eCQM QICore Content Implementation Guide
2024.0.0 - CI Build
eCQM QICore Content Implementation Guide
2024.0.0 - CI Build
eCQM QICore Content Implementation Guide, published by cqframework. This guide is not an authorized publication; it is the continuous build for version 2024.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/cqframework/ecqm-content-qicore-2024/ and changes regularly. See the Directory of published versions
| Draft as of 2024-07-09 |
<Measure xmlns="http://hl7.org/fhir">
<id value="ColonCancerScreeningFHIR"/>
<meta>
<profile
value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-measure-cqfm"/>
<profile
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<profile
value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/executable-measure-cqfm"/>
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<text>
<status value="extensions"/>
<div xmlns="http://www.w3.org/1999/xhtml">
<table class="grid dict">
<tr>
<th scope="row"><b>Title: </b></th>
<td style="padding-left: 4px;">Colorectal Cancer ScreeningFHIR</td>
</tr>
<tr>
<th scope="row"><b>Id: </b></th>
<td style="padding-left: 4px;">ColonCancerScreeningFHIR</td>
</tr>
<tr>
<th scope="row"><b>Version: </b></th>
<td style="padding-left: 4px;">0.1.000</td>
</tr>
<tr>
<th scope="row"><b>Url: </b></th>
<td style="padding-left: 4px;"><a href="Measure-ColonCancerScreeningFHIR.html">Colorectal Cancer ScreeningFHIR</a></td>
</tr>
<tr>
<th scope="row">
<b>
short-name identifier:
</b>
</th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<span>CMS130FHIR</span>
</p>
</td>
</tr>
<tr>
<th scope="row">
<b>
version-independent identifier:
</b>
</th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<span>urn:uuid:627c6e27-5c46-4412-941a-ca387492bbaa</span>
</p>
</td>
</tr>
<tr>
<th scope="row">
<b>
version-specific identifier:
</b>
</th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<span>urn:uuid:3ff5ff28-e118-4433-8467-15d0a585b45d</span>
</p>
</td>
</tr>
<tr>
<th scope="row">
<b>
publisher (CMS) identifier:
</b>
</th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<span>130FHIR</span>
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Effective Period: </b></th>
<td style="padding-left: 4px;">2025-01-01..2025-12-31</td>
</tr>
<tr>
<th scope="row"><b>Status: </b></th>
<td style="padding-left: 4px;">draft</td>
</tr>
<tr>
<th scope="row"><b>Publisher: </b></th>
<td style="padding-left: 4px;">National Committee for Quality Assurance</td>
</tr>
<tr>
<th scope="row"><b>Author: </b></th>
<td style="padding-left: 4px;">National Committee for Quality Assurance</td>
</tr>
<tr>
<th scope="row"><b>Description: </b></th>
<td style="padding-left: 4px;"><div><p>Percentage of adults 45-75 years of age who had appropriate screening for colorectal cancer</p>
</div></td>
</tr>
<tr>
<th scope="row"><b>Purpose: </b></th>
<td style="padding-left: 4px;"><div><p>UNKNOWN</p>
</div></td>
</tr>
<tr>
<th scope="row"><b>Copyright: </b></th>
<td style="padding-left: 4px;"><div><p>This Physician Performance Measure (Measure) and related data specifications are owned and were developed by the National Committee for Quality Assurance (NCQA). NCQA is not responsible for any use of the Measure. NCQA makes no representations, warranties, or endorsement about the quality of any organization or physician that uses or reports performance measures and NCQA has no liability to anyone who relies on such measures or specifications. NCQA holds a copyright in the Measure. The Measure can be reproduced and distributed, without modification, for noncommercial purposes (e.g., use by healthcare providers in connection with their practices) without obtaining approval from NCQA. Commercial use is defined as the sale, licensing, 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. All commercial uses or requests for modification must be approved by NCQA and are subject to a license at the discretion of NCQA. (C) 2012-2024 National Committee for Quality Assurance. All Rights Reserved. Limited proprietary coding is contained in the Measure specifications for user convenience. Users of proprietary code sets should obtain all necessary licenses from the owners of the code sets. NCQA disclaims all liability for use or accuracy of any third-party codes contained in the specifications. CPT(R) codes, descriptions and other data are copyright 2024. American Medical Association. All rights reserved. CPT is a trademark of the American Medical Association. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein. Applicable FARS/DFARS restrictions apply to government use. Some measure specifications contain coding from LOINC(R) (http://loinc.org). The LOINC table, LOINC codes, LOINC panels and form file, LOINC linguistic variants file, LOINC/RSNA Radiology Playbook, and LOINC/IEEE Medical Device Code Mapping Table are copyright 2004-2024 Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee, and are available at no cost under the license at http://loinc.org/terms-of-use. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2023 International Health Terminology Standards Development Organisation. ICD-10 copyright 2024 World Health Organization. All Rights Reserved. Some measures use RxNorm, a standardized nomenclature and coding for clinical drugs and drug delivery devices, which is made publicly available courtesy of the U.S. National Library of Medicine (NLM), National Institutes of Health, Department of Health and Human Services. NLM is not responsible for the measures and does not endorse or recommend this or any other product. “HL7” is the registered trademark of Health Level Seven International.</p>
</div></td>
</tr>
<tr>
<th scope="row"><b>Disclaimer: </b></th>
<td style="padding-left: 4px;"><div><p>The performance Measure is not a clinical guideline and does not establish a standard of medical care, and has not been tested for all potential applications. THE MEASURE AND SPECIFICATIONS ARE PROVIDED "AS IS" WITHOUT WARRANTY OF ANY KIND. Due to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM].</p>
</div></td>
</tr>
<tr>
<th scope="row"><b>Rationale: </b></th>
<td style="padding-left: 4px;"><div><p>Colorectal cancer represents eight percent of all new cancer cases in the United States. In 2020, there were an estimated 147,950 new cases of colorectal cancer and an estimated 53,200 deaths attributed to it. According to the National Cancer Institute, about 4.2 percent of men and women will be diagnosed with colorectal cancer at some point during their lifetimes. For most adults, older age is the most important risk factor for colorectal cancer, although being male and black are also associated with higher incidence and mortality. Colorectal cancer is most frequently diagnosed among people 65 to 74 years old (Howlader et al., 2020). Screening can be effective for finding precancerous lesions (polyps) that could later become malignant, and for detecting early cancers that can be more easily and effectively treated. Precancerous polyps usually take about 10 to 15 years to develop into colorectal cancer, and most can be found and removed before turning into cancer. The five-year relative survival rate for people whose colorectal cancer is found in the early stage before it has spread is about 90 percent (SEER, 2022).</p>
</div></td>
</tr>
<tr>
<th scope="row"><b>Clinical recommendation statement: </b></th>
<td style="padding-left: 4px;"><div><p>The U.S. Preventive Services Task Force (2021) recommends screening for colorectal cancer in adults aged 45 to 49 years. This is a Grade B recommendation (U.S. Preventive Services Task Force, 2021). The U.S. Preventive Services Task Force (2021) recommends screening for colorectal cancer in adults aged 50 to 75 years. This is a Grade A recommendation (U.S. Preventive Services Task Force, 2021). Appropriate screenings are defined by any one of the following: - Fecal occult blood test (annually) - Stool DNA (sDNA) with FIT test (every 3 years) - Flexible sigmoidoscopy (every 5 years) - Computed tomographic (CT) colonography (every 5 years) - Colonoscopy (every 10 years)</p>
</div></td>
</tr>
<tr>
<th scope="row"><b>Guidance (Usage): </b></th>
<td style="padding-left: 4px;">Do not count digital rectal exams (DRE), fecal occult blood tests (FOBTs) performed in an office setting or performed on a sample collected via DRE. Please note the measure may include screenings performed outside the age range of patients referenced in the initial population. Screenings that occur prior to the measurement period are valid to meet measure criteria. This eCQM is a patient-based measure. This FHIR-based measure has been derived from the QDM-based measure: CMS130v13. Please refer to the HL7 QI-Core Implementation Guide (http://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 (http://hl7.org/fhir/us/qicore/STU4.1.1/qdm-to-qicore.html).</td>
</tr>
<tr>
<th scope="row"><b>Population Criteria: </b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr>
<th><b>654a405f78418140875e351c</b></th>
</tr>
<tr>
<td>Initial Population:</td>
<td>Patients 46-75 years of age by the end of the measurement period with a visit during the measurement period</td>
</tr>
<tr>
<td>Denominator:</td>
<td>Equals Initial Population</td>
</tr>
<tr>
<td>Denominator Exclusion:</td>
<td>Exclude patients who are in hospice care for any part of the measurement period. Exclude patients with a diagnosis or past history of total colectomy or colorectal cancer. Exclude patients 66 and older by the end of the measurement period with an indication of frailty for any part of the measurement period who also meet any of the following advanced illness criteria: - Advanced illness diagnosis during the measurement period or the year prior - OR taking dementia medications during the measurement period or the year prior Exclude patients 66 and older by the end of the measurement period who are living long term in a nursing home any time on or before the end of the measurement period. Exclude patients receiving palliative care for any part of the measurement period.</td>
</tr>
<tr>
<td>Numerator:</td>
<td>Patients with one or more screenings for colorectal cancer. Appropriate screenings are defined by any one of the following criteria: - Fecal occult blood test (FOBT) during the measurement period - Stool DNA (sDNA) with FIT test during the measurement period or the two years prior to the measurement period - Flexible sigmoidoscopy during the measurement period or the four years prior to the measurement period - CT Colonography during the measurement period or the four years prior to the measurement period - Colonoscopy during the measurement period or the nine years prior to the measurement period</td>
</tr>
<tr><b>Stratifier Criteria: </b></tr>
<tr>
<td>Stratum:</td>
<td>Patients age 46-49 by the end of the measurement period</td>
</tr>
<tr>
<td>Stratum:</td>
<td>Patients age 50-75 by the end of the measurement period</td>
</tr>
</table>
</td>
</tr>
<tr>
<th scope="row"><b>Libraries: </b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr>
<td><a href="Library-ColonCancerScreeningFHIR.html">ColonCancerScreeningFHIR</a></td>
</tr>
</table>
</td>
</tr>
<tr>
<th scope="row"><b>Terminology and Other Dependencies: </b></th>
<td style="padding-left: 4px;">
<li><code>Library/Status|1.8.000</code></li>
<li><code>Library/FHIRHelpers|4.4.000</code></li>
<li><code>Library/QICoreCommon|2.1.000</code></li>
<li><code>Library/AdultOutpatientEncounters|4.11.000</code></li>
<li><code>Library/Hospice|6.12.000</code></li>
<li><code>Library/AdvancedIllnessandFrailty|1.16.000</code></li>
<li><code>Library/CumulativeMedicationDuration|4.1.000</code></li>
<li><code>Library/PalliativeCare|1.11.000</code></li>
<li><a href="http://terminology.hl7.org/5.5.0/CodeSystem-observation-category.html">Observation Category Codes</a></li>
<li><a href="http://hl7.org/fhir/R4/codesystem-snomedct.html">SNOMED CT (all versions)</a></li>
<li><a href="http://terminology.hl7.org/5.5.0/CodeSystem-v3-loinc.html">Logical Observation Identifiers, Names and Codes (LOINC)</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.198.12.1011/expansion">Fecal Occult Blood Test (FOBT)</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.108.12.1039/expansion">FIT DNA</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.198.12.1010/expansion">Flexible Sigmoidoscopy</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.108.12.1038/expansion">CT Colonography</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.108.12.1020/expansion">Colonoscopy</a></li>
<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>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1240/expansion">Annual Wellness Visit</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1025/expansion">Preventive Care Services - Established Office Visit, 18 and Up</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1023/expansion">Preventive Care Services-Initial Office Visit, 18 and Up</a></li>
<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>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1089/expansion">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1089</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1080/expansion">Telephone Visits</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.666.5.307/expansion">Encounter Inpatient</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.1003/expansion">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1003</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1584/expansion">Hospice Care Ambulatory</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.1165/expansion">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1165</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.108.12.1001/expansion">Malignant Neoplasm of Colon</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.198.12.1019/expansion">Total Colectomy</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.118.12.1300/expansion">Frailty Device</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.113.12.1074/expansion">Frailty Diagnosis</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1088/expansion">Frailty Encounter</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.113.12.1075/expansion">Frailty Symptom</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.110.12.1082/expansion">Advanced Illness</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.196.12.1510/expansion">Dementia Medications</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.1167/expansion">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1167</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1090/expansion">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1090</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.198.12.1135/expansion">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1135</a></li>
</td>
</tr>
<tr>
<th scope="row"><b>Parameters:</b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr>
<th><b>name</b></th>
<th><b>use</b></th>
<th><b>min</b></th>
<th><b>max</b></th>
<th><b>type</b></th>
</tr>
<tr>
<td>Measurement Period</td>
<td>In</td>
<td>0</td>
<td>1</td>
<td>Period</td>
</tr>
<tr>
<td>ErrorLevel</td>
<td>In</td>
<td>0</td>
<td>1</td>
<td>string</td>
</tr>
<tr>
<td>Numerator</td>
<td>Out</td>
<td>0</td>
<td>1</td>
<td>boolean</td>
</tr>
<tr>
<td>Stratification 2</td>
<td>Out</td>
<td>0</td>
<td>1</td>
<td>boolean</td>
</tr>
<tr>
<td>Stratification 1</td>
<td>Out</td>
<td>0</td>
<td>1</td>
<td>boolean</td>
</tr>
<tr>
<td>Denominator</td>
<td>Out</td>
<td>0</td>
<td>1</td>
<td>boolean</td>
</tr>
<tr>
<td>Initial Population</td>
<td>Out</td>
<td>0</td>
<td>1</td>
<td>boolean</td>
</tr>
<tr>
<td>Denominator Exclusion</td>
<td>Out</td>
<td>0</td>
<td>1</td>
<td>boolean</td>
</tr>
</table>
</td>
</tr>
<tr>
<th scope="row"><b>DataRequirements:</b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr>
<th><b>Resource Type</b></th>
<th><b>Resource Elements</b></th>
<th><b>Valueset Name</b></th>
<th><b>Valueset</b></th>
</tr>
<tr>
<td>Observation(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-observation.html">QICoreObservation</a>)</td>
<td>
code
value
effective
status
status.value
category
</td>
<td>
Fecal Occult Blood Test (FOBT)
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.198.12.1011/expansion">Fecal Occult Blood Test (FOBT)</a></td>
</tr>
<tr>
<td>Observation(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-observation.html">QICoreObservation</a>)</td>
<td>
code
value
effective
status
status.value
category
</td>
<td>
sDNA FIT Test
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.108.12.1039/expansion">FIT DNA</a></td>
</tr>
<tr>
<td>Observation(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-observation.html">QICoreObservation</a>)</td>
<td>
code
effective
status
status.value
category
</td>
<td>
CT Colonography
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.108.12.1038/expansion">CT Colonography</a></td>
</tr>
<tr>
<td>Observation(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-observation.html">QICoreObservation</a>)</td>
<td>
code
value
effective
status
status.value
category
</td>
<td>
</td>
<td/>
</tr>
<tr>
<td>Observation(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-observation.html">QICoreObservation</a>)</td>
<td>
code
value
effective
status
status.value
category
</td>
<td>
</td>
<td/>
</tr>
<tr>
<td>Observation(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-observation.html">QICoreObservation</a>)</td>
<td>
code
effective
status
status.value
category
</td>
<td>
Frailty Symptom
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.113.12.1075/expansion">Frailty Symptom</a></td>
</tr>
<tr>
<td>Observation(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-observation.html">QICoreObservation</a>)</td>
<td>
code
effective
status
status.value
category
</td>
<td>
</td>
<td/>
</tr>
<tr>
<td>Observation(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-observation.html">QICoreObservation</a>)</td>
<td>
code
effective
value
status
status.value
category
</td>
<td>
</td>
<td/>
</tr>
<tr>
<td>Observation(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-observation.html">QICoreObservation</a>)</td>
<td>
code
effective
status
status.value
category
</td>
<td>
</td>
<td/>
</tr>
<tr>
<td>Procedure(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html">QICoreProcedure</a>)</td>
<td>
code
performed
status
status.value
</td>
<td>
Flexible Sigmoidoscopy
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.198.12.1010/expansion">Flexible Sigmoidoscopy</a></td>
</tr>
<tr>
<td>Procedure(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html">QICoreProcedure</a>)</td>
<td>
code
performed
status
status.value
</td>
<td>
Colonoscopy
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.108.12.1020/expansion">Colonoscopy</a></td>
</tr>
<tr>
<td>Procedure(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html">QICoreProcedure</a>)</td>
<td>
code
performed
status
status.value
</td>
<td>
Hospice Care Ambulatory
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1584/expansion">Hospice Care Ambulatory</a></td>
</tr>
<tr>
<td>Procedure(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html">QICoreProcedure</a>)</td>
<td>
code
performed
status
status.value
</td>
<td>
Total Colectomy
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.198.12.1019/expansion">Total Colectomy</a></td>
</tr>
<tr>
<td>Procedure(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html">QICoreProcedure</a>)</td>
<td>
code
performed
status
status.value
</td>
<td>
Palliative Care Intervention
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.198.12.1135/expansion">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1135</a></td>
</tr>
<tr>
<td>Patient(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-patient.html">QICorePatient</a>)</td>
<td>
</td>
<td>
</td>
<td/>
</tr>
<tr>
<td>Encounter(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html">QICoreEncounter</a>)</td>
<td>
type
status
status.value
period
</td>
<td>
Office Visit
</td>
<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>
</tr>
<tr>
<td>Encounter(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html">QICoreEncounter</a>)</td>
<td>
type
status
status.value
period
</td>
<td>
Annual Wellness Visit
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1240/expansion">Annual Wellness Visit</a></td>
</tr>
<tr>
<td>Encounter(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html">QICoreEncounter</a>)</td>
<td>
type
status
status.value
period
</td>
<td>
Preventive Care Services Established Office Visit, 18 and Up
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1025/expansion">Preventive Care Services - Established Office Visit, 18 and Up</a></td>
</tr>
<tr>
<td>Encounter(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html">QICoreEncounter</a>)</td>
<td>
type
status
status.value
period
</td>
<td>
Preventive Care Services Initial Office Visit, 18 and Up
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1023/expansion">Preventive Care Services-Initial Office Visit, 18 and Up</a></td>
</tr>
<tr>
<td>Encounter(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html">QICoreEncounter</a>)</td>
<td>
type
status
status.value
period
</td>
<td>
Home Healthcare Services
</td>
<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>
</tr>
<tr>
<td>Encounter(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html">QICoreEncounter</a>)</td>
<td>
type
status
status.value
period
</td>
<td>
Virtual Encounter
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1089/expansion">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1089</a></td>
</tr>
<tr>
<td>Encounter(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html">QICoreEncounter</a>)</td>
<td>
type
status
status.value
period
</td>
<td>
Telephone Visits
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1080/expansion">Telephone Visits</a></td>
</tr>
<tr>
<td>Encounter(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html">QICoreEncounter</a>)</td>
<td>
type
hospitalization
hospitalization.dischargeDisposition
period
status
status.value
</td>
<td>
Encounter Inpatient
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.666.5.307/expansion">Encounter Inpatient</a></td>
</tr>
<tr>
<td>Encounter(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html">QICoreEncounter</a>)</td>
<td>
type
period
status
status.value
</td>
<td>
Hospice Encounter
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.1003/expansion">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1003</a></td>
</tr>
<tr>
<td>Encounter(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html">QICoreEncounter</a>)</td>
<td>
type
period
status
status.value
</td>
<td>
Frailty Encounter
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1088/expansion">Frailty Encounter</a></td>
</tr>
<tr>
<td>Encounter(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html">QICoreEncounter</a>)</td>
<td>
type
period
status
status.value
</td>
<td>
Palliative Care Encounter
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1090/expansion">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1090</a></td>
</tr>
<tr>
<td>ServiceRequest(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-servicerequest.html">QICoreServiceRequest</a>)</td>
<td>
code
authoredOn
authoredOn.value
status
status.value
intent
intent.value
</td>
<td>
Hospice Care Ambulatory
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1584/expansion">Hospice Care Ambulatory</a></td>
</tr>
<tr>
<td>Condition(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-condition.html">QICoreCondition</a>)</td>
<td>
code
</td>
<td>
Hospice Diagnosis
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.1165/expansion">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1165</a></td>
</tr>
<tr>
<td>Condition(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-condition.html">QICoreCondition</a>)</td>
<td>
code
</td>
<td>
Malignant Neoplasm of Colon
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.108.12.1001/expansion">Malignant Neoplasm of Colon</a></td>
</tr>
<tr>
<td>Condition(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-condition.html">QICoreCondition</a>)</td>
<td>
code
</td>
<td>
Frailty Diagnosis
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.113.12.1074/expansion">Frailty Diagnosis</a></td>
</tr>
<tr>
<td>Condition(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-condition.html">QICoreCondition</a>)</td>
<td>
code
</td>
<td>
Advanced Illness
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.110.12.1082/expansion">Advanced Illness</a></td>
</tr>
<tr>
<td>Condition(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-condition.html">QICoreCondition</a>)</td>
<td>
code
</td>
<td>
Palliative Care Diagnosis
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.1167/expansion">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1167</a></td>
</tr>
<tr>
<td>DeviceRequest(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-devicerequest.html">QICoreDeviceRequest</a>)</td>
<td>
code
status
status.value
intent
intent.value
url
url.value
value
authoredOn
authoredOn.value
</td>
<td>
Frailty Device
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.118.12.1300/expansion">Frailty Device</a></td>
</tr>
<tr>
<td>MedicationRequest(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-medicationrequest.html">QICoreMedicationRequest</a>)</td>
<td>
medication
status
status.value
intent
intent.value
dosageInstruction
dispenseRequest
dispenseRequest.expectedSupplyDuration
dispenseRequest.quantity
dispenseRequest.numberOfRepeatsAllowed
dispenseRequest.numberOfRepeatsAllowed.value
authoredOn
authoredOn.value
dispenseRequest.validityPeriod
</td>
<td>
Dementia Medications
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.196.12.1510/expansion">Dementia Medications</a></td>
</tr>
</table>
</td>
</tr>
<tr>
<th scope="row"><b>Direct Reference Codes:</b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr>
<th><b>display</b></th>
<th><b>code</b></th>
<th><b>system</b></th>
</tr>
<tr>
<td>laboratory</td>
<td>laboratory</td>
<td><a href="http://hl7.org/fhir/R4/codesystem-observation-category.html">http://terminology.hl7.org/CodeSystem/observation-category</a></td>
</tr>
<tr>
<td>Discharge to home for hospice care (procedure)</td>
<td>428361000124107</td>
<td><a href="http://hl7.org/fhir/R4/codesystem-snomedct.html">http://snomed.info/sct</a></td>
</tr>
<tr>
<td>Discharge to healthcare facility for hospice care (procedure)</td>
<td>428371000124100</td>
<td><a href="http://hl7.org/fhir/R4/codesystem-snomedct.html">http://snomed.info/sct</a></td>
</tr>
<tr>
<td>survey</td>
<td>survey</td>
<td><a href="http://hl7.org/fhir/R4/codesystem-observation-category.html">http://terminology.hl7.org/CodeSystem/observation-category</a></td>
</tr>
<tr>
<td>Yes (qualifier value)</td>
<td>373066001</td>
<td><a href="http://hl7.org/fhir/R4/codesystem-snomedct.html">http://snomed.info/sct</a></td>
</tr>
<tr>
<td>Hospice care [Minimum Data Set]</td>
<td>45755-6</td>
<td><a href="http://terminology.hl7.org/5.5.0/CodeSystem-v3-loinc.html">http://loinc.org</a></td>
</tr>
<tr>
<td>Medical equipment used</td>
<td>98181-1</td>
<td><a href="http://terminology.hl7.org/5.5.0/CodeSystem-v3-loinc.html">http://loinc.org</a></td>
</tr>
<tr>
<td>Housing status</td>
<td>71802-3</td>
<td><a href="http://terminology.hl7.org/5.5.0/CodeSystem-v3-loinc.html">http://loinc.org</a></td>
</tr>
<tr>
<td>Lives in a nursing home (finding)</td>
<td>160734000</td>
<td><a href="http://hl7.org/fhir/R4/codesystem-snomedct.html">http://snomed.info/sct</a></td>
</tr>
<tr>
<td>Functional Assessment of Chronic Illness Therapy - Palliative Care Questionnaire (FACIT-Pal)</td>
<td>71007-9</td>
<td><a href="http://terminology.hl7.org/5.5.0/CodeSystem-v3-loinc.html">http://loinc.org</a></td>
</tr>
</table>
</td>
</tr>
<tr>
<th scope="row"><b>Logic Definitions:</b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr>
<th><b>Group</b></th>
<th><b>Scoring</b></th>
<th><b>Population Criteria</b></th>
<th><b>Expression</b></th>
</tr>
<tr>
<td> 654a405f78418140875e351c </td>
<td colspan="3" style="padding-left: 4px;">
<b>Group scoring:</b>
<span> proportion </span>
<tr>
<th scope="row"><b>Type: </b></th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<span>Process </span>
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Rate Aggregation: </b></th>
<td colspan="3" style="padding-left: 4px;">None</td>
</tr>
<tr>
<th scope="row"><b>Improvement Notation: </b></th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<span>increase </span>
</p>
</td>
</tr>
</td>
<tr>
<td/>
<td/>
<td>Initial Population</td>
<td>
<pre><code class="language-cql">define "Initial Population":
AgeInYearsAt(date from
end of "Measurement Period"
) in Interval[46, 75]
and exists AdultOutpatientEncounters."Qualifying Encounters"</code></pre>
</td>
</tr>
<tr>
<td/>
<td/>
<td>Denominator</td>
<td>
<pre><code class="language-cql">define "Denominator":
"Initial Population"</code></pre>
</td>
</tr>
<tr>
<td/>
<td/>
<td>Denominator Exclusion</td>
<td>
<pre><code class="language-cql">define "Denominator Exclusion":
Hospice."Has Hospice Services"
or exists "Malignant Neoplasm"
or exists "Total Colectomy Performed"
or AIFrailLTCF."Is Age 66 or Older with Advanced Illness and Frailty"
or AIFrailLTCF."Is Age 66 or Older Living Long Term in a Nursing Home"
or PalliativeCare."Has Palliative Care in the Measurement Period"</code></pre>
</td>
</tr>
<tr>
<td/>
<td/>
<td>Numerator</td>
<td>
<pre><code class="language-cql">define "Numerator":
exists "Fecal Occult Blood Test Performed"
or exists "Stool DNA with FIT Test Performed"
or exists "Flexible Sigmoidoscopy Performed"
or exists "CT Colonography Performed"
or exists "Colonoscopy Performed"</code></pre>
</td>
</tr>
<tr>
<td/>
<td/>
<td/>
<td>
<pre><code class="language-cql"/></pre>
</td>
</tr>
<tr>
<td/>
<td/>
<td/>
<td>
<pre><code class="language-cql"/></pre>
</td>
</tr>
</tr>
</table>
<table class="grid-dict">
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>ColonCancerScreeningFHIR</td>
<td>Fecal Occult Blood Test Performed</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Fecal Occult Blood Test Performed":
( ( [Observation: "Fecal Occult Blood Test (FOBT)"] ).isLaboratoryTestPerformed ( ) ) FecalOccultResult
where FecalOccultResult.value is not null
and FecalOccultResult.effective.latest ( ) during day of "Measurement Period"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>ColonCancerScreeningFHIR</td>
<td>Stool DNA with FIT Test Performed</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Stool DNA with FIT Test Performed":
( ( [Observation: "sDNA FIT Test"] ).isLaboratoryTestPerformed ( ) ) sDNATest
where sDNATest.value is not null
and sDNATest.effective.latest ( ) during day of Interval[start of "Measurement Period" - 2 years, end of "Measurement Period"]</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>ColonCancerScreeningFHIR</td>
<td>Flexible Sigmoidoscopy Performed</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Flexible Sigmoidoscopy Performed":
( ( [Procedure: "Flexible Sigmoidoscopy"] ).isProcedurePerformed ( ) ) FlexibleSigmoidoscopy
where FlexibleSigmoidoscopy.performed.toInterval ( ) ends during day of Interval[start of "Measurement Period" - 4 years, end of "Measurement Period"]</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>ColonCancerScreeningFHIR</td>
<td>CT Colonography Performed</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "CT Colonography Performed":
( ( [Observation: "CT Colonography"] ).isDiagnosticStudyPerformed ( ) ) Colonography
where Colonography.effective.toInterval ( ) ends during day of Interval[start of "Measurement Period" - 4 years, end of "Measurement Period"]</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>ColonCancerScreeningFHIR</td>
<td>Colonoscopy Performed</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Colonoscopy Performed":
( ( [Procedure: "Colonoscopy"] ).isProcedurePerformed ( ) ) Colonoscopy
where Colonoscopy.performed.toInterval ( ) ends during day of Interval[start of "Measurement Period" - 9 years, end of "Measurement Period"]</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>ColonCancerScreeningFHIR</td>
<td>Numerator</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Numerator":
exists "Fecal Occult Blood Test Performed"
or exists "Stool DNA with FIT Test Performed"
or exists "Flexible Sigmoidoscopy Performed"
or exists "CT Colonography Performed"
or exists "Colonoscopy Performed"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>ColonCancerScreeningFHIR</td>
<td>Stratification 2</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Stratification 2":
AgeInYearsAt(date from
end of "Measurement Period"
) in Interval[50, 75]</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>ColonCancerScreeningFHIR</td>
<td>Stratification 1</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Stratification 1":
AgeInYearsAt(date from
end of "Measurement Period"
) in Interval[46, 49]</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>AdultOutpatientEncounters</td>
<td>Qualifying Encounters</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Qualifying Encounters":
( ( [Encounter: "Office Visit"]
union [Encounter: "Annual Wellness Visit"]
union [Encounter: "Preventive Care Services Established Office Visit, 18 and Up"]
union [Encounter: "Preventive Care Services Initial Office Visit, 18 and Up"]
union [Encounter: "Home Healthcare Services"]
union [Encounter: "Virtual Encounter"]
union [Encounter: "Telephone Visits"] ).isEncounterPerformed() ) ValidEncounter
where ValidEncounter.period.toInterval() during day of "Measurement Period"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>ColonCancerScreeningFHIR</td>
<td>Initial Population</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Initial Population":
AgeInYearsAt(date from
end of "Measurement Period"
) in Interval[46, 75]
and exists AdultOutpatientEncounters."Qualifying Encounters"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>ColonCancerScreeningFHIR</td>
<td>Denominator</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Denominator":
"Initial Population"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>Hospice</td>
<td>Has Hospice Services</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Has Hospice Services":
exists ((([Encounter: "Encounter Inpatient"]).isEncounterPerformed()) InpatientEncounter
where (InpatientEncounter.hospitalization.dischargeDisposition ~ "Discharge to home for hospice care (procedure)"
or InpatientEncounter.hospitalization.dischargeDisposition ~ "Discharge to healthcare facility for hospice care (procedure)"
)
and InpatientEncounter.period.toInterval() ends during day of "Measurement Period"
)
or exists ((([Encounter: "Hospice Encounter"]).isEncounterPerformed()) HospiceEncounter
where HospiceEncounter.period.toInterval() overlaps day of "Measurement Period"
)
or exists ((([Observation: "Hospice care [Minimum Data Set]"]).isAssessmentPerformed()) HospiceAssessment
where HospiceAssessment.value ~ "Yes (qualifier value)"
and HospiceAssessment.effective.toInterval() overlaps day of "Measurement Period"
)
or exists ((([ServiceRequest: "Hospice Care Ambulatory"]).isInterventionOrder()) HospiceOrder
where HospiceOrder.authoredOn.toInterval() during day of "Measurement Period"
// and HospiceOrder.doNotPerform is not true
// https://oncprojectracking.healthit.gov/support/browse/CQLIT-447
)
or exists ((([Procedure: "Hospice Care Ambulatory"]).isInterventionPerformed()) HospicePerformed
where HospicePerformed.performed.toInterval() overlaps day of "Measurement Period"
)
or exists (([Condition: "Hospice Diagnosis"]) HospiceCareDiagnosis
where HospiceCareDiagnosis.prevalenceInterval() overlaps day of "Measurement Period"
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>ColonCancerScreeningFHIR</td>
<td>Malignant Neoplasm</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Malignant Neoplasm":
( [Condition: "Malignant Neoplasm of Colon"] ) ColorectalCancer
where ColorectalCancer.prevalenceInterval ( ) starts on or before day of end of "Measurement Period"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>ColonCancerScreeningFHIR</td>
<td>Total Colectomy Performed</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Total Colectomy Performed":
( ( [Procedure: "Total Colectomy"] ).isProcedurePerformed ( ) ) Colectomy
where Colectomy.performed.toInterval ( ) ends on or before day of end of "Measurement Period"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>AdvancedIllnessandFrailty</td>
<td>Has Criteria Indicating Frailty</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Has Criteria Indicating Frailty":
exists ( (([DeviceRequest: "Frailty Device"]).isDeviceOrder()) FrailtyDeviceOrder
where FrailtyDeviceOrder.doNotPerform() is not true
and FrailtyDeviceOrder.authoredOn.toInterval() during day of "Measurement Period"
)
or exists ( (([Observation: "Medical equipment used"]).isAssessmentPerformed()) EquipmentUsed
where EquipmentUsed.value as Concept in "Frailty Device"
and EquipmentUsed.effective.toInterval() ends during day of "Measurement Period"
)
or exists ( ([Condition: "Frailty Diagnosis"]) FrailtyDiagnosis
where FrailtyDiagnosis.prevalenceInterval() overlaps day of "Measurement Period"
)
or exists ( (([Encounter: "Frailty Encounter"]).isEncounterPerformed()) FrailtyEncounter
where FrailtyEncounter.period.toInterval() overlaps day of "Measurement Period"
)
or exists ( (([Observation: "Frailty Symptom"]).isSymptom()) FrailtySymptom
where FrailtySymptom.effective.toInterval() overlaps day of "Measurement Period"
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>AdvancedIllnessandFrailty</td>
<td>Has Advanced Illness in Year Before or During Measurement Period</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Has Advanced Illness in Year Before or During Measurement Period":
exists ([Condition: "Advanced Illness"] AdvancedIllnessDiagnosis
where AdvancedIllnessDiagnosis.prevalenceInterval() starts during day of Interval[start of "Measurement Period" - 1 year, end of "Measurement Period"])</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>AdvancedIllnessandFrailty</td>
<td>Has Dementia Medications in Year Before or During Measurement Period</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Has Dementia Medications in Year Before or During Measurement Period":
exists (( ([MedicationRequest: medication in "Dementia Medications"]).isMedicationActive()) DementiaMedication
// https://oncprojectracking.healthit.gov/support/browse/CQLIT-449
where DementiaMedication.medicationRequestPeriod() overlaps day of Interval[start of "Measurement Period" - 1 year,
end of "Measurement Period"]
// and DementiaMedication.doNotPerform is not true
// https://oncprojectracking.healthit.gov/support/browse/CQLIT-447
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>AdvancedIllnessandFrailty</td>
<td>Is Age 66 or Older with Advanced Illness and Frailty</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Is Age 66 or Older with Advanced Illness and Frailty":
AgeInYearsAt(date from end of "Measurement Period")>= 66
and "Has Criteria Indicating Frailty"
and ( "Has Advanced Illness in Year Before or During Measurement Period"
or "Has Dementia Medications in Year Before or During Measurement Period"
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>AdvancedIllnessandFrailty</td>
<td>Is Age 66 or Older Living Long Term in a Nursing Home</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Is Age 66 or Older Living Long Term in a Nursing Home":
AgeInYearsAt(date from
end of "Measurement Period"
)>= 66
and ( ( Last( (([Observation: "Housing status"]).isAssessmentPerformed()) HousingStatus
where HousingStatus.effective.toInterval() ends on or before
day of end of "Measurement Period"
sort by
end of effective.toInterval() asc
)) LastHousingStatus
where LastHousingStatus.value ~ "Lives in a nursing home (finding)"
) is not null</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>PalliativeCare</td>
<td>Has Palliative Care in the Measurement Period</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Has Palliative Care in the Measurement Period":
exists ((([Observation: "Functional Assessment of Chronic Illness Therapy - Palliative Care Questionnaire (FACIT-Pal)"]).isAssessmentPerformed()) PalliativeAssessment
where PalliativeAssessment.effective.toInterval() overlaps day of "Measurement Period"
)
or exists ([Condition: "Palliative Care Diagnosis"] PalliativeDiagnosis
where PalliativeDiagnosis.prevalenceInterval() overlaps day of "Measurement Period"
)
or exists ((([Encounter: "Palliative Care Encounter"]).isEncounterPerformed()) PalliativeEncounter
where PalliativeEncounter.period.toInterval() overlaps day of "Measurement Period"
)
or exists ((([Procedure: "Palliative Care Intervention"]).isInterventionPerformed()) PalliativeIntervention
where PalliativeIntervention.performed.toInterval() overlaps day of "Measurement Period"
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>ColonCancerScreeningFHIR</td>
<td>Denominator Exclusion</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Denominator Exclusion":
Hospice."Has Hospice Services"
or exists "Malignant Neoplasm"
or exists "Total Colectomy Performed"
or AIFrailLTCF."Is Age 66 or Older with Advanced Illness and Frailty"
or AIFrailLTCF."Is Age 66 or Older Living Long Term in a Nursing Home"
or PalliativeCare."Has Palliative Care in the Measurement Period"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>Status</td>
<td>isLaboratoryTestPerformed</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">//Laboratory Test, Performed
define fluent function isLaboratoryTestPerformed(Obs List<Observation>):
Obs O
where O.status in { 'final', 'amended', 'corrected' }
and exists ( O.category ObservationCategory
where ( ObservationCategory ) ~ "laboratory"
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>FHIRHelpers</td>
<td>ToConcept</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">/*
@description: Converts the given FHIR [CodeableConcept](https://hl7.org/fhir/datatypes.html#CodeableConcept) value to a CQL Concept.
*/
define function ToConcept(concept FHIR.CodeableConcept):
if concept is null then
null
else
System.Concept {
codes: concept.coding C return ToCode(C),
display: concept.text.value
}</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>QICoreCommon</td>
<td>latest</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">/*
@description: Given an interval, returns the ending point if the interval has an ending boundary specified,
otherwise, returns the starting point
*/
define fluent function latest(choice Choice<DateTime, Quantity, Interval<DateTime>, Interval<Quantity>> ):
(choice.toInterval()) period
return
if (period."hasEnd"()) then end of period
else start of period</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>Status</td>
<td>isProcedurePerformed</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">//Procedure, Performed
define fluent function isProcedurePerformed(Proc List<Procedure>):
Proc P
where P.status ~ 'completed'</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>Status</td>
<td>isDiagnosticStudyPerformed</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">//Diagnostic Study, Performed
define fluent function isDiagnosticStudyPerformed(Obs List<Observation>):
Obs O
where O.status in {'final', 'amended', 'corrected' }</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>Status</td>
<td>isEncounterPerformed</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">//Encounter, Performed
//General usage unless required otherwise by measure intent (e.g., follow-up encounters)
define fluent function isEncounterPerformed(Enc List<Encounter>):
Enc E
where E.status in {'finished', 'arrived', 'triaged', 'in-progress', 'onleave'}</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>QICoreCommon</td>
<td>toInterval</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">/*
@description: Normalizes a value that is a choice of timing-valued types to an equivalent interval
@comment: Normalizes a choice type of DateTime, Quanitty, Interval<DateTime>, or Interval<Quantity> types
to an equivalent interval. This selection of choice types is a superset of the majority of choice types that are used as possible
representations for timing-valued elements in QICore, allowing this function to be used across any resource.
The input can be provided as a DateTime, Quantity, Interval<DateTime> or Interval<Quantity>.
The intent of this function is to provide a clear and concise mechanism to treat single
elements that have multiple possible representations as intervals so that logic doesn't have to account
for the variability. More complex calculations (such as medication request period or dispense period
calculation) need specific guidance and consideration. That guidance may make use of this function, but
the focus of this function is on single element calculations where the semantics are unambiguous.
If the input is a DateTime, the result a DateTime Interval beginning and ending on that DateTime.
If the input is a Quantity, the quantity is expected to be a calendar-duration interpreted as an Age,
and the result is a DateTime Interval beginning on the Date the patient turned that age and ending immediately before one year later.
If the input is a DateTime Interval, the result is the input.
If the input is a Quantity Interval, the quantities are expected to be calendar-durations interpreted as an Age, and the result
is a DateTime Interval beginning on the date the patient turned the age given as the start of the quantity interval, and ending
immediately before one year later than the date the patient turned the age given as the end of the quantity interval.
If the input is a Timing, an error will be thrown indicating that Timing calculations are not implemented. Any other input will reslt in a null DateTime Interval
*/
define fluent function toInterval(choice Choice<DateTime, Quantity, Interval<DateTime>, Interval<Quantity>, Timing>):
case
when choice is DateTime then
Interval[choice as DateTime, choice as DateTime]
when choice is Interval<DateTime> then
choice as Interval<DateTime>
when choice is Quantity then
Interval[Patient.birthDate + (choice as Quantity),
Patient.birthDate + (choice as Quantity) + 1 year)
when choice is Interval<Quantity> then
Interval[Patient.birthDate + (choice.low as Quantity),
Patient.birthDate + (choice.high as Quantity) + 1 year)
when choice is Timing then
Message(null, true, 'NOT_IMPLEMENTED', 'Error', 'Calculation of an interval from a Timing value is not supported') as Interval<DateTime>
else
null as Interval<DateTime>
end</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>Status</td>
<td>isAssessmentPerformed</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">//This library contains functions that are based on QDM 5.6 to QICore 4.1.1 March 2023 (https://github.com/cqframework/CQL-Formatting-and-Usage-Wiki/wiki/Authoring-Patterns---QICore-v4.1.1). The functions may appear similar to some QICoreCommon functions but different in that they have constraints that are relevant for measures authored by NCQA.
//Assessment, Performed
define fluent function isAssessmentPerformed(Obs List<Observation>):
Obs O
where O.status in { 'final', 'amended', 'corrected' }
and exists ( O.category ObservationCategory
where ( ObservationCategory ) ~ "survey"
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>Status</td>
<td>isInterventionOrder</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">//Intervention, Order: active and completed only
define fluent function isInterventionOrder(ServiceRequest List<ServiceRequest>):
ServiceRequest S
where S.status in { 'active', 'completed' }
and S.intent = 'order'</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>Status</td>
<td>isInterventionPerformed</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">//Intervention, Performed
define fluent function isInterventionPerformed(Proc List<Procedure>):
Proc P
where P.status ~ 'completed'</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>QICoreCommon</td>
<td>prevalenceInterval</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">/*
@description: Returns an interval representing the normalized prevalence period of a given Condition.
@comment: Uses the ToInterval and ToAbatementInterval functions to determine the widest potential interval from
onset to abatement as specified in the given Condition. If the condition is active, or has an abatement date the resulting
interval will have a closed ending boundary. Otherwise, the resulting interval will have an open ending boundary.
*/
define fluent function prevalenceInterval(condition Condition):
if condition.clinicalStatus ~ "active"
or condition.clinicalStatus ~ "recurrence"
or condition.clinicalStatus ~ "relapse" then
Interval[start of condition.onset.toInterval(), end of condition.abatementInterval()]
else
(end of condition.abatementInterval()) abatementDate
return if abatementDate is null then
Interval[start of condition.onset.toInterval(), abatementDate)
else
Interval[start of condition.onset.toInterval(), abatementDate]</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>Status</td>
<td>isDeviceOrder</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">//Device, Order - Personal Use Devices: active and completed only
define fluent function isDeviceOrder(DeviceRequest List<DeviceRequest>):
DeviceRequest D
where D.status in { 'active', 'completed' }
and D.intent = 'order'</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>QICoreCommon</td>
<td>doNotPerform</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">/*
@description: Returns true if the given DeviceRequest is a negation (i.e. do not perform this order)
*/
define fluent function doNotPerform(deviceRequest DeviceRequest):
singleton from (
deviceRequest.modifierExtension E
where E.url = 'http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-doNotPerform'
return E.value as Boolean
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>Status</td>
<td>isSymptom</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">//Symptom
define fluent function isSymptom(Obs List<Observation>):
Obs O
where O.status in { 'preliminary', 'final', 'amended', 'corrected' }</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>Status</td>
<td>isMedicationActive</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">//Medication, Active
define fluent function isMedicationActive(MedicationRequest List<MedicationRequest>):
MedicationRequest M
where M.status = 'active'
and M.intent = 'order'</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>CumulativeMedicationDuration</td>
<td>medicationRequestPeriod</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define fluent function medicationRequestPeriod(Request "MedicationRequest"):
Request R
let
dosage: singleton from R.dosageInstruction,
doseAndRate: singleton from dosage.doseAndRate,
timing: dosage.timing,
frequency: Coalesce(timing.repeat.frequencyMax, timing.repeat.frequency),
period: Quantity(timing.repeat.period, timing.repeat.periodUnit),
doseRange: doseAndRate.dose,
doseQuantity: doseAndRate.dose,
dose: Coalesce(end of doseRange, doseQuantity),
dosesPerDay: Coalesce(ToDaily(frequency, period), Count(timing.repeat.timeOfDay), 1.0),
boundsPeriod: timing.repeat.bounds as Interval<DateTime>,
daysSupply: (convert R.dispenseRequest.expectedSupplyDuration to days).value,
quantity: R.dispenseRequest.quantity,
refills: Coalesce(R.dispenseRequest.numberOfRepeatsAllowed, 0),
startDate:
Coalesce(
date from start of boundsPeriod,
date from R.authoredOn,
date from start of R.dispenseRequest.validityPeriod
),
totalDaysSupplied: Coalesce(daysSupply, quantity.value / (dose.value * dosesPerDay)) * (1 + refills)
return
if startDate is not null and totalDaysSupplied is not null then
Interval[startDate, startDate + Quantity(totalDaysSupplied - 1, 'day') ]
else if startDate is not null and boundsPeriod."high" is not null then
Interval[startDate, date from end of boundsPeriod]
else
null</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>CumulativeMedicationDuration</td>
<td>Quantity</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">/**********************************************************************/
/* Functions in this region are copied from opioid-mme-r4 */
/**********************************************************************/
define function Quantity(value Decimal, unit String):
if value is not null then
System.Quantity { value: value, unit: unit }
else
null</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>CumulativeMedicationDuration</td>
<td>ToDaily</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">/*
Goal is to get to number of days
Two broad approaches to the calculation:
1) Based on supply and frequency, calculate the number of expected days the medication will cover/has covered
2) Based on relevant period, determine a covered interval and calculate the length of that interval in days
This topic covers several use cases and illustrates how to calculate Cumulative
Medication Duration for each type of medication resource using the supply and
frequency approach.
*/
/*
For the first approach, we need to get from frequency to a frequency/day
So we define ToDaily
*/
/*
Calculates daily frequency given frequency within a period
*/
define function ToDaily(frequency System.Integer, period System.Quantity):
case period.unit
when 'h' then frequency * (24.0 / period.value)
when 'min' then frequency * (24.0 / period.value) * 60
when 's' then frequency * (24.0 / period.value) * 60 * 60
when 'd' then frequency * (24.0 / period.value) / 24
when 'wk' then frequency * (24.0 / period.value) / (24 * 7)
when 'mo' then frequency * (24.0 / period.value) / (24 * 30) /* assuming 30 days in month */
when 'a' then frequency * (24.0 / period.value) / (24 * 365) /* assuming 365 days in year */
when 'hour' then frequency * (24.0 / period.value)
when 'minute' then frequency * (24.0 / period.value) * 60
when 'second' then frequency * (24.0 / period.value) * 60 * 60
when 'day' then frequency * (24.0 / period.value) / 24
when 'week' then frequency * (24.0 / period.value) / (24 * 7)
when 'month' then frequency * (24.0 / period.value) / (24 * 30) /* assuming 30 days in month */
when 'year' then frequency * (24.0 / period.value) / (24 * 365) /* assuming 365 days in year */
when 'hours' then frequency * (24.0 / period.value)
when 'minutes' then frequency * (24.0 / period.value) * 60
when 'seconds' then frequency * (24.0 / period.value) * 60 * 60
when 'days' then frequency * (24.0 / period.value) / 24
when 'weeks' then frequency * (24.0 / period.value) / (24 * 7)
when 'months' then frequency * (24.0 / period.value) / (24 * 30) /* assuming 30 days in month */
when 'years' then frequency * (24.0 / period.value) / (24 * 365) /* assuming 365 days in year */
else Message(null, true, 'CMDLogic.ToDaily.UnknownUnit', ErrorLevel, 'Unknown unit ' & period.unit)
end</code></pre>
</td>
</tr>
</table>
</td>
</tr>
</table>
</div>
</text>
<contained>
<Library>
<id value="effective-data-requirements"/>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
<valueCoding>
<system
value="http://terminology.hl7.org/CodeSystem/observation-category"/>
<code value="laboratory"/>
<display value="laboratory"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="428361000124107"/>
<display value="Discharge to home for hospice care (procedure)"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="428371000124100"/>
<display
value="Discharge to healthcare facility for hospice care (procedure)"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
<valueCoding>
<system
value="http://terminology.hl7.org/CodeSystem/observation-category"/>
<code value="survey"/>
<display value="survey"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="373066001"/>
<display value="Yes (qualifier value)"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
<valueCoding>
<system value="http://loinc.org"/>
<code value="45755-6"/>
<display value="Hospice care [Minimum Data Set]"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
<valueCoding>
<system value="http://loinc.org"/>
<code value="98181-1"/>
<display value="Medical equipment used"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
<valueCoding>
<system value="http://loinc.org"/>
<code value="71802-3"/>
<display value="Housing status"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="160734000"/>
<display value="Lives in a nursing home (finding)"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
<valueCoding>
<system value="http://loinc.org"/>
<code value="71007-9"/>
<display
value="Functional Assessment of Chronic Illness Therapy - Palliative Care Questionnaire (FACIT-Pal)"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="ColonCancerScreeningFHIR"/>
</extension>
<extension url="name">
<valueString value="Fecal Occult Blood Test Performed"/>
</extension>
<extension url="statement">
<valueString
value="define "Fecal Occult Blood Test Performed":
( ( [Observation: "Fecal Occult Blood Test (FOBT)"] ).isLaboratoryTestPerformed ( ) ) FecalOccultResult
where FecalOccultResult.value is not null
and FecalOccultResult.effective.latest ( ) during day of "Measurement Period""/>
</extension>
<extension url="displaySequence">
<valueInteger value="0"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="ColonCancerScreeningFHIR"/>
</extension>
<extension url="name">
<valueString value="Stool DNA with FIT Test Performed"/>
</extension>
<extension url="statement">
<valueString
value="define "Stool DNA with FIT Test Performed":
( ( [Observation: "sDNA FIT Test"] ).isLaboratoryTestPerformed ( ) ) sDNATest
where sDNATest.value is not null
and sDNATest.effective.latest ( ) during day of Interval[start of "Measurement Period" - 2 years, end of "Measurement Period"]"/>
</extension>
<extension url="displaySequence">
<valueInteger value="1"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="ColonCancerScreeningFHIR"/>
</extension>
<extension url="name">
<valueString value="Flexible Sigmoidoscopy Performed"/>
</extension>
<extension url="statement">
<valueString
value="define "Flexible Sigmoidoscopy Performed":
( ( [Procedure: "Flexible Sigmoidoscopy"] ).isProcedurePerformed ( ) ) FlexibleSigmoidoscopy
where FlexibleSigmoidoscopy.performed.toInterval ( ) ends during day of Interval[start of "Measurement Period" - 4 years, end of "Measurement Period"]"/>
</extension>
<extension url="displaySequence">
<valueInteger value="2"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="ColonCancerScreeningFHIR"/>
</extension>
<extension url="name">
<valueString value="CT Colonography Performed"/>
</extension>
<extension url="statement">
<valueString
value="define "CT Colonography Performed":
( ( [Observation: "CT Colonography"] ).isDiagnosticStudyPerformed ( ) ) Colonography
where Colonography.effective.toInterval ( ) ends during day of Interval[start of "Measurement Period" - 4 years, end of "Measurement Period"]"/>
</extension>
<extension url="displaySequence">
<valueInteger value="3"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="ColonCancerScreeningFHIR"/>
</extension>
<extension url="name">
<valueString value="Colonoscopy Performed"/>
</extension>
<extension url="statement">
<valueString
value="define "Colonoscopy Performed":
( ( [Procedure: "Colonoscopy"] ).isProcedurePerformed ( ) ) Colonoscopy
where Colonoscopy.performed.toInterval ( ) ends during day of Interval[start of "Measurement Period" - 9 years, end of "Measurement Period"]"/>
</extension>
<extension url="displaySequence">
<valueInteger value="4"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="ColonCancerScreeningFHIR"/>
</extension>
<extension url="name">
<valueString value="Numerator"/>
</extension>
<extension url="statement">
<valueString
value="define "Numerator":
exists "Fecal Occult Blood Test Performed"
or exists "Stool DNA with FIT Test Performed"
or exists "Flexible Sigmoidoscopy Performed"
or exists "CT Colonography Performed"
or exists "Colonoscopy Performed""/>
</extension>
<extension url="displaySequence">
<valueInteger value="5"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="ColonCancerScreeningFHIR"/>
</extension>
<extension url="name">
<valueString value="Stratification 2"/>
</extension>
<extension url="statement">
<valueString
value="define "Stratification 2":
AgeInYearsAt(date from
end of "Measurement Period"
) in Interval[50, 75]"/>
</extension>
<extension url="displaySequence">
<valueInteger value="6"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="ColonCancerScreeningFHIR"/>
</extension>
<extension url="name">
<valueString value="Stratification 1"/>
</extension>
<extension url="statement">
<valueString
value="define "Stratification 1":
AgeInYearsAt(date from
end of "Measurement Period"
) in Interval[46, 49]"/>
</extension>
<extension url="displaySequence">
<valueInteger value="7"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="AdultOutpatientEncounters"/>
</extension>
<extension url="name">
<valueString value="Qualifying Encounters"/>
</extension>
<extension url="statement">
<valueString
value="define "Qualifying Encounters":
( ( [Encounter: "Office Visit"]
union [Encounter: "Annual Wellness Visit"]
union [Encounter: "Preventive Care Services Established Office Visit, 18 and Up"]
union [Encounter: "Preventive Care Services Initial Office Visit, 18 and Up"]
union [Encounter: "Home Healthcare Services"]
union [Encounter: "Virtual Encounter"]
union [Encounter: "Telephone Visits"] ).isEncounterPerformed() ) ValidEncounter
where ValidEncounter.period.toInterval() during day of "Measurement Period""/>
</extension>
<extension url="displaySequence">
<valueInteger value="8"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="ColonCancerScreeningFHIR"/>
</extension>
<extension url="name">
<valueString value="Initial Population"/>
</extension>
<extension url="statement">
<valueString
value="define "Initial Population":
AgeInYearsAt(date from
end of "Measurement Period"
) in Interval[46, 75]
and exists AdultOutpatientEncounters."Qualifying Encounters""/>
</extension>
<extension url="displaySequence">
<valueInteger value="9"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="ColonCancerScreeningFHIR"/>
</extension>
<extension url="name">
<valueString value="Denominator"/>
</extension>
<extension url="statement">
<valueString
value="define "Denominator":
"Initial Population""/>
</extension>
<extension url="displaySequence">
<valueInteger value="10"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="Hospice"/>
</extension>
<extension url="name">
<valueString value="Has Hospice Services"/>
</extension>
<extension url="statement">
<valueString
value="define "Has Hospice Services":
exists ((([Encounter: "Encounter Inpatient"]).isEncounterPerformed()) InpatientEncounter
where (InpatientEncounter.hospitalization.dischargeDisposition ~ "Discharge to home for hospice care (procedure)"
or InpatientEncounter.hospitalization.dischargeDisposition ~ "Discharge to healthcare facility for hospice care (procedure)"
)
and InpatientEncounter.period.toInterval() ends during day of "Measurement Period"
)
or exists ((([Encounter: "Hospice Encounter"]).isEncounterPerformed()) HospiceEncounter
where HospiceEncounter.period.toInterval() overlaps day of "Measurement Period"
)
or exists ((([Observation: "Hospice care [Minimum Data Set]"]).isAssessmentPerformed()) HospiceAssessment
where HospiceAssessment.value ~ "Yes (qualifier value)"
and HospiceAssessment.effective.toInterval() overlaps day of "Measurement Period"
)
or exists ((([ServiceRequest: "Hospice Care Ambulatory"]).isInterventionOrder()) HospiceOrder
where HospiceOrder.authoredOn.toInterval() during day of "Measurement Period"
// and HospiceOrder.doNotPerform is not true
// https://oncprojectracking.healthit.gov/support/browse/CQLIT-447
)
or exists ((([Procedure: "Hospice Care Ambulatory"]).isInterventionPerformed()) HospicePerformed
where HospicePerformed.performed.toInterval() overlaps day of "Measurement Period"
)
or exists (([Condition: "Hospice Diagnosis"]) HospiceCareDiagnosis
where HospiceCareDiagnosis.prevalenceInterval() overlaps day of "Measurement Period"
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="11"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="ColonCancerScreeningFHIR"/>
</extension>
<extension url="name">
<valueString value="Malignant Neoplasm"/>
</extension>
<extension url="statement">
<valueString
value="define "Malignant Neoplasm":
( [Condition: "Malignant Neoplasm of Colon"] ) ColorectalCancer
where ColorectalCancer.prevalenceInterval ( ) starts on or before day of end of "Measurement Period""/>
</extension>
<extension url="displaySequence">
<valueInteger value="12"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="ColonCancerScreeningFHIR"/>
</extension>
<extension url="name">
<valueString value="Total Colectomy Performed"/>
</extension>
<extension url="statement">
<valueString
value="define "Total Colectomy Performed":
( ( [Procedure: "Total Colectomy"] ).isProcedurePerformed ( ) ) Colectomy
where Colectomy.performed.toInterval ( ) ends on or before day of end of "Measurement Period""/>
</extension>
<extension url="displaySequence">
<valueInteger value="13"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="AdvancedIllnessandFrailty"/>
</extension>
<extension url="name">
<valueString value="Has Criteria Indicating Frailty"/>
</extension>
<extension url="statement">
<valueString
value="define "Has Criteria Indicating Frailty":
exists ( (([DeviceRequest: "Frailty Device"]).isDeviceOrder()) FrailtyDeviceOrder
where FrailtyDeviceOrder.doNotPerform() is not true
and FrailtyDeviceOrder.authoredOn.toInterval() during day of "Measurement Period"
)
or exists ( (([Observation: "Medical equipment used"]).isAssessmentPerformed()) EquipmentUsed
where EquipmentUsed.value as Concept in "Frailty Device"
and EquipmentUsed.effective.toInterval() ends during day of "Measurement Period"
)
or exists ( ([Condition: "Frailty Diagnosis"]) FrailtyDiagnosis
where FrailtyDiagnosis.prevalenceInterval() overlaps day of "Measurement Period"
)
or exists ( (([Encounter: "Frailty Encounter"]).isEncounterPerformed()) FrailtyEncounter
where FrailtyEncounter.period.toInterval() overlaps day of "Measurement Period"
)
or exists ( (([Observation: "Frailty Symptom"]).isSymptom()) FrailtySymptom
where FrailtySymptom.effective.toInterval() overlaps day of "Measurement Period"
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="14"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="AdvancedIllnessandFrailty"/>
</extension>
<extension url="name">
<valueString
value="Has Advanced Illness in Year Before or During Measurement Period"/>
</extension>
<extension url="statement">
<valueString
value="define "Has Advanced Illness in Year Before or During Measurement Period":
exists ([Condition: "Advanced Illness"] AdvancedIllnessDiagnosis
where AdvancedIllnessDiagnosis.prevalenceInterval() starts during day of Interval[start of "Measurement Period" - 1 year, end of "Measurement Period"])"/>
</extension>
<extension url="displaySequence">
<valueInteger value="15"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="AdvancedIllnessandFrailty"/>
</extension>
<extension url="name">
<valueString
value="Has Dementia Medications in Year Before or During Measurement Period"/>
</extension>
<extension url="statement">
<valueString
value="define "Has Dementia Medications in Year Before or During Measurement Period":
exists (( ([MedicationRequest: medication in "Dementia Medications"]).isMedicationActive()) DementiaMedication
// https://oncprojectracking.healthit.gov/support/browse/CQLIT-449
where DementiaMedication.medicationRequestPeriod() overlaps day of Interval[start of "Measurement Period" - 1 year,
end of "Measurement Period"]
// and DementiaMedication.doNotPerform is not true
// https://oncprojectracking.healthit.gov/support/browse/CQLIT-447
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="16"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="AdvancedIllnessandFrailty"/>
</extension>
<extension url="name">
<valueString
value="Is Age 66 or Older with Advanced Illness and Frailty"/>
</extension>
<extension url="statement">
<valueString
value="define "Is Age 66 or Older with Advanced Illness and Frailty":
AgeInYearsAt(date from end of "Measurement Period")>= 66
and "Has Criteria Indicating Frailty"
and ( "Has Advanced Illness in Year Before or During Measurement Period"
or "Has Dementia Medications in Year Before or During Measurement Period"
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="17"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="AdvancedIllnessandFrailty"/>
</extension>
<extension url="name">
<valueString
value="Is Age 66 or Older Living Long Term in a Nursing Home"/>
</extension>
<extension url="statement">
<valueString
value="define "Is Age 66 or Older Living Long Term in a Nursing Home":
AgeInYearsAt(date from
end of "Measurement Period"
)>= 66
and ( ( Last( (([Observation: "Housing status"]).isAssessmentPerformed()) HousingStatus
where HousingStatus.effective.toInterval() ends on or before
day of end of "Measurement Period"
sort by
end of effective.toInterval() asc
)) LastHousingStatus
where LastHousingStatus.value ~ "Lives in a nursing home (finding)"
) is not null"/>
</extension>
<extension url="displaySequence">
<valueInteger value="18"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="PalliativeCare"/>
</extension>
<extension url="name">
<valueString value="Has Palliative Care in the Measurement Period"/>
</extension>
<extension url="statement">
<valueString
value="define "Has Palliative Care in the Measurement Period":
exists ((([Observation: "Functional Assessment of Chronic Illness Therapy - Palliative Care Questionnaire (FACIT-Pal)"]).isAssessmentPerformed()) PalliativeAssessment
where PalliativeAssessment.effective.toInterval() overlaps day of "Measurement Period"
)
or exists ([Condition: "Palliative Care Diagnosis"] PalliativeDiagnosis
where PalliativeDiagnosis.prevalenceInterval() overlaps day of "Measurement Period"
)
or exists ((([Encounter: "Palliative Care Encounter"]).isEncounterPerformed()) PalliativeEncounter
where PalliativeEncounter.period.toInterval() overlaps day of "Measurement Period"
)
or exists ((([Procedure: "Palliative Care Intervention"]).isInterventionPerformed()) PalliativeIntervention
where PalliativeIntervention.performed.toInterval() overlaps day of "Measurement Period"
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="19"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="ColonCancerScreeningFHIR"/>
</extension>
<extension url="name">
<valueString value="Denominator Exclusion"/>
</extension>
<extension url="statement">
<valueString
value="define "Denominator Exclusion":
Hospice."Has Hospice Services"
or exists "Malignant Neoplasm"
or exists "Total Colectomy Performed"
or AIFrailLTCF."Is Age 66 or Older with Advanced Illness and Frailty"
or AIFrailLTCF."Is Age 66 or Older Living Long Term in a Nursing Home"
or PalliativeCare."Has Palliative Care in the Measurement Period""/>
</extension>
<extension url="displaySequence">
<valueInteger value="20"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="Status"/>
</extension>
<extension url="name">
<valueString value="isLaboratoryTestPerformed"/>
</extension>
<extension url="statement">
<valueString
value="//Laboratory Test, Performed
define fluent function isLaboratoryTestPerformed(Obs List<Observation>):
Obs O
where O.status in { 'final', 'amended', 'corrected' }
and exists ( O.category ObservationCategory
where ( ObservationCategory ) ~ "laboratory"
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="21"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="FHIRHelpers"/>
</extension>
<extension url="name">
<valueString value="ToConcept"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Converts the given FHIR [CodeableConcept](https://hl7.org/fhir/datatypes.html#CodeableConcept) value to a CQL Concept.
*/
define function ToConcept(concept FHIR.CodeableConcept):
if concept is null then
null
else
System.Concept {
codes: concept.coding C return ToCode(C),
display: concept.text.value
}"/>
</extension>
<extension url="displaySequence">
<valueInteger value="22"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="QICoreCommon"/>
</extension>
<extension url="name">
<valueString value="latest"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Given an interval, returns the ending point if the interval has an ending boundary specified,
otherwise, returns the starting point
*/
define fluent function latest(choice Choice<DateTime, Quantity, Interval<DateTime>, Interval<Quantity>> ):
(choice.toInterval()) period
return
if (period."hasEnd"()) then end of period
else start of period"/>
</extension>
<extension url="displaySequence">
<valueInteger value="23"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="Status"/>
</extension>
<extension url="name">
<valueString value="isProcedurePerformed"/>
</extension>
<extension url="statement">
<valueString
value="//Procedure, Performed
define fluent function isProcedurePerformed(Proc List<Procedure>):
Proc P
where P.status ~ 'completed'"/>
</extension>
<extension url="displaySequence">
<valueInteger value="24"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="Status"/>
</extension>
<extension url="name">
<valueString value="isDiagnosticStudyPerformed"/>
</extension>
<extension url="statement">
<valueString
value="//Diagnostic Study, Performed
define fluent function isDiagnosticStudyPerformed(Obs List<Observation>):
Obs O
where O.status in {'final', 'amended', 'corrected' }"/>
</extension>
<extension url="displaySequence">
<valueInteger value="25"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="Status"/>
</extension>
<extension url="name">
<valueString value="isEncounterPerformed"/>
</extension>
<extension url="statement">
<valueString
value="//Encounter, Performed
//General usage unless required otherwise by measure intent (e.g., follow-up encounters)
define fluent function isEncounterPerformed(Enc List<Encounter>):
Enc E
where E.status in {'finished', 'arrived', 'triaged', 'in-progress', 'onleave'}"/>
</extension>
<extension url="displaySequence">
<valueInteger value="26"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="QICoreCommon"/>
</extension>
<extension url="name">
<valueString value="toInterval"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Normalizes a value that is a choice of timing-valued types to an equivalent interval
@comment: Normalizes a choice type of DateTime, Quanitty, Interval<DateTime>, or Interval<Quantity> types
to an equivalent interval. This selection of choice types is a superset of the majority of choice types that are used as possible
representations for timing-valued elements in QICore, allowing this function to be used across any resource.
The input can be provided as a DateTime, Quantity, Interval<DateTime> or Interval<Quantity>.
The intent of this function is to provide a clear and concise mechanism to treat single
elements that have multiple possible representations as intervals so that logic doesn't have to account
for the variability. More complex calculations (such as medication request period or dispense period
calculation) need specific guidance and consideration. That guidance may make use of this function, but
the focus of this function is on single element calculations where the semantics are unambiguous.
If the input is a DateTime, the result a DateTime Interval beginning and ending on that DateTime.
If the input is a Quantity, the quantity is expected to be a calendar-duration interpreted as an Age,
and the result is a DateTime Interval beginning on the Date the patient turned that age and ending immediately before one year later.
If the input is a DateTime Interval, the result is the input.
If the input is a Quantity Interval, the quantities are expected to be calendar-durations interpreted as an Age, and the result
is a DateTime Interval beginning on the date the patient turned the age given as the start of the quantity interval, and ending
immediately before one year later than the date the patient turned the age given as the end of the quantity interval.
If the input is a Timing, an error will be thrown indicating that Timing calculations are not implemented. Any other input will reslt in a null DateTime Interval
*/
define fluent function toInterval(choice Choice<DateTime, Quantity, Interval<DateTime>, Interval<Quantity>, Timing>):
case
when choice is DateTime then
Interval[choice as DateTime, choice as DateTime]
when choice is Interval<DateTime> then
choice as Interval<DateTime>
when choice is Quantity then
Interval[Patient.birthDate + (choice as Quantity),
Patient.birthDate + (choice as Quantity) + 1 year)
when choice is Interval<Quantity> then
Interval[Patient.birthDate + (choice.low as Quantity),
Patient.birthDate + (choice.high as Quantity) + 1 year)
when choice is Timing then
Message(null, true, 'NOT_IMPLEMENTED', 'Error', 'Calculation of an interval from a Timing value is not supported') as Interval<DateTime>
else
null as Interval<DateTime>
end"/>
</extension>
<extension url="displaySequence">
<valueInteger value="27"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="Status"/>
</extension>
<extension url="name">
<valueString value="isAssessmentPerformed"/>
</extension>
<extension url="statement">
<valueString
value="//This library contains functions that are based on QDM 5.6 to QICore 4.1.1 March 2023 (https://github.com/cqframework/CQL-Formatting-and-Usage-Wiki/wiki/Authoring-Patterns---QICore-v4.1.1). The functions may appear similar to some QICoreCommon functions but different in that they have constraints that are relevant for measures authored by NCQA.
//Assessment, Performed
define fluent function isAssessmentPerformed(Obs List<Observation>):
Obs O
where O.status in { 'final', 'amended', 'corrected' }
and exists ( O.category ObservationCategory
where ( ObservationCategory ) ~ "survey"
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="28"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="Status"/>
</extension>
<extension url="name">
<valueString value="isInterventionOrder"/>
</extension>
<extension url="statement">
<valueString
value="//Intervention, Order: active and completed only
define fluent function isInterventionOrder(ServiceRequest List<ServiceRequest>):
ServiceRequest S
where S.status in { 'active', 'completed' }
and S.intent = 'order'"/>
</extension>
<extension url="displaySequence">
<valueInteger value="29"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="Status"/>
</extension>
<extension url="name">
<valueString value="isInterventionPerformed"/>
</extension>
<extension url="statement">
<valueString
value="//Intervention, Performed
define fluent function isInterventionPerformed(Proc List<Procedure>):
Proc P
where P.status ~ 'completed'"/>
</extension>
<extension url="displaySequence">
<valueInteger value="30"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="QICoreCommon"/>
</extension>
<extension url="name">
<valueString value="prevalenceInterval"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Returns an interval representing the normalized prevalence period of a given Condition.
@comment: Uses the ToInterval and ToAbatementInterval functions to determine the widest potential interval from
onset to abatement as specified in the given Condition. If the condition is active, or has an abatement date the resulting
interval will have a closed ending boundary. Otherwise, the resulting interval will have an open ending boundary.
*/
define fluent function prevalenceInterval(condition Condition):
if condition.clinicalStatus ~ "active"
or condition.clinicalStatus ~ "recurrence"
or condition.clinicalStatus ~ "relapse" then
Interval[start of condition.onset.toInterval(), end of condition.abatementInterval()]
else
(end of condition.abatementInterval()) abatementDate
return if abatementDate is null then
Interval[start of condition.onset.toInterval(), abatementDate)
else
Interval[start of condition.onset.toInterval(), abatementDate]"/>
</extension>
<extension url="displaySequence">
<valueInteger value="31"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="Status"/>
</extension>
<extension url="name">
<valueString value="isDeviceOrder"/>
</extension>
<extension url="statement">
<valueString
value="//Device, Order - Personal Use Devices: active and completed only
define fluent function isDeviceOrder(DeviceRequest List<DeviceRequest>):
DeviceRequest D
where D.status in { 'active', 'completed' }
and D.intent = 'order'"/>
</extension>
<extension url="displaySequence">
<valueInteger value="32"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="QICoreCommon"/>
</extension>
<extension url="name">
<valueString value="doNotPerform"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Returns true if the given DeviceRequest is a negation (i.e. do not perform this order)
*/
define fluent function doNotPerform(deviceRequest DeviceRequest):
singleton from (
deviceRequest.modifierExtension E
where E.url = 'http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-doNotPerform'
return E.value as Boolean
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="33"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="Status"/>
</extension>
<extension url="name">
<valueString value="isSymptom"/>
</extension>
<extension url="statement">
<valueString
value="//Symptom
define fluent function isSymptom(Obs List<Observation>):
Obs O
where O.status in { 'preliminary', 'final', 'amended', 'corrected' }"/>
</extension>
<extension url="displaySequence">
<valueInteger value="34"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="Status"/>
</extension>
<extension url="name">
<valueString value="isMedicationActive"/>
</extension>
<extension url="statement">
<valueString
value="//Medication, Active
define fluent function isMedicationActive(MedicationRequest List<MedicationRequest>):
MedicationRequest M
where M.status = 'active'
and M.intent = 'order'"/>
</extension>
<extension url="displaySequence">
<valueInteger value="35"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="CumulativeMedicationDuration"/>
</extension>
<extension url="name">
<valueString value="medicationRequestPeriod"/>
</extension>
<extension url="statement">
<valueString
value="define fluent function medicationRequestPeriod(Request "MedicationRequest"):
Request R
let
dosage: singleton from R.dosageInstruction,
doseAndRate: singleton from dosage.doseAndRate,
timing: dosage.timing,
frequency: Coalesce(timing.repeat.frequencyMax, timing.repeat.frequency),
period: Quantity(timing.repeat.period, timing.repeat.periodUnit),
doseRange: doseAndRate.dose,
doseQuantity: doseAndRate.dose,
dose: Coalesce(end of doseRange, doseQuantity),
dosesPerDay: Coalesce(ToDaily(frequency, period), Count(timing.repeat.timeOfDay), 1.0),
boundsPeriod: timing.repeat.bounds as Interval<DateTime>,
daysSupply: (convert R.dispenseRequest.expectedSupplyDuration to days).value,
quantity: R.dispenseRequest.quantity,
refills: Coalesce(R.dispenseRequest.numberOfRepeatsAllowed, 0),
startDate:
Coalesce(
date from start of boundsPeriod,
date from R.authoredOn,
date from start of R.dispenseRequest.validityPeriod
),
totalDaysSupplied: Coalesce(daysSupply, quantity.value / (dose.value * dosesPerDay)) * (1 + refills)
return
if startDate is not null and totalDaysSupplied is not null then
Interval[startDate, startDate + Quantity(totalDaysSupplied - 1, 'day') ]
else if startDate is not null and boundsPeriod."high" is not null then
Interval[startDate, date from end of boundsPeriod]
else
null"/>
</extension>
<extension url="displaySequence">
<valueInteger value="36"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="CumulativeMedicationDuration"/>
</extension>
<extension url="name">
<valueString value="Quantity"/>
</extension>
<extension url="statement">
<valueString
value="/**********************************************************************/
/* Functions in this region are copied from opioid-mme-r4 */
/**********************************************************************/
define function Quantity(value Decimal, unit String):
if value is not null then
System.Quantity { value: value, unit: unit }
else
null"/>
</extension>
<extension url="displaySequence">
<valueInteger value="37"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="CumulativeMedicationDuration"/>
</extension>
<extension url="name">
<valueString value="ToDaily"/>
</extension>
<extension url="statement">
<valueString
value="/*
Goal is to get to number of days
Two broad approaches to the calculation:
1) Based on supply and frequency, calculate the number of expected days the medication will cover/has covered
2) Based on relevant period, determine a covered interval and calculate the length of that interval in days
This topic covers several use cases and illustrates how to calculate Cumulative
Medication Duration for each type of medication resource using the supply and
frequency approach.
*/
/*
For the first approach, we need to get from frequency to a frequency/day
So we define ToDaily
*/
/*
Calculates daily frequency given frequency within a period
*/
define function ToDaily(frequency System.Integer, period System.Quantity):
case period.unit
when 'h' then frequency * (24.0 / period.value)
when 'min' then frequency * (24.0 / period.value) * 60
when 's' then frequency * (24.0 / period.value) * 60 * 60
when 'd' then frequency * (24.0 / period.value) / 24
when 'wk' then frequency * (24.0 / period.value) / (24 * 7)
when 'mo' then frequency * (24.0 / period.value) / (24 * 30) /* assuming 30 days in month */
when 'a' then frequency * (24.0 / period.value) / (24 * 365) /* assuming 365 days in year */
when 'hour' then frequency * (24.0 / period.value)
when 'minute' then frequency * (24.0 / period.value) * 60
when 'second' then frequency * (24.0 / period.value) * 60 * 60
when 'day' then frequency * (24.0 / period.value) / 24
when 'week' then frequency * (24.0 / period.value) / (24 * 7)
when 'month' then frequency * (24.0 / period.value) / (24 * 30) /* assuming 30 days in month */
when 'year' then frequency * (24.0 / period.value) / (24 * 365) /* assuming 365 days in year */
when 'hours' then frequency * (24.0 / period.value)
when 'minutes' then frequency * (24.0 / period.value) * 60
when 'seconds' then frequency * (24.0 / period.value) * 60 * 60
when 'days' then frequency * (24.0 / period.value) / 24
when 'weeks' then frequency * (24.0 / period.value) / (24 * 7)
when 'months' then frequency * (24.0 / period.value) / (24 * 30) /* assuming 30 days in month */
when 'years' then frequency * (24.0 / period.value) / (24 * 365) /* assuming 365 days in year */
else Message(null, true, 'CMDLogic.ToDaily.UnknownUnit', ErrorLevel, 'Unknown unit ' & period.unit)
end"/>
</extension>
<extension url="displaySequence">
<valueInteger value="38"/>
</extension>
</extension>
<name value="EffectiveDataRequirements"/>
<status value="active"/>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/library-type"/>
<code value="module-definition"/>
</coding>
</type>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library Status"/>
<resource value="Library/Status|1.8.000"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library FHIRHelpers"/>
<resource value="Library/FHIRHelpers|4.4.000"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library QICoreCommon"/>
<resource value="Library/QICoreCommon|2.1.000"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library AdultOutpatientEncounters"/>
<resource value="Library/AdultOutpatientEncounters|4.11.000"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library Hospice"/>
<resource value="Library/Hospice|6.12.000"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library AIFrailLTCF"/>
<resource value="Library/AdvancedIllnessandFrailty|1.16.000"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library CMD"/>
<resource value="Library/CumulativeMedicationDuration|4.1.000"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library PalliativeCare"/>
<resource value="Library/PalliativeCare|1.11.000"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Code system ObservationCategoryCodes"/>
<resource
value="http://terminology.hl7.org/CodeSystem/observation-category"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Code system SNOMEDCT"/>
<resource value="http://snomed.info/sct"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Code system LOINC"/>
<resource value="http://loinc.org"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Fecal Occult Blood Test (FOBT)"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1011"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set sDNA FIT Test"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1039"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Flexible Sigmoidoscopy"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1010"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set CT Colonography"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1038"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Colonoscopy"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1020"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Office Visit"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Annual Wellness Visit"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display
value="Value set Preventive Care Services Established Office Visit, 18 and Up"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display
value="Value set Preventive Care Services Initial Office Visit, 18 and Up"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Home Healthcare Services"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Virtual Encounter"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1089"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Telephone Visits"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1080"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Encounter Inpatient"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Hospice Encounter"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1003"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Hospice Care Ambulatory"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1584"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Hospice Diagnosis"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1165"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Malignant Neoplasm of Colon"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1001"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Total Colectomy"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1019"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Frailty Device"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.118.12.1300"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Frailty Diagnosis"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.113.12.1074"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Frailty Encounter"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1088"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Frailty Symptom"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.113.12.1075"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Advanced Illness"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1082"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Dementia Medications"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.196.12.1510"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Palliative Care Diagnosis"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1167"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Palliative Care Encounter"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1090"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Palliative Care Intervention"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1135"/>
</relatedArtifact>
<parameter>
<name value="Measurement Period"/>
<use value="in"/>
<min value="0"/>
<max value="1"/>
<type value="Period"/>
</parameter>
<parameter>
<name value="ErrorLevel"/>
<use value="in"/>
<min value="0"/>
<max value="1"/>
<type value="string"/>
</parameter>
<parameter>
<name value="Numerator"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="boolean"/>
</parameter>
<parameter>
<name value="Stratification 2"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="boolean"/>
</parameter>
<parameter>
<name value="Stratification 1"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="boolean"/>
</parameter>
<parameter>
<name value="Denominator"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="boolean"/>
</parameter>
<parameter>
<name value="Initial Population"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="boolean"/>
</parameter>
<parameter>
<name value="Denominator Exclusion"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="boolean"/>
</parameter>
<dataRequirement>
<type value="Observation"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation"/>
<mustSupport value="code"/>
<mustSupport value="value"/>
<mustSupport value="effective"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="category"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1011"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Observation"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation"/>
<mustSupport value="code"/>
<mustSupport value="value"/>
<mustSupport value="effective"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="category"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1039"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Observation"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation"/>
<mustSupport value="code"/>
<mustSupport value="effective"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="category"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1038"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Observation"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation"/>
<mustSupport value="code"/>
<mustSupport value="value"/>
<mustSupport value="effective"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="category"/>
<codeFilter>
<path value="code"/>
<code>
<system value="http://loinc.org"/>
<code value="45755-6"/>
<display value="Hospice care [Minimum Data Set]"/>
</code>
</codeFilter>
<codeFilter>
<path value="value"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Observation"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation"/>
<mustSupport value="code"/>
<mustSupport value="value"/>
<mustSupport value="effective"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="category"/>
<codeFilter>
<path value="code"/>
<code>
<system value="http://loinc.org"/>
<code value="98181-1"/>
<display value="Medical equipment used"/>
</code>
</codeFilter>
<codeFilter>
<path value="value"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.118.12.1300"/>
</codeFilter>
<dateFilter>
<path value="effective"/>
<valuePeriod>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-expression">
<valueExpression>
<language value="text/cql-identifier"/>
<expression value="Measurement Period"/>
</valueExpression>
</extension>
</valuePeriod>
</dateFilter>
</dataRequirement>
<dataRequirement>
<type value="Observation"/>
<profile
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<mustSupport value="code"/>
<mustSupport value="effective"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="category"/>
<codeFilter>
<path value="code"/>
<valueSet
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</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Observation"/>
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<mustSupport value="code"/>
<mustSupport value="effective"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="category"/>
<codeFilter>
<path value="code"/>
<code>
<system value="http://loinc.org"/>
<code value="71802-3"/>
<display value="Housing status"/>
</code>
</codeFilter>
<dateFilter>
<path value="effective"/>
</dateFilter>
</dataRequirement>
<dataRequirement>
<type value="Observation"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation"/>
<mustSupport value="code"/>
<mustSupport value="effective"/>
<mustSupport value="value"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="category"/>
<codeFilter>
<path value="code"/>
<code>
<system value="http://loinc.org"/>
<code value="71802-3"/>
<display value="Housing status"/>
</code>
</codeFilter>
<codeFilter>
<path value="value"/>
</codeFilter>
<dateFilter>
<path value="effective"/>
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</dataRequirement>
<dataRequirement>
<type value="Observation"/>
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<mustSupport value="code"/>
<mustSupport value="effective"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="category"/>
<codeFilter>
<path value="code"/>
<code>
<system value="http://loinc.org"/>
<code value="71007-9"/>
<display
value="Functional Assessment of Chronic Illness Therapy - Palliative Care Questionnaire (FACIT-Pal)"/>
</code>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Procedure"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure"/>
<mustSupport value="code"/>
<mustSupport value="performed"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1010"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Procedure"/>
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<mustSupport value="code"/>
<mustSupport value="performed"/>
<mustSupport value="status"/>
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<path value="code"/>
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</dataRequirement>
<dataRequirement>
<type value="Procedure"/>
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<mustSupport value="code"/>
<mustSupport value="performed"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1584"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Procedure"/>
<profile
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<mustSupport value="code"/>
<mustSupport value="performed"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
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<path value="code"/>
<valueSet
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</codeFilter>
<dateFilter>
<path value="performed"/>
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</dataRequirement>
<dataRequirement>
<type value="Procedure"/>
<profile
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<mustSupport value="code"/>
<mustSupport value="performed"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
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<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1135"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Patient"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"/>
</dataRequirement>
<dataRequirement>
<type value="Encounter"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"/>
<mustSupport value="type"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="period"/>
<codeFilter>
<path value="type"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Encounter"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"/>
<mustSupport value="type"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="period"/>
<codeFilter>
<path value="type"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Encounter"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"/>
<mustSupport value="type"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="period"/>
<codeFilter>
<path value="type"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Encounter"/>
<profile
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<mustSupport value="type"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="period"/>
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<path value="type"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Encounter"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"/>
<mustSupport value="type"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="period"/>
<codeFilter>
<path value="type"/>
<valueSet
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</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Encounter"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"/>
<mustSupport value="type"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="period"/>
<codeFilter>
<path value="type"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1089"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Encounter"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"/>
<mustSupport value="type"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="period"/>
<codeFilter>
<path value="type"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1080"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Encounter"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"/>
<mustSupport value="type"/>
<mustSupport value="hospitalization"/>
<mustSupport value="hospitalization.dischargeDisposition"/>
<mustSupport value="period"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<codeFilter>
<path value="type"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Encounter"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"/>
<mustSupport value="type"/>
<mustSupport value="period"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<codeFilter>
<path value="type"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1003"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Encounter"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"/>
<mustSupport value="type"/>
<mustSupport value="period"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<codeFilter>
<path value="type"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1088"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Encounter"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"/>
<mustSupport value="type"/>
<mustSupport value="period"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<codeFilter>
<path value="type"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1090"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="ServiceRequest"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest"/>
<mustSupport value="code"/>
<mustSupport value="authoredOn"/>
<mustSupport value="authoredOn.value"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="intent"/>
<mustSupport value="intent.value"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1584"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Condition"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition"/>
<mustSupport value="code"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1165"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Condition"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition"/>
<mustSupport value="code"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1001"/>
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</dataRequirement>
<dataRequirement>
<type value="Condition"/>
<profile
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<mustSupport value="code"/>
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<path value="code"/>
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value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.113.12.1074"/>
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</dataRequirement>
<dataRequirement>
<type value="Condition"/>
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value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition"/>
<mustSupport value="code"/>
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<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1082"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Condition"/>
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<mustSupport value="code"/>
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<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1167"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="DeviceRequest"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-devicerequest"/>
<mustSupport value="code"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="intent"/>
<mustSupport value="intent.value"/>
<mustSupport value="url"/>
<mustSupport value="url.value"/>
<mustSupport value="value"/>
<mustSupport value="authoredOn"/>
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<codeFilter>
<path value="code"/>
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value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.118.12.1300"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="MedicationRequest"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest"/>
<mustSupport value="medication"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="intent"/>
<mustSupport value="intent.value"/>
<mustSupport value="dosageInstruction"/>
<mustSupport value="dispenseRequest"/>
<mustSupport value="dispenseRequest.expectedSupplyDuration"/>
<mustSupport value="dispenseRequest.quantity"/>
<mustSupport value="dispenseRequest.numberOfRepeatsAllowed"/>
<mustSupport value="dispenseRequest.numberOfRepeatsAllowed.value"/>
<mustSupport value="authoredOn"/>
<mustSupport value="authoredOn.value"/>
<mustSupport value="dispenseRequest.validityPeriod"/>
<codeFilter>
<path value="medication"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.196.12.1510"/>
</codeFilter>
</dataRequirement>
</Library>
</contained>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-effectiveDataRequirements" id="effective-data-requirements">
<valueReference>
<reference value="#effective-data-requirements"/>
</valueReference>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-softwaresystem">
<valueReference>
<reference value="Device/cqf-tooling"/>
</valueReference>
</extension>
<url value="https://madie.cms.gov/Measure/ColonCancerScreeningFHIR"/>
<identifier>
<use value="usual"/>
<type>
<coding>
<system
value="http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type"/>
<code value="short-name"/>
</coding>
</type>
<system value="https://madie.cms.gov/measure/shortName"/>
<value value="CMS130FHIR"/>
</identifier>
<identifier>
<use value="official"/>
<type>
<coding>
<system
value="http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type"/>
<code value="version-independent"/>
</coding>
</type>
<system value="urn:ietf:rfc:3986"/>
<value value="urn:uuid:627c6e27-5c46-4412-941a-ca387492bbaa"/>
</identifier>
<identifier>
<use value="official"/>
<type>
<coding>
<system
value="http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type"/>
<code value="version-specific"/>
</coding>
</type>
<system value="urn:ietf:rfc:3986"/>
<value value="urn:uuid:3ff5ff28-e118-4433-8467-15d0a585b45d"/>
</identifier>
<identifier>
<use value="official"/>
<type>
<coding>
<system
value="http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type"/>
<code value="publisher"/>
</coding>
</type>
<system value="https://madie.cms.gov/measure/cmsId"/>
<value value="130FHIR"/>
<assigner>
<display value="CMS"/>
</assigner>
</identifier>
<version value="0.1.000"/>
<name value="ColonCancerScreeningFHIR"/>
<title value="Colorectal Cancer ScreeningFHIR"/>
<status value="draft"/>
<experimental value="false"/>
<date value="2024-07-09T14:53:56+00:00"/>
<publisher value="National Committee for Quality Assurance"/>
<contact>
<telecom>
<system value="url"/>
<value value="https://www.ncqa.org/"/>
</telecom>
</contact>
<description
value="Percentage of adults 45-75 years of age who had appropriate screening for colorectal cancer"/>
<purpose value="UNKNOWN"/>
<usage
value="Do not count digital rectal exams (DRE), fecal occult blood tests (FOBTs) performed in an office setting or performed on a sample collected via DRE. Please note the measure may include screenings performed outside the age range of patients referenced in the initial population. Screenings that occur prior to the measurement period are valid to meet measure criteria. This eCQM is a patient-based measure. This FHIR-based measure has been derived from the QDM-based measure: CMS130v13. Please refer to the HL7 QI-Core Implementation Guide (http://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 (http://hl7.org/fhir/us/qicore/STU4.1.1/qdm-to-qicore.html)."/>
<copyright
value="This Physician Performance Measure (Measure) and related data specifications are owned and were developed by the National Committee for Quality Assurance (NCQA). NCQA is not responsible for any use of the Measure. NCQA makes no representations, warranties, or endorsement about the quality of any organization or physician that uses or reports performance measures and NCQA has no liability to anyone who relies on such measures or specifications. NCQA holds a copyright in the Measure. The Measure can be reproduced and distributed, without modification, for noncommercial purposes (e.g., use by healthcare providers in connection with their practices) without obtaining approval from NCQA. Commercial use is defined as the sale, licensing, 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. All commercial uses or requests for modification must be approved by NCQA and are subject to a license at the discretion of NCQA. (C) 2012-2024 National Committee for Quality Assurance. All Rights Reserved. Limited proprietary coding is contained in the Measure specifications for user convenience. Users of proprietary code sets should obtain all necessary licenses from the owners of the code sets. NCQA disclaims all liability for use or accuracy of any third-party codes contained in the specifications. CPT(R) codes, descriptions and other data are copyright 2024. American Medical Association. All rights reserved. CPT is a trademark of the American Medical Association. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein. Applicable FARS/DFARS restrictions apply to government use. Some measure specifications contain coding from LOINC(R) (http://loinc.org). The LOINC table, LOINC codes, LOINC panels and form file, LOINC linguistic variants file, LOINC/RSNA Radiology Playbook, and LOINC/IEEE Medical Device Code Mapping Table are copyright 2004-2024 Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee, and are available at no cost under the license at http://loinc.org/terms-of-use. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2023 International Health Terminology Standards Development Organisation. ICD-10 copyright 2024 World Health Organization. All Rights Reserved. Some measures use RxNorm, a standardized nomenclature and coding for clinical drugs and drug delivery devices, which is made publicly available courtesy of the U.S. National Library of Medicine (NLM), National Institutes of Health, Department of Health and Human Services. NLM is not responsible for the measures and does not endorse or recommend this or any other product. “HL7” is the registered trademark of Health Level Seven International."/>
<effectivePeriod>
<start value="2025-01-01"/>
<end value="2025-12-31"/>
</effectivePeriod>
<author>
<name value="National Committee for Quality Assurance"/>
<telecom>
<system value="url"/>
<value value="https://www.ncqa.org/"/>
</telecom>
</author>
<library value="https://madie.cms.gov/Library/ColonCancerScreeningFHIR"/>
<disclaimer
value="The performance Measure is not a clinical guideline and does not establish a standard of medical care, and has not been tested for all potential applications. THE MEASURE AND SPECIFICATIONS ARE PROVIDED "AS IS" WITHOUT WARRANTY OF ANY KIND. Due to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM]."/>
<rationale
value="Colorectal cancer represents eight percent of all new cancer cases in the United States. In 2020, there were an estimated 147,950 new cases of colorectal cancer and an estimated 53,200 deaths attributed to it. According to the National Cancer Institute, about 4.2 percent of men and women will be diagnosed with colorectal cancer at some point during their lifetimes. For most adults, older age is the most important risk factor for colorectal cancer, although being male and black are also associated with higher incidence and mortality. Colorectal cancer is most frequently diagnosed among people 65 to 74 years old (Howlader et al., 2020). Screening can be effective for finding precancerous lesions (polyps) that could later become malignant, and for detecting early cancers that can be more easily and effectively treated. Precancerous polyps usually take about 10 to 15 years to develop into colorectal cancer, and most can be found and removed before turning into cancer. The five-year relative survival rate for people whose colorectal cancer is found in the early stage before it has spread is about 90 percent (SEER, 2022)."/>
<clinicalRecommendationStatement
value="The U.S. Preventive Services Task Force (2021) recommends screening for colorectal cancer in adults aged 45 to 49 years. This is a Grade B recommendation (U.S. Preventive Services Task Force, 2021). The U.S. Preventive Services Task Force (2021) recommends screening for colorectal cancer in adults aged 50 to 75 years. This is a Grade A recommendation (U.S. Preventive Services Task Force, 2021). Appropriate screenings are defined by any one of the following: - Fecal occult blood test (annually) - Stool DNA (sDNA) with FIT test (every 3 years) - Flexible sigmoidoscopy (every 5 years) - Computed tomographic (CT) colonography (every 5 years) - Colonoscopy (every 10 years)"/>
<group id="654a405f78418140875e351c">
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring">
<valueCodeableConcept>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-scoring"/>
<code value="proportion"/>
<display value="Proportion"/>
</coding>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis">
<valueCode value="boolean"/>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-type">
<valueCodeableConcept>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/measure-type"/>
<code value="process"/>
<display value="Process"/>
</coding>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-rateAggregation">
<valueCode value="None"/>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-improvementNotation">
<valueCodeableConcept>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-improvement-notation"/>
<code value="decrease"/>
<display value="increase"/>
</coding>
</valueCodeableConcept>
</extension>
<population id="7423DF07-8C1A-4B0C-89EA-64932F943566">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="initial-population"/>
<display value="Initial Population"/>
</coding>
</code>
<description
value="Patients 46-75 years of age by the end of the measurement period with a visit during the measurement period"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Initial Population"/>
</criteria>
</population>
<population id="EB843F58-5BA6-4B74-BA7D-2D313E9C1F94">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="denominator"/>
<display value="Denominator"/>
</coding>
</code>
<description value="Equals Initial Population"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Denominator"/>
</criteria>
</population>
<population id="4a91dd44-46af-44ee-bcee-2bdc0e811188">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="denominator-exclusion"/>
<display value="Denominator Exclusion"/>
</coding>
</code>
<description
value="Exclude patients who are in hospice care for any part of the measurement period. Exclude patients with a diagnosis or past history of total colectomy or colorectal cancer. Exclude patients 66 and older by the end of the measurement period with an indication of frailty for any part of the measurement period who also meet any of the following advanced illness criteria: - Advanced illness diagnosis during the measurement period or the year prior - OR taking dementia medications during the measurement period or the year prior Exclude patients 66 and older by the end of the measurement period who are living long term in a nursing home any time on or before the end of the measurement period. Exclude patients receiving palliative care for any part of the measurement period."/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Denominator Exclusion"/>
</criteria>
</population>
<population id="AA394954-274E-4BAD-99FA-5B188C962903">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="numerator"/>
<display value="Numerator"/>
</coding>
</code>
<description
value="Patients with one or more screenings for colorectal cancer. Appropriate screenings are defined by any one of the following criteria: - Fecal occult blood test (FOBT) during the measurement period - Stool DNA (sDNA) with FIT test during the measurement period or the two years prior to the measurement period - Flexible sigmoidoscopy during the measurement period or the four years prior to the measurement period - CT Colonography during the measurement period or the four years prior to the measurement period - Colonoscopy during the measurement period or the nine years prior to the measurement period"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Numerator"/>
</criteria>
</population>
<stratifier id="736a0ff4-9544-4c88-88dd-76274cc3d540">
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo">
<valueCodeableConcept>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="initial-population"/>
<display value="Initial Population"/>
</coding>
</valueCodeableConcept>
</extension>
<description
value="Patients age 46-49 by the end of the measurement period"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Stratification 1"/>
</criteria>
</stratifier>
<stratifier id="426f0691-b064-459c-9661-88dadc8d3f7b">
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo">
<valueCodeableConcept>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="initial-population"/>
<display value="Initial Population"/>
</coding>
</valueCodeableConcept>
</extension>
<description
value="Patients age 50-75 by the end of the measurement period"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Stratification 2"/>
</criteria>
</stratifier>
</group>
</Measure>
IG © 2023+ cqframework. Package gov.healthit.ecqi.ecqms#2024.0.0 based on FHIR 4.0.1. Generated 2024-11-07
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