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 2024-12-18 |
{
"resourceType" : "Measure",
"id" : "CADBetaBlockerTherapyPriorMIorLVSDFHIR",
"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;\">Coronary Artery Disease (CAD): Beta-Blocker Therapy-Prior Myocardial Infarction (MI) or Left Ventricular Systolic Dysfunction (LVEF less than or equal to 40%)FHIR</td>\n </tr>\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Id: </b></th>\n <td style=\"padding-left: 4px;\">CADBetaBlockerTherapyPriorMIorLVSDFHIR</td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Version: </b></th>\n <td style=\"padding-left: 4px;\">0.2.000</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-CADBetaBlockerTherapyPriorMIorLVSDFHIR.html\">Coronary Artery Disease (CAD): Beta-Blocker Therapy-Prior Myocardial Infarction (MI) or Left Ventricular Systolic Dysfunction (LVEF less than or equal to 40%)FHIR</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>CMS145FHIR</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:466e5d36-1e01-478b-9dcb-edac33594dd5</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:b4533eba-331a-4cb7-88b3-6f2d07e225e9</span>\n </p>\n \n </td>\n </tr>\n \n <tr>\n <th scope=\"row\">\n <b>\n \n \n endorser (CMS Consensus Based Entity) identifier:\n \n \n </b>\n </th>\n\n <td style=\"padding-left: 4px;\">\n \n <p style=\"margin-bottom: 5px;\">\n <span>0070e</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>145FHIR</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;\">American Heart Association</td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Author: </b></th>\n <td style=\"padding-left: 4px;\">American Heart Association, American Medical Association (AMA), American Medical Association-convened Physician Consortium for Performance Improvement(R) (AMA-PCPI)</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 aged 18 years and older with a diagnosis of coronary artery disease seen within a 12-month period who also have a prior MI or a current or prior left ventricular ejection fraction (LVEF) <=40% who were prescribed beta-blocker therapy</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>Copyright 2024 American College of Cardiology and American Heart Association. 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 Measure is not a clinical guideline, does not establish a standard of medical care, and has not been tested for all potential applications.</p>\n<p>The Measure, while copyrighted, can be reproduced and distributed, without modification, for noncommercial purposes, e.g., use by health care providers in connection with their practices. Commercial use is defined as the sale, license, or distribution of the Measure for commercial gain, or incorporation of the Measure into a product or service that is sold, licensed or distributed for commercial gain.</p>\n<p>Commercial uses of the Measure require a license agreement between the user and the American College of Cardiology (ACC) or the American Heart Association (AHA). Neither the ACC, nor AHA, nor their members shall be responsible for any use of the Measure.</p>\n<p>ACC and AHA encourage use of the Measure by other health care professionals, where appropriate.</p>\n<p>THE MEASURE AND SPECIFICATIONS ARE PROVIDED "AS IS" WITHOUT WARRANTY OF ANY KIND.</p>\n<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. The ACC and AHA and their members disclaim all liability for use or accuracy of any Current Procedural Terminology (CPT[R]) or other coding contained in the specifications.</p>\n<p>CPT(R) contained in the Measure specifications is copyright 2004-2023 American Medical Association. LOINC(R) is 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 is copyright 2023 World Health Organization. All Rights Reserved.</p>\n<p>The American Medical Association’s and the PCPI(R) Foundation’s significant past efforts and contributions to the performance measure are gratefully acknowledged.</p>\n<p>Due to technical limitations, registered trademarks are indicated by (R) or [R].</p>\n</div></td>\n </tr>\n \n\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Scoring: </b></th>\n <td style=\"padding-left: 4px;\">\n \n \n <p style=\"margin-bottom: 5px;\">\n <span>Proportion </span>\n </p>\n \n \n \n </td>\n </tr>\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>For patients with coronary artery disease (CAD), beta-blockers are recommended for 3 years after myocardial infarction or acute coronary syndrome. Beta-blockers, particularly carvedilol, metoprolol succinate, or bisoprolol which have been shown to reduce risk of death, are recommended indefinitely for patients with CAD and LV systolic dysfunction. These agents have proven efficacy in reducing angina onset and improving the ischemic threshold during exercise. In patients who have suffered an MI, beta-blockers significantly reduce deaths and recurrent MIs (Fihn et al., 2012).</p>\n<p>Nonadherence to cardioprotective medications is prevalent among outpatients with CAD and can be associated with a broad range of adverse outcomes, including all-cause and cardiovascular mortality, cardiovascular hospitalizations, and the need for revascularization procedures (Gibbons et al., 2002).</p>\n<p>This measure is intended to promote beta-blocker usage in select patients with CAD.</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>Beta-blocker therapy should be started and continued for 3 years in all patients with normal LV function after MI or acute coronary syndrome (ACS) (Class I, Level of Evidence: B) (Fihn et al., 2012).</p>\n<p>Beta-blocker therapy should be used in all patients with LV systolic dysfunction (EF <= 40%) with heart failure or prior MI, unless contraindicated. (Use should be limited to carvedilol, metoprolol succinate, or bisoprolol, which have been shown to reduce risk of death.) (Class I, Level of Evidence: A) (Fihn et al., 2012).</p>\n<p>In patients with chronic coronary disease (CCD) and LVEF ≤40% with or without previous MI, the use of beta-blocker therapy is recommended to reduce the risk of future Major Adverse Cardiac Events (MACE), including cardiovascular death. (Class 1, Level of Evidence: A) (Virani et al., 2023)</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;\">Beta-blocker therapy:\n- For patients with prior MI, beta-blocker therapy includes any agent within the beta-blocker drug class. As of 2015, no recommendations or evidence are cited in current stable ischemic heart disease guidelines for preferential use of specific agents.\n- For patients with prior LVEF <=40%, beta-blocker therapy includes the following: bisoprolol, carvedilol, or sustained release metoprolol succinate.\n\nThe requirement of two or more visits is to establish that the eligible clinician has an existing relationship with the patient.\n\nA range value should satisfy the logic requirement for 'Ejection Fraction' as long as the ranged observation value clearly meets the less than or equal to 40% threshold noted in the denominator logic. A range that is greater than 40% would not meet the measure requirement.\n\nIn order for the Ejection Fraction result pathway to be recognized as below 40%, the result must be reported as a number with unit of %. A text string of "below 40%" or "ejection fraction between 35 and 40%" will not be recognized through electronic data capture. Although, this criteria can also be met using the Diagnosis pathway if specified as "Moderate or Severe."\n\nIf a patient has had a myocardial infarction (MI) within the past 3 years and a current or prior LVEF <=40% (or moderate or severe LVSD), the patient should only be counted in Population Criteria 1. \n\nThis eCQM is a patient-based measure.\n\nThis FHIR-based measure has been derived from the QDM-based measure: CMS145v13.\n\nPlease 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>6643a4bda7a1805d3b73744c</b></th>\n </tr>\n \n \n <tr>\n <td>Initial Population:</td>\n\n \n \n <td>All patients aged 18 years and older with two qualifying encounters during the measurement period and a diagnosis of coronary artery disease</td>\n \n \n\n </tr>\n \n <tr>\n <td>Denominator:</td>\n\n \n \n <td>Equals Initial Population who also have prior (within the past 3 years) MI or a current or prior LVEF <=40%</td>\n \n \n\n </tr>\n \n <tr>\n <td>Numerator:</td>\n\n \n \n <td>Patients who were prescribed beta-blocker therapy</td>\n \n \n\n </tr>\n \n <tr>\n <td>Denominator Exception:</td>\n\n \n \n <td>Documentation of medical reason(s) for not prescribing beta-blocker therapy (e.g., arrhythmia, asthma, bradycardia, hypotension, patients with atrioventricular block without cardiac pacer, observation of consecutive heart rates <50, allergy, intolerance, other medical reasons).\n\nDocumentation of patient reason(s) for not prescribing beta-blocker therapy (e.g., patient declined, other patient reasons).</td>\n \n \n\n </tr>\n \n \n </table>\n \n <table class=\"grid-dict\">\n \n <tr>\n <th><b>6643a4bda7a1805d3b73744d</b></th>\n </tr>\n \n \n <tr>\n <td>Initial Population:</td>\n\n \n \n <td>All patients aged 18 years and older with two qualifying encounters during the measurement period and a diagnosis of coronary artery disease</td>\n \n \n\n </tr>\n \n <tr>\n <td>Denominator:</td>\n\n \n \n <td>Equals Initial Population who also have prior (within the past 3 years) MI or a current or prior LVEF <=40%</td>\n \n \n\n </tr>\n \n <tr>\n <td>Numerator:</td>\n\n \n \n <td>Patients who were prescribed beta-blocker therapy</td>\n \n \n\n </tr>\n \n <tr>\n <td>Denominator Exception:</td>\n\n \n \n <td>Documentation of medical reason(s) for not prescribing beta-blocker therapy (e.g., arrhythmia, asthma, bradycardia, hypotension, patients with atrioventricular block without cardiac pacer, observation of consecutive heart rates <50, allergy, intolerance, other medical reasons).\n\nDocumentation of patient reason(s) for not prescribing beta-blocker therapy (e.g., patient declined, other patient reasons).</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 Sex</p>\n \n \n \n \n \n <p>SDE Race</p>\n \n \n \n \n \n <p>SDE Payer</p>\n \n \n \n \n \n <p>SDE Ethnicity</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-CADBetaBlockerTherapyPriorMIorLVSDFHIR.html\">CADBetaBlockerTherapyPriorMIorLVSDFHIR</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/AHAOverall|2.8.000</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://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=\"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-allergyintolerance-clinical.html\">AllergyIntolerance Clinical Status Codes</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/2.16.840.1.113883.3.464.1003.101.12.1008/expansion\">Outpatient Consultation</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1012/expansion\">Nursing Facility Visit</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1014/expansion\">Care Services in Long-Term Residential Facility</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1016/expansion\">Home Healthcare Services</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1012/expansion\">Patient Provider Interaction</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.369/expansion\">Coronary Artery Disease No MI</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.371/expansion\">Cardiac Surgery</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.403/expansion\">Myocardial Infarction</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1134/expansion\">Ejection Fraction</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1090/expansion\">Moderate or Severe LVSD</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1092/expansion\">Moderate or Severe</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.366/expansion\">Arrhythmia</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.362/expansion\">Asthma</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.412/expansion\">Bradycardia</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.370/expansion\">Hypotension</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1493/expansion\">Beta Blocker Therapy Ingredient</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1177/expansion\">Allergy to Beta Blocker Therapy</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1178/expansion\">Intolerance to Beta Blocker Therapy</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.367/expansion\">Atrioventricular Block</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.368/expansion\">Cardiac Pacer in Situ</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1178.53/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1178.53</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1184/expansion\">Beta Blocker Therapy for LVSD</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 <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1174/expansion\">Beta Blocker Therapy</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>Denominator 2</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 Exceptions 1</td>\n <td>Out</td>\n <td>0</td>\n <td>1</td>\n <td>boolean</td>\n </tr>\n \n <tr>\n <td>Numerator 1</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>Numerator 2</td>\n <td>Out</td>\n <td>0</td>\n <td>1</td>\n <td>boolean</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>Denominator Exceptions 2</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 Race</td>\n <td>Out</td>\n <td>0</td>\n <td>1</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Denominator 1</td>\n <td>Out</td>\n <td>0</td>\n <td>1</td>\n <td>boolean</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>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 id\n \n id.value\n \n </td>\n <td>\n \n \n Patient Provider Interaction\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1012/expansion\">Patient Provider Interaction</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 id\n \n id.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>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 id\n \n id.value\n \n </td>\n <td>\n \n \n Outpatient Consultation\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1008/expansion\">Outpatient Consultation</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 id\n \n id.value\n \n </td>\n <td>\n \n \n Care Services in Long Term Residential Facility\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1014/expansion\">Care Services in Long-Term Residential Facility</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 id\n \n id.value\n \n </td>\n <td>\n \n \n Home Healthcare Services\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1016/expansion\">Home Healthcare Services</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 id\n \n id.value\n \n </td>\n <td>\n \n \n Nursing Facility Visit\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1012/expansion\">Nursing Facility Visit</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 </td>\n <td>\n \n \n Coronary Artery Disease No MI\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.369/expansion\">Coronary Artery Disease No MI</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 severity\n \n </td>\n <td>\n \n </td>\n <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 </td>\n <td>\n \n \n Moderate or Severe LVSD\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1090/expansion\">Moderate or Severe LVSD</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 </td>\n <td>\n \n \n Myocardial Infarction\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.403/expansion\">Myocardial Infarction</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 </td>\n <td>\n \n \n Arrhythmia\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.366/expansion\">Arrhythmia</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 </td>\n <td>\n \n \n Asthma\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.362/expansion\">Asthma</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 </td>\n <td>\n \n \n Bradycardia\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.412/expansion\">Bradycardia</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 </td>\n <td>\n \n \n Hypotension\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.370/expansion\">Hypotension</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 </td>\n <td>\n \n \n Allergy to Beta Blocker Therapy\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1177/expansion\">Allergy to Beta Blocker Therapy</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 </td>\n <td>\n \n \n Intolerance to Beta Blocker Therapy\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1178/expansion\">Intolerance to Beta Blocker Therapy</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 </td>\n <td>\n \n \n Atrioventricular Block\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.367/expansion\">Atrioventricular Block</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 </td>\n <td>\n \n \n Cardiac Pacer in Situ\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.368/expansion\">Cardiac Pacer in Situ</a></td>\n </tr>\n \n <tr>\n <td>Procedure(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html\">QICoreProcedure</a>)</td>\n <td>\n \n code\n \n performed\n \n status\n \n status.value\n \n </td>\n <td>\n \n \n Cardiac Surgery\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.371/expansion\">Cardiac Surgery</a></td>\n </tr>\n \n <tr>\n <td>Procedure(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html\">QICoreProcedure</a>)</td>\n <td>\n \n code\n \n performed\n \n </td>\n <td>\n \n \n Cardiac Pacer\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1178.53/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1178.53</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 value\n \n status\n \n status.value\n \n </td>\n <td>\n \n \n Ejection Fraction\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1134/expansion\">Ejection Fraction</a></td>\n </tr>\n \n <tr>\n <td>Observation(<a href=\"http://hl7.org/fhir/R4/heartrate.html\">Observation Heart Rate Profile</a>)</td>\n <td>\n \n effective\n \n value\n \n status\n \n status.value\n \n </td>\n <td>\n \n </td>\n <td/>\n </tr>\n \n <tr>\n <td>AllergyIntolerance(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-allergyintolerance.html\">QICoreAllergyIntolerance</a>)</td>\n <td>\n \n code\n \n </td>\n <td>\n \n \n Beta Blocker Therapy Ingredient\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1493/expansion\">Beta Blocker Therapy Ingredient</a></td>\n </tr>\n \n <tr>\n <td>AllergyIntolerance(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-allergyintolerance.html\">QICoreAllergyIntolerance</a>)</td>\n <td>\n \n code\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 </td>\n <td>\n \n \n Beta Blocker Therapy for LVSD\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1184/expansion\">Beta Blocker Therapy for LVSD</a></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 </td>\n <td>\n \n \n Beta Blocker Therapy\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1174/expansion\">Beta Blocker Therapy</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>Active</td>\n <td>active</td>\n <td><a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-condition-clinical.html\">http://terminology.hl7.org/CodeSystem/condition-clinical</a></td>\n </tr>\n \n <tr>\n <td>Recurrence</td>\n <td>recurrence</td>\n <td><a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-condition-clinical.html\">http://terminology.hl7.org/CodeSystem/condition-clinical</a></td>\n </tr>\n \n <tr>\n <td>Relapse</td>\n <td>relapse</td>\n <td><a href=\"http://terminology.hl7.org/5.5.0/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://terminology.hl7.org/5.5.0/CodeSystem-condition-ver-status.html\">http://terminology.hl7.org/CodeSystem/condition-ver-status</a></td>\n </tr>\n \n <tr>\n <td>Left ventricular systolic dysfunction (disorder)</td>\n <td>134401001</td>\n <td><a href=\"https://browser.ihtsdotools.org/\">http://snomed.info/sct</a></td>\n </tr>\n \n <tr>\n <td>Substance with beta adrenergic receptor antagonist mechanism of action (substance)</td>\n <td>373254001</td>\n <td><a href=\"https://browser.ihtsdotools.org/\">http://snomed.info/sct</a></td>\n </tr>\n \n <tr>\n <td>Active</td>\n <td>active</td>\n <td><a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-allergyintolerance-clinical.html\">http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical</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> 6643a4bda7a1805d3b73744c </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 <b>Measure scoring:</b>\n \n <p style=\"margin-bottom: 5px;\">\n <span>Proportion</span>\n </p>\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;\">This measure is intended to have one reporting rate, which aggregates the following populations into a single performance rate for reporting purposes: \n- Population 1: Patients with left ventricular systolic dysfunction (LVEF <=40%)\n- Population 2: Patients with a prior (within the past 3 years) myocardial infarction\n\nFor the purposes of this measure, a single performance rate can be calculated as follows:\nPerformance Rate = (Numerator 1 + Numerator 2)/ [(Denominator 1 - Denominator Exceptions 1) + (Denominator 2 - Denominator Exceptions 2)]</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 AgeInYearsAt(date from start of "Measurement Period") >= 18\n and exists ( "Qualifying Encounter During Measurement Period" Encounter1\n with "Qualifying Encounter During Measurement Period" Encounter2\n such that Encounter2.id !~ Encounter1.id\n )\n and exists "Qualifying CAD Encounter"</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 1":\n "Initial Population"\n and exists "Qualifying CAD Encounter and History of Moderate or Severe LVSD"</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 1":\n "Has Beta Blocker Therapy for LVSD Ordered"\n or "Is Currently Taking Beta Blocker Therapy for LVSD"</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: "Has Medical or Patient Reason for Not Ordering Beta Blocker for LVSD"\n@commentedOutReason: Negation issue noted in https://github.com/cqframework/cql-execution/issues/296, which is tied to https://oncprojectracking.healthit.gov/support/browse/BONNIEMAT-1455\n*/\n\n\ndefine "Denominator Exceptions 1":\n "Has Arrhythmia with Qualifying CAD Encounter and History of Moderate or Severe LVSD"\n or "Has Asthma with Qualifying CAD Encounter and History of Moderate or Severe LVSD"\n or "Has Bradycardia with Qualifying CAD Encounter and History of Moderate or Severe LVSD"\n or "Has Hypotension with Qualifying CAD Encounter and History of Moderate or Severe LVSD"\n or "Has Consecutive Heart Rates Less than 50 with Qualifying CAD Encounter and History of Moderate or Severe LVSD"\n or "Has Allergy or Intolerance to Beta Blocker Therapy Ingredient with Qualifying CAD Encounter and History of Moderate or Severe LVSD"\n or "Has Diagnosis of Allergy or Intolerance to Beta Blocker Therapy with Qualifying CAD Encounter and History of Moderate or Severe LVSD"\n //or "Has Medical or Patient Reason for Not Ordering Beta Blocker for LVSD"\n \n or "Has Atrioventricular Block with Qualifying CAD Encounter and History of Moderate or Severe LVSD without Cardiac Pacer"</code></pre>\n \n </td>\n </tr>\n \n \n \n <td> 6643a4bda7a1805d3b73744d </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 <b>Measure scoring:</b>\n \n <p style=\"margin-bottom: 5px;\">\n <span>Proportion</span>\n </p>\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;\">This measure is intended to have one reporting rate, which aggregates the following populations into a single performance rate for reporting purposes: \n- Population 1: Patients with left ventricular systolic dysfunction (LVEF <=40%)\n- Population 2: Patients with a prior (within the past 3 years) myocardial infarction\n\nFor the purposes of this measure, a single performance rate can be calculated as follows:\nPerformance Rate = (Numerator 1 + Numerator 2)/ [(Denominator 1 - Denominator Exceptions 1) + (Denominator 2 - Denominator Exceptions 2)]</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 AgeInYearsAt(date from start of "Measurement Period") >= 18\n and exists ( "Qualifying Encounter During Measurement Period" Encounter1\n with "Qualifying Encounter During Measurement Period" Encounter2\n such that Encounter2.id !~ Encounter1.id\n )\n and exists "Qualifying CAD Encounter"</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 2":\n "Initial Population"\n and exists "Qualifying CAD Encounter and Prior MI"</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 2":\n "Has Beta Blocker Therapy Ordered"\n or "Is Currently Taking Beta Blocker Therapy"</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: "Has Medical or Patient Reason for Not Ordering Beta Blocker Therapy" \n@commentedOutReason: Negation issue noted in https://github.com/cqframework/cql-execution/issues/296, which is tied to https://oncprojectracking.healthit.gov/support/browse/BONNIEMAT-1455\n*/\n\n\ndefine "Denominator Exceptions 2":\n "Has Arrhythmia with Qualifying CAD Encounter and Prior MI"\n or "Has Asthma with Qualifying CAD Encounter and Prior MI"\n or "Has Bradycardia with Qualifying CAD Encounter and Prior MI"\n or "Has Hypotension with Qualifying CAD Encounter and Prior MI"\n or "Has Consecutive Heart Rates Less than 50 with Qualifying CAD Encounter and Prior MI"\n or "Has Allergy or Intolerance to Beta Blocker Therapy Ingredient with Qualifying CAD Encounter and Prior MI"\n or "Has Diagnosis of Allergy or Intolerance to Beta Blocker Therapy with Qualifying CAD Encounter and Prior MI"\n //or "Has Medical or Patient Reason for Not Ordering Beta Blocker Therapy"\n \n or "Has Atrioventricular Block with Qualifying CAD Encounter and Prior MI without Cardiac Pacer"</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>CADBetaBlockerTherapyPriorMIorLVSDFHIR</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>CADBetaBlockerTherapyPriorMIorLVSDFHIR</td>\n \n \n <td>Qualifying Encounter During Measurement Period</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Qualifying Encounter During Measurement Period":\n ( [Encounter: "Office Visit"]\n union [Encounter: "Outpatient Consultation"]\n union [Encounter: "Nursing Facility Visit"]\n union [Encounter: "Care Services in Long Term Residential Facility"]\n union [Encounter: "Home Healthcare Services"]\n union [Encounter: "Patient Provider Interaction"] ) ValidEncounter\n where ValidEncounter.period during day of "Measurement Period"\n and ValidEncounter.status = 'finished'</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>CADBetaBlockerTherapyPriorMIorLVSDFHIR</td>\n \n \n <td>Outpatient Encounter During Measurement Period</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Outpatient Encounter During Measurement Period":\n ( [Encounter: "Office Visit"]\n union [Encounter: "Outpatient Consultation"]\n union [Encounter: "Care Services in Long Term Residential Facility"]\n union [Encounter: "Home Healthcare Services"]\n union [Encounter: "Nursing Facility Visit"] ) QualifyingEncounter\n where QualifyingEncounter.period during day of "Measurement Period"\n and QualifyingEncounter.status = 'finished'</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>CADBetaBlockerTherapyPriorMIorLVSDFHIR</td>\n \n \n <td>Coronary Artery Disease Encounter</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Coronary Artery Disease Encounter":\n "Outpatient Encounter During Measurement Period" ValidQualifyingEncounter\n with [Condition: "Coronary Artery Disease No MI"] CoronaryArteryDisease\n such that CoronaryArteryDisease.overlapsDayOfEncounter ( ValidQualifyingEncounter )</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>CADBetaBlockerTherapyPriorMIorLVSDFHIR</td>\n \n \n <td>History of Cardiac Surgery Prior to Encounter</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "History of Cardiac Surgery Prior to Encounter":\n "Outpatient Encounter During Measurement Period" ValidQualifyingEncounter\n with [Procedure: "Cardiac Surgery"] CardiacSurgery\n such that CardiacSurgery.performed.toInterval ( ) starts before end of ValidQualifyingEncounter.period\n and CardiacSurgery.status = 'completed'</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>CADBetaBlockerTherapyPriorMIorLVSDFHIR</td>\n \n \n <td>Qualifying CAD Encounter</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Qualifying CAD Encounter":\n "Coronary Artery Disease Encounter"\n union "History of Cardiac Surgery Prior to Encounter"</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>CADBetaBlockerTherapyPriorMIorLVSDFHIR</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 AgeInYearsAt(date from start of "Measurement Period") >= 18\n and exists ( "Qualifying Encounter During Measurement Period" Encounter1\n with "Qualifying Encounter During Measurement Period" Encounter2\n such that Encounter2.id !~ Encounter1.id\n )\n and exists "Qualifying CAD Encounter"</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>AHAOverall</td>\n \n \n <td>Moderate or Severe LVSD Findings</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">/*\n@description: Returns a union of the following:\n * Observations where the final, amended or correction ejection fraction result is <= 40\n * Moderate or Severe LVSD conditions where the diagnosis has been confirmed as active\n*/ \ndefine "Moderate or Severe LVSD Findings":\n ( [Observation: "Ejection Fraction"] EjectionFraction\n where EjectionFraction.value as Quantity <= 40 '%'\n and EjectionFraction.status in {'final', 'amended', 'corrected'} \n )\n union ( \n ( [Condition: "Moderate or Severe LVSD"]\n union ( [Condition: "Left ventricular systolic dysfunction (disorder)"] LVSDDiagnosis\n where LVSDDiagnosis.severity in "Moderate or Severe" )\n ) ModerateOrSevereLVSD \n where ModerateOrSevereLVSD.isConfirmedActiveDiagnosis()\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>CADBetaBlockerTherapyPriorMIorLVSDFHIR</td>\n \n \n <td>Qualifying CAD Encounter and Prior MI</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Qualifying CAD Encounter and Prior MI":\n "Qualifying CAD Encounter" EncounterWithCADProxy\n with [Condition: "Myocardial Infarction"] MyocardialInfarction\n such that MyocardialInfarction.prevalenceInterval ( ) starts 3 years or less before day of start of EncounterWithCADProxy.period\n and not exists AHA."Moderate or Severe LVSD Findings"</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>CADBetaBlockerTherapyPriorMIorLVSDFHIR</td>\n \n \n <td>Denominator 2</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Denominator 2":\n "Initial Population"\n and exists "Qualifying CAD Encounter and Prior MI"</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>CADBetaBlockerTherapyPriorMIorLVSDFHIR</td>\n \n \n <td>Qualifying CAD Encounter and History of Moderate or Severe LVSD</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Qualifying CAD Encounter and History of Moderate or Severe LVSD":\n "Qualifying CAD Encounter" EncounterWithCADProxy\n with AHA."Moderate or Severe LVSD Findings" LVSDFindings\n such that Coalesce(LVSDFindings.prevalenceInterval(), LVSDFindings.effective.toInterval()) starts before end of EncounterWithCADProxy.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>CADBetaBlockerTherapyPriorMIorLVSDFHIR</td>\n \n \n <td>Has Arrhythmia with Qualifying CAD Encounter and History of Moderate or Severe LVSD</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Has Arrhythmia with Qualifying CAD Encounter and History of Moderate or Severe LVSD":\n exists ( [Condition: "Arrhythmia"] ArrhythmiaDiagnosis\n where ArrhythmiaDiagnosis.overlapsDayOfEncounter ( "Qualifying CAD Encounter and History of Moderate or Severe LVSD" )\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>CADBetaBlockerTherapyPriorMIorLVSDFHIR</td>\n \n \n <td>Has Asthma with Qualifying CAD Encounter and History of Moderate or Severe LVSD</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Has Asthma with Qualifying CAD Encounter and History of Moderate or Severe LVSD":\n exists ( [Condition: "Asthma"] AsthmaDiagnosis\n where AsthmaDiagnosis.overlapsDayOfEncounter ( "Qualifying CAD Encounter and History of Moderate or Severe LVSD" )\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>CADBetaBlockerTherapyPriorMIorLVSDFHIR</td>\n \n \n <td>Has Bradycardia with Qualifying CAD Encounter and History of Moderate or Severe LVSD</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Has Bradycardia with Qualifying CAD Encounter and History of Moderate or Severe LVSD":\n exists ( [Condition: "Bradycardia"] BradycardiaDiagnosis\n where BradycardiaDiagnosis.overlapsDayOfEncounter ( "Qualifying CAD Encounter and History of Moderate or Severe LVSD" )\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>CADBetaBlockerTherapyPriorMIorLVSDFHIR</td>\n \n \n <td>Has Hypotension with Qualifying CAD Encounter and History of Moderate or Severe LVSD</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Has Hypotension with Qualifying CAD Encounter and History of Moderate or Severe LVSD":\n exists ( [Condition: "Hypotension"] HypotensionDiagnosis\n where HypotensionDiagnosis.overlapsDayOfEncounter ( "Qualifying CAD Encounter and History of Moderate or Severe LVSD" )\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>CADBetaBlockerTherapyPriorMIorLVSDFHIR</td>\n \n \n <td>Has Consecutive Heart Rates Less than 50 with Qualifying CAD Encounter and History of Moderate or Severe LVSD</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">/*\n* @code: Heart rate - 8867-4\n* @profile: http://hl7.org/fhir/StructureDefinition/heartrate \n*/\n\n\ndefine "Has Consecutive Heart Rates Less than 50 with Qualifying CAD Encounter and History of Moderate or Severe LVSD":\n exists ( from\n ["observation-heartrate"] HeartRate,\n "Qualifying CAD Encounter and History of Moderate or Severe LVSD" CADEncounterModerateOrSevereLVSD\n let PriorHeartRate: Last(["observation-heartrate"] MostRecentPriorHeartRate\n where MostRecentPriorHeartRate.effective.toInterval() during CADEncounterModerateOrSevereLVSD.period\n and MostRecentPriorHeartRate.effective.toInterval() before HeartRate.effective.toInterval()\n sort by start of effective.toInterval()\n )\n where HeartRate.effective.toInterval ( ) during CADEncounterModerateOrSevereLVSD.period\n and HeartRate.value < 50 '/min'\n and PriorHeartRate.value < 50 '/min'\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>CADBetaBlockerTherapyPriorMIorLVSDFHIR</td>\n \n \n <td>Has Allergy or Intolerance to Beta Blocker Therapy Ingredient with Qualifying CAD Encounter and History of Moderate or Severe LVSD</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Has Allergy or Intolerance to Beta Blocker Therapy Ingredient with Qualifying CAD Encounter and History of Moderate or Severe LVSD":\n exists ( ( [AllergyIntolerance: "Beta Blocker Therapy Ingredient"]\n union [AllergyIntolerance: "Substance with beta adrenergic receptor antagonist mechanism of action (substance)"] ) BetaBlockerAllergyIntolerance\n where BetaBlockerAllergyIntolerance.overlapsAfterDayOfEncounter ( "Qualifying CAD Encounter and History of Moderate or Severe LVSD" )\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>CADBetaBlockerTherapyPriorMIorLVSDFHIR</td>\n \n \n <td>Has Diagnosis of Allergy or Intolerance to Beta Blocker Therapy with Qualifying CAD Encounter and History of Moderate or Severe LVSD</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Has Diagnosis of Allergy or Intolerance to Beta Blocker Therapy with Qualifying CAD Encounter and History of Moderate or Severe LVSD":\n exists ( ( [Condition: "Allergy to Beta Blocker Therapy"]\n union [Condition: "Intolerance to Beta Blocker Therapy"] ) BetaBlockerAllergyOrIntoleranceDiagnosis\n where BetaBlockerAllergyOrIntoleranceDiagnosis.overlapsAfterDayOfEncounter ( "Qualifying CAD Encounter and History of Moderate or Severe LVSD" )\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>CADBetaBlockerTherapyPriorMIorLVSDFHIR</td>\n \n \n <td>Has Atrioventricular Block with Qualifying CAD Encounter and History of Moderate or Severe LVSD</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Has Atrioventricular Block with Qualifying CAD Encounter and History of Moderate or Severe LVSD":\n exists ( [Condition: "Atrioventricular Block"] AtrioventricularBlock\n where AtrioventricularBlock.overlapsDayOfEncounter ( "Qualifying CAD Encounter and History of Moderate or Severe LVSD" )\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>CADBetaBlockerTherapyPriorMIorLVSDFHIR</td>\n \n \n <td>Has Diagnosis of Cardiac Pacer in Situ with Qualifying CAD Encounter and History of Moderate or Severe LVSD</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Has Diagnosis of Cardiac Pacer in Situ with Qualifying CAD Encounter and History of Moderate or Severe LVSD":\n exists ( [Condition: "Cardiac Pacer in Situ"] CardiacPacerDiagnosis\n where CardiacPacerDiagnosis.overlapsDayOfEncounter ( "Qualifying CAD Encounter and History of Moderate or Severe LVSD" )\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>CADBetaBlockerTherapyPriorMIorLVSDFHIR</td>\n \n \n <td>Has Cardiac Pacer Device Implanted with Qualifying CAD Encounter and History of Moderate or Severe LVSD</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Has Cardiac Pacer Device Implanted with Qualifying CAD Encounter and History of Moderate or Severe LVSD":\n exists ( [Procedure: "Cardiac Pacer"] ImplantedCardiacPacer\n with "Qualifying CAD Encounter and History of Moderate or Severe LVSD" CADEncounterModerateOrSevereLVSD\n such that ImplantedCardiacPacer.performed.toInterval ( ) starts before end of CADEncounterModerateOrSevereLVSD.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>CADBetaBlockerTherapyPriorMIorLVSDFHIR</td>\n \n \n <td>Has Atrioventricular Block with Qualifying CAD Encounter and History of Moderate or Severe LVSD without Cardiac Pacer</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Has Atrioventricular Block with Qualifying CAD Encounter and History of Moderate or Severe LVSD without Cardiac Pacer":\n "Has Atrioventricular Block with Qualifying CAD Encounter and History of Moderate or Severe LVSD"\n and not "Has Diagnosis of Cardiac Pacer in Situ with Qualifying CAD Encounter and History of Moderate or Severe LVSD"\n and not "Has Cardiac Pacer Device Implanted with Qualifying CAD Encounter and History of Moderate or Severe LVSD"</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>CADBetaBlockerTherapyPriorMIorLVSDFHIR</td>\n \n \n <td>Denominator Exceptions 1</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">/*\n@commentedOut: "Has Medical or Patient Reason for Not Ordering Beta Blocker for LVSD"\n@commentedOutReason: Negation issue noted in https://github.com/cqframework/cql-execution/issues/296, which is tied to https://oncprojectracking.healthit.gov/support/browse/BONNIEMAT-1455\n*/\n\n\ndefine "Denominator Exceptions 1":\n "Has Arrhythmia with Qualifying CAD Encounter and History of Moderate or Severe LVSD"\n or "Has Asthma with Qualifying CAD Encounter and History of Moderate or Severe LVSD"\n or "Has Bradycardia with Qualifying CAD Encounter and History of Moderate or Severe LVSD"\n or "Has Hypotension with Qualifying CAD Encounter and History of Moderate or Severe LVSD"\n or "Has Consecutive Heart Rates Less than 50 with Qualifying CAD Encounter and History of Moderate or Severe LVSD"\n or "Has Allergy or Intolerance to Beta Blocker Therapy Ingredient with Qualifying CAD Encounter and History of Moderate or Severe LVSD"\n or "Has Diagnosis of Allergy or Intolerance to Beta Blocker Therapy with Qualifying CAD Encounter and History of Moderate or Severe LVSD"\n //or "Has Medical or Patient Reason for Not Ordering Beta Blocker for LVSD"\n \n or "Has Atrioventricular Block with Qualifying CAD Encounter and History of Moderate or Severe LVSD without Cardiac Pacer"</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>CADBetaBlockerTherapyPriorMIorLVSDFHIR</td>\n \n \n <td>Has Beta Blocker Therapy for LVSD Ordered</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Has Beta Blocker Therapy for LVSD Ordered":\n exists ( [MedicationRequest: medication in "Beta Blocker Therapy for LVSD"] BetaBlockerForLVSDOrdered\n where BetaBlockerForLVSDOrdered.authoredDuringDayOfEncounter ( "Qualifying CAD Encounter and History of Moderate or Severe LVSD" )\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>CADBetaBlockerTherapyPriorMIorLVSDFHIR</td>\n \n \n <td>Is Currently Taking Beta Blocker Therapy for LVSD</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Is Currently Taking Beta Blocker Therapy for LVSD":\n exists ( [MedicationRequest: medication in "Beta Blocker Therapy for LVSD"] ActiveBetaBlockerForLVSD\n with "Qualifying CAD Encounter and History of Moderate or Severe LVSD" CADEncounterModerateOrSevereLVSD\n such that First((collapse(ActiveBetaBlockerForLVSD.dosageInstruction.timing.repeat.bounds DoseTime\n return DoseTime.toInterval()\n )) DrugPeriod\n sort by start of $this\n ) overlaps after day of CADEncounterModerateOrSevereLVSD.period\n where ActiveBetaBlockerForLVSD.status in { 'active', 'completed' }\n and ActiveBetaBlockerForLVSD.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }\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>CADBetaBlockerTherapyPriorMIorLVSDFHIR</td>\n \n \n <td>Numerator 1</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Numerator 1":\n "Has Beta Blocker Therapy for LVSD Ordered"\n or "Is Currently Taking Beta Blocker Therapy for LVSD"</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>CADBetaBlockerTherapyPriorMIorLVSDFHIR</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>CADBetaBlockerTherapyPriorMIorLVSDFHIR</td>\n \n \n <td>Has Beta Blocker Therapy Ordered</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Has Beta Blocker Therapy Ordered":\n exists ( [MedicationRequest: medication in "Beta Blocker Therapy"] BetaBlockerOrdered\n where BetaBlockerOrdered.authoredDuringDayOfEncounter ( "Qualifying CAD Encounter and Prior MI" )\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>CADBetaBlockerTherapyPriorMIorLVSDFHIR</td>\n \n \n <td>Is Currently Taking Beta Blocker Therapy</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Is Currently Taking Beta Blocker Therapy":\n exists ( [MedicationRequest: medication in "Beta Blocker Therapy"] ActiveBetaBlocker\n with "Qualifying CAD Encounter and Prior MI" CADEncounterMI\n such that First((collapse(ActiveBetaBlocker.dosageInstruction.timing.repeat.bounds DoseTime\n return DoseTime.toInterval()\n )) DrugPeriod\n sort by start of $this\n ) overlaps after day of CADEncounterMI.period\n where ActiveBetaBlocker.status in { 'active', 'completed' }\n and ActiveBetaBlocker.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }\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>CADBetaBlockerTherapyPriorMIorLVSDFHIR</td>\n \n \n <td>Numerator 2</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Numerator 2":\n "Has Beta Blocker Therapy Ordered"\n or "Is Currently Taking Beta Blocker Therapy"</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>CADBetaBlockerTherapyPriorMIorLVSDFHIR</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>CADBetaBlockerTherapyPriorMIorLVSDFHIR</td>\n \n \n <td>Has Arrhythmia with Qualifying CAD Encounter and Prior MI</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Has Arrhythmia with Qualifying CAD Encounter and Prior MI":\n exists ( [Condition: "Arrhythmia"] ArrhythmiaDiagnosis\n where ArrhythmiaDiagnosis.overlapsDayOfEncounter ( "Qualifying CAD Encounter and Prior MI" )\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>CADBetaBlockerTherapyPriorMIorLVSDFHIR</td>\n \n \n <td>Has Asthma with Qualifying CAD Encounter and Prior MI</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Has Asthma with Qualifying CAD Encounter and Prior MI":\n exists ( [Condition: "Asthma"] AsthmaDiagnosis\n where AsthmaDiagnosis.overlapsDayOfEncounter ( "Qualifying CAD Encounter and Prior MI" )\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>CADBetaBlockerTherapyPriorMIorLVSDFHIR</td>\n \n \n <td>Has Bradycardia with Qualifying CAD Encounter and Prior MI</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Has Bradycardia with Qualifying CAD Encounter and Prior MI":\n exists ( [Condition: "Bradycardia"] BradycardiaDiagnosis\n where BradycardiaDiagnosis.overlapsDayOfEncounter ( "Qualifying CAD Encounter and Prior MI" )\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>CADBetaBlockerTherapyPriorMIorLVSDFHIR</td>\n \n \n <td>Has Hypotension with Qualifying CAD Encounter and Prior MI</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Has Hypotension with Qualifying CAD Encounter and Prior MI":\n exists ( [Condition: "Hypotension"] HypotensionDiagnosis\n where HypotensionDiagnosis.overlapsDayOfEncounter ( "Qualifying CAD Encounter and Prior MI" )\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>CADBetaBlockerTherapyPriorMIorLVSDFHIR</td>\n \n \n <td>Has Consecutive Heart Rates Less than 50 with Qualifying CAD Encounter and Prior MI</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">/*\n* @code: Heart rate - 8867-4\n* @profile: http://hl7.org/fhir/StructureDefinition/heartrate \n*/\n\n\ndefine "Has Consecutive Heart Rates Less than 50 with Qualifying CAD Encounter and Prior MI":\n exists ( from\n ["observation-heartrate"] HeartRate,\n "Qualifying CAD Encounter and Prior MI" CADEncounterMI\n let PriorHeartRate: Last(["observation-heartrate"] MostRecentPriorHeartRate\n where MostRecentPriorHeartRate.effective.toInterval() during CADEncounterMI.period\n and MostRecentPriorHeartRate.status in { 'final', 'amended', 'corrected' }\n and MostRecentPriorHeartRate.effective.toInterval() before HeartRate.effective.toInterval()\n sort by start of effective.toInterval()\n )\n where HeartRate.effective.toInterval ( ) during CADEncounterMI.period\n and HeartRate.status in { 'final', 'amended', 'corrected' }\n and HeartRate.value < 50 '/min'\n and PriorHeartRate.value < 50 '/min'\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>CADBetaBlockerTherapyPriorMIorLVSDFHIR</td>\n \n \n <td>Has Allergy or Intolerance to Beta Blocker Therapy Ingredient with Qualifying CAD Encounter and Prior MI</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Has Allergy or Intolerance to Beta Blocker Therapy Ingredient with Qualifying CAD Encounter and Prior MI":\n exists ( ( [AllergyIntolerance: "Beta Blocker Therapy Ingredient"]\n union [AllergyIntolerance: "Substance with beta adrenergic receptor antagonist mechanism of action (substance)"] ) BetaBlockerAllergyIntolerance\n where BetaBlockerAllergyIntolerance.overlapsAfterDayOfEncounter ( "Qualifying CAD Encounter and Prior MI" )\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>CADBetaBlockerTherapyPriorMIorLVSDFHIR</td>\n \n \n <td>Has Diagnosis of Allergy or Intolerance to Beta Blocker Therapy with Qualifying CAD Encounter and Prior MI</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Has Diagnosis of Allergy or Intolerance to Beta Blocker Therapy with Qualifying CAD Encounter and Prior MI":\n exists ( ( [Condition: "Allergy to Beta Blocker Therapy"]\n union [Condition: "Intolerance to Beta Blocker Therapy"] ) BetaBlockerAllergyOrIntoleranceDiagnosis\n where BetaBlockerAllergyOrIntoleranceDiagnosis.overlapsAfterDayOfEncounter ( "Qualifying CAD Encounter and Prior MI" )\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>CADBetaBlockerTherapyPriorMIorLVSDFHIR</td>\n \n \n <td>Has Atrioventricular Block with Qualifying CAD Encounter and Prior MI</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Has Atrioventricular Block with Qualifying CAD Encounter and Prior MI":\n exists ( [Condition: "Atrioventricular Block"] AtrioventricularBlock\n where AtrioventricularBlock.overlapsDayOfEncounter ( "Qualifying CAD Encounter and Prior MI" )\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>CADBetaBlockerTherapyPriorMIorLVSDFHIR</td>\n \n \n <td>Has Diagnosis of Cardiac Pacer in Situ with Qualifying CAD Encounter and Prior MI</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Has Diagnosis of Cardiac Pacer in Situ with Qualifying CAD Encounter and Prior MI":\n exists ( [Condition: "Cardiac Pacer in Situ"] CardiacPacerDiagnosis\n where CardiacPacerDiagnosis.overlapsDayOfEncounter ( "Qualifying CAD Encounter and Prior MI" )\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>CADBetaBlockerTherapyPriorMIorLVSDFHIR</td>\n \n \n <td>Has Cardiac Pacer Device Implanted with Qualifying CAD Encounter and Prior MI</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Has Cardiac Pacer Device Implanted with Qualifying CAD Encounter and Prior MI":\n exists ( [Procedure: "Cardiac Pacer"] ImplantedCardiacPacer\n with "Qualifying CAD Encounter and Prior MI" CADEncounterMI\n such that ImplantedCardiacPacer.performed.toInterval ( ) starts before end of CADEncounterMI.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>CADBetaBlockerTherapyPriorMIorLVSDFHIR</td>\n \n \n <td>Has Atrioventricular Block with Qualifying CAD Encounter and Prior MI without Cardiac Pacer</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Has Atrioventricular Block with Qualifying CAD Encounter and Prior MI without Cardiac Pacer":\n "Has Atrioventricular Block with Qualifying CAD Encounter and Prior MI"\n and not "Has Diagnosis of Cardiac Pacer in Situ with Qualifying CAD Encounter and Prior MI"\n and not "Has Cardiac Pacer Device Implanted with Qualifying CAD Encounter and Prior MI"</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>CADBetaBlockerTherapyPriorMIorLVSDFHIR</td>\n \n \n <td>Denominator Exceptions 2</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">/*\n@commentedOut: "Has Medical or Patient Reason for Not Ordering Beta Blocker Therapy" \n@commentedOutReason: Negation issue noted in https://github.com/cqframework/cql-execution/issues/296, which is tied to https://oncprojectracking.healthit.gov/support/browse/BONNIEMAT-1455\n*/\n\n\ndefine "Denominator Exceptions 2":\n "Has Arrhythmia with Qualifying CAD Encounter and Prior MI"\n or "Has Asthma with Qualifying CAD Encounter and Prior MI"\n or "Has Bradycardia with Qualifying CAD Encounter and Prior MI"\n or "Has Hypotension with Qualifying CAD Encounter and Prior MI"\n or "Has Consecutive Heart Rates Less than 50 with Qualifying CAD Encounter and Prior MI"\n or "Has Allergy or Intolerance to Beta Blocker Therapy Ingredient with Qualifying CAD Encounter and Prior MI"\n or "Has Diagnosis of Allergy or Intolerance to Beta Blocker Therapy with Qualifying CAD Encounter and Prior MI"\n //or "Has Medical or Patient Reason for Not Ordering Beta Blocker Therapy"\n \n or "Has Atrioventricular Block with Qualifying CAD Encounter and Prior MI without Cardiac Pacer"</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>CADBetaBlockerTherapyPriorMIorLVSDFHIR</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>CADBetaBlockerTherapyPriorMIorLVSDFHIR</td>\n \n \n <td>Denominator 1</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Denominator 1":\n "Initial Population"\n and exists "Qualifying CAD Encounter and History of Moderate or Severe LVSD"</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>CADBetaBlockerTherapyPriorMIorLVSDFHIR</td>\n \n \n <td>overlapsDayOfEncounter</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define fluent function overlapsDayOfEncounter(Diagnosis Condition, TheEncounter Encounter):\n TheEncounter Visit\n where Diagnosis.isConfirmedActiveDiagnosis ( )\n return Diagnosis.prevalenceInterval ( ) overlaps day of Visit.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>AHAOverall</td>\n \n \n <td>isConfirmedActiveDiagnosis</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">/*\n@description: Returns true if the given Condition is confirmed as active\n*/\ndefine fluent function isConfirmedActiveDiagnosis(condition Condition):\n condition.isActive()\n and condition.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>QICoreCommon</td>\n \n \n <td>isActive</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">/* Candidates for FHIRCommon */\n\n/*\n@description: Returns true if the given condition has a clinical status of active, recurrence, or relapse\n*/\ndefine fluent function isActive(condition Condition):\n condition.clinicalStatus ~ "active"\n or condition.clinicalStatus ~ "recurrence"\n or condition.clinicalStatus ~ "relapse"</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>CADBetaBlockerTherapyPriorMIorLVSDFHIR</td>\n \n \n <td>overlapsAfterDayOfEncounter</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define fluent function overlapsAfterDayOfEncounter(Event Choice<AllergyIntolerance, Condition>, EncounterList List<Encounter>):\n AnyTrue(EncounterList Visit\n return case\n when Event is AllergyIntolerance then Interval[start of Event.onset.toInterval(), Event.lastOccurrence]overlaps after day of Visit.period\n and(Event.clinicalStatus is null\n or Event.clinicalStatus ~ QICoreCommon."allergy-active"\n )\n when Event is Condition then Event.isConfirmedActiveDiagnosis()\n and Event.prevalenceInterval() overlaps after day of Visit.period\n and Event.verificationStatus ~ QICoreCommon."confirmed" \n else false \n end\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>CADBetaBlockerTherapyPriorMIorLVSDFHIR</td>\n \n \n <td>authoredDuringDayOfEncounter</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define fluent function authoredDuringDayOfEncounter(Order Choice<MedicationRequest, MedicationNotRequested>, EncounterList List<Encounter>):\n AnyTrue(EncounterList Visit\n return case\n when Order is MedicationRequest then Order.authoredOn during day of Visit.period\n and Order.status in { 'active', 'completed' }\n and Order.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }\n and Order.doNotPerform is not true\n when Order is MedicationNotRequested then Order.authoredOn during day of Visit.period\n and Order.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' } \n else false \n end\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>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://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-clinical",
"code" : "recurrence",
"display" : "Recurrence"
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
"valueCoding" : {
"system" : "http://terminology.hl7.org/CodeSystem/condition-clinical",
"code" : "relapse",
"display" : "Relapse"
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
"valueCoding" : {
"system" : "http://terminology.hl7.org/CodeSystem/condition-ver-status",
"code" : "confirmed",
"display" : "Confirmed"
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
"valueCoding" : {
"system" : "http://snomed.info/sct",
"code" : "134401001",
"display" : "Left ventricular systolic dysfunction (disorder)"
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
"valueCoding" : {
"system" : "http://snomed.info/sct",
"code" : "373254001",
"display" : "Substance with beta adrenergic receptor antagonist mechanism of action (substance)"
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
"valueCoding" : {
"system" : "http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical",
"code" : "active",
"display" : "Active"
}
},
{
"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" : "CADBetaBlockerTherapyPriorMIorLVSDFHIR"
},
{
"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" : "CADBetaBlockerTherapyPriorMIorLVSDFHIR"
},
{
"url" : "name",
"valueString" : "Qualifying Encounter During Measurement Period"
},
{
"url" : "statement",
"valueString" : "define \"Qualifying Encounter During Measurement Period\":\n ( [Encounter: \"Office Visit\"]\n union [Encounter: \"Outpatient Consultation\"]\n union [Encounter: \"Nursing Facility Visit\"]\n union [Encounter: \"Care Services in Long Term Residential Facility\"]\n union [Encounter: \"Home Healthcare Services\"]\n union [Encounter: \"Patient Provider Interaction\"] ) ValidEncounter\n where ValidEncounter.period during day of \"Measurement Period\"\n and ValidEncounter.status = 'finished'"
},
{
"url" : "displaySequence",
"valueInteger" : 2
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CADBetaBlockerTherapyPriorMIorLVSDFHIR"
},
{
"url" : "name",
"valueString" : "Outpatient Encounter During Measurement Period"
},
{
"url" : "statement",
"valueString" : "define \"Outpatient Encounter During Measurement Period\":\n ( [Encounter: \"Office Visit\"]\n union [Encounter: \"Outpatient Consultation\"]\n union [Encounter: \"Care Services in Long Term Residential Facility\"]\n union [Encounter: \"Home Healthcare Services\"]\n union [Encounter: \"Nursing Facility Visit\"] ) QualifyingEncounter\n where QualifyingEncounter.period during day of \"Measurement Period\"\n and QualifyingEncounter.status = 'finished'"
},
{
"url" : "displaySequence",
"valueInteger" : 3
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CADBetaBlockerTherapyPriorMIorLVSDFHIR"
},
{
"url" : "name",
"valueString" : "Coronary Artery Disease Encounter"
},
{
"url" : "statement",
"valueString" : "define \"Coronary Artery Disease Encounter\":\n \"Outpatient Encounter During Measurement Period\" ValidQualifyingEncounter\n with [Condition: \"Coronary Artery Disease No MI\"] CoronaryArteryDisease\n such that CoronaryArteryDisease.overlapsDayOfEncounter ( ValidQualifyingEncounter )"
},
{
"url" : "displaySequence",
"valueInteger" : 4
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CADBetaBlockerTherapyPriorMIorLVSDFHIR"
},
{
"url" : "name",
"valueString" : "History of Cardiac Surgery Prior to Encounter"
},
{
"url" : "statement",
"valueString" : "define \"History of Cardiac Surgery Prior to Encounter\":\n \"Outpatient Encounter During Measurement Period\" ValidQualifyingEncounter\n with [Procedure: \"Cardiac Surgery\"] CardiacSurgery\n such that CardiacSurgery.performed.toInterval ( ) starts before end of ValidQualifyingEncounter.period\n and CardiacSurgery.status = 'completed'"
},
{
"url" : "displaySequence",
"valueInteger" : 5
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CADBetaBlockerTherapyPriorMIorLVSDFHIR"
},
{
"url" : "name",
"valueString" : "Qualifying CAD Encounter"
},
{
"url" : "statement",
"valueString" : "define \"Qualifying CAD Encounter\":\n \"Coronary Artery Disease Encounter\"\n union \"History of Cardiac Surgery Prior to Encounter\""
},
{
"url" : "displaySequence",
"valueInteger" : 6
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CADBetaBlockerTherapyPriorMIorLVSDFHIR"
},
{
"url" : "name",
"valueString" : "Initial Population"
},
{
"url" : "statement",
"valueString" : "define \"Initial Population\":\n AgeInYearsAt(date from start of \"Measurement Period\") >= 18\n and exists ( \"Qualifying Encounter During Measurement Period\" Encounter1\n with \"Qualifying Encounter During Measurement Period\" Encounter2\n such that Encounter2.id !~ Encounter1.id\n )\n and exists \"Qualifying CAD Encounter\""
},
{
"url" : "displaySequence",
"valueInteger" : 7
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "AHAOverall"
},
{
"url" : "name",
"valueString" : "Moderate or Severe LVSD Findings"
},
{
"url" : "statement",
"valueString" : "/*\n@description: Returns a union of the following:\n * Observations where the final, amended or correction ejection fraction result is <= 40\n * Moderate or Severe LVSD conditions where the diagnosis has been confirmed as active\n*/ \ndefine \"Moderate or Severe LVSD Findings\":\n ( [Observation: \"Ejection Fraction\"] EjectionFraction\n where EjectionFraction.value as Quantity <= 40 '%'\n and EjectionFraction.status in {'final', 'amended', 'corrected'} \n )\n union ( \n ( [Condition: \"Moderate or Severe LVSD\"]\n union ( [Condition: \"Left ventricular systolic dysfunction (disorder)\"] LVSDDiagnosis\n where LVSDDiagnosis.severity in \"Moderate or Severe\" )\n ) ModerateOrSevereLVSD \n where ModerateOrSevereLVSD.isConfirmedActiveDiagnosis()\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 8
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CADBetaBlockerTherapyPriorMIorLVSDFHIR"
},
{
"url" : "name",
"valueString" : "Qualifying CAD Encounter and Prior MI"
},
{
"url" : "statement",
"valueString" : "define \"Qualifying CAD Encounter and Prior MI\":\n \"Qualifying CAD Encounter\" EncounterWithCADProxy\n with [Condition: \"Myocardial Infarction\"] MyocardialInfarction\n such that MyocardialInfarction.prevalenceInterval ( ) starts 3 years or less before day of start of EncounterWithCADProxy.period\n and not exists AHA.\"Moderate or Severe LVSD Findings\""
},
{
"url" : "displaySequence",
"valueInteger" : 9
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CADBetaBlockerTherapyPriorMIorLVSDFHIR"
},
{
"url" : "name",
"valueString" : "Denominator 2"
},
{
"url" : "statement",
"valueString" : "define \"Denominator 2\":\n \"Initial Population\"\n and exists \"Qualifying CAD Encounter and Prior MI\""
},
{
"url" : "displaySequence",
"valueInteger" : 10
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CADBetaBlockerTherapyPriorMIorLVSDFHIR"
},
{
"url" : "name",
"valueString" : "Qualifying CAD Encounter and History of Moderate or Severe LVSD"
},
{
"url" : "statement",
"valueString" : "define \"Qualifying CAD Encounter and History of Moderate or Severe LVSD\":\n \"Qualifying CAD Encounter\" EncounterWithCADProxy\n with AHA.\"Moderate or Severe LVSD Findings\" LVSDFindings\n such that Coalesce(LVSDFindings.prevalenceInterval(), LVSDFindings.effective.toInterval()) starts before end of EncounterWithCADProxy.period"
},
{
"url" : "displaySequence",
"valueInteger" : 11
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CADBetaBlockerTherapyPriorMIorLVSDFHIR"
},
{
"url" : "name",
"valueString" : "Has Arrhythmia with Qualifying CAD Encounter and History of Moderate or Severe LVSD"
},
{
"url" : "statement",
"valueString" : "define \"Has Arrhythmia with Qualifying CAD Encounter and History of Moderate or Severe LVSD\":\n exists ( [Condition: \"Arrhythmia\"] ArrhythmiaDiagnosis\n where ArrhythmiaDiagnosis.overlapsDayOfEncounter ( \"Qualifying CAD Encounter and History of Moderate or Severe LVSD\" )\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 12
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CADBetaBlockerTherapyPriorMIorLVSDFHIR"
},
{
"url" : "name",
"valueString" : "Has Asthma with Qualifying CAD Encounter and History of Moderate or Severe LVSD"
},
{
"url" : "statement",
"valueString" : "define \"Has Asthma with Qualifying CAD Encounter and History of Moderate or Severe LVSD\":\n exists ( [Condition: \"Asthma\"] AsthmaDiagnosis\n where AsthmaDiagnosis.overlapsDayOfEncounter ( \"Qualifying CAD Encounter and History of Moderate or Severe LVSD\" )\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 13
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CADBetaBlockerTherapyPriorMIorLVSDFHIR"
},
{
"url" : "name",
"valueString" : "Has Bradycardia with Qualifying CAD Encounter and History of Moderate or Severe LVSD"
},
{
"url" : "statement",
"valueString" : "define \"Has Bradycardia with Qualifying CAD Encounter and History of Moderate or Severe LVSD\":\n exists ( [Condition: \"Bradycardia\"] BradycardiaDiagnosis\n where BradycardiaDiagnosis.overlapsDayOfEncounter ( \"Qualifying CAD Encounter and History of Moderate or Severe LVSD\" )\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 14
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CADBetaBlockerTherapyPriorMIorLVSDFHIR"
},
{
"url" : "name",
"valueString" : "Has Hypotension with Qualifying CAD Encounter and History of Moderate or Severe LVSD"
},
{
"url" : "statement",
"valueString" : "define \"Has Hypotension with Qualifying CAD Encounter and History of Moderate or Severe LVSD\":\n exists ( [Condition: \"Hypotension\"] HypotensionDiagnosis\n where HypotensionDiagnosis.overlapsDayOfEncounter ( \"Qualifying CAD Encounter and History of Moderate or Severe LVSD\" )\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 15
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CADBetaBlockerTherapyPriorMIorLVSDFHIR"
},
{
"url" : "name",
"valueString" : "Has Consecutive Heart Rates Less than 50 with Qualifying CAD Encounter and History of Moderate or Severe LVSD"
},
{
"url" : "statement",
"valueString" : "/*\n* @code: Heart rate - 8867-4\n* @profile: http://hl7.org/fhir/StructureDefinition/heartrate \n*/\n\n\ndefine \"Has Consecutive Heart Rates Less than 50 with Qualifying CAD Encounter and History of Moderate or Severe LVSD\":\n exists ( from\n [\"observation-heartrate\"] HeartRate,\n \"Qualifying CAD Encounter and History of Moderate or Severe LVSD\" CADEncounterModerateOrSevereLVSD\n let PriorHeartRate: Last([\"observation-heartrate\"] MostRecentPriorHeartRate\n where MostRecentPriorHeartRate.effective.toInterval() during CADEncounterModerateOrSevereLVSD.period\n and MostRecentPriorHeartRate.effective.toInterval() before HeartRate.effective.toInterval()\n sort by start of effective.toInterval()\n )\n where HeartRate.effective.toInterval ( ) during CADEncounterModerateOrSevereLVSD.period\n and HeartRate.value < 50 '/min'\n and PriorHeartRate.value < 50 '/min'\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 16
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CADBetaBlockerTherapyPriorMIorLVSDFHIR"
},
{
"url" : "name",
"valueString" : "Has Allergy or Intolerance to Beta Blocker Therapy Ingredient with Qualifying CAD Encounter and History of Moderate or Severe LVSD"
},
{
"url" : "statement",
"valueString" : "define \"Has Allergy or Intolerance to Beta Blocker Therapy Ingredient with Qualifying CAD Encounter and History of Moderate or Severe LVSD\":\n exists ( ( [AllergyIntolerance: \"Beta Blocker Therapy Ingredient\"]\n union [AllergyIntolerance: \"Substance with beta adrenergic receptor antagonist mechanism of action (substance)\"] ) BetaBlockerAllergyIntolerance\n where BetaBlockerAllergyIntolerance.overlapsAfterDayOfEncounter ( \"Qualifying CAD Encounter and History of Moderate or Severe LVSD\" )\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 17
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CADBetaBlockerTherapyPriorMIorLVSDFHIR"
},
{
"url" : "name",
"valueString" : "Has Diagnosis of Allergy or Intolerance to Beta Blocker Therapy with Qualifying CAD Encounter and History of Moderate or Severe LVSD"
},
{
"url" : "statement",
"valueString" : "define \"Has Diagnosis of Allergy or Intolerance to Beta Blocker Therapy with Qualifying CAD Encounter and History of Moderate or Severe LVSD\":\n exists ( ( [Condition: \"Allergy to Beta Blocker Therapy\"]\n union [Condition: \"Intolerance to Beta Blocker Therapy\"] ) BetaBlockerAllergyOrIntoleranceDiagnosis\n where BetaBlockerAllergyOrIntoleranceDiagnosis.overlapsAfterDayOfEncounter ( \"Qualifying CAD Encounter and History of Moderate or Severe LVSD\" )\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 18
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CADBetaBlockerTherapyPriorMIorLVSDFHIR"
},
{
"url" : "name",
"valueString" : "Has Atrioventricular Block with Qualifying CAD Encounter and History of Moderate or Severe LVSD"
},
{
"url" : "statement",
"valueString" : "define \"Has Atrioventricular Block with Qualifying CAD Encounter and History of Moderate or Severe LVSD\":\n exists ( [Condition: \"Atrioventricular Block\"] AtrioventricularBlock\n where AtrioventricularBlock.overlapsDayOfEncounter ( \"Qualifying CAD Encounter and History of Moderate or Severe LVSD\" )\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 19
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CADBetaBlockerTherapyPriorMIorLVSDFHIR"
},
{
"url" : "name",
"valueString" : "Has Diagnosis of Cardiac Pacer in Situ with Qualifying CAD Encounter and History of Moderate or Severe LVSD"
},
{
"url" : "statement",
"valueString" : "define \"Has Diagnosis of Cardiac Pacer in Situ with Qualifying CAD Encounter and History of Moderate or Severe LVSD\":\n exists ( [Condition: \"Cardiac Pacer in Situ\"] CardiacPacerDiagnosis\n where CardiacPacerDiagnosis.overlapsDayOfEncounter ( \"Qualifying CAD Encounter and History of Moderate or Severe LVSD\" )\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 20
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CADBetaBlockerTherapyPriorMIorLVSDFHIR"
},
{
"url" : "name",
"valueString" : "Has Cardiac Pacer Device Implanted with Qualifying CAD Encounter and History of Moderate or Severe LVSD"
},
{
"url" : "statement",
"valueString" : "define \"Has Cardiac Pacer Device Implanted with Qualifying CAD Encounter and History of Moderate or Severe LVSD\":\n exists ( [Procedure: \"Cardiac Pacer\"] ImplantedCardiacPacer\n with \"Qualifying CAD Encounter and History of Moderate or Severe LVSD\" CADEncounterModerateOrSevereLVSD\n such that ImplantedCardiacPacer.performed.toInterval ( ) starts before end of CADEncounterModerateOrSevereLVSD.period\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 21
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CADBetaBlockerTherapyPriorMIorLVSDFHIR"
},
{
"url" : "name",
"valueString" : "Has Atrioventricular Block with Qualifying CAD Encounter and History of Moderate or Severe LVSD without Cardiac Pacer"
},
{
"url" : "statement",
"valueString" : "define \"Has Atrioventricular Block with Qualifying CAD Encounter and History of Moderate or Severe LVSD without Cardiac Pacer\":\n \"Has Atrioventricular Block with Qualifying CAD Encounter and History of Moderate or Severe LVSD\"\n and not \"Has Diagnosis of Cardiac Pacer in Situ with Qualifying CAD Encounter and History of Moderate or Severe LVSD\"\n and not \"Has Cardiac Pacer Device Implanted with Qualifying CAD Encounter and History of Moderate or Severe LVSD\""
},
{
"url" : "displaySequence",
"valueInteger" : 22
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CADBetaBlockerTherapyPriorMIorLVSDFHIR"
},
{
"url" : "name",
"valueString" : "Denominator Exceptions 1"
},
{
"url" : "statement",
"valueString" : "/*\n@commentedOut: \"Has Medical or Patient Reason for Not Ordering Beta Blocker for LVSD\"\n@commentedOutReason: Negation issue noted in https://github.com/cqframework/cql-execution/issues/296, which is tied to https://oncprojectracking.healthit.gov/support/browse/BONNIEMAT-1455\n*/\n\n\ndefine \"Denominator Exceptions 1\":\n \"Has Arrhythmia with Qualifying CAD Encounter and History of Moderate or Severe LVSD\"\n or \"Has Asthma with Qualifying CAD Encounter and History of Moderate or Severe LVSD\"\n or \"Has Bradycardia with Qualifying CAD Encounter and History of Moderate or Severe LVSD\"\n or \"Has Hypotension with Qualifying CAD Encounter and History of Moderate or Severe LVSD\"\n or \"Has Consecutive Heart Rates Less than 50 with Qualifying CAD Encounter and History of Moderate or Severe LVSD\"\n or \"Has Allergy or Intolerance to Beta Blocker Therapy Ingredient with Qualifying CAD Encounter and History of Moderate or Severe LVSD\"\n or \"Has Diagnosis of Allergy or Intolerance to Beta Blocker Therapy with Qualifying CAD Encounter and History of Moderate or Severe LVSD\"\n //or \"Has Medical or Patient Reason for Not Ordering Beta Blocker for LVSD\"\n \n or \"Has Atrioventricular Block with Qualifying CAD Encounter and History of Moderate or Severe LVSD without Cardiac Pacer\""
},
{
"url" : "displaySequence",
"valueInteger" : 23
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CADBetaBlockerTherapyPriorMIorLVSDFHIR"
},
{
"url" : "name",
"valueString" : "Has Beta Blocker Therapy for LVSD Ordered"
},
{
"url" : "statement",
"valueString" : "define \"Has Beta Blocker Therapy for LVSD Ordered\":\n exists ( [MedicationRequest: medication in \"Beta Blocker Therapy for LVSD\"] BetaBlockerForLVSDOrdered\n where BetaBlockerForLVSDOrdered.authoredDuringDayOfEncounter ( \"Qualifying CAD Encounter and History of Moderate or Severe LVSD\" )\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 24
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CADBetaBlockerTherapyPriorMIorLVSDFHIR"
},
{
"url" : "name",
"valueString" : "Is Currently Taking Beta Blocker Therapy for LVSD"
},
{
"url" : "statement",
"valueString" : "define \"Is Currently Taking Beta Blocker Therapy for LVSD\":\n exists ( [MedicationRequest: medication in \"Beta Blocker Therapy for LVSD\"] ActiveBetaBlockerForLVSD\n with \"Qualifying CAD Encounter and History of Moderate or Severe LVSD\" CADEncounterModerateOrSevereLVSD\n such that First((collapse(ActiveBetaBlockerForLVSD.dosageInstruction.timing.repeat.bounds DoseTime\n return DoseTime.toInterval()\n )) DrugPeriod\n sort by start of $this\n ) overlaps after day of CADEncounterModerateOrSevereLVSD.period\n where ActiveBetaBlockerForLVSD.status in { 'active', 'completed' }\n and ActiveBetaBlockerForLVSD.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 25
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CADBetaBlockerTherapyPriorMIorLVSDFHIR"
},
{
"url" : "name",
"valueString" : "Numerator 1"
},
{
"url" : "statement",
"valueString" : "define \"Numerator 1\":\n \"Has Beta Blocker Therapy for LVSD Ordered\"\n or \"Is Currently Taking Beta Blocker Therapy for LVSD\""
},
{
"url" : "displaySequence",
"valueInteger" : 26
}
],
"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" : 27
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CADBetaBlockerTherapyPriorMIorLVSDFHIR"
},
{
"url" : "name",
"valueString" : "SDE Payer"
},
{
"url" : "statement",
"valueString" : "define \"SDE Payer\":\n SDE.\"SDE Payer\""
},
{
"url" : "displaySequence",
"valueInteger" : 28
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CADBetaBlockerTherapyPriorMIorLVSDFHIR"
},
{
"url" : "name",
"valueString" : "Has Beta Blocker Therapy Ordered"
},
{
"url" : "statement",
"valueString" : "define \"Has Beta Blocker Therapy Ordered\":\n exists ( [MedicationRequest: medication in \"Beta Blocker Therapy\"] BetaBlockerOrdered\n where BetaBlockerOrdered.authoredDuringDayOfEncounter ( \"Qualifying CAD Encounter and Prior MI\" )\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 29
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CADBetaBlockerTherapyPriorMIorLVSDFHIR"
},
{
"url" : "name",
"valueString" : "Is Currently Taking Beta Blocker Therapy"
},
{
"url" : "statement",
"valueString" : "define \"Is Currently Taking Beta Blocker Therapy\":\n exists ( [MedicationRequest: medication in \"Beta Blocker Therapy\"] ActiveBetaBlocker\n with \"Qualifying CAD Encounter and Prior MI\" CADEncounterMI\n such that First((collapse(ActiveBetaBlocker.dosageInstruction.timing.repeat.bounds DoseTime\n return DoseTime.toInterval()\n )) DrugPeriod\n sort by start of $this\n ) overlaps after day of CADEncounterMI.period\n where ActiveBetaBlocker.status in { 'active', 'completed' }\n and ActiveBetaBlocker.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 30
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CADBetaBlockerTherapyPriorMIorLVSDFHIR"
},
{
"url" : "name",
"valueString" : "Numerator 2"
},
{
"url" : "statement",
"valueString" : "define \"Numerator 2\":\n \"Has Beta Blocker Therapy Ordered\"\n or \"Is Currently Taking Beta Blocker Therapy\""
},
{
"url" : "displaySequence",
"valueInteger" : 31
}
],
"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" : 32
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CADBetaBlockerTherapyPriorMIorLVSDFHIR"
},
{
"url" : "name",
"valueString" : "SDE Ethnicity"
},
{
"url" : "statement",
"valueString" : "define \"SDE Ethnicity\":\n SDE.\"SDE Ethnicity\""
},
{
"url" : "displaySequence",
"valueInteger" : 33
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CADBetaBlockerTherapyPriorMIorLVSDFHIR"
},
{
"url" : "name",
"valueString" : "Has Arrhythmia with Qualifying CAD Encounter and Prior MI"
},
{
"url" : "statement",
"valueString" : "define \"Has Arrhythmia with Qualifying CAD Encounter and Prior MI\":\n exists ( [Condition: \"Arrhythmia\"] ArrhythmiaDiagnosis\n where ArrhythmiaDiagnosis.overlapsDayOfEncounter ( \"Qualifying CAD Encounter and Prior MI\" )\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 34
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CADBetaBlockerTherapyPriorMIorLVSDFHIR"
},
{
"url" : "name",
"valueString" : "Has Asthma with Qualifying CAD Encounter and Prior MI"
},
{
"url" : "statement",
"valueString" : "define \"Has Asthma with Qualifying CAD Encounter and Prior MI\":\n exists ( [Condition: \"Asthma\"] AsthmaDiagnosis\n where AsthmaDiagnosis.overlapsDayOfEncounter ( \"Qualifying CAD Encounter and Prior MI\" )\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 35
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CADBetaBlockerTherapyPriorMIorLVSDFHIR"
},
{
"url" : "name",
"valueString" : "Has Bradycardia with Qualifying CAD Encounter and Prior MI"
},
{
"url" : "statement",
"valueString" : "define \"Has Bradycardia with Qualifying CAD Encounter and Prior MI\":\n exists ( [Condition: \"Bradycardia\"] BradycardiaDiagnosis\n where BradycardiaDiagnosis.overlapsDayOfEncounter ( \"Qualifying CAD Encounter and Prior MI\" )\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 36
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CADBetaBlockerTherapyPriorMIorLVSDFHIR"
},
{
"url" : "name",
"valueString" : "Has Hypotension with Qualifying CAD Encounter and Prior MI"
},
{
"url" : "statement",
"valueString" : "define \"Has Hypotension with Qualifying CAD Encounter and Prior MI\":\n exists ( [Condition: \"Hypotension\"] HypotensionDiagnosis\n where HypotensionDiagnosis.overlapsDayOfEncounter ( \"Qualifying CAD Encounter and Prior MI\" )\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 37
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CADBetaBlockerTherapyPriorMIorLVSDFHIR"
},
{
"url" : "name",
"valueString" : "Has Consecutive Heart Rates Less than 50 with Qualifying CAD Encounter and Prior MI"
},
{
"url" : "statement",
"valueString" : "/*\n* @code: Heart rate - 8867-4\n* @profile: http://hl7.org/fhir/StructureDefinition/heartrate \n*/\n\n\ndefine \"Has Consecutive Heart Rates Less than 50 with Qualifying CAD Encounter and Prior MI\":\n exists ( from\n [\"observation-heartrate\"] HeartRate,\n \"Qualifying CAD Encounter and Prior MI\" CADEncounterMI\n let PriorHeartRate: Last([\"observation-heartrate\"] MostRecentPriorHeartRate\n where MostRecentPriorHeartRate.effective.toInterval() during CADEncounterMI.period\n and MostRecentPriorHeartRate.status in { 'final', 'amended', 'corrected' }\n and MostRecentPriorHeartRate.effective.toInterval() before HeartRate.effective.toInterval()\n sort by start of effective.toInterval()\n )\n where HeartRate.effective.toInterval ( ) during CADEncounterMI.period\n and HeartRate.status in { 'final', 'amended', 'corrected' }\n and HeartRate.value < 50 '/min'\n and PriorHeartRate.value < 50 '/min'\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 38
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CADBetaBlockerTherapyPriorMIorLVSDFHIR"
},
{
"url" : "name",
"valueString" : "Has Allergy or Intolerance to Beta Blocker Therapy Ingredient with Qualifying CAD Encounter and Prior MI"
},
{
"url" : "statement",
"valueString" : "define \"Has Allergy or Intolerance to Beta Blocker Therapy Ingredient with Qualifying CAD Encounter and Prior MI\":\n exists ( ( [AllergyIntolerance: \"Beta Blocker Therapy Ingredient\"]\n union [AllergyIntolerance: \"Substance with beta adrenergic receptor antagonist mechanism of action (substance)\"] ) BetaBlockerAllergyIntolerance\n where BetaBlockerAllergyIntolerance.overlapsAfterDayOfEncounter ( \"Qualifying CAD Encounter and Prior MI\" )\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 39
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CADBetaBlockerTherapyPriorMIorLVSDFHIR"
},
{
"url" : "name",
"valueString" : "Has Diagnosis of Allergy or Intolerance to Beta Blocker Therapy with Qualifying CAD Encounter and Prior MI"
},
{
"url" : "statement",
"valueString" : "define \"Has Diagnosis of Allergy or Intolerance to Beta Blocker Therapy with Qualifying CAD Encounter and Prior MI\":\n exists ( ( [Condition: \"Allergy to Beta Blocker Therapy\"]\n union [Condition: \"Intolerance to Beta Blocker Therapy\"] ) BetaBlockerAllergyOrIntoleranceDiagnosis\n where BetaBlockerAllergyOrIntoleranceDiagnosis.overlapsAfterDayOfEncounter ( \"Qualifying CAD Encounter and Prior MI\" )\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 40
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CADBetaBlockerTherapyPriorMIorLVSDFHIR"
},
{
"url" : "name",
"valueString" : "Has Atrioventricular Block with Qualifying CAD Encounter and Prior MI"
},
{
"url" : "statement",
"valueString" : "define \"Has Atrioventricular Block with Qualifying CAD Encounter and Prior MI\":\n exists ( [Condition: \"Atrioventricular Block\"] AtrioventricularBlock\n where AtrioventricularBlock.overlapsDayOfEncounter ( \"Qualifying CAD Encounter and Prior MI\" )\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 41
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CADBetaBlockerTherapyPriorMIorLVSDFHIR"
},
{
"url" : "name",
"valueString" : "Has Diagnosis of Cardiac Pacer in Situ with Qualifying CAD Encounter and Prior MI"
},
{
"url" : "statement",
"valueString" : "define \"Has Diagnosis of Cardiac Pacer in Situ with Qualifying CAD Encounter and Prior MI\":\n exists ( [Condition: \"Cardiac Pacer in Situ\"] CardiacPacerDiagnosis\n where CardiacPacerDiagnosis.overlapsDayOfEncounter ( \"Qualifying CAD Encounter and Prior MI\" )\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 42
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CADBetaBlockerTherapyPriorMIorLVSDFHIR"
},
{
"url" : "name",
"valueString" : "Has Cardiac Pacer Device Implanted with Qualifying CAD Encounter and Prior MI"
},
{
"url" : "statement",
"valueString" : "define \"Has Cardiac Pacer Device Implanted with Qualifying CAD Encounter and Prior MI\":\n exists ( [Procedure: \"Cardiac Pacer\"] ImplantedCardiacPacer\n with \"Qualifying CAD Encounter and Prior MI\" CADEncounterMI\n such that ImplantedCardiacPacer.performed.toInterval ( ) starts before end of CADEncounterMI.period\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 43
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CADBetaBlockerTherapyPriorMIorLVSDFHIR"
},
{
"url" : "name",
"valueString" : "Has Atrioventricular Block with Qualifying CAD Encounter and Prior MI without Cardiac Pacer"
},
{
"url" : "statement",
"valueString" : "define \"Has Atrioventricular Block with Qualifying CAD Encounter and Prior MI without Cardiac Pacer\":\n \"Has Atrioventricular Block with Qualifying CAD Encounter and Prior MI\"\n and not \"Has Diagnosis of Cardiac Pacer in Situ with Qualifying CAD Encounter and Prior MI\"\n and not \"Has Cardiac Pacer Device Implanted with Qualifying CAD Encounter and Prior MI\""
},
{
"url" : "displaySequence",
"valueInteger" : 44
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CADBetaBlockerTherapyPriorMIorLVSDFHIR"
},
{
"url" : "name",
"valueString" : "Denominator Exceptions 2"
},
{
"url" : "statement",
"valueString" : "/*\n@commentedOut: \"Has Medical or Patient Reason for Not Ordering Beta Blocker Therapy\" \n@commentedOutReason: Negation issue noted in https://github.com/cqframework/cql-execution/issues/296, which is tied to https://oncprojectracking.healthit.gov/support/browse/BONNIEMAT-1455\n*/\n\n\ndefine \"Denominator Exceptions 2\":\n \"Has Arrhythmia with Qualifying CAD Encounter and Prior MI\"\n or \"Has Asthma with Qualifying CAD Encounter and Prior MI\"\n or \"Has Bradycardia with Qualifying CAD Encounter and Prior MI\"\n or \"Has Hypotension with Qualifying CAD Encounter and Prior MI\"\n or \"Has Consecutive Heart Rates Less than 50 with Qualifying CAD Encounter and Prior MI\"\n or \"Has Allergy or Intolerance to Beta Blocker Therapy Ingredient with Qualifying CAD Encounter and Prior MI\"\n or \"Has Diagnosis of Allergy or Intolerance to Beta Blocker Therapy with Qualifying CAD Encounter and Prior MI\"\n //or \"Has Medical or Patient Reason for Not Ordering Beta Blocker Therapy\"\n \n or \"Has Atrioventricular Block with Qualifying CAD Encounter and Prior MI without Cardiac Pacer\""
},
{
"url" : "displaySequence",
"valueInteger" : 45
}
],
"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" : 46
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CADBetaBlockerTherapyPriorMIorLVSDFHIR"
},
{
"url" : "name",
"valueString" : "SDE Race"
},
{
"url" : "statement",
"valueString" : "define \"SDE Race\":\n SDE.\"SDE Race\""
},
{
"url" : "displaySequence",
"valueInteger" : 47
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CADBetaBlockerTherapyPriorMIorLVSDFHIR"
},
{
"url" : "name",
"valueString" : "Denominator 1"
},
{
"url" : "statement",
"valueString" : "define \"Denominator 1\":\n \"Initial Population\"\n and exists \"Qualifying CAD Encounter and History of Moderate or Severe LVSD\""
},
{
"url" : "displaySequence",
"valueInteger" : 48
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CADBetaBlockerTherapyPriorMIorLVSDFHIR"
},
{
"url" : "name",
"valueString" : "overlapsDayOfEncounter"
},
{
"url" : "statement",
"valueString" : "define fluent function overlapsDayOfEncounter(Diagnosis Condition, TheEncounter Encounter):\n TheEncounter Visit\n where Diagnosis.isConfirmedActiveDiagnosis ( )\n return Diagnosis.prevalenceInterval ( ) overlaps day of Visit.period"
},
{
"url" : "displaySequence",
"valueInteger" : 49
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "AHAOverall"
},
{
"url" : "name",
"valueString" : "isConfirmedActiveDiagnosis"
},
{
"url" : "statement",
"valueString" : "/*\n@description: Returns true if the given Condition is confirmed as active\n*/\ndefine fluent function isConfirmedActiveDiagnosis(condition Condition):\n condition.isActive()\n and condition.verificationStatus ~ QICoreCommon.\"confirmed\""
},
{
"url" : "displaySequence",
"valueInteger" : 50
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "QICoreCommon"
},
{
"url" : "name",
"valueString" : "isActive"
},
{
"url" : "statement",
"valueString" : "/* Candidates for FHIRCommon */\n\n/*\n@description: Returns true if the given condition has a clinical status of active, recurrence, or relapse\n*/\ndefine fluent function isActive(condition Condition):\n condition.clinicalStatus ~ \"active\"\n or condition.clinicalStatus ~ \"recurrence\"\n or condition.clinicalStatus ~ \"relapse\""
},
{
"url" : "displaySequence",
"valueInteger" : 51
}
],
"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" : 52
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CADBetaBlockerTherapyPriorMIorLVSDFHIR"
},
{
"url" : "name",
"valueString" : "overlapsAfterDayOfEncounter"
},
{
"url" : "statement",
"valueString" : "define fluent function overlapsAfterDayOfEncounter(Event Choice<AllergyIntolerance, Condition>, EncounterList List<Encounter>):\n AnyTrue(EncounterList Visit\n return case\n when Event is AllergyIntolerance then Interval[start of Event.onset.toInterval(), Event.lastOccurrence]overlaps after day of Visit.period\n and(Event.clinicalStatus is null\n or Event.clinicalStatus ~ QICoreCommon.\"allergy-active\"\n )\n when Event is Condition then Event.isConfirmedActiveDiagnosis()\n and Event.prevalenceInterval() overlaps after day of Visit.period\n and Event.verificationStatus ~ QICoreCommon.\"confirmed\" \n else false \n end\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 53
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CADBetaBlockerTherapyPriorMIorLVSDFHIR"
},
{
"url" : "name",
"valueString" : "authoredDuringDayOfEncounter"
},
{
"url" : "statement",
"valueString" : "define fluent function authoredDuringDayOfEncounter(Order Choice<MedicationRequest, MedicationNotRequested>, EncounterList List<Encounter>):\n AnyTrue(EncounterList Visit\n return case\n when Order is MedicationRequest then Order.authoredOn during day of Visit.period\n and Order.status in { 'active', 'completed' }\n and Order.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }\n and Order.doNotPerform is not true\n when Order is MedicationNotRequested then Order.authoredOn during day of Visit.period\n and Order.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' } \n else false \n end\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 54
}
],
"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" : 55
}
],
"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" : 56
}
],
"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 AHA",
"resource" : "Library/AHAOverall|2.8.000"
},
{
"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 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" : "Code system SNOMEDCT",
"resource" : "http://snomed.info/sct"
},
{
"type" : "depends-on",
"display" : "Code system AllergyIntoleranceClinicalStatusCodes",
"resource" : "http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical"
},
{
"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 Outpatient Consultation",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1008"
},
{
"type" : "depends-on",
"display" : "Value set Nursing Facility Visit",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1012"
},
{
"type" : "depends-on",
"display" : "Value set Care Services in Long Term Residential Facility",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1014"
},
{
"type" : "depends-on",
"display" : "Value set Home Healthcare Services",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016"
},
{
"type" : "depends-on",
"display" : "Value set Patient Provider Interaction",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1012"
},
{
"type" : "depends-on",
"display" : "Value set Coronary Artery Disease No MI",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.369"
},
{
"type" : "depends-on",
"display" : "Value set Cardiac Surgery",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.371"
},
{
"type" : "depends-on",
"display" : "Value set Myocardial Infarction",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.403"
},
{
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"telecom" : [
{
"system" : "url",
"value" : "https://www.heart.org/"
}
]
},
{
"name" : "American Medical Association (AMA)",
"telecom" : [
{
"system" : "url",
"value" : "https://www.ama-assn.org/"
}
]
},
{
"name" : "American Medical Association-convened Physician Consortium for Performance Improvement(R) (AMA-PCPI)",
"telecom" : [
{
"system" : "url",
"value" : "https://www.ama-assn.org/"
}
]
}
],
"library" : [
🔗 "https://madie.cms.gov/Library/CADBetaBlockerTherapyPriorMIorLVSDFHIR"
],
"disclaimer" : "The Measure is not a clinical guideline, does not establish a standard of medical care, and has not been tested for all potential applications. \n\nThe Measure, while copyrighted, can be reproduced and distributed, without modification, for noncommercial purposes, e.g., use by health care providers in connection with their practices. Commercial use is defined as the sale, license, or distribution of the Measure for commercial gain, or incorporation of the Measure into a product or service that is sold, licensed or distributed for commercial gain. \n\nCommercial uses of the Measure require a license agreement between the user and the American College of Cardiology (ACC) or the American Heart Association (AHA). Neither the ACC, nor AHA, nor their members shall be responsible for any use of the Measure.\n\nACC and AHA encourage use of the Measure by other health care professionals, where appropriate.\n\nTHE MEASURE AND SPECIFICATIONS ARE PROVIDED \"AS IS\" WITHOUT WARRANTY OF ANY KIND.\n\nLimited 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. The ACC and AHA and their members disclaim all liability for use or accuracy of any Current Procedural Terminology (CPT[R]) or other coding contained in the specifications.\n\nCPT(R) contained in the Measure specifications is copyright 2004-2023 American Medical Association. LOINC(R) is 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 is copyright 2023 World Health Organization. All Rights Reserved.\n\nThe American Medical Association’s and the PCPI(R) Foundation’s significant past efforts and contributions to the performance measure are gratefully acknowledged.\n\nDue to technical limitations, registered trademarks are indicated by (R) or [R].",
"scoring" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-scoring",
"code" : "proportion",
"display" : "Proportion"
}
]
},
"rationale" : "For patients with coronary artery disease (CAD), beta-blockers are recommended for 3 years after myocardial infarction or acute coronary syndrome. Beta-blockers, particularly carvedilol, metoprolol succinate, or bisoprolol which have been shown to reduce risk of death, are recommended indefinitely for patients with CAD and LV systolic dysfunction. These agents have proven efficacy in reducing angina onset and improving the ischemic threshold during exercise. In patients who have suffered an MI, beta-blockers significantly reduce deaths and recurrent MIs (Fihn et al., 2012). \n\nNonadherence to cardioprotective medications is prevalent among outpatients with CAD and can be associated with a broad range of adverse outcomes, including all-cause and cardiovascular mortality, cardiovascular hospitalizations, and the need for revascularization procedures (Gibbons et al., 2002).\n\nThis measure is intended to promote beta-blocker usage in select patients with CAD.",
"clinicalRecommendationStatement" : "Beta-blocker therapy should be started and continued for 3 years in all patients with normal LV function after MI or acute coronary syndrome (ACS) (Class I, Level of Evidence: B) (Fihn et al., 2012).\n\nBeta-blocker therapy should be used in all patients with LV systolic dysfunction (EF <= 40%) with heart failure or prior MI, unless contraindicated. (Use should be limited to carvedilol, metoprolol succinate, or bisoprolol, which have been shown to reduce risk of death.) (Class I, Level of Evidence: A) (Fihn et al., 2012).\n\nIn patients with chronic coronary disease (CCD) and LVEF ≤40% with or without previous MI, the use of beta-blocker therapy is recommended to reduce the risk of future Major Adverse Cardiac Events (MACE), including cardiovascular death. (Class 1, Level of Evidence: A) (Virani et al., 2023)",
"group" : [
{
"id" : "6643a4bda7a1805d3b73744c",
"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" : "This measure is intended to have one reporting rate, which aggregates the following populations into a single performance rate for reporting purposes: \n- Population 1: Patients with left ventricular systolic dysfunction (LVEF <=40%)\n- Population 2: Patients with a prior (within the past 3 years) myocardial infarction\n\nFor the purposes of this measure, a single performance rate can be calculated as follows:\nPerformance Rate = (Numerator 1 + Numerator 2)/ [(Denominator 1 - Denominator Exceptions 1) + (Denominator 2 - Denominator Exceptions 2)]"
},
{
"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" : "52BDC293-998E-455E-B68D-B0BB8B6C974B",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "initial-population",
"display" : "Initial Population"
}
]
},
"description" : "All patients aged 18 years and older with two qualifying encounters during the measurement period and a diagnosis of coronary artery disease",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Initial Population"
}
},
{
"id" : "26866751-5751-420F-BD5D-90F99B79E263",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "denominator",
"display" : "Denominator"
}
]
},
"description" : "Equals Initial Population who also have prior (within the past 3 years) MI or a current or prior LVEF <=40%",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Denominator 1"
}
},
{
"id" : "9488860B-5AF1-4580-833A-83E017169EC9",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "numerator",
"display" : "Numerator"
}
]
},
"description" : "Patients who were prescribed beta-blocker therapy",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Numerator 1"
}
},
{
"id" : "686674D8-324B-49E1-A885-DF9E28538F0F",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "denominator-exception",
"display" : "Denominator Exception"
}
]
},
"description" : "Documentation of medical reason(s) for not prescribing beta-blocker therapy (e.g., arrhythmia, asthma, bradycardia, hypotension, patients with atrioventricular block without cardiac pacer, observation of consecutive heart rates <50, allergy, intolerance, other medical reasons).\n\nDocumentation of patient reason(s) for not prescribing beta-blocker therapy (e.g., patient declined, other patient reasons).",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Denominator Exceptions 1"
}
}
]
},
{
"id" : "6643a4bda7a1805d3b73744d",
"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" : "This measure is intended to have one reporting rate, which aggregates the following populations into a single performance rate for reporting purposes: \n- Population 1: Patients with left ventricular systolic dysfunction (LVEF <=40%)\n- Population 2: Patients with a prior (within the past 3 years) myocardial infarction\n\nFor the purposes of this measure, a single performance rate can be calculated as follows:\nPerformance Rate = (Numerator 1 + Numerator 2)/ [(Denominator 1 - Denominator Exceptions 1) + (Denominator 2 - Denominator Exceptions 2)]"
},
{
"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" : "E529AF68-95B2-4D98-830D-D9D98EB22CEC",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "initial-population",
"display" : "Initial Population"
}
]
},
"description" : "All patients aged 18 years and older with two qualifying encounters during the measurement period and a diagnosis of coronary artery disease",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Initial Population"
}
},
{
"id" : "6925A32F-AA11-4830-8553-B2AD5F57A302",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "denominator",
"display" : "Denominator"
}
]
},
"description" : "Equals Initial Population who also have prior (within the past 3 years) MI or a current or prior LVEF <=40%",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Denominator 2"
}
},
{
"id" : "D786FE18-9B4D-4B59-9D44-DD72AC2F66DE",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "numerator",
"display" : "Numerator"
}
]
},
"description" : "Patients who were prescribed beta-blocker therapy",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Numerator 2"
}
},
{
"id" : "3C509632-5ABE-436D-ACEE-F06A031F7466",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "denominator-exception",
"display" : "Denominator Exception"
}
]
},
"description" : "Documentation of medical reason(s) for not prescribing beta-blocker therapy (e.g., arrhythmia, asthma, bradycardia, hypotension, patients with atrioventricular block without cardiac pacer, observation of consecutive heart rates <50, allergy, intolerance, other medical reasons).\n\nDocumentation of patient reason(s) for not prescribing beta-blocker therapy (e.g., patient declined, other patient reasons).",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Denominator Exceptions 2"
}
}
]
}
],
"supplementalData" : [
{
"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"
}
},
{
"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-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-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"
}
}
]
}
IG © 2023+ cqframework. Package gov.healthit.ecqi.ecqms#2024.0.0 based on FHIR 4.0.1. Generated 2024-12-19
Links: Table of Contents |
QA Report
| Version History 
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