CMS Draft FHIR Measures
2024.1.0 - CI Build

CMS Draft FHIR Measures, published by cqframework. This guide is not an authorized publication; it is the continuous build for version 2024.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/cqframework/dqm-content-cms-2024/ and changes regularly. See the Directory of published versions

## Library: Colon Cancer Screening FHIR

Official URL: https://madie.cms.gov/Library/ColonCancerScreeningFHIR | Version: 0.1.000
Active as of 2024-05-15 | Computable Name: ColonCancerScreeningFHIR
Other Identifiers: https://madie.cms.gov/login#ColonCancerScreeningFHIR (use: official, )

Colon Cancer Screening FHIR

Metadata
Title | Colon Cancer Screening FHIR
Version | 0.1.000
Identifier | ColonCancerScreeningFHIR
Topic | FHIR
Topic | CQL
Description | Colon Cancer Screening FHIR
Type | logic-library from http://terminology.hl7.org/CodeSystem/library-type
Dependency | Description: Library FHIRHelpers Resource: FHIRHelpersversion: null4.4.000) Canonical URL: `https://madie.cms.gov/Library/FHIRHelpers|4.4.000`
Dependency | Description: Library SDE Resource: SupplementalDataElementsversion: null3.5.000) Canonical URL: `https://madie.cms.gov/Library/SupplementalDataElements|3.5.000`
Dependency | Description: Library Hospice Resource: Hospiceversion: null6.12.000) Canonical URL: `https://madie.cms.gov/Library/Hospice|6.12.000`
Dependency | Description: Library PalliativeCare Resource: PalliativeCareversion: null1.11.000) Canonical URL: `https://madie.cms.gov/Library/PalliativeCare|1.11.000`
Dependency | Description: Library AdultOutpatientEncounters Resource: AdultOutpatientEncountersversion: null4.11.000) Canonical URL: `https://madie.cms.gov/Library/AdultOutpatientEncounters|4.11.000`
Dependency | Description: Library AIFrailLTCF Resource: AdvancedIllnessandFrailtyversion: null1.16.000) Canonical URL: `https://madie.cms.gov/Library/AdvancedIllnessandFrailty|1.16.000`
Dependency | Description: Library Status Resource: Statusversion: null1.8.000) Canonical URL: `https://madie.cms.gov/Library/Status|1.8.000`
Dependency | Description: Library QICoreCommon Resource: QICoreCommonversion: null2.1.000) Canonical URL: `https://madie.cms.gov/Library/QICoreCommon|2.1.000`
Dependency | Description: Value Set Colonoscopy Resource: Colonoscopy Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1020`
Dependency | Description: Value Set CT Colonography Resource: CT Colonography Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1038`
Dependency | Description: Value Set Fecal Occult Blood Test (FOBT) Resource: Fecal Occult Blood Test (FOBT) Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1011`
Dependency | Description: Value Set sDNA FIT Test Resource: FIT DNA Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1039`
Dependency | Description: Value Set Flexible Sigmoidoscopy Resource: Flexible Sigmoidoscopy Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1010`
Dependency | Description: Value Set Malignant Neoplasm of Colon Resource: Malignant Neoplasm of Colon Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1001`
Dependency | Description: Value Set Total Colectomy Resource: Total Colectomy Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1019`
Data Requirement | Type: Condition Profile(s): QICoreCondition Code Filter(s): Path: code ValueSet: Malignant Neoplasm of Colon
Data Requirement | Type: Procedure Profile(s): QICoreProcedure Code Filter(s): Path: code ValueSet: Total Colectomy
Data Requirement | Type: Observation Profile(s): QICoreObservation Code Filter(s): Path: code ValueSet: Fecal Occult Blood Test (FOBT)
Data Requirement | Type: Observation Profile(s): QICoreObservation Code Filter(s): Path: code ValueSet: FIT DNA
Data Requirement | Type: Procedure Profile(s): QICoreProcedure Code Filter(s): Path: code ValueSet: Flexible Sigmoidoscopy
Data Requirement | Type: Observation Profile(s): QICoreObservation Code Filter(s): Path: code ValueSet: CT Colonography
Data Requirement | Type: Procedure Profile(s): QICoreProcedure Code Filter(s): Path: code ValueSet: Colonoscopy
Parameters
Name | Use | Card. | Type | Documentation
Measurement Period | In | 0..1 | Period |
Patient | Out | 0..1 | Resource |
SDE Ethnicity | Out | 0..1 | Resource |
SDE Payer | Out | 0..* | Resource |
SDE Race | Out | 0..1 | Resource |
SDE Sex | Out | 0..1 | Coding |
Initial Population | Out | 0..1 | boolean |
Denominator | Out | 0..1 | boolean |
Malignant Neoplasm | Out | 0..* | Resource |
Total Colectomy Performed | Out | 0..* | Resource |
Denominator Exclusion | Out | 0..1 | boolean |
Fecal Occult Blood Test Performed | Out | 0..* | Resource |
Stool DNA with FIT Test Performed | Out | 0..* | Resource |
Flexible Sigmoidoscopy Performed | Out | 0..* | Resource |
CT Colonography Performed | Out | 0..* | Resource |
Colonoscopy Performed | Out | 0..* | Resource |
Numerator | Out | 0..1 | boolean |
Stratification 1 | Out | 0..1 | boolean |
Stratification 2 | Out | 0..1 | boolean |
Library Content
CQL Content |
    library ColonCancerScreeningFHIR version '0.1.000'

    using QICore version '4.1.1'

    include FHIRHelpers version '4.4.000' called FHIRHelpers
    include SupplementalDataElements version '3.5.000' called SDE
    include Hospice version '6.12.000' called Hospice
    include PalliativeCare version '1.11.000' called PalliativeCare
    include AdultOutpatientEncounters version '4.11.000' called AdultOutpatientEncounters
    include AdvancedIllnessandFrailty version '1.16.000' called AIFrailLTCF
    include Status version '1.8.000' called Status
    include QICoreCommon version '2.1.000' called QICoreCommon

    valueset "Colonoscopy": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1020'
    valueset "CT Colonography": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1038'
    valueset "Fecal Occult Blood Test (FOBT)": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1011'
    valueset "sDNA FIT Test": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1039'
    valueset "Flexible Sigmoidoscopy": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1010'
    valueset "Malignant Neoplasm of Colon": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1001'
    valueset "Total Colectomy": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1019'

    parameter "Measurement Period" Interval<DateTime>
      default Interval[@2025-01-01T00:00:00.000Z, @2025-12-31T23:59:59.999Z]

    context Patient

    define "SDE Ethnicity":
      SDE."SDE Ethnicity"

    define "SDE Payer":
      SDE."SDE Payer"

    define "SDE Race":
      SDE."SDE Race"

    define "SDE Sex":
      SDE."SDE Sex"

    define "Initial Population":
      AgeInYearsAt(date from
        end of "Measurement Period"
      ) in Interval[46, 75]
        and exists AdultOutpatientEncounters."Qualifying Encounters"

    define "Denominator":
      "Initial Population"

    define "Denominator Exclusion":
      Hospice."Has Hospice Services"
        or exists "Malignant Neoplasm"
        or exists "Total Colectomy Performed"
        or AIFrailLTCF."Is Age 66 or Older with Advanced Illness and Frailty"
        or AIFrailLTCF."Is Age 66 or Older Living Long Term in a Nursing Home"
        or PalliativeCare."Has Palliative Care in the Measurement Period"

    define "Numerator":
      exists "Fecal Occult Blood Test Performed"
        or exists "Stool DNA with FIT Test Performed"
        or exists "Flexible Sigmoidoscopy Performed"
        or exists "CT Colonography Performed"
        or exists "Colonoscopy Performed"

    define "Fecal Occult Blood Test Performed":
      ( ( [Observation: "Fecal Occult Blood Test (FOBT)"] ).isLaboratoryTestPerformed ( ) ) FecalOccultResult
        where FecalOccultResult.value is not null
          and FecalOccultResult.effective.latest ( ) during day of "Measurement Period"

    define "Malignant Neoplasm":
      ( [Condition: "Malignant Neoplasm of Colon"] ) ColorectalCancer
        where ColorectalCancer.prevalenceInterval ( ) starts on or before day of end of "Measurement Period"

    define "Total Colectomy Performed":
      ( ( [Procedure: "Total Colectomy"] ).isProcedurePerformed ( ) ) Colectomy
        where Colectomy.performed.toInterval ( ) ends on or before day of end of "Measurement Period"

    define "Stratification 1":
      AgeInYearsAt(date from
        end of "Measurement Period"
      ) in Interval[46, 49]

    define "Stratification 2":
      AgeInYearsAt(date from
        end of "Measurement Period"
      ) in Interval[50, 75]

    define "Colonoscopy Performed":
      ( ( [Procedure: "Colonoscopy"] ).isProcedurePerformed ( ) ) Colonoscopy
        where Colonoscopy.performed.toInterval ( ) ends during day of Interval[start of "Measurement Period" - 9 years, end of "Measurement Period"]

    define "Flexible Sigmoidoscopy Performed":
      ( ( [Procedure: "Flexible Sigmoidoscopy"] ).isProcedurePerformed ( ) ) FlexibleSigmoidoscopy
        where FlexibleSigmoidoscopy.performed.toInterval ( ) ends during day of Interval[start of "Measurement Period" - 4 years, end of "Measurement Period"]

    define "CT Colonography Performed":
      ( ( [Observation: "CT Colonography"] ).isDiagnosticStudyPerformed ( ) ) Colonography
        where Colonography.effective.toInterval ( ) ends during day of Interval[start of "Measurement Period" - 4 years, end of "Measurement Period"]

    define "Stool DNA with FIT Test Performed":
      ( ( [Observation: "sDNA FIT Test"] ).isLaboratoryTestPerformed ( ) ) sDNATest
        where sDNATest.value is not null
          and sDNATest.effective.latest ( ) during day of Interval[start of "Measurement Period" - 2 years, end of "Measurement Period"]
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