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="CMS72FHIRSTKAntithromboticDay2"/>
<meta>
<profile
value="http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-shareablemeasure"/>
<profile
value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-measure-cqfm"/>
<profile
value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/publishable-measure-cqfm"/>
<profile
value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/executable-measure-cqfm"/>
<profile
value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cql-measure-cqfm"/>
<profile
value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/elm-measure-cqfm"/>
<profile
value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/proportion-measure-cqfm"/>
</meta>
<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">Antithrombotic Therapy by End of Hospital Day 2FHIR</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">CMS72FHIR</td>
</tr>
<tr>
<th scope="row" class="row-header">GUID (Version Independent)</th>
<td class="content-container">urn:uuid:b6ae4357-9baa-4195-a9cd-50391b7d0dab</td>
</tr>
<tr>
<th scope="row" class="row-header">GUID (Version Specific)</th>
<td class="content-container">urn:uuid:5de3156a-7293-40aa-9ec3-f3df76d3579c</td>
</tr>
<tr>
<th scope="row" class="row-header">CMS Identifier</th>
<td class="content-container">72FHIR</td>
</tr>
<tr>
<th scope="row" class="row-header">Effective Period</th>
<td class="content-container">2026-01-01 through 2026-12-31</td>
</tr>
<tr>
<th scope="row" class="row-header">Steward (Publisher)</th>
<td class="content-container">The Joint Commission</td>
</tr>
<tr>
<th scope="row" class="row-header">Developer</th>
<td class="content-container">The Joint Commission</td>
</tr>
<tr>
<th scope="row" class="row-header">Description</th>
<td class="content-container">Ischemic stroke patients administered antithrombotic therapy by the end of hospital day 2</td>
</tr>
<tr>
<th scope="row" class="row-header">Copyright</th>
<td class="content-container"><p>Measure specifications are in the Public Domain</p>
<p>LOINC(R) copyright 2004-2024 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2024 International Health Terminology Standards Development Organisation. ICD-10 copyright 2024 World Health Organization. All Rights Reserved.</p></td>
</tr>
<tr>
<th scope="row" class="row-header">Disclaimer</th>
<td class="content-container"><p>These performance measures 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 without warranty.</p></td>
</tr>
<tr>
<th scope="row" class="row-header">Rationale</th>
<td class="content-container"><p>The effectiveness of antithrombotic agents in reducing stroke mortality, stroke-related morbidity and recurrence rates has been studied in several large clinical trials. While the use of these agents for patients with acute ischemic stroke and transient ischemic attacks (TIA) continues to be the subject of study, substantial evidence is available from completed studies. Data at this time suggest that antithrombotic therapy should be administered within 2 days of symptom onset in acute ischemic stroke patients to reduce stroke mortality and morbidity as long as no contraindications exist.</p>
<p>Aspirin is the recommended antithrombotic medication for early antithrombotic therapy and most frequently administered unless contraindicated. Anticoagulants at doses to prevent venous thromboembolism (VTE) are insufficient. Subcutaneous Lovenox (enoxaparin) and unfractionated heparin (UFH) SQ at lower dosages used for VTE prophylaxis (i.e., enoxaparin SQ 40 mg once daily; enoxaparin SQ 30 mg Q12 hours; UFH 5,000 units or less two or three times daily) are not sufficient for early antithrombotic therapy.</p>
<p>Anticoagulants at doses to prevent VTE are insufficient antithrombotic therapy to prevent recurrent ischemic stroke or TIA.</p></td>
</tr>
<tr>
<th scope="row" class="row-header">Clinical Recommendation Statement</th>
<td class="content-container"><p>Antithrombotic therapy should be administered within 2 days of symptom onset in acute ischemic stroke patients to reduce stroke mortality and morbidity as long as no contraindications exist</p></td>
</tr>
<tr>
<th scope="row" class="row-header">Citation</th>
<td class="content-container">
Adams, H. P., Jr., del Zoppo, G., Alberts, M. J., et al. (2007, May). Guidelines for the early management of adults with ischemic stroke: A guideline from the American Heart Association/American Stroke Association Stroke Council, Clinical Cardiology Council, Cardiovascular Radiology and Intervention Council, and the Atherosclerotic Peripheral Vascular Disease and Quality of Care Outcomes in Research Interdisciplinary Working Groups. Stroke, 38(5), 1655-1711.
</td>
</tr>
<tr>
<th scope="row" class="row-header">Citation</th>
<td class="content-container">
Adams, H., Adams, R., del Zoppo, G., et al. (2005, April). Guidelines for the early management of patients with ischemic stroke: 2005 guidelines update-A scientific statement from the Stroke Council of the American Heart Association/American Stroke Association. Stroke, 36(4): 916-923.
</td>
</tr>
<tr>
<th scope="row" class="row-header">Citation</th>
<td class="content-container">
Albers, G. W, Amarenco, P., Easton, J. D., et al. (2001). Antithrombotic and thrombolytic therapy for ischemic stroke. Chest, 119, 300-320.
</td>
</tr>
<tr>
<th scope="row" class="row-header">Citation</th>
<td class="content-container">
Antithrombotic Trialists' Collaboration. (2002, January 12). Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high-risk patients. BMJ, 324(7329), 71-86.
</td>
</tr>
<tr>
<th scope="row" class="row-header">Citation</th>
<td class="content-container">
Brott, T. G., Clark, W. M., Fagan, S. C., et al. (2000). Stroke: The first hours. Guidelines for acute treatment. Washington, DC: National Stroke Association.
</td>
</tr>
<tr>
<th scope="row" class="row-header">Citation</th>
<td class="content-container">
Centers for Disease Control and Prevention. (2009, May 1). Prevalence and most common causes of disability among adults-United States, 2005. Morbidity and Mortality Weekly Report, 58(16), 421-426.
</td>
</tr>
<tr>
<th scope="row" class="row-header">Citation</th>
<td class="content-container">
Chen, Z. M., Sandercock, P., Pan, H. C., et al. (2000, June). Indications for early aspirin use in acute ischemic stroke: A combined analysis of 40,000 randomized patients from the Chinese Acute Stroke Trial and the International Stroke Trial. Stroke, 31(6), 1240-1249.
</td>
</tr>
<tr>
<th scope="row" class="row-header">Citation</th>
<td class="content-container">
Coull, B. M., Williams, L. S., Goldstein, L. B., et al. (2002, July). Anticoagulants and antiplatelet agents in acute ischemic stroke: Report of the Joint Stroke Guideline Development Committee of the American Academy of Neurology and the American Stroke Association (a Division of the American Heart Association). Stroke, 33(7), 1934-1942.
</td>
</tr>
<tr>
<th scope="row" class="row-header">Citation</th>
<td class="content-container">
Eccles, M., Freemantle, N., & Mason, J. (1998, April 25). North of England Evidence-Based Guideline Development Project: Guideline on the use of aspirin as secondary prophylaxis for vascular disease in primary care. BMJ, 316(7140), 1303-1309.
</td>
</tr>
<tr>
<th scope="row" class="row-header">Citation</th>
<td class="content-container">
ESPS Group. (1987, December 12). The European Stroke Prevention Study (ESPS): Principal end-points. Lancet, 2(8572), 1351-1354.
</td>
</tr>
<tr>
<th scope="row" class="row-header">Citation</th>
<td class="content-container">
Furie, K. L., Kasner, S. E., Adams, R. J., et al. (2011, January). Guidelines for the prevention of stroke in patients with stroke or transient ischemic attack: A guideline for health care professionals from the American Heart Association/American Stroke Association. Stroke, 42(1), 227-276.
</td>
</tr>
<tr>
<th scope="row" class="row-header">Citation</th>
<td class="content-container">
Gaspoz, J. M., Coxson, P. G., Goldman, P. A., et al. (2002, June 6). Cost effectiveness of aspirin, clopidogrel, or both for secondary prevention of coronary heart disease. New England Journal of Medicine, 346(23), 1800-1806.
</td>
</tr>
<tr>
<th scope="row" class="row-header">Citation</th>
<td class="content-container">
Guyatt, G. H., Akl, E. A., Crowther, M., et al. (2012, February). Executive summary: Antithrombotic therapy and prevention of thrombosis, 9th ed.: American College of Chest Physicians evidence-based clinical practice guidelines. Chest, 141(2 Suppl.), 7S-47S.
</td>
</tr>
<tr>
<th scope="row" class="row-header">Citation</th>
<td class="content-container">
International Stroke Trial Collaborative Group. (1997, May 31). The International Stroke Trial (IST): A randomised trial of aspirin, subcutaneous heparin, both, or neither among 19,435 patients with acute ischaemic stroke. Lancet, 349(9065), 1569-1581.
</td>
</tr>
<tr>
<th scope="row" class="row-header">Citation</th>
<td class="content-container">
Jauch, E. C., Saver, J. L., Adams, H. P., Jr., et al. (2013). Guidelines for the early management of patients with acute ischemic stroke: A guideline for health care professionals from the American Heart Association/American Stroke Association. Stroke, 44(3), 870-947.
</td>
</tr>
<tr>
<th scope="row" class="row-header">Citation</th>
<td class="content-container">
Johnson, E. S., Lanes, S. F., Wentworth, C. E., III, et al. (1999, June 14). A metaregression analysis of the dose-response effect of aspirin on stroke. Archives of Internal Medicine, 159(11), 1248-1253.
</td>
</tr>
<tr>
<th scope="row" class="row-header">Citation</th>
<td class="content-container">
Powers, W. J., Rabinstein, A. A., Ackerson, T., et al. (2018, January). 2018 guidelines for the early management of patients with acute ischemic stroke: A guideline for health care professionals from the American Heart Association/American Stroke Association. Stroke, 49,
</td>
</tr>
<tr>
<th scope="row" class="row-header">Citation</th>
<td class="content-container">
Roger, V. L., Go, A. S., Lloyd-Jones, D. M., et al. (2012, January 3). Heart disease and stroke statistics-2012 update: A report from the American Heart Association. Circulation, 125(1), e2-e220.
</td>
</tr>
<tr>
<th scope="row" class="row-header">Citation</th>
<td class="content-container">
Sacco, R. L., Adams, R., Albers, G., et al. (2006, February). Guidelines for prevention of stroke in patients with ischemic stroke or transient ischemic attack: A statement for health care professionals from the American Heart Association/American Stroke Association Council on Stroke: Co-sponsored by the Council on Cardiovascular Radiology and Intervention: The American Academy of Neurology affirms the value of this guideline. Stroke, 37(2), 577-617.
</td>
</tr>
<tr>
<th scope="row" class="row-header">Guidance (Usage)</th>
<td class="content-container"><p>The "Nonelective Inpatient Encounter" value set intends to capture all non-scheduled hospitalizations. This value set is a subset of the "Inpatient Encounter" value set, excluding concepts that specifically refer to elective hospital admissions. Non-elective Inpatient Encounters include emergency, urgent, and unplanned admissions.</p>
<p>NPO (Nothing by mouth) is not a valid reason for not administering antithrombotic therapy by end of hospital day 2 as another route of administration can be used (i.e., rectal or intravenous).</p>
<p>In the denominator exclusions, the intent is to only exclude patients with a total length of stay of <2 days, including Emergency Department (ED) visit (if there is one). For the dQM we model both of the scenarios of admission via the ED as well as direct admits. This statement addresses direct admits.</p>
<p>The denominator population includes patients with inpatient hospitalizations and patients from Acute Hospital Care at Home programs, who are treated and billed as inpatients but receive care in their home.</p>
<p>This dQM is an episode-based measure. An episode is defined as each inpatient hospitalization or encounter that ends during the measurement period. This FHIR-based measure has been derived from the QDM-based measure: CMS72v14. Please refer to the HL7 QI-Core Implementation Guide (<em>https://hl7.org/fhir/us/qicore/STU6/</em>) for more information on QI-Core and mapping recommendations from QDM to QI-Core STU 6. (<em>https://hl7.org/fhir/us/qicore/STU6/qdm-to-qicore.html</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#process: 'Process']</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#increase: 'Increased 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"><p>Inpatient hospitalization (non-elective admissions) for patients age 18 and older, discharged from inpatient care with a principal diagnosis of ischemic stroke that ends during the measurement period</p></p>
<em>Logic Definition</em>: <a href="#primary-cms72fhirstkantithromboticday2-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"><p>Equals Initial Population</p></p>
<em>Logic Definition</em>: <a href="#primary-cms72fhirstkantithromboticday2-denominator">Denominator</a>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Denominator Exclusion</th>
<td class="content-container">
<em>ID</em>: DenominatorExclusion_1
<br/>
<em>Description</em>:
<p style="white-space: pre-line" class="tab-one"><ul>
<li><p>Inpatient hospitalization for patients who have a duration of stay less than 2 days.</p></li>
<li><p>Inpatient hospitalization for patients with comfort measures documented day of or the day after arrival.</p></li>
<li><p>Inpatient hospitalization for patients with intra-venous or intra-arterial Thrombolytic (t-PA) Therapy administered within 24 hours prior to arrival or anytime during hospitalization.</p></li>
</ul></p>
<em>Logic Definition</em>: <a href="#primary-cms72fhirstkantithromboticday2-denominator-exclusions">Denominator Exclusions</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"><p>Inpatient hospitalization for patients who had antithrombotic therapy administered the day of or day after hospital arrival</p></p>
<em>Logic Definition</em>: <a href="#primary-cms72fhirstkantithromboticday2-numerator">Numerator</a>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Denominator Exception</th>
<td class="content-container">
<em>ID</em>: DenominatorException_1
<br/>
<em>Description</em>:
<p style="white-space: pre-line" class="tab-one"><ul>
<li><p>Inpatient hospitalization for patients with a documented reason for not administering antithrombotic therapy the day of or day after hospital arrival</p></li>
<li><p>Inpatient hospitalization for patients who receive Prasugrel as an antithrombotic therapy the day of or day after hospital arrival</p></li>
<li><p>Inpatient hospitalization for patients with an international normalized ratio (INR) greater than 3.5</p></li>
</ul></p>
<em>Logic Definition</em>: <a href="#primary-cms72fhirstkantithromboticday2-denominator-exceptions">Denominator Exceptions</a>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Supplemental Data Guidance</th>
<td class="content-container"><p>For every patient evaluated by this measure also identify payer, race, ethnicity and sex</p></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="#cms72fhirstkantithromboticday2-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="#cms72fhirstkantithromboticday2-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="#cms72fhirstkantithromboticday2-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="#cms72fhirstkantithromboticday2-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/CMS72FHIRSTKAntithromboticDay2</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-cms72fhirstkantithromboticday2-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":
TJC."Ischemic Stroke Encounter"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="primary-cms72fhirstkantithromboticday2-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-cms72fhirstkantithromboticday2-denominator-exclusions"> </a>
Denominator Exclusion
</th>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Denominator Exclusions":
"Encounter Less Than Two Days"
union "Encounter With Comfort Measures During Day Of Or Day After Arrival"
union "Encounter With Thrombolytic Therapy Given Prior To Arrival Or During Hospitalization"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="primary-cms72fhirstkantithromboticday2-numerator"> </a>
Numerator
</th>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Numerator":
"Encounter With Antithrombotic Therapy"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="primary-cms72fhirstkantithromboticday2-denominator-exceptions"> </a>
Denominator Exception
</th>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Denominator Exceptions":
"Encounter With Documented Reason For No Antithrombotic Ordered Or Administered Day Of Or Day After Hospital Arrival"
union "Encounter With Pharmacological Contraindications For Antithrombotic Therapy Given Day Of Or Day After Hospital Arrival"
union "Encounter With An INR Greater Than 3.5"</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="cms72fhirstkantithromboticday2-sde-sex"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS72FHIRSTKAntithromboticDay2</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="cms72fhirstkantithromboticday2-encounter-with-antithrombotic-therapy"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS72FHIRSTKAntithromboticDay2</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Encounter With Antithrombotic Therapy":
TJC."Ischemic Stroke Encounter" IschemicStrokeEncounter
with ["MedicationAdministration": "Antithrombotic Therapy for Ischemic Stroke"] Antithrombotic
such that Antithrombotic.status in { 'in-progress', 'completed' }
and Antithrombotic.effective.toInterval ( ) starts during day of ( start of IschemicStrokeEncounter.hospitalizationWithObservation ( ) ).calendarDayOfOrDayAfter ( )</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms72fhirstkantithromboticday2-numerator"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS72FHIRSTKAntithromboticDay2</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Numerator":
"Encounter With Antithrombotic Therapy"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms72fhirstkantithromboticday2-initial-population"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS72FHIRSTKAntithromboticDay2</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Initial Population":
TJC."Ischemic Stroke Encounter"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms72fhirstkantithromboticday2-denominator"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS72FHIRSTKAntithromboticDay2</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="cms72fhirstkantithromboticday2-sde-payer"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS72FHIRSTKAntithromboticDay2</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="cms72fhirstkantithromboticday2-sde-ethnicity"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS72FHIRSTKAntithromboticDay2</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="cms72fhirstkantithromboticday2-encounter-less-than-two-days"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS72FHIRSTKAntithromboticDay2</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Encounter Less Than Two Days":
TJC."Ischemic Stroke Encounter" IschemicStrokeEncounter
where IschemicStrokeEncounter.hospitalizationWithObservation ( ).lengthInDays ( ) < 2</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms72fhirstkantithromboticday2-encounter-with-comfort-measures-during-day-of-or-day-after-arrival"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS72FHIRSTKAntithromboticDay2</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Encounter With Comfort Measures During Day Of Or Day After Arrival":
TJC."Ischemic Stroke Encounter" IschemicStrokeEncounter
with TJC."Intervention Comfort Measures" ComfortMeasure
such that Coalesce(start of ComfortMeasure.performed.toInterval(), ComfortMeasure.authoredOn) during day of ( start of IschemicStrokeEncounter.hospitalizationWithObservation ( ) ).calendarDayOfOrDayAfter ( )</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms72fhirstkantithromboticday2-thrombolytic-therapy-medication-or-procedures"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS72FHIRSTKAntithromboticDay2</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Thrombolytic Therapy Medication Or Procedures":
( ["MedicationAdministration": "Thrombolytic tPA Therapy"] ThrombolyticMedication
where ThrombolyticMedication.status in { 'in-progress', 'completed' }
return {
id: ThrombolyticMedication.id,
effective: ThrombolyticMedication.effective
}
)
union ( ["Procedure": "Intravenous or Intraarterial Thrombolytic tPA Therapy"] ThrombolyticProcedure
where ThrombolyticProcedure.status = 'completed'
return {
id: ThrombolyticProcedure.id,
effective: ThrombolyticProcedure.performed
}
)</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms72fhirstkantithromboticday2-encounter-with-thrombolytic-therapy-medication-or-procedures"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS72FHIRSTKAntithromboticDay2</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Encounter With Thrombolytic Therapy Medication Or Procedures":
TJC."Ischemic Stroke Encounter" IschemicStrokeEncounter
with "Thrombolytic Therapy Medication Or Procedures" ThrombolyticTherapy
such that ThrombolyticTherapy.effective.toInterval ( ) starts during Interval[start of IschemicStrokeEncounter.hospitalizationWithObservation ( ) - 24 hours, end of IschemicStrokeEncounter.hospitalizationWithObservation ( ) )</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms72fhirstkantithromboticday2-encounter-with-thrombolytic-therapy-prior-to-arrival"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS72FHIRSTKAntithromboticDay2</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Encounter With Thrombolytic Therapy Prior To Arrival":
TJC."Ischemic Stroke Encounter" IschemicStrokeEncounter
where exists ( ( IschemicStrokeEncounter.encounterDiagnosis ( ) ) EncounterDiagnosis
where EncounterDiagnosis.code in "Intravenous or Intraarterial Thrombolytic tPA Therapy Prior to Arrival"
)</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms72fhirstkantithromboticday2-encounter-with-thrombolytic-therapy-documented-as-already-given"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS72FHIRSTKAntithromboticDay2</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Encounter With Thrombolytic Therapy Documented As Already Given":
( TJC."Ischemic Stroke Encounter" IschemicStrokeEncounter
where exists [ConditionProblemsHealthConcerns: "Intravenous or Intraarterial Thrombolytic tPA Therapy Prior to Arrival"] PriorTPA
where PriorTPA.recordedDate during IschemicStrokeEncounter.hospitalizationWithObservation ( )
and PriorTPA.verificationStatus is not null implies ( PriorTPA.verificationStatus !~ QICoreCommon."refuted"
and PriorTPA.verificationStatus !~ QICoreCommon."entered-in-error"
)
)
union TJC."Ischemic Stroke Encounter" IschemicStrokeEncounter
where exists ( ( IschemicStrokeEncounter.encounterDiagnosis ( ) ) EncounterDiagnosis
where EncounterDiagnosis.code in "Intravenous or Intraarterial Thrombolytic tPA Therapy Prior to Arrival"
)</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms72fhirstkantithromboticday2-encounter-with-thrombolytic-therapy-given-prior-to-arrival-or-during-hospitalization"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS72FHIRSTKAntithromboticDay2</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Encounter With Thrombolytic Therapy Given Prior To Arrival Or During Hospitalization":
"Encounter With Thrombolytic Therapy Medication Or Procedures"
union "Encounter With Thrombolytic Therapy Prior To Arrival"
union "Encounter With Thrombolytic Therapy Documented As Already Given"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms72fhirstkantithromboticday2-denominator-exclusions"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS72FHIRSTKAntithromboticDay2</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Denominator Exclusions":
"Encounter Less Than Two Days"
union "Encounter With Comfort Measures During Day Of Or Day After Arrival"
union "Encounter With Thrombolytic Therapy Given Prior To Arrival Or During Hospitalization"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms72fhirstkantithromboticday2-sde-race"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS72FHIRSTKAntithromboticDay2</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="cms72fhirstkantithromboticday2-reason-for-not-ordering-antithrombotic"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS72FHIRSTKAntithromboticDay2</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Reason For Not Ordering Antithrombotic":
( ["MedicationNotRequested": "Antithrombotic Therapy for Ischemic Stroke"] NoAntithromboticOrder
where ( NoAntithromboticOrder.reasonCode in "Medical Reason for Not Providing Treatment"
or NoAntithromboticOrder.reasonCode in "Patient Refusal"
)
and NoAntithromboticOrder.status in { 'active', 'completed' }
and NoAntithromboticOrder.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }
return {
id: NoAntithromboticOrder.id,
authoredOn: NoAntithromboticOrder.authoredOn
}
)
union ( ["MedicationRequest": "Antithrombotic Therapy for Ischemic Stroke"] MedReqAntithrombotic
with ["TaskRejected"] TaskReject
such that TaskReject.focus.references ( MedReqAntithrombotic )
and ( TaskReject.statusReason in "Medical Reason for Not Providing Treatment"
or TaskReject.statusReason in "Patient Refusal"
)
and ( MedReqAntithrombotic.status in { 'active', 'completed' }
and TaskReject.code ~ QICoreCommon."Fulfill"
)
return {
id: MedReqAntithrombotic.id,
authoredOn: MedReqAntithrombotic.authoredOn
}
)</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms72fhirstkantithromboticday2-reason-for-not-administering-antithrombotic"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS72FHIRSTKAntithromboticDay2</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Reason For Not Administering Antithrombotic":
["MedicationAdministrationNotDone": "Antithrombotic Therapy for Ischemic Stroke"] MedicationAdm
where ( MedicationAdm.statusReason in "Medical Reason for Not Providing Treatment"
or MedicationAdm.statusReason in "Patient Refusal"
)
return {
id: MedicationAdm.id,
authoredOn: MedicationAdm.recorded
}</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms72fhirstkantithromboticday2-documented-reason-for-no-antithrombotic-ordered-or-administered"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS72FHIRSTKAntithromboticDay2</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Documented Reason For No Antithrombotic Ordered Or Administered":
"Reason For Not Ordering Antithrombotic"
union "Reason For Not Administering Antithrombotic"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms72fhirstkantithromboticday2-encounter-with-documented-reason-for-no-antithrombotic-ordered-or-administered-day-of-or-day-after-hospital-arrival"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS72FHIRSTKAntithromboticDay2</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Encounter With Documented Reason For No Antithrombotic Ordered Or Administered Day Of Or Day After Hospital Arrival":
TJC."Ischemic Stroke Encounter" IschemicStrokeEncounter
with "Documented Reason For No Antithrombotic Ordered Or Administered" NoAntithrombotic
such that NoAntithrombotic.authoredOn during day of ( start of IschemicStrokeEncounter.hospitalizationWithObservation ( ) ).calendarDayOfOrDayAfter ( )</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms72fhirstkantithromboticday2-encounter-with-pharmacological-contraindications-for-antithrombotic-therapy-given-day-of-or-day-after-hospital-arrival"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS72FHIRSTKAntithromboticDay2</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Encounter With Pharmacological Contraindications For Antithrombotic Therapy Given Day Of Or Day After Hospital Arrival":
TJC."Ischemic Stroke Encounter" IschemicStrokeEncounter
with ["MedicationAdministration": "Pharmacological Contraindications For Antithrombotic Therapy"] PharmacologicalContraindications
such that PharmacologicalContraindications.status in { 'in-progress', 'completed' }
and PharmacologicalContraindications.effective.toInterval ( ) starts during day of ( start of IschemicStrokeEncounter.hospitalizationWithObservation ( ) ).calendarDayOfOrDayAfter ( )</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms72fhirstkantithromboticday2-encounter-with-an-inr-greater-than-3.5"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS72FHIRSTKAntithromboticDay2</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Encounter With An INR Greater Than 3.5":
TJC."Ischemic Stroke Encounter" IschemicStrokeEncounter
with ["LaboratoryResultObservation": "INR"] INR
such that INR.value as Quantity > 3.5
and INR.status in { 'final', 'amended', 'corrected' }
and INR.issued during day of ( start of IschemicStrokeEncounter.hospitalizationWithObservation ( ) ).calendarDayOfOrDayAfter ( )</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms72fhirstkantithromboticday2-denominator-exceptions"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS72FHIRSTKAntithromboticDay2</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Denominator Exceptions":
"Encounter With Documented Reason For No Antithrombotic Ordered Or Administered Day Of Or Day After Hospital Arrival"
union "Encounter With Pharmacological Contraindications For Antithrombotic Therapy Given Day Of Or Day After Hospital Arrival"
union "Encounter With An INR Greater Than 3.5"</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="tjcoverall-non-elective-inpatient-encounter-with-age"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> TJCOverall</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Non Elective Inpatient Encounter With Age":
["Encounter": "Nonelective Inpatient Encounter"] NonElectiveEncounter
where AgeInYearsAt(date from start of NonElectiveEncounter.period ) >= 18
and NonElectiveEncounter.period ends during day of "Measurement Period"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="tjcoverall-ischemic-stroke-encounter"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> TJCOverall</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Ischemic Stroke Encounter":
"Non Elective Inpatient Encounter With Age" NonElectiveEncounterWithAge
where NonElectiveEncounterWithAge.hasPrincipalDiagnosisOf("Ischemic Stroke" )</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="tjcoverall-intervention-comfort-measures"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> TJCOverall</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Intervention Comfort Measures":
( ["ServiceRequest": "Comfort Measures"] ComfortCare
where ComfortCare.status in { 'active', 'completed', 'on-hold' }
and ComfortCare.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }
)
union ( ["Procedure": "Comfort Measures"] ComfortCarePerformed
where ComfortCarePerformed.status in { 'completed', 'in-progress' }
)</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="tjcoverall-calendardayofordayafter"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> TJCOverall</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define fluent function calendarDayOfOrDayAfter(StartValue DateTime):
Interval [date from (StartValue), date from (StartValue) + 1 day]</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-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-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 scope="row" rowspan="2" class="row-header">
<a name="qicorecommon-tointerval"> </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: Normalizes a value that is a choice of timing-valued types to an equivalent interval
@comment: Normalizes a choice type of DateTime, Quanitty, Interval<DateTime>, or Interval<Quantity> types
to an equivalent interval. This selection of choice types is a superset of the majority of choice types that are used as possible
representations for timing-valued elements in QICore, allowing this function to be used across any resource.
The input can be provided as a DateTime, Quantity, Interval<DateTime> or Interval<Quantity>.
The intent of this function is to provide a clear and concise mechanism to treat single
elements that have multiple possible representations as intervals so that logic doesn't have to account
for the variability. More complex calculations (such as medication request period or dispense period
calculation) need specific guidance and consideration. That guidance may make use of this function, but
the focus of this function is on single element calculations where the semantics are unambiguous.
If the input is a DateTime, the result a DateTime Interval beginning and ending on that DateTime.
If the input is a Quantity, the quantity is expected to be a calendar-duration interpreted as an Age,
and the result is a DateTime Interval beginning on the Date the patient turned that age and ending immediately before one year later.
If the input is a DateTime Interval, the result is the input.
If the input is a Quantity Interval, the quantities are expected to be calendar-durations interpreted as an Age, and the result
is a DateTime Interval beginning on the date the patient turned the age given as the start of the quantity interval, and ending
immediately before one year later than the date the patient turned the age given as the end of the quantity interval.
If the input is a Timing, an error will be thrown indicating that Timing calculations are not implemented. Any other input will reslt in a null DateTime Interval
*/
define fluent function toInterval(choice Choice<DateTime, Quantity, Interval<DateTime>, Interval<Quantity>, Timing>):
case
when choice is DateTime then
Interval[choice as DateTime, choice as DateTime]
when choice is Interval<DateTime> then
choice as Interval<DateTime>
when choice is Quantity then
Interval[Patient.birthDate + (choice as Quantity),
Patient.birthDate + (choice as Quantity) + 1 year)
when choice is Interval<Quantity> then
Interval[Patient.birthDate + (choice.low as Quantity),
Patient.birthDate + (choice.high as Quantity) + 1 year)
when choice is Timing then
Message(null, true, 'NOT_IMPLEMENTED', 'Error', 'Calculation of an interval from a Timing value is not supported') as Interval<DateTime>
else
null as Interval<DateTime>
end</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="cqmcommon-hospitalizationwithobservation"> </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: Hospitalization with Observation returns the total interval from the start of any immediately prior emergency department visit through the observation visit to the discharge of the given encounter
*/
define fluent function hospitalizationWithObservation(TheEncounter Encounter ):
TheEncounter Visit
let ObsVisit: Last([Encounter: "Observation Services"] LastObs
where LastObs.status = 'finished'
and LastObs.period ends 1 hour or less on or before start of Visit.period
sort by end of period
),
VisitStart: Coalesce(start of ObsVisit.period, start of Visit.period),
EDVisit: Last([Encounter: "Emergency Department Visit"] LastED
where LastED.status = 'finished'
and LastED.period ends 1 hour or less on or before VisitStart
sort by end of period
)
return Interval[Coalesce(start of EDVisit.period, VisitStart), end of Visit.period]</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cqmcommon-lengthindays"> </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: Calculates the difference in calendar days between the start and end of the given interval.
*/
define fluent function lengthInDays(Value Interval<DateTime> ):
difference in days between start of Value and end of Value</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cqmcommon-encounterdiagnosis"> </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 resources referenced by the diagnosis element of the Encounter
*/
define fluent function encounterDiagnosis(Encounter Encounter ):
Encounter.reasonReference D
return singleton from (([ConditionEncounterDiagnosis] union [ConditionProblemsHealthConcerns]) C where D.references(C.id))</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 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">Code System</th>
<td class="content-container">
<em>Description</em>: Code system ConditionVerificationStatusCodes
<br/>
<em>Resource</em>: http://terminology.hl7.org/CodeSystem/condition-ver-status
<br/>
<em>Canonical URL</em>: <tt>http://terminology.hl7.org/CodeSystem/condition-ver-status</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Code System</th>
<td class="content-container">
<em>Description</em>: Code system TaskCodeSystem
<br/>
<em>Resource</em>: http://hl7.org/fhir/CodeSystem/task-code
<br/>
<em>Canonical URL</em>: <tt>http://hl7.org/fhir/CodeSystem/task-code</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Nonelective Inpatient Encounter
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.424
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.424</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Ischemic Stroke
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.247
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.247</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Antithrombotic Therapy for Ischemic Stroke
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.62
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.62</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 Emergency Department Visit
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292</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">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Comfort Measures
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/1.3.6.1.4.1.33895.1.3.0.45
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/1.3.6.1.4.1.33895.1.3.0.45</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Thrombolytic tPA Therapy
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.226
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.226</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Intravenous or Intraarterial Thrombolytic tPA Therapy
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.21
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.21</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Intravenous or Intraarterial Thrombolytic tPA Therapy Prior to Arrival
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.21
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.21</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Medical Reason for Not Providing Treatment
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.473
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.473</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Patient Refusal
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.93
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.93</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Pharmacological Contraindications For Antithrombotic Therapy
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.52
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.52</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set INR
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.213
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.213</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>: Principal Diagnosis
<br/>
<em>Code</em>: principal
<br/>
<em>System</em>: <tt>http://terminology.hl7.org/CodeSystem/ex-diagnosistype</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Direct Reference Code</th>
<td class="content-container">
<em>Display</em>: Refuted
<br/>
<em>Code</em>: refuted
<br/>
<em>System</em>: <tt>http://terminology.hl7.org/CodeSystem/condition-ver-status</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Direct Reference Code</th>
<td class="content-container">
<em>Display</em>: Entered in Error
<br/>
<em>Code</em>: entered-in-error
<br/>
<em>System</em>: <tt>http://terminology.hl7.org/CodeSystem/condition-ver-status</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Direct Reference Code</th>
<td class="content-container">
<em>Display</em>: Fulfill
<br/>
<em>Code</em>: fulfill
<br/>
<em>System</em>: <tt>http://hl7.org/fhir/CodeSystem/task-code</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 TJC
<br/>
<em>Resource</em>: https://madie.cms.gov/Library/TJCOverall|8.25.000
<br/>
<em>Canonical URL</em>: <tt>https://madie.cms.gov/Library/TJCOverall|8.25.000</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, birthDate, birthDate.value
<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, status, status.value, period, 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>: Encounter
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
<br/>
<em>Must Support Elements</em>: type, status, status.value, period, 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/2.16.840.1.113883.3.117.1.7.1.292
<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, 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/2.16.840.1.113883.3.117.1.7.1.424
<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>: 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>: Condition
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns
<br/>
<em>Must Support Elements</em>: code, recordedDate, recordedDate.value, verificationStatus
<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/2.16.840.1.113762.1.4.1110.21
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: MedicationAdministration
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationadministration
<br/>
<em>Must Support Elements</em>: medication, status, status.value, effective, id, id.value
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: medication</span>
<br/>
<span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.62
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: MedicationAdministration
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationadministration
<br/>
<em>Must Support Elements</em>: medication, status, status.value, effective, id, id.value
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: medication</span>
<br/>
<span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.226
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: MedicationAdministration
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationadministration
<br/>
<em>Must Support Elements</em>: medication, status, status.value, effective, id, id.value
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: medication</span>
<br/>
<span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.52
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: MedicationAdministration
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationadministration
<br/>
<em>Must Support Elements</em>: medication.reference.value, status, status.value, effective, id, id.value
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Medication
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medication
<br/>
<em>Must Support Elements</em>: id.value, code
<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 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, status, status.value, intent, intent.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/1.3.6.1.4.1.33895.1.3.0.45
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Procedure
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure
<br/>
<em>Must Support Elements</em>: code, 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/1.3.6.1.4.1.33895.1.3.0.45
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Procedure
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure
<br/>
<em>Must Support Elements</em>: code, status, status.value, id, id.value, performed
<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/2.16.840.1.113762.1.4.1045.21
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: MedicationRequest
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationnotrequested
<br/>
<em>Must Support Elements</em>: medication, reasonCode, status, status.value, intent, intent.value, id, id.value, authoredOn, authoredOn.value
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: medication</span>
<br/>
<span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.62
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: MedicationRequest
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest
<br/>
<em>Must Support Elements</em>: medication, status, status.value, id, id.value, authoredOn, authoredOn.value
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: medication</span>
<br/>
<span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.62
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: MedicationRequest
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest
<br/>
<em>Must Support Elements</em>: medication.reference.value, status, status.value, id, id.value, authoredOn, authoredOn.value
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Task
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-taskrejected
<br/>
<em>Must Support Elements</em>: focus, statusReason, code
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: MedicationAdministration
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationadministrationnotdone
<br/>
<em>Must Support Elements</em>: medication, statusReason, id, id.value, extension
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: medication</span>
<br/>
<span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.62
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Observation
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation-lab
<br/>
<em>Must Support Elements</em>: code, value, status, status.value, issued, issued.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/2.16.840.1.113883.3.117.1.7.1.213
<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/ex-diagnosistype"/>
<code value="principal"/>
<display value="Principal Diagnosis"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
<valueCoding>
<system
value="http://terminology.hl7.org/CodeSystem/condition-ver-status"/>
<code value="refuted"/>
<display value="Refuted"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
<valueCoding>
<system
value="http://terminology.hl7.org/CodeSystem/condition-ver-status"/>
<code value="entered-in-error"/>
<display value="Entered in Error"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
<valueCoding>
<system value="http://hl7.org/fhir/CodeSystem/task-code"/>
<code value="fulfill"/>
<display value="Fulfill"/>
</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="CMS72FHIRSTKAntithromboticDay2"/>
</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="TJCOverall"/>
</extension>
<extension url="name">
<valueString value="Non Elective Inpatient Encounter With Age"/>
</extension>
<extension url="statement">
<valueString
value="define "Non Elective Inpatient Encounter With Age":
["Encounter": "Nonelective Inpatient Encounter"] NonElectiveEncounter
where AgeInYearsAt(date from start of NonElectiveEncounter.period ) >= 18
and NonElectiveEncounter.period ends during day of "Measurement Period""/>
</extension>
<extension url="displaySequence">
<valueInteger value="2"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="TJCOverall"/>
</extension>
<extension url="name">
<valueString value="Ischemic Stroke Encounter"/>
</extension>
<extension url="statement">
<valueString
value="define "Ischemic Stroke Encounter":
"Non Elective Inpatient Encounter With Age" NonElectiveEncounterWithAge
where NonElectiveEncounterWithAge.hasPrincipalDiagnosisOf("Ischemic Stroke" )"/>
</extension>
<extension url="displaySequence">
<valueInteger value="3"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS72FHIRSTKAntithromboticDay2"/>
</extension>
<extension url="name">
<valueString value="Encounter With Antithrombotic Therapy"/>
</extension>
<extension url="statement">
<valueString
value="define "Encounter With Antithrombotic Therapy":
TJC."Ischemic Stroke Encounter" IschemicStrokeEncounter
with ["MedicationAdministration": "Antithrombotic Therapy for Ischemic Stroke"] Antithrombotic
such that Antithrombotic.status in { 'in-progress', 'completed' }
and Antithrombotic.effective.toInterval ( ) starts during day of ( start of IschemicStrokeEncounter.hospitalizationWithObservation ( ) ).calendarDayOfOrDayAfter ( )"/>
</extension>
<extension url="displaySequence">
<valueInteger value="4"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS72FHIRSTKAntithromboticDay2"/>
</extension>
<extension url="name">
<valueString value="Numerator"/>
</extension>
<extension url="statement">
<valueString
value="define "Numerator":
"Encounter With Antithrombotic Therapy""/>
</extension>
<extension url="displaySequence">
<valueInteger value="5"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS72FHIRSTKAntithromboticDay2"/>
</extension>
<extension url="name">
<valueString value="Initial Population"/>
</extension>
<extension url="statement">
<valueString
value="define "Initial Population":
TJC."Ischemic Stroke Encounter""/>
</extension>
<extension url="displaySequence">
<valueInteger value="6"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS72FHIRSTKAntithromboticDay2"/>
</extension>
<extension url="name">
<valueString value="Denominator"/>
</extension>
<extension url="statement">
<valueString
value="define "Denominator":
"Initial Population""/>
</extension>
<extension url="displaySequence">
<valueInteger value="7"/>
</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="8"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS72FHIRSTKAntithromboticDay2"/>
</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="9"/>
</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="10"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS72FHIRSTKAntithromboticDay2"/>
</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="11"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS72FHIRSTKAntithromboticDay2"/>
</extension>
<extension url="name">
<valueString value="Encounter Less Than Two Days"/>
</extension>
<extension url="statement">
<valueString
value="define "Encounter Less Than Two Days":
TJC."Ischemic Stroke Encounter" IschemicStrokeEncounter
where IschemicStrokeEncounter.hospitalizationWithObservation ( ).lengthInDays ( ) < 2"/>
</extension>
<extension url="displaySequence">
<valueInteger value="12"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="TJCOverall"/>
</extension>
<extension url="name">
<valueString value="Intervention Comfort Measures"/>
</extension>
<extension url="statement">
<valueString
value="define "Intervention Comfort Measures":
( ["ServiceRequest": "Comfort Measures"] ComfortCare
where ComfortCare.status in { 'active', 'completed', 'on-hold' }
and ComfortCare.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }
)
union ( ["Procedure": "Comfort Measures"] ComfortCarePerformed
where ComfortCarePerformed.status in { 'completed', 'in-progress' }
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="13"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS72FHIRSTKAntithromboticDay2"/>
</extension>
<extension url="name">
<valueString
value="Encounter With Comfort Measures During Day Of Or Day After Arrival"/>
</extension>
<extension url="statement">
<valueString
value="define "Encounter With Comfort Measures During Day Of Or Day After Arrival":
TJC."Ischemic Stroke Encounter" IschemicStrokeEncounter
with TJC."Intervention Comfort Measures" ComfortMeasure
such that Coalesce(start of ComfortMeasure.performed.toInterval(), ComfortMeasure.authoredOn) during day of ( start of IschemicStrokeEncounter.hospitalizationWithObservation ( ) ).calendarDayOfOrDayAfter ( )"/>
</extension>
<extension url="displaySequence">
<valueInteger value="14"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS72FHIRSTKAntithromboticDay2"/>
</extension>
<extension url="name">
<valueString value="Thrombolytic Therapy Medication Or Procedures"/>
</extension>
<extension url="statement">
<valueString
value="define "Thrombolytic Therapy Medication Or Procedures":
( ["MedicationAdministration": "Thrombolytic tPA Therapy"] ThrombolyticMedication
where ThrombolyticMedication.status in { 'in-progress', 'completed' }
return {
id: ThrombolyticMedication.id,
effective: ThrombolyticMedication.effective
}
)
union ( ["Procedure": "Intravenous or Intraarterial Thrombolytic tPA Therapy"] ThrombolyticProcedure
where ThrombolyticProcedure.status = 'completed'
return {
id: ThrombolyticProcedure.id,
effective: ThrombolyticProcedure.performed
}
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="15"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS72FHIRSTKAntithromboticDay2"/>
</extension>
<extension url="name">
<valueString
value="Encounter With Thrombolytic Therapy Medication Or Procedures"/>
</extension>
<extension url="statement">
<valueString
value="define "Encounter With Thrombolytic Therapy Medication Or Procedures":
TJC."Ischemic Stroke Encounter" IschemicStrokeEncounter
with "Thrombolytic Therapy Medication Or Procedures" ThrombolyticTherapy
such that ThrombolyticTherapy.effective.toInterval ( ) starts during Interval[start of IschemicStrokeEncounter.hospitalizationWithObservation ( ) - 24 hours, end of IschemicStrokeEncounter.hospitalizationWithObservation ( ) )"/>
</extension>
<extension url="displaySequence">
<valueInteger value="16"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS72FHIRSTKAntithromboticDay2"/>
</extension>
<extension url="name">
<valueString
value="Encounter With Thrombolytic Therapy Prior To Arrival"/>
</extension>
<extension url="statement">
<valueString
value="define "Encounter With Thrombolytic Therapy Prior To Arrival":
TJC."Ischemic Stroke Encounter" IschemicStrokeEncounter
where exists ( ( IschemicStrokeEncounter.encounterDiagnosis ( ) ) EncounterDiagnosis
where EncounterDiagnosis.code in "Intravenous or Intraarterial Thrombolytic tPA Therapy Prior to Arrival"
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="17"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS72FHIRSTKAntithromboticDay2"/>
</extension>
<extension url="name">
<valueString
value="Encounter With Thrombolytic Therapy Documented As Already Given"/>
</extension>
<extension url="statement">
<valueString
value="define "Encounter With Thrombolytic Therapy Documented As Already Given":
( TJC."Ischemic Stroke Encounter" IschemicStrokeEncounter
where exists [ConditionProblemsHealthConcerns: "Intravenous or Intraarterial Thrombolytic tPA Therapy Prior to Arrival"] PriorTPA
where PriorTPA.recordedDate during IschemicStrokeEncounter.hospitalizationWithObservation ( )
and PriorTPA.verificationStatus is not null implies ( PriorTPA.verificationStatus !~ QICoreCommon."refuted"
and PriorTPA.verificationStatus !~ QICoreCommon."entered-in-error"
)
)
union TJC."Ischemic Stroke Encounter" IschemicStrokeEncounter
where exists ( ( IschemicStrokeEncounter.encounterDiagnosis ( ) ) EncounterDiagnosis
where EncounterDiagnosis.code in "Intravenous or Intraarterial Thrombolytic tPA Therapy Prior to Arrival"
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="18"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS72FHIRSTKAntithromboticDay2"/>
</extension>
<extension url="name">
<valueString
value="Encounter With Thrombolytic Therapy Given Prior To Arrival Or During Hospitalization"/>
</extension>
<extension url="statement">
<valueString
value="define "Encounter With Thrombolytic Therapy Given Prior To Arrival Or During Hospitalization":
"Encounter With Thrombolytic Therapy Medication Or Procedures"
union "Encounter With Thrombolytic Therapy Prior To Arrival"
union "Encounter With Thrombolytic Therapy Documented As Already Given""/>
</extension>
<extension url="displaySequence">
<valueInteger value="19"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS72FHIRSTKAntithromboticDay2"/>
</extension>
<extension url="name">
<valueString value="Denominator Exclusions"/>
</extension>
<extension url="statement">
<valueString
value="define "Denominator Exclusions":
"Encounter Less Than Two Days"
union "Encounter With Comfort Measures During Day Of Or Day After Arrival"
union "Encounter With Thrombolytic Therapy Given Prior To Arrival Or During Hospitalization""/>
</extension>
<extension url="displaySequence">
<valueInteger value="20"/>
</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="21"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS72FHIRSTKAntithromboticDay2"/>
</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="22"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS72FHIRSTKAntithromboticDay2"/>
</extension>
<extension url="name">
<valueString value="Reason For Not Ordering Antithrombotic"/>
</extension>
<extension url="statement">
<valueString
value="define "Reason For Not Ordering Antithrombotic":
( ["MedicationNotRequested": "Antithrombotic Therapy for Ischemic Stroke"] NoAntithromboticOrder
where ( NoAntithromboticOrder.reasonCode in "Medical Reason for Not Providing Treatment"
or NoAntithromboticOrder.reasonCode in "Patient Refusal"
)
and NoAntithromboticOrder.status in { 'active', 'completed' }
and NoAntithromboticOrder.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }
return {
id: NoAntithromboticOrder.id,
authoredOn: NoAntithromboticOrder.authoredOn
}
)
union ( ["MedicationRequest": "Antithrombotic Therapy for Ischemic Stroke"] MedReqAntithrombotic
with ["TaskRejected"] TaskReject
such that TaskReject.focus.references ( MedReqAntithrombotic )
and ( TaskReject.statusReason in "Medical Reason for Not Providing Treatment"
or TaskReject.statusReason in "Patient Refusal"
)
and ( MedReqAntithrombotic.status in { 'active', 'completed' }
and TaskReject.code ~ QICoreCommon."Fulfill"
)
return {
id: MedReqAntithrombotic.id,
authoredOn: MedReqAntithrombotic.authoredOn
}
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="23"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS72FHIRSTKAntithromboticDay2"/>
</extension>
<extension url="name">
<valueString value="Reason For Not Administering Antithrombotic"/>
</extension>
<extension url="statement">
<valueString
value="define "Reason For Not Administering Antithrombotic":
["MedicationAdministrationNotDone": "Antithrombotic Therapy for Ischemic Stroke"] MedicationAdm
where ( MedicationAdm.statusReason in "Medical Reason for Not Providing Treatment"
or MedicationAdm.statusReason in "Patient Refusal"
)
return {
id: MedicationAdm.id,
authoredOn: MedicationAdm.recorded
}"/>
</extension>
<extension url="displaySequence">
<valueInteger value="24"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS72FHIRSTKAntithromboticDay2"/>
</extension>
<extension url="name">
<valueString
value="Documented Reason For No Antithrombotic Ordered Or Administered"/>
</extension>
<extension url="statement">
<valueString
value="define "Documented Reason For No Antithrombotic Ordered Or Administered":
"Reason For Not Ordering Antithrombotic"
union "Reason For Not Administering Antithrombotic""/>
</extension>
<extension url="displaySequence">
<valueInteger value="25"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS72FHIRSTKAntithromboticDay2"/>
</extension>
<extension url="name">
<valueString
value="Encounter With Documented Reason For No Antithrombotic Ordered Or Administered Day Of Or Day After Hospital Arrival"/>
</extension>
<extension url="statement">
<valueString
value="define "Encounter With Documented Reason For No Antithrombotic Ordered Or Administered Day Of Or Day After Hospital Arrival":
TJC."Ischemic Stroke Encounter" IschemicStrokeEncounter
with "Documented Reason For No Antithrombotic Ordered Or Administered" NoAntithrombotic
such that NoAntithrombotic.authoredOn during day of ( start of IschemicStrokeEncounter.hospitalizationWithObservation ( ) ).calendarDayOfOrDayAfter ( )"/>
</extension>
<extension url="displaySequence">
<valueInteger value="26"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS72FHIRSTKAntithromboticDay2"/>
</extension>
<extension url="name">
<valueString
value="Encounter With Pharmacological Contraindications For Antithrombotic Therapy Given Day Of Or Day After Hospital Arrival"/>
</extension>
<extension url="statement">
<valueString
value="define "Encounter With Pharmacological Contraindications For Antithrombotic Therapy Given Day Of Or Day After Hospital Arrival":
TJC."Ischemic Stroke Encounter" IschemicStrokeEncounter
with ["MedicationAdministration": "Pharmacological Contraindications For Antithrombotic Therapy"] PharmacologicalContraindications
such that PharmacologicalContraindications.status in { 'in-progress', 'completed' }
and PharmacologicalContraindications.effective.toInterval ( ) starts during day of ( start of IschemicStrokeEncounter.hospitalizationWithObservation ( ) ).calendarDayOfOrDayAfter ( )"/>
</extension>
<extension url="displaySequence">
<valueInteger value="27"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS72FHIRSTKAntithromboticDay2"/>
</extension>
<extension url="name">
<valueString value="Encounter With An INR Greater Than 3.5"/>
</extension>
<extension url="statement">
<valueString
value="define "Encounter With An INR Greater Than 3.5":
TJC."Ischemic Stroke Encounter" IschemicStrokeEncounter
with ["LaboratoryResultObservation": "INR"] INR
such that INR.value as Quantity > 3.5
and INR.status in { 'final', 'amended', 'corrected' }
and INR.issued during day of ( start of IschemicStrokeEncounter.hospitalizationWithObservation ( ) ).calendarDayOfOrDayAfter ( )"/>
</extension>
<extension url="displaySequence">
<valueInteger value="28"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS72FHIRSTKAntithromboticDay2"/>
</extension>
<extension url="name">
<valueString value="Denominator Exceptions"/>
</extension>
<extension url="statement">
<valueString
value="define "Denominator Exceptions":
"Encounter With Documented Reason For No Antithrombotic Ordered Or Administered Day Of Or Day After Hospital Arrival"
union "Encounter With Pharmacological Contraindications For Antithrombotic Therapy Given Day Of Or Day After Hospital Arrival"
union "Encounter With An INR Greater Than 3.5""/>
</extension>
<extension url="displaySequence">
<valueInteger value="29"/>
</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="30"/>
</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="31"/>
</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="32"/>
</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="33"/>
</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="34"/>
</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="35"/>
</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="36"/>
</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="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="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="40"/>
</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="41"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="TJCOverall"/>
</extension>
<extension url="name">
<valueString value="calendarDayOfOrDayAfter"/>
</extension>
<extension url="statement">
<valueString
value="define fluent function calendarDayOfOrDayAfter(StartValue DateTime):
Interval [date from (StartValue), date from (StartValue) + 1 day]"/>
</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="hospitalizationWithObservation"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Hospitalization with Observation returns the total interval from the start of any immediately prior emergency department visit through the observation visit to the discharge of the given encounter
*/
define fluent function hospitalizationWithObservation(TheEncounter Encounter ):
TheEncounter Visit
let ObsVisit: Last([Encounter: "Observation Services"] LastObs
where LastObs.status = 'finished'
and LastObs.period ends 1 hour or less on or before start of Visit.period
sort by end of period
),
VisitStart: Coalesce(start of ObsVisit.period, start of Visit.period),
EDVisit: Last([Encounter: "Emergency Department Visit"] LastED
where LastED.status = 'finished'
and LastED.period ends 1 hour or less on or before VisitStart
sort by end of period
)
return Interval[Coalesce(start of EDVisit.period, VisitStart), end of Visit.period]"/>
</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="lengthInDays"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Calculates the difference in calendar days between the start and end of the given interval.
*/
define fluent function lengthInDays(Value Interval<DateTime> ):
difference in days between start of Value and end of Value"/>
</extension>
<extension url="displaySequence">
<valueInteger value="44"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="QICoreCommon"/>
</extension>
<extension url="name">
<valueString value="toInterval"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Normalizes a value that is a choice of timing-valued types to an equivalent interval
@comment: Normalizes a choice type of DateTime, Quanitty, Interval<DateTime>, or Interval<Quantity> types
to an equivalent interval. This selection of choice types is a superset of the majority of choice types that are used as possible
representations for timing-valued elements in QICore, allowing this function to be used across any resource.
The input can be provided as a DateTime, Quantity, Interval<DateTime> or Interval<Quantity>.
The intent of this function is to provide a clear and concise mechanism to treat single
elements that have multiple possible representations as intervals so that logic doesn't have to account
for the variability. More complex calculations (such as medication request period or dispense period
calculation) need specific guidance and consideration. That guidance may make use of this function, but
the focus of this function is on single element calculations where the semantics are unambiguous.
If the input is a DateTime, the result a DateTime Interval beginning and ending on that DateTime.
If the input is a Quantity, the quantity is expected to be a calendar-duration interpreted as an Age,
and the result is a DateTime Interval beginning on the Date the patient turned that age and ending immediately before one year later.
If the input is a DateTime Interval, the result is the input.
If the input is a Quantity Interval, the quantities are expected to be calendar-durations interpreted as an Age, and the result
is a DateTime Interval beginning on the date the patient turned the age given as the start of the quantity interval, and ending
immediately before one year later than the date the patient turned the age given as the end of the quantity interval.
If the input is a Timing, an error will be thrown indicating that Timing calculations are not implemented. Any other input will reslt in a null DateTime Interval
*/
define fluent function toInterval(choice Choice<DateTime, Quantity, Interval<DateTime>, Interval<Quantity>, Timing>):
case
when choice is DateTime then
Interval[choice as DateTime, choice as DateTime]
when choice is Interval<DateTime> then
choice as Interval<DateTime>
when choice is Quantity then
Interval[Patient.birthDate + (choice as Quantity),
Patient.birthDate + (choice as Quantity) + 1 year)
when choice is Interval<Quantity> then
Interval[Patient.birthDate + (choice.low as Quantity),
Patient.birthDate + (choice.high as Quantity) + 1 year)
when choice is Timing then
Message(null, true, 'NOT_IMPLEMENTED', 'Error', 'Calculation of an interval from a Timing value is not supported') as Interval<DateTime>
else
null as Interval<DateTime>
end"/>
</extension>
<extension url="displaySequence">
<valueInteger value="45"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CQMCommon"/>
</extension>
<extension url="name">
<valueString value="encounterDiagnosis"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Returns the Condition resources referenced by the diagnosis element of the Encounter
*/
define fluent function encounterDiagnosis(Encounter Encounter ):
Encounter.reasonReference D
return singleton from (([ConditionEncounterDiagnosis] union [ConditionProblemsHealthConcerns]) C where D.references(C.id))"/>
</extension>
<extension url="displaySequence">
<valueInteger value="46"/>
</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 TJC"/>
<resource value="https://madie.cms.gov/Library/TJCOverall|8.25.000"/>
</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 Diagnosis Type"/>
<resource
value="http://terminology.hl7.org/CodeSystem/ex-diagnosistype"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Code system ConditionVerificationStatusCodes"/>
<resource
value="http://terminology.hl7.org/CodeSystem/condition-ver-status"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Code system TaskCodeSystem"/>
<resource value="http://hl7.org/fhir/CodeSystem/task-code"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Nonelective Inpatient Encounter"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.424"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Ischemic Stroke"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.247"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display
value="Value set Antithrombotic Therapy for Ischemic Stroke"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.62"/>
</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 Emergency Department Visit"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292"/>
</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>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Comfort Measures"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/1.3.6.1.4.1.33895.1.3.0.45"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Thrombolytic tPA Therapy"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.226"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display
value="Value set Intravenous or Intraarterial Thrombolytic tPA Therapy"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.21"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display
value="Value set Intravenous or Intraarterial Thrombolytic tPA Therapy Prior to Arrival"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.21"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display
value="Value set Medical Reason for Not Providing Treatment"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.473"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Patient Refusal"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.93"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display
value="Value set Pharmacological Contraindications For Antithrombotic Therapy"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.52"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set INR"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.213"/>
</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="Denominator Exclusions"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Resource"/>
</parameter>
<parameter>
<name value="Denominator Exceptions"/>
<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>
<dataRequirement>
<type value="Patient"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"/>
<mustSupport value="extension"/>
<mustSupport value="url"/>
<mustSupport value="birthDate"/>
<mustSupport value="birthDate.value"/>
</dataRequirement>
<dataRequirement>
<type value="Encounter"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"/>
<mustSupport value="type"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="period"/>
<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="Encounter"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"/>
<mustSupport value="type"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="period"/>
<mustSupport value="diagnosis"/>
<mustSupport value="diagnosis.code"/>
<codeFilter>
<path value="type"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292"/>
</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="diagnosis"/>
<mustSupport value="diagnosis.code"/>
<codeFilter>
<path value="type"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.424"/>
</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="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="Condition"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns"/>
<mustSupport value="code"/>
<mustSupport value="recordedDate"/>
<mustSupport value="recordedDate.value"/>
<mustSupport value="verificationStatus"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.21"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="MedicationAdministration"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationadministration"/>
<mustSupport value="medication"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="effective"/>
<mustSupport value="id"/>
<mustSupport value="id.value"/>
<codeFilter>
<path value="medication"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.62"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="MedicationAdministration"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationadministration"/>
<mustSupport value="medication"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="effective"/>
<mustSupport value="id"/>
<mustSupport value="id.value"/>
<codeFilter>
<path value="medication"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.226"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="MedicationAdministration"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationadministration"/>
<mustSupport value="medication"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="effective"/>
<mustSupport value="id"/>
<mustSupport value="id.value"/>
<codeFilter>
<path value="medication"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.52"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="MedicationAdministration"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationadministration"/>
<mustSupport value="medication.reference.value"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="effective"/>
<mustSupport value="id"/>
<mustSupport value="id.value"/>
</dataRequirement>
<dataRequirement>
<type value="Medication"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medication"/>
<mustSupport value="id.value"/>
<mustSupport value="code"/>
</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>
<dataRequirement>
<type value="ServiceRequest"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest"/>
<mustSupport value="code"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="intent"/>
<mustSupport value="intent.value"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/1.3.6.1.4.1.33895.1.3.0.45"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Procedure"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure"/>
<mustSupport value="code"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/1.3.6.1.4.1.33895.1.3.0.45"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Procedure"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure"/>
<mustSupport value="code"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="id"/>
<mustSupport value="id.value"/>
<mustSupport value="performed"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.21"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="MedicationRequest"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationnotrequested"/>
<mustSupport value="medication"/>
<mustSupport value="reasonCode"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="intent"/>
<mustSupport value="intent.value"/>
<mustSupport value="id"/>
<mustSupport value="id.value"/>
<mustSupport value="authoredOn"/>
<mustSupport value="authoredOn.value"/>
<codeFilter>
<path value="medication"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.62"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="MedicationRequest"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationnotrequested"/>
<mustSupport value="medication"/>
<mustSupport value="reasonCode"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="intent"/>
<mustSupport value="intent.value"/>
<mustSupport value="id"/>
<mustSupport value="id.value"/>
<mustSupport value="authoredOn"/>
<mustSupport value="authoredOn.value"/>
<codeFilter>
<path value="medication"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.62"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="MedicationRequest"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest"/>
<mustSupport value="medication"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="id"/>
<mustSupport value="id.value"/>
<mustSupport value="authoredOn"/>
<mustSupport value="authoredOn.value"/>
<codeFilter>
<path value="medication"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.62"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="MedicationRequest"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest"/>
<mustSupport value="medication.reference.value"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="id"/>
<mustSupport value="id.value"/>
<mustSupport value="authoredOn"/>
<mustSupport value="authoredOn.value"/>
</dataRequirement>
<dataRequirement>
<type value="Task"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-taskrejected"/>
<mustSupport value="focus"/>
<mustSupport value="statusReason"/>
<mustSupport value="code"/>
</dataRequirement>
<dataRequirement>
<type value="MedicationAdministration"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationadministrationnotdone"/>
<mustSupport value="medication"/>
<mustSupport value="statusReason"/>
<mustSupport value="id"/>
<mustSupport value="id.value"/>
<mustSupport value="extension"/>
<codeFilter>
<path value="medication"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.62"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="MedicationAdministration"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationadministrationnotdone"/>
<mustSupport value="medication"/>
<mustSupport value="statusReason"/>
<mustSupport value="id"/>
<mustSupport value="id.value"/>
<mustSupport value="extension"/>
<codeFilter>
<path value="medication"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.62"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Observation"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation-lab"/>
<mustSupport value="code"/>
<mustSupport value="value"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="issued"/>
<mustSupport value="issued.value"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.213"/>
</codeFilter>
</dataRequirement>
</Library>
</contained>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-supplementalDataGuidance" id="supplementalDataGuidance">
<extension url="guidance">
<valueString
value="<p>For every patient evaluated by this measure also identify payer, race, ethnicity and sex</p>"/>
</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/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements">
<valueReference>
<reference value="#effective-data-requirements"/>
</valueReference>
</extension>
<url value="https://madie.cms.gov/Measure/CMS72FHIRSTKAntithromboticDay2"/>
<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="CMS72FHIR"/>
</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:b6ae4357-9baa-4195-a9cd-50391b7d0dab"/>
</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:5de3156a-7293-40aa-9ec3-f3df76d3579c"/>
</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="72FHIR"/>
<assigner>
<display value="CMS"/>
</assigner>
</identifier>
<version value="1.0.000"/>
<name value="CMS72FHIRSTKAntithromboticDay2"/>
<title value="Antithrombotic Therapy by End of Hospital Day 2FHIR
"/>
<status value="active"/>
<experimental value="false"/>
<date value="2025-08-25T20:35:56+00:00"/>
<publisher value="The Joint Commission"/>
<contact>
<telecom>
<system value="url"/>
<value value="https://www.jointcommission.org/"/>
</telecom>
</contact>
<description
value="Ischemic stroke patients administered antithrombotic therapy by the end of hospital day 2
"/>
<usage
value="The "Nonelective Inpatient Encounter" value set intends to capture all non-scheduled hospitalizations. This value set is a subset of the "Inpatient Encounter" value set, excluding concepts that specifically refer to elective hospital admissions. Non-elective Inpatient Encounters include emergency, urgent, and unplanned admissions.
NPO (Nothing by mouth) is not a valid reason for not administering antithrombotic therapy by end of hospital day 2 as another route of administration can be used (i.e., rectal or intravenous).
In the denominator exclusions, the intent is to only exclude patients with a total length of stay of \<2 days, including Emergency Department (ED) visit (if there is one). For the dQM we model both of the scenarios of admission via the ED as well as direct admits. This statement addresses direct admits.
The denominator population includes patients with inpatient hospitalizations and patients from Acute Hospital Care at Home programs, who are treated and billed as inpatients but receive care in their home.
This dQM is an episode-based measure. An episode is defined as each inpatient hospitalization or encounter that ends during the measurement period. This FHIR-based measure has been derived from the QDM-based measure: CMS72v14. 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="Measure specifications are in the Public Domain
LOINC(R) copyright 2004-2024 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT\[R\]) copyright 2004-2024 International Health Terminology Standards Development Organisation. ICD-10 copyright 2024 World Health Organization. All Rights Reserved.
"/>
<effectivePeriod>
<start value="2026-01-01"/>
<end value="2026-12-31"/>
</effectivePeriod>
<author>
<name value="The Joint Commission"/>
<telecom>
<system value="url"/>
<value value="https://www.jointcommission.org/"/>
</telecom>
</author>
<relatedArtifact>
<type value="citation"/>
<citation
value="Adams, H. P., Jr., del Zoppo, G., Alberts, M. J., et al. (2007, May). Guidelines for the early management of adults with ischemic stroke: A guideline from the American Heart Association/American Stroke Association Stroke Council, Clinical Cardiology Council, Cardiovascular Radiology and Intervention Council, and the Atherosclerotic Peripheral Vascular Disease and Quality of Care Outcomes in Research Interdisciplinary Working Groups. Stroke, 38(5), 1655-1711.
"/>
</relatedArtifact>
<relatedArtifact>
<type value="citation"/>
<citation
value="Adams, H., Adams, R., del Zoppo, G., et al. (2005, April). Guidelines for the early management of patients with ischemic stroke: 2005 guidelines update-A scientific statement from the Stroke Council of the American Heart Association/American Stroke Association. Stroke, 36(4): 916-923.
"/>
</relatedArtifact>
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<type value="citation"/>
<citation
value="Albers, G. W, Amarenco, P., Easton, J. D., et al. (2001). Antithrombotic and thrombolytic therapy for ischemic stroke. Chest, 119, 300-320.
"/>
</relatedArtifact>
<relatedArtifact>
<type value="citation"/>
<citation
value="Antithrombotic Trialists' Collaboration. (2002, January 12). Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high-risk patients. BMJ, 324(7329), 71-86.
"/>
</relatedArtifact>
<relatedArtifact>
<type value="citation"/>
<citation
value="Brott, T. G., Clark, W. M., Fagan, S. C., et al. (2000). Stroke: The first hours. Guidelines for acute treatment. Washington, DC: National Stroke Association.
"/>
</relatedArtifact>
<relatedArtifact>
<type value="citation"/>
<citation
value="Centers for Disease Control and Prevention. (2009, May 1). Prevalence and most common causes of disability among adults-United States, 2005. Morbidity and Mortality Weekly Report, 58(16), 421-426.
"/>
</relatedArtifact>
<relatedArtifact>
<type value="citation"/>
<citation
value="Chen, Z. M., Sandercock, P., Pan, H. C., et al. (2000, June). Indications for early aspirin use in acute ischemic stroke: A combined analysis of 40,000 randomized patients from the Chinese Acute Stroke Trial and the International Stroke Trial. Stroke, 31(6), 1240-1249.
"/>
</relatedArtifact>
<relatedArtifact>
<type value="citation"/>
<citation
value="Coull, B. M., Williams, L. S., Goldstein, L. B., et al. (2002, July). Anticoagulants and antiplatelet agents in acute ischemic stroke: Report of the Joint Stroke Guideline Development Committee of the American Academy of Neurology and the American Stroke Association (a Division of the American Heart Association). Stroke, 33(7), 1934-1942.
"/>
</relatedArtifact>
<relatedArtifact>
<type value="citation"/>
<citation
value="Eccles, M., Freemantle, N., \& Mason, J. (1998, April 25). North of England Evidence-Based Guideline Development Project: Guideline on the use of aspirin as secondary prophylaxis for vascular disease in primary care. BMJ, 316(7140), 1303-1309.
"/>
</relatedArtifact>
<relatedArtifact>
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<citation
value="ESPS Group. (1987, December 12). The European Stroke Prevention Study (ESPS): Principal end-points. Lancet, 2(8572), 1351-1354.
"/>
</relatedArtifact>
<relatedArtifact>
<type value="citation"/>
<citation
value="Furie, K. L., Kasner, S. E., Adams, R. J., et al. (2011, January). Guidelines for the prevention of stroke in patients with stroke or transient ischemic attack: A guideline for health care professionals from the American Heart Association/American Stroke Association. Stroke, 42(1), 227-276.
"/>
</relatedArtifact>
<relatedArtifact>
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<citation
value="Gaspoz, J. M., Coxson, P. G., Goldman, P. A., et al. (2002, June 6). Cost effectiveness of aspirin, clopidogrel, or both for secondary prevention of coronary heart disease. New England Journal of Medicine, 346(23), 1800-1806.
"/>
</relatedArtifact>
<relatedArtifact>
<type value="citation"/>
<citation
value="Guyatt, G. H., Akl, E. A., Crowther, M., et al. (2012, February). Executive summary: Antithrombotic therapy and prevention of thrombosis, 9th ed.: American College of Chest Physicians evidence-based clinical practice guidelines. Chest, 141(2 Suppl.), 7S-47S.
"/>
</relatedArtifact>
<relatedArtifact>
<type value="citation"/>
<citation
value="International Stroke Trial Collaborative Group. (1997, May 31). The International Stroke Trial (IST): A randomised trial of aspirin, subcutaneous heparin, both, or neither among 19,435 patients with acute ischaemic stroke. Lancet, 349(9065), 1569-1581.
"/>
</relatedArtifact>
<relatedArtifact>
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value="Jauch, E. C., Saver, J. L., Adams, H. P., Jr., et al. (2013). Guidelines for the early management of patients with acute ischemic stroke: A guideline for health care professionals from the American Heart Association/American Stroke Association. Stroke, 44(3), 870-947.
"/>
</relatedArtifact>
<relatedArtifact>
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<citation
value="Johnson, E. S., Lanes, S. F., Wentworth, C. E., III, et al. (1999, June 14). A metaregression analysis of the dose-response effect of aspirin on stroke. Archives of Internal Medicine, 159(11), 1248-1253.
"/>
</relatedArtifact>
<relatedArtifact>
<type value="citation"/>
<citation
value="Powers, W. J., Rabinstein, A. A., Ackerson, T., et al. (2018, January). 2018 guidelines for the early management of patients with acute ischemic stroke: A guideline for health care professionals from the American Heart Association/American Stroke Association. Stroke, 49,
"/>
</relatedArtifact>
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<type value="citation"/>
<citation
value="Roger, V. L., Go, A. S., Lloyd-Jones, D. M., et al. (2012, January 3). Heart disease and stroke statistics-2012 update: A report from the American Heart Association. Circulation, 125(1), e2-e220.
"/>
</relatedArtifact>
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<citation
value="Sacco, R. L., Adams, R., Albers, G., et al. (2006, February). Guidelines for prevention of stroke in patients with ischemic stroke or transient ischemic attack: A statement for health care professionals from the American Heart Association/American Stroke Association Council on Stroke: Co-sponsored by the Council on Cardiovascular Radiology and Intervention: The American Academy of Neurology affirms the value of this guideline. Stroke, 37(2), 577-617.
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<library
value="https://madie.cms.gov/Library/CMS72FHIRSTKAntithromboticDay2"/>
<disclaimer
value="These performance measures 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 without warranty.
"/>
<rationale
value="The effectiveness of antithrombotic agents in reducing stroke mortality, stroke-related morbidity and recurrence rates has been studied in several large clinical trials. While the use of these agents for patients with acute ischemic stroke and transient ischemic attacks (TIA) continues to be the subject of study, substantial evidence is available from completed studies. Data at this time suggest that antithrombotic therapy should be administered within 2 days of symptom onset in acute ischemic stroke patients to reduce stroke mortality and morbidity as long as no contraindications exist.
Aspirin is the recommended antithrombotic medication for early antithrombotic therapy and most frequently administered unless contraindicated. Anticoagulants at doses to prevent venous thromboembolism (VTE) are insufficient. Subcutaneous Lovenox (enoxaparin) and unfractionated heparin (UFH) SQ at lower dosages used for VTE prophylaxis (i.e., enoxaparin SQ 40 mg once daily; enoxaparin SQ 30 mg Q12 hours; UFH 5,000 units or less two or three times daily) are not sufficient for early antithrombotic therapy.
Anticoagulants at doses to prevent VTE are insufficient antithrombotic therapy to prevent recurrent ischemic stroke or TIA.
"/>
<clinicalRecommendationStatement
value="Antithrombotic therapy should be administered within 2 days of symptom onset in acute ischemic stroke patients to reduce stroke mortality and morbidity as long as no contraindications exist
"/>
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url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring">
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<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-scoring"/>
<code value="proportion"/>
<display value="Proportion"/>
</coding>
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url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis">
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url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-type">
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<system value="http://terminology.hl7.org/CodeSystem/measure-type"/>
<code value="process"/>
<display value="Process"/>
</coding>
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</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="increase"/>
<display value="Increased score indicates improvement"/>
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<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="initial-population"/>
<display value="Initial Population"/>
</coding>
</code>
<description
value="Inpatient hospitalization (non-elective admissions) for patients age 18 and older, discharged from inpatient care with a principal diagnosis of ischemic stroke that ends during the measurement period
"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Initial Population"/>
</criteria>
</population>
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value="http://terminology.hl7.org/CodeSystem/measure-population"/>
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<display value="Denominator"/>
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<description value="Equals Initial Population
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<criteria>
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<expression value="Denominator"/>
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</population>
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value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="denominator-exclusion"/>
<display value="Denominator Exclusion"/>
</coding>
</code>
<description
value="* Inpatient hospitalization for patients who have a duration of stay less than 2 days.
* Inpatient hospitalization for patients with comfort measures documented day of or the day after arrival.
* Inpatient hospitalization for patients with intra-venous or intra-arterial Thrombolytic (t-PA) Therapy administered within 24 hours prior to arrival or anytime during hospitalization.
"/>
<criteria>
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<expression value="Denominator Exclusions"/>
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</population>
<population id="Numerator_1">
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<coding>
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value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="numerator"/>
<display value="Numerator"/>
</coding>
</code>
<description
value="Inpatient hospitalization for patients who had antithrombotic therapy administered the day of or day after hospital arrival
"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Numerator"/>
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</population>
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value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="denominator-exception"/>
<display value="Denominator Exception"/>
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</code>
<description
value="* Inpatient hospitalization for patients with a documented reason for not administering antithrombotic therapy the day of or day after hospital arrival
* Inpatient hospitalization for patients who receive Prasugrel as an antithrombotic therapy the day of or day after hospital arrival
* Inpatient hospitalization for patients with an international normalized ratio (INR) greater than 3.5
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<expression value="Denominator Exceptions"/>
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<code value="supplemental-data"/>
</coding>
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<description value="SDE Ethnicity
"/>
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<language value="text/cql-identifier"/>
<expression value="SDE Ethnicity"/>
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value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="supplemental-data"/>
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<description value="SDE Payer
"/>
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<language value="text/cql-identifier"/>
<expression value="SDE Payer"/>
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<code value="supplemental-data"/>
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<description value="SDE Race
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<expression value="SDE Race"/>
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value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="supplemental-data"/>
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</usage>
<description value="SDE Sex
"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="SDE Sex"/>
</criteria>
</supplementalData>
</Measure>