{
  "resourceType" : "Library",
  "id" : "CMS104FHIRSTKDCAntithrombotic",
  "text" : {
    "status" : "extensions",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <table class=\"narrative-table\">\n    <tbody>\n<tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\"><a name=\"metadata\"> </a>Metadata</th>\n\n\n</tr>\n\n\n\n\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Version</th>\n\n\n\n<td class=\"content-container\">1.1.000</td>\n\n\n</tr>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Status</th>\n\n\n\n<td class=\"content-container\">Draft</td>\n\n\n</tr>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Type</th>\n\n\n\n<td class=\"content-container\">\n    <a href=\"http://terminology.hl7.org/7.1.0/CodeSystem-library-type.html\">http://terminology.hl7.org/CodeSystem/library-type</a>#logic-library\n\n\n</td>\n\n\n</tr>\n\n\n\n\n\n\n\n\n\n\n\n\n\n<tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\"><a name=\"parameters\"> </a>Parameters</th>\n\n\n</tr>\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Parameter</th>\n\n\n\n<td class=\"content-container\">None</td>\n\n\n</tr>\n\n\n\n\n\n\n\n\n  <tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\">Library Content</th>\n\n\n</tr>\n  \n    \n    <tr>\n      <th scope=\"row\" class=\"row-header\">CQL Content</th>\n      <td>\n        <a name=\"cql-content\"> </a>\n        <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\nNOTE: For use by March 2026 US Realm Connectathon participants for internal use only. Not for use or distribution in commercial products.\n*/\nlibrary CMS104FHIRSTKDCAntithrombotic version '1.1.000'\n\nusing USQualityCore version '0.1.0-cibuild'\nusing USCore version '6.1.0-derived'\nusing FHIR version '4.0.1'\n\ninclude hl7.fhir.uv.cql.FHIRHelpers version '4.0.1' called FHIRHelpers\ninclude hl7.fhir.uv.cql.FHIRCommon version '2.0.0' called FHIRCommon\ninclude hl7.fhir.us.cql.USCoreCommon version '2.0.0-ballot' called USCoreCommon\ninclude hl7.fhir.us.cql.USCoreElements version '2.0.0-ballot' called USCoreElements\n\ninclude CQMCommon version '5.1.000' called CQMCommon\ninclude USQualityCoreCommon version '0.1.0-cibuild' called USQualityCoreCommon\ninclude SupplementalDataElements version '6.1.000' called SDE\ninclude Status version '2.1.000' called Status\n\ninclude TJCOverall version '9.1.000' called TJC\n\nvalueset &quot;Antithrombotic Therapy for Ischemic Stroke&quot;: 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.62'\nvalueset &quot;Medical Reason For Not Providing Treatment&quot;: 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.473'\nvalueset &quot;Patient Refusal&quot;: 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.93'\nvalueset &quot;Pharmacological Contraindications For Antithrombotic Therapy&quot;: 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.52'\n\nparameter &quot;Measurement Period&quot; Interval&lt;DateTime&gt;\n  default Interval[@2026-01-01T00:00:00.000Z, @2027-01-01T00:00:00.000Z)\n\ncontext Patient\n\ndefine &quot;Initial Population&quot;:\n  TJC.&quot;Ischemic Stroke Encounter&quot;\n\ndefine &quot;Denominator&quot;:\n  &quot;Initial Population&quot;\n\ndefine &quot;Denominator Exclusions&quot;:\n  TJC.&quot;Ischemic Stroke Encounters With Discharge Disposition&quot;\n    union TJC.&quot;Encounter With Comfort Measures During Hospitalization&quot;\n\ndefine &quot;Numerator&quot;:\n  TJC.&quot;Ischemic Stroke Encounter&quot; IschemicStrokeEncounter\n    with [&quot;MedicationRequest&quot;: &quot;Antithrombotic Therapy for Ischemic Stroke&quot;] DischargeAntithrombotic\n      such that DischargeAntithrombotic.status in { 'active', 'completed' }\n        and DischargeAntithrombotic.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }\n        and ( DischargeAntithrombotic.isCommunity ( )\n            or DischargeAntithrombotic.isDischarge ( )\n        )\n        and DischargeAntithrombotic.authoredOn during IschemicStrokeEncounter.period\n        and not exists ( [&quot;TaskRejected&quot;] TaskReject\n            where TaskReject.focus.references ( DischargeAntithrombotic )\n              and TaskReject.code ~ USQualityCoreCommon.&quot;Fulfill&quot;\n        )\n\ndefine &quot;Denominator Exceptions&quot;:\n  &quot;Encounter With Documented Reason For No Antithrombotic At Discharge&quot;\n    union &quot;Encounter With Pharmacological Contraindications For Antithrombotic Therapy At Discharge&quot;\n\ndefine &quot;Encounter With Documented Reason For No Antithrombotic At Discharge&quot;:\n  TJC.&quot;Ischemic Stroke Encounter&quot; IschemicStrokeEncounter\n    with &quot;Reason For Not Giving Antithrombotic At Discharge&quot; NoDischargeAntithrombotic\n      such that NoDischargeAntithrombotic.authoredOn during IschemicStrokeEncounter.period\n\ndefine &quot;Reason For Not Giving Antithrombotic At Discharge&quot;:\n  ( [&quot;MedicationNotRequested&quot;: &quot;Antithrombotic Therapy for Ischemic Stroke&quot;] NoAntithromboticDischarge\n      where ( NoAntithromboticDischarge.reasonCode in &quot;Medical Reason For Not Providing Treatment&quot;\n          or NoAntithromboticDischarge.reasonCode in &quot;Patient Refusal&quot;\n      )\n        and ( NoAntithromboticDischarge.isCommunity ( )\n            or NoAntithromboticDischarge.isDischarge ( )\n        )\n        and NoAntithromboticDischarge.status in { 'active', 'completed' }\n        and NoAntithromboticDischarge.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }\n  )\n    union ( [&quot;MedicationRequest&quot;: &quot;Antithrombotic Therapy for Ischemic Stroke&quot;] MedReqAntithrombotic\n        with [&quot;TaskRejected&quot;] TaskReject\n          such that TaskReject.focus.references ( MedReqAntithrombotic )\n            and ( TaskReject.statusReason in &quot;Medical Reason For Not Providing Treatment&quot;\n                or TaskReject.statusReason in &quot;Patient Refusal&quot;\n            )\n            and MedReqAntithrombotic.status in { 'active', 'completed' }\n            and TaskReject.code ~ USQualityCoreCommon.&quot;Fulfill&quot;\n    )\n\ndefine &quot;Encounter With Pharmacological Contraindications For Antithrombotic Therapy At Discharge&quot;:\n  TJC.&quot;Ischemic Stroke Encounter&quot; IschemicStrokeEncounter\n    with &quot;Pharmacological Contraindications For Antithrombotic Therapy At Discharge&quot; DischargePharmacological\n      such that DischargePharmacological.authoredOn during IschemicStrokeEncounter.period\n\ndefine &quot;Pharmacological Contraindications For Antithrombotic Therapy At Discharge&quot;:\n  [&quot;MedicationRequest&quot;: &quot;Pharmacological Contraindications For Antithrombotic Therapy&quot;] PharmacologicalContraindications\n    where ( PharmacologicalContraindications.isCommunity ( )\n        or PharmacologicalContraindications.isDischarge ( )\n    )\n      and PharmacologicalContraindications.status in { 'active', 'completed' }\n      and PharmacologicalContraindications.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }\n\ndefine &quot;SDE Ethnicity&quot;:\n  SDE.&quot;SDE Ethnicity&quot;\n\ndefine &quot;SDE Payer&quot;:\n  SDE.&quot;SDE Payer&quot;\n\ndefine &quot;SDE Race&quot;:\n  SDE.&quot;SDE Race&quot;\n\ndefine &quot;SDE Sex&quot;:\n  SDE.&quot;SDE Sex&quot;</code></pre>\n      </td>\n    </tr>\n    \n  \n\n\n\n<tr>\n  <th colspan=\"2\" scope=\"row\" class=\"row-header\">Generated using version 0.5.6 of the sample-content-ig Liquid templates</th>\n</tr>\n\n    </tbody>\n  </table>\n</div>"
  },
  "extension" : [{
    "url" : "http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-softwaresystem",
    "valueReference" : {
      "reference" : "Device/cqf-tooling"
    }
  }],
  "url" : "https://madie.cms.gov/Library/CMS104FHIRSTKDCAntithrombotic",
  "version" : "1.1.000",
  "name" : "CMS104FHIRSTKDCAntithrombotic",
  "status" : "draft",
  "type" : {
    "coding" : [{
      "system" : "http://terminology.hl7.org/CodeSystem/library-type",
      "code" : "logic-library"
    }]
  },
  "date" : "2026-09-19T16:31:14+00:00",
  "content" : [{
    "contentType" : "text/cql",
    "data" : 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    "url" : "https://madie.cms.gov/Library-CMS104FHIRSTKDCAntithrombotic.cql"
  }]
}