define "Initial Population":
  "Encounter With Opioid Administration Outside Of Operating Room"

define "Denominator":
  "Initial Population"

define "Numerator":
  "Encounter With NonOperating Room Opioid And Antagonist Administration"

define "SDE Sex":
  case
    when Patient.sex = '248153007' then "Male (finding)"
    when Patient.sex = '248152002' then "Female (finding)"
    else null
  end

define "SDE Payer":
  [Coverage: type in "Payer Type"] Payer
    return {
      code: Payer.type,
      period: Payer.period
    }

define "SDE Ethnicity":
  Patient.ethnicity E
    return Tuple {
      codes: { E.ombCategory } union E.detailed,
      display: E.text
    }

define "SDE Race":
  Patient.race R
    return Tuple {
      codes: R.ombCategory union R.detailed,
      display: R.text
    }

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

define "Non Enteral Opioid Antagonist Administration":
  ["MedicationAdministration": "Opioid Antagonist"] AntagonistGiven
    where AntagonistGiven.status = 'completed'

define "Opioid Administration":
  ["MedicationAdministration": "Opioids, All"] Opioids
    where Opioids.status = 'completed'

define "Qualifying Encounter":
  ["Encounter": "Encounter Inpatient"] InpatientEncounter
    where AgeInYearsAt(date from start of InpatientEncounter.period) >= 18
      and InpatientEncounter.period ends during day of "Measurement Period"
      and InpatientEncounter.status = 'finished'

define "Encounter With Opioid Administration Outside Of Operating Room":
  "Qualifying Encounter" InpatientEncounter
    with "Opioid Administration" OpioidGiven
      such that OpioidGiven.effective.toInterval ( ) starts during InpatientEncounter.hospitalizationWithObservation ( )
        and not exists ( InpatientEncounter.location EncounterLocation
            where EncounterLocation.location.getLocation ( ).type in "Operating Room Suite"
              and OpioidGiven.effective.toInterval ( ) starts during EncounterLocation.period
        )

define "Initial Population":
  "Encounter With Opioid Administration Outside Of Operating Room"

define "Denominator":
  "Initial Population"

/*
@author: Measure developer
@description: Provides guidance to implementers to interpret logic in following defintion correctly
@comment:Excludes opioid antagonist administered in operating room AND excludes opioids administered in operating room AND opioid is administered before opioid antagonist AND limits opioid antagonist to non-enteral routes
 */


define "Encounter With NonOperating Room Opioid And Antagonist Administration":
  from
    "Non Enteral Opioid Antagonist Administration" NonEnteralOpioidAntagonistGiven,
    "Opioid Administration" OpioidGiven,
    "Denominator" InpatientHospitalization
    where not exists ( InpatientHospitalization.location EncounterLocation
        where EncounterLocation.location.getLocation ( ).type in "Operating Room Suite"
          and NonEnteralOpioidAntagonistGiven.effective.toInterval ( ) starts during EncounterLocation.period
    )
      and ( NonEnteralOpioidAntagonistGiven.effective.toInterval ( ) starts during InpatientHospitalization.hospitalizationWithObservation ( )
          and OpioidGiven.effective.toInterval ( ) starts during InpatientHospitalization.hospitalizationWithObservation ( )
          and OpioidGiven.effective.toInterval ( ) ends 12 hours or less before start of NonEnteralOpioidAntagonistGiven.effective.toInterval ( )
          and NonEnteralOpioidAntagonistGiven.dosage.route in "Routes of Administration for Opioid Antagonists"
      )
    return InpatientHospitalization

define "Numerator":
  "Encounter With NonOperating Room Opioid And Antagonist Administration"

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

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

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

/*
@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]

/*
@description: Returns the Location resource specified by the given reference.
*/
define fluent function getLocation(reference Reference):
  singleton from (
    [Location] L where reference.references(L)
  )

/*
@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, '/'))

define function ToString(value uri): value.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]

/*
@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
        }

/*
@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
        }