eCQM QICore Content Implementation Guide
2024.0.0 - CI Build
eCQM QICore Content Implementation Guide
2024.0.0 - CI Build
eCQM QICore Content Implementation Guide, published by cqframework. This guide is not an authorized publication; it is the continuous build for version 2024.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/cqframework/ecqm-content-qicore-2024/ and changes regularly. See the Directory of published versions
| Draft as of 2024-12-18 |
{
"resourceType" : "Measure",
"id" : "IntensiveCareUnitVenousThromboembolismProphylaxisFHIR",
"meta" : {
"profile" : [
🔗 "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-measure-cqfm"🔗 ,
"http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/publishable-measure-cqfm"🔗 ,
"http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/executable-measure-cqfm"
]
},
"text" : {
"status" : "extensions",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <table class=\"grid dict\">\n \n <tr>\n <th scope=\"row\"><b>Title: </b></th>\n <td style=\"padding-left: 4px;\">Intensive Care Unit Venous Thromboembolism ProphylaxisFHIR</td>\n </tr>\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Id: </b></th>\n <td style=\"padding-left: 4px;\">IntensiveCareUnitVenousThromboembolismProphylaxisFHIR</td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Version: </b></th>\n <td style=\"padding-left: 4px;\">0.2.000</td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Url: </b></th>\n <td style=\"padding-left: 4px;\"><a href=\"Measure-IntensiveCareUnitVenousThromboembolismProphylaxisFHIR.html\">Intensive Care Unit Venous Thromboembolism ProphylaxisFHIR</a></td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\">\n <b>\n \n \n short-name identifier:\n \n \n </b>\n </th>\n\n <td style=\"padding-left: 4px;\">\n \n <p style=\"margin-bottom: 5px;\">\n <span>CMS190FHIR</span>\n </p>\n \n </td>\n </tr>\n \n <tr>\n <th scope=\"row\">\n <b>\n \n \n version-independent identifier:\n \n \n </b>\n </th>\n\n <td style=\"padding-left: 4px;\">\n \n <p style=\"margin-bottom: 5px;\">\n <span>urn:uuid:693f0836-228e-43cc-ac71-53388e5dc010</span>\n </p>\n \n </td>\n </tr>\n \n <tr>\n <th scope=\"row\">\n <b>\n \n \n version-specific identifier:\n \n \n </b>\n </th>\n\n <td style=\"padding-left: 4px;\">\n \n <p style=\"margin-bottom: 5px;\">\n <span>urn:uuid:6eaf8571-3c4a-4605-88ea-8c66f3294e7c</span>\n </p>\n \n </td>\n </tr>\n \n <tr>\n <th scope=\"row\">\n <b>\n \n \n publisher (CMS) identifier:\n \n \n </b>\n </th>\n\n <td style=\"padding-left: 4px;\">\n \n <p style=\"margin-bottom: 5px;\">\n <span>190FHIR</span>\n </p>\n \n </td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Effective Period: </b></th>\n <td style=\"padding-left: 4px;\">2025-01-01..2025-12-31</td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Status: </b></th>\n <td style=\"padding-left: 4px;\">draft</td>\n </tr>\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Publisher: </b></th>\n <td style=\"padding-left: 4px;\">The Joint Commission</td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Author: </b></th>\n <td style=\"padding-left: 4px;\">The Joint Commission</td>\n </tr>\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Description: </b></th>\n <td style=\"padding-left: 4px;\"><div><p>This measure assesses the number of patients who received Venous Thromboembolism (VTE) prophylaxis or have documentation why no VTE prophylaxis was given the day of or the day after the initial admission (or transfer) to the Intensive Care Unit (ICU) or surgery end date for surgeries that start the day of or the day after ICU admission (or transfer)</p>\n</div></td>\n </tr>\n \n\n \n\n \n\n \n\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Purpose: </b></th>\n <td style=\"padding-left: 4px;\"><div><p>UNKNOWN</p>\n</div></td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Copyright: </b></th>\n <td style=\"padding-left: 4px;\"><div><p>Measure specifications are in the Public Domain. LOINC(R) copyright 2004-2023 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2023 International Health Terminology Standards Development Organisation. ICD-10 copyright 2023 World Health Organization. All Rights Reserved.</p>\n</div></td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Disclaimer: </b></th>\n <td style=\"padding-left: 4px;\"><div><p>These performance measures are not clinical guidelines and do not establish a standard of medical care, and have not been tested for all potential applications. The measures and specifications are provided without warranty.</p>\n</div></td>\n </tr>\n \n\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Scoring: </b></th>\n <td style=\"padding-left: 4px;\">\n \n \n <p style=\"margin-bottom: 5px;\">\n <span>Proportion </span>\n </p>\n \n \n \n </td>\n </tr>\n \n\n \n\n \n\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Rationale: </b></th>\n <td style=\"padding-left: 4px;\"><div><p>Venous Thromboembolism (VTE) is a known complication of hospitalization, frequently extending the length of stay and increasing hospital mortality (Maynard, 2016). Approximately 20% of VTE are associated with a surgical procedure (Henke et al., 2020). Almost all hospitalized patients have at least one risk factor for VTE, and approximately 40% have three or more risk factors. Without thromboprophylaxis, the incidence of objectively confirmed, hospital-acquired deep-vein thrombosis (DVT) is approximately 10% to 40% among medical or general surgical patients and 40% to 60% following major orthopedic surgery (Geerts et al., 2008). Commonly, criteria for admission to the Intensive Care Unit (ICU) itself puts patients at an increased risk for developing VTE and subsequent increased risk of morbidity from pulmonary embolism (PE). Some risk factors are related to the acute illness present that allowed for the admission to the ICU unit, and some risk factors may be acquired during the ICU admission due to subsequent medical treatments, for example limitations of mobility, presence of central venous lines or mechanical ventilation and subsequent pharmacological paralysis. Reports of DVT in the population of ICU patients vary in relation to the acuity of the illness in this population. DVT in ICU patients diagnosed with routine venography or Doppler ultrasound found ranges between 10% to 100%. Five studies prospectively screened patients who were not receiving thromboprophylaxis during their ICU stays. The rates of DVT using Fibrinogen Uptake Test, Doppler Ultrasound or venography ranged from 13 to 31% (Geerts et al., 2008). It is essential for all ICUs to assess each patient upon admission to the ICU unit, a change in level of status, for the need for VTE prophylaxis due to the above increased development of risk factors (Geerts et al., 2004). American Society of Hematology (ASH) 2018 VTE prophylaxis guidelines strongly recommend pharmacological prophylaxis using unfractionated heparin (UFH), low molecular weight heparin (LMWH) or fondaparinux for acutely and critically ill hospitalized medical patients, unless contraindicated. The use of mechanical prophylaxis is an acceptable alternative for patients with increased risk of bleeding and preferred over no prophylaxis. ASH 2019 guidelines for surgical patients similarly recommend pharmacological or mechanical prophylaxis over no VTE prophylaxis. Some select surgeries have previously been monitored in the Surgical Care Improvement Project; since performance on these surgeries has achieved very high levels, they are not included in this measure.</p>\n</div></td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Clinical recommendation statement: </b></th>\n <td style=\"padding-left: 4px;\"><div><p>Failure to recognize and protect patients at risk for venous thromboembolism (VTE) increases the chances for critically ill hospitalized patients for developing a deep vein thrombosis or dying from a pulmonary embolism. Screening all patients is the only evidence based practice in reducing incidence of disease. All intensive care unit (ICU) patients should be evaluated for primary VTE prophylaxis, and given appropriate prophylaxis when indicated.</p>\n</div></td>\n </tr>\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Guidance (Usage): </b></th>\n <td style=\"padding-left: 4px;\">The definition of an ICU for the purpose of the measures noted above is that used by the CDC in the NHSN Patient Safety Project (CDC, 2022). An intensive care unit can be defined as a nursing care area that provides intensive observation, diagnosis, and therapeutic procedures for adults and/or children who are critically ill. An ICU excludes nursing areas that provide step-down, intermediate care or telemetry only and specialty care areas. Reasons for no pharmacological and no mechanical VTE prophylaxis must be explicitly documented by the MD/APN/PA or pharmacist and linked with VTE prophylaxis. Ambulation alone is not a sufficient reason for not administering VTE prophylaxis. In order for ambulation/patient ambulating to be considered as an acceptable reason, there needs to be explicit documentation, e.g., "patient out of bed and ambulating in halls - no VTE prophylaxis needed." The denominator population includes patients with inpatient hospitalizations and patients from Acute Hospital Care at Home programs, who are treated and billed as inpatients but receive care in their home. This eCQM is an episode-based measure. An episode is defined as each inpatient hospitalization or encounter that ends during the measurement period. This FHIR-based measure has been derived from the QDM-based measure: CMS190v13. Please refer to the HL7 QI-Core Implementation Guide (https://hl7.org/fhir/us/qicore/STU4.1.1/) for more information on QI-Core and mapping recommendations from QDM to QI-Core 4.1.1 (https://hl7.org/fhir/us/qicore/STU4.1.1/qdm-to-qicore.html).</td>\n </tr>\n \n\n \n \n <tr>\n <th scope=\"row\"><b>Population Criteria: </b></th>\n <td style=\"padding-left: 4px;\">\n \n <table class=\"grid-dict\">\n \n <tr>\n <th><b>64f8bc34da013638e7b3d801</b></th>\n </tr>\n \n \n <tr>\n <td>Initial Population:</td>\n\n \n \n <td>Inpatient hospitalizations for patients age 18 and older, discharged from hospital inpatient acute care without a diagnosis of venous thromboembolism (VTE) or obstetrics that ends during the measurement period</td>\n \n \n\n </tr>\n \n <tr>\n <td>Denominator:</td>\n\n \n \n <td>Inpatient hospitalizations for patients directly admitted or transferred to ICU during the hospitalization</td>\n \n \n\n </tr>\n \n <tr>\n <td>Denominator Exclusion:</td>\n\n \n \n <td>- Inpatient hospitalizations for patients who have a hospital length of stay (LOS) less than 2 days - Inpatient hospitalizations for patients with a principal procedure of surgical care improvement Project (SCIP) VTE selected surgeries that end the day of or the day after ICU admission or transfer - Inpatient hospitalizations for patients with comfort measures documented anytime between the day of arrival and the day after ICU admission or transfer - Inpatient hospitalizations for patients with comfort measures documented by the day after surgery end date for surgeries that end the day of or the day after ICU admission or transfer</td>\n \n \n\n </tr>\n \n <tr>\n <td>Numerator:</td>\n\n \n \n <td>Inpatient hospitalizations for patients who received VTE prophylaxis: - the day of or the day after ICU admission (or transfer) - the day of or the day after surgery end date (for surgeries that end the day of or the day after ICU admission or transfer) Inpatient hospitalizations for patients who have documentation of a reason why no VTE prophylaxis was given: - between the day of arrival and the day after ICU admission (for patients directly admitted as inpatients to the ICU) - the day of or the day after surgery end date (for surgeries that end the day of or the day after ICU admission or transfer)</td>\n \n \n\n </tr>\n \n <tr>\n <td>Denominator Exception:</td>\n\n \n \n <td>Inpatient hospitalizations for patients with ICU LOS less than one day</td>\n \n \n\n </tr>\n \n \n </table>\n \n </td>\n </tr>\n \n \n\n \n <tr>\n <th scope=\"row\"><b> Supplemental Data Elements: </b></th>\n <td style=\"padding-left: 4px;\">\n \n \n \n <p>SDE Ethnicity</p>\n \n \n \n \n \n <p>SDE Payer</p>\n \n \n \n \n \n <p>SDE Race</p>\n \n \n \n \n \n <p>SDE Sex</p>\n \n \n \n </td>\n </tr>\n \n\n \n\n \n <tr>\n <th scope=\"row\">\n <b> Supplemental Data Guidance\n : </b></th>\n <td style=\"padding-left: 4px;\"> For every patient evaluated by this measure also identify payer, race, ethnicity and sex; SDE Ethnicity-Patient's Ethnicity: Hispanic or Latino Not Hispanic or Latino SDE Payer-Patient's Payer: Categories of types of health care payer entities as defined by the US Public Health Data Consortium SOP code system SDE Race-Patient's Race: Native Hawaiian or Other Pacific Islander Asian American Indian or Alaska Native Other Race White Black or African American SDE Sex-Patient's Sex: Gender identity restricted to only Male and Female used in administrative situations requiring a restriction to these two categories. </td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Libraries: </b></th>\n <td style=\"padding-left: 4px;\">\n <table class=\"grid-dict\">\n \n <tr>\n <td><a href=\"Library-IntensiveCareUnitVenousThromboembolismProphylaxisFHIR.html\">IntensiveCareUnitVenousThromboembolismProphylaxisFHIR</a></td>\n </tr>\n \n </table>\n </td>\n </tr>\n \n\n \n\n \n \n <tr>\n <th scope=\"row\"><b>Terminology and Other Dependencies: </b></th>\n <td style=\"padding-left: 4px;\">\n \n <li><code>Library/SupplementalDataElements|3.5.000</code></li>\n \n <li><code>Library/VTE|8.8.000</code></li>\n \n <li><code>Library/CQMCommon|2.2.000</code></li>\n \n <li><code>Library/FHIRHelpers|4.4.000</code></li>\n \n <li><code>Library/QICoreCommon|2.1.000</code></li>\n \n <li><code>Library/TJCOverall|8.14.000</code></li>\n \n <li><a href=\"http://hl7.org/fhir/R4/codesystem-administrative-gender.html\">AdministrativeGender</a></li>\n \n <li><a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-condition-clinical.html\">Condition Clinical Status Codes</a></li>\n \n <li><a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-condition-ver-status.html\">ConditionVerificationStatus</a></li>\n \n <li><a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-v3-loinc.html\">Logical Observation Identifiers, Names and Codes (LOINC)</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.666.5.307/expansion\">Encounter Inpatient</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.263/expansion\">Obstetrics</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.279/expansion\">Venous Thromboembolism</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.264/expansion\">Obstetrics VTE</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.206/expansion\">Intensive Care Unit</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1045.39/expansion\">Low Dose Unfractionated Heparin for VTE Prophylaxis</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.223/expansion\">Subcutaneous route</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.219/expansion\">Low Molecular Weight Heparin for VTE Prophylaxis</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.211/expansion\">Injectable Factor Xa Inhibitor for VTE Prophylaxis</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.232/expansion\">Warfarin</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1110.50/expansion\">Rivaroxaban and Betrixaban for VTE Prophylaxis</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1110.65/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.65</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1110.64/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.64</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1110.66/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.66</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.666.5.1743/expansion\">General or Neuraxial Anesthesia</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.134/expansion\">Oral Factor Xa Inhibitor for VTE Prophylaxis or VTE Treatment</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.202/expansion\">Atrial Fibrillation/Flutter</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.259/expansion\">Hip Replacement Surgery</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.261/expansion\">Knee Replacement Surgery</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.400/expansion\">Low Risk</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.213/expansion\">INR</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.218/expansion\">Unfractionated Heparin</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.222/expansion\">Intravenous route</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.205/expansion\">Direct Thrombin Inhibitor</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1045.41/expansion\">Glycoprotein IIb/IIIa Inhibitors</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1111.143/expansion\">Observation Services</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.292/expansion\">Emergency Department Visit</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.473/expansion\">Medical Reason</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.230/expansion\">Venous foot pumps (VFP)</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.214/expansion\">Intermittent pneumatic compression devices (IPC)</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.256/expansion\">Graduated compression stockings (GCS)</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.93/expansion\">Patient Refusal</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.114222.4.11.3591/expansion\">Payer</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.255/expansion\">General Surgery</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.257/expansion\">Gynecological Surgery</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.258/expansion\">Hip Fracture Surgery</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.260/expansion\">Intracranial Neurosurgery</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.272/expansion\">Urological Surgery</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/1.3.6.1.4.1.33895.1.3.0.45/expansion\">Comfort Measures</a></li>\n \n </td>\n </tr>\n <tr>\n <th scope=\"row\"><b>Parameters:</b></th>\n <td style=\"padding-left: 4px;\">\n <table class=\"grid-dict\">\n <tr>\n <th><b>name</b></th>\n <th><b>use</b></th>\n <th><b>min</b></th>\n <th><b>max</b></th>\n <th><b>type</b></th>\n </tr>\n \n <tr>\n <td>Measurement Period</td>\n <td>In</td>\n <td>0</td>\n <td>1</td>\n <td>Period</td>\n </tr>\n \n <tr>\n <td>SDE Sex</td>\n <td>Out</td>\n <td>0</td>\n <td>1</td>\n <td>Coding</td>\n </tr>\n \n <tr>\n <td>Numerator</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Denominator</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>SDE Payer</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Initial Population</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>SDE Ethnicity</td>\n <td>Out</td>\n <td>0</td>\n <td>1</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Denominator Exclusions</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>SDE Race</td>\n <td>Out</td>\n <td>0</td>\n <td>1</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Denominator Exceptions</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n </table>\n </td>\n </tr>\n\n <tr>\n <th scope=\"row\"><b>DataRequirements:</b></th>\n <td style=\"padding-left: 4px;\">\n <table class=\"grid-dict\">\n <tr>\n <th><b>Resource Type</b></th>\n <th><b>Resource Elements</b></th>\n <th><b>Valueset Name</b></th>\n <th><b>Valueset</b></th>\n </tr>\n \n <tr>\n <td>Patient(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-patient.html\">QICorePatient</a>)</td>\n <td>\n \n ethnicity\n \n race\n \n </td>\n <td>\n \n </td>\n <td/>\n </tr>\n \n <tr>\n <td>Encounter(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html\">QICoreEncounter</a>)</td>\n <td>\n \n type\n \n status\n \n status.value\n \n period\n \n condition\n \n condition.reference\n \n condition.reference.value\n \n location\n \n location.type\n \n extension\n \n </td>\n <td>\n \n \n Encounter Inpatient\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.666.5.307/expansion\">Encounter Inpatient</a></td>\n </tr>\n \n <tr>\n <td>Encounter(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html\">QICoreEncounter</a>)</td>\n <td>\n \n type\n \n status\n \n status.value\n \n period\n \n condition\n \n condition.reference\n \n condition.reference.value\n \n location\n \n location.type\n \n extension\n \n </td>\n <td>\n \n \n Observation Services\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1111.143/expansion\">Observation Services</a></td>\n </tr>\n \n <tr>\n <td>Encounter(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html\">QICoreEncounter</a>)</td>\n <td>\n \n type\n \n status\n \n status.value\n \n period\n \n condition\n \n condition.reference\n \n condition.reference.value\n \n location\n \n location.type\n \n extension\n \n </td>\n <td>\n \n \n Emergency Department Visit\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.292/expansion\">Emergency Department Visit</a></td>\n </tr>\n \n <tr>\n <td>Condition(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-condition.html\">QICoreCondition</a>)</td>\n <td>\n \n id\n \n id.value\n \n code\n \n </td>\n <td>\n \n </td>\n <td/>\n </tr>\n \n <tr>\n <td>Condition(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-condition.html\">QICoreCondition</a>)</td>\n <td>\n \n code\n \n verificationStatus\n \n onset\n \n </td>\n <td>\n \n \n Atrial Fibrillation or Flutter\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.202/expansion\">Atrial Fibrillation/Flutter</a></td>\n </tr>\n \n <tr>\n <td>Condition(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-condition.html\">QICoreCondition</a>)</td>\n <td>\n \n code\n \n clinicalStatus\n \n verificationStatus\n \n onset\n \n </td>\n <td>\n \n \n Venous Thromboembolism\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.279/expansion\">Venous Thromboembolism</a></td>\n </tr>\n \n <tr>\n <td>Location(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-location.html\">QICoreLocation</a>)</td>\n <td>\n \n id\n \n id.value\n \n </td>\n <td>\n \n </td>\n <td/>\n </tr>\n \n <tr>\n <td>MedicationAdministration(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-medicationadministration.html\">QICoreMedicationAdministration</a>)</td>\n <td>\n \n medication\n \n status\n \n status.value\n \n dosage\n \n dosage.route\n \n effective\n \n id\n \n id.value\n \n </td>\n <td>\n \n \n Low Dose Unfractionated Heparin for VTE Prophylaxis\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1045.39/expansion\">Low Dose Unfractionated Heparin for VTE Prophylaxis</a></td>\n </tr>\n \n <tr>\n <td>MedicationAdministration(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-medicationadministration.html\">QICoreMedicationAdministration</a>)</td>\n <td>\n \n medication\n \n status\n \n status.value\n \n dosage\n \n dosage.route\n \n effective\n \n id\n \n id.value\n \n </td>\n <td>\n \n \n Low Molecular Weight Heparin for VTE Prophylaxis\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.219/expansion\">Low Molecular Weight Heparin for VTE Prophylaxis</a></td>\n </tr>\n \n <tr>\n <td>MedicationAdministration(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-medicationadministration.html\">QICoreMedicationAdministration</a>)</td>\n <td>\n \n medication\n \n status\n \n status.value\n \n dosage\n \n dosage.route\n \n effective\n \n id\n \n id.value\n \n </td>\n <td>\n \n \n Injectable Factor Xa Inhibitor for VTE Prophylaxis\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.211/expansion\">Injectable Factor Xa Inhibitor for VTE Prophylaxis</a></td>\n </tr>\n \n <tr>\n <td>MedicationAdministration(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-medicationadministration.html\">QICoreMedicationAdministration</a>)</td>\n <td>\n \n medication\n \n status\n \n status.value\n \n dosage\n \n dosage.route\n \n effective\n \n id\n \n id.value\n \n </td>\n <td>\n \n \n Warfarin\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.232/expansion\">Warfarin</a></td>\n </tr>\n \n <tr>\n <td>MedicationAdministration(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-medicationadministration.html\">QICoreMedicationAdministration</a>)</td>\n <td>\n \n medication\n \n status\n \n status.value\n \n dosage\n \n dosage.route\n \n effective\n \n id\n \n id.value\n \n </td>\n <td>\n \n \n Rivaroxaban for VTE Prophylaxis\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1110.50/expansion\">Rivaroxaban and Betrixaban for VTE Prophylaxis</a></td>\n </tr>\n \n <tr>\n <td>MedicationAdministration(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-medicationadministration.html\">QICoreMedicationAdministration</a>)</td>\n <td>\n \n medication\n \n status\n \n status.value\n \n dosage\n \n dosage.route\n \n effective\n \n id\n \n id.value\n \n </td>\n <td>\n \n \n Oral Factor Xa Inhibitor for VTE Prophylaxis or VTE Treatment\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.134/expansion\">Oral Factor Xa Inhibitor for VTE Prophylaxis or VTE Treatment</a></td>\n </tr>\n \n <tr>\n <td>MedicationAdministration(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-medicationadministration.html\">QICoreMedicationAdministration</a>)</td>\n <td>\n \n medication\n \n status\n \n status.value\n \n dosage\n \n dosage.route\n \n effective\n \n id\n \n id.value\n \n </td>\n <td>\n \n \n Unfractionated Heparin\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.218/expansion\">Unfractionated Heparin</a></td>\n </tr>\n \n <tr>\n <td>MedicationAdministration(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-medicationadministration.html\">QICoreMedicationAdministration</a>)</td>\n <td>\n \n medication\n \n status\n \n status.value\n \n dosage\n \n dosage.route\n \n effective\n \n id\n \n id.value\n \n </td>\n <td>\n \n \n Direct Thrombin Inhibitor\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.205/expansion\">Direct Thrombin Inhibitor</a></td>\n </tr>\n \n <tr>\n <td>MedicationAdministration(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-medicationadministration.html\">QICoreMedicationAdministration</a>)</td>\n <td>\n \n medication\n \n status\n \n status.value\n \n dosage\n \n dosage.route\n \n effective\n \n id\n \n id.value\n \n </td>\n <td>\n \n \n Glycoprotein IIb/IIIa Inhibitors\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1045.41/expansion\">Glycoprotein IIb/IIIa Inhibitors</a></td>\n </tr>\n \n <tr>\n <td>Procedure(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html\">QICoreProcedure</a>)</td>\n <td>\n \n code\n \n status\n \n status.value\n \n performed\n \n id\n \n id.value\n \n </td>\n <td>\n \n \n Application of Intermittent Pneumatic Compression Devices\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1110.65/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.65</a></td>\n </tr>\n \n <tr>\n <td>Procedure(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html\">QICoreProcedure</a>)</td>\n <td>\n \n code\n \n status\n \n status.value\n \n performed\n \n id\n \n id.value\n \n </td>\n <td>\n \n \n Application of Venous Foot Pumps\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1110.64/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.64</a></td>\n </tr>\n \n <tr>\n <td>Procedure(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html\">QICoreProcedure</a>)</td>\n <td>\n \n code\n \n status\n \n status.value\n \n performed\n \n id\n \n id.value\n \n </td>\n <td>\n \n \n Application of Graduated Compression Stockings\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1110.66/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.66</a></td>\n </tr>\n \n <tr>\n <td>Procedure(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html\">QICoreProcedure</a>)</td>\n <td>\n \n code\n \n status\n \n status.value\n \n performed\n \n id\n \n id.value\n \n </td>\n <td>\n \n \n General Surgery\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.255/expansion\">General Surgery</a></td>\n </tr>\n \n <tr>\n <td>Procedure(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html\">QICoreProcedure</a>)</td>\n <td>\n \n code\n \n status\n \n status.value\n \n performed\n \n id\n \n id.value\n \n </td>\n <td>\n \n \n Gynecological Surgery\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.257/expansion\">Gynecological Surgery</a></td>\n </tr>\n \n <tr>\n <td>Procedure(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html\">QICoreProcedure</a>)</td>\n <td>\n \n code\n \n status\n \n status.value\n \n performed\n \n id\n \n id.value\n \n </td>\n <td>\n \n \n Hip Fracture Surgery\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.258/expansion\">Hip Fracture Surgery</a></td>\n </tr>\n \n <tr>\n <td>Procedure(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html\">QICoreProcedure</a>)</td>\n <td>\n \n code\n \n status\n \n status.value\n \n performed\n \n id\n \n id.value\n \n </td>\n <td>\n \n \n Hip Replacement Surgery\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.259/expansion\">Hip Replacement Surgery</a></td>\n </tr>\n \n <tr>\n <td>Procedure(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html\">QICoreProcedure</a>)</td>\n <td>\n \n code\n \n status\n \n status.value\n \n performed\n \n id\n \n id.value\n \n </td>\n <td>\n \n \n Intracranial Neurosurgery\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.260/expansion\">Intracranial Neurosurgery</a></td>\n </tr>\n \n <tr>\n <td>Procedure(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html\">QICoreProcedure</a>)</td>\n <td>\n \n code\n \n status\n \n status.value\n \n performed\n \n id\n \n id.value\n \n </td>\n <td>\n \n \n Knee Replacement Surgery\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.261/expansion\">Knee Replacement Surgery</a></td>\n </tr>\n \n <tr>\n <td>Procedure(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html\">QICoreProcedure</a>)</td>\n <td>\n \n code\n \n status\n \n status.value\n \n performed\n \n id\n \n id.value\n \n </td>\n <td>\n \n \n Urological Surgery\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.272/expansion\">Urological Surgery</a></td>\n </tr>\n \n <tr>\n <td>Procedure(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html\">QICoreProcedure</a>)</td>\n <td>\n \n code\n \n status\n \n status.value\n \n performed\n \n id\n \n id.value\n \n </td>\n <td>\n \n \n Comfort Measures\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/1.3.6.1.4.1.33895.1.3.0.45/expansion\">Comfort Measures</a></td>\n </tr>\n \n <tr>\n <td>Procedure(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html\">QICoreProcedure</a>)</td>\n <td>\n \n code\n \n status\n \n status.value\n \n performed\n \n performed.low\n \n performed.lowClosed\n \n performed.high\n \n performed.highClosed\n \n id\n \n id.value\n \n </td>\n <td>\n \n \n General or Neuraxial Anesthesia\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.666.5.1743/expansion\">General or Neuraxial Anesthesia</a></td>\n </tr>\n \n <tr>\n <td>Observation(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-observation.html\">QICoreObservation</a>)</td>\n <td>\n \n code\n \n value\n \n status\n \n status.value\n \n id\n \n id.value\n \n effective\n \n </td>\n <td>\n \n </td>\n <td/>\n </tr>\n \n <tr>\n <td>Observation(<a href=\"http://hl7.org/fhir/us/core/STU3.1.1/StructureDefinition-us-core-observation-lab.html\">US Core Laboratory Result Observation Profile</a>)</td>\n <td>\n \n code\n \n value\n \n status\n \n status.value\n \n id\n \n id.value\n \n issued\n \n issued.value\n \n </td>\n <td>\n \n \n INR\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.213/expansion\">INR</a></td>\n </tr>\n \n <tr>\n <td>MedicationAdministration(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-mednotadministered.html\">QICoreMedicationAdministrationNotDone</a>)</td>\n <td>\n \n medication\n \n id\n \n id.value\n \n statusReason\n \n extension\n \n </td>\n <td>\n \n \n Low Dose Unfractionated Heparin for VTE Prophylaxis\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1045.39/expansion\">Low Dose Unfractionated Heparin for VTE Prophylaxis</a></td>\n </tr>\n \n <tr>\n <td>MedicationAdministration(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-mednotadministered.html\">QICoreMedicationAdministrationNotDone</a>)</td>\n <td>\n \n medication\n \n id\n \n id.value\n \n statusReason\n \n extension\n \n </td>\n <td>\n \n \n Low Dose Unfractionated Heparin for VTE Prophylaxis\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1045.39/expansion\">Low Dose Unfractionated Heparin for VTE Prophylaxis</a></td>\n </tr>\n \n <tr>\n <td>MedicationAdministration(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-mednotadministered.html\">QICoreMedicationAdministrationNotDone</a>)</td>\n <td>\n \n medication\n \n id\n \n id.value\n \n statusReason\n \n extension\n \n </td>\n <td>\n \n \n Low Molecular Weight Heparin for VTE Prophylaxis\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.219/expansion\">Low Molecular Weight Heparin for VTE Prophylaxis</a></td>\n </tr>\n \n <tr>\n <td>MedicationAdministration(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-mednotadministered.html\">QICoreMedicationAdministrationNotDone</a>)</td>\n <td>\n \n medication\n \n id\n \n id.value\n \n statusReason\n \n extension\n \n </td>\n <td>\n \n \n Low Molecular Weight Heparin for VTE Prophylaxis\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.219/expansion\">Low Molecular Weight Heparin for VTE Prophylaxis</a></td>\n </tr>\n \n <tr>\n <td>MedicationAdministration(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-mednotadministered.html\">QICoreMedicationAdministrationNotDone</a>)</td>\n <td>\n \n medication\n \n id\n \n id.value\n \n statusReason\n \n extension\n \n </td>\n <td>\n \n \n Injectable Factor Xa Inhibitor for VTE Prophylaxis\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.211/expansion\">Injectable Factor Xa Inhibitor for VTE Prophylaxis</a></td>\n </tr>\n \n <tr>\n <td>MedicationAdministration(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-mednotadministered.html\">QICoreMedicationAdministrationNotDone</a>)</td>\n <td>\n \n medication\n \n id\n \n id.value\n \n statusReason\n \n extension\n \n </td>\n <td>\n \n \n Injectable Factor Xa Inhibitor for VTE Prophylaxis\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.211/expansion\">Injectable Factor Xa Inhibitor for VTE Prophylaxis</a></td>\n </tr>\n \n <tr>\n <td>MedicationAdministration(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-mednotadministered.html\">QICoreMedicationAdministrationNotDone</a>)</td>\n <td>\n \n medication\n \n id\n \n id.value\n \n statusReason\n \n extension\n \n </td>\n <td>\n \n \n Warfarin\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.232/expansion\">Warfarin</a></td>\n </tr>\n \n <tr>\n <td>MedicationAdministration(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-mednotadministered.html\">QICoreMedicationAdministrationNotDone</a>)</td>\n <td>\n \n medication\n \n id\n \n id.value\n \n statusReason\n \n extension\n \n </td>\n <td>\n \n \n Warfarin\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.232/expansion\">Warfarin</a></td>\n </tr>\n \n <tr>\n <td>MedicationAdministration(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-mednotadministered.html\">QICoreMedicationAdministrationNotDone</a>)</td>\n <td>\n \n medication\n \n id\n \n id.value\n \n statusReason\n \n extension\n \n </td>\n <td>\n \n \n Rivaroxaban for VTE Prophylaxis\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1110.50/expansion\">Rivaroxaban and Betrixaban for VTE Prophylaxis</a></td>\n </tr>\n \n <tr>\n <td>MedicationAdministration(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-mednotadministered.html\">QICoreMedicationAdministrationNotDone</a>)</td>\n <td>\n \n medication\n \n id\n \n id.value\n \n statusReason\n \n extension\n \n </td>\n <td>\n \n \n Rivaroxaban for VTE Prophylaxis\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1110.50/expansion\">Rivaroxaban and Betrixaban for VTE Prophylaxis</a></td>\n </tr>\n \n <tr>\n <td>MedicationRequest(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-mednotrequested.html\">QICoreMedicationNotRequested</a>)</td>\n <td>\n \n medication\n \n intent\n \n intent.value\n \n id\n \n id.value\n \n reasonCode\n \n authoredOn\n \n authoredOn.value\n \n </td>\n <td>\n \n \n Low Dose Unfractionated Heparin for VTE Prophylaxis\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1045.39/expansion\">Low Dose Unfractionated Heparin for VTE Prophylaxis</a></td>\n </tr>\n \n <tr>\n <td>MedicationRequest(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-mednotrequested.html\">QICoreMedicationNotRequested</a>)</td>\n <td>\n \n medication\n \n intent\n \n intent.value\n \n id\n \n id.value\n \n reasonCode\n \n authoredOn\n \n authoredOn.value\n \n </td>\n <td>\n \n \n Low Dose Unfractionated Heparin for VTE Prophylaxis\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1045.39/expansion\">Low Dose Unfractionated Heparin for VTE Prophylaxis</a></td>\n </tr>\n \n <tr>\n <td>MedicationRequest(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-mednotrequested.html\">QICoreMedicationNotRequested</a>)</td>\n <td>\n \n medication\n \n intent\n \n intent.value\n \n id\n \n id.value\n \n reasonCode\n \n authoredOn\n \n authoredOn.value\n \n </td>\n <td>\n \n \n Low Molecular Weight Heparin for VTE Prophylaxis\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.219/expansion\">Low Molecular Weight Heparin for VTE Prophylaxis</a></td>\n </tr>\n \n <tr>\n <td>MedicationRequest(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-mednotrequested.html\">QICoreMedicationNotRequested</a>)</td>\n <td>\n \n medication\n \n intent\n \n intent.value\n \n id\n \n id.value\n \n reasonCode\n \n authoredOn\n \n authoredOn.value\n \n </td>\n <td>\n \n \n Low Molecular Weight Heparin for VTE Prophylaxis\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.219/expansion\">Low Molecular Weight Heparin for VTE Prophylaxis</a></td>\n </tr>\n \n <tr>\n <td>MedicationRequest(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-mednotrequested.html\">QICoreMedicationNotRequested</a>)</td>\n <td>\n \n medication\n \n intent\n \n intent.value\n \n id\n \n id.value\n \n reasonCode\n \n authoredOn\n \n authoredOn.value\n \n </td>\n <td>\n \n \n Injectable Factor Xa Inhibitor for VTE Prophylaxis\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.211/expansion\">Injectable Factor Xa Inhibitor for VTE Prophylaxis</a></td>\n </tr>\n \n <tr>\n <td>MedicationRequest(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-mednotrequested.html\">QICoreMedicationNotRequested</a>)</td>\n <td>\n \n medication\n \n intent\n \n intent.value\n \n id\n \n id.value\n \n reasonCode\n \n authoredOn\n \n authoredOn.value\n \n </td>\n <td>\n \n \n Injectable Factor Xa Inhibitor for VTE Prophylaxis\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.211/expansion\">Injectable Factor Xa Inhibitor for VTE Prophylaxis</a></td>\n </tr>\n \n <tr>\n <td>MedicationRequest(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-mednotrequested.html\">QICoreMedicationNotRequested</a>)</td>\n <td>\n \n medication\n \n intent\n \n intent.value\n \n id\n \n id.value\n \n reasonCode\n \n authoredOn\n \n authoredOn.value\n \n </td>\n <td>\n \n \n Warfarin\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.232/expansion\">Warfarin</a></td>\n </tr>\n \n <tr>\n <td>MedicationRequest(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-mednotrequested.html\">QICoreMedicationNotRequested</a>)</td>\n <td>\n \n medication\n \n intent\n \n intent.value\n \n id\n \n id.value\n \n reasonCode\n \n authoredOn\n \n authoredOn.value\n \n </td>\n <td>\n \n \n Warfarin\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.232/expansion\">Warfarin</a></td>\n </tr>\n \n <tr>\n <td>MedicationRequest(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-mednotrequested.html\">QICoreMedicationNotRequested</a>)</td>\n <td>\n \n medication\n \n intent\n \n intent.value\n \n id\n \n id.value\n \n reasonCode\n \n authoredOn\n \n authoredOn.value\n \n </td>\n <td>\n \n \n Rivaroxaban for VTE Prophylaxis\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1110.50/expansion\">Rivaroxaban and Betrixaban for VTE Prophylaxis</a></td>\n </tr>\n \n <tr>\n <td>MedicationRequest(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-mednotrequested.html\">QICoreMedicationNotRequested</a>)</td>\n <td>\n \n medication\n \n intent\n \n intent.value\n \n id\n \n id.value\n \n reasonCode\n \n authoredOn\n \n authoredOn.value\n \n </td>\n <td>\n \n \n Rivaroxaban for VTE Prophylaxis\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1110.50/expansion\">Rivaroxaban and Betrixaban for VTE Prophylaxis</a></td>\n </tr>\n \n <tr>\n <td>ServiceRequest(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-servicenotrequested.html\">QICoreServiceNotRequested</a>)</td>\n <td>\n \n code\n \n intent\n \n intent.value\n \n id\n \n id.value\n \n extension\n \n authoredOn\n \n authoredOn.value\n \n </td>\n <td>\n \n \n Venous foot pumps\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.230/expansion\">Venous foot pumps (VFP)</a></td>\n </tr>\n \n <tr>\n <td>ServiceRequest(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-servicenotrequested.html\">QICoreServiceNotRequested</a>)</td>\n <td>\n \n code\n \n intent\n \n intent.value\n \n id\n \n id.value\n \n extension\n \n authoredOn\n \n authoredOn.value\n \n </td>\n <td>\n \n \n Venous foot pumps\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.230/expansion\">Venous foot pumps (VFP)</a></td>\n </tr>\n \n <tr>\n <td>ServiceRequest(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-servicenotrequested.html\">QICoreServiceNotRequested</a>)</td>\n <td>\n \n code\n \n intent\n \n intent.value\n \n id\n \n id.value\n \n extension\n \n authoredOn\n \n authoredOn.value\n \n </td>\n <td>\n \n \n Intermittent pneumatic compression devices\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.214/expansion\">Intermittent pneumatic compression devices (IPC)</a></td>\n </tr>\n \n <tr>\n <td>ServiceRequest(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-servicenotrequested.html\">QICoreServiceNotRequested</a>)</td>\n <td>\n \n code\n \n intent\n \n intent.value\n \n id\n \n id.value\n \n extension\n \n authoredOn\n \n authoredOn.value\n \n </td>\n <td>\n \n \n Intermittent pneumatic compression devices\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.214/expansion\">Intermittent pneumatic compression devices (IPC)</a></td>\n </tr>\n \n <tr>\n <td>ServiceRequest(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-servicenotrequested.html\">QICoreServiceNotRequested</a>)</td>\n <td>\n \n code\n \n intent\n \n intent.value\n \n id\n \n id.value\n \n extension\n \n authoredOn\n \n authoredOn.value\n \n </td>\n <td>\n \n \n Graduated compression stockings\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.256/expansion\">Graduated compression stockings (GCS)</a></td>\n </tr>\n \n <tr>\n <td>ServiceRequest(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-servicenotrequested.html\">QICoreServiceNotRequested</a>)</td>\n <td>\n \n code\n \n intent\n \n intent.value\n \n id\n \n id.value\n \n extension\n \n authoredOn\n \n authoredOn.value\n \n </td>\n <td>\n \n \n Graduated compression stockings\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.256/expansion\">Graduated compression stockings (GCS)</a></td>\n </tr>\n \n <tr>\n <td>Procedure(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedurenotdone.html\">QICoreProcedureNotDone</a>)</td>\n <td>\n \n code\n \n extension\n \n id\n \n id.value\n \n statusReason\n \n </td>\n <td>\n \n \n Application of Intermittent Pneumatic Compression Devices\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1110.65/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.65</a></td>\n </tr>\n \n <tr>\n <td>Procedure(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedurenotdone.html\">QICoreProcedureNotDone</a>)</td>\n <td>\n \n code\n \n extension\n \n id\n \n id.value\n \n statusReason\n \n </td>\n <td>\n \n \n Application of Intermittent Pneumatic Compression Devices\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1110.65/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.65</a></td>\n </tr>\n \n <tr>\n <td>Procedure(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedurenotdone.html\">QICoreProcedureNotDone</a>)</td>\n <td>\n \n code\n \n extension\n \n id\n \n id.value\n \n statusReason\n \n </td>\n <td>\n \n \n Application of Venous Foot Pumps\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1110.64/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.64</a></td>\n </tr>\n \n <tr>\n <td>Procedure(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedurenotdone.html\">QICoreProcedureNotDone</a>)</td>\n <td>\n \n code\n \n extension\n \n id\n \n id.value\n \n statusReason\n \n </td>\n <td>\n \n \n Application of Venous Foot Pumps\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1110.64/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.64</a></td>\n </tr>\n \n <tr>\n <td>Procedure(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedurenotdone.html\">QICoreProcedureNotDone</a>)</td>\n <td>\n \n code\n \n extension\n \n id\n \n id.value\n \n statusReason\n \n </td>\n <td>\n \n \n Application of Graduated Compression Stockings\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1110.66/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.66</a></td>\n </tr>\n \n <tr>\n <td>Procedure(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedurenotdone.html\">QICoreProcedureNotDone</a>)</td>\n <td>\n \n code\n \n extension\n \n id\n \n id.value\n \n statusReason\n \n </td>\n <td>\n \n \n Application of Graduated Compression Stockings\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1110.66/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.66</a></td>\n </tr>\n \n <tr>\n <td>Coverage(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-coverage.html\">QICoreCoverage</a>)</td>\n <td>\n \n type\n \n period\n \n </td>\n <td>\n \n \n Payer Type\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.114222.4.11.3591/expansion\">Payer</a></td>\n </tr>\n \n <tr>\n <td>ServiceRequest(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-servicerequest.html\">QICoreServiceRequest</a>)</td>\n <td>\n \n code\n \n intent\n \n intent.value\n \n status\n \n status.value\n \n doNotPerform\n \n doNotPerform.value\n \n </td>\n <td>\n \n \n Comfort Measures\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/1.3.6.1.4.1.33895.1.3.0.45/expansion\">Comfort Measures</a></td>\n </tr>\n \n </table>\n </td>\n </tr>\n\n \n <tr>\n <th scope=\"row\"><b>Direct Reference Codes:</b></th>\n <td style=\"padding-left: 4px;\">\n <table class=\"grid-dict\">\n <tr>\n <th><b>display</b></th>\n <th><b>code</b></th>\n <th><b>system</b></th>\n </tr>\n \n <tr>\n <td>Male</td>\n <td>M</td>\n <td><a href=\"http://hl7.org/fhir/R4/codesystem-administrative-gender.html\">http://hl7.org/fhir/administrative-gender</a></td>\n </tr>\n \n <tr>\n <td>Female</td>\n <td>F</td>\n <td><a href=\"http://hl7.org/fhir/R4/codesystem-administrative-gender.html\">http://hl7.org/fhir/administrative-gender</a></td>\n </tr>\n \n <tr>\n <td>Active</td>\n <td>active</td>\n <td><a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-condition-clinical.html\">http://terminology.hl7.org/CodeSystem/condition-clinical</a></td>\n </tr>\n \n <tr>\n <td>Recurrence</td>\n <td>recurrence</td>\n <td><a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-condition-clinical.html\">http://terminology.hl7.org/CodeSystem/condition-clinical</a></td>\n </tr>\n \n <tr>\n <td>Relapse</td>\n <td>relapse</td>\n <td><a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-condition-clinical.html\">http://terminology.hl7.org/CodeSystem/condition-clinical</a></td>\n </tr>\n \n <tr>\n <td>Confirmed</td>\n <td>confirmed</td>\n <td><a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-condition-ver-status.html\">http://terminology.hl7.org/CodeSystem/condition-ver-status</a></td>\n </tr>\n \n <tr>\n <td>Inactive</td>\n <td>inactive</td>\n <td><a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-condition-clinical.html\">http://terminology.hl7.org/CodeSystem/condition-clinical</a></td>\n </tr>\n \n <tr>\n <td>Remission</td>\n <td>remission</td>\n <td><a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-condition-clinical.html\">http://terminology.hl7.org/CodeSystem/condition-clinical</a></td>\n </tr>\n \n <tr>\n <td>Resolved</td>\n <td>resolved</td>\n <td><a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-condition-clinical.html\">http://terminology.hl7.org/CodeSystem/condition-clinical</a></td>\n </tr>\n \n <tr>\n <td>Risk for venous thromboembolism</td>\n <td>72136-5</td>\n <td><a href=\"https://loinc.org/\">http://loinc.org</a></td>\n </tr>\n \n </table>\n </td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Logic Definitions:</b></th>\n <td style=\"padding-left: 4px;\">\n \n <table class=\"grid-dict\">\n <tr>\n <th><b>Group</b></th>\n <th><b>Scoring</b></th>\n <th><b>Population Criteria</b></th>\n <th><b>Expression</b></th>\n </tr>\n <tr>\n \n <td> 64f8bc34da013638e7b3d801 </td>\n <td colspan=\"3\" style=\"padding-left: 4px;\">\n \n <b>Group scoring:</b>\n \n <span> proportion </span>\n \n \n\n \n\n \n <b>Measure scoring:</b>\n \n <p style=\"margin-bottom: 5px;\">\n <span>Proportion</span>\n </p>\n \n \n\n \n\n \n <tr>\n \n <th scope=\"row\"><b>Type: </b></th>\n <td style=\"padding-left: 4px;\">\n \n \n <p style=\"margin-bottom: 5px;\">\n <span>Process </span>\n </p>\n \n \n \n </td>\n \n </tr>\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Rate Aggregation: </b></th>\n <td colspan=\"3\" style=\"padding-left: 4px;\">None</td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Improvement Notation: </b></th>\n <td style=\"padding-left: 4px;\">\n \n \n \n <p style=\"margin-bottom: 5px;\">\n <span>increase </span>\n </p>\n \n \n \n \n </td>\n </tr>\n \n\n \n\n </td>\n \n <tr>\n <td/>\n <td/>\n <td>Initial Population</td>\n <td>\n \n <pre><code class=\"language-cql\">define "Initial Population":\n VTE."Encounter with Age Range and without VTE Diagnosis or Obstetrical Conditions"</code></pre>\n \n </td>\n </tr>\n \n <tr>\n <td/>\n <td/>\n <td>Denominator</td>\n <td>\n \n <pre><code class=\"language-cql\">define "Denominator":\n "Encounter with ICU Location"</code></pre>\n \n </td>\n </tr>\n \n <tr>\n <td/>\n <td/>\n <td>Denominator Exclusion</td>\n <td>\n \n <pre><code class=\"language-cql\">define "Denominator Exclusions":\n "Encounter with ICU Location And Encounter Less Than 2 Days"\n union "Encounter with First ICU Stay with Principal Procedure of SCIP VTE Selected Surgery"\n union "Encounter with Intervention Comfort Measures From Day Of Start of Hospitalization To Day After First ICU Stay"\n union "Encounter with Intervention Comfort Measures on Day of or Day After Procedure"</code></pre>\n \n </td>\n </tr>\n \n <tr>\n <td/>\n <td/>\n <td>Numerator</td>\n <td>\n \n <pre><code class=\"language-cql\">define "Numerator":\n "Encounter with VTE Prophylaxis Received on Day of or Day After First ICU Stay or Procedure"\n union ( "Encounter with Medication Oral Factor Xa Inhibitor Administered on Day of or Day After First ICU Stay or Procedure"\n intersect ( "Encounter with Prior or Present Diagnosis of Atrial Fibrillation or Prior Diagnosis of VTE"\n union "Encounter with Prior or Present Procedure of Hip or Knee Replacement Surgery"\n )\n )\n union "Encounter with Low Risk for VTE or Anticoagulant Administered"\n union "Encounter with No VTE Prophylaxis Due to Medical Reason"\n union "Encounter with No VTE Prophylaxis Due to Patient Refusal"</code></pre>\n \n </td>\n </tr>\n \n <tr>\n <td/>\n <td/>\n <td>Denominator Exception</td>\n <td>\n \n <pre><code class=\"language-cql\">define "Denominator Exceptions":\n "Encounter with First ICU Location Stay Less Than 1 day"</code></pre>\n \n </td>\n </tr>\n \n \n \n </tr>\n </table>\n \n\n <table class=\"grid-dict\">\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SupplementalDataElements</td>\n \n \n <td>SDE Sex</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "SDE Sex":\n case\n when Patient.gender = 'male' then "M"\n when Patient.gender = 'female' then "F"\n else null\n end</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>IntensiveCareUnitVenousThromboembolismProphylaxisFHIR</td>\n \n \n <td>SDE Sex</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "SDE Sex":\n SDE."SDE Sex"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CQMCommon</td>\n \n \n <td>Inpatient Encounter</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Inpatient Encounter":\n [Encounter: "Encounter Inpatient"] EncounterInpatient\n\t\twhere EncounterInpatient.status = 'finished'\n\t\tand EncounterInpatient.period ends during day of "Measurement Period"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>VTE</td>\n \n \n <td>Admission without VTE or Obstetrical Conditions</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Admission without VTE or Obstetrical Conditions":\n CQMCommon."Inpatient Encounter" InpatientEncounter\n where not (exists (InpatientEncounter.encounterDiagnosis()) EncDx\n where (EncDx.code in "Obstetrical or Pregnancy Related Conditions" \n or EncDx.code in "Venous Thromboembolism"\n \t\t\t\tor EncDx.code in "Obstetrics VTE"\n \t\t\t )\n )</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>VTE</td>\n \n \n <td>Encounter with Age Range and without VTE Diagnosis or Obstetrical Conditions</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Encounter with Age Range and without VTE Diagnosis or Obstetrical Conditions":\n ( CQMCommon."Inpatient Encounter" InpatientEncounter\n where AgeInYearsAt(date from start of InpatientEncounter.period) >= 18 )\n intersect "Admission without VTE or Obstetrical Conditions"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>IntensiveCareUnitVenousThromboembolismProphylaxisFHIR</td>\n \n \n <td>Encounter with ICU Location</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Encounter with ICU Location":\n VTE."Encounter with Age Range and without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter\n where exists ( QualifyingEncounter.location Location\n where Location.location.getLocation ( ).type in "Intensive Care Unit"\n and Location.period during QualifyingEncounter.period\n )</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>IntensiveCareUnitVenousThromboembolismProphylaxisFHIR</td>\n \n \n <td>Pharmacological or Mechanical VTE Prophylaxis Received</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Pharmacological or Mechanical VTE Prophylaxis Received":\n ( ["MedicationAdministration": "Low Dose Unfractionated Heparin for VTE Prophylaxis"] VTEMedication\n where VTEMedication.status = 'completed'\n and VTEMedication.dosage.route in "Subcutaneous route"\n )\n union ( ["MedicationAdministration": "Low Molecular Weight Heparin for VTE Prophylaxis"] LMWH\n where LMWH.status = 'completed'\n )\n union ( ["MedicationAdministration": "Injectable Factor Xa Inhibitor for VTE Prophylaxis"] FactorXa\n where FactorXa.status = 'completed'\n )\n union ( ["MedicationAdministration": "Warfarin"] Warfarin\n where Warfarin.status = 'completed'\n )\n union ( ["MedicationAdministration": "Rivaroxaban for VTE Prophylaxis"] Rivaroxaban\n where Rivaroxaban.status = 'completed'\n )\n union ( ( ["Procedure": "Application of Intermittent Pneumatic Compression Devices"]\n union ["Procedure": "Application of Venous Foot Pumps"]\n union ["Procedure": "Application of Graduated Compression Stockings"] ) DeviceApplied\n where DeviceApplied.status = 'completed'\n )</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>IntensiveCareUnitVenousThromboembolismProphylaxisFHIR</td>\n \n \n <td>Encounter with VTE Prophylaxis Received on Day of or Day After First ICU Stay or Procedure</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Encounter with VTE Prophylaxis Received on Day of or Day After First ICU Stay or Procedure":\n ( "Encounter with ICU Location" QualifyingEncounterICU\n with "Pharmacological or Mechanical VTE Prophylaxis Received" VTEProphylaxis\n such that start of Coalesce(VTEProphylaxis.effective.toInterval(), VTEProphylaxis.performed.toInterval()) during day of QualifyingEncounterICU.StartOfFirstICU ( ).CalendarDayOfOrDayAfter ( )\n )\n union ( from\n "Encounter with ICU Location" QualifyingEncounterICU,\n ["Procedure": "General or Neuraxial Anesthesia"] AnesthesiaProcedure,\n "Pharmacological or Mechanical VTE Prophylaxis Received" VTEProphylaxis\n where AnesthesiaProcedure.status = 'completed'\n and AnesthesiaProcedure.performed.toInterval ( ) ends 1 day after day of QualifyingEncounterICU.StartOfFirstICU ( )\n and start of Coalesce(VTEProphylaxis.effective.toInterval(), VTEProphylaxis.performed.toInterval()) during day of ( end of AnesthesiaProcedure.performed.toInterval ( ) ).CalendarDayOfOrDayAfter ( )\n return QualifyingEncounterICU\n )</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>IntensiveCareUnitVenousThromboembolismProphylaxisFHIR</td>\n \n \n <td>Encounter with Medication Oral Factor Xa Inhibitor Administered on Day of or Day After First ICU Stay or Procedure</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Encounter with Medication Oral Factor Xa Inhibitor Administered on Day of or Day After First ICU Stay or Procedure":\n ( "Encounter with ICU Location" QualifyingEncounterICU\n with ["MedicationAdministration": "Oral Factor Xa Inhibitor for VTE Prophylaxis or VTE Treatment"] FactorXaMedication\n such that FactorXaMedication.status = 'completed'\n and FactorXaMedication.effective.toInterval ( ) starts during day of QualifyingEncounterICU.StartOfFirstICU ( ).CalendarDayOfOrDayAfter ( )\n )\n union ( from\n "Encounter with ICU Location" QualifyingEncounterICU,\n ["Procedure": "General or Neuraxial Anesthesia"] AnesthesiaProcedure,\n ["MedicationAdministration": "Oral Factor Xa Inhibitor for VTE Prophylaxis or VTE Treatment"] FactorXaMedication\n where FactorXaMedication.status = 'completed'\n and AnesthesiaProcedure.status = 'completed'\n and AnesthesiaProcedure.performed.toInterval ( ) ends 1 day after day of QualifyingEncounterICU.StartOfFirstICU ( )\n and FactorXaMedication.effective.toInterval ( ) starts during day of ( end of AnesthesiaProcedure.performed.toInterval ( ) ).CalendarDayOfOrDayAfter ( )\n return QualifyingEncounterICU\n )</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>IntensiveCareUnitVenousThromboembolismProphylaxisFHIR</td>\n \n \n <td>Encounter with Prior or Present Diagnosis of Atrial Fibrillation or Prior Diagnosis of VTE</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Encounter with Prior or Present Diagnosis of Atrial Fibrillation or Prior Diagnosis of VTE":\n ( "Encounter with ICU Location" QualifyingEncounterICU\n with ["Condition": "Atrial Fibrillation or Flutter"] AtrialFibrillation\n such that AtrialFibrillation.isActive ( )\n and AtrialFibrillation.verificationStatus is not null\n and AtrialFibrillation.verificationStatus ~ QICoreCommon."confirmed"\n and AtrialFibrillation.onset.toInterval ( ) starts on or before end of QualifyingEncounterICU.period\n )\n union ( "Encounter with ICU Location" QualifyingEncounterICU\n where QualifyingEncounterICU.encounterDiagnosis ( ).code in "Atrial Fibrillation or Flutter"\n )\n union ( "Encounter with ICU Location" QualifyingEncounterICU\n with ["Condition": "Venous Thromboembolism"] VTEDiagnosis\n such that ( VTEDiagnosis.clinicalStatus ~ QICoreCommon."inactive"\n or VTEDiagnosis.clinicalStatus ~ QICoreCommon."remission"\n or VTEDiagnosis.clinicalStatus ~ QICoreCommon."resolved"\n )\n and VTEDiagnosis.verificationStatus is not null\n and VTEDiagnosis.verificationStatus ~ QICoreCommon."confirmed"\n and VTEDiagnosis.onset.toInterval ( ) before start of QualifyingEncounterICU.period\n )</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>IntensiveCareUnitVenousThromboembolismProphylaxisFHIR</td>\n \n \n <td>Encounter with Prior or Present Procedure of Hip or Knee Replacement Surgery</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Encounter with Prior or Present Procedure of Hip or Knee Replacement Surgery":\n "Encounter with ICU Location" QualifyingEncounterICU\n with ( ["Procedure": "Hip Replacement Surgery"]\n union ["Procedure": "Knee Replacement Surgery"] ) HipKneeProcedure\n such that HipKneeProcedure.status = 'completed'\n and HipKneeProcedure.performed.toInterval ( ) starts on or before end of QualifyingEncounterICU.period</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>IntensiveCareUnitVenousThromboembolismProphylaxisFHIR</td>\n \n \n <td>Low Risk Indicator For VTE</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Low Risk Indicator For VTE":\n ( ["Observation": "Risk for venous thromboembolism"] VTERiskAssessment\n where VTERiskAssessment.value as Concept in "Low Risk"\n and VTERiskAssessment.status in { 'final', 'amended', 'corrected' }\n return {\n id: VTERiskAssessment.id,\n LowRiskDatetime: VTERiskAssessment.effective.earliest ( )\n }\n )\n union ( ["US Core Laboratory Result Observation Profile": "INR"] INRLabTest\n where INRLabTest.value as Quantity > 3.0\n and INRLabTest.status in { 'final', 'amended', 'corrected' }\n return {\n id: INRLabTest.id,\n LowRiskDatetime: INRLabTest.issued\n }\n )\n union ( ( ( ["MedicationAdministration": "Unfractionated Heparin"] UnfractionatedHeparin\n where UnfractionatedHeparin.dosage.route in "Intravenous route"\n )\n union ["MedicationAdministration": "Direct Thrombin Inhibitor"]\n union ["MedicationAdministration": "Glycoprotein IIb/IIIa Inhibitors"] ) AnticoagulantMedication\n where AnticoagulantMedication.status = 'completed'\n return {\n id: AnticoagulantMedication.id,\n LowRiskDatetime: start of AnticoagulantMedication.effective.toInterval ( )\n }\n )</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>IntensiveCareUnitVenousThromboembolismProphylaxisFHIR</td>\n \n \n <td>Low Risk for VTE or Anticoagulant Administered From Day of Start of Hospitalization To Day After First ICU Stay</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Low Risk for VTE or Anticoagulant Administered From Day of Start of Hospitalization To Day After First ICU Stay":\n "Encounter with ICU Location" QualifyingEncounterICU\n with "Low Risk Indicator For VTE" LowRiskForVTE\n such that LowRiskForVTE.LowRiskDatetime during day of QualifyingEncounterICU.FromDayOfStartOfHospitalizationToDayAfterFirstICU ( )</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>IntensiveCareUnitVenousThromboembolismProphylaxisFHIR</td>\n \n \n <td>Low Risk for VTE or Anticoagulant Administered on Day of or Day After Procedure</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Low Risk for VTE or Anticoagulant Administered on Day of or Day After Procedure":\n from\n "Encounter with ICU Location" QualifyingEncounterICU,\n ["Procedure": "General or Neuraxial Anesthesia"] AnesthesiaProcedure,\n "Low Risk Indicator For VTE" LowRiskForVTE\n where AnesthesiaProcedure.status = 'completed'\n and AnesthesiaProcedure.performed.toInterval ( ) ends 1 day after day of QualifyingEncounterICU.StartOfFirstICU ( )\n and LowRiskForVTE.LowRiskDatetime during day of ( end of AnesthesiaProcedure.performed.toInterval ( ) ).CalendarDayOfOrDayAfter ( )\n return QualifyingEncounterICU</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>IntensiveCareUnitVenousThromboembolismProphylaxisFHIR</td>\n \n \n <td>Encounter with Low Risk for VTE or Anticoagulant Administered</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Encounter with Low Risk for VTE or Anticoagulant Administered":\n "Low Risk for VTE or Anticoagulant Administered From Day of Start of Hospitalization To Day After First ICU Stay"\n union "Low Risk for VTE or Anticoagulant Administered on Day of or Day After Procedure"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>IntensiveCareUnitVenousThromboembolismProphylaxisFHIR</td>\n \n \n <td>No VTE Prophylaxis Medication Administered or Ordered</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "No VTE Prophylaxis Medication Administered or Ordered":\n ( ( [MedicationAdministrationNotDone: "Low Dose Unfractionated Heparin for VTE Prophylaxis"]\n union [MedicationAdministrationNotDone: "Low Molecular Weight Heparin for VTE Prophylaxis"]\n union [MedicationAdministrationNotDone: "Injectable Factor Xa Inhibitor for VTE Prophylaxis"]\n union [MedicationAdministrationNotDone: "Warfarin"]\n union [MedicationAdministrationNotDone: "Rivaroxaban for VTE Prophylaxis"] ) NoMedicationAdm\n return {\n id: NoMedicationAdm.id,\n MedicationStatusReason: NoMedicationAdm.statusReason,\n authoredOn: NoMedicationAdm.recorded\n }\n )\n union ( ( ["MedicationNotRequested": "Low Dose Unfractionated Heparin for VTE Prophylaxis"]\n union ["MedicationNotRequested": "Low Molecular Weight Heparin for VTE Prophylaxis"]\n union ["MedicationNotRequested": "Injectable Factor Xa Inhibitor for VTE Prophylaxis"]\n union ["MedicationNotRequested": "Warfarin"]\n union ["MedicationNotRequested": "Rivaroxaban for VTE Prophylaxis"] ) NoMedicationOrder\n where NoMedicationOrder.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }\n return {\n id: NoMedicationOrder.id,\n MedicationStatusReason: NoMedicationOrder.reasonCode,\n authoredOn: NoMedicationOrder.authoredOn\n }\n )</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>IntensiveCareUnitVenousThromboembolismProphylaxisFHIR</td>\n \n \n <td>No VTE Prophylaxis Medication Due to Medical Reason From Day Of Start of Hospitalization To Day After First ICU Stay</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "No VTE Prophylaxis Medication Due to Medical Reason From Day Of Start of Hospitalization To Day After First ICU Stay":\n "Encounter with ICU Location" QualifyingEncounterICU\n with "No VTE Prophylaxis Medication Administered or Ordered" NoVTEMedication\n such that NoVTEMedication.MedicationStatusReason in "Medical Reason For Not Providing Treatment"\n and NoVTEMedication.authoredOn during day of QualifyingEncounterICU.FromDayOfStartOfHospitalizationToDayAfterFirstICU ( )</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>IntensiveCareUnitVenousThromboembolismProphylaxisFHIR</td>\n \n \n <td>No Mechanical VTE Prophylaxis Performed or Ordered</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "No Mechanical VTE Prophylaxis Performed or Ordered":\n ( ( [ServiceNotRequested: "Venous foot pumps"]\n union [ServiceNotRequested: "Intermittent pneumatic compression devices"]\n union [ServiceNotRequested: "Graduated compression stockings"] ) DeviceNotOrder\n where DeviceNotOrder.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }\n return {\n id: DeviceNotOrder.id,\n requestStatusReason: DeviceNotOrder.reasonRefused,\n authoredOn: DeviceNotOrder.authoredOn\n }\n )\n union ( ( [ProcedureNotDone: "Application of Intermittent Pneumatic Compression Devices"]\n union [ProcedureNotDone: "Application of Venous Foot Pumps"]\n union [ProcedureNotDone: "Application of Graduated Compression Stockings"] ) DeviceNotApplied\n let DeviceNotDoneTiming: DeviceNotApplied.recorded\n return {\n id: DeviceNotApplied.id,\n requestStatusReason: DeviceNotApplied.statusReason,\n authoredOn: DeviceNotDoneTiming\n }\n )</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>IntensiveCareUnitVenousThromboembolismProphylaxisFHIR</td>\n \n \n <td>No Mechanical VTE Prophylaxis Due to Medical Reason From Day of Start of Hospitalization To Day After First ICU Stay</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "No Mechanical VTE Prophylaxis Due to Medical Reason From Day of Start of Hospitalization To Day After First ICU Stay":\n "Encounter with ICU Location" QualifyingEncounterICU\n with "No Mechanical VTE Prophylaxis Performed or Ordered" NoVTEDevice\n such that NoVTEDevice.requestStatusReason in "Medical Reason For Not Providing Treatment"\n and NoVTEDevice.authoredOn during day of QualifyingEncounterICU."FromDayOfStartOfHospitalizationToDayAfterFirstICU" ( )</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>IntensiveCareUnitVenousThromboembolismProphylaxisFHIR</td>\n \n \n <td>No VTE Prophylaxis Medication Due to Medical Reason on Day of or Day After Procedure</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "No VTE Prophylaxis Medication Due to Medical Reason on Day of or Day After Procedure":\n from\n "Encounter with ICU Location" QualifyingEncounterICU,\n ["Procedure": "General or Neuraxial Anesthesia"] AnesthesiaProcedure,\n "No VTE Prophylaxis Medication Administered or Ordered" NoVTEMedication\n where NoVTEMedication.MedicationStatusReason in "Medical Reason For Not Providing Treatment"\n and AnesthesiaProcedure.status = 'completed'\n and AnesthesiaProcedure.performed.toInterval ( ) ends 1 day after day of QualifyingEncounterICU.StartOfFirstICU ( )\n and NoVTEMedication.authoredOn during day of ( end of AnesthesiaProcedure.performed.toInterval ( ) ).CalendarDayOfOrDayAfter ( )\n return QualifyingEncounterICU</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>IntensiveCareUnitVenousThromboembolismProphylaxisFHIR</td>\n \n \n <td>No Mechanical VTE Prophylaxis Due to Medical Reason on Day of or Day After Procedure</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "No Mechanical VTE Prophylaxis Due to Medical Reason on Day of or Day After Procedure":\n from\n "Encounter with ICU Location" QualifyingEncounterICU,\n ["Procedure": "General or Neuraxial Anesthesia"] AnesthesiaProcedure,\n "No Mechanical VTE Prophylaxis Performed or Ordered" NoVTEDevice\n where NoVTEDevice.requestStatusReason in "Medical Reason For Not Providing Treatment"\n and AnesthesiaProcedure.status = 'completed'\n and AnesthesiaProcedure.performed.toInterval ( ) ends 1 day after day of QualifyingEncounterICU.StartOfFirstICU ( )\n and NoVTEDevice.authoredOn during day of ( end of AnesthesiaProcedure.performed.toInterval ( ) ).CalendarDayOfOrDayAfter ( )\n return QualifyingEncounterICU</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>IntensiveCareUnitVenousThromboembolismProphylaxisFHIR</td>\n \n \n <td>Encounter with No VTE Prophylaxis Due to Medical Reason</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Encounter with No VTE Prophylaxis Due to Medical Reason":\n ( "No VTE Prophylaxis Medication Due to Medical Reason From Day Of Start of Hospitalization To Day After First ICU Stay"\n intersect "No Mechanical VTE Prophylaxis Due to Medical Reason From Day of Start of Hospitalization To Day After First ICU Stay"\n )\n union ( "No VTE Prophylaxis Medication Due to Medical Reason on Day of or Day After Procedure"\n intersect "No Mechanical VTE Prophylaxis Due to Medical Reason on Day of or Day After Procedure"\n )</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>IntensiveCareUnitVenousThromboembolismProphylaxisFHIR</td>\n \n \n <td>No Mechanical or Pharmacological VTE Prophylaxis Due to Patient Refusal</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "No Mechanical or Pharmacological VTE Prophylaxis Due to Patient Refusal":\n ( "No VTE Prophylaxis Medication Administered or Ordered" NoVTEMedication\n where NoVTEMedication.MedicationStatusReason in "Patient Refusal"\n )\n union ( "No Mechanical VTE Prophylaxis Performed or Ordered" NoVTEDevice\n where NoVTEDevice.requestStatusReason in "Patient Refusal"\n )</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>IntensiveCareUnitVenousThromboembolismProphylaxisFHIR</td>\n \n \n <td>No VTE Prophylaxis Due to Patient Refusal From Day of Start of Hospitalization To Day After First ICU Stay</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "No VTE Prophylaxis Due to Patient Refusal From Day of Start of Hospitalization To Day After First ICU Stay":\n "Encounter with ICU Location" QualifyingEncounterICU\n with "No Mechanical or Pharmacological VTE Prophylaxis Due to Patient Refusal" PatientRefusal\n such that PatientRefusal.authoredOn during day of QualifyingEncounterICU.FromDayOfStartOfHospitalizationToDayAfterFirstICU ( )</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>IntensiveCareUnitVenousThromboembolismProphylaxisFHIR</td>\n \n \n <td>No VTE Prophylaxis Due to Patient Refusal on Day of or Day After Procedure</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "No VTE Prophylaxis Due to Patient Refusal on Day of or Day After Procedure":\n from\n "Encounter with ICU Location" QualifyingEncounterICU,\n ["Procedure": "General or Neuraxial Anesthesia"] AnesthesiaProcedure,\n "No Mechanical or Pharmacological VTE Prophylaxis Due to Patient Refusal" PatientRefusal\n where AnesthesiaProcedure.status = 'completed'\n and AnesthesiaProcedure.performed.toInterval ( ) ends 1 day after day of QualifyingEncounterICU.StartOfFirstICU ( )\n and PatientRefusal.authoredOn during day of ( end of AnesthesiaProcedure.performed.toInterval ( ) ).CalendarDayOfOrDayAfter ( )\n return QualifyingEncounterICU</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>IntensiveCareUnitVenousThromboembolismProphylaxisFHIR</td>\n \n \n <td>Encounter with No VTE Prophylaxis Due to Patient Refusal</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Encounter with No VTE Prophylaxis Due to Patient Refusal":\n "No VTE Prophylaxis Due to Patient Refusal From Day of Start of Hospitalization To Day After First ICU Stay"\n union "No VTE Prophylaxis Due to Patient Refusal on Day of or Day After Procedure"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>IntensiveCareUnitVenousThromboembolismProphylaxisFHIR</td>\n \n \n <td>Numerator</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Numerator":\n "Encounter with VTE Prophylaxis Received on Day of or Day After First ICU Stay or Procedure"\n union ( "Encounter with Medication Oral Factor Xa Inhibitor Administered on Day of or Day After First ICU Stay or Procedure"\n intersect ( "Encounter with Prior or Present Diagnosis of Atrial Fibrillation or Prior Diagnosis of VTE"\n union "Encounter with Prior or Present Procedure of Hip or Knee Replacement Surgery"\n )\n )\n union "Encounter with Low Risk for VTE or Anticoagulant Administered"\n union "Encounter with No VTE Prophylaxis Due to Medical Reason"\n union "Encounter with No VTE Prophylaxis Due to Patient Refusal"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>IntensiveCareUnitVenousThromboembolismProphylaxisFHIR</td>\n \n \n <td>Denominator</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Denominator":\n "Encounter with ICU Location"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SupplementalDataElements</td>\n \n \n <td>SDE Payer</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "SDE Payer":\n [Coverage: type in "Payer Type"] Payer\n return {\n code: Payer.type,\n period: Payer.period\n }</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>IntensiveCareUnitVenousThromboembolismProphylaxisFHIR</td>\n \n \n <td>SDE Payer</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "SDE Payer":\n SDE."SDE Payer"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>IntensiveCareUnitVenousThromboembolismProphylaxisFHIR</td>\n \n \n <td>Initial Population</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Initial Population":\n VTE."Encounter with Age Range and without VTE Diagnosis or Obstetrical Conditions"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SupplementalDataElements</td>\n \n \n <td>SDE Ethnicity</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "SDE Ethnicity":\n Patient.ethnicity E\n return Tuple {\n codes: { E.ombCategory } union E.detailed,\n display: E.text\n }</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>IntensiveCareUnitVenousThromboembolismProphylaxisFHIR</td>\n \n \n <td>SDE Ethnicity</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "SDE Ethnicity":\n SDE."SDE Ethnicity"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>IntensiveCareUnitVenousThromboembolismProphylaxisFHIR</td>\n \n \n <td>Encounter with ICU Location And Encounter Less Than 2 Days</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Encounter with ICU Location And Encounter Less Than 2 Days":\n "Encounter with ICU Location" QualifyingEncounterICU\n where QualifyingEncounterICU.period.lengthInDays ( ) < 2</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>IntensiveCareUnitVenousThromboembolismProphylaxisFHIR</td>\n \n \n <td>SCIP VTE Selected Surgery</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "SCIP VTE Selected Surgery":\n ( ["Procedure": "General Surgery"]\n union ["Procedure": "Gynecological Surgery"]\n union ["Procedure": "Hip Fracture Surgery"]\n union ["Procedure": "Hip Replacement Surgery"]\n union ["Procedure": "Intracranial Neurosurgery"]\n union ["Procedure": "Knee Replacement Surgery"]\n union ["Procedure": "Urological Surgery"] ) Procedure\n where Procedure.status = 'completed'</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>IntensiveCareUnitVenousThromboembolismProphylaxisFHIR</td>\n \n \n <td>Encounter with First ICU Stay with Principal Procedure of SCIP VTE Selected Surgery</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Encounter with First ICU Stay with Principal Procedure of SCIP VTE Selected Surgery":\n from\n "Encounter with ICU Location" QualifyingEncounterICU,\n "SCIP VTE Selected Surgery" SelectedProcedure\n let EncounterProcedure: singleton from ( QualifyingEncounterICU.procedure P\n where P.rank = 1\n )\n where EncounterProcedure.procedure.reference.getId ( ) = SelectedProcedure.id\n and end of SelectedProcedure.performed.toInterval ( ) during day of QualifyingEncounterICU.StartOfFirstICU ( ).CalendarDayOfOrDayAfter ( )\n return QualifyingEncounterICU</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>IntensiveCareUnitVenousThromboembolismProphylaxisFHIR</td>\n \n \n <td>Intervention Comfort Measures</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Intervention Comfort Measures":\n ( ["ServiceRequest": "Comfort Measures"] InterventionRequest\n where InterventionRequest.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }\n and InterventionRequest.status in { 'active', 'on-hold', 'completed' }\n and InterventionRequest.doNotPerform is not true\n )\n union ( ["Procedure": "Comfort Measures"] InterventionPerformed\n where InterventionPerformed.status in { 'completed', 'in-progress' }\n )</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>IntensiveCareUnitVenousThromboembolismProphylaxisFHIR</td>\n \n \n <td>Encounter with Intervention Comfort Measures From Day Of Start of Hospitalization To Day After First ICU Stay</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Encounter with Intervention Comfort Measures From Day Of Start of Hospitalization To Day After First ICU Stay":\n "Encounter with ICU Location" QualifyingEncounterICU\n with "Intervention Comfort Measures" ComfortMeasure\n such that Coalesce(start of ComfortMeasure.performed.toInterval(), ComfortMeasure.authoredOn) during day of QualifyingEncounterICU.FromDayOfStartOfHospitalizationToDayAfterFirstICU ( )</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>IntensiveCareUnitVenousThromboembolismProphylaxisFHIR</td>\n \n \n <td>Encounter with Intervention Comfort Measures on Day of or Day After Procedure</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Encounter with Intervention Comfort Measures on Day of or Day After Procedure":\n from\n "Encounter with ICU Location" QualifyingEncounterICU,\n ["Procedure": "General or Neuraxial Anesthesia"] AnesthesiaProcedure,\n "Intervention Comfort Measures" ComfortMeasure\n where AnesthesiaProcedure.status = 'completed'\n and AnesthesiaProcedure.performed.toInterval ( ) ends 1 day after day of QualifyingEncounterICU.StartOfFirstICU ( )\n and Coalesce(start of ComfortMeasure.performed.toInterval(), ComfortMeasure.authoredOn) during day of ( end of AnesthesiaProcedure.performed.toInterval ( ) ).CalendarDayOfOrDayAfter ( )\n return QualifyingEncounterICU</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>IntensiveCareUnitVenousThromboembolismProphylaxisFHIR</td>\n \n \n <td>Denominator Exclusions</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Denominator Exclusions":\n "Encounter with ICU Location And Encounter Less Than 2 Days"\n union "Encounter with First ICU Stay with Principal Procedure of SCIP VTE Selected Surgery"\n union "Encounter with Intervention Comfort Measures From Day Of Start of Hospitalization To Day After First ICU Stay"\n union "Encounter with Intervention Comfort Measures on Day of or Day After Procedure"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SupplementalDataElements</td>\n \n \n <td>SDE Race</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "SDE Race":\n Patient.race R\n return Tuple {\n codes: R.ombCategory union R.detailed,\n display: R.text\n }</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>IntensiveCareUnitVenousThromboembolismProphylaxisFHIR</td>\n \n \n <td>SDE Race</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "SDE Race":\n SDE."SDE Race"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>IntensiveCareUnitVenousThromboembolismProphylaxisFHIR</td>\n \n \n <td>Encounter with First ICU Location Stay Less Than 1 day</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Encounter with First ICU Location Stay Less Than 1 day":\n "Encounter with ICU Location" QualifyingEncounterICU\n where QualifyingEncounterICU.firstInpatientIntensiveCareUnit ( ).period.lengthInDays ( ) < 1</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>IntensiveCareUnitVenousThromboembolismProphylaxisFHIR</td>\n \n \n <td>Denominator Exceptions</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Denominator Exceptions":\n "Encounter with First ICU Location Stay Less Than 1 day"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CQMCommon</td>\n \n \n <td>encounterDiagnosis</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">/*\n@description: Returns the Condition resources referenced by the diagnosis element of the Encounter\n*/\ndefine fluent function encounterDiagnosis(Encounter Encounter ):\n Encounter.diagnosis D\n return singleton from ([Condition] C where C.id = D.condition.reference.getId())</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>QICoreCommon</td>\n \n \n <td>getId</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">/*\n@description: Returns the tail of the given uri (i.e. everything after the last slash in the URI).\n@comment: This function can be used to determine the logical id of a given resource. It can be used in\na single-server environment to trace references. However, this function does not attempt to resolve\nor distinguish the base of the given url, and so cannot be used safely in multi-server environments.\n*/\ndefine fluent function getId(uri String):\n Last(Split(uri, '/'))</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CQMCommon</td>\n \n \n <td>getLocation</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">/*\n@description: Returns the Location resource specified by the given reference.\n*/\ndefine fluent function getLocation(reference Reference ):\n singleton from (\n [Location] L where L.id = reference.reference.getId()\n )</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>FHIRHelpers</td>\n \n \n <td>ToConcept</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">/*\n@description: Converts the given FHIR [CodeableConcept](https://hl7.org/fhir/datatypes.html#CodeableConcept) value to a CQL Concept.\n*/\ndefine function ToConcept(concept FHIR.CodeableConcept):\n if concept is null then\n null\n else\n System.Concept {\n codes: concept.coding C return ToCode(C),\n display: concept.text.value\n }</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>TJCOverall</td>\n \n \n <td>CalendarDayOfOrDayAfter</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define fluent function CalendarDayOfOrDayAfter(StartValue DateTime):\n Interval [date from (StartValue), date from (StartValue) + 1 day]</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>VTE</td>\n \n \n <td>StartOfFirstICU</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define fluent function "StartOfFirstICU"(Encounter Encounter ):\n\tstart of Encounter.firstInpatientIntensiveCareUnit().period</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CQMCommon</td>\n \n \n <td>firstInpatientIntensiveCareUnit</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">/*\n@description: First Inpatient Intensive Care Unit returns the first intensive care unit for the given encounter, without considering any immediately prior emergency department visit.\n*/\ndefine fluent function firstInpatientIntensiveCareUnit(Encounter Encounter ):\n First((Encounter.location)HospitalLocation\n \t\t\twhere GetLocation(HospitalLocation.location).type in "Intensive Care Unit"\n \t\t\t\tand HospitalLocation.period during Encounter.period\n \t\t\tsort by start of period\n \t)</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CQMCommon</td>\n \n \n <td>GetLocation</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">/*\n@description: Returns the Location resource specified by the given reference\n@deprecated: This function is deprecated. Use the fluent function `getLocation()` instead.\n*/\ndefine function "GetLocation"(reference Reference ):\n singleton from (\n [Location] L where L.id = reference.reference.getId()\n )</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>QICoreCommon</td>\n \n \n <td>isActive</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">/* Candidates for FHIRCommon */\n\n/*\n@description: Returns true if the given condition has a clinical status of active, recurrence, or relapse\n*/\ndefine fluent function isActive(condition Condition):\n condition.clinicalStatus ~ "active"\n or condition.clinicalStatus ~ "recurrence"\n or condition.clinicalStatus ~ "relapse"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>QICoreCommon</td>\n \n \n <td>earliest</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">/*\n@description: Given an interval, return the starting point if the interval has a starting boundary specified,\notherwise, return the ending point\n*/\ndefine fluent function earliest(choice Choice<DateTime, Quantity, Interval<DateTime>, Interval<Quantity>> ):\n (choice.toInterval()) period\n return\n if (period."hasStart"()) then start of period\n else end of period</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>VTE</td>\n \n \n <td>FromDayOfStartOfHospitalizationToDayAfterFirstICU</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define fluent function "FromDayOfStartOfHospitalizationToDayAfterFirstICU"(Encounter Encounter ):\n\tInterval[date from (start of Encounter.hospitalizationWithObservation()), date from (Encounter.StartOfFirstICU()) + 1 day]</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CQMCommon</td>\n \n \n <td>hospitalizationWithObservation</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">/*\n@description: Hospitalization with Observation returns the total interval from the start of any immediately prior emergency department visit through the observation visit to the discharge of the given encounter\n*/\ndefine fluent function hospitalizationWithObservation(TheEncounter Encounter ):\n TheEncounter Visit\n \t\tlet ObsVisit: Last([Encounter: "Observation Services"] LastObs\n \t\t\t\twhere LastObs.status = 'finished'\n and LastObs.period ends 1 hour or less on or before start of Visit.period\n \t\t\t\tsort by end of period\n \t\t\t),\n \t\t\tVisitStart: Coalesce(start of ObsVisit.period, start of Visit.period),\n \t\t\tEDVisit: Last([Encounter: "Emergency Department Visit"] LastED\n \t\t\t\twhere LastED.status = 'finished'\n and LastED.period ends 1 hour or less on or before VisitStart\n \t\t\t\tsort by end of period\n \t\t\t)\n \t\treturn Interval[Coalesce(start of EDVisit.period, VisitStart), end of Visit.period]</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>FHIRHelpers</td>\n \n \n <td>ToString</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define function ToString(value uri): value.value</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>FHIRHelpers</td>\n \n \n <td>ToCode</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">/*\n@description: Converts the given FHIR [Coding](https://hl7.org/fhir/datatypes.html#Coding) value to a CQL Code.\n*/\ndefine function ToCode(coding FHIR.Coding):\n if coding is null then\n null\n else\n System.Code {\n code: coding.code.value,\n system: coding.system.value,\n version: coding.version.value,\n display: coding.display.value\n }</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CQMCommon</td>\n \n \n <td>lengthInDays</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">/*\n@description: Calculates the difference in calendar days between the start and end of the given interval.\n*/\ndefine fluent function lengthInDays(Value Interval<DateTime> ):\n difference in days between start of Value and end of Value</code></pre>\n </td>\n \n </tr>\n \n </table>\n </td>\n </tr>\n \n \n \n\n </table>\n</div>"
},
"contained" : [
{
"resourceType" : "Library",
"id" : "effective-data-requirements",
"extension" : [
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
"valueCoding" : {
"system" : "http://hl7.org/fhir/administrative-gender",
"code" : "M",
"display" : "Male"
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
"valueCoding" : {
"system" : "http://hl7.org/fhir/administrative-gender",
"code" : "F",
"display" : "Female"
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
"valueCoding" : {
"system" : "http://terminology.hl7.org/CodeSystem/condition-clinical",
"code" : "active",
"display" : "Active"
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
"valueCoding" : {
"system" : "http://terminology.hl7.org/CodeSystem/condition-clinical",
"code" : "recurrence",
"display" : "Recurrence"
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
"valueCoding" : {
"system" : "http://terminology.hl7.org/CodeSystem/condition-clinical",
"code" : "relapse",
"display" : "Relapse"
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
"valueCoding" : {
"system" : "http://terminology.hl7.org/CodeSystem/condition-ver-status",
"code" : "confirmed",
"display" : "Confirmed"
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
"valueCoding" : {
"system" : "http://terminology.hl7.org/CodeSystem/condition-clinical",
"code" : "inactive",
"display" : "Inactive"
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
"valueCoding" : {
"system" : "http://terminology.hl7.org/CodeSystem/condition-clinical",
"code" : "remission",
"display" : "Remission"
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
"valueCoding" : {
"system" : "http://terminology.hl7.org/CodeSystem/condition-clinical",
"code" : "resolved",
"display" : "Resolved"
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "72136-5",
"display" : "Risk for venous thromboembolism"
}
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SupplementalDataElements"
},
{
"url" : "name",
"valueString" : "SDE Sex"
},
{
"url" : "statement",
"valueString" : "define \"SDE Sex\":\n case\n when Patient.gender = 'male' then \"M\"\n when Patient.gender = 'female' then \"F\"\n else null\n end"
},
{
"url" : "displaySequence",
"valueInteger" : 0
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "IntensiveCareUnitVenousThromboembolismProphylaxisFHIR"
},
{
"url" : "name",
"valueString" : "SDE Sex"
},
{
"url" : "statement",
"valueString" : "define \"SDE Sex\":\n SDE.\"SDE Sex\""
},
{
"url" : "displaySequence",
"valueInteger" : 1
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CQMCommon"
},
{
"url" : "name",
"valueString" : "Inpatient Encounter"
},
{
"url" : "statement",
"valueString" : "define \"Inpatient Encounter\":\n [Encounter: \"Encounter Inpatient\"] EncounterInpatient\n\t\twhere EncounterInpatient.status = 'finished'\n\t\tand EncounterInpatient.period ends during day of \"Measurement Period\""
},
{
"url" : "displaySequence",
"valueInteger" : 2
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "VTE"
},
{
"url" : "name",
"valueString" : "Admission without VTE or Obstetrical Conditions"
},
{
"url" : "statement",
"valueString" : "define \"Admission without VTE or Obstetrical Conditions\":\n CQMCommon.\"Inpatient Encounter\" InpatientEncounter\n where not (exists (InpatientEncounter.encounterDiagnosis()) EncDx\n where (EncDx.code in \"Obstetrical or Pregnancy Related Conditions\" \n or EncDx.code in \"Venous Thromboembolism\"\n \t\t\t\tor EncDx.code in \"Obstetrics VTE\"\n \t\t\t )\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 3
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "VTE"
},
{
"url" : "name",
"valueString" : "Encounter with Age Range and without VTE Diagnosis or Obstetrical Conditions"
},
{
"url" : "statement",
"valueString" : "define \"Encounter with Age Range and without VTE Diagnosis or Obstetrical Conditions\":\n ( CQMCommon.\"Inpatient Encounter\" InpatientEncounter\n where AgeInYearsAt(date from start of InpatientEncounter.period) >= 18 )\n intersect \"Admission without VTE or Obstetrical Conditions\""
},
{
"url" : "displaySequence",
"valueInteger" : 4
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "IntensiveCareUnitVenousThromboembolismProphylaxisFHIR"
},
{
"url" : "name",
"valueString" : "Encounter with ICU Location"
},
{
"url" : "statement",
"valueString" : "define \"Encounter with ICU Location\":\n VTE.\"Encounter with Age Range and without VTE Diagnosis or Obstetrical Conditions\" QualifyingEncounter\n where exists ( QualifyingEncounter.location Location\n where Location.location.getLocation ( ).type in \"Intensive Care Unit\"\n and Location.period during QualifyingEncounter.period\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 5
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "IntensiveCareUnitVenousThromboembolismProphylaxisFHIR"
},
{
"url" : "name",
"valueString" : "Pharmacological or Mechanical VTE Prophylaxis Received"
},
{
"url" : "statement",
"valueString" : "define \"Pharmacological or Mechanical VTE Prophylaxis Received\":\n ( [\"MedicationAdministration\": \"Low Dose Unfractionated Heparin for VTE Prophylaxis\"] VTEMedication\n where VTEMedication.status = 'completed'\n and VTEMedication.dosage.route in \"Subcutaneous route\"\n )\n union ( [\"MedicationAdministration\": \"Low Molecular Weight Heparin for VTE Prophylaxis\"] LMWH\n where LMWH.status = 'completed'\n )\n union ( [\"MedicationAdministration\": \"Injectable Factor Xa Inhibitor for VTE Prophylaxis\"] FactorXa\n where FactorXa.status = 'completed'\n )\n union ( [\"MedicationAdministration\": \"Warfarin\"] Warfarin\n where Warfarin.status = 'completed'\n )\n union ( [\"MedicationAdministration\": \"Rivaroxaban for VTE Prophylaxis\"] Rivaroxaban\n where Rivaroxaban.status = 'completed'\n )\n union ( ( [\"Procedure\": \"Application of Intermittent Pneumatic Compression Devices\"]\n union [\"Procedure\": \"Application of Venous Foot Pumps\"]\n union [\"Procedure\": \"Application of Graduated Compression Stockings\"] ) DeviceApplied\n where DeviceApplied.status = 'completed'\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 6
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "IntensiveCareUnitVenousThromboembolismProphylaxisFHIR"
},
{
"url" : "name",
"valueString" : "Encounter with VTE Prophylaxis Received on Day of or Day After First ICU Stay or Procedure"
},
{
"url" : "statement",
"valueString" : "define \"Encounter with VTE Prophylaxis Received on Day of or Day After First ICU Stay or Procedure\":\n ( \"Encounter with ICU Location\" QualifyingEncounterICU\n with \"Pharmacological or Mechanical VTE Prophylaxis Received\" VTEProphylaxis\n such that start of Coalesce(VTEProphylaxis.effective.toInterval(), VTEProphylaxis.performed.toInterval()) during day of QualifyingEncounterICU.StartOfFirstICU ( ).CalendarDayOfOrDayAfter ( )\n )\n union ( from\n \"Encounter with ICU Location\" QualifyingEncounterICU,\n [\"Procedure\": \"General or Neuraxial Anesthesia\"] AnesthesiaProcedure,\n \"Pharmacological or Mechanical VTE Prophylaxis Received\" VTEProphylaxis\n where AnesthesiaProcedure.status = 'completed'\n and AnesthesiaProcedure.performed.toInterval ( ) ends 1 day after day of QualifyingEncounterICU.StartOfFirstICU ( )\n and start of Coalesce(VTEProphylaxis.effective.toInterval(), VTEProphylaxis.performed.toInterval()) during day of ( end of AnesthesiaProcedure.performed.toInterval ( ) ).CalendarDayOfOrDayAfter ( )\n return QualifyingEncounterICU\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 7
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "IntensiveCareUnitVenousThromboembolismProphylaxisFHIR"
},
{
"url" : "name",
"valueString" : "Encounter with Medication Oral Factor Xa Inhibitor Administered on Day of or Day After First ICU Stay or Procedure"
},
{
"url" : "statement",
"valueString" : "define \"Encounter with Medication Oral Factor Xa Inhibitor Administered on Day of or Day After First ICU Stay or Procedure\":\n ( \"Encounter with ICU Location\" QualifyingEncounterICU\n with [\"MedicationAdministration\": \"Oral Factor Xa Inhibitor for VTE Prophylaxis or VTE Treatment\"] FactorXaMedication\n such that FactorXaMedication.status = 'completed'\n and FactorXaMedication.effective.toInterval ( ) starts during day of QualifyingEncounterICU.StartOfFirstICU ( ).CalendarDayOfOrDayAfter ( )\n )\n union ( from\n \"Encounter with ICU Location\" QualifyingEncounterICU,\n [\"Procedure\": \"General or Neuraxial Anesthesia\"] AnesthesiaProcedure,\n [\"MedicationAdministration\": \"Oral Factor Xa Inhibitor for VTE Prophylaxis or VTE Treatment\"] FactorXaMedication\n where FactorXaMedication.status = 'completed'\n and AnesthesiaProcedure.status = 'completed'\n and AnesthesiaProcedure.performed.toInterval ( ) ends 1 day after day of QualifyingEncounterICU.StartOfFirstICU ( )\n and FactorXaMedication.effective.toInterval ( ) starts during day of ( end of AnesthesiaProcedure.performed.toInterval ( ) ).CalendarDayOfOrDayAfter ( )\n return QualifyingEncounterICU\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 8
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "IntensiveCareUnitVenousThromboembolismProphylaxisFHIR"
},
{
"url" : "name",
"valueString" : "Encounter with Prior or Present Diagnosis of Atrial Fibrillation or Prior Diagnosis of VTE"
},
{
"url" : "statement",
"valueString" : "define \"Encounter with Prior or Present Diagnosis of Atrial Fibrillation or Prior Diagnosis of VTE\":\n ( \"Encounter with ICU Location\" QualifyingEncounterICU\n with [\"Condition\": \"Atrial Fibrillation or Flutter\"] AtrialFibrillation\n such that AtrialFibrillation.isActive ( )\n and AtrialFibrillation.verificationStatus is not null\n and AtrialFibrillation.verificationStatus ~ QICoreCommon.\"confirmed\"\n and AtrialFibrillation.onset.toInterval ( ) starts on or before end of QualifyingEncounterICU.period\n )\n union ( \"Encounter with ICU Location\" QualifyingEncounterICU\n where QualifyingEncounterICU.encounterDiagnosis ( ).code in \"Atrial Fibrillation or Flutter\"\n )\n union ( \"Encounter with ICU Location\" QualifyingEncounterICU\n with [\"Condition\": \"Venous Thromboembolism\"] VTEDiagnosis\n such that ( VTEDiagnosis.clinicalStatus ~ QICoreCommon.\"inactive\"\n or VTEDiagnosis.clinicalStatus ~ QICoreCommon.\"remission\"\n or VTEDiagnosis.clinicalStatus ~ QICoreCommon.\"resolved\"\n )\n and VTEDiagnosis.verificationStatus is not null\n and VTEDiagnosis.verificationStatus ~ QICoreCommon.\"confirmed\"\n and VTEDiagnosis.onset.toInterval ( ) before start of QualifyingEncounterICU.period\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 9
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "IntensiveCareUnitVenousThromboembolismProphylaxisFHIR"
},
{
"url" : "name",
"valueString" : "Encounter with Prior or Present Procedure of Hip or Knee Replacement Surgery"
},
{
"url" : "statement",
"valueString" : "define \"Encounter with Prior or Present Procedure of Hip or Knee Replacement Surgery\":\n \"Encounter with ICU Location\" QualifyingEncounterICU\n with ( [\"Procedure\": \"Hip Replacement Surgery\"]\n union [\"Procedure\": \"Knee Replacement Surgery\"] ) HipKneeProcedure\n such that HipKneeProcedure.status = 'completed'\n and HipKneeProcedure.performed.toInterval ( ) starts on or before end of QualifyingEncounterICU.period"
},
{
"url" : "displaySequence",
"valueInteger" : 10
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "IntensiveCareUnitVenousThromboembolismProphylaxisFHIR"
},
{
"url" : "name",
"valueString" : "Low Risk Indicator For VTE"
},
{
"url" : "statement",
"valueString" : "define \"Low Risk Indicator For VTE\":\n ( [\"Observation\": \"Risk for venous thromboembolism\"] VTERiskAssessment\n where VTERiskAssessment.value as Concept in \"Low Risk\"\n and VTERiskAssessment.status in { 'final', 'amended', 'corrected' }\n return {\n id: VTERiskAssessment.id,\n LowRiskDatetime: VTERiskAssessment.effective.earliest ( )\n }\n )\n union ( [\"US Core Laboratory Result Observation Profile\": \"INR\"] INRLabTest\n where INRLabTest.value as Quantity > 3.0\n and INRLabTest.status in { 'final', 'amended', 'corrected' }\n return {\n id: INRLabTest.id,\n LowRiskDatetime: INRLabTest.issued\n }\n )\n union ( ( ( [\"MedicationAdministration\": \"Unfractionated Heparin\"] UnfractionatedHeparin\n where UnfractionatedHeparin.dosage.route in \"Intravenous route\"\n )\n union [\"MedicationAdministration\": \"Direct Thrombin Inhibitor\"]\n union [\"MedicationAdministration\": \"Glycoprotein IIb/IIIa Inhibitors\"] ) AnticoagulantMedication\n where AnticoagulantMedication.status = 'completed'\n return {\n id: AnticoagulantMedication.id,\n LowRiskDatetime: start of AnticoagulantMedication.effective.toInterval ( )\n }\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 11
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "IntensiveCareUnitVenousThromboembolismProphylaxisFHIR"
},
{
"url" : "name",
"valueString" : "Low Risk for VTE or Anticoagulant Administered From Day of Start of Hospitalization To Day After First ICU Stay"
},
{
"url" : "statement",
"valueString" : "define \"Low Risk for VTE or Anticoagulant Administered From Day of Start of Hospitalization To Day After First ICU Stay\":\n \"Encounter with ICU Location\" QualifyingEncounterICU\n with \"Low Risk Indicator For VTE\" LowRiskForVTE\n such that LowRiskForVTE.LowRiskDatetime during day of QualifyingEncounterICU.FromDayOfStartOfHospitalizationToDayAfterFirstICU ( )"
},
{
"url" : "displaySequence",
"valueInteger" : 12
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "IntensiveCareUnitVenousThromboembolismProphylaxisFHIR"
},
{
"url" : "name",
"valueString" : "Low Risk for VTE or Anticoagulant Administered on Day of or Day After Procedure"
},
{
"url" : "statement",
"valueString" : "define \"Low Risk for VTE or Anticoagulant Administered on Day of or Day After Procedure\":\n from\n \"Encounter with ICU Location\" QualifyingEncounterICU,\n [\"Procedure\": \"General or Neuraxial Anesthesia\"] AnesthesiaProcedure,\n \"Low Risk Indicator For VTE\" LowRiskForVTE\n where AnesthesiaProcedure.status = 'completed'\n and AnesthesiaProcedure.performed.toInterval ( ) ends 1 day after day of QualifyingEncounterICU.StartOfFirstICU ( )\n and LowRiskForVTE.LowRiskDatetime during day of ( end of AnesthesiaProcedure.performed.toInterval ( ) ).CalendarDayOfOrDayAfter ( )\n return QualifyingEncounterICU"
},
{
"url" : "displaySequence",
"valueInteger" : 13
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "IntensiveCareUnitVenousThromboembolismProphylaxisFHIR"
},
{
"url" : "name",
"valueString" : "Encounter with Low Risk for VTE or Anticoagulant Administered"
},
{
"url" : "statement",
"valueString" : "define \"Encounter with Low Risk for VTE or Anticoagulant Administered\":\n \"Low Risk for VTE or Anticoagulant Administered From Day of Start of Hospitalization To Day After First ICU Stay\"\n union \"Low Risk for VTE or Anticoagulant Administered on Day of or Day After Procedure\""
},
{
"url" : "displaySequence",
"valueInteger" : 14
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "IntensiveCareUnitVenousThromboembolismProphylaxisFHIR"
},
{
"url" : "name",
"valueString" : "No VTE Prophylaxis Medication Administered or Ordered"
},
{
"url" : "statement",
"valueString" : "define \"No VTE Prophylaxis Medication Administered or Ordered\":\n ( ( [MedicationAdministrationNotDone: \"Low Dose Unfractionated Heparin for VTE Prophylaxis\"]\n union [MedicationAdministrationNotDone: \"Low Molecular Weight Heparin for VTE Prophylaxis\"]\n union [MedicationAdministrationNotDone: \"Injectable Factor Xa Inhibitor for VTE Prophylaxis\"]\n union [MedicationAdministrationNotDone: \"Warfarin\"]\n union [MedicationAdministrationNotDone: \"Rivaroxaban for VTE Prophylaxis\"] ) NoMedicationAdm\n return {\n id: NoMedicationAdm.id,\n MedicationStatusReason: NoMedicationAdm.statusReason,\n authoredOn: NoMedicationAdm.recorded\n }\n )\n union ( ( [\"MedicationNotRequested\": \"Low Dose Unfractionated Heparin for VTE Prophylaxis\"]\n union [\"MedicationNotRequested\": \"Low Molecular Weight Heparin for VTE Prophylaxis\"]\n union [\"MedicationNotRequested\": \"Injectable Factor Xa Inhibitor for VTE Prophylaxis\"]\n union [\"MedicationNotRequested\": \"Warfarin\"]\n union [\"MedicationNotRequested\": \"Rivaroxaban for VTE Prophylaxis\"] ) NoMedicationOrder\n where NoMedicationOrder.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }\n return {\n id: NoMedicationOrder.id,\n MedicationStatusReason: NoMedicationOrder.reasonCode,\n authoredOn: NoMedicationOrder.authoredOn\n }\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 15
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "IntensiveCareUnitVenousThromboembolismProphylaxisFHIR"
},
{
"url" : "name",
"valueString" : "No VTE Prophylaxis Medication Due to Medical Reason From Day Of Start of Hospitalization To Day After First ICU Stay"
},
{
"url" : "statement",
"valueString" : "define \"No VTE Prophylaxis Medication Due to Medical Reason From Day Of Start of Hospitalization To Day After First ICU Stay\":\n \"Encounter with ICU Location\" QualifyingEncounterICU\n with \"No VTE Prophylaxis Medication Administered or Ordered\" NoVTEMedication\n such that NoVTEMedication.MedicationStatusReason in \"Medical Reason For Not Providing Treatment\"\n and NoVTEMedication.authoredOn during day of QualifyingEncounterICU.FromDayOfStartOfHospitalizationToDayAfterFirstICU ( )"
},
{
"url" : "displaySequence",
"valueInteger" : 16
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "IntensiveCareUnitVenousThromboembolismProphylaxisFHIR"
},
{
"url" : "name",
"valueString" : "No Mechanical VTE Prophylaxis Performed or Ordered"
},
{
"url" : "statement",
"valueString" : "define \"No Mechanical VTE Prophylaxis Performed or Ordered\":\n ( ( [ServiceNotRequested: \"Venous foot pumps\"]\n union [ServiceNotRequested: \"Intermittent pneumatic compression devices\"]\n union [ServiceNotRequested: \"Graduated compression stockings\"] ) DeviceNotOrder\n where DeviceNotOrder.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }\n return {\n id: DeviceNotOrder.id,\n requestStatusReason: DeviceNotOrder.reasonRefused,\n authoredOn: DeviceNotOrder.authoredOn\n }\n )\n union ( ( [ProcedureNotDone: \"Application of Intermittent Pneumatic Compression Devices\"]\n union [ProcedureNotDone: \"Application of Venous Foot Pumps\"]\n union [ProcedureNotDone: \"Application of Graduated Compression Stockings\"] ) DeviceNotApplied\n let DeviceNotDoneTiming: DeviceNotApplied.recorded\n return {\n id: DeviceNotApplied.id,\n requestStatusReason: DeviceNotApplied.statusReason,\n authoredOn: DeviceNotDoneTiming\n }\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 17
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "IntensiveCareUnitVenousThromboembolismProphylaxisFHIR"
},
{
"url" : "name",
"valueString" : "No Mechanical VTE Prophylaxis Due to Medical Reason From Day of Start of Hospitalization To Day After First ICU Stay"
},
{
"url" : "statement",
"valueString" : "define \"No Mechanical VTE Prophylaxis Due to Medical Reason From Day of Start of Hospitalization To Day After First ICU Stay\":\n \"Encounter with ICU Location\" QualifyingEncounterICU\n with \"No Mechanical VTE Prophylaxis Performed or Ordered\" NoVTEDevice\n such that NoVTEDevice.requestStatusReason in \"Medical Reason For Not Providing Treatment\"\n and NoVTEDevice.authoredOn during day of QualifyingEncounterICU.\"FromDayOfStartOfHospitalizationToDayAfterFirstICU\" ( )"
},
{
"url" : "displaySequence",
"valueInteger" : 18
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "IntensiveCareUnitVenousThromboembolismProphylaxisFHIR"
},
{
"url" : "name",
"valueString" : "No VTE Prophylaxis Medication Due to Medical Reason on Day of or Day After Procedure"
},
{
"url" : "statement",
"valueString" : "define \"No VTE Prophylaxis Medication Due to Medical Reason on Day of or Day After Procedure\":\n from\n \"Encounter with ICU Location\" QualifyingEncounterICU,\n [\"Procedure\": \"General or Neuraxial Anesthesia\"] AnesthesiaProcedure,\n \"No VTE Prophylaxis Medication Administered or Ordered\" NoVTEMedication\n where NoVTEMedication.MedicationStatusReason in \"Medical Reason For Not Providing Treatment\"\n and AnesthesiaProcedure.status = 'completed'\n and AnesthesiaProcedure.performed.toInterval ( ) ends 1 day after day of QualifyingEncounterICU.StartOfFirstICU ( )\n and NoVTEMedication.authoredOn during day of ( end of AnesthesiaProcedure.performed.toInterval ( ) ).CalendarDayOfOrDayAfter ( )\n return QualifyingEncounterICU"
},
{
"url" : "displaySequence",
"valueInteger" : 19
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "IntensiveCareUnitVenousThromboembolismProphylaxisFHIR"
},
{
"url" : "name",
"valueString" : "No Mechanical VTE Prophylaxis Due to Medical Reason on Day of or Day After Procedure"
},
{
"url" : "statement",
"valueString" : "define \"No Mechanical VTE Prophylaxis Due to Medical Reason on Day of or Day After Procedure\":\n from\n \"Encounter with ICU Location\" QualifyingEncounterICU,\n [\"Procedure\": \"General or Neuraxial Anesthesia\"] AnesthesiaProcedure,\n \"No Mechanical VTE Prophylaxis Performed or Ordered\" NoVTEDevice\n where NoVTEDevice.requestStatusReason in \"Medical Reason For Not Providing Treatment\"\n and AnesthesiaProcedure.status = 'completed'\n and AnesthesiaProcedure.performed.toInterval ( ) ends 1 day after day of QualifyingEncounterICU.StartOfFirstICU ( )\n and NoVTEDevice.authoredOn during day of ( end of AnesthesiaProcedure.performed.toInterval ( ) ).CalendarDayOfOrDayAfter ( )\n return QualifyingEncounterICU"
},
{
"url" : "displaySequence",
"valueInteger" : 20
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "IntensiveCareUnitVenousThromboembolismProphylaxisFHIR"
},
{
"url" : "name",
"valueString" : "Encounter with No VTE Prophylaxis Due to Medical Reason"
},
{
"url" : "statement",
"valueString" : "define \"Encounter with No VTE Prophylaxis Due to Medical Reason\":\n ( \"No VTE Prophylaxis Medication Due to Medical Reason From Day Of Start of Hospitalization To Day After First ICU Stay\"\n intersect \"No Mechanical VTE Prophylaxis Due to Medical Reason From Day of Start of Hospitalization To Day After First ICU Stay\"\n )\n union ( \"No VTE Prophylaxis Medication Due to Medical Reason on Day of or Day After Procedure\"\n intersect \"No Mechanical VTE Prophylaxis Due to Medical Reason on Day of or Day After Procedure\"\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 21
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "IntensiveCareUnitVenousThromboembolismProphylaxisFHIR"
},
{
"url" : "name",
"valueString" : "No Mechanical or Pharmacological VTE Prophylaxis Due to Patient Refusal"
},
{
"url" : "statement",
"valueString" : "define \"No Mechanical or Pharmacological VTE Prophylaxis Due to Patient Refusal\":\n ( \"No VTE Prophylaxis Medication Administered or Ordered\" NoVTEMedication\n where NoVTEMedication.MedicationStatusReason in \"Patient Refusal\"\n )\n union ( \"No Mechanical VTE Prophylaxis Performed or Ordered\" NoVTEDevice\n where NoVTEDevice.requestStatusReason in \"Patient Refusal\"\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 22
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "IntensiveCareUnitVenousThromboembolismProphylaxisFHIR"
},
{
"url" : "name",
"valueString" : "No VTE Prophylaxis Due to Patient Refusal From Day of Start of Hospitalization To Day After First ICU Stay"
},
{
"url" : "statement",
"valueString" : "define \"No VTE Prophylaxis Due to Patient Refusal From Day of Start of Hospitalization To Day After First ICU Stay\":\n \"Encounter with ICU Location\" QualifyingEncounterICU\n with \"No Mechanical or Pharmacological VTE Prophylaxis Due to Patient Refusal\" PatientRefusal\n such that PatientRefusal.authoredOn during day of QualifyingEncounterICU.FromDayOfStartOfHospitalizationToDayAfterFirstICU ( )"
},
{
"url" : "displaySequence",
"valueInteger" : 23
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "IntensiveCareUnitVenousThromboembolismProphylaxisFHIR"
},
{
"url" : "name",
"valueString" : "No VTE Prophylaxis Due to Patient Refusal on Day of or Day After Procedure"
},
{
"url" : "statement",
"valueString" : "define \"No VTE Prophylaxis Due to Patient Refusal on Day of or Day After Procedure\":\n from\n \"Encounter with ICU Location\" QualifyingEncounterICU,\n [\"Procedure\": \"General or Neuraxial Anesthesia\"] AnesthesiaProcedure,\n \"No Mechanical or Pharmacological VTE Prophylaxis Due to Patient Refusal\" PatientRefusal\n where AnesthesiaProcedure.status = 'completed'\n and AnesthesiaProcedure.performed.toInterval ( ) ends 1 day after day of QualifyingEncounterICU.StartOfFirstICU ( )\n and PatientRefusal.authoredOn during day of ( end of AnesthesiaProcedure.performed.toInterval ( ) ).CalendarDayOfOrDayAfter ( )\n return QualifyingEncounterICU"
},
{
"url" : "displaySequence",
"valueInteger" : 24
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "IntensiveCareUnitVenousThromboembolismProphylaxisFHIR"
},
{
"url" : "name",
"valueString" : "Encounter with No VTE Prophylaxis Due to Patient Refusal"
},
{
"url" : "statement",
"valueString" : "define \"Encounter with No VTE Prophylaxis Due to Patient Refusal\":\n \"No VTE Prophylaxis Due to Patient Refusal From Day of Start of Hospitalization To Day After First ICU Stay\"\n union \"No VTE Prophylaxis Due to Patient Refusal on Day of or Day After Procedure\""
},
{
"url" : "displaySequence",
"valueInteger" : 25
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "IntensiveCareUnitVenousThromboembolismProphylaxisFHIR"
},
{
"url" : "name",
"valueString" : "Numerator"
},
{
"url" : "statement",
"valueString" : "define \"Numerator\":\n \"Encounter with VTE Prophylaxis Received on Day of or Day After First ICU Stay or Procedure\"\n union ( \"Encounter with Medication Oral Factor Xa Inhibitor Administered on Day of or Day After First ICU Stay or Procedure\"\n intersect ( \"Encounter with Prior or Present Diagnosis of Atrial Fibrillation or Prior Diagnosis of VTE\"\n union \"Encounter with Prior or Present Procedure of Hip or Knee Replacement Surgery\"\n )\n )\n union \"Encounter with Low Risk for VTE or Anticoagulant Administered\"\n union \"Encounter with No VTE Prophylaxis Due to Medical Reason\"\n union \"Encounter with No VTE Prophylaxis Due to Patient Refusal\""
},
{
"url" : "displaySequence",
"valueInteger" : 26
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "IntensiveCareUnitVenousThromboembolismProphylaxisFHIR"
},
{
"url" : "name",
"valueString" : "Denominator"
},
{
"url" : "statement",
"valueString" : "define \"Denominator\":\n \"Encounter with ICU Location\""
},
{
"url" : "displaySequence",
"valueInteger" : 27
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SupplementalDataElements"
},
{
"url" : "name",
"valueString" : "SDE Payer"
},
{
"url" : "statement",
"valueString" : "define \"SDE Payer\":\n [Coverage: type in \"Payer Type\"] Payer\n return {\n code: Payer.type,\n period: Payer.period\n }"
},
{
"url" : "displaySequence",
"valueInteger" : 28
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "IntensiveCareUnitVenousThromboembolismProphylaxisFHIR"
},
{
"url" : "name",
"valueString" : "SDE Payer"
},
{
"url" : "statement",
"valueString" : "define \"SDE Payer\":\n SDE.\"SDE Payer\""
},
{
"url" : "displaySequence",
"valueInteger" : 29
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "IntensiveCareUnitVenousThromboembolismProphylaxisFHIR"
},
{
"url" : "name",
"valueString" : "Initial Population"
},
{
"url" : "statement",
"valueString" : "define \"Initial Population\":\n VTE.\"Encounter with Age Range and without VTE Diagnosis or Obstetrical Conditions\""
},
{
"url" : "displaySequence",
"valueInteger" : 30
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SupplementalDataElements"
},
{
"url" : "name",
"valueString" : "SDE Ethnicity"
},
{
"url" : "statement",
"valueString" : "define \"SDE Ethnicity\":\n Patient.ethnicity E\n return Tuple {\n codes: { E.ombCategory } union E.detailed,\n display: E.text\n }"
},
{
"url" : "displaySequence",
"valueInteger" : 31
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "IntensiveCareUnitVenousThromboembolismProphylaxisFHIR"
},
{
"url" : "name",
"valueString" : "SDE Ethnicity"
},
{
"url" : "statement",
"valueString" : "define \"SDE Ethnicity\":\n SDE.\"SDE Ethnicity\""
},
{
"url" : "displaySequence",
"valueInteger" : 32
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "IntensiveCareUnitVenousThromboembolismProphylaxisFHIR"
},
{
"url" : "name",
"valueString" : "Encounter with ICU Location And Encounter Less Than 2 Days"
},
{
"url" : "statement",
"valueString" : "define \"Encounter with ICU Location And Encounter Less Than 2 Days\":\n \"Encounter with ICU Location\" QualifyingEncounterICU\n where QualifyingEncounterICU.period.lengthInDays ( ) < 2"
},
{
"url" : "displaySequence",
"valueInteger" : 33
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "IntensiveCareUnitVenousThromboembolismProphylaxisFHIR"
},
{
"url" : "name",
"valueString" : "SCIP VTE Selected Surgery"
},
{
"url" : "statement",
"valueString" : "define \"SCIP VTE Selected Surgery\":\n ( [\"Procedure\": \"General Surgery\"]\n union [\"Procedure\": \"Gynecological Surgery\"]\n union [\"Procedure\": \"Hip Fracture Surgery\"]\n union [\"Procedure\": \"Hip Replacement Surgery\"]\n union [\"Procedure\": \"Intracranial Neurosurgery\"]\n union [\"Procedure\": \"Knee Replacement Surgery\"]\n union [\"Procedure\": \"Urological Surgery\"] ) Procedure\n where Procedure.status = 'completed'"
},
{
"url" : "displaySequence",
"valueInteger" : 34
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "IntensiveCareUnitVenousThromboembolismProphylaxisFHIR"
},
{
"url" : "name",
"valueString" : "Encounter with First ICU Stay with Principal Procedure of SCIP VTE Selected Surgery"
},
{
"url" : "statement",
"valueString" : "define \"Encounter with First ICU Stay with Principal Procedure of SCIP VTE Selected Surgery\":\n from\n \"Encounter with ICU Location\" QualifyingEncounterICU,\n \"SCIP VTE Selected Surgery\" SelectedProcedure\n let EncounterProcedure: singleton from ( QualifyingEncounterICU.procedure P\n where P.rank = 1\n )\n where EncounterProcedure.procedure.reference.getId ( ) = SelectedProcedure.id\n and end of SelectedProcedure.performed.toInterval ( ) during day of QualifyingEncounterICU.StartOfFirstICU ( ).CalendarDayOfOrDayAfter ( )\n return QualifyingEncounterICU"
},
{
"url" : "displaySequence",
"valueInteger" : 35
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "IntensiveCareUnitVenousThromboembolismProphylaxisFHIR"
},
{
"url" : "name",
"valueString" : "Intervention Comfort Measures"
},
{
"url" : "statement",
"valueString" : "define \"Intervention Comfort Measures\":\n ( [\"ServiceRequest\": \"Comfort Measures\"] InterventionRequest\n where InterventionRequest.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }\n and InterventionRequest.status in { 'active', 'on-hold', 'completed' }\n and InterventionRequest.doNotPerform is not true\n )\n union ( [\"Procedure\": \"Comfort Measures\"] InterventionPerformed\n where InterventionPerformed.status in { 'completed', 'in-progress' }\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 36
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "IntensiveCareUnitVenousThromboembolismProphylaxisFHIR"
},
{
"url" : "name",
"valueString" : "Encounter with Intervention Comfort Measures From Day Of Start of Hospitalization To Day After First ICU Stay"
},
{
"url" : "statement",
"valueString" : "define \"Encounter with Intervention Comfort Measures From Day Of Start of Hospitalization To Day After First ICU Stay\":\n \"Encounter with ICU Location\" QualifyingEncounterICU\n with \"Intervention Comfort Measures\" ComfortMeasure\n such that Coalesce(start of ComfortMeasure.performed.toInterval(), ComfortMeasure.authoredOn) during day of QualifyingEncounterICU.FromDayOfStartOfHospitalizationToDayAfterFirstICU ( )"
},
{
"url" : "displaySequence",
"valueInteger" : 37
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "IntensiveCareUnitVenousThromboembolismProphylaxisFHIR"
},
{
"url" : "name",
"valueString" : "Encounter with Intervention Comfort Measures on Day of or Day After Procedure"
},
{
"url" : "statement",
"valueString" : "define \"Encounter with Intervention Comfort Measures on Day of or Day After Procedure\":\n from\n \"Encounter with ICU Location\" QualifyingEncounterICU,\n [\"Procedure\": \"General or Neuraxial Anesthesia\"] AnesthesiaProcedure,\n \"Intervention Comfort Measures\" ComfortMeasure\n where AnesthesiaProcedure.status = 'completed'\n and AnesthesiaProcedure.performed.toInterval ( ) ends 1 day after day of QualifyingEncounterICU.StartOfFirstICU ( )\n and Coalesce(start of ComfortMeasure.performed.toInterval(), ComfortMeasure.authoredOn) during day of ( end of AnesthesiaProcedure.performed.toInterval ( ) ).CalendarDayOfOrDayAfter ( )\n return QualifyingEncounterICU"
},
{
"url" : "displaySequence",
"valueInteger" : 38
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "IntensiveCareUnitVenousThromboembolismProphylaxisFHIR"
},
{
"url" : "name",
"valueString" : "Denominator Exclusions"
},
{
"url" : "statement",
"valueString" : "define \"Denominator Exclusions\":\n \"Encounter with ICU Location And Encounter Less Than 2 Days\"\n union \"Encounter with First ICU Stay with Principal Procedure of SCIP VTE Selected Surgery\"\n union \"Encounter with Intervention Comfort Measures From Day Of Start of Hospitalization To Day After First ICU Stay\"\n union \"Encounter with Intervention Comfort Measures on Day of or Day After Procedure\""
},
{
"url" : "displaySequence",
"valueInteger" : 39
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SupplementalDataElements"
},
{
"url" : "name",
"valueString" : "SDE Race"
},
{
"url" : "statement",
"valueString" : "define \"SDE Race\":\n Patient.race R\n return Tuple {\n codes: R.ombCategory union R.detailed,\n display: R.text\n }"
},
{
"url" : "displaySequence",
"valueInteger" : 40
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "IntensiveCareUnitVenousThromboembolismProphylaxisFHIR"
},
{
"url" : "name",
"valueString" : "SDE Race"
},
{
"url" : "statement",
"valueString" : "define \"SDE Race\":\n SDE.\"SDE Race\""
},
{
"url" : "displaySequence",
"valueInteger" : 41
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "IntensiveCareUnitVenousThromboembolismProphylaxisFHIR"
},
{
"url" : "name",
"valueString" : "Encounter with First ICU Location Stay Less Than 1 day"
},
{
"url" : "statement",
"valueString" : "define \"Encounter with First ICU Location Stay Less Than 1 day\":\n \"Encounter with ICU Location\" QualifyingEncounterICU\n where QualifyingEncounterICU.firstInpatientIntensiveCareUnit ( ).period.lengthInDays ( ) < 1"
},
{
"url" : "displaySequence",
"valueInteger" : 42
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "IntensiveCareUnitVenousThromboembolismProphylaxisFHIR"
},
{
"url" : "name",
"valueString" : "Denominator Exceptions"
},
{
"url" : "statement",
"valueString" : "define \"Denominator Exceptions\":\n \"Encounter with First ICU Location Stay Less Than 1 day\""
},
{
"url" : "displaySequence",
"valueInteger" : 43
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CQMCommon"
},
{
"url" : "name",
"valueString" : "encounterDiagnosis"
},
{
"url" : "statement",
"valueString" : "/*\n@description: Returns the Condition resources referenced by the diagnosis element of the Encounter\n*/\ndefine fluent function encounterDiagnosis(Encounter Encounter ):\n Encounter.diagnosis D\n return singleton from ([Condition] C where C.id = D.condition.reference.getId())"
},
{
"url" : "displaySequence",
"valueInteger" : 44
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "QICoreCommon"
},
{
"url" : "name",
"valueString" : "getId"
},
{
"url" : "statement",
"valueString" : "/*\n@description: Returns the tail of the given uri (i.e. everything after the last slash in the URI).\n@comment: This function can be used to determine the logical id of a given resource. It can be used in\na single-server environment to trace references. However, this function does not attempt to resolve\nor distinguish the base of the given url, and so cannot be used safely in multi-server environments.\n*/\ndefine fluent function getId(uri String):\n Last(Split(uri, '/'))"
},
{
"url" : "displaySequence",
"valueInteger" : 45
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CQMCommon"
},
{
"url" : "name",
"valueString" : "getLocation"
},
{
"url" : "statement",
"valueString" : "/*\n@description: Returns the Location resource specified by the given reference.\n*/\ndefine fluent function getLocation(reference Reference ):\n singleton from (\n [Location] L where L.id = reference.reference.getId()\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 46
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "FHIRHelpers"
},
{
"url" : "name",
"valueString" : "ToConcept"
},
{
"url" : "statement",
"valueString" : "/*\n@description: Converts the given FHIR [CodeableConcept](https://hl7.org/fhir/datatypes.html#CodeableConcept) value to a CQL Concept.\n*/\ndefine function ToConcept(concept FHIR.CodeableConcept):\n if concept is null then\n null\n else\n System.Concept {\n codes: concept.coding C return ToCode(C),\n display: concept.text.value\n }"
},
{
"url" : "displaySequence",
"valueInteger" : 47
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "TJCOverall"
},
{
"url" : "name",
"valueString" : "CalendarDayOfOrDayAfter"
},
{
"url" : "statement",
"valueString" : "define fluent function CalendarDayOfOrDayAfter(StartValue DateTime):\n Interval [date from (StartValue), date from (StartValue) + 1 day]"
},
{
"url" : "displaySequence",
"valueInteger" : 48
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "VTE"
},
{
"url" : "name",
"valueString" : "StartOfFirstICU"
},
{
"url" : "statement",
"valueString" : "define fluent function \"StartOfFirstICU\"(Encounter Encounter ):\n\tstart of Encounter.firstInpatientIntensiveCareUnit().period"
},
{
"url" : "displaySequence",
"valueInteger" : 49
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CQMCommon"
},
{
"url" : "name",
"valueString" : "firstInpatientIntensiveCareUnit"
},
{
"url" : "statement",
"valueString" : "/*\n@description: First Inpatient Intensive Care Unit returns the first intensive care unit for the given encounter, without considering any immediately prior emergency department visit.\n*/\ndefine fluent function firstInpatientIntensiveCareUnit(Encounter Encounter ):\n First((Encounter.location)HospitalLocation\n \t\t\twhere GetLocation(HospitalLocation.location).type in \"Intensive Care Unit\"\n \t\t\t\tand HospitalLocation.period during Encounter.period\n \t\t\tsort by start of period\n \t)"
},
{
"url" : "displaySequence",
"valueInteger" : 50
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CQMCommon"
},
{
"url" : "name",
"valueString" : "GetLocation"
},
{
"url" : "statement",
"valueString" : "/*\n@description: Returns the Location resource specified by the given reference\n@deprecated: This function is deprecated. Use the fluent function `getLocation()` instead.\n*/\ndefine function \"GetLocation\"(reference Reference ):\n singleton from (\n [Location] L where L.id = reference.reference.getId()\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 51
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "QICoreCommon"
},
{
"url" : "name",
"valueString" : "isActive"
},
{
"url" : "statement",
"valueString" : "/* Candidates for FHIRCommon */\n\n/*\n@description: Returns true if the given condition has a clinical status of active, recurrence, or relapse\n*/\ndefine fluent function isActive(condition Condition):\n condition.clinicalStatus ~ \"active\"\n or condition.clinicalStatus ~ \"recurrence\"\n or condition.clinicalStatus ~ \"relapse\""
},
{
"url" : "displaySequence",
"valueInteger" : 52
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "QICoreCommon"
},
{
"url" : "name",
"valueString" : "earliest"
},
{
"url" : "statement",
"valueString" : "/*\n@description: Given an interval, return the starting point if the interval has a starting boundary specified,\notherwise, return the ending point\n*/\ndefine fluent function earliest(choice Choice<DateTime, Quantity, Interval<DateTime>, Interval<Quantity>> ):\n (choice.toInterval()) period\n return\n if (period.\"hasStart\"()) then start of period\n else end of period"
},
{
"url" : "displaySequence",
"valueInteger" : 53
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "VTE"
},
{
"url" : "name",
"valueString" : "FromDayOfStartOfHospitalizationToDayAfterFirstICU"
},
{
"url" : "statement",
"valueString" : "define fluent function \"FromDayOfStartOfHospitalizationToDayAfterFirstICU\"(Encounter Encounter ):\n\tInterval[date from (start of Encounter.hospitalizationWithObservation()), date from (Encounter.StartOfFirstICU()) + 1 day]"
},
{
"url" : "displaySequence",
"valueInteger" : 54
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CQMCommon"
},
{
"url" : "name",
"valueString" : "hospitalizationWithObservation"
},
{
"url" : "statement",
"valueString" : "/*\n@description: Hospitalization with Observation returns the total interval from the start of any immediately prior emergency department visit through the observation visit to the discharge of the given encounter\n*/\ndefine fluent function hospitalizationWithObservation(TheEncounter Encounter ):\n TheEncounter Visit\n \t\tlet ObsVisit: Last([Encounter: \"Observation Services\"] LastObs\n \t\t\t\twhere LastObs.status = 'finished'\n and LastObs.period ends 1 hour or less on or before start of Visit.period\n \t\t\t\tsort by end of period\n \t\t\t),\n \t\t\tVisitStart: Coalesce(start of ObsVisit.period, start of Visit.period),\n \t\t\tEDVisit: Last([Encounter: \"Emergency Department Visit\"] LastED\n \t\t\t\twhere LastED.status = 'finished'\n and LastED.period ends 1 hour or less on or before VisitStart\n \t\t\t\tsort by end of period\n \t\t\t)\n \t\treturn Interval[Coalesce(start of EDVisit.period, VisitStart), end of Visit.period]"
},
{
"url" : "displaySequence",
"valueInteger" : 55
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "FHIRHelpers"
},
{
"url" : "name",
"valueString" : "ToString"
},
{
"url" : "statement",
"valueString" : "define function ToString(value uri): value.value"
},
{
"url" : "displaySequence",
"valueInteger" : 56
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "FHIRHelpers"
},
{
"url" : "name",
"valueString" : "ToCode"
},
{
"url" : "statement",
"valueString" : "/*\n@description: Converts the given FHIR [Coding](https://hl7.org/fhir/datatypes.html#Coding) value to a CQL Code.\n*/\ndefine function ToCode(coding FHIR.Coding):\n if coding is null then\n null\n else\n System.Code {\n code: coding.code.value,\n system: coding.system.value,\n version: coding.version.value,\n display: coding.display.value\n }"
},
{
"url" : "displaySequence",
"valueInteger" : 57
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CQMCommon"
},
{
"url" : "name",
"valueString" : "lengthInDays"
},
{
"url" : "statement",
"valueString" : "/*\n@description: Calculates the difference in calendar days between the start and end of the given interval.\n*/\ndefine fluent function lengthInDays(Value Interval<DateTime> ):\n difference in days between start of Value and end of Value"
},
{
"url" : "displaySequence",
"valueInteger" : 58
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
}
],
"name" : "EffectiveDataRequirements",
"status" : "active",
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/library-type",
"code" : "module-definition"
}
]
},
"relatedArtifact" : [
{
"type" : "depends-on",
"display" : "Library SDE",
"resource" : "Library/SupplementalDataElements|3.5.000"
},
{
"type" : "depends-on",
"display" : "Library VTE",
"resource" : "Library/VTE|8.8.000"
},
{
"type" : "depends-on",
"display" : "Library CQMCommon",
"resource" : "Library/CQMCommon|2.2.000"
},
{
"type" : "depends-on",
"display" : "Library FHIRHelpers",
"resource" : "Library/FHIRHelpers|4.4.000"
},
{
"type" : "depends-on",
"display" : "Library QICoreCommon",
"resource" : "Library/QICoreCommon|2.1.000"
},
{
"type" : "depends-on",
"display" : "Library TJC",
"resource" : "Library/TJCOverall|8.14.000"
},
{
"type" : "depends-on",
"display" : "Code system AdministrativeGender",
"resource" : "http://hl7.org/fhir/administrative-gender"
},
{
"type" : "depends-on",
"display" : "Code system ConditionClinicalStatusCodes",
"resource" : "http://terminology.hl7.org/CodeSystem/condition-clinical"
},
{
"type" : "depends-on",
"display" : "Code system ConditionVerificationStatusCodes",
"resource" : "http://terminology.hl7.org/CodeSystem/condition-ver-status"
},
{
"type" : "depends-on",
"display" : "Code system LOINC",
"resource" : "http://loinc.org"
},
{
"type" : "depends-on",
"display" : "Value set Encounter Inpatient",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307"
},
{
"type" : "depends-on",
"display" : "Value set Obstetrical or Pregnancy Related Conditions",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.263"
},
{
"type" : "depends-on",
"display" : "Value set Venous Thromboembolism",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.279"
},
{
"type" : "depends-on",
"display" : "Value set Obstetrics VTE",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.264"
},
{
"type" : "depends-on",
"display" : "Value set Intensive Care Unit",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.206"
},
{
"type" : "depends-on",
"display" : "Value set Low Dose Unfractionated Heparin for VTE Prophylaxis",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.39"
},
{
"type" : "depends-on",
"display" : "Value set Subcutaneous route",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.223"
},
{
"type" : "depends-on",
"display" : "Value set Low Molecular Weight Heparin for VTE Prophylaxis",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.219"
},
{
"type" : "depends-on",
"display" : "Value set Injectable Factor Xa Inhibitor for VTE Prophylaxis",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.211"
},
{
"type" : "depends-on",
"display" : "Value set Warfarin",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.232"
},
{
"type" : "depends-on",
"display" : "Value set Rivaroxaban for VTE Prophylaxis",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.50"
},
{
"type" : "depends-on",
"display" : "Value set Application of Intermittent Pneumatic Compression Devices",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.65"
},
{
"type" : "depends-on",
"display" : "Value set Application of Venous Foot Pumps",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.64"
},
{
"type" : "depends-on",
"display" : "Value set Application of Graduated Compression Stockings",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.66"
},
{
"type" : "depends-on",
"display" : "Value set General or Neuraxial Anesthesia",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.1743"
},
{
"type" : "depends-on",
"display" : "Value set Oral Factor Xa Inhibitor for VTE Prophylaxis or VTE Treatment",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.134"
},
{
"type" : "depends-on",
"display" : "Value set Atrial Fibrillation or Flutter",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.202"
},
{
"type" : "depends-on",
"display" : "Value set Hip Replacement Surgery",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.259"
},
{
"type" : "depends-on",
"display" : "Value set Knee Replacement Surgery",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.261"
},
{
"type" : "depends-on",
"display" : "Value set Low Risk",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.400"
},
{
"type" : "depends-on",
"display" : "Value set INR",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.213"
},
{
"type" : "depends-on",
"display" : "Value set Unfractionated Heparin",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.218"
},
{
"type" : "depends-on",
"display" : "Value set Intravenous route",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.222"
},
{
"type" : "depends-on",
"display" : "Value set Direct Thrombin Inhibitor",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.205"
},
{
"type" : "depends-on",
"display" : "Value set Glycoprotein IIb/IIIa Inhibitors",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.41"
},
{
"type" : "depends-on",
"display" : "Value set Observation Services",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.143"
},
{
"type" : "depends-on",
"display" : "Value set Emergency Department Visit",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292"
},
{
"type" : "depends-on",
"display" : "Value set Medical Reason For Not Providing Treatment",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.473"
},
{
"type" : "depends-on",
"display" : "Value set Venous foot pumps",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.230"
},
{
"type" : "depends-on",
"display" : "Value set Intermittent pneumatic compression devices",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.214"
},
{
"type" : "depends-on",
"display" : "Value set Graduated compression stockings",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.256"
},
{
"type" : "depends-on",
"display" : "Value set Patient Refusal",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.93"
},
{
"type" : "depends-on",
"display" : "Value set Payer Type",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"
},
{
"type" : "depends-on",
"display" : "Value set General Surgery",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.255"
},
{
"type" : "depends-on",
"display" : "Value set Gynecological Surgery",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.257"
},
{
"type" : "depends-on",
"display" : "Value set Hip Fracture Surgery",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.258"
},
{
"type" : "depends-on",
"display" : "Value set Intracranial Neurosurgery",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.260"
},
{
"type" : "depends-on",
"display" : "Value set Urological Surgery",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.272"
},
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"name" : "IntensiveCareUnitVenousThromboembolismProphylaxisFHIR",
"title" : "Intensive Care Unit Venous Thromboembolism ProphylaxisFHIR",
"status" : "draft",
"experimental" : false,
"date" : "2024-12-18T16:19:07+00:00",
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"description" : "This measure assesses the number of patients who received Venous Thromboembolism (VTE) prophylaxis or have documentation why no VTE prophylaxis was given the day of or the day after the initial admission (or transfer) to the Intensive Care Unit (ICU) or surgery end date for surgeries that start the day of or the day after ICU admission (or transfer)",
"purpose" : "UNKNOWN",
"usage" : "The definition of an ICU for the purpose of the measures noted above is that used by the CDC in the NHSN Patient Safety Project (CDC, 2022). An intensive care unit can be defined as a nursing care area that provides intensive observation, diagnosis, and therapeutic procedures for adults and/or children who are critically ill. An ICU excludes nursing areas that provide step-down, intermediate care or telemetry only and specialty care areas. Reasons for no pharmacological and no mechanical VTE prophylaxis must be explicitly documented by the MD/APN/PA or pharmacist and linked with VTE prophylaxis. Ambulation alone is not a sufficient reason for not administering VTE prophylaxis. In order for ambulation/patient ambulating to be considered as an acceptable reason, there needs to be explicit documentation, e.g., \"patient out of bed and ambulating in halls - no VTE prophylaxis needed.\" The denominator population includes patients with inpatient hospitalizations and patients from Acute Hospital Care at Home programs, who are treated and billed as inpatients but receive care in their home. This eCQM is an episode-based measure. An episode is defined as each inpatient hospitalization or encounter that ends during the measurement period. This FHIR-based measure has been derived from the QDM-based measure: CMS190v13. Please refer to the HL7 QI-Core Implementation Guide (https://hl7.org/fhir/us/qicore/STU4.1.1/) for more information on QI-Core and mapping recommendations from QDM to QI-Core 4.1.1 (https://hl7.org/fhir/us/qicore/STU4.1.1/qdm-to-qicore.html).",
"copyright" : "Measure specifications are in the Public Domain. LOINC(R) copyright 2004-2023 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2023 International Health Terminology Standards Development Organisation. ICD-10 copyright 2023 World Health Organization. All Rights Reserved.",
"effectivePeriod" : {
"start" : "2025-01-01",
"end" : "2025-12-31"
},
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],
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"disclaimer" : "These performance measures are not clinical guidelines and do not establish a standard of medical care, and have not been tested for all potential applications. The measures and specifications are provided without warranty.",
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"code" : "proportion",
"display" : "Proportion"
}
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},
"rationale" : "Venous Thromboembolism (VTE) is a known complication of hospitalization, frequently extending the length of stay and increasing hospital mortality (Maynard, 2016). Approximately 20% of VTE are associated with a surgical procedure (Henke et al., 2020). Almost all hospitalized patients have at least one risk factor for VTE, and approximately 40% have three or more risk factors. Without thromboprophylaxis, the incidence of objectively confirmed, hospital-acquired deep-vein thrombosis (DVT) is approximately 10% to 40% among medical or general surgical patients and 40% to 60% following major orthopedic surgery (Geerts et al., 2008). Commonly, criteria for admission to the Intensive Care Unit (ICU) itself puts patients at an increased risk for developing VTE and subsequent increased risk of morbidity from pulmonary embolism (PE). Some risk factors are related to the acute illness present that allowed for the admission to the ICU unit, and some risk factors may be acquired during the ICU admission due to subsequent medical treatments, for example limitations of mobility, presence of central venous lines or mechanical ventilation and subsequent pharmacological paralysis. Reports of DVT in the population of ICU patients vary in relation to the acuity of the illness in this population. DVT in ICU patients diagnosed with routine venography or Doppler ultrasound found ranges between 10% to 100%. Five studies prospectively screened patients who were not receiving thromboprophylaxis during their ICU stays. The rates of DVT using Fibrinogen Uptake Test, Doppler Ultrasound or venography ranged from 13 to 31% (Geerts et al., 2008). It is essential for all ICUs to assess each patient upon admission to the ICU unit, a change in level of status, for the need for VTE prophylaxis due to the above increased development of risk factors (Geerts et al., 2004). American Society of Hematology (ASH) 2018 VTE prophylaxis guidelines strongly recommend pharmacological prophylaxis using unfractionated heparin (UFH), low molecular weight heparin (LMWH) or fondaparinux for acutely and critically ill hospitalized medical patients, unless contraindicated. The use of mechanical prophylaxis is an acceptable alternative for patients with increased risk of bleeding and preferred over no prophylaxis. ASH 2019 guidelines for surgical patients similarly recommend pharmacological or mechanical prophylaxis over no VTE prophylaxis. Some select surgeries have previously been monitored in the Surgical Care Improvement Project; since performance on these surgeries has achieved very high levels, they are not included in this measure.",
"clinicalRecommendationStatement" : "Failure to recognize and protect patients at risk for venous thromboembolism (VTE) increases the chances for critically ill hospitalized patients for developing a deep vein thrombosis or dying from a pulmonary embolism. Screening all patients is the only evidence based practice in reducing incidence of disease. All intensive care unit (ICU) patients should be evaluated for primary VTE prophylaxis, and given appropriate prophylaxis when indicated.",
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"description" : "Inpatient hospitalizations for patients age 18 and older, discharged from hospital inpatient acute care without a diagnosis of venous thromboembolism (VTE) or obstetrics that ends during the measurement period",
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},
{
"id" : "70838E02-8A05-4B6F-92C4-B623EC871103",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "denominator",
"display" : "Denominator"
}
]
},
"description" : "Inpatient hospitalizations for patients directly admitted or transferred to ICU during the hospitalization",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Denominator"
}
},
{
"id" : "296628E9-82AF-4ECC-8294-DD79485E736F",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "denominator-exclusion",
"display" : "Denominator Exclusion"
}
]
},
"description" : "- Inpatient hospitalizations for patients who have a hospital length of stay (LOS) less than 2 days - Inpatient hospitalizations for patients with a principal procedure of surgical care improvement Project (SCIP) VTE selected surgeries that end the day of or the day after ICU admission or transfer - Inpatient hospitalizations for patients with comfort measures documented anytime between the day of arrival and the day after ICU admission or transfer - Inpatient hospitalizations for patients with comfort measures documented by the day after surgery end date for surgeries that end the day of or the day after ICU admission or transfer",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Denominator Exclusions"
}
},
{
"id" : "95E30AD0-31E8-453D-9554-F8A560467009",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "numerator",
"display" : "Numerator"
}
]
},
"description" : "Inpatient hospitalizations for patients who received VTE prophylaxis: - the day of or the day after ICU admission (or transfer) - the day of or the day after surgery end date (for surgeries that end the day of or the day after ICU admission or transfer) Inpatient hospitalizations for patients who have documentation of a reason why no VTE prophylaxis was given: - between the day of arrival and the day after ICU admission (for patients directly admitted as inpatients to the ICU) - the day of or the day after surgery end date (for surgeries that end the day of or the day after ICU admission or transfer)",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Numerator"
}
},
{
"id" : "CACDC10F-3571-454C-B982-546111D7F51B",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "denominator-exception",
"display" : "Denominator Exception"
}
]
},
"description" : "Inpatient hospitalizations for patients with ICU LOS less than one day",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Denominator Exceptions"
}
}
]
}
],
"supplementalData" : [
{
"id" : "sde-ethnicity",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "supplemental-data"
}
]
}
],
"description" : "SDE Ethnicity",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "SDE Ethnicity"
}
},
{
"id" : "sde-payer",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "supplemental-data"
}
]
}
],
"description" : "SDE Payer",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "SDE Payer"
}
},
{
"id" : "sde-race",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "supplemental-data"
}
]
}
],
"description" : "SDE Race",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "SDE Race"
}
},
{
"id" : "sde-sex",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "supplemental-data"
}
]
}
],
"description" : "SDE Sex",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "SDE Sex"
}
}
]
}
IG © 2023+ cqframework. Package gov.healthit.ecqi.ecqms#2024.0.0 based on FHIR 4.0.1. Generated 2024-12-19
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