| CMS144FHIRHFBetaBlockerForLVSD |
| 1.0.000 |
| CMS144FHIRHFBetaBlockerForLVSD |
| American Heart Association |
| CMS144FHIRHFBetaBlockerForLVSD |
| [http://terminology.hl7.org/CodeSystem/library-type#logic-library] |
Type: MedicationRequest
Profile(s):
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest
Must Support Elements: medication
Code Filter(s):
Path: medication
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1184
|
Type: MedicationRequest
Profile(s):
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest
Must Support Elements: medication.reference.value
|
Type: Medication
Profile(s):
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medication
Must Support Elements: id.value, code
|
Type: Observation
Profile(s):
http://hl7.org/fhir/us/core/StructureDefinition/us-core-heart-rate
Must Support Elements: effective
|
Type: Condition
Profile(s):
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.366
|
Type: Condition
Profile(s):
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.370
|
Type: Condition
Profile(s):
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.362
|
Type: Condition
Profile(s):
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1177
|
Type: Condition
Profile(s):
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1178
|
Type: Condition
Profile(s):
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.412
|
Type: Condition
Profile(s):
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.367
|
Type: Condition
Profile(s):
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.368
|
Type: Condition
Profile(s):
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.366
|
Type: Condition
Profile(s):
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.370
|
Type: Condition
Profile(s):
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.362
|
Type: Condition
Profile(s):
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1177
|
Type: Condition
Profile(s):
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1178
|
Type: Condition
Profile(s):
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.412
|
Type: Condition
Profile(s):
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.367
|
Type: Condition
Profile(s):
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.368
|
Type: AllergyIntolerance
Profile(s):
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-allergyintolerance
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1493
|
Type: AllergyIntolerance
Profile(s):
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-allergyintolerance
Must Support Elements: code
Code Filter(s):
Path: code
Code(s):
http://snomed.info/sct#373254001: 'Substance with beta adrenergic receptor antagonist mechanism of action (substance)'
|
library CMS144FHIRHFBetaBlockerForLVSD version '1.0.000'
using QICore version '6.0.0'
include FHIRHelpers version '4.4.000' called FHIRHelpers
include SupplementalDataElements version '5.1.000' called SDE
include QICoreCommon version '4.0.000' called QICoreCommon
include AHAOverall version '4.1.000' called AHA
codesystem "SNOMEDCT": 'http://snomed.info/sct'
valueset "Allergy to Beta Blocker Therapy": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1177'
valueset "Arrhythmia": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.366'
valueset "Asthma": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.362'
valueset "Atrioventricular Block": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.367'
valueset "Beta Blocker Therapy for LVSD": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1184'
valueset "Beta Blocker Therapy Ingredient": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1493'
valueset "Bradycardia": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.412'
valueset "Cardiac Pacer": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1178.53'
valueset "Cardiac Pacer in Situ": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.368'
valueset "Hypotension": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.370'
valueset "Intolerance to Beta Blocker Therapy": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1178'
valueset "Medical Reason": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1007'
valueset "Patient Reason": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1008'
code "Substance with beta adrenergic receptor antagonist mechanism of action (substance)": '373254001' from "SNOMEDCT" display 'Substance with beta adrenergic receptor antagonist mechanism of action (substance)'
parameter "Measurement Period" Interval<DateTime>
context Patient
define "Initial Population":
AHA."Is Adult With Two Qualifying Outpatient Encounters and One Heart Failure Outpatient Encounter During the Measurement Period"
define "Denominator":
"Initial Population"
and exists AHA."Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD"
define "Denominator Exclusions":
AHA."Has Heart Transplant"
or AHA."Has Heart Transplant Complications"
or AHA."Has Left Ventricular Assist Device"
or AHA."Has Left Ventricular Assist Device Complications"
define "Numerator":
"Has Beta Blocker Therapy for LVSD Ordered"
or "Is Currently Taking Beta Blocker Therapy for LVSD"
define "Denominator Exceptions":
"Has Consecutive Heart Rates Less than 50"
or "Has Medical or Patient Reason for Not Ordering Beta Blocker for LVSD"
or "Has Arrhythmia Diagnosis"
or "Has Hypotension Diagnosis"
or "Has Asthma Diagnosis"
or "Has Diagnosis of Allergy or Intolerance to Beta Blocker Therapy"
or "Has Bradycardia Diagnosis"
or "Has Allergy or Intolerance to Beta Blocker Therapy Ingredient"
or "Atrioventricular Block without Cardiac Pacer"
define "SDE Ethnicity":
SDE."SDE Ethnicity"
define "SDE Payer":
SDE."SDE Payer"
define "SDE Race":
SDE."SDE Race"
define "SDE Sex":
SDE."SDE Sex"
define "Atrioventricular Block without Cardiac Pacer":
"Has Atrioventricular Block Diagnosis"
and not "Has Diagnosis of Cardiac Pacer in Situ"
and not "Has Cardiac Pacer Device Implanted"
define "Has Cardiac Pacer Device Implanted":
exists ( [Procedure: "Cardiac Pacer"] ImplantedCardiacPacer
with AHA."Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD" ModerateOrSevereLVSDHFOutpatientEncounter
such that ImplantedCardiacPacer.performed.toInterval ( ) starts before end of ModerateOrSevereLVSDHFOutpatientEncounter.period
where ImplantedCardiacPacer.status = 'completed'
)
define "Is Currently Taking Beta Blocker Therapy for LVSD":
exists ( ["MedicationRequest": "Beta Blocker Therapy for LVSD"] ActiveBetaBlocker
where ActiveBetaBlocker.overlapsAfterHeartFailureOutpatientEncounter ( )
)
define "Has Hypotension Diagnosis":
exists ( ( ["ConditionProblemsHealthConcerns": "Hypotension"]
union ["ConditionEncounterDiagnosis": "Hypotension"] ) HypotensionAlias
where HypotensionAlias.overlapsHeartFailureOutpatientEncounter ( )
and HypotensionAlias.isVerified ( )
)
define "Has Diagnosis of Cardiac Pacer in Situ":
exists ( ( ["ConditionProblemsHealthConcerns": "Cardiac Pacer in Situ"]
union ["ConditionEncounterDiagnosis": "Cardiac Pacer in Situ"] ) CardiacPacerDiagnosis
where CardiacPacerDiagnosis.overlapsAfterHeartFailureOutpatientEncounter ( )
and CardiacPacerDiagnosis.isVerified ( )
)
define "Has Diagnosis of Allergy or Intolerance to Beta Blocker Therapy":
exists ( ( ( ["ConditionProblemsHealthConcerns": "Allergy to Beta Blocker Therapy"]
union ["ConditionEncounterDiagnosis": "Allergy to Beta Blocker Therapy"]
)
union ( ["ConditionProblemsHealthConcerns": "Intolerance to Beta Blocker Therapy"] )
union ["ConditionEncounterDiagnosis": "Intolerance to Beta Blocker Therapy"] ) BetaBlockerAllergyOrIntoleranceDiagnosis
where BetaBlockerAllergyOrIntoleranceDiagnosis.overlapsAfterHeartFailureOutpatientEncounter ( )
and BetaBlockerAllergyOrIntoleranceDiagnosis.isVerified ( )
)
define "Has Bradycardia Diagnosis":
exists ( ( [ConditionProblemsHealthConcerns: "Bradycardia"]
union [ConditionEncounterDiagnosis: "Bradycardia"] ) BradycardiaAlias
where BradycardiaAlias.overlapsHeartFailureOutpatientEncounter ( )
and BradycardiaAlias.isVerified ( )
)
define "Has Consecutive Heart Rates Less than 50":
exists ( from
["USCoreHeartRateProfile"] HeartRate,
AHA."Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD" ModerateOrSevereLVSDHFOutpatientEncounter
let PriorHeartRate: Last(["USCoreHeartRateProfile"] MostRecentPriorHeartRate
where MostRecentPriorHeartRate.effective.toInterval() during ModerateOrSevereLVSDHFOutpatientEncounter.period
and MostRecentPriorHeartRate.effective.toInterval() before HeartRate.effective.toInterval()
sort by start of effective.toInterval()
)
where HeartRate.effective.toInterval ( ) during ModerateOrSevereLVSDHFOutpatientEncounter.period
and HeartRate.status in { 'final', 'amended', 'corrected' }
and HeartRate.value < 50 '/min'
and PriorHeartRate.value < 50 '/min'
return HeartRate
)
define "Has Allergy or Intolerance to Beta Blocker Therapy Ingredient":
exists ( ( [AllergyIntolerance: "Beta Blocker Therapy Ingredient"]
union [AllergyIntolerance: "Substance with beta adrenergic receptor antagonist mechanism of action (substance)"] ) BetaBlockerAllergyIntolerance
where BetaBlockerAllergyIntolerance.overlapsAfterHeartFailureOutpatientEncounter ( )
and BetaBlockerAllergyIntolerance.isVerified ( )
)
define "Has Arrhythmia Diagnosis":
exists ( ( [ConditionProblemsHealthConcerns: "Arrhythmia"]
union [ConditionEncounterDiagnosis: "Arrhythmia"] ) ArrhythmiaAlias
where ArrhythmiaAlias.overlapsHeartFailureOutpatientEncounter ( )
and ArrhythmiaAlias.isVerified ( )
)
define "Has Asthma Diagnosis":
exists ( ( [ConditionProblemsHealthConcerns: "Asthma"]
union [ConditionEncounterDiagnosis: "Asthma"] ) AsthmaAlias
where AsthmaAlias.overlapsHeartFailureOutpatientEncounter ( )
and AsthmaAlias.isVerified ( )
)
define "Has Atrioventricular Block Diagnosis":
exists ( ( [ConditionProblemsHealthConcerns: "Atrioventricular Block"]
union [ConditionEncounterDiagnosis: "Atrioventricular Block"] ) AtrioventricularBlockAlias
where AtrioventricularBlockAlias.overlapsHeartFailureOutpatientEncounter ( )
and AtrioventricularBlockAlias.isVerified ( )
)
define "Has Beta Blocker Therapy for LVSD Ordered":
exists ( [MedicationRequest: medication in "Beta Blocker Therapy for LVSD"] BetaBlockerOrdered
where BetaBlockerOrdered.isOrderedDuringHeartFailureOutpatientEncounter ( )
)
define "Has Medical or Patient Reason for Not Ordering Beta Blocker for LVSD":
exists ( ["MedicationNotRequested": medication in "Beta Blocker Therapy for LVSD"] NoBetaBlockerOrdered
with AHA."Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD" ModerateOrSevereLVSDHFOutpatientEncounter
such that NoBetaBlockerOrdered.authoredOn during day of ModerateOrSevereLVSDHFOutpatientEncounter.period
where ( NoBetaBlockerOrdered.reasonCode in "Medical Reason"
or NoBetaBlockerOrdered.reasonCode in "Patient Reason"
)
)
/*
@description: Returns true if the given condition either has no verification status or has a verification status of confirmed, unconfirmed, provisional, or differential
*/
define fluent function isVerified(allergyIntolerance QICore.AllergyIntolerance):
allergyIntolerance.verificationStatus is not null implies ( allergyIntolerance.verificationStatus ~ QICoreCommon."allergy-confirmed"
or allergyIntolerance.verificationStatus ~ QICoreCommon."allergy-unconfirmed"
)
|