eCQM QICore Content Implementation Guide
2024.0.0 - CI Build
eCQM QICore Content Implementation Guide
2024.0.0 - CI Build
eCQM QICore Content Implementation Guide, published by cqframework. This guide is not an authorized publication; it is the continuous build for version 2024.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/cqframework/ecqm-content-qicore-2024/ and changes regularly. See the Directory of published versions
| Draft as of 2024-07-09 |
{
"resourceType" : "Measure",
"id" : "BoneDensityProstateCancerAndrogenDeprivationTherapyFHIR",
"meta" : {
"profile" : [
🔗 "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-measure-cqfm"🔗 ,
"http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/publishable-measure-cqfm"🔗 ,
"http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/executable-measure-cqfm"
]
},
"text" : {
"status" : "extensions",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <table class=\"grid dict\">\n \n <tr>\n <th scope=\"row\"><b>Title: </b></th>\n <td style=\"padding-left: 4px;\">Bone Density Evaluation for Patients with Prostate Cancer and Receiving Androgen Deprivation TherapyFHIR</td>\n </tr>\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Id: </b></th>\n <td style=\"padding-left: 4px;\">BoneDensityProstateCancerAndrogenDeprivationTherapyFHIR</td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Version: </b></th>\n <td style=\"padding-left: 4px;\">1.4.000</td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Url: </b></th>\n <td style=\"padding-left: 4px;\"><a href=\"Measure-BoneDensityProstateCancerAndrogenDeprivationTherapyFHIR.html\">Bone Density Evaluation for Patients with Prostate Cancer and Receiving Androgen Deprivation TherapyFHIR</a></td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\">\n <b>\n \n \n short-name identifier:\n \n \n </b>\n </th>\n\n <td style=\"padding-left: 4px;\">\n \n <p style=\"margin-bottom: 5px;\">\n <span>CMS645FHIR</span>\n </p>\n \n </td>\n </tr>\n \n <tr>\n <th scope=\"row\">\n <b>\n \n \n version-independent identifier:\n \n \n </b>\n </th>\n\n <td style=\"padding-left: 4px;\">\n \n <p style=\"margin-bottom: 5px;\">\n <span>urn:uuid:299de9c4-755d-4f5a-ac9e-fa74fe34f759</span>\n </p>\n \n </td>\n </tr>\n \n <tr>\n <th scope=\"row\">\n <b>\n \n \n version-specific identifier:\n \n \n </b>\n </th>\n\n <td style=\"padding-left: 4px;\">\n \n <p style=\"margin-bottom: 5px;\">\n <span>urn:uuid:aed79368-1b42-422a-b31b-c01a9de8501f</span>\n </p>\n \n </td>\n </tr>\n \n <tr>\n <th scope=\"row\">\n <b>\n \n \n publisher (CMS) identifier:\n \n \n </b>\n </th>\n\n <td style=\"padding-left: 4px;\">\n \n <p style=\"margin-bottom: 5px;\">\n <span>645FHIR</span>\n </p>\n \n </td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Effective Period: </b></th>\n <td style=\"padding-left: 4px;\">2025-01-01..2025-12-31</td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Status: </b></th>\n <td style=\"padding-left: 4px;\">draft</td>\n </tr>\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Publisher: </b></th>\n <td style=\"padding-left: 4px;\">Oregon Urology</td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Author: </b></th>\n <td style=\"padding-left: 4px;\">Oregon Urology</td>\n </tr>\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Description: </b></th>\n <td style=\"padding-left: 4px;\"><div><p>Percentage of patients determined as having prostate cancer who are currently starting or undergoing androgen deprivation therapy (ADT), for an anticipated period of 12 months or greater and who receive an initial bone density evaluation. The bone density evaluation must be prior to the start of ADT or within 3 months of the start of ADT.</p>\n</div></td>\n </tr>\n \n\n \n\n \n\n \n\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Purpose: </b></th>\n <td style=\"padding-left: 4px;\"><div><p>UNKNOWN</p>\n</div></td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Copyright: </b></th>\n <td style=\"padding-left: 4px;\"><div><p>Limited proprietary coding is contained in the measure specifications for convenience. Users of the proprietary code sets should obtain all necessary licenses from the owners of these code sets. Oregon Urology Institute (OUI) and Large Urology Group Practice Association (LUGPA) disclaim all liability for use or accuracy of third party codes contained in the specifications. CPT(R) contained in the Measure specifications is copyright 2004-2023. American Medical Association. LOINC(R) copyright 2004-2023 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2023. International Health Terminology Standards Development Organisation. ICD-10 copyright 2023 World Health Organization. All Rights Reserved.</p>\n</div></td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Disclaimer: </b></th>\n <td style=\"padding-left: 4px;\"><div><p>The performance measure is not a clinical guideline and does not establish a standard of medical care, and has not been tested for all potential applications. THE MEASURES AND SPECIFICATIONS ARE PROVIDED "AS IS" WITHOUT WARRANTY OF ANY KIND. Due to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM].</p>\n</div></td>\n </tr>\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Rationale: </b></th>\n <td style=\"padding-left: 4px;\"><div><p>Androgen suppression as a treatment for prostate cancer can cause osteoporosis (Qaseem, 2008). Men undergoing prolonged androgen deprivation therapy (ADT) incur bone loss at a rate higher than menopausal women (Guise, 2007). In preserving bone health, the goal is to prevent or treat osteopenia/osteoporosis for the patient on ADT and to prevent or delay skeletal related events. The National Osteoporosis Foundation recommendations including a baseline assessment of bone density with a dual energy X-ray absorptiometry (DEXA) scan and daily calcium and Vitamin D supplementation (Watts, 2012). The DEXA scan is the gold standard for bone density screening. Men at risk for adverse bone consequences from chronic ADT do not always receive care according to evidence-based guidelines. These findings call for improved processes that standardize evidence-based practice including baseline and follow up bone density assessment (Watts, 2012).</p>\n</div></td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Clinical recommendation statement: </b></th>\n <td style=\"padding-left: 4px;\"><div><p>Bone density screening should be performed at the start of Androgen Deprivation Therapy (ADT) for prostate cancer. It should also be performed every 2 years for the patient with continued ADT or for patients with known osteoporosis. Current insurance practice is to possibly cover the cost of bone density screening if osteoporosis is known or if there is a high-risk drug. Some patients choose to delay bone density screening until after ADT is started and they therefore have insurance authorization due to the administration of a high-risk drug.</p>\n</div></td>\n </tr>\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Guidance (Usage): </b></th>\n <td style=\"padding-left: 4px;\">In order to capture the practitioner's intent of androgen deprivation therapy (ADT) for a period of 12 months or greater, SNOMEDCT 456381000124102 which is Injection of leuprolide acetate for twelve-month period (regime/therapy) is the correct code. This eCQM is a patient-based measure. This FHIR-based measure has been derived from the QDM-based measure: CMS645v8. Please refer to the HL7 QI-Core Implementation Guide (https://hl7.org/fhir/us/qicore/STU4.1.1/) for more information on QI-Core and mapping recommendations from QDM to QI-Core 4.1.1 (https://hl7.org/fhir/us/qicore/STU4.1.1/qdm-to-qicore.html).</td>\n </tr>\n \n\n \n \n <tr>\n <th scope=\"row\"><b>Population Criteria: </b></th>\n <td style=\"padding-left: 4px;\">\n \n <table class=\"grid-dict\">\n \n <tr>\n <th><b>6643b7c1a7a1805d3b7374f8</b></th>\n </tr>\n \n \n <tr>\n <td>Initial Population:</td>\n\n \n \n <td>Patients with a qualifying encounter in the measurement period AND with a diagnosis of prostate cancer AND with an order for ADT or an active medication of ADT with an intent for treatment greater than or equal to 12 months during the measurement period AND order for ADT in 3 months before to 9 months after the start of the measurement period</td>\n \n \n\n </tr>\n \n <tr>\n <td>Denominator:</td>\n\n \n \n <td>Equals Initial Population</td>\n \n \n\n </tr>\n \n <tr>\n <td>Numerator:</td>\n\n \n \n <td>Patients with a bone density evaluation within the two years prior to the start of or less than three months after the start of ADT treatment</td>\n \n \n\n </tr>\n \n <tr>\n <td>Denominator Exception:</td>\n\n \n \n <td>Patient refused the bone density evaluation at the time ordered or did not have it performed within 3 months after the start of ADT NOTE: Created a placeholder population due to issues around negation: refer to https://github.com/cqframework/cql-execution/issues/296, which is tied to https://oncprojectracking.healthit.gov/support/browse/BONNIEMAT-1455</td>\n \n \n\n </tr>\n \n \n </table>\n \n </td>\n </tr>\n \n \n\n \n <tr>\n <th scope=\"row\"><b> Supplemental Data Elements: </b></th>\n <td style=\"padding-left: 4px;\">\n \n \n \n <p>SDE Ethnicity</p>\n \n \n \n \n \n <p>SDE Payer</p>\n \n \n \n \n \n <p>SDE Race</p>\n \n \n \n \n \n <p>SDE Sex</p>\n \n \n \n </td>\n </tr>\n \n\n \n\n \n <tr>\n <th scope=\"row\">\n <b> Supplemental Data Guidance\n : </b></th>\n <td style=\"padding-left: 4px;\"> For every patient evaluated by this measure also identify payer, race, ethnicity and sex </td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Libraries: </b></th>\n <td style=\"padding-left: 4px;\">\n <table class=\"grid-dict\">\n \n <tr>\n <td><a href=\"Library-BoneDensityProstateCancerAndrogenDeprivationTherapyFHIR.html\">BoneDensityProstateCancerAndrogenDeprivationTherapyFHIR</a></td>\n </tr>\n \n </table>\n </td>\n </tr>\n \n\n \n\n \n \n <tr>\n <th scope=\"row\"><b>Terminology and Other Dependencies: </b></th>\n <td style=\"padding-left: 4px;\">\n \n <li><code>Library/SupplementalDataElements|3.5.000</code></li>\n \n <li><code>Library/FHIRHelpers|4.4.000</code></li>\n \n <li><code>Library/QICoreCommon|2.1.000</code></li>\n \n <li><a href=\"http://hl7.org/fhir/R4/codesystem-administrative-gender.html\">AdministrativeGender</a></li>\n \n <li><a href=\"http://hl7.org/fhir/R4/codesystem-snomedct.html\">SNOMED CT (all versions)</a></li>\n \n <li><a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-condition-clinical.html\">Condition Clinical Status Codes</a></li>\n \n <li><a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-condition-ver-status.html\">ConditionVerificationStatus</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1151.38/expansion\">DEXA Dual Energy Xray Absorptiometry, Bone Density for Urology Care</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1151.48/expansion\">Androgen deprivation therapy for Urology Care</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.319/expansion\">Prostate Cancer</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1001/expansion\">Office Visit</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.114222.4.11.3591/expansion\">Payer</a></li>\n \n </td>\n </tr>\n <tr>\n <th scope=\"row\"><b>Parameters:</b></th>\n <td style=\"padding-left: 4px;\">\n <table class=\"grid-dict\">\n <tr>\n <th><b>name</b></th>\n <th><b>use</b></th>\n <th><b>min</b></th>\n <th><b>max</b></th>\n <th><b>type</b></th>\n </tr>\n \n <tr>\n <td>Measurement Period</td>\n <td>In</td>\n <td>0</td>\n <td>1</td>\n <td>Period</td>\n </tr>\n \n <tr>\n <td>SDE Sex</td>\n <td>Out</td>\n <td>0</td>\n <td>1</td>\n <td>Coding</td>\n </tr>\n \n <tr>\n <td>Numerator</td>\n <td>Out</td>\n <td>0</td>\n <td>1</td>\n <td>boolean</td>\n </tr>\n \n <tr>\n <td>Denominator Exception</td>\n <td>Out</td>\n <td>0</td>\n <td>1</td>\n <td>boolean</td>\n </tr>\n \n <tr>\n <td>Denominator</td>\n <td>Out</td>\n <td>0</td>\n <td>1</td>\n <td>boolean</td>\n </tr>\n \n <tr>\n <td>SDE Payer</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Initial Population</td>\n <td>Out</td>\n <td>0</td>\n <td>1</td>\n <td>boolean</td>\n </tr>\n \n <tr>\n <td>SDE Ethnicity</td>\n <td>Out</td>\n <td>0</td>\n <td>1</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>SDE Race</td>\n <td>Out</td>\n <td>0</td>\n <td>1</td>\n <td>Resource</td>\n </tr>\n \n </table>\n </td>\n </tr>\n\n <tr>\n <th scope=\"row\"><b>DataRequirements:</b></th>\n <td style=\"padding-left: 4px;\">\n <table class=\"grid-dict\">\n <tr>\n <th><b>Resource Type</b></th>\n <th><b>Resource Elements</b></th>\n <th><b>Valueset Name</b></th>\n <th><b>Valueset</b></th>\n </tr>\n \n <tr>\n <td>Patient(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-patient.html\">QICorePatient</a>)</td>\n <td>\n \n ethnicity\n \n race\n \n </td>\n <td>\n \n </td>\n <td/>\n </tr>\n \n <tr>\n <td>Medication(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-medication.html\">QICoreMedication</a>)</td>\n <td>\n \n id\n \n </td>\n <td>\n \n </td>\n <td/>\n </tr>\n \n <tr>\n <td>Medication(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-medication.html\">QICoreMedication</a>)</td>\n <td>\n \n id\n \n </td>\n <td>\n \n </td>\n <td/>\n </tr>\n \n <tr>\n <td>MedicationRequest(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-medicationrequest.html\">QICoreMedicationRequest</a>)</td>\n <td>\n \n medication.reference\n \n dosageInstruction\n \n status\n \n status.value\n \n intent\n \n intent.value\n \n authoredOn\n \n authoredOn.value\n \n </td>\n <td>\n \n </td>\n <td/>\n </tr>\n \n <tr>\n <td>MedicationRequest(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-medicationrequest.html\">QICoreMedicationRequest</a>)</td>\n <td>\n \n medication\n \n dosageInstruction\n \n status\n \n status.value\n \n intent\n \n intent.value\n \n authoredOn\n \n authoredOn.value\n \n </td>\n <td>\n \n \n Androgen deprivation therapy for Urology Care\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1151.48/expansion\">Androgen deprivation therapy for Urology Care</a></td>\n </tr>\n \n <tr>\n <td>Condition(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-condition.html\">QICoreCondition</a>)</td>\n <td>\n \n code\n \n clinicalStatus\n \n verificationStatus\n \n </td>\n <td>\n \n \n Prostate Cancer\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.319/expansion\">Prostate Cancer</a></td>\n </tr>\n \n <tr>\n <td>ServiceRequest(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-servicerequest.html\">QICoreServiceRequest</a>)</td>\n <td>\n \n code\n \n authoredOn\n \n authoredOn.value\n \n status\n \n status.value\n \n intent\n \n intent.value\n \n doNotPerform\n \n doNotPerform.value\n \n </td>\n <td>\n \n </td>\n <td/>\n </tr>\n \n <tr>\n <td>ServiceRequest(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-servicerequest.html\">QICoreServiceRequest</a>)</td>\n <td>\n \n code\n \n authoredOn\n \n authoredOn.value\n \n status\n \n status.value\n \n intent\n \n intent.value\n \n doNotPerform\n \n doNotPerform.value\n \n </td>\n <td>\n \n \n DEXA Dual Energy Xray Absorptiometry, Bone Density for Urology Care\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1151.38/expansion\">DEXA Dual Energy Xray Absorptiometry, Bone Density for Urology Care</a></td>\n </tr>\n \n <tr>\n <td>Observation(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-observation.html\">QICoreObservation</a>)</td>\n <td>\n \n code\n \n effective\n \n status\n \n status.value\n \n </td>\n <td>\n \n \n DEXA Dual Energy Xray Absorptiometry, Bone Density for Urology Care\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1151.38/expansion\">DEXA Dual Energy Xray Absorptiometry, Bone Density for Urology Care</a></td>\n </tr>\n \n <tr>\n <td>Encounter(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html\">QICoreEncounter</a>)</td>\n <td>\n \n type\n \n period\n \n status\n \n status.value\n \n </td>\n <td>\n \n \n Office Visit\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1001/expansion\">Office Visit</a></td>\n </tr>\n \n <tr>\n <td>Coverage(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-coverage.html\">QICoreCoverage</a>)</td>\n <td>\n \n type\n \n period\n \n </td>\n <td>\n \n \n Payer Type\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.114222.4.11.3591/expansion\">Payer</a></td>\n </tr>\n \n </table>\n </td>\n </tr>\n\n \n <tr>\n <th scope=\"row\"><b>Direct Reference Codes:</b></th>\n <td style=\"padding-left: 4px;\">\n <table class=\"grid-dict\">\n <tr>\n <th><b>display</b></th>\n <th><b>code</b></th>\n <th><b>system</b></th>\n </tr>\n \n <tr>\n <td>Male</td>\n <td>M</td>\n <td><a href=\"http://hl7.org/fhir/R4/codesystem-administrative-gender.html\">http://hl7.org/fhir/administrative-gender</a></td>\n </tr>\n \n <tr>\n <td>Female</td>\n <td>F</td>\n <td><a href=\"http://hl7.org/fhir/R4/codesystem-administrative-gender.html\">http://hl7.org/fhir/administrative-gender</a></td>\n </tr>\n \n <tr>\n <td>Injection of leuprolide acetate for twelve month period (regime/therapy)</td>\n <td>456381000124102</td>\n <td><a href=\"http://hl7.org/fhir/R4/codesystem-snomedct.html\">http://snomed.info/sct</a></td>\n </tr>\n \n <tr>\n <td>Active</td>\n <td>active</td>\n <td><a href=\"http://hl7.org/fhir/R4/codesystem-condition-clinical.html\">http://terminology.hl7.org/CodeSystem/condition-clinical</a></td>\n </tr>\n \n <tr>\n <td>Confirmed</td>\n <td>confirmed</td>\n <td><a href=\"http://hl7.org/fhir/R4/codesystem-condition-ver-status.html\">http://terminology.hl7.org/CodeSystem/condition-ver-status</a></td>\n </tr>\n \n </table>\n </td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Logic Definitions:</b></th>\n <td style=\"padding-left: 4px;\">\n \n <table class=\"grid-dict\">\n <tr>\n <th><b>Group</b></th>\n <th><b>Scoring</b></th>\n <th><b>Population Criteria</b></th>\n <th><b>Expression</b></th>\n </tr>\n <tr>\n \n <td> 6643b7c1a7a1805d3b7374f8 </td>\n <td colspan=\"3\" style=\"padding-left: 4px;\">\n \n <b>Group scoring:</b>\n \n <span> proportion </span>\n \n \n\n \n\n \n\n \n\n \n <tr>\n \n <th scope=\"row\"><b>Type: </b></th>\n <td style=\"padding-left: 4px;\">\n \n \n <p style=\"margin-bottom: 5px;\">\n <span>Process </span>\n </p>\n \n \n \n </td>\n \n </tr>\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Rate Aggregation: </b></th>\n <td colspan=\"3\" style=\"padding-left: 4px;\">None</td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Improvement Notation: </b></th>\n <td style=\"padding-left: 4px;\">\n \n \n \n <p style=\"margin-bottom: 5px;\">\n <span>Increased score indicates improvement </span>\n </p>\n \n \n \n \n </td>\n </tr>\n \n\n \n\n </td>\n \n <tr>\n <td/>\n <td/>\n <td>Initial Population</td>\n <td>\n \n <pre><code class=\"language-cql\">define "Initial Population":\n "Has Qualifying Encounter"\n and exists "Order for 12 Months of ADT in 3 Months Before to 9 Months After Start of Measurement Period"</code></pre>\n \n </td>\n </tr>\n \n <tr>\n <td/>\n <td/>\n <td>Denominator</td>\n <td>\n \n <pre><code class=\"language-cql\">define "Denominator":\n "Initial Population"</code></pre>\n \n </td>\n </tr>\n \n <tr>\n <td/>\n <td/>\n <td>Numerator</td>\n <td>\n \n <pre><code class=\"language-cql\">define "Numerator":\n "Has Baseline DEXA Scan Two Years Prior to the Start of or Less than Three Months After the Start of ADT"</code></pre>\n \n </td>\n </tr>\n \n <tr>\n <td/>\n <td/>\n <td>Denominator Exception</td>\n <td>\n \n <pre><code class=\"language-cql\">/*\n@commentedOut: exists ( "No Bone Density Scan Ordered Due to Patient Refusal" ) \n or exists ( "No Bone Density Scan Performed Due to Patient Refusal" )\n@commmentedOutReason: Negation issue related to https://github.com/cqframework/cql-execution/issues/296, which is tied to https://oncprojectracking.healthit.gov/support/browse/BONNIEMAT-1455. Due to this being the only logic in population, created a 'false' placeholder\n*/\n\n\ndefine "Denominator Exception":\n //placeholder\n \n false</code></pre>\n \n </td>\n </tr>\n \n \n \n </tr>\n </table>\n \n\n <table class=\"grid-dict\">\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SupplementalDataElements</td>\n \n \n <td>SDE Sex</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "SDE Sex":\n case\n when Patient.gender = 'male' then "M"\n when Patient.gender = 'female' then "F"\n else null\n end</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>BoneDensityProstateCancerAndrogenDeprivationTherapyFHIR</td>\n \n \n <td>SDE Sex</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "SDE Sex":\n SDE."SDE Sex"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>BoneDensityProstateCancerAndrogenDeprivationTherapyFHIR</td>\n \n \n <td>Androgen Deprivation Therapy for Urology Care Medication Active Start Dates</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Androgen Deprivation Therapy for Urology Care Medication Active Start Dates":\n [MedicationRequest: "Androgen deprivation therapy for Urology Care"] ADTActive\n let firstMedicationPeriod: First((collapse(ADTActive.dosageInstruction.timing.repeat.bounds DoseTime\n return DoseTime.toInterval()\n )) DrugPeriods\n sort by start of $this\n ),\n //get the very first event\n \n firstMedicationEvent: First((ADTActive.dosageInstruction.timing dosageTiming\n //returns first event for the specific dosageTiming\n \n return First(dosageTiming.event dosageTimingEvents\n sort ascending\n )) firstEvents\n sort ascending\n ),\n medicationDateTime: NormalizeInterval(firstMedicationEvent, firstMedicationPeriod).earliest ( )\n where ADTActive.status in { 'active', 'completed' }\n and ADTActive.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }\n return medicationDateTime</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>BoneDensityProstateCancerAndrogenDeprivationTherapyFHIR</td>\n \n \n <td>Androgen Deprivation Therapy for Urology Care Medication Order Start Dates</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Androgen Deprivation Therapy for Urology Care Medication Order Start Dates":\n [MedicationRequest: "Androgen deprivation therapy for Urology Care"] ADTOrder\n let firstMedicationPeriod: First((collapse(ADTOrder.dosageInstruction.timing.repeat.bounds DoseTime\n return DoseTime.toInterval()\n )) DrugPeriods\n sort by start of $this\n ),\n medicationDateTime: NormalizeInterval(ADTOrder.authoredOn, firstMedicationPeriod).earliest ( )\n where ADTOrder.status in { 'active', 'completed' }\n and ADTOrder.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }\n return medicationDateTime</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>BoneDensityProstateCancerAndrogenDeprivationTherapyFHIR</td>\n \n \n <td>Prostate Cancer Diagnosis</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Prostate Cancer Diagnosis":\n [Condition: "Prostate Cancer"] ProstateCancer\n where ProstateCancer.prevalenceInterval ( ) overlaps "Measurement Period"\n and ProstateCancer.clinicalStatus ~ QICoreCommon."active"\n and ProstateCancer.verificationStatus ~ QICoreCommon."confirmed"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>BoneDensityProstateCancerAndrogenDeprivationTherapyFHIR</td>\n \n \n <td>First ADT in 3 Months Before to 9 Months After Start of Measurement Period</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "First ADT in 3 Months Before to 9 Months After Start of Measurement Period":\n First(("Androgen Deprivation Therapy for Urology Care Medication Active Start Dates"\n union "Androgen Deprivation Therapy for Urology Care Medication Order Start Dates") ADTDateTime\n with "Prostate Cancer Diagnosis" ProstateCancer\n such that ADTDateTime during day of ProstateCancer.prevalenceInterval()\n and ADTDateTime during day of Interval[start of "Measurement Period" - 3 months, start of "Measurement Period" + 9 months]\n sort ascending\n )</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>BoneDensityProstateCancerAndrogenDeprivationTherapyFHIR</td>\n \n \n <td>Order for 12 Months of ADT in 3 Months Before to 9 Months After Start of Measurement Period</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Order for 12 Months of ADT in 3 Months Before to 9 Months After Start of Measurement Period":\n [ServiceRequest: "Injection of leuprolide acetate for twelve month period (regime/therapy)"] OrderTwelveMonthADT\n with "First ADT in 3 Months Before to 9 Months After Start of Measurement Period" FirstADTMP\n such that OrderTwelveMonthADT.authoredOn on or after day of FirstADTMP\n and OrderTwelveMonthADT.authoredOn during day of Interval[start of "Measurement Period" - 3 months, start of "Measurement Period" + 9 months]\n and OrderTwelveMonthADT.status in { 'active', 'completed' }\n and OrderTwelveMonthADT.intent = 'order'\n and OrderTwelveMonthADT.doNotPerform is not true</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>BoneDensityProstateCancerAndrogenDeprivationTherapyFHIR</td>\n \n \n <td>Has Baseline DEXA Scan Two Years Prior to the Start of or Less than Three Months After the Start of ADT</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Has Baseline DEXA Scan Two Years Prior to the Start of or Less than Three Months After the Start of ADT":\n exists ( ( [ServiceRequest: "DEXA Dual Energy Xray Absorptiometry, Bone Density for Urology Care"] DEXAOrdered\n with "Order for 12 Months of ADT in 3 Months Before to 9 Months After Start of Measurement Period" OrderTwelveMonthsADT\n such that DEXAOrdered.authoredOn 3 months or less on or after day of OrderTwelveMonthsADT.authoredOn\n or DEXAOrdered.authoredOn 2 years or less before day of OrderTwelveMonthsADT.authoredOn\n where DEXAOrdered.status in { 'active', 'completed' }\n and DEXAOrdered.intent = 'order'\n and DEXAOrdered.doNotPerform is not true\n )\n union ( [Observation: "DEXA Dual Energy Xray Absorptiometry, Bone Density for Urology Care"] DEXAPerformed\n with "Order for 12 Months of ADT in 3 Months Before to 9 Months After Start of Measurement Period" OrderTwelveMonthsADT\n such that DEXAPerformed.effective.toInterval ( ) 3 months or less on or after day of OrderTwelveMonthsADT.authoredOn\n or DEXAPerformed.effective.toInterval ( ) 2 years or less before day of OrderTwelveMonthsADT.authoredOn\n where DEXAPerformed.status in { 'final', 'amended', 'corrected' }\n )\n )</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>BoneDensityProstateCancerAndrogenDeprivationTherapyFHIR</td>\n \n \n <td>Numerator</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Numerator":\n "Has Baseline DEXA Scan Two Years Prior to the Start of or Less than Three Months After the Start of ADT"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>BoneDensityProstateCancerAndrogenDeprivationTherapyFHIR</td>\n \n \n <td>Denominator Exception</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">/*\n@commentedOut: exists ( "No Bone Density Scan Ordered Due to Patient Refusal" ) \n or exists ( "No Bone Density Scan Performed Due to Patient Refusal" )\n@commmentedOutReason: Negation issue related to https://github.com/cqframework/cql-execution/issues/296, which is tied to https://oncprojectracking.healthit.gov/support/browse/BONNIEMAT-1455. Due to this being the only logic in population, created a 'false' placeholder\n*/\n\n\ndefine "Denominator Exception":\n //placeholder\n \n false</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>BoneDensityProstateCancerAndrogenDeprivationTherapyFHIR</td>\n \n \n <td>Has Qualifying Encounter</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Has Qualifying Encounter":\n exists ( ["Encounter": "Office Visit"] OfficeVisit\n where OfficeVisit.period during "Measurement Period"\n and OfficeVisit.status = 'finished'\n )</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>BoneDensityProstateCancerAndrogenDeprivationTherapyFHIR</td>\n \n \n <td>Initial Population</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Initial Population":\n "Has Qualifying Encounter"\n and exists "Order for 12 Months of ADT in 3 Months Before to 9 Months After Start of Measurement Period"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>BoneDensityProstateCancerAndrogenDeprivationTherapyFHIR</td>\n \n \n <td>Denominator</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Denominator":\n "Initial Population"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SupplementalDataElements</td>\n \n \n <td>SDE Payer</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "SDE Payer":\n [Coverage: type in "Payer Type"] Payer\n return {\n code: Payer.type,\n period: Payer.period\n }</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>BoneDensityProstateCancerAndrogenDeprivationTherapyFHIR</td>\n \n \n <td>SDE Payer</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "SDE Payer":\n SDE."SDE Payer"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SupplementalDataElements</td>\n \n \n <td>SDE Ethnicity</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "SDE Ethnicity":\n Patient.ethnicity E\n return Tuple {\n codes: { E.ombCategory } union E.detailed,\n display: E.text\n }</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>BoneDensityProstateCancerAndrogenDeprivationTherapyFHIR</td>\n \n \n <td>SDE Ethnicity</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "SDE Ethnicity":\n SDE."SDE Ethnicity"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SupplementalDataElements</td>\n \n \n <td>SDE Race</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "SDE Race":\n Patient.race R\n return Tuple {\n codes: R.ombCategory union R.detailed,\n display: R.text\n }</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>BoneDensityProstateCancerAndrogenDeprivationTherapyFHIR</td>\n \n \n <td>SDE Race</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "SDE Race":\n SDE."SDE Race"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>QICoreCommon</td>\n \n \n <td>earliest</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">/*\n@description: Given an interval, return the starting point if the interval has a starting boundary specified,\notherwise, return the ending point\n*/\ndefine fluent function earliest(choice Choice<DateTime, Quantity, Interval<DateTime>, Interval<Quantity>> ):\n (choice.toInterval()) period\n return\n if (period."hasStart"()) then start of period\n else end of period</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>BoneDensityProstateCancerAndrogenDeprivationTherapyFHIR</td>\n \n \n <td>NormalizeInterval</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define function NormalizeInterval(pointInTime DateTime, dateTimeInterval Interval<DateTime>):\n if pointInTime is not null then Interval[pointInTime, pointInTime]\n else if dateTimeInterval is not null then dateTimeInterval \n else null as Interval<DateTime></code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>QICoreCommon</td>\n \n \n <td>prevalenceInterval</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">/*\n@description: Returns an interval representing the normalized prevalence period of a given Condition.\n@comment: Uses the ToInterval and ToAbatementInterval functions to determine the widest potential interval from\nonset to abatement as specified in the given Condition. If the condition is active, or has an abatement date the resulting \ninterval will have a closed ending boundary. Otherwise, the resulting interval will have an open ending boundary.\n*/\ndefine fluent function prevalenceInterval(condition Condition):\nif condition.clinicalStatus ~ "active"\n or condition.clinicalStatus ~ "recurrence"\n or condition.clinicalStatus ~ "relapse" then\n Interval[start of condition.onset.toInterval(), end of condition.abatementInterval()]\nelse\n (end of condition.abatementInterval()) abatementDate\n return if abatementDate is null then\n Interval[start of condition.onset.toInterval(), abatementDate)\n else\n Interval[start of condition.onset.toInterval(), abatementDate]</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>FHIRHelpers</td>\n \n \n <td>ToString</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define function ToString(value uri): value.value</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>FHIRHelpers</td>\n \n \n <td>ToCode</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">/*\n@description: Converts the given FHIR [Coding](https://hl7.org/fhir/datatypes.html#Coding) value to a CQL Code.\n*/\ndefine function ToCode(coding FHIR.Coding):\n if coding is null then\n null\n else\n System.Code {\n code: coding.code.value,\n system: coding.system.value,\n version: coding.version.value,\n display: coding.display.value\n }</code></pre>\n </td>\n \n </tr>\n \n </table>\n </td>\n </tr>\n \n \n \n\n </table>\n</div>"
},
"contained" : [
{
"resourceType" : "Library",
"id" : "effective-data-requirements",
"extension" : [
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
"valueCoding" : {
"system" : "http://hl7.org/fhir/administrative-gender",
"code" : "M",
"display" : "Male"
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
"valueCoding" : {
"system" : "http://hl7.org/fhir/administrative-gender",
"code" : "F",
"display" : "Female"
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
"valueCoding" : {
"system" : "http://snomed.info/sct",
"code" : "456381000124102",
"display" : "Injection of leuprolide acetate for twelve month period (regime/therapy)"
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
"valueCoding" : {
"system" : "http://terminology.hl7.org/CodeSystem/condition-clinical",
"code" : "active",
"display" : "Active"
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
"valueCoding" : {
"system" : "http://terminology.hl7.org/CodeSystem/condition-ver-status",
"code" : "confirmed",
"display" : "Confirmed"
}
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SupplementalDataElements"
},
{
"url" : "name",
"valueString" : "SDE Sex"
},
{
"url" : "statement",
"valueString" : "define \"SDE Sex\":\n case\n when Patient.gender = 'male' then \"M\"\n when Patient.gender = 'female' then \"F\"\n else null\n end"
},
{
"url" : "displaySequence",
"valueInteger" : 0
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "BoneDensityProstateCancerAndrogenDeprivationTherapyFHIR"
},
{
"url" : "name",
"valueString" : "SDE Sex"
},
{
"url" : "statement",
"valueString" : "define \"SDE Sex\":\n SDE.\"SDE Sex\""
},
{
"url" : "displaySequence",
"valueInteger" : 1
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "BoneDensityProstateCancerAndrogenDeprivationTherapyFHIR"
},
{
"url" : "name",
"valueString" : "Androgen Deprivation Therapy for Urology Care Medication Active Start Dates"
},
{
"url" : "statement",
"valueString" : "define \"Androgen Deprivation Therapy for Urology Care Medication Active Start Dates\":\n [MedicationRequest: \"Androgen deprivation therapy for Urology Care\"] ADTActive\n let firstMedicationPeriod: First((collapse(ADTActive.dosageInstruction.timing.repeat.bounds DoseTime\n return DoseTime.toInterval()\n )) DrugPeriods\n sort by start of $this\n ),\n //get the very first event\n \n firstMedicationEvent: First((ADTActive.dosageInstruction.timing dosageTiming\n //returns first event for the specific dosageTiming\n \n return First(dosageTiming.event dosageTimingEvents\n sort ascending\n )) firstEvents\n sort ascending\n ),\n medicationDateTime: NormalizeInterval(firstMedicationEvent, firstMedicationPeriod).earliest ( )\n where ADTActive.status in { 'active', 'completed' }\n and ADTActive.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }\n return medicationDateTime"
},
{
"url" : "displaySequence",
"valueInteger" : 2
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "BoneDensityProstateCancerAndrogenDeprivationTherapyFHIR"
},
{
"url" : "name",
"valueString" : "Androgen Deprivation Therapy for Urology Care Medication Order Start Dates"
},
{
"url" : "statement",
"valueString" : "define \"Androgen Deprivation Therapy for Urology Care Medication Order Start Dates\":\n [MedicationRequest: \"Androgen deprivation therapy for Urology Care\"] ADTOrder\n let firstMedicationPeriod: First((collapse(ADTOrder.dosageInstruction.timing.repeat.bounds DoseTime\n return DoseTime.toInterval()\n )) DrugPeriods\n sort by start of $this\n ),\n medicationDateTime: NormalizeInterval(ADTOrder.authoredOn, firstMedicationPeriod).earliest ( )\n where ADTOrder.status in { 'active', 'completed' }\n and ADTOrder.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }\n return medicationDateTime"
},
{
"url" : "displaySequence",
"valueInteger" : 3
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "BoneDensityProstateCancerAndrogenDeprivationTherapyFHIR"
},
{
"url" : "name",
"valueString" : "Prostate Cancer Diagnosis"
},
{
"url" : "statement",
"valueString" : "define \"Prostate Cancer Diagnosis\":\n [Condition: \"Prostate Cancer\"] ProstateCancer\n where ProstateCancer.prevalenceInterval ( ) overlaps \"Measurement Period\"\n and ProstateCancer.clinicalStatus ~ QICoreCommon.\"active\"\n and ProstateCancer.verificationStatus ~ QICoreCommon.\"confirmed\""
},
{
"url" : "displaySequence",
"valueInteger" : 4
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "BoneDensityProstateCancerAndrogenDeprivationTherapyFHIR"
},
{
"url" : "name",
"valueString" : "First ADT in 3 Months Before to 9 Months After Start of Measurement Period"
},
{
"url" : "statement",
"valueString" : "define \"First ADT in 3 Months Before to 9 Months After Start of Measurement Period\":\n First((\"Androgen Deprivation Therapy for Urology Care Medication Active Start Dates\"\n union \"Androgen Deprivation Therapy for Urology Care Medication Order Start Dates\") ADTDateTime\n with \"Prostate Cancer Diagnosis\" ProstateCancer\n such that ADTDateTime during day of ProstateCancer.prevalenceInterval()\n and ADTDateTime during day of Interval[start of \"Measurement Period\" - 3 months, start of \"Measurement Period\" + 9 months]\n sort ascending\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 5
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "BoneDensityProstateCancerAndrogenDeprivationTherapyFHIR"
},
{
"url" : "name",
"valueString" : "Order for 12 Months of ADT in 3 Months Before to 9 Months After Start of Measurement Period"
},
{
"url" : "statement",
"valueString" : "define \"Order for 12 Months of ADT in 3 Months Before to 9 Months After Start of Measurement Period\":\n [ServiceRequest: \"Injection of leuprolide acetate for twelve month period (regime/therapy)\"] OrderTwelveMonthADT\n with \"First ADT in 3 Months Before to 9 Months After Start of Measurement Period\" FirstADTMP\n such that OrderTwelveMonthADT.authoredOn on or after day of FirstADTMP\n and OrderTwelveMonthADT.authoredOn during day of Interval[start of \"Measurement Period\" - 3 months, start of \"Measurement Period\" + 9 months]\n and OrderTwelveMonthADT.status in { 'active', 'completed' }\n and OrderTwelveMonthADT.intent = 'order'\n and OrderTwelveMonthADT.doNotPerform is not true"
},
{
"url" : "displaySequence",
"valueInteger" : 6
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "BoneDensityProstateCancerAndrogenDeprivationTherapyFHIR"
},
{
"url" : "name",
"valueString" : "Has Baseline DEXA Scan Two Years Prior to the Start of or Less than Three Months After the Start of ADT"
},
{
"url" : "statement",
"valueString" : "define \"Has Baseline DEXA Scan Two Years Prior to the Start of or Less than Three Months After the Start of ADT\":\n exists ( ( [ServiceRequest: \"DEXA Dual Energy Xray Absorptiometry, Bone Density for Urology Care\"] DEXAOrdered\n with \"Order for 12 Months of ADT in 3 Months Before to 9 Months After Start of Measurement Period\" OrderTwelveMonthsADT\n such that DEXAOrdered.authoredOn 3 months or less on or after day of OrderTwelveMonthsADT.authoredOn\n or DEXAOrdered.authoredOn 2 years or less before day of OrderTwelveMonthsADT.authoredOn\n where DEXAOrdered.status in { 'active', 'completed' }\n and DEXAOrdered.intent = 'order'\n and DEXAOrdered.doNotPerform is not true\n )\n union ( [Observation: \"DEXA Dual Energy Xray Absorptiometry, Bone Density for Urology Care\"] DEXAPerformed\n with \"Order for 12 Months of ADT in 3 Months Before to 9 Months After Start of Measurement Period\" OrderTwelveMonthsADT\n such that DEXAPerformed.effective.toInterval ( ) 3 months or less on or after day of OrderTwelveMonthsADT.authoredOn\n or DEXAPerformed.effective.toInterval ( ) 2 years or less before day of OrderTwelveMonthsADT.authoredOn\n where DEXAPerformed.status in { 'final', 'amended', 'corrected' }\n )\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 7
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "BoneDensityProstateCancerAndrogenDeprivationTherapyFHIR"
},
{
"url" : "name",
"valueString" : "Numerator"
},
{
"url" : "statement",
"valueString" : "define \"Numerator\":\n \"Has Baseline DEXA Scan Two Years Prior to the Start of or Less than Three Months After the Start of ADT\""
},
{
"url" : "displaySequence",
"valueInteger" : 8
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "BoneDensityProstateCancerAndrogenDeprivationTherapyFHIR"
},
{
"url" : "name",
"valueString" : "Denominator Exception"
},
{
"url" : "statement",
"valueString" : "/*\n@commentedOut: exists ( \"No Bone Density Scan Ordered Due to Patient Refusal\" ) \n or exists ( \"No Bone Density Scan Performed Due to Patient Refusal\" )\n@commmentedOutReason: Negation issue related to https://github.com/cqframework/cql-execution/issues/296, which is tied to https://oncprojectracking.healthit.gov/support/browse/BONNIEMAT-1455. Due to this being the only logic in population, created a 'false' placeholder\n*/\n\n\ndefine \"Denominator Exception\":\n //placeholder\n \n false"
},
{
"url" : "displaySequence",
"valueInteger" : 9
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "BoneDensityProstateCancerAndrogenDeprivationTherapyFHIR"
},
{
"url" : "name",
"valueString" : "Has Qualifying Encounter"
},
{
"url" : "statement",
"valueString" : "define \"Has Qualifying Encounter\":\n exists ( [\"Encounter\": \"Office Visit\"] OfficeVisit\n where OfficeVisit.period during \"Measurement Period\"\n and OfficeVisit.status = 'finished'\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 10
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "BoneDensityProstateCancerAndrogenDeprivationTherapyFHIR"
},
{
"url" : "name",
"valueString" : "Initial Population"
},
{
"url" : "statement",
"valueString" : "define \"Initial Population\":\n \"Has Qualifying Encounter\"\n and exists \"Order for 12 Months of ADT in 3 Months Before to 9 Months After Start of Measurement Period\""
},
{
"url" : "displaySequence",
"valueInteger" : 11
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "BoneDensityProstateCancerAndrogenDeprivationTherapyFHIR"
},
{
"url" : "name",
"valueString" : "Denominator"
},
{
"url" : "statement",
"valueString" : "define \"Denominator\":\n \"Initial Population\""
},
{
"url" : "displaySequence",
"valueInteger" : 12
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SupplementalDataElements"
},
{
"url" : "name",
"valueString" : "SDE Payer"
},
{
"url" : "statement",
"valueString" : "define \"SDE Payer\":\n [Coverage: type in \"Payer Type\"] Payer\n return {\n code: Payer.type,\n period: Payer.period\n }"
},
{
"url" : "displaySequence",
"valueInteger" : 13
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "BoneDensityProstateCancerAndrogenDeprivationTherapyFHIR"
},
{
"url" : "name",
"valueString" : "SDE Payer"
},
{
"url" : "statement",
"valueString" : "define \"SDE Payer\":\n SDE.\"SDE Payer\""
},
{
"url" : "displaySequence",
"valueInteger" : 14
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SupplementalDataElements"
},
{
"url" : "name",
"valueString" : "SDE Ethnicity"
},
{
"url" : "statement",
"valueString" : "define \"SDE Ethnicity\":\n Patient.ethnicity E\n return Tuple {\n codes: { E.ombCategory } union E.detailed,\n display: E.text\n }"
},
{
"url" : "displaySequence",
"valueInteger" : 15
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "BoneDensityProstateCancerAndrogenDeprivationTherapyFHIR"
},
{
"url" : "name",
"valueString" : "SDE Ethnicity"
},
{
"url" : "statement",
"valueString" : "define \"SDE Ethnicity\":\n SDE.\"SDE Ethnicity\""
},
{
"url" : "displaySequence",
"valueInteger" : 16
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SupplementalDataElements"
},
{
"url" : "name",
"valueString" : "SDE Race"
},
{
"url" : "statement",
"valueString" : "define \"SDE Race\":\n Patient.race R\n return Tuple {\n codes: R.ombCategory union R.detailed,\n display: R.text\n }"
},
{
"url" : "displaySequence",
"valueInteger" : 17
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "BoneDensityProstateCancerAndrogenDeprivationTherapyFHIR"
},
{
"url" : "name",
"valueString" : "SDE Race"
},
{
"url" : "statement",
"valueString" : "define \"SDE Race\":\n SDE.\"SDE Race\""
},
{
"url" : "displaySequence",
"valueInteger" : 18
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "QICoreCommon"
},
{
"url" : "name",
"valueString" : "earliest"
},
{
"url" : "statement",
"valueString" : "/*\n@description: Given an interval, return the starting point if the interval has a starting boundary specified,\notherwise, return the ending point\n*/\ndefine fluent function earliest(choice Choice<DateTime, Quantity, Interval<DateTime>, Interval<Quantity>> ):\n (choice.toInterval()) period\n return\n if (period.\"hasStart\"()) then start of period\n else end of period"
},
{
"url" : "displaySequence",
"valueInteger" : 19
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "BoneDensityProstateCancerAndrogenDeprivationTherapyFHIR"
},
{
"url" : "name",
"valueString" : "NormalizeInterval"
},
{
"url" : "statement",
"valueString" : "define function NormalizeInterval(pointInTime DateTime, dateTimeInterval Interval<DateTime>):\n if pointInTime is not null then Interval[pointInTime, pointInTime]\n else if dateTimeInterval is not null then dateTimeInterval \n else null as Interval<DateTime>"
},
{
"url" : "displaySequence",
"valueInteger" : 20
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "QICoreCommon"
},
{
"url" : "name",
"valueString" : "prevalenceInterval"
},
{
"url" : "statement",
"valueString" : "/*\n@description: Returns an interval representing the normalized prevalence period of a given Condition.\n@comment: Uses the ToInterval and ToAbatementInterval functions to determine the widest potential interval from\nonset to abatement as specified in the given Condition. If the condition is active, or has an abatement date the resulting \ninterval will have a closed ending boundary. Otherwise, the resulting interval will have an open ending boundary.\n*/\ndefine fluent function prevalenceInterval(condition Condition):\nif condition.clinicalStatus ~ \"active\"\n or condition.clinicalStatus ~ \"recurrence\"\n or condition.clinicalStatus ~ \"relapse\" then\n Interval[start of condition.onset.toInterval(), end of condition.abatementInterval()]\nelse\n (end of condition.abatementInterval()) abatementDate\n return if abatementDate is null then\n Interval[start of condition.onset.toInterval(), abatementDate)\n else\n Interval[start of condition.onset.toInterval(), abatementDate]"
},
{
"url" : "displaySequence",
"valueInteger" : 21
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "FHIRHelpers"
},
{
"url" : "name",
"valueString" : "ToString"
},
{
"url" : "statement",
"valueString" : "define function ToString(value uri): value.value"
},
{
"url" : "displaySequence",
"valueInteger" : 22
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "FHIRHelpers"
},
{
"url" : "name",
"valueString" : "ToCode"
},
{
"url" : "statement",
"valueString" : "/*\n@description: Converts the given FHIR [Coding](https://hl7.org/fhir/datatypes.html#Coding) value to a CQL Code.\n*/\ndefine function ToCode(coding FHIR.Coding):\n if coding is null then\n null\n else\n System.Code {\n code: coding.code.value,\n system: coding.system.value,\n version: coding.version.value,\n display: coding.display.value\n }"
},
{
"url" : "displaySequence",
"valueInteger" : 23
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
}
],
"name" : "EffectiveDataRequirements",
"status" : "active",
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/library-type",
"code" : "module-definition"
}
]
},
"relatedArtifact" : [
{
"type" : "depends-on",
"display" : "Library SDE",
"resource" : "Library/SupplementalDataElements|3.5.000"
},
{
"type" : "depends-on",
"display" : "Library FHIRHelpers",
"resource" : "Library/FHIRHelpers|4.4.000"
},
{
"type" : "depends-on",
"display" : "Library QICoreCommon",
"resource" : "Library/QICoreCommon|2.1.000"
},
{
"type" : "depends-on",
"display" : "Code system AdministrativeGender",
"resource" : "http://hl7.org/fhir/administrative-gender"
},
{
"type" : "depends-on",
"display" : "Code system SNOMEDCT",
"resource" : "http://snomed.info/sct"
},
{
"type" : "depends-on",
"display" : "Code system ConditionClinicalStatusCodes",
"resource" : "http://terminology.hl7.org/CodeSystem/condition-clinical"
},
{
"type" : "depends-on",
"display" : "Code system ConditionVerificationStatusCodes",
"resource" : "http://terminology.hl7.org/CodeSystem/condition-ver-status"
},
{
"type" : "depends-on",
"display" : "Value set DEXA Dual Energy Xray Absorptiometry, Bone Density for Urology Care",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1151.38"
},
{
"type" : "depends-on",
"display" : "Value set Androgen deprivation therapy for Urology Care",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1151.48"
},
{
"type" : "depends-on",
"display" : "Value set Prostate Cancer",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.319"
},
{
"type" : "depends-on",
"display" : "Value set Office Visit",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001"
},
{
"type" : "depends-on",
"display" : "Value set Payer Type",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"
}
],
"parameter" : [
{
"name" : "Measurement Period",
"use" : "in",
"min" : 0,
"max" : "1",
"type" : "Period"
},
{
"name" : "SDE Sex",
"use" : "out",
"min" : 0,
"max" : "1",
"type" : "Coding"
},
{
"name" : "Numerator",
"use" : "out",
"min" : 0,
"max" : "1",
"type" : "boolean"
},
{
"name" : "Denominator Exception",
"use" : "out",
"min" : 0,
"max" : "1",
"type" : "boolean"
},
{
"name" : "Denominator",
"use" : "out",
"min" : 0,
"max" : "1",
"type" : "boolean"
},
{
"name" : "SDE Payer",
"use" : "out",
"min" : 0,
"max" : "*",
"type" : "Resource"
},
{
"name" : "Initial Population",
"use" : "out",
"min" : 0,
"max" : "1",
"type" : "boolean"
},
{
"name" : "SDE Ethnicity",
"use" : "out",
"min" : 0,
"max" : "1",
"type" : "Resource"
},
{
"name" : "SDE Race",
"use" : "out",
"min" : 0,
"max" : "1",
"type" : "Resource"
}
],
"dataRequirement" : [
{
"type" : "Patient",
"profile" : [
🔗 "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"
],
"mustSupport" : [
"ethnicity",
"race"
]
},
{
"type" : "Medication",
"profile" : [
🔗 "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medication"
],
"mustSupport" : [
"id"
]
},
{
"type" : "Medication",
"profile" : [
🔗 "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medication"
],
"mustSupport" : [
"id"
]
},
{
"type" : "MedicationRequest",
"profile" : [
🔗 "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest"
],
"mustSupport" : [
"medication.reference",
"dosageInstruction",
"status",
"status.value",
"intent",
"intent.value",
"authoredOn",
"authoredOn.value"
]
},
{
"type" : "MedicationRequest",
"profile" : [
🔗 "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest"
],
"mustSupport" : [
"medication",
"dosageInstruction",
"status",
"status.value",
"intent",
"intent.value",
"authoredOn",
"authoredOn.value"
],
"codeFilter" : [
{
"path" : "medication",
"valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1151.48"
}
]
},
{
"type" : "Condition",
"profile" : [
🔗 "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition"
],
"mustSupport" : [
"code",
"clinicalStatus",
"verificationStatus"
],
"codeFilter" : [
{
"path" : "code",
"valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.319"
},
{
"path" : "clinicalStatus"
},
{
"path" : "verificationStatus"
}
]
},
{
"type" : "ServiceRequest",
"profile" : [
🔗 "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest"
],
"mustSupport" : [
"code",
"authoredOn",
"authoredOn.value",
"status",
"status.value",
"intent",
"intent.value",
"doNotPerform",
"doNotPerform.value"
],
"codeFilter" : [
{
"path" : "code",
"code" : [
{
"system" : "http://snomed.info/sct",
"code" : "456381000124102",
"display" : "Injection of leuprolide acetate for twelve month period (regime/therapy)"
}
]
},
{
"path" : "intent.value",
"code" : [
{
"code" : "order"
}
]
}
],
"dateFilter" : [
{
"path" : "authoredOn.value",
"valuePeriod" : {
"extension" : [
{
"url" : "http://hl7.org/fhir/uv/crmi-analysisException",
"valueString" : "Error attempting to determine filter value: toFhirValue not implemented for Subtract"
}
]
}
}
]
},
{
"type" : "ServiceRequest",
"profile" : [
🔗 "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest"
],
"mustSupport" : [
"code",
"authoredOn",
"authoredOn.value",
"status",
"status.value",
"intent",
"intent.value",
"doNotPerform",
"doNotPerform.value"
],
"codeFilter" : [
{
"path" : "code",
"valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1151.38"
}
]
},
{
"type" : "Observation",
"profile" : [
🔗 "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation"
],
"mustSupport" : [
"code",
"effective",
"status",
"status.value"
],
"codeFilter" : [
{
"path" : "code",
"valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1151.38"
}
]
},
{
"type" : "Encounter",
"profile" : [
🔗 "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"
],
"mustSupport" : [
"type",
"period",
"status",
"status.value"
],
"codeFilter" : [
{
"path" : "type",
"valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001"
},
{
"path" : "status.value",
"code" : [
{
"code" : "finished"
}
]
}
]
},
{
"type" : "Coverage",
"profile" : [
🔗 "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-coverage"
],
"mustSupport" : [
"type",
"period"
],
"codeFilter" : [
{
"path" : "type",
"valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"
}
]
}
]
}
],
"extension" : [
{
"id" : "supplementalDataGuidance",
"extension" : [
{
"url" : "guidance",
"valueString" : "For every patient evaluated by this measure also identify payer, race, ethnicity and sex"
},
{
"url" : "usage",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "supplemental-data",
"display" : "Supplemental Data"
}
],
"text" : "Supplemental Data Guidance"
}
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-supplementalDataGuidance"
},
{
"id" : "effective-data-requirements",
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-effectiveDataRequirements",
"valueReference" : {
"reference" : "#effective-data-requirements"
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-softwaresystem",
"valueReference" : {
"reference" : "Device/cqf-tooling"
}
}
],
"url" : "https://madie.cms.gov/Measure/BoneDensityProstateCancerAndrogenDeprivationTherapyFHIR",
"identifier" : [
{
"use" : "usual",
"type" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type",
"code" : "short-name"
}
]
},
"system" : "https://madie.cms.gov/measure/shortName",
"value" : "CMS645FHIR"
},
{
"use" : "official",
"type" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type",
"code" : "version-independent"
}
]
},
"system" : "urn:ietf:rfc:3986",
"value" : "urn:uuid:299de9c4-755d-4f5a-ac9e-fa74fe34f759"
},
{
"use" : "official",
"type" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type",
"code" : "version-specific"
}
]
},
"system" : "urn:ietf:rfc:3986",
"value" : "urn:uuid:aed79368-1b42-422a-b31b-c01a9de8501f"
},
{
"use" : "official",
"type" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type",
"code" : "publisher"
}
]
},
"system" : "https://madie.cms.gov/measure/cmsId",
"value" : "645FHIR",
"assigner" : {
"display" : "CMS"
}
}
],
"version" : "1.4.000",
"name" : "BoneDensityProstateCancerAndrogenDeprivationTherapyFHIR",
"title" : "Bone Density Evaluation for Patients with Prostate Cancer and Receiving Androgen Deprivation TherapyFHIR",
"status" : "draft",
"experimental" : false,
"date" : "2024-07-09T14:53:57+00:00",
"publisher" : "Oregon Urology",
"contact" : [
{
"telecom" : [
{
"system" : "url",
"value" : "www.oregonurology.com"
}
]
}
],
"description" : "Percentage of patients determined as having prostate cancer who are currently starting or undergoing androgen deprivation therapy (ADT), for an anticipated period of 12 months or greater and who receive an initial bone density evaluation. The bone density evaluation must be prior to the start of ADT or within 3 months of the start of ADT.",
"purpose" : "UNKNOWN",
"usage" : "In order to capture the practitioner's intent of androgen deprivation therapy (ADT) for a period of 12 months or greater, SNOMEDCT 456381000124102 which is Injection of leuprolide acetate for twelve-month period (regime/therapy) is the correct code. This eCQM is a patient-based measure. This FHIR-based measure has been derived from the QDM-based measure: CMS645v8. Please refer to the HL7 QI-Core Implementation Guide (https://hl7.org/fhir/us/qicore/STU4.1.1/) for more information on QI-Core and mapping recommendations from QDM to QI-Core 4.1.1 (https://hl7.org/fhir/us/qicore/STU4.1.1/qdm-to-qicore.html).",
"copyright" : "Limited proprietary coding is contained in the measure specifications for convenience. Users of the proprietary code sets should obtain all necessary licenses from the owners of these code sets. Oregon Urology Institute (OUI) and Large Urology Group Practice Association (LUGPA) disclaim all liability for use or accuracy of third party codes contained in the specifications. CPT(R) contained in the Measure specifications is copyright 2004-2023. American Medical Association. LOINC(R) copyright 2004-2023 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2023. International Health Terminology Standards Development Organisation. ICD-10 copyright 2023 World Health Organization. All Rights Reserved.",
"effectivePeriod" : {
"start" : "2025-01-01",
"end" : "2025-12-31"
},
"author" : [
{
"name" : "Oregon Urology",
"telecom" : [
{
"system" : "url",
"value" : "www.oregonurology.com"
}
]
}
],
"library" : [
🔗 "https://madie.cms.gov/Library/BoneDensityProstateCancerAndrogenDeprivationTherapyFHIR"
],
"disclaimer" : "The performance measure is not a clinical guideline and does not establish a standard of medical care, and has not been tested for all potential applications. THE MEASURES AND SPECIFICATIONS ARE PROVIDED \"AS IS\" WITHOUT WARRANTY OF ANY KIND. Due to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM].",
"rationale" : "Androgen suppression as a treatment for prostate cancer can cause osteoporosis (Qaseem, 2008). Men undergoing prolonged androgen deprivation therapy (ADT) incur bone loss at a rate higher than menopausal women (Guise, 2007). In preserving bone health, the goal is to prevent or treat osteopenia/osteoporosis for the patient on ADT and to prevent or delay skeletal related events. The National Osteoporosis Foundation recommendations including a baseline assessment of bone density with a dual energy X-ray absorptiometry (DEXA) scan and daily calcium and Vitamin D supplementation (Watts, 2012). The DEXA scan is the gold standard for bone density screening. Men at risk for adverse bone consequences from chronic ADT do not always receive care according to evidence-based guidelines. These findings call for improved processes that standardize evidence-based practice including baseline and follow up bone density assessment (Watts, 2012).",
"clinicalRecommendationStatement" : "Bone density screening should be performed at the start of Androgen Deprivation Therapy (ADT) for prostate cancer. It should also be performed every 2 years for the patient with continued ADT or for patients with known osteoporosis. Current insurance practice is to possibly cover the cost of bone density screening if osteoporosis is known or if there is a high-risk drug. Some patients choose to delay bone density screening until after ADT is started and they therefore have insurance authorization due to the administration of a high-risk drug.",
"group" : [
{
"id" : "6643b7c1a7a1805d3b7374f8",
"extension" : [
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-scoring",
"code" : "proportion",
"display" : "Proportion"
}
]
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis",
"valueCode" : "boolean"
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-type",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-type",
"code" : "process",
"display" : "Process"
}
]
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-rateAggregation",
"valueCode" : "None"
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-improvementNotation",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-improvement-notation",
"code" : "increase",
"display" : "Increased score indicates improvement"
}
]
}
}
],
"population" : [
{
"id" : "E8F25116-1779-4BA6-B606-34F12AE4F5BA",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "initial-population",
"display" : "Initial Population"
}
]
},
"description" : "Patients with a qualifying encounter in the measurement period AND with a diagnosis of prostate cancer AND with an order for ADT or an active medication of ADT with an intent for treatment greater than or equal to 12 months during the measurement period AND order for ADT in 3 months before to 9 months after the start of the measurement period",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Initial Population"
}
},
{
"id" : "1C145A56-9250-4444-A497-86C44F55CFDB",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "denominator",
"display" : "Denominator"
}
]
},
"description" : "Equals Initial Population",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Denominator"
}
},
{
"id" : "B1E0E3D2-D44E-4BFF-92F8-077CF1AE234F",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "numerator",
"display" : "Numerator"
}
]
},
"description" : "Patients with a bone density evaluation within the two years prior to the start of or less than three months after the start of ADT treatment",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Numerator"
}
},
{
"id" : "A9552F46-139C-4270-835C-224132205362",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "denominator-exception",
"display" : "Denominator Exception"
}
]
},
"description" : "Patient refused the bone density evaluation at the time ordered or did not have it performed within 3 months after the start of ADT NOTE: Created a placeholder population due to issues around negation: refer to https://github.com/cqframework/cql-execution/issues/296, which is tied to https://oncprojectracking.healthit.gov/support/browse/BONNIEMAT-1455",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Denominator Exception"
}
}
]
}
],
"supplementalData" : [
{
"id" : "sde-ethnicity",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "supplemental-data"
}
]
}
],
"description" : "SDE Ethnicity",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "SDE Ethnicity"
}
},
{
"id" : "sde-payer",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "supplemental-data"
}
]
}
],
"description" : "SDE Payer",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "SDE Payer"
}
},
{
"id" : "sde-race",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "supplemental-data"
}
]
}
],
"description" : "SDE Race",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "SDE Race"
}
},
{
"id" : "sde-sex",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "supplemental-data"
}
]
}
],
"description" : "SDE Sex",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "SDE Sex"
}
}
]
}
IG © 2023+ cqframework. Package gov.healthit.ecqi.ecqms#2024.0.0 based on FHIR 4.0.1. Generated 2024-11-07
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