eCQM QICore Content Implementation Guide
2024.0.0 - CI Build
eCQM QICore Content Implementation Guide
2024.0.0 - CI Build
eCQM QICore Content Implementation Guide, published by cqframework. This guide is not an authorized publication; it is the continuous build for version 2024.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/cqframework/ecqm-content-qicore-2024/ and changes regularly. See the Directory of published versions
| Draft as of 2024-07-09 |
<Measure xmlns="http://hl7.org/fhir">
<id value="PCSBPScreeningFollowUpFHIR"/>
<meta>
<profile
value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-measure-cqfm"/>
<profile
value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/publishable-measure-cqfm"/>
<profile
value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/executable-measure-cqfm"/>
</meta>
<text>
<status value="extensions"/>
<div xmlns="http://www.w3.org/1999/xhtml">
<table class="grid dict">
<tr>
<th scope="row"><b>Title: </b></th>
<td style="padding-left: 4px;">Preventive Care and Screening Screening for High Blood Pressure and Follow Up DocumentedFHIR</td>
</tr>
<tr>
<th scope="row"><b>Id: </b></th>
<td style="padding-left: 4px;">PCSBPScreeningFollowUpFHIR</td>
</tr>
<tr>
<th scope="row"><b>Version: </b></th>
<td style="padding-left: 4px;">0.2.000</td>
</tr>
<tr>
<th scope="row"><b>Url: </b></th>
<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>
</tr>
<tr>
<th scope="row">
<b>
short-name identifier:
</b>
</th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<span>CMS22FHIR</span>
</p>
</td>
</tr>
<tr>
<th scope="row">
<b>
version-independent identifier:
</b>
</th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<span>urn:uuid:1b17d846-cbe0-49fa-b503-518addf19fb0</span>
</p>
</td>
</tr>
<tr>
<th scope="row">
<b>
version-specific identifier:
</b>
</th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<span>urn:uuid:b7b775e9-0c0d-4f9b-8457-b7ad1a255f80</span>
</p>
</td>
</tr>
<tr>
<th scope="row">
<b>
publisher (CMS) identifier:
</b>
</th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<span>22FHIR</span>
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Effective Period: </b></th>
<td style="padding-left: 4px;">2025-01-01..2025-12-31</td>
</tr>
<tr>
<th scope="row"><b>Status: </b></th>
<td style="padding-left: 4px;">draft</td>
</tr>
<tr>
<th scope="row"><b>Publisher: </b></th>
<td style="padding-left: 4px;">Centers for Medicare & Medicaid Services (CMS)</td>
</tr>
<tr>
<th scope="row"><b>Author: </b></th>
<td style="padding-left: 4px;">Mathematica</td>
</tr>
<tr>
<th scope="row"><b>Description: </b></th>
<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>
</div></td>
</tr>
<tr>
<th scope="row"><b>Purpose: </b></th>
<td style="padding-left: 4px;"><div><p>UNKNOWN</p>
</div></td>
</tr>
<tr>
<th scope="row"><b>Copyright: </b></th>
<td style="padding-left: 4px;"><div><p>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>
</div></td>
</tr>
<tr>
<th scope="row"><b>Disclaimer: </b></th>
<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>
</div></td>
</tr>
<tr>
<th scope="row"><b>Rationale: </b></th>
<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>
</div></td>
</tr>
<tr>
<th scope="row"><b>Clinical recommendation statement: </b></th>
<td style="padding-left: 4px;"><div><p>The U.S. Preventive Services Task Force (USPSTF, 2021) recommends screening for high blood pressure in adults aged 18 years and older. This is a grade A recommendation.</p>
</div></td>
</tr>
<tr>
<th scope="row"><b>Guidance (Usage): </b></th>
<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>
</tr>
<tr>
<th scope="row"><b>Population Criteria: </b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr>
<th><b>64ef76cf56d636294b157c3f</b></th>
</tr>
<tr>
<td>Initial Population:</td>
<td>All patient visits for patients aged 18 years and older at the beginning of the measurement period</td>
</tr>
<tr>
<td>Denominator:</td>
<td>Equals Initial Population</td>
</tr>
<tr>
<td>Denominator Exclusion:</td>
<td>Patient has an active diagnosis of hypertension</td>
</tr>
<tr>
<td>Numerator:</td>
<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>
</tr>
<tr>
<td>Denominator Exception:</td>
<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>
</tr>
</table>
</td>
</tr>
<tr>
<th scope="row"><b> Supplemental Data Elements: </b></th>
<td style="padding-left: 4px;">
<p>SDE Ethnicity</p>
<p>SDE Payer</p>
<p>SDE Race</p>
<p>SDE Sex</p>
</td>
</tr>
<tr>
<th scope="row">
<b> Supplemental Data Guidance
: </b></th>
<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>
</tr>
<tr>
<th scope="row"><b>Libraries: </b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr>
<td><a href="Library-PCSBPScreeningFollowUpFHIR.html">PCSBPScreeningFollowUpFHIR</a></td>
</tr>
</table>
</td>
</tr>
<tr>
<th scope="row"><b>Terminology and Other Dependencies: </b></th>
<td style="padding-left: 4px;">
<li><code>Library/SupplementalDataElements|3.5.000</code></li>
<li><code>Library/FHIRHelpers|4.4.000</code></li>
<li><code>Library/QICoreCommon|2.1.000</code></li>
<li><a href="http://hl7.org/fhir/R4/codesystem-administrative-gender.html">AdministrativeGender</a></li>
<li><a href="http://terminology.hl7.org/5.5.0/CodeSystem-v3-ActCode.html">ActCode</a></li>
<li><a href="http://terminology.hl7.org/5.5.0/CodeSystem-v3-loinc.html">Logical Observation Identifiers, Names and Codes (LOINC)</a></li>
<li><a href="http://terminology.hl7.org/5.5.0/CodeSystem-condition-category.html">Condition Category Codes</a></li>
<li><a href="http://hl7.org/fhir/us/core/STU3.1.1/CodeSystem-condition-category.html">US Core Condition Category Extension Codes</a></li>
<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>
<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>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1581/expansion">Lifestyle Recommendation</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.600.1510/expansion">Weight Reduction Recommended</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.600.1515/expansion">Dietary Recommendations</a></li>
<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>
<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>
<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>
<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>
<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>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.600.1482/expansion">Laboratory Tests for Hypertension</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.1577/expansion">Pharmacologic Therapy for Hypertension</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.114222.4.11.3591/expansion">Payer</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.600.263/expansion">Diagnosis of Hypertension</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1582/expansion">Patient Declined</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1007/expansion">Medical Reason</a></li>
</td>
</tr>
<tr>
<th scope="row"><b>Parameters:</b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr>
<th><b>name</b></th>
<th><b>use</b></th>
<th><b>min</b></th>
<th><b>max</b></th>
<th><b>type</b></th>
</tr>
<tr>
<td>Measurement Period</td>
<td>In</td>
<td>0</td>
<td>1</td>
<td>Period</td>
</tr>
<tr>
<td>SDE Sex</td>
<td>Out</td>
<td>0</td>
<td>1</td>
<td>Coding</td>
</tr>
<tr>
<td>Numerator</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Denominator</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>SDE Payer</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Initial Population</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>SDE Ethnicity</td>
<td>Out</td>
<td>0</td>
<td>1</td>
<td>Resource</td>
</tr>
<tr>
<td>Denominator Exclusions</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>SDE Race</td>
<td>Out</td>
<td>0</td>
<td>1</td>
<td>Resource</td>
</tr>
<tr>
<td>Denominator Exceptions</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
</table>
</td>
</tr>
<tr>
<th scope="row"><b>DataRequirements:</b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr>
<th><b>Resource Type</b></th>
<th><b>Resource Elements</b></th>
<th><b>Valueset Name</b></th>
<th><b>Valueset</b></th>
</tr>
<tr>
<td>Patient(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-patient.html">QICorePatient</a>)</td>
<td>
ethnicity
race
</td>
<td>
</td>
<td/>
</tr>
<tr>
<td>Encounter(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html">QICoreEncounter</a>)</td>
<td>
type
period
status
status.value
class
</td>
<td>
Encounter to Screen for Blood Pressure
</td>
<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>
</tr>
<tr>
<td>Observation(<a href="http://hl7.org/fhir/R4/bp.html">Observation Blood Pressure Profile</a>)</td>
<td>
effective
status
status.value
component
</td>
<td>
</td>
<td/>
</tr>
<tr>
<td>ServiceRequest(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-servicerequest.html">QICoreServiceRequest</a>)</td>
<td>
code
intent
intent.value
authoredOn
authoredOn.value
</td>
<td>
Lifestyle Recommendation
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1581/expansion">Lifestyle Recommendation</a></td>
</tr>
<tr>
<td>ServiceRequest(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-servicerequest.html">QICoreServiceRequest</a>)</td>
<td>
code
intent
intent.value
authoredOn
authoredOn.value
</td>
<td>
Weight Reduction Recommended
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.600.1510/expansion">Weight Reduction Recommended</a></td>
</tr>
<tr>
<td>ServiceRequest(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-servicerequest.html">QICoreServiceRequest</a>)</td>
<td>
code
intent
intent.value
authoredOn
authoredOn.value
</td>
<td>
Dietary Recommendations
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.600.1515/expansion">Dietary Recommendations</a></td>
</tr>
<tr>
<td>ServiceRequest(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-servicerequest.html">QICoreServiceRequest</a>)</td>
<td>
code
intent
intent.value
authoredOn
authoredOn.value
</td>
<td>
Recommendation to Increase Physical Activity
</td>
<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>
</tr>
<tr>
<td>ServiceRequest(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-servicerequest.html">QICoreServiceRequest</a>)</td>
<td>
code
intent
intent.value
authoredOn
authoredOn.value
</td>
<td>
Referral or Counseling for Alcohol Consumption
</td>
<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>
</tr>
<tr>
<td>ServiceRequest(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-servicerequest.html">QICoreServiceRequest</a>)</td>
<td>
code
intent
intent.value
authoredOn
authoredOn.value
</td>
<td>
Follow Up Within 6 Months
</td>
<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>
</tr>
<tr>
<td>ServiceRequest(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-servicerequest.html">QICoreServiceRequest</a>)</td>
<td>
code
intent
intent.value
authoredOn
authoredOn.value
</td>
<td>
</td>
<td/>
</tr>
<tr>
<td>ServiceRequest(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-servicerequest.html">QICoreServiceRequest</a>)</td>
<td>
code
intent
intent.value
authoredOn
authoredOn.value
</td>
<td>
</td>
<td/>
</tr>
<tr>
<td>ServiceRequest(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-servicerequest.html">QICoreServiceRequest</a>)</td>
<td>
code
intent
intent.value
authoredOn
authoredOn.value
</td>
<td>
Laboratory Tests for Hypertension
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.600.1482/expansion">Laboratory Tests for Hypertension</a></td>
</tr>
<tr>
<td>ServiceRequest(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-servicerequest.html">QICoreServiceRequest</a>)</td>
<td>
code
intent
intent.value
authoredOn
authoredOn.value
</td>
<td>
Follow Up Within 6 Months
</td>
<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>
</tr>
<tr>
<td>ServiceRequest(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-servicerequest.html">QICoreServiceRequest</a>)</td>
<td>
code
authoredOn
authoredOn.value
intent
intent.value
</td>
<td>
Follow Up Within 4 Weeks
</td>
<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>
</tr>
<tr>
<td>ServiceRequest(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-servicerequest.html">QICoreServiceRequest</a>)</td>
<td>
code
reasonCode
intent
intent.value
authoredOn
authoredOn.value
</td>
<td>
Referral to Primary Care or Alternate Provider
</td>
<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>
</tr>
<tr>
<td>Medication(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-medication.html">QICoreMedication</a>)</td>
<td>
id
</td>
<td>
</td>
<td/>
</tr>
<tr>
<td>MedicationRequest(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-medicationrequest.html">QICoreMedicationRequest</a>)</td>
<td>
medication.reference
authoredOn
authoredOn.value
status
status.value
</td>
<td>
</td>
<td/>
</tr>
<tr>
<td>MedicationRequest(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-medicationrequest.html">QICoreMedicationRequest</a>)</td>
<td>
medication
authoredOn
authoredOn.value
status
status.value
</td>
<td>
Pharmacologic Therapy for Hypertension
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.1577/expansion">Pharmacologic Therapy for Hypertension</a></td>
</tr>
<tr>
<td>Coverage(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-coverage.html">QICoreCoverage</a>)</td>
<td>
type
period
</td>
<td>
Payer Type
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.114222.4.11.3591/expansion">Payer</a></td>
</tr>
<tr>
<td>Condition(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-condition.html">QICoreCondition</a>)</td>
<td>
code
</td>
<td>
Diagnosis of Hypertension
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.600.263/expansion">Diagnosis of Hypertension</a></td>
</tr>
<tr>
<td>Observation(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-observationnotdone.html">QICoreObservationNotDone</a>)</td>
<td>
code
issued
issued.value
extension
status
status.value
</td>
<td>
</td>
<td/>
</tr>
<tr>
<td>Observation(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-observationnotdone.html">QICoreObservationNotDone</a>)</td>
<td>
code
issued
issued.value
extension
status
status.value
</td>
<td>
</td>
<td/>
</tr>
<tr>
<td>ServiceRequest(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-servicenotrequested.html">QICoreServiceNotRequested</a>)</td>
<td>
code
extension
status
status.value
authoredOn
authoredOn.value
</td>
<td>
Lifestyle Recommendation
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1581/expansion">Lifestyle Recommendation</a></td>
</tr>
<tr>
<td>ServiceRequest(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-servicenotrequested.html">QICoreServiceNotRequested</a>)</td>
<td>
code
extension
status
status.value
authoredOn
authoredOn.value
</td>
<td>
Lifestyle Recommendation
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1581/expansion">Lifestyle Recommendation</a></td>
</tr>
<tr>
<td>ServiceRequest(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-servicenotrequested.html">QICoreServiceNotRequested</a>)</td>
<td>
code
extension
status
status.value
authoredOn
authoredOn.value
</td>
<td>
Weight Reduction Recommended
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.600.1510/expansion">Weight Reduction Recommended</a></td>
</tr>
<tr>
<td>ServiceRequest(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-servicenotrequested.html">QICoreServiceNotRequested</a>)</td>
<td>
code
extension
status
status.value
authoredOn
authoredOn.value
</td>
<td>
Weight Reduction Recommended
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.600.1510/expansion">Weight Reduction Recommended</a></td>
</tr>
<tr>
<td>ServiceRequest(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-servicenotrequested.html">QICoreServiceNotRequested</a>)</td>
<td>
code
extension
status
status.value
authoredOn
authoredOn.value
</td>
<td>
Dietary Recommendations
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.600.1515/expansion">Dietary Recommendations</a></td>
</tr>
<tr>
<td>ServiceRequest(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-servicenotrequested.html">QICoreServiceNotRequested</a>)</td>
<td>
code
extension
status
status.value
authoredOn
authoredOn.value
</td>
<td>
Dietary Recommendations
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.600.1515/expansion">Dietary Recommendations</a></td>
</tr>
<tr>
<td>ServiceRequest(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-servicenotrequested.html">QICoreServiceNotRequested</a>)</td>
<td>
code
extension
status
status.value
authoredOn
authoredOn.value
</td>
<td>
Recommendation to Increase Physical Activity
</td>
<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>
</tr>
<tr>
<td>ServiceRequest(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-servicenotrequested.html">QICoreServiceNotRequested</a>)</td>
<td>
code
extension
status
status.value
authoredOn
authoredOn.value
</td>
<td>
Recommendation to Increase Physical Activity
</td>
<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>
</tr>
<tr>
<td>ServiceRequest(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-servicenotrequested.html">QICoreServiceNotRequested</a>)</td>
<td>
code
extension
status
status.value
authoredOn
authoredOn.value
</td>
<td>
Referral or Counseling for Alcohol Consumption
</td>
<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>
</tr>
<tr>
<td>ServiceRequest(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-servicenotrequested.html">QICoreServiceNotRequested</a>)</td>
<td>
code
extension
status
status.value
authoredOn
authoredOn.value
</td>
<td>
Referral or Counseling for Alcohol Consumption
</td>
<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>
</tr>
<tr>
<td>ServiceRequest(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-servicenotrequested.html">QICoreServiceNotRequested</a>)</td>
<td>
code
extension
status
status.value
authoredOn
authoredOn.value
</td>
<td>
</td>
<td/>
</tr>
<tr>
<td>ServiceRequest(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-servicenotrequested.html">QICoreServiceNotRequested</a>)</td>
<td>
code
extension
status
status.value
authoredOn
authoredOn.value
</td>
<td>
</td>
<td/>
</tr>
<tr>
<td>ServiceRequest(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-servicenotrequested.html">QICoreServiceNotRequested</a>)</td>
<td>
code
extension
status
status.value
authoredOn
authoredOn.value
</td>
<td>
Laboratory Tests for Hypertension
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.600.1482/expansion">Laboratory Tests for Hypertension</a></td>
</tr>
<tr>
<td>ServiceRequest(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-servicenotrequested.html">QICoreServiceNotRequested</a>)</td>
<td>
code
extension
status
status.value
authoredOn
authoredOn.value
</td>
<td>
Laboratory Tests for Hypertension
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.600.1482/expansion">Laboratory Tests for Hypertension</a></td>
</tr>
<tr>
<td>ServiceRequest(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-servicenotrequested.html">QICoreServiceNotRequested</a>)</td>
<td>
code
extension
status
status.value
authoredOn
authoredOn.value
</td>
<td>
Follow Up Within 6 Months
</td>
<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>
</tr>
<tr>
<td>ServiceRequest(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-servicenotrequested.html">QICoreServiceNotRequested</a>)</td>
<td>
code
extension
status
status.value
authoredOn
authoredOn.value
</td>
<td>
Follow Up Within 6 Months
</td>
<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>
</tr>
<tr>
<td>ServiceRequest(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-servicenotrequested.html">QICoreServiceNotRequested</a>)</td>
<td>
code
extension
status
status.value
authoredOn
authoredOn.value
</td>
<td>
Follow Up Within 4 Weeks
</td>
<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>
</tr>
<tr>
<td>ServiceRequest(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-servicenotrequested.html">QICoreServiceNotRequested</a>)</td>
<td>
code
extension
status
status.value
authoredOn
authoredOn.value
</td>
<td>
Follow Up Within 4 Weeks
</td>
<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>
</tr>
<tr>
<td>ServiceRequest(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-servicenotrequested.html">QICoreServiceNotRequested</a>)</td>
<td>
code
extension
status
status.value
authoredOn
authoredOn.value
</td>
<td>
Referral to Primary Care or Alternate Provider
</td>
<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>
</tr>
<tr>
<td>ServiceRequest(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-servicenotrequested.html">QICoreServiceNotRequested</a>)</td>
<td>
code
extension
status
status.value
authoredOn
authoredOn.value
</td>
<td>
Referral to Primary Care or Alternate Provider
</td>
<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>
</tr>
<tr>
<td>MedicationRequest(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-mednotrequested.html">QICoreMedicationNotRequested</a>)</td>
<td>
medication
status
status.value
</td>
<td>
Pharmacologic Therapy for Hypertension
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.1577/expansion">Pharmacologic Therapy for Hypertension</a></td>
</tr>
<tr>
<td>MedicationRequest(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-mednotrequested.html">QICoreMedicationNotRequested</a>)</td>
<td>
medication
status
status.value
</td>
<td>
Pharmacologic Therapy for Hypertension
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.1577/expansion">Pharmacologic Therapy for Hypertension</a></td>
</tr>
</table>
</td>
</tr>
<tr>
<th scope="row"><b>Direct Reference Codes:</b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr>
<th><b>display</b></th>
<th><b>code</b></th>
<th><b>system</b></th>
</tr>
<tr>
<td>Male</td>
<td>M</td>
<td><a href="http://hl7.org/fhir/R4/codesystem-administrative-gender.html">http://hl7.org/fhir/administrative-gender</a></td>
</tr>
<tr>
<td>Female</td>
<td>F</td>
<td><a href="http://hl7.org/fhir/R4/codesystem-administrative-gender.html">http://hl7.org/fhir/administrative-gender</a></td>
</tr>
<tr>
<td>virtual</td>
<td>VR</td>
<td><a href="http://hl7.org/fhir/R4/v3/ActCode/cs.html">http://terminology.hl7.org/CodeSystem/v3-ActCode</a></td>
</tr>
<tr>
<td>EKG 12 channel panel</td>
<td>34534-8</td>
<td><a href="http://terminology.hl7.org/5.5.0/CodeSystem-v3-loinc.html">http://loinc.org</a></td>
</tr>
<tr>
<td>EKG study</td>
<td>11524-6</td>
<td><a href="http://terminology.hl7.org/5.5.0/CodeSystem-v3-loinc.html">http://loinc.org</a></td>
</tr>
<tr>
<td>Problem List Item</td>
<td>problem-list-item</td>
<td><a href="http://hl7.org/fhir/R4/codesystem-condition-category.html">http://terminology.hl7.org/CodeSystem/condition-category</a></td>
</tr>
<tr>
<td>Health Concern</td>
<td>health-concern</td>
<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>
</tr>
<tr>
<td>Systolic blood pressure</td>
<td>8480-6</td>
<td><a href="http://terminology.hl7.org/5.5.0/CodeSystem-v3-loinc.html">http://loinc.org</a></td>
</tr>
<tr>
<td>Diastolic blood pressure</td>
<td>8462-4</td>
<td><a href="http://terminology.hl7.org/5.5.0/CodeSystem-v3-loinc.html">http://loinc.org</a></td>
</tr>
</table>
</td>
</tr>
<tr>
<th scope="row"><b>Logic Definitions:</b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr>
<th><b>Group</b></th>
<th><b>Scoring</b></th>
<th><b>Population Criteria</b></th>
<th><b>Expression</b></th>
</tr>
<tr>
<td> 64ef76cf56d636294b157c3f </td>
<td colspan="3" style="padding-left: 4px;">
<b>Group scoring:</b>
<span> proportion </span>
<tr>
<th scope="row"><b>Type: </b></th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<span>Process </span>
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Rate Aggregation: </b></th>
<td colspan="3" style="padding-left: 4px;">None</td>
</tr>
<tr>
<th scope="row"><b>Improvement Notation: </b></th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<span>increase </span>
</p>
</td>
</tr>
</td>
<tr>
<td/>
<td/>
<td>Initial Population</td>
<td>
<pre><code class="language-cql">define "Initial Population":
"Qualifying Encounter during Measurement Period" QualifyingEncounter
where AgeInYearsAt(start of "Measurement Period") >= 18</code></pre>
</td>
</tr>
<tr>
<td/>
<td/>
<td>Denominator</td>
<td>
<pre><code class="language-cql">define "Denominator":
"Initial Population"</code></pre>
</td>
</tr>
<tr>
<td/>
<td/>
<td>Denominator Exclusion</td>
<td>
<pre><code class="language-cql">define "Denominator Exclusions":
"Qualifying Encounter during Measurement Period" QualifyingEncounter
with [Condition: "Diagnosis of Hypertension"] Hypertension
such that ( Hypertension.isProblemListItem ( )
or Hypertension.isHealthConcern ( )
)
and Hypertension.prevalenceInterval ( ) starts before or on day of QualifyingEncounter.period</code></pre>
</td>
</tr>
<tr>
<td/>
<td/>
<td>Numerator</td>
<td>
<pre><code class="language-cql">define "Numerator":
"Encounter with Normal Blood Pressure Reading"
union ( "Encounter with Elevated Blood Pressure Reading SBP 120 to 129 AND DBP less than 80 and Interventions" )
union ( "Encounter with First Hypertensive Reading SBP Greater than or Equal to 130 OR DBP Greater than or Equal to 80 and Interventions" )
union ( "Encounter with Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89 and Interventions" )
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>
</td>
</tr>
<tr>
<td/>
<td/>
<td>Denominator Exception</td>
<td>
<pre><code class="language-cql">define "Denominator Exceptions":
"Encounter with Medical Reason for Not Obtaining or Patient Declined Blood Pressure Measurement"
union "Encounter with Order for Hypertension Follow Up Declined by Patient"</code></pre>
</td>
</tr>
</tr>
</table>
<table class="grid-dict">
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SupplementalDataElements</td>
<td>SDE Sex</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "SDE Sex":
case
when Patient.gender = 'male' then "M"
when Patient.gender = 'female' then "F"
else null
end</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>PCSBPScreeningFollowUpFHIR</td>
<td>SDE Sex</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "SDE Sex":
SDE."SDE Sex"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>PCSBPScreeningFollowUpFHIR</td>
<td>Qualifying Encounter during Measurement Period</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Qualifying Encounter during Measurement Period":
[Encounter: "Encounter to Screen for Blood Pressure"] ValidEncounter
where ValidEncounter.period during day of "Measurement Period"
and ValidEncounter.status ~ 'finished'
and ValidEncounter.class !~ "virtual"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>PCSBPScreeningFollowUpFHIR</td>
<td>Encounter with Normal Blood Pressure Reading</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Encounter with Normal Blood Pressure Reading":
"Qualifying Encounter during Measurement Period" QualifyingEncounter
let EncounterLastBP: Last(["observation-bp"] BloodPressure
where BloodPressure.effective.toInterval() ends during QualifyingEncounter.period
and BloodPressure.status in { 'final', 'amended', 'corrected' }
sort by start of effective.toInterval()
)
where EncounterLastBP.SystolicBP.value in Interval[1 'mm[Hg]', 120 'mm[Hg]' )
and EncounterLastBP.DiastolicBP.value in Interval[1 'mm[Hg]', 80 'mm[Hg]' )</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>PCSBPScreeningFollowUpFHIR</td>
<td>Encounter with Elevated Blood Pressure Reading SBP 120 to 129 AND DBP less than 80</td>
</tr>
<tr>
<td/>
<td>
<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":
"Qualifying Encounter during Measurement Period" QualifyingEncounter
let EncounterLastBP: Last(["observation-bp"] BloodPressure
where BloodPressure.effective.toInterval() ends during QualifyingEncounter.period
and BloodPressure.status in { 'final', 'amended', 'corrected' }
sort by start of effective.toInterval()
)
where ( EncounterLastBP.SystolicBP.value in Interval[120 'mm[Hg]', 129 'mm[Hg]']
and EncounterLastBP.DiastolicBP.value in Interval[1 'mm[Hg]', 80 'mm[Hg]' )
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>PCSBPScreeningFollowUpFHIR</td>
<td>Follow up with Rescreen Within 6 Months</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Follow up with Rescreen Within 6 Months":
[ServiceRequest: "Follow Up Within 6 Months"] FollowUp
where FollowUp.intent ~ 'order'</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>PCSBPScreeningFollowUpFHIR</td>
<td>NonPharmacological Interventions</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "NonPharmacological Interventions":
( [ServiceRequest: "Lifestyle Recommendation"]
union [ServiceRequest: "Weight Reduction Recommended"]
union [ServiceRequest: "Dietary Recommendations"]
union [ServiceRequest: "Recommendation to Increase Physical Activity"]
union [ServiceRequest: "Referral or Counseling for Alcohol Consumption"] ) NonPharmaInterventions
where NonPharmaInterventions.intent ~ 'order'</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>PCSBPScreeningFollowUpFHIR</td>
<td>Referral to Alternate or Primary Healthcare Professional for Hypertensive Reading</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Referral to Alternate or Primary Healthcare Professional for Hypertensive Reading":
[ServiceRequest: "Referral to Primary Care or Alternate Provider"] Referral
where Referral.reasonCode in "Finding of Elevated Blood Pressure or Hypertension"
and Referral.intent ~ 'order'</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>PCSBPScreeningFollowUpFHIR</td>
<td>Encounter with Elevated Blood Pressure Reading SBP 120 to 129 AND DBP less than 80 and Interventions</td>
</tr>
<tr>
<td/>
<td>
<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":
( "Encounter with Elevated Blood Pressure Reading SBP 120 to 129 AND DBP less than 80" ElevatedEncounter
with "Follow up with Rescreen Within 6 Months" Twoto6MonthRescreen
such that Twoto6MonthRescreen.authoredOn during day of ElevatedEncounter.period
with "NonPharmacological Interventions" NonPharmInterventions
such that NonPharmInterventions.authoredOn during day of ElevatedEncounter.period
)
union ( "Encounter with Elevated Blood Pressure Reading SBP 120 to 129 AND DBP less than 80" ElevatedEncounter
with "Referral to Alternate or Primary Healthcare Professional for Hypertensive Reading" Referral
such that Referral.authoredOn during day of ElevatedEncounter.period
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>PCSBPScreeningFollowUpFHIR</td>
<td>Encounter with Hypertensive Reading Within Year Prior</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Encounter with Hypertensive Reading Within Year Prior":
( "Qualifying Encounter during Measurement Period" QualifyingEncounter
let EncounterLastBP: Last(["observation-bp"] BloodPressure
where BloodPressure.effective.toInterval() ends 1 year or less before or on start of QualifyingEncounter.period
and BloodPressure.status in { 'final', 'amended', 'corrected' }
sort by start of effective.toInterval()
)
where ( EncounterLastBP.SystolicBP.value > 0 'mm[Hg]'
and EncounterLastBP.DiastolicBP.value > 0 'mm[Hg]'
and ( EncounterLastBP.SystolicBP.value >= 130 'mm[Hg]'
or EncounterLastBP.DiastolicBP.value >= 80 'mm[Hg]'
)
)
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>PCSBPScreeningFollowUpFHIR</td>
<td>Encounter with First Hypertensive Reading SBP Greater than or Equal to 130 OR DBP Greater than or Equal to 80</td>
</tr>
<tr>
<td/>
<td>
<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":
( "Qualifying Encounter during Measurement Period" QualifyingEncounter
let EncounterLastBP: Last(["observation-bp"] BloodPressure
where BloodPressure.effective.toInterval() ends during day of QualifyingEncounter.period
sort by start of effective.toInterval()
)
where ( ( EncounterLastBP.SystolicBP.value > 0 'mm[Hg]'
and EncounterLastBP.DiastolicBP.value > 0 'mm[Hg]'
)
and ( EncounterLastBP.SystolicBP.value >= 130 'mm[Hg]'
or EncounterLastBP.DiastolicBP.value >= 80 'mm[Hg]'
)
)
)
except "Encounter with Hypertensive Reading Within Year Prior"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>PCSBPScreeningFollowUpFHIR</td>
<td>First Hypertensive Reading Interventions or Referral to Alternate Professional</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "First Hypertensive Reading Interventions or Referral to Alternate Professional":
( [ServiceRequest: "Follow Up Within 4 Weeks"] FourWeekRescreen
with "NonPharmacological Interventions" NonPharmInterventionsHTN
such that FourWeekRescreen.authoredOn during day of "Measurement Period"
and NonPharmInterventionsHTN.authoredOn during day of "Measurement Period"
and FourWeekRescreen.intent ~ 'order'
)
union ( "Referral to Alternate or Primary Healthcare Professional for Hypertensive Reading" )</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>PCSBPScreeningFollowUpFHIR</td>
<td>Encounter with First Hypertensive Reading SBP Greater than or Equal to 130 OR DBP Greater than or Equal to 80 and Interventions</td>
</tr>
<tr>
<td/>
<td>
<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":
"Encounter with First Hypertensive Reading SBP Greater than or Equal to 130 OR DBP Greater than or Equal to 80" FirstHTNEncounter
with "First Hypertensive Reading Interventions or Referral to Alternate Professional" FirstHTNIntervention
such that FirstHTNIntervention.authoredOn during day of FirstHTNEncounter.period</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>PCSBPScreeningFollowUpFHIR</td>
<td>Encounter with Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Encounter with Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89":
( "Qualifying Encounter during Measurement Period" QualifyingEncounter
let EncounterLastBP: Last(["observation-bp"] BloodPressure
where BloodPressure.effective.toInterval() ends during day of QualifyingEncounter.period
and BloodPressure.status in { 'final', 'amended', 'corrected' }
sort by start of effective.toInterval()
)
where ( ( EncounterLastBP.SystolicBP.value in Interval[130 'mm[Hg]', 139 'mm[Hg]']
or EncounterLastBP.DiastolicBP.value in Interval[80 'mm[Hg]', 89 'mm[Hg]']
)
and not ( EncounterLastBP.SystolicBP.value >= 140 'mm[Hg]'
or EncounterLastBP.DiastolicBP.value >= 90 'mm[Hg]'
)
)
and ( exists "Encounter with Hypertensive Reading Within Year Prior" )
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>PCSBPScreeningFollowUpFHIR</td>
<td>Laboratory Test or ECG for Hypertension</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Laboratory Test or ECG for Hypertension":
( [ServiceRequest: "12 lead EKG panel"]
union [ServiceRequest: "EKG study"]
union [ServiceRequest: "Laboratory Tests for Hypertension"] ) EKGLab
where EKGLab.intent ~ 'order'</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>PCSBPScreeningFollowUpFHIR</td>
<td>Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89 and Interventions</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89 and Interventions":
"Follow up with Rescreen Within 6 Months" Rescreen2to6
with "Laboratory Test or ECG for Hypertension" LabECGIntervention
such that Rescreen2to6.authoredOn during day of "Measurement Period"
and LabECGIntervention.authoredOn during day of "Measurement Period"
with "NonPharmacological Interventions" NonPharmSecondIntervention
such that NonPharmSecondIntervention.authoredOn during day of "Measurement Period"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>PCSBPScreeningFollowUpFHIR</td>
<td>Encounter with Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89 and Interventions</td>
</tr>
<tr>
<td/>
<td>
<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":
( "Encounter with Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89" SecondHTNEncounterReading
with "Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89 and Interventions" EncounterInterventions
such that EncounterInterventions.authoredOn during day of SecondHTNEncounterReading.period
)
union ( "Encounter with Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89" SecondHTNEncounterReading
with "Referral to Alternate or Primary Healthcare Professional for Hypertensive Reading" ReferralForHTN
such that ReferralForHTN.authoredOn during day of SecondHTNEncounterReading.period
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>PCSBPScreeningFollowUpFHIR</td>
<td>Encounter with Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90</td>
</tr>
<tr>
<td/>
<td>
<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":
( "Qualifying Encounter during Measurement Period" QualifyingEncounter
let EncounterLastBP: Last(["observation-bp"] BloodPressure
where BloodPressure.effective.toInterval() ends during QualifyingEncounter.period
and BloodPressure.status in { 'final', 'amended', 'corrected' }
sort by start of effective.toInterval()
)
where ( EncounterLastBP.SystolicBP.value > 0 'mm[Hg]'
and EncounterLastBP.DiastolicBP.value > 0 'mm[Hg]'
and ( EncounterLastBP.SystolicBP.value >= 140 'mm[Hg]'
or EncounterLastBP.DiastolicBP.value >= 90 'mm[Hg]'
)
)
and ( exists "Encounter with Hypertensive Reading Within Year Prior" )
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>PCSBPScreeningFollowUpFHIR</td>
<td>Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90 Interventions</td>
</tr>
<tr>
<td/>
<td>
<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":
( [ServiceRequest: "Follow Up Within 4 Weeks"] WeeksRescreen
with "Laboratory Test or ECG for Hypertension" ECGLabTest
such that WeeksRescreen.authoredOn during day of "Measurement Period"
and ECGLabTest.authoredOn during day of "Measurement Period"
and WeeksRescreen.intent ~ 'order'
and ECGLabTest.intent ~ 'order'
with "NonPharmacological Interventions" HTNInterventions
such that HTNInterventions.authoredOn during day of "Measurement Period"
with ["MedicationRequest": "Pharmacologic Therapy for Hypertension"] Medications
such that Medications.authoredOn during day of "Measurement Period"
and Medications.status ~ 'active'
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>PCSBPScreeningFollowUpFHIR</td>
<td>Encounter with Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90 and Interventions</td>
</tr>
<tr>
<td/>
<td>
<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":
( "Encounter with Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90" SecondHTNEncounterReading140Over90
with "Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90 Interventions" SecondHTN140Over90Interventions
such that SecondHTN140Over90Interventions.authoredOn during day of SecondHTNEncounterReading140Over90.period
)
union "Encounter with Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90" SecondHTNEncounterReading140Over90
with "Referral to Alternate or Primary Healthcare Professional for Hypertensive Reading" ReferralToProfessional
such that ReferralToProfessional.authoredOn during day of SecondHTNEncounterReading140Over90.period</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>PCSBPScreeningFollowUpFHIR</td>
<td>Numerator</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Numerator":
"Encounter with Normal Blood Pressure Reading"
union ( "Encounter with Elevated Blood Pressure Reading SBP 120 to 129 AND DBP less than 80 and Interventions" )
union ( "Encounter with First Hypertensive Reading SBP Greater than or Equal to 130 OR DBP Greater than or Equal to 80 and Interventions" )
union ( "Encounter with Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89 and Interventions" )
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>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>PCSBPScreeningFollowUpFHIR</td>
<td>Initial Population</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Initial Population":
"Qualifying Encounter during Measurement Period" QualifyingEncounter
where AgeInYearsAt(start of "Measurement Period") >= 18</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>PCSBPScreeningFollowUpFHIR</td>
<td>Denominator</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Denominator":
"Initial Population"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SupplementalDataElements</td>
<td>SDE Payer</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "SDE Payer":
[Coverage: type in "Payer Type"] Payer
return {
code: Payer.type,
period: Payer.period
}</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>PCSBPScreeningFollowUpFHIR</td>
<td>SDE Payer</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "SDE Payer":
SDE."SDE Payer"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SupplementalDataElements</td>
<td>SDE Ethnicity</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "SDE Ethnicity":
Patient.ethnicity E
return Tuple {
codes: { E.ombCategory } union E.detailed,
display: E.text
}</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>PCSBPScreeningFollowUpFHIR</td>
<td>SDE Ethnicity</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "SDE Ethnicity":
SDE."SDE Ethnicity"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>PCSBPScreeningFollowUpFHIR</td>
<td>Denominator Exclusions</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Denominator Exclusions":
"Qualifying Encounter during Measurement Period" QualifyingEncounter
with [Condition: "Diagnosis of Hypertension"] Hypertension
such that ( Hypertension.isProblemListItem ( )
or Hypertension.isHealthConcern ( )
)
and Hypertension.prevalenceInterval ( ) starts before or on day of QualifyingEncounter.period</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SupplementalDataElements</td>
<td>SDE Race</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "SDE Race":
Patient.race R
return Tuple {
codes: R.ombCategory union R.detailed,
display: R.text
}</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>PCSBPScreeningFollowUpFHIR</td>
<td>SDE Race</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "SDE Race":
SDE."SDE Race"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>PCSBPScreeningFollowUpFHIR</td>
<td>Encounter with Medical Reason for Not Obtaining or Patient Declined Blood Pressure Measurement</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Encounter with Medical Reason for Not Obtaining or Patient Declined Blood Pressure Measurement":
"Qualifying Encounter during Measurement Period" QualifyingEncounter
with ( [ObservationNotDone: code ~ "Systolic blood pressure"]
union [ObservationNotDone: code ~ "Diastolic blood pressure"] ) NoBPScreen
such that NoBPScreen.issued during day of QualifyingEncounter.period
and ( NoBPScreen.notDoneReason in "Patient Declined"
or NoBPScreen.notDoneReason in "Medical Reason"
)
and NoBPScreen.status = 'cancelled'</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>PCSBPScreeningFollowUpFHIR</td>
<td>NonPharmacological Intervention Not Ordered</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "NonPharmacological Intervention Not Ordered":
( [ServiceNotRequested: "Lifestyle Recommendation"]
union [ServiceNotRequested: "Weight Reduction Recommended"]
union [ServiceNotRequested: "Dietary Recommendations"]
union [ServiceNotRequested: "Recommendation to Increase Physical Activity"]
union [ServiceNotRequested: "Referral or Counseling for Alcohol Consumption"] ) NonPharmIntervention
where NonPharmIntervention.reasonRefused in "Patient Declined"
and NonPharmIntervention.status = 'completed'</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>PCSBPScreeningFollowUpFHIR</td>
<td>Laboratory Test or ECG for Hypertension Not Ordered</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Laboratory Test or ECG for Hypertension Not Ordered":
( [ServiceNotRequested: code = "12 lead EKG panel"]
union [ServiceNotRequested: code = "EKG study"]
union [ServiceNotRequested: "Laboratory Tests for Hypertension"] ) LabECGNotDone
where LabECGNotDone.reasonRefused in "Patient Declined"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>PCSBPScreeningFollowUpFHIR</td>
<td>Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89 Interventions Declined</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89 Interventions Declined":
( ( ( [ServiceNotRequested: "Referral to Primary Care or Alternate Provider"]
union [ServiceNotRequested: "Follow Up Within 6 Months"] ) SecondHTNDeclinedReferralAndFollowUp
where SecondHTNDeclinedReferralAndFollowUp.reasonRefused in "Patient Declined"
and SecondHTNDeclinedReferralAndFollowUp.status = 'completed'
)
union "Laboratory Test or ECG for Hypertension Not Ordered"
union "NonPharmacological Intervention Not Ordered"
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>PCSBPScreeningFollowUpFHIR</td>
<td>Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90 Interventions Declined</td>
</tr>
<tr>
<td/>
<td>
<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":
( ( ( [ServiceNotRequested: "Referral to Primary Care or Alternate Provider"]
union [ServiceNotRequested: "Follow Up Within 4 Weeks"] ) SecondHTN140Over90ReferralFollowUpNotDone
where SecondHTN140Over90ReferralFollowUpNotDone.reasonRefused in "Patient Declined"
and SecondHTN140Over90ReferralFollowUpNotDone.status = 'completed'
)
union ( [MedicationNotRequested: "Pharmacologic Therapy for Hypertension"] MedicationRequestNotOrdered
where MedicationRequestNotOrdered.status = 'completed'
)
union "Laboratory Test or ECG for Hypertension Not Ordered"
union "NonPharmacological Intervention Not Ordered"
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>PCSBPScreeningFollowUpFHIR</td>
<td>Encounter with Order for Hypertension Follow Up Declined by Patient</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Encounter with Order for Hypertension Follow Up Declined by Patient":
( ( "Encounter with Elevated Blood Pressure Reading SBP 120 to 129 AND DBP less than 80" ElevatedBPEncounter
with ( [ServiceNotRequested: "Referral to Primary Care or Alternate Provider"]
union [ServiceNotRequested: "Follow Up Within 6 Months"] ) ElevatedBPDeclinedInterventions
such that ElevatedBPDeclinedInterventions.reasonRefused in "Patient Declined"
and ElevatedBPDeclinedInterventions.authoredOn during day of ElevatedBPEncounter.period
and ElevatedBPDeclinedInterventions.status = 'completed'
)
union ( "Encounter with Elevated Blood Pressure Reading SBP 120 to 129 AND DBP less than 80" ElevatedBPEncounter
with "NonPharmacological Intervention Not Ordered" NotOrdered
such that NotOrdered.authoredOn during day of ElevatedBPEncounter.period
)
union ( "Encounter with First Hypertensive Reading SBP Greater than or Equal to 130 OR DBP Greater than or Equal to 80" FirstHTNEncounter
with ( [ServiceNotRequested: "Follow Up Within 4 Weeks"]
union [ServiceNotRequested: "Referral to Primary Care or Alternate Provider"] ) FirstHTNDeclinedInterventions
such that FirstHTNDeclinedInterventions.reasonRefused in "Patient Declined"
and FirstHTNDeclinedInterventions.authoredOn during day of FirstHTNEncounter.period
and FirstHTNDeclinedInterventions.status = 'completed'
)
union ( "Encounter with First Hypertensive Reading SBP Greater than or Equal to 130 OR DBP Greater than or Equal to 80" FirstHTNEncounter
with "NonPharmacological Intervention Not Ordered" NoNonPharm
such that NoNonPharm.authoredOn during day of FirstHTNEncounter.period
)
union ( "Encounter with Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89" SecondHTNEncounter
with "Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89 Interventions Declined" SecondHTNDeclinedInterventions
such that SecondHTNDeclinedInterventions.authoredOn during day of SecondHTNEncounter.period
)
union ( "Encounter with Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90" SecondHTN140Over90Encounter
with "Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90 Interventions Declined" SecondHTN140Over90DeclinedInterventions
such that SecondHTN140Over90DeclinedInterventions.authoredOn during day of SecondHTN140Over90Encounter.period
)
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>PCSBPScreeningFollowUpFHIR</td>
<td>Denominator Exceptions</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Denominator Exceptions":
"Encounter with Medical Reason for Not Obtaining or Patient Declined Blood Pressure Measurement"
union "Encounter with Order for Hypertension Follow Up Declined by Patient"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>FHIRHelpers</td>
<td>ToString</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define function ToString(value uri): value.value</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>FHIRHelpers</td>
<td>ToConcept</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">/*
@description: Converts the given FHIR [CodeableConcept](https://hl7.org/fhir/datatypes.html#CodeableConcept) value to a CQL Concept.
*/
define function ToConcept(concept FHIR.CodeableConcept):
if concept is null then
null
else
System.Concept {
codes: concept.coding C return ToCode(C),
display: concept.text.value
}</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>FHIRHelpers</td>
<td>ToCode</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">/*
@description: Converts the given FHIR [Coding](https://hl7.org/fhir/datatypes.html#Coding) value to a CQL Code.
*/
define function ToCode(coding FHIR.Coding):
if coding is null then
null
else
System.Code {
code: coding.code.value,
system: coding.system.value,
version: coding.version.value,
display: coding.display.value
}</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>QICoreCommon</td>
<td>isProblemListItem</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">/*
@description: Returns true if the given condition is a problem list item.
*/
define fluent function isProblemListItem(condition Condition):
exists (condition.category C
where C ~ "problem-list-item"
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>QICoreCommon</td>
<td>isHealthConcern</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">/*
@description: Returns true if the given condition is a health concern
*/
define fluent function isHealthConcern(condition Condition):
exists (condition.category C
where C ~ "health-concern"
)</code></pre>
</td>
</tr>
</table>
</td>
</tr>
</table>
</div>
</text>
<contained>
<Library>
<id value="effective-data-requirements"/>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
<valueCoding>
<system value="http://hl7.org/fhir/administrative-gender"/>
<code value="M"/>
<display value="Male"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
<valueCoding>
<system value="http://hl7.org/fhir/administrative-gender"/>
<code value="F"/>
<display value="Female"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
<valueCoding>
<system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
<code value="VR"/>
<display value="virtual"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
<valueCoding>
<system value="http://loinc.org"/>
<code value="34534-8"/>
<display value="EKG 12 channel panel"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
<valueCoding>
<system value="http://loinc.org"/>
<code value="11524-6"/>
<display value="EKG study"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
<valueCoding>
<system
value="http://terminology.hl7.org/CodeSystem/condition-category"/>
<code value="problem-list-item"/>
<display value="Problem List Item"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
<valueCoding>
<system
value="http://hl7.org/fhir/us/core/CodeSystem/condition-category"/>
<code value="health-concern"/>
<display value="Health Concern"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
<valueCoding>
<system value="http://loinc.org"/>
<code value="8480-6"/>
<display value="Systolic blood pressure"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
<valueCoding>
<system value="http://loinc.org"/>
<code value="8462-4"/>
<display value="Diastolic blood pressure"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SupplementalDataElements"/>
</extension>
<extension url="name">
<valueString value="SDE Sex"/>
</extension>
<extension url="statement">
<valueString
value="define "SDE Sex":
case
when Patient.gender = 'male' then "M"
when Patient.gender = 'female' then "F"
else null
end"/>
</extension>
<extension url="displaySequence">
<valueInteger value="0"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="PCSBPScreeningFollowUpFHIR"/>
</extension>
<extension url="name">
<valueString value="SDE Sex"/>
</extension>
<extension url="statement">
<valueString
value="define "SDE Sex":
SDE."SDE Sex""/>
</extension>
<extension url="displaySequence">
<valueInteger value="1"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="PCSBPScreeningFollowUpFHIR"/>
</extension>
<extension url="name">
<valueString
value="Qualifying Encounter during Measurement Period"/>
</extension>
<extension url="statement">
<valueString
value="define "Qualifying Encounter during Measurement Period":
[Encounter: "Encounter to Screen for Blood Pressure"] ValidEncounter
where ValidEncounter.period during day of "Measurement Period"
and ValidEncounter.status ~ 'finished'
and ValidEncounter.class !~ "virtual""/>
</extension>
<extension url="displaySequence">
<valueInteger value="2"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="PCSBPScreeningFollowUpFHIR"/>
</extension>
<extension url="name">
<valueString value="Encounter with Normal Blood Pressure Reading"/>
</extension>
<extension url="statement">
<valueString
value="define "Encounter with Normal Blood Pressure Reading":
"Qualifying Encounter during Measurement Period" QualifyingEncounter
let EncounterLastBP: Last(["observation-bp"] BloodPressure
where BloodPressure.effective.toInterval() ends during QualifyingEncounter.period
and BloodPressure.status in { 'final', 'amended', 'corrected' }
sort by start of effective.toInterval()
)
where EncounterLastBP.SystolicBP.value in Interval[1 'mm[Hg]', 120 'mm[Hg]' )
and EncounterLastBP.DiastolicBP.value in Interval[1 'mm[Hg]', 80 'mm[Hg]' )"/>
</extension>
<extension url="displaySequence">
<valueInteger value="3"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="PCSBPScreeningFollowUpFHIR"/>
</extension>
<extension url="name">
<valueString
value="Encounter with Elevated Blood Pressure Reading SBP 120 to 129 AND DBP less than 80"/>
</extension>
<extension url="statement">
<valueString
value="define "Encounter with Elevated Blood Pressure Reading SBP 120 to 129 AND DBP less than 80":
"Qualifying Encounter during Measurement Period" QualifyingEncounter
let EncounterLastBP: Last(["observation-bp"] BloodPressure
where BloodPressure.effective.toInterval() ends during QualifyingEncounter.period
and BloodPressure.status in { 'final', 'amended', 'corrected' }
sort by start of effective.toInterval()
)
where ( EncounterLastBP.SystolicBP.value in Interval[120 'mm[Hg]', 129 'mm[Hg]']
and EncounterLastBP.DiastolicBP.value in Interval[1 'mm[Hg]', 80 'mm[Hg]' )
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="4"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="PCSBPScreeningFollowUpFHIR"/>
</extension>
<extension url="name">
<valueString value="Follow up with Rescreen Within 6 Months"/>
</extension>
<extension url="statement">
<valueString
value="define "Follow up with Rescreen Within 6 Months":
[ServiceRequest: "Follow Up Within 6 Months"] FollowUp
where FollowUp.intent ~ 'order'"/>
</extension>
<extension url="displaySequence">
<valueInteger value="5"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="PCSBPScreeningFollowUpFHIR"/>
</extension>
<extension url="name">
<valueString value="NonPharmacological Interventions"/>
</extension>
<extension url="statement">
<valueString
value="define "NonPharmacological Interventions":
( [ServiceRequest: "Lifestyle Recommendation"]
union [ServiceRequest: "Weight Reduction Recommended"]
union [ServiceRequest: "Dietary Recommendations"]
union [ServiceRequest: "Recommendation to Increase Physical Activity"]
union [ServiceRequest: "Referral or Counseling for Alcohol Consumption"] ) NonPharmaInterventions
where NonPharmaInterventions.intent ~ 'order'"/>
</extension>
<extension url="displaySequence">
<valueInteger value="6"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="PCSBPScreeningFollowUpFHIR"/>
</extension>
<extension url="name">
<valueString
value="Referral to Alternate or Primary Healthcare Professional for Hypertensive Reading"/>
</extension>
<extension url="statement">
<valueString
value="define "Referral to Alternate or Primary Healthcare Professional for Hypertensive Reading":
[ServiceRequest: "Referral to Primary Care or Alternate Provider"] Referral
where Referral.reasonCode in "Finding of Elevated Blood Pressure or Hypertension"
and Referral.intent ~ 'order'"/>
</extension>
<extension url="displaySequence">
<valueInteger value="7"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="PCSBPScreeningFollowUpFHIR"/>
</extension>
<extension url="name">
<valueString
value="Encounter with Elevated Blood Pressure Reading SBP 120 to 129 AND DBP less than 80 and Interventions"/>
</extension>
<extension url="statement">
<valueString
value="define "Encounter with Elevated Blood Pressure Reading SBP 120 to 129 AND DBP less than 80 and Interventions":
( "Encounter with Elevated Blood Pressure Reading SBP 120 to 129 AND DBP less than 80" ElevatedEncounter
with "Follow up with Rescreen Within 6 Months" Twoto6MonthRescreen
such that Twoto6MonthRescreen.authoredOn during day of ElevatedEncounter.period
with "NonPharmacological Interventions" NonPharmInterventions
such that NonPharmInterventions.authoredOn during day of ElevatedEncounter.period
)
union ( "Encounter with Elevated Blood Pressure Reading SBP 120 to 129 AND DBP less than 80" ElevatedEncounter
with "Referral to Alternate or Primary Healthcare Professional for Hypertensive Reading" Referral
such that Referral.authoredOn during day of ElevatedEncounter.period
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="8"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="PCSBPScreeningFollowUpFHIR"/>
</extension>
<extension url="name">
<valueString
value="Encounter with Hypertensive Reading Within Year Prior"/>
</extension>
<extension url="statement">
<valueString
value="define "Encounter with Hypertensive Reading Within Year Prior":
( "Qualifying Encounter during Measurement Period" QualifyingEncounter
let EncounterLastBP: Last(["observation-bp"] BloodPressure
where BloodPressure.effective.toInterval() ends 1 year or less before or on start of QualifyingEncounter.period
and BloodPressure.status in { 'final', 'amended', 'corrected' }
sort by start of effective.toInterval()
)
where ( EncounterLastBP.SystolicBP.value > 0 'mm[Hg]'
and EncounterLastBP.DiastolicBP.value > 0 'mm[Hg]'
and ( EncounterLastBP.SystolicBP.value >= 130 'mm[Hg]'
or EncounterLastBP.DiastolicBP.value >= 80 'mm[Hg]'
)
)
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="9"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="PCSBPScreeningFollowUpFHIR"/>
</extension>
<extension url="name">
<valueString
value="Encounter with First Hypertensive Reading SBP Greater than or Equal to 130 OR DBP Greater than or Equal to 80"/>
</extension>
<extension url="statement">
<valueString
value="define "Encounter with First Hypertensive Reading SBP Greater than or Equal to 130 OR DBP Greater than or Equal to 80":
( "Qualifying Encounter during Measurement Period" QualifyingEncounter
let EncounterLastBP: Last(["observation-bp"] BloodPressure
where BloodPressure.effective.toInterval() ends during day of QualifyingEncounter.period
sort by start of effective.toInterval()
)
where ( ( EncounterLastBP.SystolicBP.value > 0 'mm[Hg]'
and EncounterLastBP.DiastolicBP.value > 0 'mm[Hg]'
)
and ( EncounterLastBP.SystolicBP.value >= 130 'mm[Hg]'
or EncounterLastBP.DiastolicBP.value >= 80 'mm[Hg]'
)
)
)
except "Encounter with Hypertensive Reading Within Year Prior""/>
</extension>
<extension url="displaySequence">
<valueInteger value="10"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="PCSBPScreeningFollowUpFHIR"/>
</extension>
<extension url="name">
<valueString
value="First Hypertensive Reading Interventions or Referral to Alternate Professional"/>
</extension>
<extension url="statement">
<valueString
value="define "First Hypertensive Reading Interventions or Referral to Alternate Professional":
( [ServiceRequest: "Follow Up Within 4 Weeks"] FourWeekRescreen
with "NonPharmacological Interventions" NonPharmInterventionsHTN
such that FourWeekRescreen.authoredOn during day of "Measurement Period"
and NonPharmInterventionsHTN.authoredOn during day of "Measurement Period"
and FourWeekRescreen.intent ~ 'order'
)
union ( "Referral to Alternate or Primary Healthcare Professional for Hypertensive Reading" )"/>
</extension>
<extension url="displaySequence">
<valueInteger value="11"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="PCSBPScreeningFollowUpFHIR"/>
</extension>
<extension url="name">
<valueString
value="Encounter with First Hypertensive Reading SBP Greater than or Equal to 130 OR DBP Greater than or Equal to 80 and Interventions"/>
</extension>
<extension url="statement">
<valueString
value="define "Encounter with First Hypertensive Reading SBP Greater than or Equal to 130 OR DBP Greater than or Equal to 80 and Interventions":
"Encounter with First Hypertensive Reading SBP Greater than or Equal to 130 OR DBP Greater than or Equal to 80" FirstHTNEncounter
with "First Hypertensive Reading Interventions or Referral to Alternate Professional" FirstHTNIntervention
such that FirstHTNIntervention.authoredOn during day of FirstHTNEncounter.period"/>
</extension>
<extension url="displaySequence">
<valueInteger value="12"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="PCSBPScreeningFollowUpFHIR"/>
</extension>
<extension url="name">
<valueString
value="Encounter with Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89"/>
</extension>
<extension url="statement">
<valueString
value="define "Encounter with Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89":
( "Qualifying Encounter during Measurement Period" QualifyingEncounter
let EncounterLastBP: Last(["observation-bp"] BloodPressure
where BloodPressure.effective.toInterval() ends during day of QualifyingEncounter.period
and BloodPressure.status in { 'final', 'amended', 'corrected' }
sort by start of effective.toInterval()
)
where ( ( EncounterLastBP.SystolicBP.value in Interval[130 'mm[Hg]', 139 'mm[Hg]']
or EncounterLastBP.DiastolicBP.value in Interval[80 'mm[Hg]', 89 'mm[Hg]']
)
and not ( EncounterLastBP.SystolicBP.value >= 140 'mm[Hg]'
or EncounterLastBP.DiastolicBP.value >= 90 'mm[Hg]'
)
)
and ( exists "Encounter with Hypertensive Reading Within Year Prior" )
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="13"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="PCSBPScreeningFollowUpFHIR"/>
</extension>
<extension url="name">
<valueString value="Laboratory Test or ECG for Hypertension"/>
</extension>
<extension url="statement">
<valueString
value="define "Laboratory Test or ECG for Hypertension":
( [ServiceRequest: "12 lead EKG panel"]
union [ServiceRequest: "EKG study"]
union [ServiceRequest: "Laboratory Tests for Hypertension"] ) EKGLab
where EKGLab.intent ~ 'order'"/>
</extension>
<extension url="displaySequence">
<valueInteger value="14"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="PCSBPScreeningFollowUpFHIR"/>
</extension>
<extension url="name">
<valueString
value="Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89 and Interventions"/>
</extension>
<extension url="statement">
<valueString
value="define "Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89 and Interventions":
"Follow up with Rescreen Within 6 Months" Rescreen2to6
with "Laboratory Test or ECG for Hypertension" LabECGIntervention
such that Rescreen2to6.authoredOn during day of "Measurement Period"
and LabECGIntervention.authoredOn during day of "Measurement Period"
with "NonPharmacological Interventions" NonPharmSecondIntervention
such that NonPharmSecondIntervention.authoredOn during day of "Measurement Period""/>
</extension>
<extension url="displaySequence">
<valueInteger value="15"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="PCSBPScreeningFollowUpFHIR"/>
</extension>
<extension url="name">
<valueString
value="Encounter with Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89 and Interventions"/>
</extension>
<extension url="statement">
<valueString
value="define "Encounter with Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89 and Interventions":
( "Encounter with Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89" SecondHTNEncounterReading
with "Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89 and Interventions" EncounterInterventions
such that EncounterInterventions.authoredOn during day of SecondHTNEncounterReading.period
)
union ( "Encounter with Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89" SecondHTNEncounterReading
with "Referral to Alternate or Primary Healthcare Professional for Hypertensive Reading" ReferralForHTN
such that ReferralForHTN.authoredOn during day of SecondHTNEncounterReading.period
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="16"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="PCSBPScreeningFollowUpFHIR"/>
</extension>
<extension url="name">
<valueString
value="Encounter with Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90"/>
</extension>
<extension url="statement">
<valueString
value="define "Encounter with Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90":
( "Qualifying Encounter during Measurement Period" QualifyingEncounter
let EncounterLastBP: Last(["observation-bp"] BloodPressure
where BloodPressure.effective.toInterval() ends during QualifyingEncounter.period
and BloodPressure.status in { 'final', 'amended', 'corrected' }
sort by start of effective.toInterval()
)
where ( EncounterLastBP.SystolicBP.value > 0 'mm[Hg]'
and EncounterLastBP.DiastolicBP.value > 0 'mm[Hg]'
and ( EncounterLastBP.SystolicBP.value >= 140 'mm[Hg]'
or EncounterLastBP.DiastolicBP.value >= 90 'mm[Hg]'
)
)
and ( exists "Encounter with Hypertensive Reading Within Year Prior" )
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="17"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="PCSBPScreeningFollowUpFHIR"/>
</extension>
<extension url="name">
<valueString
value="Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90 Interventions"/>
</extension>
<extension url="statement">
<valueString
value="define "Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90 Interventions":
( [ServiceRequest: "Follow Up Within 4 Weeks"] WeeksRescreen
with "Laboratory Test or ECG for Hypertension" ECGLabTest
such that WeeksRescreen.authoredOn during day of "Measurement Period"
and ECGLabTest.authoredOn during day of "Measurement Period"
and WeeksRescreen.intent ~ 'order'
and ECGLabTest.intent ~ 'order'
with "NonPharmacological Interventions" HTNInterventions
such that HTNInterventions.authoredOn during day of "Measurement Period"
with ["MedicationRequest": "Pharmacologic Therapy for Hypertension"] Medications
such that Medications.authoredOn during day of "Measurement Period"
and Medications.status ~ 'active'
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="18"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="PCSBPScreeningFollowUpFHIR"/>
</extension>
<extension url="name">
<valueString
value="Encounter with Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90 and Interventions"/>
</extension>
<extension url="statement">
<valueString
value="define "Encounter with Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90 and Interventions":
( "Encounter with Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90" SecondHTNEncounterReading140Over90
with "Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90 Interventions" SecondHTN140Over90Interventions
such that SecondHTN140Over90Interventions.authoredOn during day of SecondHTNEncounterReading140Over90.period
)
union "Encounter with Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90" SecondHTNEncounterReading140Over90
with "Referral to Alternate or Primary Healthcare Professional for Hypertensive Reading" ReferralToProfessional
such that ReferralToProfessional.authoredOn during day of SecondHTNEncounterReading140Over90.period"/>
</extension>
<extension url="displaySequence">
<valueInteger value="19"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="PCSBPScreeningFollowUpFHIR"/>
</extension>
<extension url="name">
<valueString value="Numerator"/>
</extension>
<extension url="statement">
<valueString
value="define "Numerator":
"Encounter with Normal Blood Pressure Reading"
union ( "Encounter with Elevated Blood Pressure Reading SBP 120 to 129 AND DBP less than 80 and Interventions" )
union ( "Encounter with First Hypertensive Reading SBP Greater than or Equal to 130 OR DBP Greater than or Equal to 80 and Interventions" )
union ( "Encounter with Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89 and Interventions" )
union ( "Encounter with Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90 and Interventions" )"/>
</extension>
<extension url="displaySequence">
<valueInteger value="20"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="PCSBPScreeningFollowUpFHIR"/>
</extension>
<extension url="name">
<valueString value="Initial Population"/>
</extension>
<extension url="statement">
<valueString
value="define "Initial Population":
"Qualifying Encounter during Measurement Period" QualifyingEncounter
where AgeInYearsAt(start of "Measurement Period") >= 18"/>
</extension>
<extension url="displaySequence">
<valueInteger value="21"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="PCSBPScreeningFollowUpFHIR"/>
</extension>
<extension url="name">
<valueString value="Denominator"/>
</extension>
<extension url="statement">
<valueString
value="define "Denominator":
"Initial Population""/>
</extension>
<extension url="displaySequence">
<valueInteger value="22"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SupplementalDataElements"/>
</extension>
<extension url="name">
<valueString value="SDE Payer"/>
</extension>
<extension url="statement">
<valueString
value="define "SDE Payer":
[Coverage: type in "Payer Type"] Payer
return {
code: Payer.type,
period: Payer.period
}"/>
</extension>
<extension url="displaySequence">
<valueInteger value="23"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="PCSBPScreeningFollowUpFHIR"/>
</extension>
<extension url="name">
<valueString value="SDE Payer"/>
</extension>
<extension url="statement">
<valueString
value="define "SDE Payer":
SDE."SDE Payer""/>
</extension>
<extension url="displaySequence">
<valueInteger value="24"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SupplementalDataElements"/>
</extension>
<extension url="name">
<valueString value="SDE Ethnicity"/>
</extension>
<extension url="statement">
<valueString
value="define "SDE Ethnicity":
Patient.ethnicity E
return Tuple {
codes: { E.ombCategory } union E.detailed,
display: E.text
}"/>
</extension>
<extension url="displaySequence">
<valueInteger value="25"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="PCSBPScreeningFollowUpFHIR"/>
</extension>
<extension url="name">
<valueString value="SDE Ethnicity"/>
</extension>
<extension url="statement">
<valueString
value="define "SDE Ethnicity":
SDE."SDE Ethnicity""/>
</extension>
<extension url="displaySequence">
<valueInteger value="26"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="PCSBPScreeningFollowUpFHIR"/>
</extension>
<extension url="name">
<valueString value="Denominator Exclusions"/>
</extension>
<extension url="statement">
<valueString
value="define "Denominator Exclusions":
"Qualifying Encounter during Measurement Period" QualifyingEncounter
with [Condition: "Diagnosis of Hypertension"] Hypertension
such that ( Hypertension.isProblemListItem ( )
or Hypertension.isHealthConcern ( )
)
and Hypertension.prevalenceInterval ( ) starts before or on day of QualifyingEncounter.period"/>
</extension>
<extension url="displaySequence">
<valueInteger value="27"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SupplementalDataElements"/>
</extension>
<extension url="name">
<valueString value="SDE Race"/>
</extension>
<extension url="statement">
<valueString
value="define "SDE Race":
Patient.race R
return Tuple {
codes: R.ombCategory union R.detailed,
display: R.text
}"/>
</extension>
<extension url="displaySequence">
<valueInteger value="28"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="PCSBPScreeningFollowUpFHIR"/>
</extension>
<extension url="name">
<valueString value="SDE Race"/>
</extension>
<extension url="statement">
<valueString
value="define "SDE Race":
SDE."SDE Race""/>
</extension>
<extension url="displaySequence">
<valueInteger value="29"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="PCSBPScreeningFollowUpFHIR"/>
</extension>
<extension url="name">
<valueString
value="Encounter with Medical Reason for Not Obtaining or Patient Declined Blood Pressure Measurement"/>
</extension>
<extension url="statement">
<valueString
value="define "Encounter with Medical Reason for Not Obtaining or Patient Declined Blood Pressure Measurement":
"Qualifying Encounter during Measurement Period" QualifyingEncounter
with ( [ObservationNotDone: code ~ "Systolic blood pressure"]
union [ObservationNotDone: code ~ "Diastolic blood pressure"] ) NoBPScreen
such that NoBPScreen.issued during day of QualifyingEncounter.period
and ( NoBPScreen.notDoneReason in "Patient Declined"
or NoBPScreen.notDoneReason in "Medical Reason"
)
and NoBPScreen.status = 'cancelled'"/>
</extension>
<extension url="displaySequence">
<valueInteger value="30"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="PCSBPScreeningFollowUpFHIR"/>
</extension>
<extension url="name">
<valueString value="NonPharmacological Intervention Not Ordered"/>
</extension>
<extension url="statement">
<valueString
value="define "NonPharmacological Intervention Not Ordered":
( [ServiceNotRequested: "Lifestyle Recommendation"]
union [ServiceNotRequested: "Weight Reduction Recommended"]
union [ServiceNotRequested: "Dietary Recommendations"]
union [ServiceNotRequested: "Recommendation to Increase Physical Activity"]
union [ServiceNotRequested: "Referral or Counseling for Alcohol Consumption"] ) NonPharmIntervention
where NonPharmIntervention.reasonRefused in "Patient Declined"
and NonPharmIntervention.status = 'completed'"/>
</extension>
<extension url="displaySequence">
<valueInteger value="31"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="PCSBPScreeningFollowUpFHIR"/>
</extension>
<extension url="name">
<valueString
value="Laboratory Test or ECG for Hypertension Not Ordered"/>
</extension>
<extension url="statement">
<valueString
value="define "Laboratory Test or ECG for Hypertension Not Ordered":
( [ServiceNotRequested: code = "12 lead EKG panel"]
union [ServiceNotRequested: code = "EKG study"]
union [ServiceNotRequested: "Laboratory Tests for Hypertension"] ) LabECGNotDone
where LabECGNotDone.reasonRefused in "Patient Declined""/>
</extension>
<extension url="displaySequence">
<valueInteger value="32"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="PCSBPScreeningFollowUpFHIR"/>
</extension>
<extension url="name">
<valueString
value="Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89 Interventions Declined"/>
</extension>
<extension url="statement">
<valueString
value="define "Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89 Interventions Declined":
( ( ( [ServiceNotRequested: "Referral to Primary Care or Alternate Provider"]
union [ServiceNotRequested: "Follow Up Within 6 Months"] ) SecondHTNDeclinedReferralAndFollowUp
where SecondHTNDeclinedReferralAndFollowUp.reasonRefused in "Patient Declined"
and SecondHTNDeclinedReferralAndFollowUp.status = 'completed'
)
union "Laboratory Test or ECG for Hypertension Not Ordered"
union "NonPharmacological Intervention Not Ordered"
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="33"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="PCSBPScreeningFollowUpFHIR"/>
</extension>
<extension url="name">
<valueString
value="Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90 Interventions Declined"/>
</extension>
<extension url="statement">
<valueString
value="define "Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90 Interventions Declined":
( ( ( [ServiceNotRequested: "Referral to Primary Care or Alternate Provider"]
union [ServiceNotRequested: "Follow Up Within 4 Weeks"] ) SecondHTN140Over90ReferralFollowUpNotDone
where SecondHTN140Over90ReferralFollowUpNotDone.reasonRefused in "Patient Declined"
and SecondHTN140Over90ReferralFollowUpNotDone.status = 'completed'
)
union ( [MedicationNotRequested: "Pharmacologic Therapy for Hypertension"] MedicationRequestNotOrdered
where MedicationRequestNotOrdered.status = 'completed'
)
union "Laboratory Test or ECG for Hypertension Not Ordered"
union "NonPharmacological Intervention Not Ordered"
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="34"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="PCSBPScreeningFollowUpFHIR"/>
</extension>
<extension url="name">
<valueString
value="Encounter with Order for Hypertension Follow Up Declined by Patient"/>
</extension>
<extension url="statement">
<valueString
value="define "Encounter with Order for Hypertension Follow Up Declined by Patient":
( ( "Encounter with Elevated Blood Pressure Reading SBP 120 to 129 AND DBP less than 80" ElevatedBPEncounter
with ( [ServiceNotRequested: "Referral to Primary Care or Alternate Provider"]
union [ServiceNotRequested: "Follow Up Within 6 Months"] ) ElevatedBPDeclinedInterventions
such that ElevatedBPDeclinedInterventions.reasonRefused in "Patient Declined"
and ElevatedBPDeclinedInterventions.authoredOn during day of ElevatedBPEncounter.period
and ElevatedBPDeclinedInterventions.status = 'completed'
)
union ( "Encounter with Elevated Blood Pressure Reading SBP 120 to 129 AND DBP less than 80" ElevatedBPEncounter
with "NonPharmacological Intervention Not Ordered" NotOrdered
such that NotOrdered.authoredOn during day of ElevatedBPEncounter.period
)
union ( "Encounter with First Hypertensive Reading SBP Greater than or Equal to 130 OR DBP Greater than or Equal to 80" FirstHTNEncounter
with ( [ServiceNotRequested: "Follow Up Within 4 Weeks"]
union [ServiceNotRequested: "Referral to Primary Care or Alternate Provider"] ) FirstHTNDeclinedInterventions
such that FirstHTNDeclinedInterventions.reasonRefused in "Patient Declined"
and FirstHTNDeclinedInterventions.authoredOn during day of FirstHTNEncounter.period
and FirstHTNDeclinedInterventions.status = 'completed'
)
union ( "Encounter with First Hypertensive Reading SBP Greater than or Equal to 130 OR DBP Greater than or Equal to 80" FirstHTNEncounter
with "NonPharmacological Intervention Not Ordered" NoNonPharm
such that NoNonPharm.authoredOn during day of FirstHTNEncounter.period
)
union ( "Encounter with Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89" SecondHTNEncounter
with "Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89 Interventions Declined" SecondHTNDeclinedInterventions
such that SecondHTNDeclinedInterventions.authoredOn during day of SecondHTNEncounter.period
)
union ( "Encounter with Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90" SecondHTN140Over90Encounter
with "Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90 Interventions Declined" SecondHTN140Over90DeclinedInterventions
such that SecondHTN140Over90DeclinedInterventions.authoredOn during day of SecondHTN140Over90Encounter.period
)
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="35"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="PCSBPScreeningFollowUpFHIR"/>
</extension>
<extension url="name">
<valueString value="Denominator Exceptions"/>
</extension>
<extension url="statement">
<valueString
value="define "Denominator Exceptions":
"Encounter with Medical Reason for Not Obtaining or Patient Declined Blood Pressure Measurement"
union "Encounter with Order for Hypertension Follow Up Declined by Patient""/>
</extension>
<extension url="displaySequence">
<valueInteger value="36"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="FHIRHelpers"/>
</extension>
<extension url="name">
<valueString value="ToString"/>
</extension>
<extension url="statement">
<valueString
value="define function ToString(value uri): value.value"/>
</extension>
<extension url="displaySequence">
<valueInteger value="37"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="FHIRHelpers"/>
</extension>
<extension url="name">
<valueString value="ToConcept"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Converts the given FHIR [CodeableConcept](https://hl7.org/fhir/datatypes.html#CodeableConcept) value to a CQL Concept.
*/
define function ToConcept(concept FHIR.CodeableConcept):
if concept is null then
null
else
System.Concept {
codes: concept.coding C return ToCode(C),
display: concept.text.value
}"/>
</extension>
<extension url="displaySequence">
<valueInteger value="38"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="FHIRHelpers"/>
</extension>
<extension url="name">
<valueString value="ToCode"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Converts the given FHIR [Coding](https://hl7.org/fhir/datatypes.html#Coding) value to a CQL Code.
*/
define function ToCode(coding FHIR.Coding):
if coding is null then
null
else
System.Code {
code: coding.code.value,
system: coding.system.value,
version: coding.version.value,
display: coding.display.value
}"/>
</extension>
<extension url="displaySequence">
<valueInteger value="39"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="QICoreCommon"/>
</extension>
<extension url="name">
<valueString value="isProblemListItem"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Returns true if the given condition is a problem list item.
*/
define fluent function isProblemListItem(condition Condition):
exists (condition.category C
where C ~ "problem-list-item"
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="40"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="QICoreCommon"/>
</extension>
<extension url="name">
<valueString value="isHealthConcern"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Returns true if the given condition is a health concern
*/
define fluent function isHealthConcern(condition Condition):
exists (condition.category C
where C ~ "health-concern"
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="41"/>
</extension>
</extension>
<name value="EffectiveDataRequirements"/>
<status value="active"/>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/library-type"/>
<code value="module-definition"/>
</coding>
</type>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library SDE"/>
<resource value="Library/SupplementalDataElements|3.5.000"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library FHIRHelpers"/>
<resource value="Library/FHIRHelpers|4.4.000"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library QICoreCommon"/>
<resource value="Library/QICoreCommon|2.1.000"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Code system AdministrativeGender"/>
<resource value="http://hl7.org/fhir/administrative-gender"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Code system ActCode"/>
<resource value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Code system LOINC"/>
<resource value="http://loinc.org"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Code system ConditionCategory"/>
<resource
value="http://terminology.hl7.org/CodeSystem/condition-category"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Code system USCoreConditionCategoryExtensionCodes"/>
<resource
value="http://hl7.org/fhir/us/core/CodeSystem/condition-category"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Encounter to Screen for Blood Pressure"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1920"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Follow Up Within 6 Months"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.125"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Lifestyle Recommendation"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1581"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Weight Reduction Recommended"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1510"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Dietary Recommendations"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1515"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display
value="Value set Recommendation to Increase Physical Activity"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1518"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display
value="Value set Referral or Counseling for Alcohol Consumption"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1583"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display
value="Value set Referral to Primary Care or Alternate Provider"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1580"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display
value="Value set Finding of Elevated Blood Pressure or Hypertension"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1047.514"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Follow Up Within 4 Weeks"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1578"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Laboratory Tests for Hypertension"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1482"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Pharmacologic Therapy for Hypertension"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.1577"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Payer Type"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Diagnosis of Hypertension"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.263"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Patient Declined"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1582"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Medical Reason"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1007"/>
</relatedArtifact>
<parameter>
<name value="Measurement Period"/>
<use value="in"/>
<min value="0"/>
<max value="1"/>
<type value="Period"/>
</parameter>
<parameter>
<name value="SDE Sex"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="Coding"/>
</parameter>
<parameter>
<name value="Numerator"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Resource"/>
</parameter>
<parameter>
<name value="Denominator"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Resource"/>
</parameter>
<parameter>
<name value="SDE Payer"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Resource"/>
</parameter>
<parameter>
<name value="Initial Population"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Resource"/>
</parameter>
<parameter>
<name value="SDE Ethnicity"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="Resource"/>
</parameter>
<parameter>
<name value="Denominator Exclusions"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Resource"/>
</parameter>
<parameter>
<name value="SDE Race"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="Resource"/>
</parameter>
<parameter>
<name value="Denominator Exceptions"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Resource"/>
</parameter>
<dataRequirement>
<type value="Patient"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"/>
<mustSupport value="ethnicity"/>
<mustSupport value="race"/>
</dataRequirement>
<dataRequirement>
<type value="Encounter"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"/>
<mustSupport value="type"/>
<mustSupport value="period"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="class"/>
<codeFilter>
<path value="type"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1920"/>
</codeFilter>
<codeFilter>
<path value="status.value"/>
<code>
<code value="finished"/>
</code>
</codeFilter>
<codeFilter>
<path value="class"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Observation"/>
<profile value="http://hl7.org/fhir/StructureDefinition/bp"/>
<mustSupport value="effective"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="component"/>
</dataRequirement>
<dataRequirement>
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<code>
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<dateFilter>
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<valuePeriod>
<extension
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<valueExpression>
<language value="text/cql-identifier"/>
<expression value="Measurement Period"/>
</valueExpression>
</extension>
</valuePeriod>
</dateFilter>
</dataRequirement>
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<code>
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</code>
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<dateFilter>
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<valuePeriod>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-expression">
<valueExpression>
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<expression value="Measurement Period"/>
</valueExpression>
</extension>
</valuePeriod>
</dateFilter>
</dataRequirement>
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<codeFilter>
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<code>
<code value="order"/>
</code>
</codeFilter>
</dataRequirement>
<dataRequirement>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-relatedRequirement">
<extension url="targetId">
<valueString value="1425"/>
</extension>
<extension url="targetProperty">
<valueString value="medication"/>
</extension>
</extension>
<type value="Medication"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medication"/>
<mustSupport value="id"/>
</dataRequirement>
<dataRequirement id="1425">
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<profile
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<mustSupport value="medication.reference"/>
<mustSupport value="authoredOn"/>
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<dataRequirement>
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<profile
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<mustSupport value="authoredOn"/>
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</dataRequirement>
<dataRequirement>
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<mustSupport value="period"/>
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<dataRequirement>
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<mustSupport value="issued"/>
<mustSupport value="issued.value"/>
<mustSupport value="extension"/>
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<mustSupport value="status.value"/>
<codeFilter>
<path value="code"/>
<code>
<system value="http://loinc.org"/>
<code value="8480-6"/>
<display value="Systolic blood pressure"/>
</code>
</codeFilter>
</dataRequirement>
<dataRequirement>
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<codeFilter>
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<code>
<system value="http://loinc.org"/>
<code value="8462-4"/>
<display value="Diastolic blood pressure"/>
</code>
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<dataRequirement>
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<mustSupport value="medication"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<codeFilter>
<path value="medication"/>
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</dataRequirement>
<dataRequirement>
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<mustSupport value="medication"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<codeFilter>
<path value="medication"/>
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</codeFilter>
</dataRequirement>
</Library>
</contained>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-supplementalDataGuidance" id="supplementalDataGuidance">
<extension url="guidance">
<valueString
value="For every patient evaluated by this measure also identify payer, race, ethnicity and sex; SDE Ethnicity SDE Payer SDE Race SDE Sex "/>
</extension>
<extension url="usage">
<valueCodeableConcept>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="supplemental-data"/>
<display value="Supplemental Data"/>
</coding>
<text value="Supplemental Data Guidance"/>
</valueCodeableConcept>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-effectiveDataRequirements" id="effective-data-requirements">
<valueReference>
<reference value="#effective-data-requirements"/>
</valueReference>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-softwaresystem">
<valueReference>
<reference value="Device/cqf-tooling"/>
</valueReference>
</extension>
<url value="https://madie.cms.gov/Measure/PCSBPScreeningFollowUpFHIR"/>
<identifier>
<use value="usual"/>
<type>
<coding>
<system
value="http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type"/>
<code value="short-name"/>
</coding>
</type>
<system value="https://madie.cms.gov/measure/shortName"/>
<value value="CMS22FHIR"/>
</identifier>
<identifier>
<use value="official"/>
<type>
<coding>
<system
value="http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type"/>
<code value="version-independent"/>
</coding>
</type>
<system value="urn:ietf:rfc:3986"/>
<value value="urn:uuid:1b17d846-cbe0-49fa-b503-518addf19fb0"/>
</identifier>
<identifier>
<use value="official"/>
<type>
<coding>
<system
value="http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type"/>
<code value="version-specific"/>
</coding>
</type>
<system value="urn:ietf:rfc:3986"/>
<value value="urn:uuid:b7b775e9-0c0d-4f9b-8457-b7ad1a255f80"/>
</identifier>
<identifier>
<use value="official"/>
<type>
<coding>
<system
value="http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type"/>
<code value="publisher"/>
</coding>
</type>
<system value="https://madie.cms.gov/measure/cmsId"/>
<value value="22FHIR"/>
<assigner>
<display value="CMS"/>
</assigner>
</identifier>
<version value="0.2.000"/>
<name value="PCSBPScreeningFollowUpFHIR"/>
<title
value="Preventive Care and Screening Screening for High Blood Pressure and Follow Up DocumentedFHIR"/>
<status value="draft"/>
<experimental value="false"/>
<date value="2024-07-09T14:53:57+00:00"/>
<publisher value="Centers for Medicare & Medicaid Services (CMS)"/>
<contact>
<telecom>
<system value="url"/>
<value value="https://www.cms.gov/"/>
</telecom>
</contact>
<description
value="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"/>
<purpose value="UNKNOWN"/>
<usage
value="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
value="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 value="2025-01-01"/>
<end value="2025-12-31"/>
</effectivePeriod>
<author>
<name value="Mathematica"/>
<telecom>
<system value="url"/>
<value value="https://www.mathematica.org/"/>
</telecom>
</author>
<library value="https://madie.cms.gov/Library/PCSBPScreeningFollowUpFHIR"/>
<disclaimer
value="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]."/>
<rationale
value="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
value="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."/>
<group id="64ef76cf56d636294b157c3f">
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring">
<valueCodeableConcept>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-scoring"/>
<code value="proportion"/>
<display value="Proportion"/>
</coding>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis">
<valueCode value="Encounter"/>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-type">
<valueCodeableConcept>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/measure-type"/>
<code value="process"/>
<display value="Process"/>
</coding>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-rateAggregation">
<valueCode value="None"/>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-improvementNotation">
<valueCodeableConcept>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-improvement-notation"/>
<code value="decrease"/>
<display value="increase"/>
</coding>
</valueCodeableConcept>
</extension>
<description
value="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"/>
<population id="4B56079F-F91E-4F0D-9721-0FB51857A70B">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="initial-population"/>
<display value="Initial Population"/>
</coding>
</code>
<description
value="All patient visits for patients aged 18 years and older at the beginning of the measurement period"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Initial Population"/>
</criteria>
</population>
<population id="57E90104-3DEF-45EE-9BA4-06B93E155B33">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="denominator"/>
<display value="Denominator"/>
</coding>
</code>
<description value="Equals Initial Population"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Denominator"/>
</criteria>
</population>
<population id="F2E50C62-7B4F-4C59-9BBD-F1203697F827">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="denominator-exclusion"/>
<display value="Denominator Exclusion"/>
</coding>
</code>
<description value="Patient has an active diagnosis of hypertension"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Denominator Exclusions"/>
</criteria>
</population>
<population id="E6B4386A-666C-4E35-B065-711BB18A6026">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="numerator"/>
<display value="Numerator"/>
</coding>
</code>
<description
value="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 value="text/cql-identifier"/>
<expression value="Numerator"/>
</criteria>
</population>
<population id="DACDF805-EA30-4892-9F23-4D3B3D095C22">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="denominator-exception"/>
<display value="Denominator Exception"/>
</coding>
</code>
<description
value="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 value="text/cql-identifier"/>
<expression value="Denominator Exceptions"/>
</criteria>
</population>
</group>
<supplementalData id="sde-ethnicity">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="supplemental-data"/>
</coding>
</usage>
<description value="SDE Ethnicity"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="SDE Ethnicity"/>
</criteria>
</supplementalData>
<supplementalData id="sde-payer">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="supplemental-data"/>
</coding>
</usage>
<description value="SDE Payer"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="SDE Payer"/>
</criteria>
</supplementalData>
<supplementalData id="sde-race">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="supplemental-data"/>
</coding>
</usage>
<description value="SDE Race"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="SDE Race"/>
</criteria>
</supplementalData>
<supplementalData id="sde-sex">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="supplemental-data"/>
</coding>
</usage>
<description value="SDE Sex"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="SDE Sex"/>
</criteria>
</supplementalData>
</Measure>
IG © 2023+ cqframework. Package gov.healthit.ecqi.ecqms#2024.0.0 based on FHIR 4.0.1. Generated 2024-11-07
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