dQM QICore Content Implementation Guide
2025.0.0 - CI Build

dQM QICore Content Implementation Guide, published by cqframework. This guide is not an authorized publication; it is the continuous build for version 2025.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/cqframework/dqm-content-qicore-2025/ and changes regularly. See the Directory of published versions

Library: CMS144FHIRHFBetaBlockerForLVSD

Official URL: https://madie.cms.gov/Library/CMS144FHIRHFBetaBlockerForLVSD Version: 1.0.000
Active as of 2025-08-22 Responsible: American Heart Association Computable Name: CMS144FHIRHFBetaBlockerForLVSD
Other Identifiers: https://madie.cms.gov/login#CMS144FHIRHFBetaBlockerForLVSD (use: official, )

CMS144FHIRHFBetaBlockerForLVSD

Metadata
Title CMS144FHIRHFBetaBlockerForLVSD
Version 1.0.000
Identifier CMS144FHIRHFBetaBlockerForLVSD
Steward (Publisher) American Heart Association
Description

CMS144FHIRHFBetaBlockerForLVSD

Type logic-library from http://terminology.hl7.org/CodeSystem/library-type
Parameter Name: Measurement Period
Use: In
Min Cardinality: 0
Max Cardinality: 1
Type: Period
Parameter Name: Patient
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: Resource
Parameter Name: Initial Population
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: boolean
Parameter Name: Denominator
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: boolean
Parameter Name: Denominator Exclusions
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: boolean
Parameter Name: Has Beta Blocker Therapy for LVSD Ordered
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: boolean
Parameter Name: Is Currently Taking Beta Blocker Therapy for LVSD
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: boolean
Parameter Name: Numerator
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: boolean
Parameter Name: Has Consecutive Heart Rates Less than 50
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: boolean
Parameter Name: Has Medical or Patient Reason for Not Ordering Beta Blocker for LVSD
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: boolean
Parameter Name: Has Arrhythmia Diagnosis
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: boolean
Parameter Name: Has Hypotension Diagnosis
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: boolean
Parameter Name: Has Asthma Diagnosis
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: boolean
Parameter Name: Has Diagnosis of Allergy or Intolerance to Beta Blocker Therapy
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: boolean
Parameter Name: Has Bradycardia Diagnosis
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: boolean
Parameter Name: Has Allergy or Intolerance to Beta Blocker Therapy Ingredient
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: boolean
Parameter Name: Has Atrioventricular Block Diagnosis
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: boolean
Parameter Name: Has Diagnosis of Cardiac Pacer in Situ
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: boolean
Parameter Name: Has Cardiac Pacer Device Implanted
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: boolean
Parameter Name: Atrioventricular Block without Cardiac Pacer
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: boolean
Parameter Name: Denominator Exceptions
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: boolean
Parameter Name: SDE Ethnicity
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: Resource
Parameter Name: SDE Payer
Use: Out
Min Cardinality: 0
Max Cardinality: *
Type: Resource
Parameter Name: SDE Race
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: Resource
Parameter Name: SDE Sex
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: Coding
Data Requirement Type: Patient
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient
Data Requirement Type: MedicationRequest
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest
Must Support Elements: medication
Code Filter(s):
Path: medication
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1184
Data Requirement Type: MedicationRequest
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest
Must Support Elements: medication.reference.value
Data Requirement Type: Medication
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medication
Must Support Elements: id.value, code
Data Requirement Type: Observation
Profile(s): http://hl7.org/fhir/us/core/StructureDefinition/us-core-heart-rate
Must Support Elements: effective, status, status.value, value
Data Requirement Type: Observation
Profile(s): http://hl7.org/fhir/us/core/StructureDefinition/us-core-heart-rate
Must Support Elements: effective
Data Requirement Type: Observation
Profile(s): http://hl7.org/fhir/us/core/StructureDefinition/us-core-heart-rate
Must Support Elements: effective, value
Data Requirement Type: MedicationRequest
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationnotrequested
Must Support Elements: medication, authoredOn, authoredOn.value, reasonCode
Code Filter(s):
Path: medication
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1184
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.366
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.366
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.370
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.370
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.362
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.362
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1177
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1177
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1178
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1178
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.412
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.412
Data Requirement Type: AllergyIntolerance
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-allergyintolerance
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1493
Data Requirement Type: AllergyIntolerance
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-allergyintolerance
Must Support Elements: code
Code Filter(s):
Path: code
Code(s): SNOMED CT 373254001: Substance with beta adrenergic receptor antagonist mechanism of action (substance)
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.367
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.367
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.368
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.368
Data Requirement Type: Procedure
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure
Must Support Elements: code, performed, status, status.value
Code Filter(s):
Path: code
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1178.53
Library Content
CQL Content
library CMS144FHIRHFBetaBlockerForLVSD version '1.0.000'

using QICore version '6.0.0'

include FHIRHelpers version '4.4.000' called FHIRHelpers
include SupplementalDataElements version '5.1.000' called SDE
include QICoreCommon version '4.0.000' called QICoreCommon
include AHAOverall version '4.1.000' called AHA

codesystem "SNOMEDCT": 'http://snomed.info/sct'

valueset "Allergy to Beta Blocker Therapy": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1177'
valueset "Arrhythmia": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.366'
valueset "Asthma": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.362'
valueset "Atrioventricular Block": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.367'
valueset "Beta Blocker Therapy for LVSD": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1184'
valueset "Beta Blocker Therapy Ingredient": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1493'
valueset "Bradycardia": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.412'
valueset "Cardiac Pacer": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1178.53'
valueset "Cardiac Pacer in Situ": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.368'
valueset "Hypotension": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.370'
valueset "Intolerance to Beta Blocker Therapy": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1178'
valueset "Medical Reason": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1007'
valueset "Patient Reason": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1008'

code "Substance with beta adrenergic receptor antagonist mechanism of action (substance)": '373254001' from "SNOMEDCT" display 'Substance with beta adrenergic receptor antagonist mechanism of action (substance)'

parameter "Measurement Period" Interval<DateTime>

context Patient

define "Initial Population":
  AHA."Is Adult With Two Qualifying Outpatient Encounters and One Heart Failure Outpatient Encounter During the Measurement Period"

define "Denominator":
  "Initial Population"
    and exists AHA."Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD"

define "Denominator Exclusions":
  AHA."Has Heart Transplant"
    or AHA."Has Heart Transplant Complications"
    or AHA."Has Left Ventricular Assist Device"
    or AHA."Has Left Ventricular Assist Device Complications"

define "Numerator":
  "Has Beta Blocker Therapy for LVSD Ordered"
    or "Is Currently Taking Beta Blocker Therapy for LVSD"

define "Denominator Exceptions":
  "Has Consecutive Heart Rates Less than 50"
    or "Has Medical or Patient Reason for Not Ordering Beta Blocker for LVSD"
    or "Has Arrhythmia Diagnosis"
    or "Has Hypotension Diagnosis"
    or "Has Asthma Diagnosis"
    or "Has Diagnosis of Allergy or Intolerance to Beta Blocker Therapy"
    or "Has Bradycardia Diagnosis"
    or "Has Allergy or Intolerance to Beta Blocker Therapy Ingredient"
    or "Atrioventricular Block without Cardiac Pacer"

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 "Atrioventricular Block without Cardiac Pacer":
  "Has Atrioventricular Block Diagnosis"
    and not "Has Diagnosis of Cardiac Pacer in Situ"
    and not "Has Cardiac Pacer Device Implanted"

define "Has Cardiac Pacer Device Implanted":
  exists ( [Procedure: "Cardiac Pacer"] ImplantedCardiacPacer
      with AHA."Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD" ModerateOrSevereLVSDHFOutpatientEncounter
        such that ImplantedCardiacPacer.performed.toInterval ( ) starts before end of ModerateOrSevereLVSDHFOutpatientEncounter.period
      where ImplantedCardiacPacer.status = 'completed'
  )

define "Is Currently Taking Beta Blocker Therapy for LVSD":
  exists ( ["MedicationRequest": "Beta Blocker Therapy for LVSD"] ActiveBetaBlocker
      where ActiveBetaBlocker.overlapsAfterHeartFailureOutpatientEncounter ( )
  )

define "Has Hypotension Diagnosis":
  exists ( ( ["ConditionProblemsHealthConcerns": "Hypotension"]
      union ["ConditionEncounterDiagnosis": "Hypotension"] ) HypotensionAlias
      where HypotensionAlias.overlapsHeartFailureOutpatientEncounter ( )
        and HypotensionAlias.isVerified ( )
  )

define "Has Diagnosis of Cardiac Pacer in Situ":
  exists ( ( ["ConditionProblemsHealthConcerns": "Cardiac Pacer in Situ"]
      union ["ConditionEncounterDiagnosis": "Cardiac Pacer in Situ"] ) CardiacPacerDiagnosis
      where CardiacPacerDiagnosis.overlapsAfterHeartFailureOutpatientEncounter ( )
        and CardiacPacerDiagnosis.isVerified ( )
  )

define "Has Diagnosis of Allergy or Intolerance to Beta Blocker Therapy":
  exists ( ( ( ["ConditionProblemsHealthConcerns": "Allergy to Beta Blocker Therapy"]
        union ["ConditionEncounterDiagnosis": "Allergy to Beta Blocker Therapy"]
    )
      union ( ["ConditionProblemsHealthConcerns": "Intolerance to Beta Blocker Therapy"] )
      union ["ConditionEncounterDiagnosis": "Intolerance to Beta Blocker Therapy"] ) BetaBlockerAllergyOrIntoleranceDiagnosis
      where BetaBlockerAllergyOrIntoleranceDiagnosis.overlapsAfterHeartFailureOutpatientEncounter ( )
        and BetaBlockerAllergyOrIntoleranceDiagnosis.isVerified ( )
  )

define "Has Bradycardia Diagnosis":
  exists ( ( [ConditionProblemsHealthConcerns: "Bradycardia"]
      union [ConditionEncounterDiagnosis: "Bradycardia"] ) BradycardiaAlias
      where BradycardiaAlias.overlapsHeartFailureOutpatientEncounter ( )
        and BradycardiaAlias.isVerified ( )
  )

define "Has Consecutive Heart Rates Less than 50":
  exists ( from
      ["USCoreHeartRateProfile"] HeartRate,
      AHA."Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD" ModerateOrSevereLVSDHFOutpatientEncounter
      let PriorHeartRate: Last(["USCoreHeartRateProfile"] MostRecentPriorHeartRate
          where MostRecentPriorHeartRate.effective.toInterval() during ModerateOrSevereLVSDHFOutpatientEncounter.period
            and MostRecentPriorHeartRate.effective.toInterval() before HeartRate.effective.toInterval()
          sort by start of effective.toInterval()
      )
      where HeartRate.effective.toInterval ( ) during ModerateOrSevereLVSDHFOutpatientEncounter.period
        and HeartRate.status in { 'final', 'amended', 'corrected' }
        and HeartRate.value < 50 '/min'
        and PriorHeartRate.value < 50 '/min'
      return HeartRate
  )

define "Has Allergy or Intolerance to Beta Blocker Therapy Ingredient":
  exists ( ( [AllergyIntolerance: "Beta Blocker Therapy Ingredient"]
      union [AllergyIntolerance: "Substance with beta adrenergic receptor antagonist mechanism of action (substance)"] ) BetaBlockerAllergyIntolerance
      where BetaBlockerAllergyIntolerance.overlapsAfterHeartFailureOutpatientEncounter ( )
        and BetaBlockerAllergyIntolerance.isVerified ( )
  )

define "Has Arrhythmia Diagnosis":
  exists ( ( [ConditionProblemsHealthConcerns: "Arrhythmia"]
      union [ConditionEncounterDiagnosis: "Arrhythmia"] ) ArrhythmiaAlias
      where ArrhythmiaAlias.overlapsHeartFailureOutpatientEncounter ( )
        and ArrhythmiaAlias.isVerified ( )
  )

define "Has Asthma Diagnosis":
  exists ( ( [ConditionProblemsHealthConcerns: "Asthma"]
      union [ConditionEncounterDiagnosis: "Asthma"] ) AsthmaAlias
      where AsthmaAlias.overlapsHeartFailureOutpatientEncounter ( )
        and AsthmaAlias.isVerified ( )
  )

define "Has Atrioventricular Block Diagnosis":
  exists ( ( [ConditionProblemsHealthConcerns: "Atrioventricular Block"]
      union [ConditionEncounterDiagnosis: "Atrioventricular Block"] ) AtrioventricularBlockAlias
      where AtrioventricularBlockAlias.overlapsHeartFailureOutpatientEncounter ( )
        and AtrioventricularBlockAlias.isVerified ( )
  )

define "Has Beta Blocker Therapy for LVSD Ordered":
  exists ( [MedicationRequest: medication in "Beta Blocker Therapy for LVSD"] BetaBlockerOrdered
      where BetaBlockerOrdered.isOrderedDuringHeartFailureOutpatientEncounter ( )
  )

define "Has Medical or Patient Reason for Not Ordering Beta Blocker for LVSD":
  exists ( ["MedicationNotRequested": medication in "Beta Blocker Therapy for LVSD"] NoBetaBlockerOrdered
      with AHA."Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD" ModerateOrSevereLVSDHFOutpatientEncounter
        such that NoBetaBlockerOrdered.authoredOn during day of ModerateOrSevereLVSDHFOutpatientEncounter.period
      where ( NoBetaBlockerOrdered.reasonCode in "Medical Reason"
          or NoBetaBlockerOrdered.reasonCode in "Patient Reason"
      )
  )
  
 /*
@description: Returns true if the given condition either has no verification status or has a verification status of confirmed, unconfirmed, provisional, or differential
*/


define fluent function isVerified(allergyIntolerance QICore.AllergyIntolerance):
  allergyIntolerance.verificationStatus is not null implies ( allergyIntolerance.verificationStatus ~ QICoreCommon."allergy-confirmed"
      or allergyIntolerance.verificationStatus ~ QICoreCommon."allergy-unconfirmed"
  )
ELM XML Content
Encoded data (219840 characters)
ELM JSON Content
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