Proportion

Process

increase

define "Initial Population":
  "Has Active HIV Diagnosis Starts On or Before First 240 Days of Measurement Period"
    and "Has Qualifying Encounter During First 240 Days of Measurement Period"

define "Denominator":
  "Initial Population"

define "Numerator":
  "Has One Encounter With HIV and One Viral Load Test At Least 90 Days Apart"
    or "Has Two Encounters With HIV At Least 90 Days Apart"

define "SDE Sex":
  case
    when Patient.gender = 'male' then "M"
    when Patient.gender = 'female' then "F"
    else null
  end

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

define "Encounter During Measurement Period With HIV":
  ( ( ["Encounter": "Office Visit"]
      union ["Encounter": "Outpatient Consultation"]
      union ["Encounter": "Annual Wellness Visit"]
      union ["Encounter": "Face-to-Face Interaction"]
      union ["Encounter": "Home Healthcare Services"]
      union ["Encounter": "Preventive Care Services Established Office Visit, 18 and Up"]
      union ["Encounter": "Preventive Care Services Initial Office Visit, 18 and Up"]
      union ["Encounter": "Preventive Care Services, Initial Office Visit, 0 to 17"]
      union ["Encounter": "Preventive Care, Established Office Visit, 0 to 17"]
      union ["Encounter": "Telephone Visits"]
      union ["Encounter": "Preventive Care Services Other"] ) ValidEncounter
      with ["Condition": "HIV"] HIVDiagnosis
        such that ValidEncounter.period during day of "Measurement Period"
          and HIVDiagnosis.prevalenceInterval ( ) starts on or before day of ValidEncounter.period
          and HIVDiagnosis.isActive ( )
  )

define "Has One Encounter With HIV and One Viral Load Test At Least 90 Days Apart":
  exists ( "Encounter During Measurement Period With HIV" ) EncounterWithHIV
    with ["Observation": "HIV Viral Load"] ViralLoadTest
      such that ViralLoadTest.effective.toInterval ( ) during day of "Measurement Period"
        and ( ( ViralLoadTest.effective.toInterval ( ) starts 90 days or more after day of end of EncounterWithHIV.period )
            or ( EncounterWithHIV.period starts 90 days or more after day of end of ViralLoadTest.effective.toInterval ( ) )
        )

define "Has Two Encounters With HIV At Least 90 Days Apart":
  exists "Encounter During Measurement Period With HIV" EncounterWithHIV
    with "Encounter During Measurement Period With HIV" AnotherEncounterWithHIV
      such that EncounterWithHIV !~ AnotherEncounterWithHIV
        and AnotherEncounterWithHIV.period starts 90 days or more after day of end of EncounterWithHIV.period

define "Numerator":
  "Has One Encounter With HIV and One Viral Load Test At Least 90 Days Apart"
    or "Has Two Encounters With HIV At Least 90 Days Apart"

define "Has Active HIV Diagnosis Starts On or Before First 240 Days of Measurement Period":
  exists ( ["Condition": "HIV"] HIVDx
      where HIVDx.prevalenceInterval ( ) starts on or before day of ( start of "Measurement Period" + 240 days )
        and HIVDx.isActive ( )
  )

define "Has Qualifying Encounter During First 240 Days of Measurement Period":
  exists ( ["Encounter": "Office Visit"]
    union ["Encounter": "Outpatient Consultation"]
    union ["Encounter": "Annual Wellness Visit"]
    union ["Encounter": "Face-to-Face Interaction"]
    union ["Encounter": "Home Healthcare Services"]
    union ["Encounter": "Preventive Care Services Established Office Visit, 18 and Up"]
    union ["Encounter": "Preventive Care Services Initial Office Visit, 18 and Up"]
    union ["Encounter": "Preventive Care Services, Initial Office Visit, 0 to 17"]
    union ["Encounter": "Preventive Care, Established Office Visit, 0 to 17"]
    union ["Encounter": "Telephone Visits"]
    union ["Encounter": "Preventive Care Services Other"] ) QualifyingEncounter
    where QualifyingEncounter.period during day of Interval[start of "Measurement Period", start of "Measurement Period" + 240 days]

define "Initial Population":
  "Has Active HIV Diagnosis Starts On or Before First 240 Days of Measurement Period"
    and "Has Qualifying Encounter During First 240 Days of Measurement Period"

define "Denominator":
  "Initial Population"

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

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

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

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

/* Candidates for FHIRCommon */

/*
@description: Returns true if the given condition has a clinical status of active, recurrence, or relapse
*/
define fluent function isActive(condition Condition):
  condition.clinicalStatus ~ "active"
    or condition.clinicalStatus ~ "recurrence"
    or condition.clinicalStatus ~ "relapse"

/*
@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]

define function ToString(value uri): value.value

/*
@description: Converts the given FHIR [Coding](https://hl7.org/fhir/datatypes.html#Coding) value to a CQL Code.
*/
define function ToCode(coding FHIR.Coding):
    if coding is null then
        null
    else
        System.Code {
          code: coding.code.value,
          system: coding.system.value,
          version: coding.version.value,
          display: coding.display.value
        }