/*
NOTE: For use by March 2026 US Realm Connectathon participants for internal use only. Not for use or distribution in commercial products.
*/
library NHSNGlycemicControlHypoglycemiaInitialPopulation version '1.1.000'

using USQualityCore version '0.1.0-cibuild'
using USCore version '6.1.0-derived'
using FHIR version '4.0.1'

include hl7.fhir.uv.cql.FHIRHelpers version '4.0.1' called FHIRHelpers
include hl7.fhir.uv.cql.FHIRCommon version '2.0.0' called FHIRCommon
include hl7.fhir.us.cql.USCoreCommon version '2.0.0-ballot' called USCoreCommon
include hl7.fhir.us.cql.USCoreElements version '2.0.0-ballot' called USCoreElements

include USQualityCoreCommon version '0.1.0-cibuild' called USQualityCoreCommon
include SupplementalDataElements version '6.1.000' called SDE
include CQMCommon version '5.1.000' called CQMCommon

codesystem "ActCode": 'http://terminology.hl7.org/CodeSystem/v3-ActCode'
codesystem "HSLOC": 'https://www.cdc.gov/nhsn/cdaportal/terminology/codesystem/hsloc.html'
codesystem "LOINC": 'http://loinc.org'
codesystem "RxNorm": 'https://www.nlm.nih.gov/research/umls/rxnorm/index.html'
codesystem "SNOMEDCT": 'http://snomed.info/sct'

valueset "Blood Glucose Laboratory and Point of Care Tests": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1190.38'
valueset "Diabetes Medications": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1190.58'
valueset "Encounter Inpatient": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307'
valueset "Inpatient, Emergency, and Observation Locations": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.265'
valueset "NHSN Inpatient Encounter Class Codes": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.274'

parameter "Measurement Period" Interval<DateTime>
  default Interval[@2026-01-01T00:00:00.000Z, @2027-01-01T00:00:00.000Z)

context Patient

// Initial Population


define "Initial Population":
  ( "Inpatient Encounters During Measurement Period"
    union "Encounters with Patient Hospital Locations" ) InpatientEncounters
    with "Antidiabetic Drugs Administered or Ordered" ADD
      such that Coalesce(start of ADD.effective.toInterval(), ADD.authoredOn) during InpatientEncounters."hospitalizationWithObservation" ( )
    where ( InpatientEncounters.status = 'finished'
        or InpatientEncounters.status = 'in-progress'
        or InpatientEncounters.status = 'triaged'
        or InpatientEncounters.status = 'onleave'
        or InpatientEncounters.status = 'entered-in-error'
    )

define "Inpatient Encounters During Measurement Period":
  [Encounter: "Encounter Inpatient"] InpatientEncounters
    where InpatientEncounters.period ends during day of "Measurement Period"
      and ( InpatientEncounters.class ~ USQualityCoreCommon."inpatient non-acute"
          or InpatientEncounters.class ~ USQualityCoreCommon."inpatient non-acute"
          or InpatientEncounters.class ~ USQualityCoreCommon."short stay"
          or InpatientEncounters.class ~ USQualityCoreCommon."inpatient acute"
          or InpatientEncounters.class ~ USQualityCoreCommon."inpatient encounter"
      )

define "Encounters with Patient Hospital Locations":
  "Inpatient Encounters During Measurement Period" InpatientEncounter
    where exists ( InpatientEncounter.location HospitalLocation
        where HospitalLocation.location.getLocation ( ).type in "Inpatient, Emergency, and Observation Locations"
          and HospitalLocation.period during day of InpatientEncounter.period
    )

define "Antidiabetic Drugs Administered or Ordered":
  ( "MedicationRequests"
    union "MedicationAdministrations" ) MedReqOrAdmin
    where MedReqOrAdmin.getMedicationCode() in "Diabetes Medications"

//Supplemental Data Elements


define "SDE Blood Glucose Observation":
  ( ["LaboratoryResultObservation": "Blood Glucose Laboratory and Point of Care Tests"] GlucoseTest
      where exists ( "Initial Population" InitialPopulation
          where start of GlucoseTest.effective.toInterval ( ) during day of InitialPopulation.period
            or GlucoseTest.issued during day of InitialPopulation.period
      )
      return { GlucoseTest.id, GlucoseTest.extension, GlucoseTest.text, GlucoseTest.referenceRange, GlucoseTest.component, GlucoseTest.basedOn, GlucoseTest.partOf, GlucoseTest.category, GlucoseTest.status, GlucoseTest.subject, GlucoseTest.focus, GlucoseTest.encounter, GlucoseTest.effective, GlucoseTest.issued, GlucoseTest.performer, GlucoseTest.value, GlucoseTest.dataAbsentReason, GlucoseTest.interpretation, GlucoseTest.note, GlucoseTest.bodySite, GlucoseTest.method, GlucoseTest.specimen, GlucoseTest.device, GlucoseTest.hasMember, GlucoseTest.derivedFrom }
  )

define "SDE Chief Complaint":
  "Initial Population" IP
    where exists ( IP.diagnosis InitialPopulationDiagnosis
        where InitialPopulationDiagnosis.use ~ FHIRCommon."CC"
    )
    return { IP.id, IP.meta, IP.identifier, IP.status, IP.statusHistory, IP.class, IP.classHistory, IP.type, IP.serviceType, IP.priority, IP.subject, IP.period, IP.length, IP.reasonCode, IP.reasonReference, IP.diagnosis, IP.account, IP.hospitalization, IP.location, IP.partOf }

define "Conditions":
  ["ConditionProblemsHealthConcerns"]
    union ["ConditionEncounterDiagnosis"]

define "SDE Condition":
  ["ConditionProblemsHealthConcerns"] Diagnosis
    where exists ( "Initial Population" IP
        where Diagnosis.prevalenceInterval ( ) overlaps day of IP.period
    )
    return { Diagnosis.id, Diagnosis.meta, Diagnosis.clinicalStatus, Diagnosis.verificationStatus, Diagnosis.category, Diagnosis.severity, Diagnosis.code, Diagnosis.bodySite, Diagnosis.subject, Diagnosis.encounter.reference.getId(), Diagnosis.onset, Diagnosis.stage, Diagnosis.evidence, Diagnosis.note }

define "SDE Coverage":
  [Coverage] Coverages
    where exists ( "Initial Population" IP
        where Coverages.period starts before or on day of IP.period
          and end of Coverages.period on or after day of end of IP.period
    )
    return { Coverages.id, Coverages.meta, Coverages.status, Coverages.type, Coverages.policyHolder, Coverages.subscriber, Coverages.subscriberId, Coverages.beneficiary, Coverages.dependent, Coverages.relationship, Coverages.period, Coverages.payor, Coverages.class, Coverages.order, Coverages.network, Coverages.subrogation, Coverages.contract }

define "Encounters":
  [Encounter]

define "SDE Encounter Locations":
  "Initial Population" IP
    where exists ( IP.location InitialPopulationLocation
        let types: ( InitialPopulationLocation.location ).getLocation ( ).type
        where exists ( types type
            where type in "Inpatient, Emergency, and Observation Locations"
        )
          and InitialPopulationLocation.period during IP.period
    )
    return { IP.id, IP.meta, IP.identifier, IP.status, IP.statusHistory, IP.class, IP.classHistory, IP.type, IP.serviceType, IP.priority, IP.subject, IP.period, IP.length, IP.reasonCode, IP.reasonReference, IP.diagnosis, IP.account, IP.hospitalization, IP.location, IP.partOf }

define "Get Locations from Initial Population":
  flatten ( "Initial Population" IP
      let locationElements: IP.location
      return locationElements LE
        let locationReference: LE.location
        return ( locationReference.getLocation ( ) )
  )

define "SDE Location":
  "Get Locations from Initial Population" Locations
    where exists "Initial Population"
      and Locations is not null
    return { Locations.id, Locations.meta, Locations.extension, Locations.status, Locations.operationalStatus, Locations.name, Locations.alias, Locations.description, Locations.mode, Locations.type, Locations.telecom, Locations.address, Locations.physicalType, Locations.position, Locations.managingOrganization, Locations.partOf, Locations.hoursOfOperation, Locations.availabilityExceptions, Locations.endpoint }

define "SDE Initial Population Encounters":
  "Initial Population" IP
    return { IP.id, IP.meta, IP.identifier, IP.status, IP.statusHistory, IP.class, IP.classHistory, IP.type, IP.serviceType, IP.priority, IP.subject, IP.period, IP.length, IP.reasonCode, IP.reasonReference, IP.diagnosis, IP.account, IP.hospitalization, IP.location, IP.partOf }

define "SDE Medication":
  ( "MedicationRequests"
    union "MedicationAdministrations" ) MedReqOrAdmin
    let medication: GetMedication(MedReqOrAdmin.medication as Reference)
    where medication is not null
      and exists ( "Initial Population" IP
          where Coalesce(MedReqOrAdmin.effective.toInterval(), MedReqOrAdmin.authoredOn.toInterval()) overlaps IP."hospitalizationWithObservation" ( )
      )
    return { medication.id, medication.meta, medication.code, medication.status, medication.manufacturer, medication.form, medication.amount, medication.ingredient, medication.batch }

define function "GetMedication"(reference Reference):
  singleton from ( [Medication] Medication
      where reference.references ( Medication )
  )

define "MedicationAdministrations":
  [MedicationAdministration]

define "SDE Medication Administration":
  "MedicationAdministrations" MedAdministrations
    where exists ( "Initial Population" InitialPopulation
        where MedAdministrations.effective.toInterval ( ) overlaps InitialPopulation."hospitalizationWithObservation" ( )
    )
    return { MedAdministrations.id, MedAdministrations.meta, MedAdministrations.instantiates, MedAdministrations.partOf, MedAdministrations.status, MedAdministrations.statusReason, MedAdministrations.category, MedAdministrations.medication, MedAdministrations.subject, MedAdministrations.context, MedAdministrations.supportingInformation, MedAdministrations.effective, MedAdministrations.performer, MedAdministrations.reasonCode, MedAdministrations.reasonReference, MedAdministrations.request, MedAdministrations.device, MedAdministrations.note, MedAdministrations.dosage }

define "MedicationRequests":
  [MedicationRequest]

define "SDE Medication Request":
  "MedicationRequests" MedRequests
    where exists ( "Initial Population" InitialPopulation
        where MedRequests.authoredOn during InitialPopulation."hospitalizationWithObservation" ( )
    )
    return { MedRequests.id, MedRequests.meta, MedRequests.status, MedRequests.statusReason, MedRequests.intent, MedRequests.category, MedRequests.priority, MedRequests.doNotPerform, MedRequests.reported, MedRequests.medication, MedRequests.subject, MedRequests.encounter, MedRequests.authoredOn, MedRequests.requester, MedRequests.recorder, MedRequests.reasonCode, MedRequests.reasonReference, MedRequests.instantiatesCanonical, MedRequests.instantiatesUri, MedRequests.courseOfTherapyType, MedRequests.dosageInstruction }

define "SDE Minimal Patient":
  [Patient] MinPt
    where exists "Initial Population"
    return { MinPt.id, MinPt.meta, MinPt.extension, MinPt.identifier, MinPt.active, MinPt.name, MinPt.telecom, MinPt.gender, MinPt.birthDate, MinPt.deceased, MinPt.address, MinPt.maritalStatus, MinPt.multipleBirth, MinPt.photo, MinPt.contact, MinPt.communication, MinPt.generalPractitioner, MinPt.managingOrganization, MinPt.link }

define "SDE Service Request":
  [ServiceRequest] ServiceRequests
    where exists ( "Initial Population" InitialPopulation
        where ServiceRequests.authoredOn during InitialPopulation.period
    )
    return { ServiceRequests.id, ServiceRequests.meta, ServiceRequests.instantiatesCanonical, ServiceRequests.instantiatesUri, ServiceRequests.basedOn, ServiceRequests.replaces, ServiceRequests.requisition, ServiceRequests.status, ServiceRequests.intent, ServiceRequests.category, ServiceRequests.priority, ServiceRequests.doNotPerform, ServiceRequests.code, ServiceRequests.orderDetail, ServiceRequests.quantity, ServiceRequests.subject, ServiceRequests.encounter, ServiceRequests.occurrence, ServiceRequests.asNeeded, ServiceRequests.authoredOn, ServiceRequests.requester, ServiceRequests.performerType, ServiceRequests.performer, ServiceRequests.locationCode, ServiceRequests.reasonCode, ServiceRequests.reasonReference, ServiceRequests.insurance, ServiceRequests.bodySite, ServiceRequests.note, ServiceRequests.patientInstruction }

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

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

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

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