name
    l: name
  value: String
    v: ToDaily
extension:
  url:
    v: statement
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  value: String
    v: /* Goal is to get to number of days Two broad approaches to the calculation: 1) Based on supply and frequency, calculate the number of expected days the medication will cover/has covered 2) Based on relevant period, determine a covered interval and calculate the length of that interval in days This topic covers several use cases and illustrates how to calculate Cumulative Medication Duration for each type of medication resource using the supply and frequency approach. */ /* For the first approach, we need to get from frequency to a frequency/day So we define ToDaily */ /* Calculates daily frequency given frequency within a period */ define function ToDaily(frequency System.Integer, period System.Quantity): case period.unit when 'h' then frequency * (24.0 / period.value) when 'min' then frequency * (24.0 / period.value) * 60 when 's' then frequency * (24.0 / period.value) * 60 * 60 when 'd' then frequency * (24.0 / period.value) / 24 when 'wk' then frequency * (24.0 / period.value) / (24 * 7) when 'mo' then frequency * (24.0 / period.value) / (24 * 30) /* assuming 30 days in month */ when 'a' then frequency * (24.0 / period.value) / (24 * 365) /* assuming 365 days in year */ when 'hour' then frequency * (24.0 / period.value) when 'minute' then frequency * (24.0 / period.value) * 60 when 'second' then frequency * (24.0 / period.value) * 60 * 60 when 'day' then frequency * (24.0 / period.value) / 24 when 'week' then frequency * (24.0 / period.value) / (24 * 7) when 'month' then frequency * (24.0 / period.value) / (24 * 30) /* assuming 30 days in month */ when 'year' then frequency * (24.0 / period.value) / (24 * 365) /* assuming 365 days in year */ when 'hours' then frequency * (24.0 / period.value) when 'minutes' then frequency * (24.0 / period.value) * 60 when 'seconds' then frequency * (24.0 / period.value) * 60 * 60 when 'days' then frequency * (24.0 / period.value) / 24 when 'weeks' then frequency * (24.0 / period.value) / (24 * 7) when 'months' then frequency * (…
extension:
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    v: displaySequence
    l: displaySequence
  value: Integer
    v: 53
url:
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v: EffectiveDataRequirements

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type:
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display:
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type:
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display:
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type:
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type:
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type:
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display:
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name:
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type:
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name:
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name:
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name:
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name:
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use:
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name:
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use:
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name:
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name:
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name:
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type:
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must support:
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type:
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profile:
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type:
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  l: qicore-encounter
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  v: type
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  v: status
must support:
  v: status.value
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  v: period
code filter:
  path:
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type:
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profile:
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  l: qicore-encounter
must support:
  v: type
must support:
  v: status
must support:
  v: status.value
must support:
  v: period
code filter:
  path:
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type:
  v: Encounter
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
  l: qicore-encounter
must support:
  v: type
must support:
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must support:
  v: hospitalization.dischargeDisposition
must support:
  v: period
must support:
  v: status
must support:
  v: status.value
code filter:
  path:
    v: type
  value set:
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    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307

type:
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profile:
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  l: qicore-encounter
must support:
  v: type
must support:
  v: period
must support:
  v: status
must support:
  v: status.value
code filter:
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type:
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  v: type
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  v: period
must support:
  v: status
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code filter:
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date filter:
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type:
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must support:
  v: type
must support:
  v: period
must support:
  v: status
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  v: status.value
code filter:
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type:
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  l: qicore-encounter
must support:
  v: type
must support:
  v: period
must support:
  v: status
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  v: status.value
code filter:
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type:
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  l: bp
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  v: encounter
must support:
  v: encounter.class
must support:
  v: encounter.class.code
must support:
  v: effective
must support:
  v: status
must support:
  v: status.value
must support:
  v: component
date filter:
  path:
    v: effective
  value: Period
    extension:
      url:
        v: http://hl7.org/fhir/StructureDefinition/cqf-expression
        l: cqf-expression
      value: Expression

v: text/cql-identifier

v: Measurement Period

type:
  v: Condition
profile:
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  l: qicore-condition
must support:
  v: code
code filter:
  path:
    v: code
  value set:
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    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.104.12.1011

type:
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  l: qicore-condition
must support:
  v: code
code filter:
  path:
    v: code
  value set:
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    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/us/qicore/StructureDefinition/qicore-condition
  l: qicore-condition
must support:
  v: code
code filter:
  path:
    v: code
  value set:
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    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.378

type:
  v: Condition
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition
  l: qicore-condition
must support:
  v: code
code filter:
  path:
    v: code
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.353
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.353

type:
  v: Condition
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition
  l: qicore-condition
must support:
  v: code
code filter:
  path:
    v: code
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.109.12.1029
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.109.12.1029

type:
  v: Condition
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition
  l: qicore-condition
must support:
  v: code
code filter:
  path:
    v: code
  value set:
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    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1002

type:
  v: Condition
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition
  l: qicore-condition
must support:
  v: code
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/us/qicore/StructureDefinition/qicore-condition
  l: qicore-condition
must support:
  v: code
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/us/qicore/StructureDefinition/qicore-condition
  l: qicore-condition
must support:
  v: code
code filter:
  path:
    v: code
  value set:
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    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/us/qicore/StructureDefinition/qicore-coverage
  l: qicore-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: Observation
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation
  l: qicore-observation
must support:
  v: code
must support:
  v: value
must support:
  v: effective
must support:
  v: status
must support:
  v: status.value
must support:
  v: category
code filter:
  path:
    v: code
  code: 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]
code filter:
  path:
    v: value

type:
  v: Observation
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation
  l: qicore-observation
must support:
  v: code
must support:
  v: value
must support:
  v: effective
must support:
  v: status
must support:
  v: status.value
must support:
  v: category
code filter:
  path:
    v: code
  code: https://loinc.org/rdf/98181-1
    system:
      v: http://loinc.org
      l: loinc.org
    code:
      v: 98181-1
    display:
      v: Medical equipment used
code filter:
  path:
    v: value
  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
date filter:
  path:
    v: effective
  value: Period
    extension:
      url:
        v: http://hl7.org/fhir/StructureDefinition/cqf-expression
        l: cqf-expression
      value: Expression

v: text/cql-identifier

v: Measurement Period

type:
  v: Observation
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation
  l: qicore-observation
must support:
  v: code
must support:
  v: effective
must support:
  v: status
must support:
  v: status.value
must support:
  v: category
code filter:
  path:
    v: code
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.113.12.1075
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.113.12.1075

type:
  v: Observation
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation
  l: qicore-observation
must support:
  v: code
must support:
  v: effective
must support:
  v: status
must support:
  v: status.value
must support:
  v: category
code filter:
  path:
    v: code
  code: https://loinc.org/rdf/71802-3
    system:
      v: http://loinc.org
      l: loinc.org
    code:
      v: 71802-3
    display:
      v: Housing status
date filter:
  path:
    v: effective

type:
  v: Observation
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation
  l: qicore-observation
must support:
  v: code
must support:
  v: effective
must support:
  v: value
must support:
  v: status
must support:
  v: status.value
must support:
  v: category
code filter:
  path:
    v: code
  code: https://loinc.org/rdf/71802-3
    system:
      v: http://loinc.org
      l: loinc.org
    code:
      v: 71802-3
    display:
      v: Housing status
code filter:
  path:
    v: value
date filter:
  path:
    v: effective

type:
  v: Observation
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation
  l: qicore-observation
must support:
  v: code
must support:
  v: effective
must support:
  v: status
must support:
  v: status.value
must support:
  v: category
code filter:
  path:
    v: code
  code: 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)

type:
  v: ServiceRequest
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest
  l: qicore-servicerequest
must support:
  v: code
must support:
  v: authoredOn
must support:
  v: authoredOn.value
must support:
  v: status
must support:
  v: status.value
must support:
  v: intent
must support:
  v: intent.value
code filter:
  path:
    v: code
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1584
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1584

type:
  v: Procedure
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure
  l: qicore-procedure
must support:
  v: code
must support:
  v: performed
must support:
  v: status
must support:
  v: status.value
code filter:
  path:
    v: code
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1584
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1584

type:
  v: Procedure
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure
  l: qicore-procedure
must support:
  v: code
must support:
  v: status
must support:
  v: status.value
must support:
  v: performed
code filter:
  path:
    v: code
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.109.12.1012
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.109.12.1012

type:
  v: Procedure
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure
  l: qicore-procedure
must support:
  v: code
must support:
  v: status
must support:
  v: status.value
must support:
  v: performed
code filter:
  path:
    v: code
  value set:
    v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.109.12.1013
    l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.109.12.1013

type:
  v: Procedure
profile:
  v: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure
  l: qicore-procedure
must support:
  v: code
must support:
  v: performed
must support:
  v: status
must support:
  v: status.value
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/us/qicore/StructureDefinition/qicore-devicerequest
  l: qicore-devicerequest
must support:
  v: code
must support:
  v: status
must support:
  v: status.value
must support:
  v: intent
must support:
  v: intent.value
must support:
  v: url
must support:
  v: url.value
must support:
  v: value
must support:
  v: authoredOn
must support:
  v: authoredOn.value
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/us/qicore/StructureDefinition/qicore-medicationrequest
  l: qicore-medicationrequest
must support:
  v: medication
must support:
  v: status
must support:
  v: status.value
must support:
  v: intent
must support:
  v: intent.value
must support:
  v: dosageInstruction
must support:
  v: dispenseRequest
must support:
  v: dispenseRequest.expectedSupplyDuration
must support:
  v: dispenseRequest.quantity
must support:
  v: dispenseRequest.numberOfRepeatsAllowed
must support:
  v: dispenseRequest.numberOfRepeatsAllowed.value
must support:
  v: authoredOn
must support:
  v: authoredOn.value
must support:
  v: dispenseRequest.validityPeriod
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

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
type:
  coding:
    system:
      v: http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type
      l: identifier-type
    code:
      v: short-name
system:
  v: https://madie.cms.gov/measure/shortName
  l: shortName
value:
  v: CMS165FHIR

use:
  v: official
type:
  coding:
    system:
      v: http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type
      l: identifier-type
    code:
      v: version-independent
system:
  v: urn:ietf:rfc:3986
  l: 3986

use:
  v: official
type:
  coding:
    system:
      v: http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type
      l: identifier-type
    code:
      v: version-specific
system:
  v: urn:ietf:rfc:3986
  l: 3986

use:
  v: official
type:
  coding:
    system:
      v: http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type
      l: identifier-type
    code:
      v: publisher
system:
  v: https://madie.cms.gov/measure/cmsId
  l: cmsId
value:
  v: 165FHIR
assigner:
  display:
    v: CMS

v: 0.1.000

v: ControllingHighBloodPressureFHIR

v: Controlling High Blood PressureFHIR

v: draft

v: false

v: 2026-03-13T01:50:41+00:00

v: National Committee for Quality Assurance

telecom:
  system:
    v: url
  value:
    v: https://www.ncqa.org/

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

v: UNKNOWN

v: In reference to the numerator element, only blood pressure readings performed by a clinician or an automated blood pressure monitor or device are acceptable for numerator compliance with this measure. This includes blood pressures taken in person by a clinician and blood pressures measured remotely by electronic monitoring devices capable of transmitting the blood pressure data to the clinician. Blood pressure readings taken by an automated blood pressure monitor or device and conveyed by the patient to the clinician are also acceptable. It is the clinician’s responsibility and discretion to confirm the automated blood pressure monitor or device used to obtain the blood pressure is considered acceptable and reliable and whether the blood pressure reading is considered accurate before documenting it in the patient’s medical record. Do not include BP readings taken during an acute inpatient stay or an emergency department (ED) visit. If no blood pressure is recorded during the measurement period, the patient's blood pressure is assumed "not controlled". If there are multiple blood pressure readings on the same day, use the lowest systolic and the lowest diastolic reading as the most recent blood pressure reading. Ranges and thresholds do not meet criteria for this measure. A distinct numeric result for both the systolic and diastolic BP reading is required for numerator compliance. This eCQM is a patient-based measure. This FHIR-based measure has been derived from the QDM-based measure: CMS165v13. Please refer to the HL7 QI-Core Implementation Guide (http://hl7.org/fhir/us/qicore/STU4.1.1/) for more information on QI-Core and mapping recommendations from QDM to QI-Core 4.1.1 (http://hl7.org/fhir/us/qicore/STU4.1.1/qdm-to-qicore.html).

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) 2012-2024 National Committee for Quality Assurance. All Rights Reserved. Limited proprietary coding is contained in the Measure specifications for user convenience. Users of proprietary code sets should obtain all necessary licenses from the owners of the code sets. NCQA disclaims all liability for use or accuracy of any third-party codes contained in the specifications. CPT(R) codes, descriptions and other data are copyright 2024. American Medical Association. All rights reserved. CPT is a trademark of the American Medical Association. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein. Applicable FARS/DFARS restrictions apply to government use. Some measure spe…

start:
  v: 2025-01-01
end:
  v: 2025-12-31

name:
  v: National Committee for Quality Assurance
telecom:
  system:
    v: url
  value:
    v: https://www.ncqa.org/

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

v: High blood pressure (HBP), also known as hypertension, is when the pressure in blood vessels is higher than normal (Centers for Disease Control and Prevention [CDC], 2023). The causes of hypertension are multiple and multifaceted and can be based on genetic predisposition, environmental risk factors, being overweight and obese, sodium intake, potassium intake, physical activity, and alcohol use. High blood pressure is common; according to the American Heart Association, between 2013-2016, approximately 121.5 million US adults >= 20 years of age had HBP and the prevalence of hypertension among US adults 65 and older was 77.0 percent (Virani et al., 2021). In an analysis of adults with hypertension in National Health and Nutrition Examination Survey (NHANES), the estimated age-adjusted proportion with controlled blood pressure (BP) increased from 31.8 percent in 1999 to 53.8 percent in 2014. However, that proportion declined to 43.7 percent in 2017 to 2018 (Tsao et al., 2022). HBP increases risks of heart disease and stroke which are two of the leading causes of death in the US (CDC, 2023). A person who has HBP is four times more likely to die from a stroke and three times more likely to die from heart disease (CDC, 2021). The National Center for Health Statistics reported that in 2020 there were over 670,000 deaths with HBP as a primary or contributing cause (CDC, 2022). Between 2009 and 2019 the number of deaths due to HBP rose by 65.3 percent (Tsao et al., 2022). Managing and treating HBP would reduce cardiovascular disease mortality for males and females by 30.4 percent and 38.0 percent, respectively (Patel et al., 2015). Age-adjusted death rates attributable to HBP in 2019 were more than twice as high in non-Hispanic Black males (56.7 percent) when compared to rates for non-Hispanic White males (25.7 percent) (Tsao et al., 2022). HBP costs the U.S. approximately 131 billion dollars each year, averaged over 12 years from 2003 to 2014 (Kirkland et al., 2018). A stu…

v: U.S. Preventive Services Task Force (USPSTF) (2021): - The USPSTF recommends screening for hypertension in adults 18 years or older with office blood pressure measurement (OBPM). The USPSTF recommends obtaining blood pressure measurements outside of the clinical setting for diagnostic confirmation before starting treatment. This is a grade A recommendation. American College of Cardiology/American Heart Association (2017): - For adults with confirmed hypertension and known cardiovascular disease (CVD) or 10-year atherosclerotic cardiovascular disease (ASCVD) event risk of 10 percent or higher, a blood pressure target of less than 130/80 mmHg is recommended (Level of evidence: B-R (for systolic blood pressures), Level of evidence: C-EO (for diastolic blood pressure)) - For adults with confirmed hypertension, without additional markers of increased CVD risk, a blood pressure target of less than 130/80 mmHg may be reasonable (Note: clinical trial evidence is strongest for a target blood pressure of 140/90 mmHg in this population. However, observational studies suggest that these individuals often have a high lifetime risk and would benefit from blood pressure control earlier in life) (Level of evidence: B-NR (for systolic blood pressure), Level of evidence: C-EO (for diastolic blood pressure)). American Academy of Family Physicians (2022): - Treat adults who have hypertension to a standard blood pressure target (less than 140/90 mm Hg) to reduce the risk of all-cause and cardiovascular mortality (strong recommendation; high-quality evidence). Treating to a lower blood pressure target (less than 135/85 mm Hg) does not provide additional benefit at preventing mortality; however, a lower blood pressure target could be considered based on patient preferences and values. (Grade: strong recommendation, Quality of evidence: high) - Consider treating adults who have hypertension to a lower blood pressure target (less than 135/85 mm Hg) to reduce risk of myocardial infarction (w…

id:
  v: 650b4f94da013638e7b3dd9a
extension:
  url:
    v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring
    l: cqfm-scoring
  value: CodeableConcept
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/measure-scoring
        l: measure-scoring
      code:
        v: proportion
      display:
        v: Proportion
extension:
  url:
    v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis
    l: cqfm-populationBasis
  value: Code
    v: boolean
extension:
  url:
    v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-type
    l: cqfm-type
  value: CodeableConcept
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/measure-type
        l: measure-type
      code:
        v: outcome
      display:
        v: Outcome
extension:
  url:
    v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-rateAggregation
    l: cqfm-rateAggregation
  value: Code
    v: None
extension:
  url:
    v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-improvementNotation
    l: cqfm-improvementNotation
  value: CodeableConcept
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/measure-improvement-notation
        l: measure-improvement-notation
      code:
        v: decrease
      display:
        v: increase
population:
  code:
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/measure-population
        l: measure-population
      code:
        v: initial-population
      display:
        v: Initial Population
  description:
    v: Patients 18-85 years of age by the end of the measurement period who had a visit during the measurement period and diagnosis of essential hypertension starting before and continuing into, or starting during the first six months of the measurement period
  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: Equals Initial Population
  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: denominator-exclusion
      display:
        v: Denominator Exclusion
  description:
    v: Exclude patients who are in hospice care for any part of the measurement period. Patients with evidence of end stage renal disease (ESRD), dialysis or renal transplant before or during the measurement period. Also exclude patients with a diagnosis of pregnancy during the measurement period. Exclude patients 66-80 by the end of the measurement period with an indication of frailty for any part of the measurement period who also meet any of the following advanced illness criteria: - Advanced illness diagnosis during the measurement period or the year prior - OR taking dementia medications during the measurement period or the year prior Exclude patients 81 and older by the end of the measurement period with an indication of frailty for any part of the measurement period. Exclude patients 66 and older by the end of the measurement period who are living long term in a nursing home any time on or before the end of the measurement period. Exclude patients receiving palliative care for any part of the measurement period.
  criteria:
    language:
      v: text/cql-identifier
    expression:
      v: Denominator Exclusions
population:
  code:
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/measure-population
        l: measure-population
      code:
        v: numerator
      display:
        v: Numerator
  description:
    v: Patients whose most recent blood pressure is adequately controlled (systolic blood pressure < 140 mmHg and diastolic blood pressure < 90 mmHg) during the measurement period
  criteria:
    language:
      v: text/cql-identifier
    expression:
      v: Numerator
stratifier:
  extension:
    url:
      v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo
      l: cqfm-appliesTo
    value: CodeableConcept
  criteria:
    language:
      v: text/cql-identifier
stratifier:
  extension:
    url:
      v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo
      l: cqfm-appliesTo
    value: CodeableConcept
  criteria:
    language:
      v: text/cql-identifier

v: initial-population

v: Initial Population

v: initial-population

v: Initial Population

id:
  v: sde-sex
usage:
  coding:
    system:
      v: http://terminology.hl7.org/CodeSystem/measure-data-usage
      l: measure-data-usage
    code:
      v: supplemental-data
description:
  v: SDE Sex
criteria:
  language:
    v: text/cql-identifier
  expression:
    v: SDE Sex

id:
  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: SDE Race
criteria:
  language:
    v: text/cql-identifier
  expression:
    v: SDE Race

id:
  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: SDE Payer
criteria:
  language:
    v: text/cql-identifier
  expression:
    v: SDE Payer

id:
  v: sde-ethnicity
usage:
  coding:
    system:
      v: http://terminology.hl7.org/CodeSystem/measure-data-usage
      l: measure-data-usage
    code:
      v: supplemental-data
description:
  v: SDE Ethnicity
criteria:
  language:
    v: text/cql-identifier
  expression:
    v: SDE Ethnicity