dQM QICore Content Implementation Guide
2025.0.0 - CI Build
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
| Active as of 2025-08-25 |
<Measure xmlns="http://hl7.org/fhir">
<id value="CMS1264FHIRECATREHQR"/>
<meta>
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value="http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-shareablemeasure"/>
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value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/publishable-measure-cqfm"/>
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value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/executable-measure-cqfm"/>
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value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cql-measure-cqfm"/>
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<profile
value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/proportion-measure-cqfm"/>
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<text>
<status value="extensions"/>
<div xmlns="http://www.w3.org/1999/xhtml" class="col-12">
<table class="narrative-table">
<tbody>
<tr>
<th colspan="2" scope="row" class="row-header">Metadata</th>
</tr>
<tr>
<th scope="row" class="row-header">Title</th>
<td class="content-container">Emergency Care Access & Timeliness (REHQR)FHIR</td>
</tr>
<tr>
<th scope="row" class="row-header">Version</th>
<td class="content-container">1.0.000</td>
</tr>
<tr>
<th scope="row" class="row-header">Short Name</th>
<td class="content-container">CMS1264FHIR</td>
</tr>
<tr>
<th scope="row" class="row-header">GUID (Version Independent)</th>
<td class="content-container">urn:uuid:eb3e269b-97ef-4548-9e87-c89b25789184</td>
</tr>
<tr>
<th scope="row" class="row-header">GUID (Version Specific)</th>
<td class="content-container">urn:uuid:c83b4461-25cb-4d66-af72-6502b14ebab8</td>
</tr>
<tr>
<th scope="row" class="row-header">CMS Identifier</th>
<td class="content-container">1264FHIR</td>
</tr>
<tr>
<th scope="row" class="row-header">CMS Consensus Based Entity Identifier</th>
<td class="content-container">4625e</td>
</tr>
<tr>
<th scope="row" class="row-header">Effective Period</th>
<td class="content-container">2027-01-01 through 2027-12-31</td>
</tr>
<tr>
<th scope="row" class="row-header">Steward (Publisher)</th>
<td class="content-container">Centers for Medicare & Medicaid Services (CMS)</td>
</tr>
<tr>
<th scope="row" class="row-header">Developer</th>
<td class="content-container">Acumen, LLC</td>
</tr>
<tr>
<th scope="row" class="row-header">Description</th>
<td class="content-container">This measure assesses the variation in access and timeliness of emergency care to support rural emergency hospital (REH) quality improvement for patients requiring emergency care in an emergency department (ED). This measure is designed to align with incentives to promote improved care both in EDs and the broader health system to help identify where patients do not receive timely access to emergency care. Emergency care access and timeliness gaps are inclusive of several concepts pertaining to boarding and crowding in an ED, including significantly longer ED wait times, higher left without being seen rates, longer boarding times, and longer total length of stay in the ED.</td>
</tr>
<tr>
<th scope="row" class="row-header">Copyright</th>
<td class="content-container">Limited proprietary coding is contained in these specifications for user convenience. Users of proprietary code sets should obtain all necessary licenses from the owners of the code sets. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2024 International Health Terminology Standards Development Organisation. All rights reserved. ICD-10 copyright 2024 World Health Organization. All Rights Reserved. CPT(R) contained in the measure specifications is copyright 2004-2024 American Medical Association.</td>
</tr>
<tr>
<th scope="row" class="row-header">Disclaimer</th>
<td class="content-container">These performance specifications are not clinical guidelines, do not establish a standard of medical care, and have not been tested for all potential applications. THE MEASURES AND SPECIFICATIONS ARE PROVIDED "AS IS" WITHOUT WARRANTY OF ANY KIND. Due to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM].</td>
</tr>
<tr>
<th scope="row" class="row-header">Rationale</th>
<td class="content-container">This measure aims to reduce patient harm and improve outcomes for patients requiring emergency care in an ED by addressing the variation in emergency care and measuring access and timeliness of emergency care. There are long-standing concerns about parameters that impact access and timeliness of care in the ED. Currently, there are no national metrics to assess the proportion of patients impacted by access and timeliness of ED care.</td>
</tr>
<tr>
<th scope="row" class="row-header">Clinical Recommendation Statement</th>
<td class="content-container">Changes in care provision and workflow are anticipated from implementing this Emergency Care Access & Timeliness (ECAT) REH dQM. To improve time to place a patient in a treatment space (as defined by the numerator below), changes in care may include improving patient flow processes, triaging interventions (such as inclusion of predictive models or different clinical deployment), or increased availability and access to outpatient clinical and social services. Other changes in care may include increases in local healthcare capacity including mental health care (mental health liaisons, co-located mental health services, or specialist psychiatry services), and use of ‘hospital home’ care models. Furthermore, changes to the following may also be considered: staffing models, ED observation units, diagnostic testing and imaging processes, or physical changes to ED layout. Such changes may result in the following: decreased waiting room time, decreased door to provider times, higher proportion of patients seen within 1 hour, decrease in proportion of patients who leave without being evaluated, better management of mental health diagnoses, reduced length of stay in the ED, decreased turnaround time for diagnostic tests and imaging, improved time to treatment, and decreased ambulance diversion. Changes in clinician or patient-reported outcomes and costs may include the following: improved patient experience, decrease in morbidity and mortality, increased ED revenue, and improved patient outcomes.</td>
</tr>
<tr>
<th scope="row" class="row-header">Citation</th>
<td class="content-container">
American Medical Association. (2022). What is Behavioral Health. https://www.ama-assn.org/delivering-care/public-health/what-behavioral-health
</td>
</tr>
<tr>
<th scope="row" class="row-header">Definition</th>
<td class="content-container">Boarding: The practice of holding transfer patients in the emergency department after a decision to transfer has been made.</td>
</tr>
<tr>
<th scope="row" class="row-header">Definition</th>
<td class="content-container">ED Observation: Observation stays are inclusive of both ED observation care in which a patient initially evaluated in the ED is cared for under observation status for an extended period of time in the ED or in a care area dedicated to observation care, as well as hospital observation stays in which a patient initially evaluated in the ED is cared for in observation status often in a hospital bed used for both inpatient or observation status admissions. Because these two forms of observation stays cannot be easily distinguished in a standardized fashion in existing electronic health record data ontologies, for the purposes of this quality measure all observation stays have been considered an exclusion from both numerator outcomes 3 and 4.</td>
</tr>
<tr>
<th scope="row" class="row-header">Definition</th>
<td class="content-container">Left Without Being Seen (LWBS): Patients arrive to the ED for evaluation and leave before seeing a physician, advanced practice nurse, or physician’s assistant.</td>
</tr>
<tr>
<th scope="row" class="row-header">Definition</th>
<td class="content-container">Mental Health: Mental health generally refers to mental health diagnoses, life stressors and crises, and stress-related physical symptoms (American Medical Association [AMA], 2022). For this measure, mental health conditions will be defined separately from substance use disorders.</td>
</tr>
<tr>
<th scope="row" class="row-header">Guidance (Usage)</th>
<td class="content-container"><p>Measure Score Calculation The measure score is calculated at the individual ED level as the proportion of ED visits where any one of the four outcomes occurred, as defined by the numerator. For CMS Certification Numbers (CCNs) with more than one ED, scores are combined as a weighted average for that CCN. This dQM is an episode-based measure. An episode is defined as an ED visit that ends during the measurement period. This FHIR-based measure has been derived from the QDM-based measure: CMS1264v1. Please refer to the HL7 QI-Core Implementation Guide (<em><u>https://hl7.org/fhir/us/qicore/STU6/</u></em>) for more information on QI-Core and mapping recommendations from QDM to QI-Core STU 6 (<em><u>https://hl7.org/fhir/us/qicore/STU6/qdm-to-qicore.html</u></em>).</p></td>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header">Measure Group (Rate) (ID: Group_1)</th>
</tr>
<tr>
<th scope="row" class="row-header">Basis</th>
<td class="content-container">Encounter</td>
</tr>
<tr>
<th scope="row" class="row-header">Scoring</th>
<td class="content-container">[http://terminology.hl7.org/CodeSystem/measure-scoring#proportion: 'Proportion']</td>
</tr>
<tr>
<th scope="row" class="row-header">Type</th>
<td class="content-container">[http://terminology.hl7.org/CodeSystem/measure-type#outcome: 'Outcome']</td>
</tr>
<tr>
<th scope="row" class="row-header">Rate Aggregation</th>
<td class="content-container">None</td>
</tr>
<tr>
<th scope="row" class="row-header">Improvement Notation</th>
<td class="content-container">[http://terminology.hl7.org/CodeSystem/measure-improvement-notation#decrease: 'Decreased score indicates improvement']</td>
</tr>
<tr>
<th scope="row" class="row-header">Initial Population</th>
<td class="content-container">
<em>ID</em>: InitialPopulation_1
<br/>
<em>Description</em>:
<p style="white-space: pre-line" class="tab-one">All ED visits at REHs that end during the measurement period for all patients</p>
<em>Logic Definition</em>: <a href="#primary-cms1264fhirecatrehqr-initial-population">Initial Population</a>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Denominator</th>
<td class="content-container">
<em>ID</em>: Denominator_1
<br/>
<em>Description</em>:
<p style="white-space: pre-line" class="tab-one">Equals Initial Population</p>
<em>Logic Definition</em>: <a href="#primary-cms1264fhirecatrehqr-denominator">Denominator</a>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Numerator</th>
<td class="content-container">
<em>ID</em>: Numerator_1
<br/>
<em>Description</em>:
<p style="white-space: pre-line" class="tab-one">The numerator is comprised of any ED visit in the denominator with any quality gap in access; if the patient experiences any of the following during a visit, the visit is included in the numerator: 1. The patient waited longer than 60 minutes (1 hour) after arrival to ED to be placed in a treatment room or dedicated treatment area that allows for audiovisual privacy during history-taking and physical examination, or 2. The patient left the ED without being evaluated, or 3. The patient, if transferred, boarded for longer than 240 minutes (4 hours), or 4. The patient had an ED length of stay (LOS) (time from ED arrival to ED departure as defined by the ED departure timestamp indicating when the patient physically left the ED) of longer than 480 minutes (8 hours). ED encounters with ED observation stays are excluded from criteria #3 (boarded) and #4 (ED LOS)</p>
<em>Logic Definition</em>: <a href="#primary-cms1264fhirecatrehqr-numerator">Numerator</a>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Stratifier</th>
<td class="content-container">
<em>ID</em>: Stratification_1_1
<br/>
<em>Description</em>: All patients aged less than 18 years seen in the ED who do not have an ED encounter principal diagnosis consistent with mental health diagnosis. Patients who have an ED encounter principal diagnosis consistent with substance use disorders will be included in this stratification.
</td>
</tr>
<tr>
<th scope="row" class="row-header">Stratifier</th>
<td class="content-container">
<em>ID</em>: Stratification_1_2
<br/>
<em>Description</em>: All patients aged 18 years and older seen in the ED who do not have an ED encounter principal diagnosis consistent with mental health diagnosis. Patients who have an ED encounter principal diagnosis consistent with substance use disorders will be included in this stratification.
</td>
</tr>
<tr>
<th scope="row" class="row-header">Stratifier</th>
<td class="content-container">
<em>ID</em>: Stratification_1_3
<br/>
<em>Description</em>: All patients aged less than 18 years seen in the ED who have an ED encounter principal diagnosis consistent with mental health diagnosis.
</td>
</tr>
<tr>
<th scope="row" class="row-header">Stratifier</th>
<td class="content-container">
<em>ID</em>: Stratification_1_4
<br/>
<em>Description</em>: All patients aged 18 years and older seen in the ED who have an ED encounter principal diagnosis consistent with mental health diagnosis.
</td>
</tr>
<tr>
<th scope="row" class="row-header">Supplemental Data Guidance</th>
<td class="content-container">For every patient evaluated by this measure also identify payer, race, ethnicity and sex</td>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header">Supplemental Data Elements</th>
</tr>
<tr>
<th scope="row" class="row-header">Supplemental Data Element</th>
<td class="content-container">
<em>ID</em>: sde-ethnicity
<br/>
<em>Usage Code</em>: [http://terminology.hl7.org/CodeSystem/measure-data-usage#supplemental-data]
<br/>
<em>Description</em>: SDE Ethnicity
<br/>
<em>Logic Definition</em>: <a href="#cms1264fhirecatrehqr-sde-ethnicity">SDE Ethnicity</a>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Supplemental Data Element</th>
<td class="content-container">
<em>ID</em>: sde-payer
<br/>
<em>Usage Code</em>: [http://terminology.hl7.org/CodeSystem/measure-data-usage#supplemental-data]
<br/>
<em>Description</em>: SDE Payer
<br/>
<em>Logic Definition</em>: <a href="#cms1264fhirecatrehqr-sde-payer">SDE Payer</a>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Supplemental Data Element</th>
<td class="content-container">
<em>ID</em>: sde-race
<br/>
<em>Usage Code</em>: [http://terminology.hl7.org/CodeSystem/measure-data-usage#supplemental-data]
<br/>
<em>Description</em>: SDE Race
<br/>
<em>Logic Definition</em>: <a href="#cms1264fhirecatrehqr-sde-race">SDE Race</a>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Supplemental Data Element</th>
<td class="content-container">
<em>ID</em>: sde-sex
<br/>
<em>Usage Code</em>: [http://terminology.hl7.org/CodeSystem/measure-data-usage#supplemental-data]
<br/>
<em>Description</em>: SDE Sex
<br/>
<em>Logic Definition</em>: <a href="#cms1264fhirecatrehqr-sde-sex">SDE Sex</a>
</td>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header">Measure Logic</th>
</tr>
<tr>
<th scope="row" class="row-header">Primary Library</th>
<td class="content-container">https://madie.cms.gov/Library/CMS1264FHIRECATREHQR</td>
</tr>
<tr>
<th scope="row" class="row-header">Contents</th>
<td class="content-container">
<em><a href="#population-criteria">Population Criteria</a></em>
<br/>
<em><a href="#definitions">Logic Definitions</a></em>
<br/>
<em><a href="#terminology">Terminology</a></em>
<br/>
<em><a href="#dependencies">Dependencies</a></em>
<br/>
<em><a href="#data-requirements">Data Requirements</a></em>
<br/>
</td>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header"><a name="population-criteria"> </a>Population Criteria</th>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header">Measure Group (Rate) (ID: Group_1)</th>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="primary-cms1264fhirecatrehqr-initial-population"> </a>
Initial Population
</th>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Initial Population":
"ED Evaluation and Management"
union "ED Triage Excluding Those Prior To ED Encounters"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="primary-cms1264fhirecatrehqr-denominator"> </a>
Denominator
</th>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Denominator":
"Initial Population"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="primary-cms1264fhirecatrehqr-numerator"> </a>
Numerator
</th>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Numerator":
"Time to Treatment Room Greater Than 60 Minutes"
union "ED Arrival Left Without Being Seen"
union "Boarded Time Greater Than 240 Minutes and No Observation Stay"
union "ED Length of Stay Greater Than 480 Minutes and No Observation Stay"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="primary-cms1264fhirecatrehqr-stratification-1"> </a>
Stratifier
</th>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Stratification 1":
"Pediatric With No Mental Health Diagnosis"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="primary-cms1264fhirecatrehqr-stratification-2"> </a>
Stratifier
</th>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Stratification 2":
"Adult With No Mental Health Diagnosis"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="primary-cms1264fhirecatrehqr-stratification-3"> </a>
Stratifier
</th>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Stratification 3":
"Pediatric With Mental Health Diagnosis"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="primary-cms1264fhirecatrehqr-stratification-4"> </a>
Stratifier
</th>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Stratification 4":
"Adult With Mental Health Diagnosis"</code></pre>
</td>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header"><a name="definitions"> </a>Logic Definitions</th>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="supplementaldataelements-sde-sex"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> SupplementalDataElements</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "SDE Sex":
case
when Patient.sex = '248153007' then "Male (finding)"
when Patient.sex = '248152002' then "Female (finding)"
else null
end</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="supplementaldataelements-sde-payer"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> SupplementalDataElements</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "SDE Payer":
[Coverage: type in "Payer Type"] Payer
return {
code: Payer.type,
period: Payer.period
}</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="supplementaldataelements-sde-ethnicity"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> SupplementalDataElements</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "SDE Ethnicity":
Patient.ethnicity E
return Tuple {
codes: { E.ombCategory } union E.detailed,
display: E.text
}</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="supplementaldataelements-sde-race"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> SupplementalDataElements</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "SDE Race":
Patient.race R
return Tuple {
codes: R.ombCategory union R.detailed,
display: R.text
}</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="fhirhelpers-tostring"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> FHIRHelpers</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define function ToString(value uri): value.value</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="fhirhelpers-tointerval"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> FHIRHelpers</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
@description: Converts the given [Period](https://hl7.org/fhir/datatypes.html#Period)
value to a CQL DateTime Interval
@comment: If the start value of the given period is unspecified, the starting
boundary of the resulting interval will be open (meaning the start of the interval
is unknown, as opposed to interpreted as the beginning of time).
*/
define function ToInterval(period FHIR.Period):
if period is null then
null
else
if period."start" is null then
Interval(period."start".value, period."end".value]
else
Interval[period."start".value, period."end".value]</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="fhirhelpers-toconcept"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> FHIRHelpers</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
@description: Converts the given FHIR [CodeableConcept](https://hl7.org/fhir/datatypes.html#CodeableConcept) value to a CQL Concept.
*/
define function ToConcept(concept FHIR.CodeableConcept):
if concept is null then
null
else
System.Concept {
codes: concept.coding C return ToCode(C),
display: concept.text.value
}</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="fhirhelpers-tocode"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> FHIRHelpers</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
@description: Converts the given FHIR [Coding](https://hl7.org/fhir/datatypes.html#Coding) value to a CQL Code.
*/
define function ToCode(coding FHIR.Coding):
if coding is null then
null
else
System.Code {
code: coding.code.value,
system: coding.system.value,
version: coding.version.value,
display: coding.display.value
}</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms1264fhirecatrehqr-sde-sex"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS1264FHIRECATREHQR</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "SDE Sex":
SDE."SDE Sex"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms1264fhirecatrehqr-ed-evaluation-and-management"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS1264FHIRECATREHQR</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "ED Evaluation and Management":
[Encounter: "Emergency Department Evaluation and Management Visit"] EDEvalManagementVisit
where EDEvalManagementVisit.period ends during day of "Measurement Period"
and EDEvalManagementVisit.status = 'finished'</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms1264fhirecatrehqr-ed-triage"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS1264FHIRECATREHQR</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "ED Triage":
[Encounter: "Triage"] EDTriage
where EDTriage.period ends during day of "Measurement Period"
and EDTriage.status in { 'finished', 'triaged' }</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms1264fhirecatrehqr-ed-triage-excluding-those-prior-to-ed-encounters"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS1264FHIRECATREHQR</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "ED Triage Excluding Those Prior To ED Encounters":
"ED Triage" EDTriageinMP
where not exists ( "ED Evaluation and Management" EDEvalManagementinMP
where ( ( EDTriageinMP.period overlaps before EDEvalManagementinMP.period )
or ( EDTriageinMP.period during EDEvalManagementinMP.period )
or ( EDEvalManagementinMP.period during EDTriageinMP.period )
or ( EDTriageinMP.period ends 120 minutes or less before start of EDEvalManagementinMP.period )
)
)</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms1264fhirecatrehqr-initial-population"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS1264FHIRECATREHQR</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Initial Population":
"ED Evaluation and Management"
union "ED Triage Excluding Those Prior To ED Encounters"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms1264fhirecatrehqr-denominator"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS1264FHIRECATREHQR</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Denominator":
"Initial Population"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms1264fhirecatrehqr-ed-triage-before-evaluation-management"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS1264FHIRECATREHQR</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "ED Triage Before Evaluation Management":
"ED Triage" EDTriageinMP
with "Denominator" EDEncounter
such that ( ( EDTriageinMP.period overlaps before EDEncounter.period )
or ( EDTriageinMP.period during EDEncounter.period )
or ( EDEncounter.period during EDTriageinMP.period )
or ( EDTriageinMP.period ends 120 minutes or less before start of EDEncounter.period )
)</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms1264fhirecatrehqr-ed-triage-and-evaluation-management"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS1264FHIRECATREHQR</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "ED Triage and Evaluation Management":
"Denominator"
union "ED Triage Before Evaluation Management"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms1264fhirecatrehqr-time-to-treatment-room-greater-than-60-minutes"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS1264FHIRECATREHQR</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Time to Treatment Room Greater Than 60 Minutes":
"ED Evaluation and Management" EDEvalManagementinMP
where EDEvalManagementinMP.edArrivalTime ( ) 61 minutes or more before EDEvalManagementinMP.edTreatmentRoomTimeArrivalTime ( )</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms1264fhirecatrehqr-ed-arrival-left-without-being-seen"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS1264FHIRECATREHQR</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "ED Arrival Left Without Being Seen":
"Denominator" EDEncounter
where EDEncounter.hospitalization.dischargeDisposition ~ "Patient left without being seen (finding)"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms1264fhirecatrehqr-boarded-time-greater-than-240-minutes"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS1264FHIRECATREHQR</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Boarded Time Greater Than 240 Minutes":
"Denominator" EDEncounter
where EDEncounter.TransferDecisionUsingOrder ( ) 241 minutes or more before EDEncounter.edDepartureTime ( )</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms1264fhirecatrehqr-ed-observation-status"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS1264FHIRECATREHQR</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "ED Observation Status":
[Encounter: "Observation Services"] EDObsEncounter
with "Denominator" EDStay
such that EDObsEncounter.period during EDStay.period
and EDObsEncounter.status = 'finished'</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms1264fhirecatrehqr-boarded-time-greater-than-240-minutes-and-no-observation-stay"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS1264FHIRECATREHQR</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Boarded Time Greater Than 240 Minutes and No Observation Stay":
( "Boarded Time Greater Than 240 Minutes" Boarding
where not exists ( "ED Observation Status" EDObs
where ( EDObs.period during Boarding.period )
)
)</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms1264fhirecatrehqr-ed-length-of-stay-greater-than-480-minutes"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS1264FHIRECATREHQR</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "ED Length of Stay Greater Than 480 Minutes":
"Denominator" EDEncounter
where EDEncounter.edArrivalTime ( ) 481 minutes or more before EDEncounter.edDepartureTime ( )</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms1264fhirecatrehqr-ed-length-of-stay-greater-than-480-minutes-and-no-observation-stay"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS1264FHIRECATREHQR</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "ED Length of Stay Greater Than 480 Minutes and No Observation Stay":
( "ED Length of Stay Greater Than 480 Minutes" EDStay
where not exists ( "ED Observation Status" EDObs
where ( EDObs.period during EDStay.period )
)
)</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms1264fhirecatrehqr-numerator"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS1264FHIRECATREHQR</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Numerator":
"Time to Treatment Room Greater Than 60 Minutes"
union "ED Arrival Left Without Being Seen"
union "Boarded Time Greater Than 240 Minutes and No Observation Stay"
union "ED Length of Stay Greater Than 480 Minutes and No Observation Stay"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms1264fhirecatrehqr-ed-encounter-or-triage-of-patients-18-years-and-older"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS1264FHIRECATREHQR</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "ED Encounter or Triage of Patients 18 Years and Older":
"Denominator" EDEncounter
where AgeInYearsAt(date from start of EDEncounter.period) >= 18</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms1264fhirecatrehqr-adult-with-mental-health-diagnosis"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS1264FHIRECATREHQR</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Adult With Mental Health Diagnosis":
( "ED Encounter or Triage of Patients 18 Years and Older" AdultEDEncounters
where ( AdultEDEncounters.hasPrincipalDiagnosisOf ( "Mental Health Diagnosis without Substance Use Disorders" ) )
)</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms1264fhirecatrehqr-stratification-4"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS1264FHIRECATREHQR</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Stratification 4":
"Adult With Mental Health Diagnosis"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms1264fhirecatrehqr-ed-encounter-or-triage-of-patients-less-than-18-years"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS1264FHIRECATREHQR</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "ED Encounter or Triage of Patients Less Than 18 Years":
"Denominator" EDEncounter
where AgeInYearsAt(date from start of EDEncounter.period) < 18</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms1264fhirecatrehqr-pediatric-with-mental-health-diagnosis"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS1264FHIRECATREHQR</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Pediatric With Mental Health Diagnosis":
( "ED Encounter or Triage of Patients Less Than 18 Years" PediatricEDEncounters
where ( PediatricEDEncounters.hasPrincipalDiagnosisOf ( "Mental Health Diagnosis without Substance Use Disorders" ) )
)</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms1264fhirecatrehqr-stratification-3"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS1264FHIRECATREHQR</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Stratification 3":
"Pediatric With Mental Health Diagnosis"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms1264fhirecatrehqr-adult-with-no-mental-health-diagnosis"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS1264FHIRECATREHQR</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Adult With No Mental Health Diagnosis":
( "ED Encounter or Triage of Patients 18 Years and Older" AdultEDEncounters
where not ( AdultEDEncounters.hasPrincipalDiagnosisOf ( "Mental Health Diagnosis without Substance Use Disorders" ) )
)</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms1264fhirecatrehqr-stratification-2"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS1264FHIRECATREHQR</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Stratification 2":
"Adult With No Mental Health Diagnosis"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms1264fhirecatrehqr-pediatric-with-no-mental-health-diagnosis"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS1264FHIRECATREHQR</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Pediatric With No Mental Health Diagnosis":
( "ED Encounter or Triage of Patients Less Than 18 Years" PediatricEDEncounters
where not ( PediatricEDEncounters.hasPrincipalDiagnosisOf ( "Mental Health Diagnosis without Substance Use Disorders" ) )
)</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms1264fhirecatrehqr-stratification-1"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS1264FHIRECATREHQR</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Stratification 1":
"Pediatric With No Mental Health Diagnosis"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms1264fhirecatrehqr-sde-payer"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS1264FHIRECATREHQR</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "SDE Payer":
SDE."SDE Payer"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms1264fhirecatrehqr-sde-ethnicity"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS1264FHIRECATREHQR</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "SDE Ethnicity":
SDE."SDE Ethnicity"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms1264fhirecatrehqr-sde-race"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS1264FHIRECATREHQR</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "SDE Race":
SDE."SDE Race"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms1264fhirecatrehqr-edarrivaltime"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS1264FHIRECATREHQR</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define fluent function "edArrivalTime"(EDEncounter Encounter):
Last("ED Triage and Evaluation Management".location Location
where exists((Location.location.getLocation().type) LocationType
where(LocationType in "Emergency Department Location"
or LocationType ~ "Emergency room"
or LocationType ~ "Emergency trauma unit"
)
)
and start of Location.period is not null
and(Location.period ends 120 minutes or less before start of EDEncounter.period
or Location.period overlaps before EDEncounter.period
or EDEncounter.period overlaps before Location.period
or Location.period starts same as start of EDEncounter.period
)
return start of Location.period
sort ascending
)</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms1264fhirecatrehqr-edtreatmentroomtimearrivaltime"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS1264FHIRECATREHQR</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define fluent function "edTreatmentRoomTimeArrivalTime"(EDEncounter Encounter):
First(EDEncounter.location Location
where Location.location.getLocation().type in "Emergency Department Treatment Location"
and start of Location.period is not null
return start of Location.period
sort ascending
)</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms1264fhirecatrehqr-transferdecisionusingorder"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS1264FHIRECATREHQR</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define fluent function "TransferDecisionUsingOrder"(EDEncounter Encounter):
Last([ServiceRequest: "Decision to Transfer"] TransferOrder
where TransferOrder.authoredOn during EDEncounter.period
and TransferOrder.intent = 'order'
and TransferOrder.status in { 'active', 'completed' }
return TransferOrder.authoredOn
sort ascending
)</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms1264fhirecatrehqr-eddeparturetime"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS1264FHIRECATREHQR</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define fluent function "edDepartureTime"(EDEncounter Encounter):
Last("ED Triage and Evaluation Management".location Location
where exists((Location.location.getLocation().type) LocationType
where(LocationType in "Emergency Department Location"
or LocationType ~ "Emergency room"
or LocationType ~ "Emergency trauma unit"
)
)
and
end of Location.period is not null
and(Location.period ends 120 minutes or less before start of EDEncounter.period
or Location.period overlaps before EDEncounter.period
or EDEncounter.period overlaps before Location.period
or Location.period starts same as start of EDEncounter.period
)
return
end of Location.period
sort ascending
)</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cqmcommon-getlocation"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CQMCommon</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
@description: Returns the Location resource specified by the given reference.
*/
define fluent function getLocation(reference Reference):
singleton from (
[Location] L where reference.references(L)
)</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cqmcommon-hasprincipaldiagnosisof"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CQMCommon</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
@description: Returns the condition that is specified as the principal diagnosis for the encounter and has a code in the given valueSet.
@comment: See the QICore 6 Authoring Patterns discussion on [Principal Diagnosis and Present on Admission](https://github.com/cqframework/CQL-Formatting-and-Usage-Wiki/wiki/Authoring-Patterns-QICore-v6.0.0#conditions-present-on-admission-and-principal-diagnoses) for more information
*/
define fluent function hasPrincipalDiagnosisOf(encounter Encounter, valueSet ValueSet):
(encounter.principalDiagnosis()) PD
return PD.diagnosis in valueSet
or PD.diagnosis.getCondition().code in valueSet</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cqmcommon-principaldiagnosis"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CQMCommon</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
@description: Returns the claim diagnosis element that is specified as the principal diagnosis for the encounter
@comment: See the QICore 6 Authoring Patterns discussion on [Principal Diagnosis and Present on Admission](https://github.com/cqframework/CQL-Formatting-and-Usage-Wiki/wiki/Authoring-Patterns-QICore-v6.0.0#conditions-present-on-admission-and-principal-diagnoses) for more information
*/
define fluent function principalDiagnosis(encounter Encounter):
singleton from (
(encounter.claimDiagnosis()) CD
where CD.type.includesCode("Principal Diagnosis")
)</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cqmcommon-claimdiagnosis"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CQMCommon</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
@description: Returns the claim diagnosis elements for the given encounter
@comment: See the QICore 6 Authoring Patterns discussion on [Principal Diagnosis and Present on Admission](https://github.com/cqframework/CQL-Formatting-and-Usage-Wiki/wiki/Authoring-Patterns-QICore-v6.0.0#conditions-present-on-admission-and-principal-diagnoses) for more information
*/
define fluent function claimDiagnosis(encounter Encounter):
encounter E
let
claim: ([Claim] C where C.status = 'active' and C.use = 'claim' and exists (C.item I where I.encounter.references(E))),
claimItem: (claim.item I where I.encounter.references(E))
return claim.diagnosis D where D.sequence in claimItem.diagnosisSequence</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cqmcommon-getcondition"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CQMCommon</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
@description: Returns the Condition resource for the given reference
*/
define fluent function getCondition(reference Reference):
singleton from (([ConditionEncounterDiagnosis] union [ConditionProblemsHealthConcerns]) C where reference.references(C.id))</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="qicorecommon-references"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> QICoreCommon</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
@description: Returns true if the given reference is to the given resource
@comment: Returns true if the `id` element of the given resource exactly equals the tail of the given reference.
NOTE: This function assumes resources from the same source server.
*/
define fluent function references(reference Reference, resource Resource):
resource.id = Last(Split(reference.reference, '/'))</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="qicorecommon-references"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> QICoreCommon</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
@description: Returns true if any of the given references are to the given resource
@comment: Returns true if the `id` element of the given resource exactly equals the tail of any of the given references.
NOTE: This function assumes resources from the same source server.
*/
define fluent function references(references List<Reference>, resource Resource):
exists (references R where R.references(resource))</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="qicorecommon-includescode"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> QICoreCommon</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
@description: Returns true if the given code is in the given codeList
@comment: Returns true if the `code` is equivalent to any of the codes in the given `codeList`, false otherwise.
*/
define fluent function includesCode(codeList List<Concept>, code Code):
exists (codeList C where C ~ code)</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="qicorecommon-references"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> QICoreCommon</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
@description: Returns true if the given reference is to the given resourceId
@comment: Returns true if the `resourceId` parameter exactly equals the tail of the given reference.
NOTE: This function assumes resources from the same source server.
*/
define fluent function references(reference Reference, resourceId String):
resourceId = Last(Split(reference.reference, '/'))</code></pre>
</td>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header"><a name="terminology"> </a>Terminology</th>
</tr>
<tr>
<th scope="row" class="row-header">Code System</th>
<td class="content-container">
<em>Description</em>: Code system SNOMEDCT
<br/>
<em>Resource</em>: http://snomed.info/sct
<br/>
<em>Canonical URL</em>: <tt>http://snomed.info/sct</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Code System</th>
<td class="content-container">
<em>Description</em>: Code system RoleCode
<br/>
<em>Resource</em>: http://terminology.hl7.org/CodeSystem/v3-RoleCode
<br/>
<em>Canonical URL</em>: <tt>http://terminology.hl7.org/CodeSystem/v3-RoleCode</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Code System</th>
<td class="content-container">
<em>Description</em>: Code system Diagnosis Type
<br/>
<em>Resource</em>: http://terminology.hl7.org/CodeSystem/ex-diagnosistype
<br/>
<em>Canonical URL</em>: <tt>http://terminology.hl7.org/CodeSystem/ex-diagnosistype</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Emergency Department Evaluation and Management Visit
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1010
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1010</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Triage
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.279
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.279</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Emergency Department Location
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.284
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.284</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Emergency Department Treatment Location
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.278
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.278</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Decision to Transfer
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.286
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.286</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Observation Services
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.143
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.143</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Mental Health Diagnosis without Substance Use Disorders
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.285
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.285</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Payer Type
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Direct Reference Code</th>
<td class="content-container">
<em>Display</em>: Male (finding)
<br/>
<em>Code</em>: 248153007
<br/>
<em>System</em>: <tt>http://snomed.info/sct</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Direct Reference Code</th>
<td class="content-container">
<em>Display</em>: Female (finding)
<br/>
<em>Code</em>: 248152002
<br/>
<em>System</em>: <tt>http://snomed.info/sct</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Direct Reference Code</th>
<td class="content-container">
<em>Display</em>: Emergency room
<br/>
<em>Code</em>: ER
<br/>
<em>System</em>: <tt>http://terminology.hl7.org/CodeSystem/v3-RoleCode</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Direct Reference Code</th>
<td class="content-container">
<em>Display</em>: Emergency trauma unit
<br/>
<em>Code</em>: ETU
<br/>
<em>System</em>: <tt>http://terminology.hl7.org/CodeSystem/v3-RoleCode</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Direct Reference Code</th>
<td class="content-container">
<em>Display</em>: Patient left without being seen (finding)
<br/>
<em>Code</em>: 21541000119102
<br/>
<em>System</em>: <tt>http://snomed.info/sct</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Direct Reference Code</th>
<td class="content-container">
<em>Display</em>: Principal Diagnosis
<br/>
<em>Code</em>: principal
<br/>
<em>System</em>: <tt>http://terminology.hl7.org/CodeSystem/ex-diagnosistype</tt>
</td>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header"><a name="dependencies"> </a>Dependencies</th>
</tr>
<tr>
<th scope="row" class="row-header">Dependency</th>
<td class="content-container">
<em>Description</em>: QICore model information
<br/>
<em>Resource</em>: http://hl7.org/fhir/Library/QICore-ModelInfo
<br/>
<em>Canonical URL</em>: <tt>http://hl7.org/fhir/Library/QICore-ModelInfo</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Dependency</th>
<td class="content-container">
<em>Description</em>: Library SDE
<br/>
<em>Resource</em>: https://madie.cms.gov/Library/SupplementalDataElements|5.1.000
<br/>
<em>Canonical URL</em>: <tt>https://madie.cms.gov/Library/SupplementalDataElements|5.1.000</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Dependency</th>
<td class="content-container">
<em>Description</em>: Library FHIRHelpers
<br/>
<em>Resource</em>: https://madie.cms.gov/Library/FHIRHelpers|4.4.000
<br/>
<em>Canonical URL</em>: <tt>https://madie.cms.gov/Library/FHIRHelpers|4.4.000</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Dependency</th>
<td class="content-container">
<em>Description</em>: Library CQMCommon
<br/>
<em>Resource</em>: https://madie.cms.gov/Library/CQMCommon|4.1.000
<br/>
<em>Canonical URL</em>: <tt>https://madie.cms.gov/Library/CQMCommon|4.1.000</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Dependency</th>
<td class="content-container">
<em>Description</em>: Library QICoreCommon
<br/>
<em>Resource</em>: https://madie.cms.gov/Library/QICoreCommon|4.0.000
<br/>
<em>Canonical URL</em>: <tt>https://madie.cms.gov/Library/QICoreCommon|4.0.000</tt>
</td>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header"><a name="data-requirements"> </a>Data Requirements</th>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Patient
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient
<br/>
<em>Must Support Elements</em>: extension, url
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Encounter
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
<br/>
<em>Must Support Elements</em>: type, period, status, status.value, location, location.type, hospitalization, hospitalization.dischargeDisposition, diagnosis, diagnosis.code
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: type</span>
<br/>
<span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.279
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Encounter
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
<br/>
<em>Must Support Elements</em>: type, period, status, status.value, location, location.type, hospitalization, hospitalization.dischargeDisposition, diagnosis, diagnosis.code
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: type</span>
<br/>
<span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1010
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Encounter
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
<br/>
<em>Must Support Elements</em>: period, location, location.type, hospitalization, hospitalization.dischargeDisposition, type, diagnosis, diagnosis.code
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Encounter
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
<br/>
<em>Must Support Elements</em>: type, period, status, status.value, location, location.type, hospitalization, hospitalization.dischargeDisposition, diagnosis, diagnosis.code
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: type</span>
<br/>
<span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.143
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Resource
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/StructureDefinition/Resource
<br/>
<em>Must Support Elements</em>: id, id.value
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Location
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-location
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: ServiceRequest
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest
<br/>
<em>Must Support Elements</em>: code, authoredOn, authoredOn.value, intent, intent.value, status, status.value
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: code</span>
<br/>
<span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.286
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Claim
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-claim
<br/>
<em>Must Support Elements</em>: status, status.value, use, use.value, item
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Condition
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Condition
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Coverage
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-coverage
<br/>
<em>Must Support Elements</em>: type, period
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: type</span>
<br/>
<span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591
<br/>
</td>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header">Generated using version 0.4.8 of the sample-content-ig Liquid templates</th>
</tr>
</tbody>
</table>
</div>
</text>
<contained>
<Library>
<id value="effective-data-requirements"/>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="248153007"/>
<display value="Male (finding)"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="248152002"/>
<display value="Female (finding)"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
<valueCoding>
<system value="http://terminology.hl7.org/CodeSystem/v3-RoleCode"/>
<code value="ER"/>
<display value="Emergency room"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
<valueCoding>
<system value="http://terminology.hl7.org/CodeSystem/v3-RoleCode"/>
<code value="ETU"/>
<display value="Emergency trauma unit"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="21541000119102"/>
<display value="Patient left without being seen (finding)"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
<valueCoding>
<system
value="http://terminology.hl7.org/CodeSystem/ex-diagnosistype"/>
<code value="principal"/>
<display value="Principal Diagnosis"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="SupplementalDataElements"/>
</extension>
<extension url="name">
<valueString value="SDE Sex"/>
</extension>
<extension url="statement">
<valueString
value="define "SDE Sex":
case
when Patient.sex = '248153007' then "Male (finding)"
when Patient.sex = '248152002' then "Female (finding)"
else null
end"/>
</extension>
<extension url="displaySequence">
<valueInteger value="0"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1264FHIRECATREHQR"/>
</extension>
<extension url="name">
<valueString value="SDE Sex"/>
</extension>
<extension url="statement">
<valueString
value="define "SDE Sex":
SDE."SDE Sex""/>
</extension>
<extension url="displaySequence">
<valueInteger value="1"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1264FHIRECATREHQR"/>
</extension>
<extension url="name">
<valueString value="ED Evaluation and Management"/>
</extension>
<extension url="statement">
<valueString
value="define "ED Evaluation and Management":
[Encounter: "Emergency Department Evaluation and Management Visit"] EDEvalManagementVisit
where EDEvalManagementVisit.period ends during day of "Measurement Period"
and EDEvalManagementVisit.status = 'finished'"/>
</extension>
<extension url="displaySequence">
<valueInteger value="2"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1264FHIRECATREHQR"/>
</extension>
<extension url="name">
<valueString value="ED Triage"/>
</extension>
<extension url="statement">
<valueString
value="define "ED Triage":
[Encounter: "Triage"] EDTriage
where EDTriage.period ends during day of "Measurement Period"
and EDTriage.status in { 'finished', 'triaged' }"/>
</extension>
<extension url="displaySequence">
<valueInteger value="3"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1264FHIRECATREHQR"/>
</extension>
<extension url="name">
<valueString
value="ED Triage Excluding Those Prior To ED Encounters"/>
</extension>
<extension url="statement">
<valueString
value="define "ED Triage Excluding Those Prior To ED Encounters":
"ED Triage" EDTriageinMP
where not exists ( "ED Evaluation and Management" EDEvalManagementinMP
where ( ( EDTriageinMP.period overlaps before EDEvalManagementinMP.period )
or ( EDTriageinMP.period during EDEvalManagementinMP.period )
or ( EDEvalManagementinMP.period during EDTriageinMP.period )
or ( EDTriageinMP.period ends 120 minutes or less before start of EDEvalManagementinMP.period )
)
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="4"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1264FHIRECATREHQR"/>
</extension>
<extension url="name">
<valueString value="Initial Population"/>
</extension>
<extension url="statement">
<valueString
value="define "Initial Population":
"ED Evaluation and Management"
union "ED Triage Excluding Those Prior To ED Encounters""/>
</extension>
<extension url="displaySequence">
<valueInteger value="5"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1264FHIRECATREHQR"/>
</extension>
<extension url="name">
<valueString value="Denominator"/>
</extension>
<extension url="statement">
<valueString
value="define "Denominator":
"Initial Population""/>
</extension>
<extension url="displaySequence">
<valueInteger value="6"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1264FHIRECATREHQR"/>
</extension>
<extension url="name">
<valueString value="ED Triage Before Evaluation Management"/>
</extension>
<extension url="statement">
<valueString
value="define "ED Triage Before Evaluation Management":
"ED Triage" EDTriageinMP
with "Denominator" EDEncounter
such that ( ( EDTriageinMP.period overlaps before EDEncounter.period )
or ( EDTriageinMP.period during EDEncounter.period )
or ( EDEncounter.period during EDTriageinMP.period )
or ( EDTriageinMP.period ends 120 minutes or less before start of EDEncounter.period )
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="7"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1264FHIRECATREHQR"/>
</extension>
<extension url="name">
<valueString value="ED Triage and Evaluation Management"/>
</extension>
<extension url="statement">
<valueString
value="define "ED Triage and Evaluation Management":
"Denominator"
union "ED Triage Before Evaluation Management""/>
</extension>
<extension url="displaySequence">
<valueInteger value="8"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1264FHIRECATREHQR"/>
</extension>
<extension url="name">
<valueString
value="Time to Treatment Room Greater Than 60 Minutes"/>
</extension>
<extension url="statement">
<valueString
value="define "Time to Treatment Room Greater Than 60 Minutes":
"ED Evaluation and Management" EDEvalManagementinMP
where EDEvalManagementinMP.edArrivalTime ( ) 61 minutes or more before EDEvalManagementinMP.edTreatmentRoomTimeArrivalTime ( )"/>
</extension>
<extension url="displaySequence">
<valueInteger value="9"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1264FHIRECATREHQR"/>
</extension>
<extension url="name">
<valueString value="ED Arrival Left Without Being Seen"/>
</extension>
<extension url="statement">
<valueString
value="define "ED Arrival Left Without Being Seen":
"Denominator" EDEncounter
where EDEncounter.hospitalization.dischargeDisposition ~ "Patient left without being seen (finding)""/>
</extension>
<extension url="displaySequence">
<valueInteger value="10"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1264FHIRECATREHQR"/>
</extension>
<extension url="name">
<valueString value="Boarded Time Greater Than 240 Minutes"/>
</extension>
<extension url="statement">
<valueString
value="define "Boarded Time Greater Than 240 Minutes":
"Denominator" EDEncounter
where EDEncounter.TransferDecisionUsingOrder ( ) 241 minutes or more before EDEncounter.edDepartureTime ( )"/>
</extension>
<extension url="displaySequence">
<valueInteger value="11"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1264FHIRECATREHQR"/>
</extension>
<extension url="name">
<valueString value="ED Observation Status"/>
</extension>
<extension url="statement">
<valueString
value="define "ED Observation Status":
[Encounter: "Observation Services"] EDObsEncounter
with "Denominator" EDStay
such that EDObsEncounter.period during EDStay.period
and EDObsEncounter.status = 'finished'"/>
</extension>
<extension url="displaySequence">
<valueInteger value="12"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1264FHIRECATREHQR"/>
</extension>
<extension url="name">
<valueString
value="Boarded Time Greater Than 240 Minutes and No Observation Stay"/>
</extension>
<extension url="statement">
<valueString
value="define "Boarded Time Greater Than 240 Minutes and No Observation Stay":
( "Boarded Time Greater Than 240 Minutes" Boarding
where not exists ( "ED Observation Status" EDObs
where ( EDObs.period during Boarding.period )
)
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="13"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1264FHIRECATREHQR"/>
</extension>
<extension url="name">
<valueString value="ED Length of Stay Greater Than 480 Minutes"/>
</extension>
<extension url="statement">
<valueString
value="define "ED Length of Stay Greater Than 480 Minutes":
"Denominator" EDEncounter
where EDEncounter.edArrivalTime ( ) 481 minutes or more before EDEncounter.edDepartureTime ( )"/>
</extension>
<extension url="displaySequence">
<valueInteger value="14"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1264FHIRECATREHQR"/>
</extension>
<extension url="name">
<valueString
value="ED Length of Stay Greater Than 480 Minutes and No Observation Stay"/>
</extension>
<extension url="statement">
<valueString
value="define "ED Length of Stay Greater Than 480 Minutes and No Observation Stay":
( "ED Length of Stay Greater Than 480 Minutes" EDStay
where not exists ( "ED Observation Status" EDObs
where ( EDObs.period during EDStay.period )
)
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="15"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1264FHIRECATREHQR"/>
</extension>
<extension url="name">
<valueString value="Numerator"/>
</extension>
<extension url="statement">
<valueString
value="define "Numerator":
"Time to Treatment Room Greater Than 60 Minutes"
union "ED Arrival Left Without Being Seen"
union "Boarded Time Greater Than 240 Minutes and No Observation Stay"
union "ED Length of Stay Greater Than 480 Minutes and No Observation Stay""/>
</extension>
<extension url="displaySequence">
<valueInteger value="16"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1264FHIRECATREHQR"/>
</extension>
<extension url="name">
<valueString
value="ED Encounter or Triage of Patients 18 Years and Older"/>
</extension>
<extension url="statement">
<valueString
value="define "ED Encounter or Triage of Patients 18 Years and Older":
"Denominator" EDEncounter
where AgeInYearsAt(date from start of EDEncounter.period) >= 18"/>
</extension>
<extension url="displaySequence">
<valueInteger value="17"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1264FHIRECATREHQR"/>
</extension>
<extension url="name">
<valueString value="Adult With Mental Health Diagnosis"/>
</extension>
<extension url="statement">
<valueString
value="define "Adult With Mental Health Diagnosis":
( "ED Encounter or Triage of Patients 18 Years and Older" AdultEDEncounters
where ( AdultEDEncounters.hasPrincipalDiagnosisOf ( "Mental Health Diagnosis without Substance Use Disorders" ) )
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="18"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1264FHIRECATREHQR"/>
</extension>
<extension url="name">
<valueString value="Stratification 4"/>
</extension>
<extension url="statement">
<valueString
value="define "Stratification 4":
"Adult With Mental Health Diagnosis""/>
</extension>
<extension url="displaySequence">
<valueInteger value="19"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1264FHIRECATREHQR"/>
</extension>
<extension url="name">
<valueString
value="ED Encounter or Triage of Patients Less Than 18 Years"/>
</extension>
<extension url="statement">
<valueString
value="define "ED Encounter or Triage of Patients Less Than 18 Years":
"Denominator" EDEncounter
where AgeInYearsAt(date from start of EDEncounter.period) < 18"/>
</extension>
<extension url="displaySequence">
<valueInteger value="20"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1264FHIRECATREHQR"/>
</extension>
<extension url="name">
<valueString value="Pediatric With Mental Health Diagnosis"/>
</extension>
<extension url="statement">
<valueString
value="define "Pediatric With Mental Health Diagnosis":
( "ED Encounter or Triage of Patients Less Than 18 Years" PediatricEDEncounters
where ( PediatricEDEncounters.hasPrincipalDiagnosisOf ( "Mental Health Diagnosis without Substance Use Disorders" ) )
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="21"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1264FHIRECATREHQR"/>
</extension>
<extension url="name">
<valueString value="Stratification 3"/>
</extension>
<extension url="statement">
<valueString
value="define "Stratification 3":
"Pediatric With Mental Health Diagnosis""/>
</extension>
<extension url="displaySequence">
<valueInteger value="22"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1264FHIRECATREHQR"/>
</extension>
<extension url="name">
<valueString value="Adult With No Mental Health Diagnosis"/>
</extension>
<extension url="statement">
<valueString
value="define "Adult With No Mental Health Diagnosis":
( "ED Encounter or Triage of Patients 18 Years and Older" AdultEDEncounters
where not ( AdultEDEncounters.hasPrincipalDiagnosisOf ( "Mental Health Diagnosis without Substance Use Disorders" ) )
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="23"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1264FHIRECATREHQR"/>
</extension>
<extension url="name">
<valueString value="Stratification 2"/>
</extension>
<extension url="statement">
<valueString
value="define "Stratification 2":
"Adult With No Mental Health Diagnosis""/>
</extension>
<extension url="displaySequence">
<valueInteger value="24"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1264FHIRECATREHQR"/>
</extension>
<extension url="name">
<valueString value="Pediatric With No Mental Health Diagnosis"/>
</extension>
<extension url="statement">
<valueString
value="define "Pediatric With No Mental Health Diagnosis":
( "ED Encounter or Triage of Patients Less Than 18 Years" PediatricEDEncounters
where not ( PediatricEDEncounters.hasPrincipalDiagnosisOf ( "Mental Health Diagnosis without Substance Use Disorders" ) )
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="25"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1264FHIRECATREHQR"/>
</extension>
<extension url="name">
<valueString value="Stratification 1"/>
</extension>
<extension url="statement">
<valueString
value="define "Stratification 1":
"Pediatric With No Mental Health Diagnosis""/>
</extension>
<extension url="displaySequence">
<valueInteger value="26"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="SupplementalDataElements"/>
</extension>
<extension url="name">
<valueString value="SDE Payer"/>
</extension>
<extension url="statement">
<valueString
value="define "SDE Payer":
[Coverage: type in "Payer Type"] Payer
return {
code: Payer.type,
period: Payer.period
}"/>
</extension>
<extension url="displaySequence">
<valueInteger value="27"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1264FHIRECATREHQR"/>
</extension>
<extension url="name">
<valueString value="SDE Payer"/>
</extension>
<extension url="statement">
<valueString
value="define "SDE Payer":
SDE."SDE Payer""/>
</extension>
<extension url="displaySequence">
<valueInteger value="28"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="SupplementalDataElements"/>
</extension>
<extension url="name">
<valueString value="SDE Ethnicity"/>
</extension>
<extension url="statement">
<valueString
value="define "SDE Ethnicity":
Patient.ethnicity E
return Tuple {
codes: { E.ombCategory } union E.detailed,
display: E.text
}"/>
</extension>
<extension url="displaySequence">
<valueInteger value="29"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1264FHIRECATREHQR"/>
</extension>
<extension url="name">
<valueString value="SDE Ethnicity"/>
</extension>
<extension url="statement">
<valueString
value="define "SDE Ethnicity":
SDE."SDE Ethnicity""/>
</extension>
<extension url="displaySequence">
<valueInteger value="30"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="SupplementalDataElements"/>
</extension>
<extension url="name">
<valueString value="SDE Race"/>
</extension>
<extension url="statement">
<valueString
value="define "SDE Race":
Patient.race R
return Tuple {
codes: R.ombCategory union R.detailed,
display: R.text
}"/>
</extension>
<extension url="displaySequence">
<valueInteger value="31"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1264FHIRECATREHQR"/>
</extension>
<extension url="name">
<valueString value="SDE Race"/>
</extension>
<extension url="statement">
<valueString
value="define "SDE Race":
SDE."SDE Race""/>
</extension>
<extension url="displaySequence">
<valueInteger value="32"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="FHIRHelpers"/>
</extension>
<extension url="name">
<valueString value="ToString"/>
</extension>
<extension url="statement">
<valueString
value="define function ToString(value uri): value.value"/>
</extension>
<extension url="displaySequence">
<valueInteger value="33"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="FHIRHelpers"/>
</extension>
<extension url="name">
<valueString value="ToInterval"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Converts the given [Period](https://hl7.org/fhir/datatypes.html#Period)
value to a CQL DateTime Interval
@comment: If the start value of the given period is unspecified, the starting
boundary of the resulting interval will be open (meaning the start of the interval
is unknown, as opposed to interpreted as the beginning of time).
*/
define function ToInterval(period FHIR.Period):
if period is null then
null
else
if period."start" is null then
Interval(period."start".value, period."end".value]
else
Interval[period."start".value, period."end".value]"/>
</extension>
<extension url="displaySequence">
<valueInteger value="34"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1264FHIRECATREHQR"/>
</extension>
<extension url="name">
<valueString value="edArrivalTime"/>
</extension>
<extension url="statement">
<valueString
value="define fluent function "edArrivalTime"(EDEncounter Encounter):
Last("ED Triage and Evaluation Management".location Location
where exists((Location.location.getLocation().type) LocationType
where(LocationType in "Emergency Department Location"
or LocationType ~ "Emergency room"
or LocationType ~ "Emergency trauma unit"
)
)
and start of Location.period is not null
and(Location.period ends 120 minutes or less before start of EDEncounter.period
or Location.period overlaps before EDEncounter.period
or EDEncounter.period overlaps before Location.period
or Location.period starts same as start of EDEncounter.period
)
return start of Location.period
sort ascending
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="35"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CQMCommon"/>
</extension>
<extension url="name">
<valueString value="getLocation"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Returns the Location resource specified by the given reference.
*/
define fluent function getLocation(reference Reference):
singleton from (
[Location] L where reference.references(L)
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="36"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="QICoreCommon"/>
</extension>
<extension url="name">
<valueString value="references"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Returns true if the given reference is to the given resource
@comment: Returns true if the `id` element of the given resource exactly equals the tail of the given reference.
NOTE: This function assumes resources from the same source server.
*/
define fluent function references(reference Reference, resource Resource):
resource.id = Last(Split(reference.reference, '/'))"/>
</extension>
<extension url="displaySequence">
<valueInteger value="37"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="FHIRHelpers"/>
</extension>
<extension url="name">
<valueString value="ToConcept"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Converts the given FHIR [CodeableConcept](https://hl7.org/fhir/datatypes.html#CodeableConcept) value to a CQL Concept.
*/
define function ToConcept(concept FHIR.CodeableConcept):
if concept is null then
null
else
System.Concept {
codes: concept.coding C return ToCode(C),
display: concept.text.value
}"/>
</extension>
<extension url="displaySequence">
<valueInteger value="38"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="FHIRHelpers"/>
</extension>
<extension url="name">
<valueString value="ToCode"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Converts the given FHIR [Coding](https://hl7.org/fhir/datatypes.html#Coding) value to a CQL Code.
*/
define function ToCode(coding FHIR.Coding):
if coding is null then
null
else
System.Code {
code: coding.code.value,
system: coding.system.value,
version: coding.version.value,
display: coding.display.value
}"/>
</extension>
<extension url="displaySequence">
<valueInteger value="39"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1264FHIRECATREHQR"/>
</extension>
<extension url="name">
<valueString value="edTreatmentRoomTimeArrivalTime"/>
</extension>
<extension url="statement">
<valueString
value="define fluent function "edTreatmentRoomTimeArrivalTime"(EDEncounter Encounter):
First(EDEncounter.location Location
where Location.location.getLocation().type in "Emergency Department Treatment Location"
and start of Location.period is not null
return start of Location.period
sort ascending
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="40"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1264FHIRECATREHQR"/>
</extension>
<extension url="name">
<valueString value="TransferDecisionUsingOrder"/>
</extension>
<extension url="statement">
<valueString
value="define fluent function "TransferDecisionUsingOrder"(EDEncounter Encounter):
Last([ServiceRequest: "Decision to Transfer"] TransferOrder
where TransferOrder.authoredOn during EDEncounter.period
and TransferOrder.intent = 'order'
and TransferOrder.status in { 'active', 'completed' }
return TransferOrder.authoredOn
sort ascending
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="41"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS1264FHIRECATREHQR"/>
</extension>
<extension url="name">
<valueString value="edDepartureTime"/>
</extension>
<extension url="statement">
<valueString
value="define fluent function "edDepartureTime"(EDEncounter Encounter):
Last("ED Triage and Evaluation Management".location Location
where exists((Location.location.getLocation().type) LocationType
where(LocationType in "Emergency Department Location"
or LocationType ~ "Emergency room"
or LocationType ~ "Emergency trauma unit"
)
)
and
end of Location.period is not null
and(Location.period ends 120 minutes or less before start of EDEncounter.period
or Location.period overlaps before EDEncounter.period
or EDEncounter.period overlaps before Location.period
or Location.period starts same as start of EDEncounter.period
)
return
end of Location.period
sort ascending
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="42"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CQMCommon"/>
</extension>
<extension url="name">
<valueString value="hasPrincipalDiagnosisOf"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Returns the condition that is specified as the principal diagnosis for the encounter and has a code in the given valueSet.
@comment: See the QICore 6 Authoring Patterns discussion on [Principal Diagnosis and Present on Admission](https://github.com/cqframework/CQL-Formatting-and-Usage-Wiki/wiki/Authoring-Patterns-QICore-v6.0.0#conditions-present-on-admission-and-principal-diagnoses) for more information
*/
define fluent function hasPrincipalDiagnosisOf(encounter Encounter, valueSet ValueSet):
(encounter.principalDiagnosis()) PD
return PD.diagnosis in valueSet
or PD.diagnosis.getCondition().code in valueSet"/>
</extension>
<extension url="displaySequence">
<valueInteger value="43"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CQMCommon"/>
</extension>
<extension url="name">
<valueString value="principalDiagnosis"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Returns the claim diagnosis element that is specified as the principal diagnosis for the encounter
@comment: See the QICore 6 Authoring Patterns discussion on [Principal Diagnosis and Present on Admission](https://github.com/cqframework/CQL-Formatting-and-Usage-Wiki/wiki/Authoring-Patterns-QICore-v6.0.0#conditions-present-on-admission-and-principal-diagnoses) for more information
*/
define fluent function principalDiagnosis(encounter Encounter):
singleton from (
(encounter.claimDiagnosis()) CD
where CD.type.includesCode("Principal Diagnosis")
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="44"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CQMCommon"/>
</extension>
<extension url="name">
<valueString value="claimDiagnosis"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Returns the claim diagnosis elements for the given encounter
@comment: See the QICore 6 Authoring Patterns discussion on [Principal Diagnosis and Present on Admission](https://github.com/cqframework/CQL-Formatting-and-Usage-Wiki/wiki/Authoring-Patterns-QICore-v6.0.0#conditions-present-on-admission-and-principal-diagnoses) for more information
*/
define fluent function claimDiagnosis(encounter Encounter):
encounter E
let
claim: ([Claim] C where C.status = 'active' and C.use = 'claim' and exists (C.item I where I.encounter.references(E))),
claimItem: (claim.item I where I.encounter.references(E))
return claim.diagnosis D where D.sequence in claimItem.diagnosisSequence"/>
</extension>
<extension url="displaySequence">
<valueInteger value="45"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="QICoreCommon"/>
</extension>
<extension url="name">
<valueString value="references"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Returns true if any of the given references are to the given resource
@comment: Returns true if the `id` element of the given resource exactly equals the tail of any of the given references.
NOTE: This function assumes resources from the same source server.
*/
define fluent function references(references List<Reference>, resource Resource):
exists (references R where R.references(resource))"/>
</extension>
<extension url="displaySequence">
<valueInteger value="46"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="QICoreCommon"/>
</extension>
<extension url="name">
<valueString value="includesCode"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Returns true if the given code is in the given codeList
@comment: Returns true if the `code` is equivalent to any of the codes in the given `codeList`, false otherwise.
*/
define fluent function includesCode(codeList List<Concept>, code Code):
exists (codeList C where C ~ code)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="47"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CQMCommon"/>
</extension>
<extension url="name">
<valueString value="getCondition"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Returns the Condition resource for the given reference
*/
define fluent function getCondition(reference Reference):
singleton from (([ConditionEncounterDiagnosis] union [ConditionProblemsHealthConcerns]) C where reference.references(C.id))"/>
</extension>
<extension url="displaySequence">
<valueInteger value="48"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="QICoreCommon"/>
</extension>
<extension url="name">
<valueString value="references"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Returns true if the given reference is to the given resourceId
@comment: Returns true if the `resourceId` parameter exactly equals the tail of the given reference.
NOTE: This function assumes resources from the same source server.
*/
define fluent function references(reference Reference, resourceId String):
resourceId = Last(Split(reference.reference, '/'))"/>
</extension>
<extension url="displaySequence">
<valueInteger value="49"/>
</extension>
</extension>
<name value="EffectiveDataRequirements"/>
<status value="active"/>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/library-type"/>
<code value="module-definition"/>
</coding>
</type>
<relatedArtifact>
<type value="depends-on"/>
<display value="QICore model information"/>
<resource value="http://hl7.org/fhir/Library/QICore-ModelInfo"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library SDE"/>
<resource
value="https://madie.cms.gov/Library/SupplementalDataElements|5.1.000"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library FHIRHelpers"/>
<resource value="https://madie.cms.gov/Library/FHIRHelpers|4.4.000"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library CQMCommon"/>
<resource value="https://madie.cms.gov/Library/CQMCommon|4.1.000"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library QICoreCommon"/>
<resource value="https://madie.cms.gov/Library/QICoreCommon|4.0.000"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Code system SNOMEDCT"/>
<resource value="http://snomed.info/sct"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Code system RoleCode"/>
<resource value="http://terminology.hl7.org/CodeSystem/v3-RoleCode"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Code system Diagnosis Type"/>
<resource
value="http://terminology.hl7.org/CodeSystem/ex-diagnosistype"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display
value="Value set Emergency Department Evaluation and Management Visit"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1010"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Triage"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.279"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Emergency Department Location"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.284"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Emergency Department Treatment Location"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.278"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Decision to Transfer"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.286"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Observation Services"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.143"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display
value="Value set Mental Health Diagnosis without Substance Use Disorders"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.285"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Payer Type"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"/>
</relatedArtifact>
<parameter>
<name value="Measurement Period"/>
<use value="in"/>
<min value="0"/>
<max value="1"/>
<type value="Period"/>
</parameter>
<parameter>
<name value="Numerator"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Resource"/>
</parameter>
<parameter>
<name value="Denominator"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Resource"/>
</parameter>
<parameter>
<name value="Initial Population"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Resource"/>
</parameter>
<parameter>
<name value="SDE Sex"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="Coding"/>
</parameter>
<parameter>
<name value="SDE Payer"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Resource"/>
</parameter>
<parameter>
<name value="SDE Ethnicity"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="Resource"/>
</parameter>
<parameter>
<name value="SDE Race"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="Resource"/>
</parameter>
<parameter>
<name value="Stratification 4"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Resource"/>
</parameter>
<parameter>
<name value="Stratification 3"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Resource"/>
</parameter>
<parameter>
<name value="Stratification 2"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Resource"/>
</parameter>
<parameter>
<name value="Stratification 1"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Resource"/>
</parameter>
<dataRequirement>
<type value="Patient"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"/>
<mustSupport value="extension"/>
<mustSupport value="url"/>
</dataRequirement>
<dataRequirement>
<type value="Encounter"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"/>
<mustSupport value="type"/>
<mustSupport value="period"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="location"/>
<mustSupport value="location.type"/>
<mustSupport value="hospitalization"/>
<mustSupport value="hospitalization.dischargeDisposition"/>
<mustSupport value="diagnosis"/>
<mustSupport value="diagnosis.code"/>
<codeFilter>
<path value="type"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.279"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Encounter"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"/>
<mustSupport value="type"/>
<mustSupport value="period"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="location"/>
<mustSupport value="location.type"/>
<mustSupport value="hospitalization"/>
<mustSupport value="hospitalization.dischargeDisposition"/>
<mustSupport value="diagnosis"/>
<mustSupport value="diagnosis.code"/>
<codeFilter>
<path value="type"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1010"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Encounter"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"/>
<mustSupport value="period"/>
<mustSupport value="location"/>
<mustSupport value="location.type"/>
<mustSupport value="hospitalization"/>
<mustSupport value="hospitalization.dischargeDisposition"/>
<mustSupport value="type"/>
<mustSupport value="diagnosis"/>
<mustSupport value="diagnosis.code"/>
</dataRequirement>
<dataRequirement>
<type value="Encounter"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"/>
<mustSupport value="type"/>
<mustSupport value="period"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="location"/>
<mustSupport value="location.type"/>
<mustSupport value="hospitalization"/>
<mustSupport value="hospitalization.dischargeDisposition"/>
<mustSupport value="diagnosis"/>
<mustSupport value="diagnosis.code"/>
<codeFilter>
<path value="type"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.143"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Resource"/>
<profile value="http://hl7.org/fhir/StructureDefinition/Resource"/>
<mustSupport value="id"/>
<mustSupport value="id.value"/>
</dataRequirement>
<dataRequirement>
<type value="Location"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-location"/>
</dataRequirement>
<dataRequirement>
<type value="ServiceRequest"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest"/>
<mustSupport value="code"/>
<mustSupport value="authoredOn"/>
<mustSupport value="authoredOn.value"/>
<mustSupport value="intent"/>
<mustSupport value="intent.value"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.286"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Claim"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-claim"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="use"/>
<mustSupport value="use.value"/>
<mustSupport value="item"/>
</dataRequirement>
<dataRequirement>
<type value="Condition"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis"/>
</dataRequirement>
<dataRequirement>
<type value="Condition"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns"/>
</dataRequirement>
<dataRequirement>
<type value="Coverage"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-coverage"/>
<mustSupport value="type"/>
<mustSupport value="period"/>
<codeFilter>
<path value="type"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"/>
</codeFilter>
</dataRequirement>
</Library>
</contained>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-supplementalDataGuidance" id="supplementalDataGuidance">
<extension url="guidance">
<valueString
value="For every patient evaluated by this measure also identify payer, race, ethnicity and sex"/>
</extension>
<extension url="usage">
<valueCodeableConcept>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="supplemental-data"/>
<display value="Supplemental Data"/>
</coding>
<text value="Supplemental Data Guidance"/>
</valueCodeableConcept>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-definitionTerm">
<extension url="term">
<valueString value="Boarding"/>
</extension>
<extension url="definition">
<valueMarkdown
value="The practice of holding transfer patients in the emergency department after a decision to transfer has been made.
"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-definitionTerm">
<extension url="term">
<valueString value="ED Observation"/>
</extension>
<extension url="definition">
<valueMarkdown
value="Observation stays are inclusive of both ED observation care in which a patient initially evaluated in the ED is cared for under observation status for an extended period of time in the ED or in a care area dedicated to observation care, as well as hospital observation stays in which a patient initially evaluated in the ED is cared for in observation status often in a hospital bed used for both inpatient or observation status admissions. Because these two forms of observation stays cannot be easily distinguished in a standardized fashion in existing electronic health record data ontologies, for the purposes of this quality measure all observation stays have been considered an exclusion from both numerator outcomes 3 and 4.
"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-definitionTerm">
<extension url="term">
<valueString value="Left Without Being Seen (LWBS)"/>
</extension>
<extension url="definition">
<valueMarkdown
value="Patients arrive to the ED for evaluation and leave before seeing a physician, advanced practice nurse, or physician's assistant.
"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-definitionTerm">
<extension url="term">
<valueString value="Mental Health"/>
</extension>
<extension url="definition">
<valueMarkdown
value="Mental health generally refers to mental health diagnoses, life stressors and crises, and stress-related physical symptoms (American Medical Association \[AMA\], 2022). For this measure, mental health conditions will be defined separately from substance use disorders.
"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements">
<valueReference>
<reference value="#effective-data-requirements"/>
</valueReference>
</extension>
<url value="https://madie.cms.gov/Measure/CMS1264FHIRECATREHQR"/>
<identifier>
<use value="usual"/>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/artifact-identifier-type"/>
<code value="short-name"/>
<display value="Short Name"/>
</coding>
</type>
<system value="https://madie.cms.gov/measure/shortName"/>
<value value="CMS1264FHIR"/>
</identifier>
<identifier>
<use value="official"/>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/artifact-identifier-type"/>
<code value="version-independent"/>
<display value="Version Independent"/>
</coding>
</type>
<system value="urn:ietf:rfc:3986"/>
<value value="urn:uuid:eb3e269b-97ef-4548-9e87-c89b25789184"/>
</identifier>
<identifier>
<use value="official"/>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/artifact-identifier-type"/>
<code value="version-specific"/>
<display value="Version Specific"/>
</coding>
</type>
<system value="urn:ietf:rfc:3986"/>
<value value="urn:uuid:c83b4461-25cb-4d66-af72-6502b14ebab8"/>
</identifier>
<identifier>
<use value="official"/>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/artifact-identifier-type"/>
<code value="endorser"/>
<display value="Endorser"/>
</coding>
</type>
<system value="https://madie.cms.gov/measure/cbeId"/>
<value value="4625e"/>
<assigner>
<display value="CMS Consensus Based Entity"/>
</assigner>
</identifier>
<identifier>
<use value="official"/>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/artifact-identifier-type"/>
<code value="publisher"/>
<display value="Publisher"/>
</coding>
</type>
<system value="https://madie.cms.gov/measure/cmsId"/>
<value value="1264FHIR"/>
<assigner>
<display value="CMS"/>
</assigner>
</identifier>
<version value="1.0.000"/>
<name value="CMS1264FHIRECATREHQR"/>
<title value="Emergency Care Access \& Timeliness (REHQR)FHIR
"/>
<status value="active"/>
<experimental value="false"/>
<date value="2025-08-25T19:25:28+00:00"/>
<publisher value="Centers for Medicare &amp; Medicaid Services (CMS)"/>
<contact>
<telecom>
<system value="url"/>
<value value="https://www.cms.gov/"/>
</telecom>
</contact>
<description
value="This measure assesses the variation in access and timeliness of emergency care to support rural emergency hospital (REH) quality improvement for patients requiring emergency care in an emergency department (ED). This measure is designed to align with incentives to promote improved care both in EDs and the broader health system to help identify where patients do not receive timely access to emergency care. Emergency care access and timeliness gaps are inclusive of several concepts pertaining to boarding and crowding in an ED, including significantly longer ED wait times, higher left without being seen rates, longer boarding times, and longer total length of stay in the ED.
"/>
<usage
value="Measure Score Calculation The measure score is calculated at the individual ED level as the proportion of ED visits where any one of the four outcomes occurred, as defined by the numerator. For CMS Certification Numbers (CCNs) with more than one ED, scores are combined as a weighted average for that CCN. This dQM is an episode-based measure. An episode is defined as an ED visit that ends during the measurement period. This FHIR-based measure has been derived from the QDM-based measure: CMS1264v1. Please refer to the HL7 QI-Core Implementation Guide (*++https://hl7.org/fhir/us/qicore/STU6/++* ) for more information on QI-Core and mapping recommendations from QDM to QI-Core STU 6 (*++https://hl7.org/fhir/us/qicore/STU6/qdm-to-qicore.html++*).
"/>
<copyright
value="Limited proprietary coding is contained in these specifications for user convenience. Users of proprietary code sets should obtain all necessary licenses from the owners of the code sets. This material contains SNOMED Clinical Terms(R) (SNOMED CT\[R\]) copyright 2004-2024 International Health Terminology Standards Development Organisation. All rights reserved. ICD-10 copyright 2024 World Health Organization. All Rights Reserved. CPT(R) contained in the measure specifications is copyright 2004-2024 American Medical Association.
"/>
<effectivePeriod>
<start value="2027-01-01"/>
<end value="2027-12-31"/>
</effectivePeriod>
<author>
<name value="Acumen, LLC"/>
<telecom>
<system value="url"/>
<value value="https://www.acumenllc.com/"/>
</telecom>
</author>
<relatedArtifact>
<type value="citation"/>
<citation
value="American Medical Association. (2022). What is Behavioral Health. https://www.ama-assn.org/delivering-care/public-health/what-behavioral-health
"/>
</relatedArtifact>
<library value="https://madie.cms.gov/Library/CMS1264FHIRECATREHQR"/>
<disclaimer
value="These performance specifications are not clinical guidelines, do not establish a standard of medical care, and have not been tested for all potential applications. THE MEASURES AND SPECIFICATIONS ARE PROVIDED "AS IS" WITHOUT WARRANTY OF ANY KIND. Due to technical limitations, registered trademarks are indicated by (R) or \[R\] and unregistered trademarks are indicated by (TM) or \[TM\].
"/>
<rationale
value="This measure aims to reduce patient harm and improve outcomes for patients requiring emergency care in an ED by addressing the variation in emergency care and measuring access and timeliness of emergency care. There are long-standing concerns about parameters that impact access and timeliness of care in the ED. Currently, there are no national metrics to assess the proportion of patients impacted by access and timeliness of ED care.
"/>
<clinicalRecommendationStatement
value="Changes in care provision and workflow are anticipated from implementing this Emergency Care Access \& Timeliness (ECAT) REH dQM. To improve time to place a patient in a treatment space (as defined by the numerator below), changes in care may include improving patient flow processes, triaging interventions (such as inclusion of predictive models or different clinical deployment), or increased availability and access to outpatient clinical and social services. Other changes in care may include increases in local healthcare capacity including mental health care (mental health liaisons, co-located mental health services, or specialist psychiatry services), and use of 'hospital home' care models. Furthermore, changes to the following may also be considered: staffing models, ED observation units, diagnostic testing and imaging processes, or physical changes to ED layout. Such changes may result in the following: decreased waiting room time, decreased door to provider times, higher proportion of patients seen within 1 hour, decrease in proportion of patients who leave without being evaluated, better management of mental health diagnoses, reduced length of stay in the ED, decreased turnaround time for diagnostic tests and imaging, improved time to treatment, and decreased ambulance diversion. Changes in clinician or patient-reported outcomes and costs may include the following: improved patient experience, decrease in morbidity and mortality, increased ED revenue, and improved patient outcomes.
"/>
<group id="Group_1">
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring">
<valueCodeableConcept>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-scoring"/>
<code value="proportion"/>
<display value="Proportion"/>
</coding>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis">
<valueCode value="Encounter"/>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-type">
<valueCodeableConcept>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/measure-type"/>
<code value="outcome"/>
<display value="Outcome"/>
</coding>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-rateAggregation">
<valueString value="None
"/>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-improvementNotation">
<valueCodeableConcept>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-improvement-notation"/>
<code value="decrease"/>
<display value="Decreased score indicates improvement"/>
</coding>
</valueCodeableConcept>
</extension>
<population id="InitialPopulation_1">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="initial-population"/>
<display value="Initial Population"/>
</coding>
</code>
<description
value="All ED visits at REHs that end during the measurement period for all patients
"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Initial Population"/>
</criteria>
</population>
<population id="Denominator_1">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="denominator"/>
<display value="Denominator"/>
</coding>
</code>
<description value="Equals Initial Population
"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Denominator"/>
</criteria>
</population>
<population id="Numerator_1">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="numerator"/>
<display value="Numerator"/>
</coding>
</code>
<description
value="The numerator is comprised of any ED visit in the denominator with any quality gap in access; if the patient experiences any of the following during a visit, the visit is included in the numerator: 1. The patient waited longer than 60 minutes (1 hour) after arrival to ED to be placed in a treatment room or dedicated treatment area that allows for audiovisual privacy during history-taking and physical examination, or 2. The patient left the ED without being evaluated, or 3. The patient, if transferred, boarded for longer than 240 minutes (4 hours), or 4. The patient had an ED length of stay (LOS) (time from ED arrival to ED departure as defined by the ED departure timestamp indicating when the patient physically left the ED) of longer than 480 minutes (8 hours). ED encounters with ED observation stays are excluded from criteria #3 (boarded) and #4 (ED LOS)
"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Numerator"/>
</criteria>
</population>
<stratifier id="Stratification_1_1">
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo">
<valueCodeableConcept>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="initial-population"/>
<display value="Initial Population"/>
</coding>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo">
<valueCodeableConcept>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="denominator"/>
<display value="Denominator"/>
</coding>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo">
<valueCodeableConcept>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="numerator"/>
<display value="Numerator"/>
</coding>
</valueCodeableConcept>
</extension>
<description
value="All patients aged less than 18 years seen in the ED who do not have an ED encounter principal diagnosis consistent with mental health diagnosis. Patients who have an ED encounter principal diagnosis consistent with substance use disorders will be included in this stratification.
"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Stratification 1"/>
</criteria>
</stratifier>
<stratifier id="Stratification_1_2">
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo">
<valueCodeableConcept>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="initial-population"/>
<display value="Initial Population"/>
</coding>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo">
<valueCodeableConcept>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="denominator"/>
<display value="Denominator"/>
</coding>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo">
<valueCodeableConcept>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="numerator"/>
<display value="Numerator"/>
</coding>
</valueCodeableConcept>
</extension>
<description
value="All patients aged 18 years and older seen in the ED who do not have an ED encounter principal diagnosis consistent with mental health diagnosis. Patients who have an ED encounter principal diagnosis consistent with substance use disorders will be included in this stratification.
"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Stratification 2"/>
</criteria>
</stratifier>
<stratifier id="Stratification_1_3">
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo">
<valueCodeableConcept>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="initial-population"/>
<display value="Initial Population"/>
</coding>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo">
<valueCodeableConcept>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="denominator"/>
<display value="Denominator"/>
</coding>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo">
<valueCodeableConcept>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="numerator"/>
<display value="Numerator"/>
</coding>
</valueCodeableConcept>
</extension>
<description
value="All patients aged less than 18 years seen in the ED who have an ED encounter principal diagnosis consistent with mental health diagnosis.
"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Stratification 3"/>
</criteria>
</stratifier>
<stratifier id="Stratification_1_4">
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo">
<valueCodeableConcept>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="initial-population"/>
<display value="Initial Population"/>
</coding>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo">
<valueCodeableConcept>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="denominator"/>
<display value="Denominator"/>
</coding>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo">
<valueCodeableConcept>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="numerator"/>
<display value="Numerator"/>
</coding>
</valueCodeableConcept>
</extension>
<description
value="All patients aged 18 years and older seen in the ED who have an ED encounter principal diagnosis consistent with mental health diagnosis.
"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Stratification 4"/>
</criteria>
</stratifier>
</group>
<supplementalData id="sde-ethnicity">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="supplemental-data"/>
</coding>
</usage>
<description value="SDE Ethnicity
"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="SDE Ethnicity"/>
</criteria>
</supplementalData>
<supplementalData id="sde-payer">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="supplemental-data"/>
</coding>
</usage>
<description value="SDE Payer
"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="SDE Payer"/>
</criteria>
</supplementalData>
<supplementalData id="sde-race">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="supplemental-data"/>
</coding>
</usage>
<description value="SDE Race
"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="SDE Race"/>
</criteria>
</supplementalData>
<supplementalData id="sde-sex">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="supplemental-data"/>
</coding>
</usage>
<description value="SDE Sex
"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="SDE Sex"/>
</criteria>
</supplementalData>
</Measure>