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: TJCOverall

Official URL: https://madie.cms.gov/Library/TJCOverall Version: 8.25.000
Active as of 2025-08-25 Responsible: The Joint Commission Computable Name: TJCOverall
Other Identifiers: https://madie.cms.gov/login#688cc6f9b500212afe574154 (use: official, )

Common functions and definitions used by TJC measures

Metadata
Title TJCOverall
Version 8.25.000
Identifier 688cc6f9b500212afe574154
Steward (Publisher) The Joint Commission
Description

Common functions and definitions used by TJC measures
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: Non Elective Inpatient Encounter With Age
Use: Out
Min Cardinality: 0
Max Cardinality: *
Type: Resource
Parameter Name: Ischemic Stroke Encounter
Use: Out
Min Cardinality: 0
Max Cardinality: *
Type: Resource
Parameter Name: Ischemic Stroke Encounters With Discharge Disposition
Use: Out
Min Cardinality: 0
Max Cardinality: *
Type: Resource
Parameter Name: Intervention Comfort Measures
Use: Out
Min Cardinality: 0
Max Cardinality: *
Type: Resource
Parameter Name: Encounter With Comfort Measures During Hospitalization
Use: Out
Min Cardinality: 0
Max Cardinality: *
Type: Resource
Data Requirement Type: Patient
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient
Data Requirement Type: Encounter
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
Must Support Elements: type, period, hospitalization, hospitalization.dischargeDisposition
Code Filter(s):
Path: type
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.424
Data Requirement Type: ServiceRequest
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest
Must Support Elements: code, status, status.value, intent, intent.value
Code Filter(s):
Path: code
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/1.3.6.1.4.1.33895.1.3.0.45
Data Requirement Type: Procedure
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure
Must Support Elements: code, status, status.value
Code Filter(s):
Path: code
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/1.3.6.1.4.1.33895.1.3.0.45
Data Requirement Type: Encounter
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
Must Support Elements: type, period
Code Filter(s):
Path: type
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.424
Library Content
CQL Content 
library TJCOverall version '8.25.000'

using QICore version '6.0.0'

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

valueset "Comfort Measures": 'http://cts.nlm.nih.gov/fhir/ValueSet/1.3.6.1.4.1.33895.1.3.0.45'
valueset "Discharge To Acute Care Facility": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.87'
valueset "Discharged to Health Care Facility for Hospice Care": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.207'
valueset "Discharged to Home for Hospice Care": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.209'
valueset "Ischemic Stroke": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.247'
valueset "Left Against Medical Advice": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.308'
valueset "Nonelective Inpatient Encounter": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.424'
valueset "Patient Expired": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.309'

parameter "Measurement Period" Interval<DateTime>

context Patient

define "Non Elective Inpatient Encounter With Age":
  ["Encounter": "Nonelective Inpatient Encounter"] NonElectiveEncounter
        where AgeInYearsAt(date from start of NonElectiveEncounter.period ) >= 18
         and NonElectiveEncounter.period ends during day of "Measurement Period"

define "Ischemic Stroke Encounter":
  "Non Elective Inpatient Encounter With Age" NonElectiveEncounterWithAge
   where NonElectiveEncounterWithAge.hasPrincipalDiagnosisOf("Ischemic Stroke" )

define "Ischemic Stroke Encounters With Discharge Disposition":
  "Ischemic Stroke Encounter" IschemicStrokeEncounter
  let DischDisp: IschemicStrokeEncounter.hospitalization.dischargeDisposition
  	where  DischDisp in "Discharge To Acute Care Facility"
		or DischDisp in "Left Against Medical Advice"
		or DischDisp in "Patient Expired"
		or DischDisp in "Discharged to Home for Hospice Care"
		or DischDisp in "Discharged to Health Care Facility for Hospice Care"			

define "Encounter With Comfort Measures During Hospitalization":
  "Ischemic Stroke Encounter" IschemicStrokeEncounter
    with "Intervention Comfort Measures" ComfortMeasure
     such that Coalesce(start of ComfortMeasure.performed.toInterval(), ComfortMeasure.authoredOn) during IschemicStrokeEncounter.hospitalizationWithObservation()

define "Intervention Comfort Measures":
  ( ["ServiceRequest": "Comfort Measures"] ComfortCare
    where ComfortCare.status in { 'active', 'completed', 'on-hold' }
      and ComfortCare.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }
  )  
  union ( ["Procedure": "Comfort Measures"] ComfortCarePerformed
        where ComfortCarePerformed.status in { 'completed', 'in-progress' }
  )
  
define fluent function calendarDayOfOrDayAfter(StartValue DateTime):
  Interval [date from (StartValue), date from (StartValue) + 1 day]
ELM XML Content 
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ELM JSON Content 
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