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" : "PCSBPScreeningFollowUpFHIR",
"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;\">Preventive Care and Screening Screening for High Blood Pressure and Follow Up DocumentedFHIR</td>\n </tr>\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Id: </b></th>\n <td style=\"padding-left: 4px;\">PCSBPScreeningFollowUpFHIR</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-PCSBPScreeningFollowUpFHIR.html\">Preventive Care and Screening Screening for High Blood Pressure and Follow Up DocumentedFHIR</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>CMS22FHIR</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:1b17d846-cbe0-49fa-b503-518addf19fb0</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:b7b775e9-0c0d-4f9b-8457-b7ad1a255f80</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>22FHIR</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;\">Centers for Medicare & Medicaid Services (CMS)</td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Author: </b></th>\n <td style=\"padding-left: 4px;\">Mathematica</td>\n </tr>\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Description: </b></th>\n <td style=\"padding-left: 4px;\"><div><p>Percentage of patient visits for patients aged 18 years and older seen during the measurement period who were screened for high blood pressure AND a recommended follow-up plan is documented, as indicated, if blood pressure is elevated or hypertensive</p>\n</div></td>\n </tr>\n \n\n \n\n \n\n \n\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Purpose: </b></th>\n <td style=\"padding-left: 4px;\"><div><p>UNKNOWN</p>\n</div></td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Copyright: </b></th>\n <td style=\"padding-left: 4px;\"><div><p>Limited proprietary coding is contained in the measure specifications for convenience. Users of the proprietary code sets should obtain all necessary licenses from the owners of these code sets. CPT(R) contained in the Measure specifications is copyright 2004-2023 American Medical Association. LOINC(R) is copyright 2004-2023 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2023 International Health Terminology Standards Development Organisation. ICD-10 is copyright 2023 World Health Organization. All Rights Reserved.</p>\n</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 "AS IS" WITHOUT WARRANTY OF ANY KIND. Due to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM].</p>\n</div></td>\n </tr>\n \n\n \n\n \n\n \n <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>Hypertension is a prevalent condition that affects approximately 66.9 million people in the United States. It is estimated that about 20-40 percent of the adult population has hypertension; the majority of people over age 65 have a hypertension diagnosis (Appleton et al., 2013 and Luehr et al., 2012). Winter (2013) noted that 1 in 3 American adults have hypertension and the lifetime risk of developing hypertension is 90 percent. The African American population or non-Hispanic Blacks, the elderly, diabetics and those with chronic kidney disease are at increased risk of stroke, myocardial infarction and renal disease. Non-Hispanic Blacks have the highest prevalence at 38.6 percent (Winter et al., 2013). Hypertension is a major risk factor for ischemic heart disease, left ventricular hypertrophy, renal failure, stroke and dementia (Luehr et al., 2012). Prevention of hypertension and the treatment of established hypertension are complementary approaches to reducing cardiovascular disease risk in the population, but prevention of hypertension provides the optimal means of reducing risk and avoiding harmful consequences. Periodic blood pressure (BP) screening can identify individuals who develop elevated BP over time. More frequent BP screening may be particularly important for individuals with elevated atherosclerotic cardiovascular disease (ASCVD) risk (Whelton et al., 2018). Hypertension is the most common reason for adult office visits other than pregnancy. Garrison (2013) stated that in 2007, 42 million ambulatory visits were attributed to hypertension (Garrison & Oberhelman, 2013). It also has the highest utilization of prescription drugs. Numerous resources and treatment options are available, yet only about 40-50 percent of the hypertensive patients have their blood pressure under control (<140/90) (Appleton et al., 2013 and Luehr et al., 2012). In addition to medication non-compliance, poor outcomes are also attributed to poor adherence to lifestyle changes such as a low-sodium diet, weight loss, increased exercise and limiting alcohol intake. Many adults find it difficult to continue medications and lifestyle changes when they are asymptomatic. Symptoms of elevated blood pressure usually do not occur until secondary problems arise such as with vascular diseases (myocardial infarction, stroke, heart failure and renal insufficiency) (Luehr et al., 2012). Appropriate follow-up after blood pressure measurement is a pivotal component in preventing the progression of hypertension and the development of heart disease. Detection of marginally or fully elevated blood pressure by a specialty clinician warrants referral to a provider familiar with the management of hypertension and prehypertension. The American College of Cardiology/American Heart Association (ACC/AHA) 2017 Guidelines provide updated recommendations for ASCVD risk. For additional information please refer to the 2017 ACC/AHA guidelines: https://www.acc.org/latest-in-cardiology/ten-points-to-remember/2017/11/09/11/41/2017-guideline-for-high-blood-pressure-in-adults. Lifestyle modifications have demonstrated effectiveness in lowering blood pressure (U.S. Department of Health and Human Services, 2003). The synergistic effect of several lifestyle modifications results in greater benefits than a single modification alone. Baseline diagnostic/laboratory testing establishes if a co-existing underlying condition is the etiology of hypertension and evaluates if end organ damage from hypertension has already occurred. Landmark trials such as the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) have repeatedly proven the efficacy of pharmacologic therapy to control blood pressure and reduce the complications of hypertension. A review of 35 studies found that the pharmacist-led interventions involved medication counseling and patient education. Twenty-nine of the 35 studies showed statistically significant improvement in BP levels of the intervention groups at follow-up (Reeves et al., 2020). Follow-up intervals based on blood pressure control have been established by the 2017 ACC/AHA guideline and the United States Preventive Services Task Force (Whelton et al., 2018; USPSTF, 2021).</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>The U.S. Preventive Services Task Force (USPSTF, 2021) recommends screening for high blood pressure in adults aged 18 years and older. This is a grade A recommendation.</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;\">This eCQM is an episode-based measure. An episode is defined as each eligible encounter for patients aged 18 years and older during the measurement period. This measure should be reported for every visit. The measure requires that blood pressure measurements (i.e., diastolic and systolic) be obtained during each visit in order to determine the blood pressure reading used to evaluate if an intervention is needed. Both the systolic and diastolic blood pressure measurements are required for inclusion. If there are multiple blood pressures obtained during a patient visit, only the last, or most recent, pressure measurement will be used to evaluate the measure requirements. The intent of this measure is to screen patients for high blood pressure and provide recommended follow-up as indicated. The documented follow-up plan must be related to the current blood pressure reading as indicated, example: "Patient referred to primary care provider for BP management." Telehealth encounters are not eligible for this measure because the measure requires a clinical action that cannot be conducted via telehealth. 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: CMS 22v13. 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>64ef76cf56d636294b157c3f</b></th>\n </tr>\n \n \n <tr>\n <td>Initial Population:</td>\n\n \n \n <td>All patient visits for patients aged 18 years and older at the beginning of the measurement period</td>\n \n \n\n </tr>\n \n <tr>\n <td>Denominator:</td>\n\n \n \n <td>Equals Initial Population</td>\n \n \n\n </tr>\n \n <tr>\n <td>Denominator Exclusion:</td>\n\n \n \n <td>Patient has an active diagnosis of hypertension</td>\n \n \n\n </tr>\n \n <tr>\n <td>Numerator:</td>\n\n \n \n <td>Patient visits where patients were screened for high blood pressure AND have a recommended follow-up plan documented, as indicated, if the blood pressure is elevated or hypertensive</td>\n \n \n\n </tr>\n \n <tr>\n <td>Denominator Exception:</td>\n\n \n \n <td>Documentation of medical reason(s) for not screening for high blood pressure (e.g., patient is in an urgent or emergent medical situation where time is of the essence and to delay treatment would jeopardize the patient's health status). Documentation of patient reason(s) for not screening for blood pressure measurements or for not ordering an appropriate follow-up intervention if patient BP is elevated or hypertensive (e.g., patient refuses).</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 SDE Payer SDE Race SDE Sex </td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Libraries: </b></th>\n <td style=\"padding-left: 4px;\">\n <table class=\"grid-dict\">\n \n <tr>\n <td><a href=\"Library-PCSBPScreeningFollowUpFHIR.html\">PCSBPScreeningFollowUpFHIR</a></td>\n </tr>\n \n </table>\n </td>\n </tr>\n \n\n \n\n \n \n <tr>\n <th scope=\"row\"><b>Terminology and Other Dependencies: </b></th>\n <td style=\"padding-left: 4px;\">\n \n <li><code>Library/SupplementalDataElements|3.5.000</code></li>\n \n <li><code>Library/FHIRHelpers|4.4.000</code></li>\n \n <li><code>Library/QICoreCommon|2.1.000</code></li>\n \n <li><a href=\"http://hl7.org/fhir/R4/codesystem-administrative-gender.html\">AdministrativeGender</a></li>\n \n <li><a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-v3-ActCode.html\">ActCode</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=\"http://terminology.hl7.org/5.5.0/CodeSystem-condition-category.html\">Condition Category Codes</a></li>\n \n <li><a href=\"http://hl7.org/fhir/us/core/STU3.1.1/CodeSystem-condition-category.html\">US Core Condition Category Extension Codes</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.600.1920/expansion\">Encounter to Screen for Blood Pressure</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1108.125/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.125</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1581/expansion\">Lifestyle Recommendation</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.600.1510/expansion\">Weight Reduction Recommended</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.600.1515/expansion\">Dietary Recommendations</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.600.1518/expansion\">Recommendation to Increase Physical Activity</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1583/expansion\">Referral or Counseling for Alcohol Consumption</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1580/expansion\">Referral to Primary Care or Alternate Provider</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1047.514/expansion\">Finding of Elevated Blood Pressure or Hypertension</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1578/expansion\">Follow Up Within 4 Weeks</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.600.1482/expansion\">Laboratory Tests for Hypertension</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.1577/expansion\">Pharmacologic Therapy for Hypertension</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/2.16.840.1.113883.3.600.263/expansion\">Diagnosis of Hypertension</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1582/expansion\">Patient Declined</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1007/expansion\">Medical Reason</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 period\n \n status\n \n status.value\n \n class\n \n </td>\n <td>\n \n \n Encounter to Screen for Blood Pressure\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.600.1920/expansion\">Encounter to Screen for Blood Pressure</a></td>\n </tr>\n \n <tr>\n <td>Observation(<a href=\"http://hl7.org/fhir/R4/bp.html\">Observation Blood Pressure Profile</a>)</td>\n <td>\n \n effective\n \n status\n \n status.value\n \n component\n \n </td>\n <td>\n \n </td>\n <td/>\n </tr>\n \n <tr>\n <td>ServiceRequest(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-servicerequest.html\">QICoreServiceRequest</a>)</td>\n <td>\n \n code\n \n intent\n \n intent.value\n \n authoredOn\n \n authoredOn.value\n \n </td>\n <td>\n \n \n Lifestyle Recommendation\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1581/expansion\">Lifestyle Recommendation</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 authoredOn\n \n authoredOn.value\n \n </td>\n <td>\n \n \n Weight Reduction Recommended\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.600.1510/expansion\">Weight Reduction Recommended</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 authoredOn\n \n authoredOn.value\n \n </td>\n <td>\n \n \n Dietary Recommendations\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.600.1515/expansion\">Dietary Recommendations</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 authoredOn\n \n authoredOn.value\n \n </td>\n <td>\n \n \n Recommendation to Increase Physical Activity\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.600.1518/expansion\">Recommendation to Increase Physical Activity</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 authoredOn\n \n authoredOn.value\n \n </td>\n <td>\n \n \n Referral or Counseling for Alcohol Consumption\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1583/expansion\">Referral or Counseling for Alcohol Consumption</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 authoredOn\n \n authoredOn.value\n \n </td>\n <td>\n \n \n Follow Up Within 6 Months\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1108.125/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.125</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 authoredOn\n \n authoredOn.value\n \n </td>\n <td>\n \n </td>\n <td/>\n </tr>\n \n <tr>\n <td>ServiceRequest(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-servicerequest.html\">QICoreServiceRequest</a>)</td>\n <td>\n \n code\n \n intent\n \n intent.value\n \n authoredOn\n \n authoredOn.value\n \n </td>\n <td>\n \n </td>\n <td/>\n </tr>\n \n <tr>\n <td>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 authoredOn\n \n authoredOn.value\n \n </td>\n <td>\n \n \n Laboratory Tests for Hypertension\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.600.1482/expansion\">Laboratory Tests for Hypertension</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 authoredOn\n \n authoredOn.value\n \n </td>\n <td>\n \n \n Follow Up Within 6 Months\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1108.125/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.125</a></td>\n </tr>\n \n <tr>\n <td>ServiceRequest(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-servicerequest.html\">QICoreServiceRequest</a>)</td>\n <td>\n \n code\n \n authoredOn\n \n authoredOn.value\n \n intent\n \n intent.value\n \n </td>\n <td>\n \n \n Follow Up Within 4 Weeks\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1578/expansion\">Follow Up Within 4 Weeks</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 reasonCode\n \n intent\n \n intent.value\n \n authoredOn\n \n authoredOn.value\n \n </td>\n <td>\n \n \n Referral to Primary Care or Alternate Provider\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1580/expansion\">Referral to Primary Care or Alternate Provider</a></td>\n </tr>\n \n <tr>\n <td>Medication(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-medication.html\">QICoreMedication</a>)</td>\n <td>\n \n id\n \n </td>\n <td>\n \n </td>\n <td/>\n </tr>\n \n <tr>\n <td>MedicationRequest(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-medicationrequest.html\">QICoreMedicationRequest</a>)</td>\n <td>\n \n medication.reference\n \n authoredOn\n \n authoredOn.value\n \n status\n \n status.value\n \n </td>\n <td>\n \n </td>\n <td/>\n </tr>\n \n <tr>\n <td>MedicationRequest(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-medicationrequest.html\">QICoreMedicationRequest</a>)</td>\n <td>\n \n medication\n \n authoredOn\n \n authoredOn.value\n \n status\n \n status.value\n \n </td>\n <td>\n \n \n Pharmacologic Therapy for Hypertension\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.1577/expansion\">Pharmacologic Therapy for Hypertension</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>Condition(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-condition.html\">QICoreCondition</a>)</td>\n <td>\n \n code\n \n </td>\n <td>\n \n \n Diagnosis of Hypertension\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.600.263/expansion\">Diagnosis of Hypertension</a></td>\n </tr>\n \n <tr>\n <td>Observation(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-observationnotdone.html\">QICoreObservationNotDone</a>)</td>\n <td>\n \n code\n \n issued\n \n issued.value\n \n extension\n \n status\n \n status.value\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/qicore/STU4.1.1/StructureDefinition-qicore-observationnotdone.html\">QICoreObservationNotDone</a>)</td>\n <td>\n \n code\n \n issued\n \n issued.value\n \n extension\n \n status\n \n status.value\n \n </td>\n <td>\n \n </td>\n <td/>\n </tr>\n \n <tr>\n <td>ServiceRequest(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-servicenotrequested.html\">QICoreServiceNotRequested</a>)</td>\n <td>\n \n code\n \n extension\n \n status\n \n status.value\n \n authoredOn\n \n authoredOn.value\n \n </td>\n <td>\n \n \n Lifestyle Recommendation\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1581/expansion\">Lifestyle Recommendation</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 extension\n \n status\n \n status.value\n \n authoredOn\n \n authoredOn.value\n \n </td>\n <td>\n \n \n Lifestyle Recommendation\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1581/expansion\">Lifestyle Recommendation</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 extension\n \n status\n \n status.value\n \n authoredOn\n \n authoredOn.value\n \n </td>\n <td>\n \n \n Weight Reduction Recommended\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.600.1510/expansion\">Weight Reduction Recommended</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 extension\n \n status\n \n status.value\n \n authoredOn\n \n authoredOn.value\n \n </td>\n <td>\n \n \n Weight Reduction Recommended\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.600.1510/expansion\">Weight Reduction Recommended</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 extension\n \n status\n \n status.value\n \n authoredOn\n \n authoredOn.value\n \n </td>\n <td>\n \n \n Dietary Recommendations\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.600.1515/expansion\">Dietary Recommendations</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 extension\n \n status\n \n status.value\n \n authoredOn\n \n authoredOn.value\n \n </td>\n <td>\n \n \n Dietary Recommendations\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.600.1515/expansion\">Dietary Recommendations</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 extension\n \n status\n \n status.value\n \n authoredOn\n \n authoredOn.value\n \n </td>\n <td>\n \n \n Recommendation to Increase Physical Activity\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.600.1518/expansion\">Recommendation to Increase Physical Activity</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 extension\n \n status\n \n status.value\n \n authoredOn\n \n authoredOn.value\n \n </td>\n <td>\n \n \n Recommendation to Increase Physical Activity\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.600.1518/expansion\">Recommendation to Increase Physical Activity</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 extension\n \n status\n \n status.value\n \n authoredOn\n \n authoredOn.value\n \n </td>\n <td>\n \n \n Referral or Counseling for Alcohol Consumption\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1583/expansion\">Referral or Counseling for Alcohol Consumption</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 extension\n \n status\n \n status.value\n \n authoredOn\n \n authoredOn.value\n \n </td>\n <td>\n \n \n Referral or Counseling for Alcohol Consumption\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1583/expansion\">Referral or Counseling for Alcohol Consumption</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 extension\n \n status\n \n status.value\n \n authoredOn\n \n authoredOn.value\n \n </td>\n <td>\n \n </td>\n <td/>\n </tr>\n \n <tr>\n <td>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 extension\n \n status\n \n status.value\n \n authoredOn\n \n authoredOn.value\n \n </td>\n <td>\n \n </td>\n <td/>\n </tr>\n \n <tr>\n <td>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 extension\n \n status\n \n status.value\n \n authoredOn\n \n authoredOn.value\n \n </td>\n <td>\n \n \n Laboratory Tests for Hypertension\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.600.1482/expansion\">Laboratory Tests for Hypertension</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 extension\n \n status\n \n status.value\n \n authoredOn\n \n authoredOn.value\n \n </td>\n <td>\n \n \n Laboratory Tests for Hypertension\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.600.1482/expansion\">Laboratory Tests for Hypertension</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 extension\n \n status\n \n status.value\n \n authoredOn\n \n authoredOn.value\n \n </td>\n <td>\n \n \n Follow Up Within 6 Months\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1108.125/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.125</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 extension\n \n status\n \n status.value\n \n authoredOn\n \n authoredOn.value\n \n </td>\n <td>\n \n \n Follow Up Within 6 Months\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1108.125/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.125</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 extension\n \n status\n \n status.value\n \n authoredOn\n \n authoredOn.value\n \n </td>\n <td>\n \n \n Follow Up Within 4 Weeks\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1578/expansion\">Follow Up Within 4 Weeks</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 extension\n \n status\n \n status.value\n \n authoredOn\n \n authoredOn.value\n \n </td>\n <td>\n \n \n Follow Up Within 4 Weeks\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1578/expansion\">Follow Up Within 4 Weeks</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 extension\n \n status\n \n status.value\n \n authoredOn\n \n authoredOn.value\n \n </td>\n <td>\n \n \n Referral to Primary Care or Alternate Provider\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1580/expansion\">Referral to Primary Care or Alternate Provider</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 extension\n \n status\n \n status.value\n \n authoredOn\n \n authoredOn.value\n \n </td>\n <td>\n \n \n Referral to Primary Care or Alternate Provider\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1580/expansion\">Referral to Primary Care or Alternate Provider</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 status\n \n status.value\n \n </td>\n <td>\n \n \n Pharmacologic Therapy for Hypertension\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.1577/expansion\">Pharmacologic Therapy for Hypertension</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 status\n \n status.value\n \n </td>\n <td>\n \n \n Pharmacologic Therapy for Hypertension\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.1577/expansion\">Pharmacologic Therapy for Hypertension</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>virtual</td>\n <td>VR</td>\n <td><a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-v3-ActCode.html\">http://terminology.hl7.org/CodeSystem/v3-ActCode</a></td>\n </tr>\n \n <tr>\n <td>EKG 12 channel panel</td>\n <td>34534-8</td>\n <td><a href=\"https://loinc.org/\">http://loinc.org</a></td>\n </tr>\n \n <tr>\n <td>EKG study</td>\n <td>11524-6</td>\n <td><a href=\"https://loinc.org/\">http://loinc.org</a></td>\n </tr>\n \n <tr>\n <td>Problem List Item</td>\n <td>problem-list-item</td>\n <td><a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-condition-category.html\">http://terminology.hl7.org/CodeSystem/condition-category</a></td>\n </tr>\n \n <tr>\n <td>Health Concern</td>\n <td>health-concern</td>\n <td><a href=\"http://hl7.org/fhir/us/core/STU3.1.1/CodeSystem-condition-category.html\">http://hl7.org/fhir/us/core/CodeSystem/condition-category</a></td>\n </tr>\n \n <tr>\n <td>Systolic blood pressure</td>\n <td>8480-6</td>\n <td><a href=\"https://loinc.org/\">http://loinc.org</a></td>\n </tr>\n \n <tr>\n <td>Diastolic blood pressure</td>\n <td>8462-4</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> 64ef76cf56d636294b157c3f </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 "Qualifying Encounter during Measurement Period" QualifyingEncounter\n where AgeInYearsAt(start of "Measurement Period") >= 18</code></pre>\n \n </td>\n </tr>\n \n <tr>\n <td/>\n <td/>\n <td>Denominator</td>\n <td>\n \n <pre><code class=\"language-cql\">define "Denominator":\n "Initial Population"</code></pre>\n \n </td>\n </tr>\n \n <tr>\n <td/>\n <td/>\n <td>Denominator Exclusion</td>\n <td>\n \n <pre><code class=\"language-cql\">define "Denominator Exclusions":\n "Qualifying Encounter during Measurement Period" QualifyingEncounter\n with [Condition: "Diagnosis of Hypertension"] Hypertension\n such that ( Hypertension.isProblemListItem ( )\n or Hypertension.isHealthConcern ( )\n )\n and Hypertension.prevalenceInterval ( ) starts before or on day of QualifyingEncounter.period</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 Normal Blood Pressure Reading"\n union ( "Encounter with Elevated Blood Pressure Reading SBP 120 to 129 AND DBP less than 80 and Interventions" )\n union ( "Encounter with First Hypertensive Reading SBP Greater than or Equal to 130 OR DBP Greater than or Equal to 80 and Interventions" )\n union ( "Encounter with Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89 and Interventions" )\n union ( "Encounter with Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90 and Interventions" )</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 Medical Reason for Not Obtaining or Patient Declined Blood Pressure Measurement"\n union "Encounter with Order for Hypertension Follow Up Declined by Patient"</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>PCSBPScreeningFollowUpFHIR</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>PCSBPScreeningFollowUpFHIR</td>\n \n \n <td>Qualifying Encounter during Measurement Period</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Qualifying Encounter during Measurement Period":\n [Encounter: "Encounter to Screen for Blood Pressure"] ValidEncounter\n where ValidEncounter.period during day of "Measurement Period"\n and ValidEncounter.status ~ 'finished'\n and ValidEncounter.class !~ "virtual"</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>PCSBPScreeningFollowUpFHIR</td>\n \n \n <td>Encounter with Normal Blood Pressure Reading</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Encounter with Normal Blood Pressure Reading":\n "Qualifying Encounter during Measurement Period" QualifyingEncounter\n let EncounterLastBP: Last(["observation-bp"] BloodPressure\n where BloodPressure.effective.toInterval() ends during QualifyingEncounter.period\n and BloodPressure.status in { 'final', 'amended', 'corrected' }\n sort by start of effective.toInterval()\n )\n where EncounterLastBP.SystolicBP.value in Interval[1 'mm[Hg]', 120 'mm[Hg]' )\n and EncounterLastBP.DiastolicBP.value in Interval[1 'mm[Hg]', 80 'mm[Hg]' )</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>PCSBPScreeningFollowUpFHIR</td>\n \n \n <td>Encounter with Elevated Blood Pressure Reading SBP 120 to 129 AND DBP less than 80</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Encounter with Elevated Blood Pressure Reading SBP 120 to 129 AND DBP less than 80":\n "Qualifying Encounter during Measurement Period" QualifyingEncounter\n let EncounterLastBP: Last(["observation-bp"] BloodPressure\n where BloodPressure.effective.toInterval() ends during QualifyingEncounter.period\n and BloodPressure.status in { 'final', 'amended', 'corrected' }\n sort by start of effective.toInterval()\n )\n where ( EncounterLastBP.SystolicBP.value in Interval[120 'mm[Hg]', 129 'mm[Hg]']\n and EncounterLastBP.DiastolicBP.value in Interval[1 'mm[Hg]', 80 'mm[Hg]' )\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>PCSBPScreeningFollowUpFHIR</td>\n \n \n <td>Follow up with Rescreen Within 6 Months</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Follow up with Rescreen Within 6 Months":\n [ServiceRequest: "Follow Up Within 6 Months"] FollowUp\n where FollowUp.intent ~ 'order'</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>PCSBPScreeningFollowUpFHIR</td>\n \n \n <td>NonPharmacological Interventions</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "NonPharmacological Interventions":\n ( [ServiceRequest: "Lifestyle Recommendation"]\n union [ServiceRequest: "Weight Reduction Recommended"]\n union [ServiceRequest: "Dietary Recommendations"]\n union [ServiceRequest: "Recommendation to Increase Physical Activity"]\n union [ServiceRequest: "Referral or Counseling for Alcohol Consumption"] ) NonPharmaInterventions\n where NonPharmaInterventions.intent ~ 'order'</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>PCSBPScreeningFollowUpFHIR</td>\n \n \n <td>Referral to Alternate or Primary Healthcare Professional for Hypertensive Reading</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Referral to Alternate or Primary Healthcare Professional for Hypertensive Reading":\n [ServiceRequest: "Referral to Primary Care or Alternate Provider"] Referral\n where Referral.reasonCode in "Finding of Elevated Blood Pressure or Hypertension"\n and Referral.intent ~ 'order'</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>PCSBPScreeningFollowUpFHIR</td>\n \n \n <td>Encounter with Elevated Blood Pressure Reading SBP 120 to 129 AND DBP less than 80 and Interventions</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Encounter with Elevated Blood Pressure Reading SBP 120 to 129 AND DBP less than 80 and Interventions":\n ( "Encounter with Elevated Blood Pressure Reading SBP 120 to 129 AND DBP less than 80" ElevatedEncounter\n with "Follow up with Rescreen Within 6 Months" Twoto6MonthRescreen\n such that Twoto6MonthRescreen.authoredOn during day of ElevatedEncounter.period\n with "NonPharmacological Interventions" NonPharmInterventions\n such that NonPharmInterventions.authoredOn during day of ElevatedEncounter.period\n )\n union ( "Encounter with Elevated Blood Pressure Reading SBP 120 to 129 AND DBP less than 80" ElevatedEncounter\n with "Referral to Alternate or Primary Healthcare Professional for Hypertensive Reading" Referral\n such that Referral.authoredOn during day of ElevatedEncounter.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>PCSBPScreeningFollowUpFHIR</td>\n \n \n <td>Encounter with Hypertensive Reading Within Year Prior</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Encounter with Hypertensive Reading Within Year Prior":\n ( "Qualifying Encounter during Measurement Period" QualifyingEncounter\n let EncounterLastBP: Last(["observation-bp"] BloodPressure\n where BloodPressure.effective.toInterval() ends 1 year or less before or on start of QualifyingEncounter.period\n and BloodPressure.status in { 'final', 'amended', 'corrected' }\n sort by start of effective.toInterval()\n )\n where ( EncounterLastBP.SystolicBP.value > 0 'mm[Hg]'\n and EncounterLastBP.DiastolicBP.value > 0 'mm[Hg]'\n and ( EncounterLastBP.SystolicBP.value >= 130 'mm[Hg]'\n or EncounterLastBP.DiastolicBP.value >= 80 'mm[Hg]'\n )\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>PCSBPScreeningFollowUpFHIR</td>\n \n \n <td>Encounter with First Hypertensive Reading SBP Greater than or Equal to 130 OR DBP Greater than or Equal to 80</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 Hypertensive Reading SBP Greater than or Equal to 130 OR DBP Greater than or Equal to 80":\n ( "Qualifying Encounter during Measurement Period" QualifyingEncounter\n let EncounterLastBP: Last(["observation-bp"] BloodPressure\n where BloodPressure.effective.toInterval() ends during day of QualifyingEncounter.period\n sort by start of effective.toInterval()\n )\n where ( ( EncounterLastBP.SystolicBP.value > 0 'mm[Hg]'\n and EncounterLastBP.DiastolicBP.value > 0 'mm[Hg]'\n )\n and ( EncounterLastBP.SystolicBP.value >= 130 'mm[Hg]'\n or EncounterLastBP.DiastolicBP.value >= 80 'mm[Hg]'\n )\n )\n )\n except "Encounter with Hypertensive Reading Within Year Prior"</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>PCSBPScreeningFollowUpFHIR</td>\n \n \n <td>First Hypertensive Reading Interventions or Referral to Alternate Professional</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "First Hypertensive Reading Interventions or Referral to Alternate Professional":\n ( [ServiceRequest: "Follow Up Within 4 Weeks"] FourWeekRescreen\n with "NonPharmacological Interventions" NonPharmInterventionsHTN\n such that FourWeekRescreen.authoredOn during day of "Measurement Period"\n and NonPharmInterventionsHTN.authoredOn during day of "Measurement Period"\n and FourWeekRescreen.intent ~ 'order'\n )\n union ( "Referral to Alternate or Primary Healthcare Professional for Hypertensive Reading" )</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>PCSBPScreeningFollowUpFHIR</td>\n \n \n <td>Encounter with First Hypertensive Reading SBP Greater than or Equal to 130 OR DBP Greater than or Equal to 80 and Interventions</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 Hypertensive Reading SBP Greater than or Equal to 130 OR DBP Greater than or Equal to 80 and Interventions":\n "Encounter with First Hypertensive Reading SBP Greater than or Equal to 130 OR DBP Greater than or Equal to 80" FirstHTNEncounter\n with "First Hypertensive Reading Interventions or Referral to Alternate Professional" FirstHTNIntervention\n such that FirstHTNIntervention.authoredOn during day of FirstHTNEncounter.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>PCSBPScreeningFollowUpFHIR</td>\n \n \n <td>Encounter with Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Encounter with Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89":\n ( "Qualifying Encounter during Measurement Period" QualifyingEncounter\n let EncounterLastBP: Last(["observation-bp"] BloodPressure\n where BloodPressure.effective.toInterval() ends during day of QualifyingEncounter.period\n and BloodPressure.status in { 'final', 'amended', 'corrected' }\n sort by start of effective.toInterval()\n )\n where ( ( EncounterLastBP.SystolicBP.value in Interval[130 'mm[Hg]', 139 'mm[Hg]']\n or EncounterLastBP.DiastolicBP.value in Interval[80 'mm[Hg]', 89 'mm[Hg]']\n )\n and not ( EncounterLastBP.SystolicBP.value >= 140 'mm[Hg]'\n or EncounterLastBP.DiastolicBP.value >= 90 'mm[Hg]'\n )\n )\n and ( exists "Encounter with Hypertensive Reading Within Year Prior" )\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>PCSBPScreeningFollowUpFHIR</td>\n \n \n <td>Laboratory Test or ECG for Hypertension</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Laboratory Test or ECG for Hypertension":\n ( [ServiceRequest: "12 lead EKG panel"]\n union [ServiceRequest: "EKG study"]\n union [ServiceRequest: "Laboratory Tests for Hypertension"] ) EKGLab\n where EKGLab.intent ~ 'order'</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>PCSBPScreeningFollowUpFHIR</td>\n \n \n <td>Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89 and Interventions</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89 and Interventions":\n "Follow up with Rescreen Within 6 Months" Rescreen2to6\n with "Laboratory Test or ECG for Hypertension" LabECGIntervention\n such that Rescreen2to6.authoredOn during day of "Measurement Period"\n and LabECGIntervention.authoredOn during day of "Measurement Period"\n with "NonPharmacological Interventions" NonPharmSecondIntervention\n such that NonPharmSecondIntervention.authoredOn 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>PCSBPScreeningFollowUpFHIR</td>\n \n \n <td>Encounter with Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89 and Interventions</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Encounter with Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89 and Interventions":\n ( "Encounter with Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89" SecondHTNEncounterReading\n with "Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89 and Interventions" EncounterInterventions\n such that EncounterInterventions.authoredOn during day of SecondHTNEncounterReading.period\n )\n union ( "Encounter with Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89" SecondHTNEncounterReading\n with "Referral to Alternate or Primary Healthcare Professional for Hypertensive Reading" ReferralForHTN\n such that ReferralForHTN.authoredOn during day of SecondHTNEncounterReading.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>PCSBPScreeningFollowUpFHIR</td>\n \n \n <td>Encounter with Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Encounter with Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90":\n ( "Qualifying Encounter during Measurement Period" QualifyingEncounter\n let EncounterLastBP: Last(["observation-bp"] BloodPressure\n where BloodPressure.effective.toInterval() ends during QualifyingEncounter.period\n and BloodPressure.status in { 'final', 'amended', 'corrected' }\n sort by start of effective.toInterval()\n )\n where ( EncounterLastBP.SystolicBP.value > 0 'mm[Hg]'\n and EncounterLastBP.DiastolicBP.value > 0 'mm[Hg]'\n and ( EncounterLastBP.SystolicBP.value >= 140 'mm[Hg]'\n or EncounterLastBP.DiastolicBP.value >= 90 'mm[Hg]'\n )\n )\n and ( exists "Encounter with Hypertensive Reading Within Year Prior" )\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>PCSBPScreeningFollowUpFHIR</td>\n \n \n <td>Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90 Interventions</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90 Interventions":\n ( [ServiceRequest: "Follow Up Within 4 Weeks"] WeeksRescreen\n with "Laboratory Test or ECG for Hypertension" ECGLabTest\n such that WeeksRescreen.authoredOn during day of "Measurement Period"\n and ECGLabTest.authoredOn during day of "Measurement Period"\n and WeeksRescreen.intent ~ 'order'\n and ECGLabTest.intent ~ 'order'\n with "NonPharmacological Interventions" HTNInterventions\n such that HTNInterventions.authoredOn during day of "Measurement Period"\n with ["MedicationRequest": "Pharmacologic Therapy for Hypertension"] Medications\n such that Medications.authoredOn during day of "Measurement Period"\n and Medications.status ~ 'active'\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>PCSBPScreeningFollowUpFHIR</td>\n \n \n <td>Encounter with Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90 and Interventions</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Encounter with Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90 and Interventions":\n ( "Encounter with Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90" SecondHTNEncounterReading140Over90\n with "Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90 Interventions" SecondHTN140Over90Interventions\n such that SecondHTN140Over90Interventions.authoredOn during day of SecondHTNEncounterReading140Over90.period\n )\n union "Encounter with Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90" SecondHTNEncounterReading140Over90\n with "Referral to Alternate or Primary Healthcare Professional for Hypertensive Reading" ReferralToProfessional\n such that ReferralToProfessional.authoredOn during day of SecondHTNEncounterReading140Over90.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>PCSBPScreeningFollowUpFHIR</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 Normal Blood Pressure Reading"\n union ( "Encounter with Elevated Blood Pressure Reading SBP 120 to 129 AND DBP less than 80 and Interventions" )\n union ( "Encounter with First Hypertensive Reading SBP Greater than or Equal to 130 OR DBP Greater than or Equal to 80 and Interventions" )\n union ( "Encounter with Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89 and Interventions" )\n union ( "Encounter with Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90 and Interventions" )</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>PCSBPScreeningFollowUpFHIR</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 "Qualifying Encounter during Measurement Period" QualifyingEncounter\n where AgeInYearsAt(start of "Measurement Period") >= 18</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>PCSBPScreeningFollowUpFHIR</td>\n \n \n <td>Denominator</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Denominator":\n "Initial Population"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SupplementalDataElements</td>\n \n \n <td>SDE Payer</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "SDE Payer":\n [Coverage: type in "Payer Type"] Payer\n return {\n code: Payer.type,\n period: Payer.period\n }</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>PCSBPScreeningFollowUpFHIR</td>\n \n \n <td>SDE Payer</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "SDE Payer":\n SDE."SDE Payer"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SupplementalDataElements</td>\n \n \n <td>SDE Ethnicity</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "SDE Ethnicity":\n Patient.ethnicity E\n return Tuple {\n codes: { E.ombCategory } union E.detailed,\n display: E.text\n }</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>PCSBPScreeningFollowUpFHIR</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>PCSBPScreeningFollowUpFHIR</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 "Qualifying Encounter during Measurement Period" QualifyingEncounter\n with [Condition: "Diagnosis of Hypertension"] Hypertension\n such that ( Hypertension.isProblemListItem ( )\n or Hypertension.isHealthConcern ( )\n )\n and Hypertension.prevalenceInterval ( ) starts before or on day of QualifyingEncounter.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>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>PCSBPScreeningFollowUpFHIR</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>PCSBPScreeningFollowUpFHIR</td>\n \n \n <td>Encounter with Medical Reason for Not Obtaining or Patient Declined Blood Pressure Measurement</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Encounter with Medical Reason for Not Obtaining or Patient Declined Blood Pressure Measurement":\n "Qualifying Encounter during Measurement Period" QualifyingEncounter\n with ( [ObservationNotDone: code ~ "Systolic blood pressure"]\n union [ObservationNotDone: code ~ "Diastolic blood pressure"] ) NoBPScreen\n such that NoBPScreen.issued during day of QualifyingEncounter.period\n and ( NoBPScreen.notDoneReason in "Patient Declined"\n or NoBPScreen.notDoneReason in "Medical Reason"\n )\n and NoBPScreen.status = 'cancelled'</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>PCSBPScreeningFollowUpFHIR</td>\n \n \n <td>NonPharmacological Intervention Not Ordered</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "NonPharmacological Intervention Not Ordered":\n ( [ServiceNotRequested: "Lifestyle Recommendation"]\n union [ServiceNotRequested: "Weight Reduction Recommended"]\n union [ServiceNotRequested: "Dietary Recommendations"]\n union [ServiceNotRequested: "Recommendation to Increase Physical Activity"]\n union [ServiceNotRequested: "Referral or Counseling for Alcohol Consumption"] ) NonPharmIntervention\n where NonPharmIntervention.reasonRefused in "Patient Declined"\n and NonPharmIntervention.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>PCSBPScreeningFollowUpFHIR</td>\n \n \n <td>Laboratory Test or ECG for Hypertension Not Ordered</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Laboratory Test or ECG for Hypertension Not Ordered":\n ( [ServiceNotRequested: code = "12 lead EKG panel"]\n union [ServiceNotRequested: code = "EKG study"]\n union [ServiceNotRequested: "Laboratory Tests for Hypertension"] ) LabECGNotDone\n where LabECGNotDone.reasonRefused in "Patient Declined"</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>PCSBPScreeningFollowUpFHIR</td>\n \n \n <td>Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89 Interventions Declined</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89 Interventions Declined":\n ( ( ( [ServiceNotRequested: "Referral to Primary Care or Alternate Provider"]\n union [ServiceNotRequested: "Follow Up Within 6 Months"] ) SecondHTNDeclinedReferralAndFollowUp\n where SecondHTNDeclinedReferralAndFollowUp.reasonRefused in "Patient Declined"\n and SecondHTNDeclinedReferralAndFollowUp.status = 'completed'\n )\n union "Laboratory Test or ECG for Hypertension Not Ordered"\n union "NonPharmacological Intervention Not Ordered"\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>PCSBPScreeningFollowUpFHIR</td>\n \n \n <td>Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90 Interventions Declined</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90 Interventions Declined":\n ( ( ( [ServiceNotRequested: "Referral to Primary Care or Alternate Provider"]\n union [ServiceNotRequested: "Follow Up Within 4 Weeks"] ) SecondHTN140Over90ReferralFollowUpNotDone\n where SecondHTN140Over90ReferralFollowUpNotDone.reasonRefused in "Patient Declined"\n and SecondHTN140Over90ReferralFollowUpNotDone.status = 'completed'\n )\n union ( [MedicationNotRequested: "Pharmacologic Therapy for Hypertension"] MedicationRequestNotOrdered\n where MedicationRequestNotOrdered.status = 'completed'\n )\n union "Laboratory Test or ECG for Hypertension Not Ordered"\n union "NonPharmacological Intervention Not Ordered"\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>PCSBPScreeningFollowUpFHIR</td>\n \n \n <td>Encounter with Order for Hypertension Follow Up Declined by Patient</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Encounter with Order for Hypertension Follow Up Declined by Patient":\n ( ( "Encounter with Elevated Blood Pressure Reading SBP 120 to 129 AND DBP less than 80" ElevatedBPEncounter\n with ( [ServiceNotRequested: "Referral to Primary Care or Alternate Provider"]\n union [ServiceNotRequested: "Follow Up Within 6 Months"] ) ElevatedBPDeclinedInterventions\n such that ElevatedBPDeclinedInterventions.reasonRefused in "Patient Declined"\n and ElevatedBPDeclinedInterventions.authoredOn during day of ElevatedBPEncounter.period\n and ElevatedBPDeclinedInterventions.status = 'completed'\n )\n union ( "Encounter with Elevated Blood Pressure Reading SBP 120 to 129 AND DBP less than 80" ElevatedBPEncounter\n with "NonPharmacological Intervention Not Ordered" NotOrdered\n such that NotOrdered.authoredOn during day of ElevatedBPEncounter.period\n )\n union ( "Encounter with First Hypertensive Reading SBP Greater than or Equal to 130 OR DBP Greater than or Equal to 80" FirstHTNEncounter\n with ( [ServiceNotRequested: "Follow Up Within 4 Weeks"]\n union [ServiceNotRequested: "Referral to Primary Care or Alternate Provider"] ) FirstHTNDeclinedInterventions\n such that FirstHTNDeclinedInterventions.reasonRefused in "Patient Declined"\n and FirstHTNDeclinedInterventions.authoredOn during day of FirstHTNEncounter.period\n and FirstHTNDeclinedInterventions.status = 'completed'\n )\n union ( "Encounter with First Hypertensive Reading SBP Greater than or Equal to 130 OR DBP Greater than or Equal to 80" FirstHTNEncounter\n with "NonPharmacological Intervention Not Ordered" NoNonPharm\n such that NoNonPharm.authoredOn during day of FirstHTNEncounter.period\n )\n union ( "Encounter with Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89" SecondHTNEncounter\n with "Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89 Interventions Declined" SecondHTNDeclinedInterventions\n such that SecondHTNDeclinedInterventions.authoredOn during day of SecondHTNEncounter.period\n )\n union ( "Encounter with Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90" SecondHTN140Over90Encounter\n with "Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90 Interventions Declined" SecondHTN140Over90DeclinedInterventions\n such that SecondHTN140Over90DeclinedInterventions.authoredOn during day of SecondHTN140Over90Encounter.period\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>PCSBPScreeningFollowUpFHIR</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 Medical Reason for Not Obtaining or Patient Declined Blood Pressure Measurement"\n union "Encounter with Order for Hypertension Follow Up Declined by Patient"</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>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>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>QICoreCommon</td>\n \n \n <td>isProblemListItem</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">/*\n@description: Returns true if the given condition is a problem list item.\n*/\ndefine fluent function isProblemListItem(condition Condition):\n exists (condition.category C\n where C ~ "problem-list-item"\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>isHealthConcern</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">/*\n@description: Returns true if the given condition is a health concern\n*/\ndefine fluent function isHealthConcern(condition Condition):\n exists (condition.category C\n where C ~ "health-concern"\n )</code></pre>\n </td>\n \n </tr>\n \n </table>\n </td>\n </tr>\n \n \n \n\n </table>\n</div>"
},
"contained" : [
{
"resourceType" : "Library",
"id" : "effective-data-requirements",
"extension" : [
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
"valueCoding" : {
"system" : "http://hl7.org/fhir/administrative-gender",
"code" : "M",
"display" : "Male"
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
"valueCoding" : {
"system" : "http://hl7.org/fhir/administrative-gender",
"code" : "F",
"display" : "Female"
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
"valueCoding" : {
"system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"code" : "VR",
"display" : "virtual"
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "34534-8",
"display" : "EKG 12 channel panel"
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "11524-6",
"display" : "EKG study"
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
"valueCoding" : {
"system" : "http://terminology.hl7.org/CodeSystem/condition-category",
"code" : "problem-list-item",
"display" : "Problem List Item"
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
"valueCoding" : {
"system" : "http://hl7.org/fhir/us/core/CodeSystem/condition-category",
"code" : "health-concern",
"display" : "Health Concern"
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "8480-6",
"display" : "Systolic blood pressure"
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "8462-4",
"display" : "Diastolic blood pressure"
}
},
{
"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" : "PCSBPScreeningFollowUpFHIR"
},
{
"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" : "PCSBPScreeningFollowUpFHIR"
},
{
"url" : "name",
"valueString" : "Qualifying Encounter during Measurement Period"
},
{
"url" : "statement",
"valueString" : "define \"Qualifying Encounter during Measurement Period\":\n [Encounter: \"Encounter to Screen for Blood Pressure\"] ValidEncounter\n where ValidEncounter.period during day of \"Measurement Period\"\n and ValidEncounter.status ~ 'finished'\n and ValidEncounter.class !~ \"virtual\""
},
{
"url" : "displaySequence",
"valueInteger" : 2
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "PCSBPScreeningFollowUpFHIR"
},
{
"url" : "name",
"valueString" : "Encounter with Normal Blood Pressure Reading"
},
{
"url" : "statement",
"valueString" : "define \"Encounter with Normal Blood Pressure Reading\":\n \"Qualifying Encounter during Measurement Period\" QualifyingEncounter\n let EncounterLastBP: Last([\"observation-bp\"] BloodPressure\n where BloodPressure.effective.toInterval() ends during QualifyingEncounter.period\n and BloodPressure.status in { 'final', 'amended', 'corrected' }\n sort by start of effective.toInterval()\n )\n where EncounterLastBP.SystolicBP.value in Interval[1 'mm[Hg]', 120 'mm[Hg]' )\n and EncounterLastBP.DiastolicBP.value in Interval[1 'mm[Hg]', 80 'mm[Hg]' )"
},
{
"url" : "displaySequence",
"valueInteger" : 3
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "PCSBPScreeningFollowUpFHIR"
},
{
"url" : "name",
"valueString" : "Encounter with Elevated Blood Pressure Reading SBP 120 to 129 AND DBP less than 80"
},
{
"url" : "statement",
"valueString" : "define \"Encounter with Elevated Blood Pressure Reading SBP 120 to 129 AND DBP less than 80\":\n \"Qualifying Encounter during Measurement Period\" QualifyingEncounter\n let EncounterLastBP: Last([\"observation-bp\"] BloodPressure\n where BloodPressure.effective.toInterval() ends during QualifyingEncounter.period\n and BloodPressure.status in { 'final', 'amended', 'corrected' }\n sort by start of effective.toInterval()\n )\n where ( EncounterLastBP.SystolicBP.value in Interval[120 'mm[Hg]', 129 'mm[Hg]']\n and EncounterLastBP.DiastolicBP.value in Interval[1 'mm[Hg]', 80 'mm[Hg]' )\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 4
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "PCSBPScreeningFollowUpFHIR"
},
{
"url" : "name",
"valueString" : "Follow up with Rescreen Within 6 Months"
},
{
"url" : "statement",
"valueString" : "define \"Follow up with Rescreen Within 6 Months\":\n [ServiceRequest: \"Follow Up Within 6 Months\"] FollowUp\n where FollowUp.intent ~ 'order'"
},
{
"url" : "displaySequence",
"valueInteger" : 5
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "PCSBPScreeningFollowUpFHIR"
},
{
"url" : "name",
"valueString" : "NonPharmacological Interventions"
},
{
"url" : "statement",
"valueString" : "define \"NonPharmacological Interventions\":\n ( [ServiceRequest: \"Lifestyle Recommendation\"]\n union [ServiceRequest: \"Weight Reduction Recommended\"]\n union [ServiceRequest: \"Dietary Recommendations\"]\n union [ServiceRequest: \"Recommendation to Increase Physical Activity\"]\n union [ServiceRequest: \"Referral or Counseling for Alcohol Consumption\"] ) NonPharmaInterventions\n where NonPharmaInterventions.intent ~ 'order'"
},
{
"url" : "displaySequence",
"valueInteger" : 6
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "PCSBPScreeningFollowUpFHIR"
},
{
"url" : "name",
"valueString" : "Referral to Alternate or Primary Healthcare Professional for Hypertensive Reading"
},
{
"url" : "statement",
"valueString" : "define \"Referral to Alternate or Primary Healthcare Professional for Hypertensive Reading\":\n [ServiceRequest: \"Referral to Primary Care or Alternate Provider\"] Referral\n where Referral.reasonCode in \"Finding of Elevated Blood Pressure or Hypertension\"\n and Referral.intent ~ 'order'"
},
{
"url" : "displaySequence",
"valueInteger" : 7
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "PCSBPScreeningFollowUpFHIR"
},
{
"url" : "name",
"valueString" : "Encounter with Elevated Blood Pressure Reading SBP 120 to 129 AND DBP less than 80 and Interventions"
},
{
"url" : "statement",
"valueString" : "define \"Encounter with Elevated Blood Pressure Reading SBP 120 to 129 AND DBP less than 80 and Interventions\":\n ( \"Encounter with Elevated Blood Pressure Reading SBP 120 to 129 AND DBP less than 80\" ElevatedEncounter\n with \"Follow up with Rescreen Within 6 Months\" Twoto6MonthRescreen\n such that Twoto6MonthRescreen.authoredOn during day of ElevatedEncounter.period\n with \"NonPharmacological Interventions\" NonPharmInterventions\n such that NonPharmInterventions.authoredOn during day of ElevatedEncounter.period\n )\n union ( \"Encounter with Elevated Blood Pressure Reading SBP 120 to 129 AND DBP less than 80\" ElevatedEncounter\n with \"Referral to Alternate or Primary Healthcare Professional for Hypertensive Reading\" Referral\n such that Referral.authoredOn during day of ElevatedEncounter.period\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 8
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "PCSBPScreeningFollowUpFHIR"
},
{
"url" : "name",
"valueString" : "Encounter with Hypertensive Reading Within Year Prior"
},
{
"url" : "statement",
"valueString" : "define \"Encounter with Hypertensive Reading Within Year Prior\":\n ( \"Qualifying Encounter during Measurement Period\" QualifyingEncounter\n let EncounterLastBP: Last([\"observation-bp\"] BloodPressure\n where BloodPressure.effective.toInterval() ends 1 year or less before or on start of QualifyingEncounter.period\n and BloodPressure.status in { 'final', 'amended', 'corrected' }\n sort by start of effective.toInterval()\n )\n where ( EncounterLastBP.SystolicBP.value > 0 'mm[Hg]'\n and EncounterLastBP.DiastolicBP.value > 0 'mm[Hg]'\n and ( EncounterLastBP.SystolicBP.value >= 130 'mm[Hg]'\n or EncounterLastBP.DiastolicBP.value >= 80 'mm[Hg]'\n )\n )\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 9
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "PCSBPScreeningFollowUpFHIR"
},
{
"url" : "name",
"valueString" : "Encounter with First Hypertensive Reading SBP Greater than or Equal to 130 OR DBP Greater than or Equal to 80"
},
{
"url" : "statement",
"valueString" : "define \"Encounter with First Hypertensive Reading SBP Greater than or Equal to 130 OR DBP Greater than or Equal to 80\":\n ( \"Qualifying Encounter during Measurement Period\" QualifyingEncounter\n let EncounterLastBP: Last([\"observation-bp\"] BloodPressure\n where BloodPressure.effective.toInterval() ends during day of QualifyingEncounter.period\n sort by start of effective.toInterval()\n )\n where ( ( EncounterLastBP.SystolicBP.value > 0 'mm[Hg]'\n and EncounterLastBP.DiastolicBP.value > 0 'mm[Hg]'\n )\n and ( EncounterLastBP.SystolicBP.value >= 130 'mm[Hg]'\n or EncounterLastBP.DiastolicBP.value >= 80 'mm[Hg]'\n )\n )\n )\n except \"Encounter with Hypertensive Reading Within Year Prior\""
},
{
"url" : "displaySequence",
"valueInteger" : 10
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "PCSBPScreeningFollowUpFHIR"
},
{
"url" : "name",
"valueString" : "First Hypertensive Reading Interventions or Referral to Alternate Professional"
},
{
"url" : "statement",
"valueString" : "define \"First Hypertensive Reading Interventions or Referral to Alternate Professional\":\n ( [ServiceRequest: \"Follow Up Within 4 Weeks\"] FourWeekRescreen\n with \"NonPharmacological Interventions\" NonPharmInterventionsHTN\n such that FourWeekRescreen.authoredOn during day of \"Measurement Period\"\n and NonPharmInterventionsHTN.authoredOn during day of \"Measurement Period\"\n and FourWeekRescreen.intent ~ 'order'\n )\n union ( \"Referral to Alternate or Primary Healthcare Professional for Hypertensive Reading\" )"
},
{
"url" : "displaySequence",
"valueInteger" : 11
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "PCSBPScreeningFollowUpFHIR"
},
{
"url" : "name",
"valueString" : "Encounter with First Hypertensive Reading SBP Greater than or Equal to 130 OR DBP Greater than or Equal to 80 and Interventions"
},
{
"url" : "statement",
"valueString" : "define \"Encounter with First Hypertensive Reading SBP Greater than or Equal to 130 OR DBP Greater than or Equal to 80 and Interventions\":\n \"Encounter with First Hypertensive Reading SBP Greater than or Equal to 130 OR DBP Greater than or Equal to 80\" FirstHTNEncounter\n with \"First Hypertensive Reading Interventions or Referral to Alternate Professional\" FirstHTNIntervention\n such that FirstHTNIntervention.authoredOn during day of FirstHTNEncounter.period"
},
{
"url" : "displaySequence",
"valueInteger" : 12
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "PCSBPScreeningFollowUpFHIR"
},
{
"url" : "name",
"valueString" : "Encounter with Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89"
},
{
"url" : "statement",
"valueString" : "define \"Encounter with Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89\":\n ( \"Qualifying Encounter during Measurement Period\" QualifyingEncounter\n let EncounterLastBP: Last([\"observation-bp\"] BloodPressure\n where BloodPressure.effective.toInterval() ends during day of QualifyingEncounter.period\n and BloodPressure.status in { 'final', 'amended', 'corrected' }\n sort by start of effective.toInterval()\n )\n where ( ( EncounterLastBP.SystolicBP.value in Interval[130 'mm[Hg]', 139 'mm[Hg]']\n or EncounterLastBP.DiastolicBP.value in Interval[80 'mm[Hg]', 89 'mm[Hg]']\n )\n and not ( EncounterLastBP.SystolicBP.value >= 140 'mm[Hg]'\n or EncounterLastBP.DiastolicBP.value >= 90 'mm[Hg]'\n )\n )\n and ( exists \"Encounter with Hypertensive Reading Within Year Prior\" )\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 13
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "PCSBPScreeningFollowUpFHIR"
},
{
"url" : "name",
"valueString" : "Laboratory Test or ECG for Hypertension"
},
{
"url" : "statement",
"valueString" : "define \"Laboratory Test or ECG for Hypertension\":\n ( [ServiceRequest: \"12 lead EKG panel\"]\n union [ServiceRequest: \"EKG study\"]\n union [ServiceRequest: \"Laboratory Tests for Hypertension\"] ) EKGLab\n where EKGLab.intent ~ 'order'"
},
{
"url" : "displaySequence",
"valueInteger" : 14
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "PCSBPScreeningFollowUpFHIR"
},
{
"url" : "name",
"valueString" : "Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89 and Interventions"
},
{
"url" : "statement",
"valueString" : "define \"Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89 and Interventions\":\n \"Follow up with Rescreen Within 6 Months\" Rescreen2to6\n with \"Laboratory Test or ECG for Hypertension\" LabECGIntervention\n such that Rescreen2to6.authoredOn during day of \"Measurement Period\"\n and LabECGIntervention.authoredOn during day of \"Measurement Period\"\n with \"NonPharmacological Interventions\" NonPharmSecondIntervention\n such that NonPharmSecondIntervention.authoredOn during day of \"Measurement Period\""
},
{
"url" : "displaySequence",
"valueInteger" : 15
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "PCSBPScreeningFollowUpFHIR"
},
{
"url" : "name",
"valueString" : "Encounter with Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89 and Interventions"
},
{
"url" : "statement",
"valueString" : "define \"Encounter with Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89 and Interventions\":\n ( \"Encounter with Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89\" SecondHTNEncounterReading\n with \"Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89 and Interventions\" EncounterInterventions\n such that EncounterInterventions.authoredOn during day of SecondHTNEncounterReading.period\n )\n union ( \"Encounter with Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89\" SecondHTNEncounterReading\n with \"Referral to Alternate or Primary Healthcare Professional for Hypertensive Reading\" ReferralForHTN\n such that ReferralForHTN.authoredOn during day of SecondHTNEncounterReading.period\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 16
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "PCSBPScreeningFollowUpFHIR"
},
{
"url" : "name",
"valueString" : "Encounter with Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90"
},
{
"url" : "statement",
"valueString" : "define \"Encounter with Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90\":\n ( \"Qualifying Encounter during Measurement Period\" QualifyingEncounter\n let EncounterLastBP: Last([\"observation-bp\"] BloodPressure\n where BloodPressure.effective.toInterval() ends during QualifyingEncounter.period\n and BloodPressure.status in { 'final', 'amended', 'corrected' }\n sort by start of effective.toInterval()\n )\n where ( EncounterLastBP.SystolicBP.value > 0 'mm[Hg]'\n and EncounterLastBP.DiastolicBP.value > 0 'mm[Hg]'\n and ( EncounterLastBP.SystolicBP.value >= 140 'mm[Hg]'\n or EncounterLastBP.DiastolicBP.value >= 90 'mm[Hg]'\n )\n )\n and ( exists \"Encounter with Hypertensive Reading Within Year Prior\" )\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 17
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "PCSBPScreeningFollowUpFHIR"
},
{
"url" : "name",
"valueString" : "Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90 Interventions"
},
{
"url" : "statement",
"valueString" : "define \"Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90 Interventions\":\n ( [ServiceRequest: \"Follow Up Within 4 Weeks\"] WeeksRescreen\n with \"Laboratory Test or ECG for Hypertension\" ECGLabTest\n such that WeeksRescreen.authoredOn during day of \"Measurement Period\"\n and ECGLabTest.authoredOn during day of \"Measurement Period\"\n and WeeksRescreen.intent ~ 'order'\n and ECGLabTest.intent ~ 'order'\n with \"NonPharmacological Interventions\" HTNInterventions\n such that HTNInterventions.authoredOn during day of \"Measurement Period\"\n with [\"MedicationRequest\": \"Pharmacologic Therapy for Hypertension\"] Medications\n such that Medications.authoredOn during day of \"Measurement Period\"\n and Medications.status ~ 'active'\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 18
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "PCSBPScreeningFollowUpFHIR"
},
{
"url" : "name",
"valueString" : "Encounter with Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90 and Interventions"
},
{
"url" : "statement",
"valueString" : "define \"Encounter with Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90 and Interventions\":\n ( \"Encounter with Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90\" SecondHTNEncounterReading140Over90\n with \"Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90 Interventions\" SecondHTN140Over90Interventions\n such that SecondHTN140Over90Interventions.authoredOn during day of SecondHTNEncounterReading140Over90.period\n )\n union \"Encounter with Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90\" SecondHTNEncounterReading140Over90\n with \"Referral to Alternate or Primary Healthcare Professional for Hypertensive Reading\" ReferralToProfessional\n such that ReferralToProfessional.authoredOn during day of SecondHTNEncounterReading140Over90.period"
},
{
"url" : "displaySequence",
"valueInteger" : 19
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "PCSBPScreeningFollowUpFHIR"
},
{
"url" : "name",
"valueString" : "Numerator"
},
{
"url" : "statement",
"valueString" : "define \"Numerator\":\n \"Encounter with Normal Blood Pressure Reading\"\n union ( \"Encounter with Elevated Blood Pressure Reading SBP 120 to 129 AND DBP less than 80 and Interventions\" )\n union ( \"Encounter with First Hypertensive Reading SBP Greater than or Equal to 130 OR DBP Greater than or Equal to 80 and Interventions\" )\n union ( \"Encounter with Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89 and Interventions\" )\n union ( \"Encounter with Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90 and Interventions\" )"
},
{
"url" : "displaySequence",
"valueInteger" : 20
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "PCSBPScreeningFollowUpFHIR"
},
{
"url" : "name",
"valueString" : "Initial Population"
},
{
"url" : "statement",
"valueString" : "define \"Initial Population\":\n \"Qualifying Encounter during Measurement Period\" QualifyingEncounter\n where AgeInYearsAt(start of \"Measurement Period\") >= 18"
},
{
"url" : "displaySequence",
"valueInteger" : 21
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "PCSBPScreeningFollowUpFHIR"
},
{
"url" : "name",
"valueString" : "Denominator"
},
{
"url" : "statement",
"valueString" : "define \"Denominator\":\n \"Initial Population\""
},
{
"url" : "displaySequence",
"valueInteger" : 22
}
],
"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" : 23
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "PCSBPScreeningFollowUpFHIR"
},
{
"url" : "name",
"valueString" : "SDE Payer"
},
{
"url" : "statement",
"valueString" : "define \"SDE Payer\":\n SDE.\"SDE Payer\""
},
{
"url" : "displaySequence",
"valueInteger" : 24
}
],
"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" : 25
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "PCSBPScreeningFollowUpFHIR"
},
{
"url" : "name",
"valueString" : "SDE Ethnicity"
},
{
"url" : "statement",
"valueString" : "define \"SDE Ethnicity\":\n SDE.\"SDE Ethnicity\""
},
{
"url" : "displaySequence",
"valueInteger" : 26
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "PCSBPScreeningFollowUpFHIR"
},
{
"url" : "name",
"valueString" : "Denominator Exclusions"
},
{
"url" : "statement",
"valueString" : "define \"Denominator Exclusions\":\n \"Qualifying Encounter during Measurement Period\" QualifyingEncounter\n with [Condition: \"Diagnosis of Hypertension\"] Hypertension\n such that ( Hypertension.isProblemListItem ( )\n or Hypertension.isHealthConcern ( )\n )\n and Hypertension.prevalenceInterval ( ) starts before or on day of QualifyingEncounter.period"
},
{
"url" : "displaySequence",
"valueInteger" : 27
}
],
"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" : 28
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "PCSBPScreeningFollowUpFHIR"
},
{
"url" : "name",
"valueString" : "SDE Race"
},
{
"url" : "statement",
"valueString" : "define \"SDE Race\":\n SDE.\"SDE Race\""
},
{
"url" : "displaySequence",
"valueInteger" : 29
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "PCSBPScreeningFollowUpFHIR"
},
{
"url" : "name",
"valueString" : "Encounter with Medical Reason for Not Obtaining or Patient Declined Blood Pressure Measurement"
},
{
"url" : "statement",
"valueString" : "define \"Encounter with Medical Reason for Not Obtaining or Patient Declined Blood Pressure Measurement\":\n \"Qualifying Encounter during Measurement Period\" QualifyingEncounter\n with ( [ObservationNotDone: code ~ \"Systolic blood pressure\"]\n union [ObservationNotDone: code ~ \"Diastolic blood pressure\"] ) NoBPScreen\n such that NoBPScreen.issued during day of QualifyingEncounter.period\n and ( NoBPScreen.notDoneReason in \"Patient Declined\"\n or NoBPScreen.notDoneReason in \"Medical Reason\"\n )\n and NoBPScreen.status = 'cancelled'"
},
{
"url" : "displaySequence",
"valueInteger" : 30
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "PCSBPScreeningFollowUpFHIR"
},
{
"url" : "name",
"valueString" : "NonPharmacological Intervention Not Ordered"
},
{
"url" : "statement",
"valueString" : "define \"NonPharmacological Intervention Not Ordered\":\n ( [ServiceNotRequested: \"Lifestyle Recommendation\"]\n union [ServiceNotRequested: \"Weight Reduction Recommended\"]\n union [ServiceNotRequested: \"Dietary Recommendations\"]\n union [ServiceNotRequested: \"Recommendation to Increase Physical Activity\"]\n union [ServiceNotRequested: \"Referral or Counseling for Alcohol Consumption\"] ) NonPharmIntervention\n where NonPharmIntervention.reasonRefused in \"Patient Declined\"\n and NonPharmIntervention.status = 'completed'"
},
{
"url" : "displaySequence",
"valueInteger" : 31
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "PCSBPScreeningFollowUpFHIR"
},
{
"url" : "name",
"valueString" : "Laboratory Test or ECG for Hypertension Not Ordered"
},
{
"url" : "statement",
"valueString" : "define \"Laboratory Test or ECG for Hypertension Not Ordered\":\n ( [ServiceNotRequested: code = \"12 lead EKG panel\"]\n union [ServiceNotRequested: code = \"EKG study\"]\n union [ServiceNotRequested: \"Laboratory Tests for Hypertension\"] ) LabECGNotDone\n where LabECGNotDone.reasonRefused in \"Patient Declined\""
},
{
"url" : "displaySequence",
"valueInteger" : 32
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "PCSBPScreeningFollowUpFHIR"
},
{
"url" : "name",
"valueString" : "Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89 Interventions Declined"
},
{
"url" : "statement",
"valueString" : "define \"Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89 Interventions Declined\":\n ( ( ( [ServiceNotRequested: \"Referral to Primary Care or Alternate Provider\"]\n union [ServiceNotRequested: \"Follow Up Within 6 Months\"] ) SecondHTNDeclinedReferralAndFollowUp\n where SecondHTNDeclinedReferralAndFollowUp.reasonRefused in \"Patient Declined\"\n and SecondHTNDeclinedReferralAndFollowUp.status = 'completed'\n )\n union \"Laboratory Test or ECG for Hypertension Not Ordered\"\n union \"NonPharmacological Intervention Not Ordered\"\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 33
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "PCSBPScreeningFollowUpFHIR"
},
{
"url" : "name",
"valueString" : "Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90 Interventions Declined"
},
{
"url" : "statement",
"valueString" : "define \"Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90 Interventions Declined\":\n ( ( ( [ServiceNotRequested: \"Referral to Primary Care or Alternate Provider\"]\n union [ServiceNotRequested: \"Follow Up Within 4 Weeks\"] ) SecondHTN140Over90ReferralFollowUpNotDone\n where SecondHTN140Over90ReferralFollowUpNotDone.reasonRefused in \"Patient Declined\"\n and SecondHTN140Over90ReferralFollowUpNotDone.status = 'completed'\n )\n union ( [MedicationNotRequested: \"Pharmacologic Therapy for Hypertension\"] MedicationRequestNotOrdered\n where MedicationRequestNotOrdered.status = 'completed'\n )\n union \"Laboratory Test or ECG for Hypertension Not Ordered\"\n union \"NonPharmacological Intervention Not Ordered\"\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 34
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "PCSBPScreeningFollowUpFHIR"
},
{
"url" : "name",
"valueString" : "Encounter with Order for Hypertension Follow Up Declined by Patient"
},
{
"url" : "statement",
"valueString" : "define \"Encounter with Order for Hypertension Follow Up Declined by Patient\":\n ( ( \"Encounter with Elevated Blood Pressure Reading SBP 120 to 129 AND DBP less than 80\" ElevatedBPEncounter\n with ( [ServiceNotRequested: \"Referral to Primary Care or Alternate Provider\"]\n union [ServiceNotRequested: \"Follow Up Within 6 Months\"] ) ElevatedBPDeclinedInterventions\n such that ElevatedBPDeclinedInterventions.reasonRefused in \"Patient Declined\"\n and ElevatedBPDeclinedInterventions.authoredOn during day of ElevatedBPEncounter.period\n and ElevatedBPDeclinedInterventions.status = 'completed'\n )\n union ( \"Encounter with Elevated Blood Pressure Reading SBP 120 to 129 AND DBP less than 80\" ElevatedBPEncounter\n with \"NonPharmacological Intervention Not Ordered\" NotOrdered\n such that NotOrdered.authoredOn during day of ElevatedBPEncounter.period\n )\n union ( \"Encounter with First Hypertensive Reading SBP Greater than or Equal to 130 OR DBP Greater than or Equal to 80\" FirstHTNEncounter\n with ( [ServiceNotRequested: \"Follow Up Within 4 Weeks\"]\n union [ServiceNotRequested: \"Referral to Primary Care or Alternate Provider\"] ) FirstHTNDeclinedInterventions\n such that FirstHTNDeclinedInterventions.reasonRefused in \"Patient Declined\"\n and FirstHTNDeclinedInterventions.authoredOn during day of FirstHTNEncounter.period\n and FirstHTNDeclinedInterventions.status = 'completed'\n )\n union ( \"Encounter with First Hypertensive Reading SBP Greater than or Equal to 130 OR DBP Greater than or Equal to 80\" FirstHTNEncounter\n with \"NonPharmacological Intervention Not Ordered\" NoNonPharm\n such that NoNonPharm.authoredOn during day of FirstHTNEncounter.period\n )\n union ( \"Encounter with Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89\" SecondHTNEncounter\n with \"Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89 Interventions Declined\" SecondHTNDeclinedInterventions\n such that SecondHTNDeclinedInterventions.authoredOn during day of SecondHTNEncounter.period\n )\n union ( \"Encounter with Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90\" SecondHTN140Over90Encounter\n with \"Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90 Interventions Declined\" SecondHTN140Over90DeclinedInterventions\n such that SecondHTN140Over90DeclinedInterventions.authoredOn during day of SecondHTN140Over90Encounter.period\n )\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 35
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
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"url" : "libraryName",
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{
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{
"url" : "statement",
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},
{
"url" : "displaySequence",
"valueInteger" : 36
}
],
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"valueInteger" : 38
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},
{
"url" : "displaySequence",
"valueInteger" : 39
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
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{
"url" : "libraryName",
"valueString" : "QICoreCommon"
},
{
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"valueString" : "isProblemListItem"
},
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"valueString" : "/*\n@description: Returns true if the given condition is a problem list item.\n*/\ndefine fluent function isProblemListItem(condition Condition):\n exists (condition.category C\n where C ~ \"problem-list-item\"\n )"
},
{
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"valueInteger" : 40
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
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{
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"valueString" : "isHealthConcern"
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"valueString" : "/*\n@description: Returns true if the given condition is a health concern\n*/\ndefine fluent function isHealthConcern(condition Condition):\n exists (condition.category C\n where C ~ \"health-concern\"\n )"
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{
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{
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},
{
"type" : "depends-on",
"display" : "Code system ActCode",
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},
{
"type" : "depends-on",
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{
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{
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"display" : "Code system USCoreConditionCategoryExtensionCodes",
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{
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},
{
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"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.125"
},
{
"type" : "depends-on",
"display" : "Value set Lifestyle Recommendation",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1581"
},
{
"type" : "depends-on",
"display" : "Value set Weight Reduction Recommended",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1510"
},
{
"type" : "depends-on",
"display" : "Value set Dietary Recommendations",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1515"
},
{
"type" : "depends-on",
"display" : "Value set Recommendation to Increase Physical Activity",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1518"
},
{
"type" : "depends-on",
"display" : "Value set Referral or Counseling for Alcohol Consumption",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1583"
},
{
"type" : "depends-on",
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"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1580"
},
{
"type" : "depends-on",
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"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1047.514"
},
{
"type" : "depends-on",
"display" : "Value set Follow Up Within 4 Weeks",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1578"
},
{
"type" : "depends-on",
"display" : "Value set Laboratory Tests for Hypertension",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1482"
},
{
"type" : "depends-on",
"display" : "Value set Pharmacologic Therapy for Hypertension",
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},
{
"type" : "depends-on",
"display" : "Value set Payer Type",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"
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{
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{
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"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1007"
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],
"parameter" : [
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},
{
"name" : "SDE Sex",
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"min" : 0,
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{
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{
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{
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{
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"min" : 0,
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{
"name" : "Denominator Exclusions",
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"min" : 0,
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},
{
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"min" : 0,
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},
{
"name" : "Denominator Exceptions",
"use" : "out",
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"dataRequirement" : [
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"profile" : [
🔗 "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"
],
"mustSupport" : [
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{
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{
"path" : "status.value",
"code" : [
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{
"path" : "class"
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},
{
"type" : "Observation",
"profile" : [
🔗 "http://hl7.org/fhir/StructureDefinition/bp"
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"mustSupport" : [
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{
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"mustSupport" : [
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]
},
{
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"profile" : [
🔗 "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest"
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{
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{
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{
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{
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{
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{
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{
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{
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{
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{
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{
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{
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},
{
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"title" : "Preventive Care and Screening Screening for High Blood Pressure and Follow Up DocumentedFHIR",
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"description" : "Percentage of patient visits for patients aged 18 years and older seen during the measurement period who were screened for high blood pressure AND a recommended follow-up plan is documented, as indicated, if blood pressure is elevated or hypertensive",
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"usage" : "This eCQM is an episode-based measure. An episode is defined as each eligible encounter for patients aged 18 years and older during the measurement period. This measure should be reported for every visit. The measure requires that blood pressure measurements (i.e., diastolic and systolic) be obtained during each visit in order to determine the blood pressure reading used to evaluate if an intervention is needed. Both the systolic and diastolic blood pressure measurements are required for inclusion. If there are multiple blood pressures obtained during a patient visit, only the last, or most recent, pressure measurement will be used to evaluate the measure requirements. The intent of this measure is to screen patients for high blood pressure and provide recommended follow-up as indicated. The documented follow-up plan must be related to the current blood pressure reading as indicated, example: \"Patient referred to primary care provider for BP management.\" Telehealth encounters are not eligible for this measure because the measure requires a clinical action that cannot be conducted via telehealth. 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: CMS 22v13. Please refer to the HL7 QI-Core Implementation Guide (https://hl7.org/fhir/us/qicore/STU4.1.1/) for more information on QI-Core and mapping recommendations from QDM to QI-Core 4.1.1 (https://hl7.org/fhir/us/qicore/STU4.1.1/qdm-to-qicore.html).",
"copyright" : "Limited proprietary coding is contained in the measure specifications for convenience. Users of the proprietary code sets should obtain all necessary licenses from the owners of these code sets. CPT(R) contained in the Measure specifications is copyright 2004-2023 American Medical Association. LOINC(R) is copyright 2004-2023 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2023 International Health Terminology Standards Development Organisation. ICD-10 is copyright 2023 World Health Organization. All Rights Reserved.",
"effectivePeriod" : {
"start" : "2025-01-01",
"end" : "2025-12-31"
},
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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 \"AS IS\" WITHOUT WARRANTY OF ANY KIND. Due to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM].",
"scoring" : {
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"code" : "proportion",
"display" : "Proportion"
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"rationale" : "Hypertension is a prevalent condition that affects approximately 66.9 million people in the United States. It is estimated that about 20-40 percent of the adult population has hypertension; the majority of people over age 65 have a hypertension diagnosis (Appleton et al., 2013 and Luehr et al., 2012). Winter (2013) noted that 1 in 3 American adults have hypertension and the lifetime risk of developing hypertension is 90 percent. The African American population or non-Hispanic Blacks, the elderly, diabetics and those with chronic kidney disease are at increased risk of stroke, myocardial infarction and renal disease. Non-Hispanic Blacks have the highest prevalence at 38.6 percent (Winter et al., 2013). Hypertension is a major risk factor for ischemic heart disease, left ventricular hypertrophy, renal failure, stroke and dementia (Luehr et al., 2012). Prevention of hypertension and the treatment of established hypertension are complementary approaches to reducing cardiovascular disease risk in the population, but prevention of hypertension provides the optimal means of reducing risk and avoiding harmful consequences. Periodic blood pressure (BP) screening can identify individuals who develop elevated BP over time. More frequent BP screening may be particularly important for individuals with elevated atherosclerotic cardiovascular disease (ASCVD) risk (Whelton et al., 2018). Hypertension is the most common reason for adult office visits other than pregnancy. Garrison (2013) stated that in 2007, 42 million ambulatory visits were attributed to hypertension (Garrison & Oberhelman, 2013). It also has the highest utilization of prescription drugs. Numerous resources and treatment options are available, yet only about 40-50 percent of the hypertensive patients have their blood pressure under control (<140/90) (Appleton et al., 2013 and Luehr et al., 2012). In addition to medication non-compliance, poor outcomes are also attributed to poor adherence to lifestyle changes such as a low-sodium diet, weight loss, increased exercise and limiting alcohol intake. Many adults find it difficult to continue medications and lifestyle changes when they are asymptomatic. Symptoms of elevated blood pressure usually do not occur until secondary problems arise such as with vascular diseases (myocardial infarction, stroke, heart failure and renal insufficiency) (Luehr et al., 2012). Appropriate follow-up after blood pressure measurement is a pivotal component in preventing the progression of hypertension and the development of heart disease. Detection of marginally or fully elevated blood pressure by a specialty clinician warrants referral to a provider familiar with the management of hypertension and prehypertension. The American College of Cardiology/American Heart Association (ACC/AHA) 2017 Guidelines provide updated recommendations for ASCVD risk. For additional information please refer to the 2017 ACC/AHA guidelines: https://www.acc.org/latest-in-cardiology/ten-points-to-remember/2017/11/09/11/41/2017-guideline-for-high-blood-pressure-in-adults. Lifestyle modifications have demonstrated effectiveness in lowering blood pressure (U.S. Department of Health and Human Services, 2003). The synergistic effect of several lifestyle modifications results in greater benefits than a single modification alone. Baseline diagnostic/laboratory testing establishes if a co-existing underlying condition is the etiology of hypertension and evaluates if end organ damage from hypertension has already occurred. Landmark trials such as the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) have repeatedly proven the efficacy of pharmacologic therapy to control blood pressure and reduce the complications of hypertension. A review of 35 studies found that the pharmacist-led interventions involved medication counseling and patient education. Twenty-nine of the 35 studies showed statistically significant improvement in BP levels of the intervention groups at follow-up (Reeves et al., 2020). Follow-up intervals based on blood pressure control have been established by the 2017 ACC/AHA guideline and the United States Preventive Services Task Force (Whelton et al., 2018; USPSTF, 2021).",
"clinicalRecommendationStatement" : "The U.S. Preventive Services Task Force (USPSTF, 2021) recommends screening for high blood pressure in adults aged 18 years and older. This is a grade A recommendation.",
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"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "numerator",
"display" : "Numerator"
}
]
},
"description" : "Patient visits where patients were screened for high blood pressure AND have a recommended follow-up plan documented, as indicated, if the blood pressure is elevated or hypertensive",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Numerator"
}
},
{
"id" : "DACDF805-EA30-4892-9F23-4D3B3D095C22",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "denominator-exception",
"display" : "Denominator Exception"
}
]
},
"description" : "Documentation of medical reason(s) for not screening for high blood pressure (e.g., patient is in an urgent or emergent medical situation where time is of the essence and to delay treatment would jeopardize the patient's health status). Documentation of patient reason(s) for not screening for blood pressure measurements or for not ordering an appropriate follow-up intervention if patient BP is elevated or hypertensive (e.g., patient refuses).",
"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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