eCQM QICore Content Implementation Guide
2024.0.0 - CI Build
eCQM QICore Content Implementation Guide
2024.0.0 - CI Build
eCQM QICore Content Implementation Guide, published by cqframework. This guide is not an authorized publication; it is the continuous build for version 2024.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/cqframework/ecqm-content-qicore-2024/ and changes regularly. See the Directory of published versions
| Draft as of 2024-12-18 |
{
"resourceType" : "Measure",
"id" : "SevereObstetricComplicationsFHIR",
"meta" : {
"profile" : [
🔗 "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-measure-cqfm"🔗 ,
"http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/publishable-measure-cqfm"🔗 ,
"http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/executable-measure-cqfm"
]
},
"text" : {
"status" : "extensions",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <table class=\"grid dict\">\n \n <tr>\n <th scope=\"row\"><b>Title: </b></th>\n <td style=\"padding-left: 4px;\">Severe Obstetric ComplicationsFHIR</td>\n </tr>\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Id: </b></th>\n <td style=\"padding-left: 4px;\">SevereObstetricComplicationsFHIR</td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Version: </b></th>\n <td style=\"padding-left: 4px;\">0.1.000</td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Url: </b></th>\n <td style=\"padding-left: 4px;\"><a href=\"Measure-SevereObstetricComplicationsFHIR.html\">Severe Obstetric ComplicationsFHIR</a></td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\">\n <b>\n \n \n short-name identifier:\n \n \n </b>\n </th>\n\n <td style=\"padding-left: 4px;\">\n \n <p style=\"margin-bottom: 5px;\">\n <span>CMS1028FHIR</span>\n </p>\n \n </td>\n </tr>\n \n <tr>\n <th scope=\"row\">\n <b>\n \n \n version-independent identifier:\n \n \n </b>\n </th>\n\n <td style=\"padding-left: 4px;\">\n \n <p style=\"margin-bottom: 5px;\">\n <span>urn:uuid:6cf03fe2-b962-4f83-ac37-26d7477183c7</span>\n </p>\n \n </td>\n </tr>\n \n <tr>\n <th scope=\"row\">\n <b>\n \n \n version-specific identifier:\n \n \n </b>\n </th>\n\n <td style=\"padding-left: 4px;\">\n \n <p style=\"margin-bottom: 5px;\">\n <span>urn:uuid:3efa7f95-1d8e-45fa-af68-023d3554e8c1</span>\n </p>\n \n </td>\n </tr>\n \n <tr>\n <th scope=\"row\">\n <b>\n \n \n publisher (CMS) identifier:\n \n \n </b>\n </th>\n\n <td style=\"padding-left: 4px;\">\n \n <p style=\"margin-bottom: 5px;\">\n <span>1028FHIR</span>\n </p>\n \n </td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Effective Period: </b></th>\n <td style=\"padding-left: 4px;\">2025-01-01..2025-12-31</td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Status: </b></th>\n <td style=\"padding-left: 4px;\">draft</td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Experimental: </b></th>\n <td style=\"padding-left: 4px;\">true</td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Publisher: </b></th>\n <td style=\"padding-left: 4px;\">The Joint Commission</td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Author: </b></th>\n <td style=\"padding-left: 4px;\">The Joint Commission, Centers for Medicare & Medicaid Services (CMS), Yale New Haven Health Service Corporation/ Center for Outcomes Research and Evaluation</td>\n </tr>\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Description: </b></th>\n <td style=\"padding-left: 4px;\"><div><p>Patients with severe obstetric complications that occur during the inpatient delivery hospitalization</p>\n</div></td>\n </tr>\n \n\n \n\n \n\n \n\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Purpose: </b></th>\n <td style=\"padding-left: 4px;\"><div><p>UNKNOWN</p>\n</div></td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Copyright: </b></th>\n <td style=\"padding-left: 4px;\"><div><p>Measure specifications are in the Public Domain.</p>\n<p>LOINC(R) copyright 2004-2023 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2023 International Health Terminology Standards Development Organisation. ICD-10 copyright 2023 World Health Organization. All Rights Reserved.</p>\n</div></td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Disclaimer: </b></th>\n <td style=\"padding-left: 4px;\"><div><p>These performance measures are not clinical guidelines and do not establish a standard of medical care, and have not been tested for all potential applications. The measures and specifications are provided without warranty.</p>\n</div></td>\n </tr>\n \n\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Scoring: </b></th>\n <td style=\"padding-left: 4px;\">\n \n \n <p style=\"margin-bottom: 5px;\">\n <span>Proportion </span>\n </p>\n \n \n \n </td>\n </tr>\n \n\n \n\n \n\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Rationale: </b></th>\n <td style=\"padding-left: 4px;\"><div><p>The United States (US) experiences higher rates of maternal morbidity and mortality than most other developed countries. These rates have continued to trend upward in recent decades (CDC, 2021). Research indicates that the overall rate of severe maternal morbidity (SMM) increased by almost 200% between 1993 and 2014 to 144 per 10,000 delivery hospitalizations (CDC, 2021), with more than 25,000 women per year experiencing obstetric complications (U.S. Department of Health and Human Services, 2020). Recent maternal mortality data from 2018 reveal that 658 women in the US died from maternal causes, resulting in a rate of 17.4 deaths per 100,000 live births, with 77% of the deaths attributed to direct obstetric causes like hemorrhage, preeclampsia, obstetric embolism, and other complications (Hoyert & Minino, 2018). 144 per 10,000 women hospitalized for delivery have experienced SMM, including hemorrhage, embolism, hypertension, stroke, and other serious complications (CDC, 2021). Racial and ethnic disparities exist: Black women and Hispanic women are at a significantly higher risk for developing these complications than are Non-Hispanic White women (Leonard, Main, Scott, Profit, & Carmichael, 2019). Increasing rates of SMM are resulting in increased healthcare costs, longer hospitalization stays and impacts on a woman's health (Callaghan, Creanga, & Kuklina, 2012).</p>\n<p>There is limited national evaluation of hospitals' performance on maternal morbidity and mortality although SMM is widely used at the population level. SMM is linked to maternal mortality, varies significantly among hospitals, and has significant racial/ethnic and urban/rural disparities. SMM is a cost driver for both Medicaid and commercial plans. This measure is important as it will assist in the discovery and understanding of SMM patterns that can lead to improvements in the safety and quality of maternal care necessary to reduce SMM rates.</p>\n</div></td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Clinical recommendation statement: </b></th>\n <td style=\"padding-left: 4px;\"><div><p>Healthy People 2030 Measure (MICH-05): Reduce severe maternal complications identified during delivery hospitalizations (U.S. Department of Health and Human Services, n.d.).</p>\n<p>The American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine recommend identifying potential cases of severe maternal morbidity for further review, with a focus on outcomes and complications, and consider this an important step toward promoting safe obstetric care (American College of Obstetricians and Gynecologists and the Society for Maternal–Fetal Medicine, Kilpatrick, & Ecker, 2016).</p>\n</div></td>\n </tr>\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Guidance (Usage): </b></th>\n <td style=\"padding-left: 4px;\">In the case of multiple births, map the first delivery date/time (Baby A) as the delivery date/time for the encounter. This measure allows for 3 approaches to determine gestational age (GA) in the following order of precedence:\n\n1. The GA is calculated using the American College of Obstetricians and Gynecologists ReVITALize guidelines.*\n2. The GA is obtained from a discrete field in the electronic health record. This option is only used when the calculated GA is not available.\n3. The GA is based on ICD10 or SNOMED codes indicative of weeks gestation. This option is only used when results from items #1 and #2 (see above) are not available.\n\nWherever gestational age is mentioned, relative to the delivery, the intent is to capture the last estimated gestational age prior to or at the time of delivery. \n \n*ACOG ReVITALize Guidelines for Calculating Gestational Age (ACOG, 2014): \n \n Gestational Age = (280-(Estimated Due Date minus Reference Date))/7\n\n--Estimated Due Date (EDD): The best obstetrical EDD is determined by last menstrual period if confirmed by early ultrasound or no ultrasound performed, or early ultrasound if no known last menstrual period or the ultrasound is not consistent with last menstrual period, or known date of fertilization (e.g., assisted reproductive technology) \n--Reference Date is the date on which you are trying to determine gestational age. For purposes of this eCQM, Reference Date would be the Date of Delivery. \n\nNote however the calculation may yield a non-whole number and gestational age should be rounded down to the nearest completed week. For example, an infant born on the 5th day of the 36th week (35 weeks and 5/7 days) is at a gestational age of 35 weeks, not 36 weeks.\n\nDefinition:\nFor this measure, specifications are modeled after the nationally available and adopted CDC definition for Severe Maternal Morbidity (SMM) with the addition of maternal mortality. At times, we may refer to the CDC indicators of morbidity as SMM, but the outcome of the measure, which includes morbidity and mortality, is referred to as Severe Obstetric Complications (SOC).\n\nThis eCQM is an episode-based measure. An episode is defined as each inpatient hospitalization or encounter that ends during the measurement period.\n\nThis FHIR-based measure has been derived from the QDM-based measure CMS1028v3.\n\nPlease refer to the HL7 QI-Core Implementation Guide (https://hl7.org/fhir/us/qicore/STU4.1.1/) for more information on QI-Core and mapping recommendations from QDM to QI-Core 4.1.1 (https://hl7.org/fhir/us/qicore/STU4.1.1/qdm-to-qicore.html).</td>\n </tr>\n \n\n \n \n <tr>\n <th scope=\"row\"><b>Population Criteria: </b></th>\n <td style=\"padding-left: 4px;\">\n \n <table class=\"grid-dict\">\n \n <tr>\n <th><b>64efa90856d636294b157c9a</b></th>\n </tr>\n \n \n <tr>\n <td>Initial Population:</td>\n\n \n \n <td>Inpatient hospitalizations for patients age greater than or equal to 8 years and less than 65 admitted to the hospital for inpatient acute care who undergo a delivery procedure with a discharge date during the measurement period</td>\n \n \n\n </tr>\n \n <tr>\n <td>Denominator:</td>\n\n \n \n <td>Inpatient hospitalizations for patients delivering stillborn or live birth with greater than or equal to 20 weeks, 0 days gestation completed</td>\n \n \n\n </tr>\n \n <tr>\n <td>Denominator Exclusion:</td>\n\n \n \n <td>Inpatient hospitalizations for patients with confirmed diagnosis of COVID with COVID-related respiratory condition or patients with confirmed diagnosis of COVID with COVID-related respiratory procedure during the encounter</td>\n \n \n\n </tr>\n \n <tr>\n <td>Numerator:</td>\n\n \n \n <td>Two numerator populations are defined for this measure:\n\n1. All Severe Obstetric Complications (SOC).\n2. SOC excluding encounters where transfusion was the only SOC.\n\nInpatient hospitalizations for patients with severe obstetric complications (not present on admission that occur during the current delivery encounter) including the following: \n- Severe maternal morbidity diagnoses (see list below)\n- Severe maternal morbidity procedures (see list below)\n- Discharge disposition of expired\nPlease note that present on admission codes may be extracted from billing/claims data that was entered by coding staff.\n\nSevere Maternal Morbidity Diagnoses:\n- Cardiac\n\t Acute heart failure \n\t Acute myocardial infarction\n\t Aortic aneurysm\n\t Cardiac arrest/ventricular fibrillation\n\t Heart failure/arrest during procedure or surgery\n- Hemorrhage\n\t Disseminated intravascular coagulation\n\t Shock\n- Renal\n Acute renal failure\n- Respiratory\n\t Adult respiratory distress syndrome\n\t Pulmonary edema\n- Sepsis\n- Other OB\n\t Air and thrombotic embolism\n\t Amniotic fluid embolism\n\t Eclampsia\n\t Severe anesthesia complications\n- Other Medical\n\t Puerperal cerebrovascular disorder\n\t Sickle cell disease with crisis\n\nSevere Maternal Morbidity Procedures:\n- Blood transfusion\n- Conversion of cardiac rhythm\n- Hysterectomy\n- Temporary tracheostomy\n- Ventilation</td>\n \n \n\n </tr>\n \n <tr>\n <td>Numerator Exclusion:</td>\n\n \n \n <td>Inpatient hospitalizations with blood transfusion or hysterectomy with a diagnosis of placenta percreta or placenta increta and no additional severe obstetrical complications.</td>\n \n \n\n </tr>\n \n \n <tr><b>Stratifier Criteria: </b></tr>\n \n <tr>\n \n <td>Stratum:</td>\n \n\n \n <td>This measure will be stratified by race/ethnicity and payer after measure submission.</td>\n \n </tr>\n \n \n </table>\n \n <table class=\"grid-dict\">\n \n <tr>\n <th><b>658b2eadd4b024647cc00341</b></th>\n </tr>\n \n \n <tr>\n <td>Initial Population:</td>\n\n \n \n <td>Inpatient hospitalizations for patients age >= 8 years and < 65 admitted to the hospital for inpatient acute care who undergo a delivery procedure with a discharge date that ends during the measurement period</td>\n \n \n\n </tr>\n \n <tr>\n <td>Denominator:</td>\n\n \n \n <td>Inpatient hospitalizations for patients delivering stillborn or live birth with >= 20 weeks, 0 days gestation completed</td>\n \n \n\n </tr>\n \n <tr>\n <td>Denominator Exclusion:</td>\n\n \n \n <td>Inpatient hospitalizations for patients with confirmed diagnosis of COVID with COVID-related respiratory condition or patients with confirmed diagnosis of COVID with COVID-related respiratory procedure during the encounter</td>\n \n \n\n </tr>\n \n <tr>\n <td>Numerator:</td>\n\n \n \n <td>Inpatient hospitalizations for patients with severe obstetric complications (not present on admission that occur during the current delivery encounter) including severe maternal morbidity diagnoses (see following list), severe maternal morbidity procedures (see following list), and discharge disposition of expired, yet excluding encounters where transfusion was the only SOC. \nPlease note that present on admission codes may be those entered by coding staff, extracted from billing/claims data.\n\nSevere Maternal Morbidity Diagnoses:\n- Cardiac\n\t Acute heart failure \n\t Acute myocardial infarction\n\t Aortic aneurysm\n\t Cardiac arrest/ventricular fibrillation\n\t Heart failure/arrest during procedure or surgery\n- Hemorrhage\n\t Disseminated intravascular coagulation\n\t Shock\n- Renal\n Acute renal failure\n- Respiratory\n\t Adult respiratory distress syndrome\n\t Pulmonary edema\n- Sepsis\n- Other OB\n\t Air and thrombotic embolism\n\t Amniotic fluid embolism\n\t Eclampsia\n\t Severe anesthesia complications\n- Other Medical\n\t Puerperal cerebrovascular disorder\n\t Sickle cell disease with crisis\n\nSevere Maternal Morbidity Procedures:\n- Blood transfusion\n- Conversion of cardiac rhythm\n- Hysterectomy\n- Temporary tracheostomy\n- Ventilation</td>\n \n \n\n </tr>\n \n <tr>\n <td>Numerator Exclusion:</td>\n\n \n \n <td>Inpatient hospitalizations with blood transfusion or hysterectomy with a diagnosis of placenta percreta or placenta increta and no additional severe obstetrical complications.</td>\n \n \n\n </tr>\n \n \n </table>\n \n </td>\n </tr>\n \n \n\n \n <tr>\n <th scope=\"row\"><b> Supplemental Data Elements: </b></th>\n <td style=\"padding-left: 4px;\">\n \n \n \n <p>SDE Ethnicity</p>\n \n \n \n \n \n <p>SDE Payer</p>\n \n \n \n \n \n <p>SDE Race</p>\n \n \n \n \n \n <p>SDE Sex</p>\n \n \n \n \n \n <p>SDE Variable Calculated Gestational Age</p>\n \n \n \n </td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Risk Adjustment Variable: </b></th>\n <td style=\"padding-left: 4px;\">\n \n \n \n <p>Risk Variable Lab and Physical Exam Results</p>\n \n \n \n \n \n <p>Risk Variable Asthma</p>\n \n \n \n \n \n <p>Risk Variable Autoimmune Disease</p>\n \n \n \n \n \n <p>Risk Variable Bariatric Surgery</p>\n \n \n \n \n \n <p>Risk Variable Bleeding Disorder</p>\n \n \n \n \n \n <p>Risk Variable Morbid Obesity</p>\n \n \n \n \n \n <p>Risk Variable Cardiac Disease</p>\n \n \n \n \n \n <p>Risk Variable Economic Housing Instability</p>\n \n \n \n \n \n <p>Risk Variable Gastrointestinal Disease</p>\n \n \n \n \n \n <p>Risk Variable Gestational Diabetes</p>\n \n \n \n \n \n <p>Risk Variable HIV</p>\n \n \n \n \n \n <p>Risk Variable Hypertension</p>\n \n \n \n \n \n <p>Risk Variable Long Term Anticoagulant Use</p>\n \n \n \n \n \n <p>Risk Variable Mental Health Disorder</p>\n \n \n \n \n \n <p>Risk Variable Multiple Pregnancy</p>\n \n \n \n \n \n <p>Risk Variable Neuromuscular</p>\n \n \n \n \n \n <p>Risk Variable Obstetrical VTE</p>\n \n \n \n \n \n <p>Risk Variable Placenta Previa</p>\n \n \n \n \n \n <p>Risk Variable Placental Abruption</p>\n \n \n \n \n \n <p>Risk Variable Placental Accreta Spectrum</p>\n \n \n \n \n \n <p>Risk Variable Preexisting Diabetes</p>\n \n \n \n \n \n <p>Risk Variable Previous Cesarean</p>\n \n \n \n \n \n <p>Risk Variable Pulmonary Hypertension</p>\n \n \n \n \n \n <p>Risk Variable Renal Disease</p>\n \n \n \n \n \n <p>Risk Variable Severe Preeclampsia</p>\n \n \n \n \n \n <p>Risk Variable Substance Abuse</p>\n \n \n \n \n \n <p>Risk Variable Thyrotoxicosis</p>\n \n \n \n \n \n <p>Risk Variable Other Preeclampsia</p>\n \n \n \n \n \n <p>Risk Variable Preterm Birth</p>\n \n \n \n \n \n <p>Risk Variable Anemia</p>\n \n \n \n \n \n <p>Risk Variable Systolic Blood Pressure</p>\n \n \n \n \n \n <p>Risk Variable Heart Rate</p>\n \n \n \n \n \n <p>Risk Variable First White Blood Cell Count Lab Test</p>\n \n \n \n \n \n <p>Risk Variable First Hematocrit Lab Test</p>\n \n \n \n \n \n <p>Delivery Encounters with Blood Transfusion</p>\n \n \n \n \n \n <p>Risk Variable Maternal Age</p>\n \n \n \n </td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\">\n <b> Supplemental Data Guidance\n : </b></th>\n <td style=\"padding-left: 4px;\"> For every patient evaluated by this measure also identify payer, race, ethnicity, sex, variable calculated gestational age, SOC diagnosis details, and SOC procedure details\n\n \n </td>\n </tr>\n \n <tr>\n <th scope=\"row\">\n <b> Risk Adjustment Variable Guidance\n : </b></th>\n <td style=\"padding-left: 4px;\"> The Severe Obstetric Complications Risk Adjustment Methodology Report is available on the eCQI Resource Center (https://ecqi.healthit.gov).\nPre-existing conditions and variables must be present on admission. Please note that present on admission codes may be extracted from billing/claims data that was entered by coding staff (Leonard, Kennedy, Carmichael, Lyell, & Main, 2020; Main, Leonard, & Menard, 2020).\n- Anemia (includes sickle cell disease)\n- Asthma \n- Autoimmune Disease\n- Bariatric Surgery\n- Bleeding Disorder\n- Cardiac Disease\n- Economic Housing Instability\n- Gastrointestinal Disease \n- Gestational Diabetes\n- HIV\n- Hypertension\n- Long-term Anticoagulant Use\n- Maternal Age (derived from birthdate)\n- Mental Health Disorder\n- Morbid Obesity\n- Multiple Pregnancy\t\n- Neuromuscular Disease\n- Obstetric VTE\n- Other Pre-eclampsia\n- Placenta Previa\n- Placental Abruption\n- Placental Accreta Spectrum\n- Pre-existing Diabetes \n- Preterm Birth\n- Previous Cesarean \n- Pulmonary Hypertension\n- Renal Disease \n- Severe Pre-eclampsia\n- Substance Abuse\n- Thyrotoxicosis \n\nLab and Physical Exam Results:\nReport the first resulted value 24 hours prior to start of encounter and before time of delivery in UCUM units specified:\n- Heart rate: {beats}/min\n- Systolic blood pressure: mm[Hg]\n- Hematocrit: %\n- White blood cell count: 10*3/uL \n\n\nNote regarding submission of risk variable data: The risk variable definitions are included in the specifications and risk variable data should be sent with eCQM data in the QRDA1 file. Specific risk variable templates are not needed in the QRDA1 files. </td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Libraries: </b></th>\n <td style=\"padding-left: 4px;\">\n <table class=\"grid-dict\">\n \n <tr>\n <td><a href=\"Library-SevereObstetricComplicationsFHIR.html\">SevereObstetricComplicationsFHIR</a></td>\n </tr>\n \n </table>\n </td>\n </tr>\n \n\n \n\n \n \n <tr>\n <th scope=\"row\"><b>Terminology and Other Dependencies: </b></th>\n <td style=\"padding-left: 4px;\">\n \n <li><code>Library/PCMaternal|5.19.000</code></li>\n \n <li><code>Library/CQMCommon|2.2.000</code></li>\n \n <li><code>Library/FHIRHelpers|4.4.000</code></li>\n \n <li><code>Library/QICoreCommon|2.1.000</code></li>\n \n <li><code>Library/SupplementalDataElements|3.5.000</code></li>\n \n <li><a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-v3-loinc.html\">Logical Observation Identifiers, Names and Codes (LOINC)</a></li>\n \n <li><a href=\"http://hl7.org/fhir/R4/codesystem-administrative-gender.html\">AdministrativeGender</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.666.5.307/expansion\">Encounter Inpatient</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1045.59/expansion\">Delivery Procedures</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1111.143/expansion\">Observation Services</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.369/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.369</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1045.26/expansion\">Estimated Gestational Age at Delivery</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1110.67/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.67</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1110.63/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.63</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.271/expansion\">Asthma</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.302/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.302</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.388/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.388</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.308/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.308</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.332/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.332</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.370/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.370</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.255/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.255</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.256/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.256</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.309/expansion\">Patient Expired</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.213/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.213</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.358/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.358</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.357/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.357</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.359/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.359</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.360/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.360</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.299/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.299</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.114222.4.11.3591/expansion\">Payer</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.305/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.305</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.373/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.373</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.376/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.376</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.379/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.379</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.290/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.290</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.275/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.275</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.317/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.317</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1110.78/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.78</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.287/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.287</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1045.129/expansion\">White blood cells count lab test</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1045.114/expansion\">Hematocrit lab test</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.327/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.327</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.323/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.323</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.341/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.341</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.366/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.366</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.320/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.320</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.335/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.335</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.338/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.338</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.281/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.281</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.296/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.296</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.329/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.329</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.292/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.292</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.272/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.272</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.314/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.314</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.363/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.363</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.311/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.311</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.278/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.278</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.269/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.269</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.284/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.284</a></li>\n \n </td>\n </tr>\n <tr>\n <th scope=\"row\"><b>Parameters:</b></th>\n <td style=\"padding-left: 4px;\">\n <table class=\"grid-dict\">\n <tr>\n <th><b>name</b></th>\n <th><b>use</b></th>\n <th><b>min</b></th>\n <th><b>max</b></th>\n <th><b>type</b></th>\n </tr>\n \n <tr>\n <td>Measurement Period</td>\n <td>In</td>\n <td>0</td>\n <td>1</td>\n <td>Period</td>\n </tr>\n \n <tr>\n <td>Risk Variable Asthma</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Risk Variable Placental Accreta Spectrum</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Risk Variable Neuromuscular</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Risk Variable Hypertension</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>SOC with Hysterectomy or Blood Transfusion with Placenta Increta or Placenta Percreta Without Additional SOC</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Risk Variable Preterm Birth</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>SDE Payer</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Risk Variable Placental Abruption</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Denominator Exclusion</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Risk Variable Morbid Obesity</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Risk Variable Preexisting Diabetes</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Risk Variable Bariatric Surgery</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>SDE Race</td>\n <td>Out</td>\n <td>0</td>\n <td>1</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Risk Variable Placenta Previa</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>SDE Sex</td>\n <td>Out</td>\n <td>0</td>\n <td>1</td>\n <td>Coding</td>\n </tr>\n \n <tr>\n <td>Risk Variable Bleeding Disorder</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Risk Variable First White Blood Cell Count Lab Test</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Risk Variable First Hematocrit Lab Test</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Delivery Encounters with Severe Obstetric Complications</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Risk Variable Severe Preeclampsia</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Risk Variable Anemia</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Risk Variable Cardiac Disease</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Risk Variable Long Term Anticoagulant Use</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Risk Variable Systolic Blood Pressure</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Risk Variable Substance Abuse</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Risk Variable Renal Disease</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>SDE Variable Calculated Gestational Age</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Risk Variable Gastrointestinal Disease</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions Only</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Risk Variable Pulmonary Hypertension</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Risk Variable Thyrotoxicosis</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Risk Variable Other Preeclampsia</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Initial Population</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Risk Variable Economic Housing Instability</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Risk Variable HIV</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>SOC Excluding Blood Transfusions Only with Hysterectomy or Blood Transfusion with Placenta Increta or Placenta Percreta Without Additional SOC</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Risk Variable Heart Rate</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Risk Variable Maternal Age</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Risk Variable Mental Health Disorder</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Risk Variable Obstetrical VTE</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Risk Variable Autoimmune Disease</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Risk Variable Previous Cesarean</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Risk Variable Gestational Diabetes</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Risk Variable Multiple Pregnancy</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Denominator</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Delivery Encounters with Blood Transfusion</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>SDE Ethnicity</td>\n <td>Out</td>\n <td>0</td>\n <td>1</td>\n <td>Resource</td>\n </tr>\n \n </table>\n </td>\n </tr>\n\n <tr>\n <th scope=\"row\"><b>DataRequirements:</b></th>\n <td style=\"padding-left: 4px;\">\n <table class=\"grid-dict\">\n <tr>\n <th><b>Resource Type</b></th>\n <th><b>Resource Elements</b></th>\n <th><b>Valueset Name</b></th>\n <th><b>Valueset</b></th>\n </tr>\n \n <tr>\n <td>Encounter(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html\">QICoreEncounter</a>)</td>\n <td>\n \n type\n \n period\n \n status\n \n status.value\n \n condition\n \n condition.reference\n \n condition.reference.value\n \n extension\n \n condition.code\n \n hospitalization\n \n hospitalization.dischargeDisposition\n \n id\n \n id.value\n \n </td>\n <td>\n \n \n Observation Services\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1111.143/expansion\">Observation Services</a></td>\n </tr>\n \n <tr>\n <td>Encounter(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html\">QICoreEncounter</a>)</td>\n <td>\n \n type\n \n period\n \n status\n \n status.value\n \n condition\n \n condition.reference\n \n condition.reference.value\n \n extension\n \n condition.code\n \n hospitalization\n \n hospitalization.dischargeDisposition\n \n id\n \n id.value\n \n </td>\n <td>\n \n \n ED Visit and OB Triage\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.369/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.369</a></td>\n </tr>\n \n <tr>\n <td>Encounter(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html\">QICoreEncounter</a>)</td>\n <td>\n \n type\n \n status\n \n status.value\n \n period\n \n condition\n \n condition.reference\n \n condition.reference.value\n \n extension\n \n condition.code\n \n hospitalization\n \n hospitalization.dischargeDisposition\n \n id\n \n id.value\n \n </td>\n <td>\n \n \n Encounter Inpatient\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.666.5.307/expansion\">Encounter Inpatient</a></td>\n </tr>\n \n <tr>\n <td>Patient(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-patient.html\">QICorePatient</a>)</td>\n <td>\n \n race\n \n ethnicity\n \n </td>\n <td>\n \n </td>\n <td/>\n </tr>\n \n <tr>\n <td>Procedure(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html\">QICoreProcedure</a>)</td>\n <td>\n \n code\n \n status\n \n status.value\n \n performed\n \n </td>\n <td>\n \n \n Delivery Procedures\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1045.59/expansion\">Delivery Procedures</a></td>\n </tr>\n \n <tr>\n <td>Procedure(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html\">QICoreProcedure</a>)</td>\n <td>\n \n code\n \n status\n \n status.value\n \n performed\n \n </td>\n <td>\n \n \n Severe Maternal Morbidity Procedures\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.256/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.256</a></td>\n </tr>\n \n <tr>\n <td>Procedure(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html\">QICoreProcedure</a>)</td>\n <td>\n \n code\n \n status\n \n status.value\n \n performed\n \n </td>\n <td>\n \n \n Hysterectomy\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.358/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.358</a></td>\n </tr>\n \n <tr>\n <td>Procedure(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html\">QICoreProcedure</a>)</td>\n <td>\n \n code\n \n status\n \n status.value\n \n performed\n \n </td>\n <td>\n \n \n Conversion of Cardiac Rhythm\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.357/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.357</a></td>\n </tr>\n \n <tr>\n <td>Procedure(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html\">QICoreProcedure</a>)</td>\n <td>\n \n code\n \n status\n \n status.value\n \n performed\n \n </td>\n <td>\n \n \n Tracheostomy\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.359/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.359</a></td>\n </tr>\n \n <tr>\n <td>Procedure(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html\">QICoreProcedure</a>)</td>\n <td>\n \n code\n \n status\n \n status.value\n \n performed\n \n </td>\n <td>\n \n \n Ventilation\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.360/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.360</a></td>\n </tr>\n \n <tr>\n <td>Procedure(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html\">QICoreProcedure</a>)</td>\n <td>\n \n code\n \n status\n \n status.value\n \n performed\n \n </td>\n <td>\n \n \n Respiratory Support Procedures Related to COVID 19\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.379/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.379</a></td>\n </tr>\n \n <tr>\n <td>Procedure(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html\">QICoreProcedure</a>)</td>\n <td>\n \n code\n \n status\n \n status.value\n \n performed\n \n </td>\n <td>\n \n \n Blood Transfusion\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.213/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.213</a></td>\n </tr>\n \n <tr>\n <td>Observation(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-observation.html\">QICoreObservation</a>)</td>\n <td>\n \n code\n \n value\n \n status\n \n status.value\n \n effective\n \n </td>\n <td>\n \n </td>\n <td/>\n </tr>\n \n <tr>\n <td>Observation(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-observation.html\">QICoreObservation</a>)</td>\n <td>\n \n code\n \n value\n \n status\n \n status.value\n \n effective\n \n </td>\n <td>\n \n </td>\n <td/>\n </tr>\n \n <tr>\n <td>Observation(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-observation.html\">QICoreObservation</a>)</td>\n <td>\n \n code\n \n effective\n \n value\n \n status\n \n status.value\n \n </td>\n <td>\n \n \n Estimated Gestational Age at Delivery\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1045.26/expansion\">Estimated Gestational Age at Delivery</a></td>\n </tr>\n \n <tr>\n <td>Condition(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-condition.html\">QICoreCondition</a>)</td>\n <td>\n \n id\n \n id.value\n \n code\n \n </td>\n <td>\n \n </td>\n <td/>\n </tr>\n \n <tr>\n <td>Coverage(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-coverage.html\">QICoreCoverage</a>)</td>\n <td>\n \n type\n \n period\n \n </td>\n <td>\n \n \n Payer Type\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.114222.4.11.3591/expansion\">Payer</a></td>\n </tr>\n \n <tr>\n <td>Observation(<a href=\"http://hl7.org/fhir/us/core/STU3.1.1/StructureDefinition-us-core-observation-lab.html\">US Core Laboratory Result Observation Profile</a>)</td>\n <td>\n \n code\n \n issued\n \n issued.value\n \n status\n \n status.value\n \n value\n \n </td>\n <td>\n \n \n White blood cells count lab test\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1045.129/expansion\">White blood cells count lab test</a></td>\n </tr>\n \n <tr>\n <td>Observation(<a href=\"http://hl7.org/fhir/us/core/STU3.1.1/StructureDefinition-us-core-observation-lab.html\">US Core Laboratory Result Observation Profile</a>)</td>\n <td>\n \n code\n \n issued\n \n issued.value\n \n status\n \n status.value\n \n value\n \n </td>\n <td>\n \n \n Hematocrit lab test\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1045.114/expansion\">Hematocrit lab test</a></td>\n </tr>\n \n <tr>\n <td>Observation(<a href=\"http://hl7.org/fhir/R4/bp.html\">Observation Blood Pressure Profile</a>)</td>\n <td>\n \n effective\n \n status\n \n status.value\n \n component\n \n </td>\n <td>\n \n </td>\n <td/>\n </tr>\n \n <tr>\n <td>Observation(<a href=\"http://hl7.org/fhir/R4/heartrate.html\">Observation Heart Rate Profile</a>)</td>\n <td>\n \n effective\n \n status\n \n status.value\n \n value\n \n </td>\n <td>\n \n </td>\n <td/>\n </tr>\n \n </table>\n </td>\n </tr>\n\n \n <tr>\n <th scope=\"row\"><b>Direct Reference Codes:</b></th>\n <td style=\"padding-left: 4px;\">\n <table class=\"grid-dict\">\n <tr>\n <th><b>display</b></th>\n <th><b>code</b></th>\n <th><b>system</b></th>\n </tr>\n \n <tr>\n <td>Date and time of obstetric delivery</td>\n <td>93857-1</td>\n <td><a href=\"https://loinc.org/\">http://loinc.org</a></td>\n </tr>\n \n <tr>\n <td>Delivery date Estimated</td>\n <td>11778-8</td>\n <td><a href=\"https://loinc.org/\">http://loinc.org</a></td>\n </tr>\n \n <tr>\n <td>Male</td>\n <td>M</td>\n <td><a href=\"http://hl7.org/fhir/R4/codesystem-administrative-gender.html\">http://hl7.org/fhir/administrative-gender</a></td>\n </tr>\n \n <tr>\n <td>Female</td>\n <td>F</td>\n <td><a href=\"http://hl7.org/fhir/R4/codesystem-administrative-gender.html\">http://hl7.org/fhir/administrative-gender</a></td>\n </tr>\n \n <tr>\n <td>Systolic BP</td>\n <td>8480-6</td>\n <td><a href=\"https://loinc.org/\">http://loinc.org</a></td>\n </tr>\n \n </table>\n </td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Logic Definitions:</b></th>\n <td style=\"padding-left: 4px;\">\n \n <table class=\"grid-dict\">\n <tr>\n <th><b>Group</b></th>\n <th><b>Scoring</b></th>\n <th><b>Population Criteria</b></th>\n <th><b>Expression</b></th>\n </tr>\n <tr>\n \n <td> 64efa90856d636294b157c9a </td>\n <td colspan=\"3\" style=\"padding-left: 4px;\">\n \n <b>Group scoring:</b>\n \n <span> proportion </span>\n \n \n\n \n\n \n <b>Measure scoring:</b>\n \n <p style=\"margin-bottom: 5px;\">\n <span>Proportion</span>\n </p>\n \n \n\n \n\n \n <tr>\n \n <th scope=\"row\"><b>Type: </b></th>\n <td style=\"padding-left: 4px;\">\n \n \n <p style=\"margin-bottom: 5px;\">\n <span>Outcome </span>\n </p>\n \n \n \n </td>\n \n </tr>\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Rate Aggregation: </b></th>\n <td colspan=\"3\" style=\"padding-left: 4px;\">Two hospital-level measure scores are calculated as a risk-adjusted proportion reported as a rate per 10,000 delivery hospitalizations: 1. All Severe Obstetric Complications (SOC). ((Num1 – NumExcl) / (Den-DenExcl)) * 10,000 2. SOC excluding encounters where transfusion was the only SOC. ((Num2 – NumExcl) / (Den-DenExcl)) * 10,000 Num1: Number of delivery encounters with SOC Num2: Number of delivery encounters with SOC excluding encounters where transfusion was the only SOC NumExcl: Delivery encounters with blood transfusion or hysterectomy with Placenta Percreta or Placenta Increta Den: Delivery encounters with > or = 20 weeks gestation completed DenExcl: Delivery encounters for patients with a COVID diagnosis and COVID-related respiratory condition or a COVID diagnosis and COVID-related respiratory procedure</td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Improvement Notation: </b></th>\n <td style=\"padding-left: 4px;\">\n \n \n \n <p style=\"margin-bottom: 5px;\">\n <span>Decreased score indicates improvement </span>\n </p>\n \n \n \n \n </td>\n </tr>\n \n\n \n\n </td>\n \n <tr>\n <td/>\n <td/>\n <td>Initial Population</td>\n <td>\n \n <pre><code class=\"language-cql\">define "Initial Population":\n PCMaternal."Delivery Encounter with Age Range"</code></pre>\n \n </td>\n </tr>\n \n <tr>\n <td/>\n <td/>\n <td>Denominator</td>\n <td>\n \n <pre><code class=\"language-cql\">define "Denominator":\n "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation"</code></pre>\n \n </td>\n </tr>\n \n <tr>\n <td/>\n <td/>\n <td>Denominator Exclusion</td>\n <td>\n \n <pre><code class=\"language-cql\">define "Denominator Exclusion":\n "Delivery Encounters with COVID and Respiratory Condition or Procedure"</code></pre>\n \n </td>\n </tr>\n \n <tr>\n <td/>\n <td/>\n <td>Numerator</td>\n <td>\n \n <pre><code class=\"language-cql\">define "Delivery Encounters with Severe Obstetric Complications":\n "Delivery Encounters with Severe Obstetric Complications Diagnosis or Procedure Excluding Blood Transfusion"\n union "Delivery Encounters with Expiration"\n union "Delivery Encounters with Blood Transfusion"</code></pre>\n \n </td>\n </tr>\n \n <tr>\n <td/>\n <td/>\n <td>Numerator Exclusion</td>\n <td>\n \n <pre><code class=\"language-cql\">define "SOC with Hysterectomy or Blood Transfusion with Placenta Increta or Placenta Percreta Without Additional SOC":\n ( "Delivery Encounters with Severe Obstetric Complications" SOCEncounter\n where exists ( ( SOCEncounter.encounterDiagnosis ( ) ) EncounterDiagnosis\n where EncounterDiagnosis.code in "Placenta Increta or Percreta"\n )\n and ( exists "Delivery Encounters with Blood Transfusion"\n or exists "Delivery Encounters with Hysterectomy"\n )\n )\n\t//The following logic keeps encounter in the numerator if there is an additional SOC besides Blood Transfusion or Hysterectomy\n \n except ( ( "Delivery Encounters with Severe Obstetric Complications" SOCEncounter\n where ( SOCEncounter.pOAIsNoOrUTD ( ) in "Severe Maternal Morbidity Diagnoses" )\n )\n union "Delivery Encounters with Cardiac Conversion, Tracheostomy or Ventilation Procedures"\n union "Delivery Encounters with Expiration"\n )</code></pre>\n \n </td>\n </tr>\n \n \n <tr>\n <td/>\n <td/>\n <td/>\n <td>\n \n None\n \n </td>\n </tr>\n \n \n <td> 658b2eadd4b024647cc00341 </td>\n <td colspan=\"3\" style=\"padding-left: 4px;\">\n \n <b>Group scoring:</b>\n \n <span> proportion </span>\n \n \n\n \n\n \n <b>Measure scoring:</b>\n \n <p style=\"margin-bottom: 5px;\">\n <span>Proportion</span>\n </p>\n \n \n\n \n\n \n <tr>\n \n <th scope=\"row\"><b>Type: </b></th>\n <td style=\"padding-left: 4px;\">\n \n \n <p style=\"margin-bottom: 5px;\">\n <span>Outcome </span>\n </p>\n \n \n \n </td>\n \n </tr>\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Rate Aggregation: </b></th>\n <td colspan=\"3\" style=\"padding-left: 4px;\">SOC excluding encounters where transfusion was the only SOC, calculated as a risk-adjusted proportion reported as a rate per 10,000 delivery hospitalizations: ((Num2 – NumExcl) / (Den-DenExcl)) * 10,000 Num2: Number of delivery encounters with SOC excluding encounters where transfusion was the only SOC; NumExcl: Delivery encounters with blood transfusion or hysterectomy with Placenta Percreta or Placenta Increta; Den: Delivery encounters with > or = 20 weeks gestation completed; DenExcl: Delivery encounters for patients with a COVID diagnosis and COVID-related respiratory condition or a COVID diagnosis and COVID-related respiratory procedure</td>\n </tr>\n \n\n \n\n \n\n </td>\n \n <tr>\n <td/>\n <td/>\n <td>Initial Population</td>\n <td>\n \n <pre><code class=\"language-cql\">define "Initial Population":\n PCMaternal."Delivery Encounter with Age Range"</code></pre>\n \n </td>\n </tr>\n \n <tr>\n <td/>\n <td/>\n <td>Denominator</td>\n <td>\n \n <pre><code class=\"language-cql\">define "Denominator":\n "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation"</code></pre>\n \n </td>\n </tr>\n \n <tr>\n <td/>\n <td/>\n <td>Denominator Exclusion</td>\n <td>\n \n <pre><code class=\"language-cql\">define "Denominator Exclusion":\n "Delivery Encounters with COVID and Respiratory Condition or Procedure"</code></pre>\n \n </td>\n </tr>\n \n <tr>\n <td/>\n <td/>\n <td>Numerator</td>\n <td>\n \n <pre><code class=\"language-cql\">define "Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions Only":\n "Delivery Encounters with Severe Obstetric Complications"\n intersect "Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions"</code></pre>\n \n </td>\n </tr>\n \n <tr>\n <td/>\n <td/>\n <td>Numerator Exclusion</td>\n <td>\n \n <pre><code class=\"language-cql\">define "SOC Excluding Blood Transfusions Only with Hysterectomy or Blood Transfusion with Placenta Increta or Placenta Percreta Without Additional SOC":\n ( "Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions Only" SOCExcludingTransfusion\n where exists ( ( SOCExcludingTransfusion.encounterDiagnosis ( ) ) EncounterDiagnoses\n where EncounterDiagnoses.code in "Placenta Increta or Percreta"\n )\n and ( exists "Delivery Encounters with Blood Transfusion"\n or exists "Delivery Encounters with Hysterectomy"\n )\n )\n\t\n\t//The following logic keeps encounter in the numerator if there is an additional SOC besides Blood Transfusion or Hysterectomy\n \n except ( ( "Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions Only" SOCExcludingTransfusion\n where SOCExcludingTransfusion.pOAIsNoOrUTD ( ) in "Severe Maternal Morbidity Diagnoses"\n )\n union "Delivery Encounters with Cardiac Conversion, Tracheostomy or Ventilation Procedures"\n union "Delivery Encounters with Expiration"\n )</code></pre>\n \n </td>\n </tr>\n \n \n \n </tr>\n </table>\n \n\n <table class=\"grid-dict\">\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CQMCommon</td>\n \n \n <td>Inpatient Encounter</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Inpatient Encounter":\n [Encounter: "Encounter Inpatient"] EncounterInpatient\n\t\twhere EncounterInpatient.status = 'finished'\n\t\tand EncounterInpatient.period ends during day of "Measurement Period"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>PCMaternal</td>\n \n \n <td>Encounter with Age Range</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Encounter with Age Range":\n CQMCommon."Inpatient Encounter" InpatientEncounter\n where AgeInYearsAt(date from start of InpatientEncounter.period) in Interval[ 8, 65 )</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>PCMaternal</td>\n \n \n <td>Delivery Encounter with Age Range</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Delivery Encounter with Age Range":\n "Encounter with Age Range" EncounterWithAge\n with ["Procedure": "Delivery Procedures"] DeliveryProcedure\n such that DeliveryProcedure.status = 'completed'\n and DeliveryProcedure.performed.toInterval ( ) starts during EncounterWithAge.hospitalizationWithEDOBTriageObservation ()</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SevereObstetricComplicationsFHIR</td>\n \n \n <td>Delivery Encounters with Calculated Gestational Age Greater than or Equal to 20 Weeks</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Delivery Encounters with Calculated Gestational Age Greater than or Equal to 20 Weeks":\n PCMaternal."Delivery Encounter with Age Range" DeliveryEncounter\n where DeliveryEncounter.calculatedGestationalAge ( ) >= 20</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SevereObstetricComplicationsFHIR</td>\n \n \n <td>Delivery Encounters with Estimated Gestational Age Assessment Greater than or Equal to 20 Weeks</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Delivery Encounters with Estimated Gestational Age Assessment Greater than or Equal to 20 Weeks":\n PCMaternal."Delivery Encounter with Age Range" DeliveryEncounter\n where DeliveryEncounter.calculatedGestationalAge ( ) is null\n and ( DeliveryEncounter.lastEstimatedGestationalAge ( ) >= 20 weeks )</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SevereObstetricComplicationsFHIR</td>\n \n \n <td>Delivery Encounters with Gestational Age Greater than or Equal to 20 Weeks Based on Coding</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Delivery Encounters with Gestational Age Greater than or Equal to 20 Weeks Based on Coding":\n PCMaternal."Delivery Encounter with Age Range" DeliveryEncounter\n let CGA: DeliveryEncounter.calculatedGestationalAge ( ),\n EGA: DeliveryEncounter.lastEstimatedGestationalAge ( )\n where CGA is null\n and EGA is null\n and exists ( ( DeliveryEncounter.encounterDiagnosis ( ) ) EncounterDiagnosis\n where EncounterDiagnosis.code in "20 to 42 Plus Weeks Gestation"\n )</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SevereObstetricComplicationsFHIR</td>\n \n \n <td>Delivery Encounters At Greater than or Equal to 20 Weeks Gestation</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation":\n "Delivery Encounters with Calculated Gestational Age Greater than or Equal to 20 Weeks"\n union "Delivery Encounters with Estimated Gestational Age Assessment Greater than or Equal to 20 Weeks"\n union "Delivery Encounters with Gestational Age Greater than or Equal to 20 Weeks Based on Coding"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SevereObstetricComplicationsFHIR</td>\n \n \n <td>Risk Variable Asthma</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Risk Variable Asthma":\n "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Acute or Persistent Asthma"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SevereObstetricComplicationsFHIR</td>\n \n \n <td>Risk Variable Placental Accreta Spectrum</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Risk Variable Placental Accreta Spectrum":\n "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Placenta Accreta"\n or TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Placenta Increta or Percreta"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SevereObstetricComplicationsFHIR</td>\n \n \n <td>Risk Variable Neuromuscular</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Risk Variable Neuromuscular":\n "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Neuromuscular Disease"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SevereObstetricComplicationsFHIR</td>\n \n \n <td>Risk Variable Hypertension</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Risk Variable Hypertension":\n "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Hypertension"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SevereObstetricComplicationsFHIR</td>\n \n \n <td>Delivery Encounters with Severe Obstetric Complications Diagnosis or Procedure Excluding Blood Transfusion</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Delivery Encounters with Severe Obstetric Complications Diagnosis or Procedure Excluding Blood Transfusion":\n "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsNoOrUTD ( ) in "Severe Maternal Morbidity Diagnoses"\n or exists ( ["Procedure": "Severe Maternal Morbidity Procedures"] SMMProcedures\n where SMMProcedures.status = 'completed'\n and SMMProcedures.performed.toInterval ( ) starts during day of TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation ( )\n )</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SevereObstetricComplicationsFHIR</td>\n \n \n <td>Delivery Encounters with Expiration</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Delivery Encounters with Expiration":\n "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.hospitalization.dischargeDisposition in "Patient Expired"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SevereObstetricComplicationsFHIR</td>\n \n \n <td>Delivery Encounters with Blood Transfusion</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Delivery Encounters with Blood Transfusion":\n "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter\n with ["Procedure": "Blood Transfusion"] BloodTransfusion\n such that BloodTransfusion.status = 'completed'\n and BloodTransfusion.performed.toInterval ( ) starts during day of TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation ( )</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SevereObstetricComplicationsFHIR</td>\n \n \n <td>Delivery Encounters with Severe Obstetric Complications</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Delivery Encounters with Severe Obstetric Complications":\n "Delivery Encounters with Severe Obstetric Complications Diagnosis or Procedure Excluding Blood Transfusion"\n union "Delivery Encounters with Expiration"\n union "Delivery Encounters with Blood Transfusion"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SevereObstetricComplicationsFHIR</td>\n \n \n <td>Delivery Encounters with Hysterectomy</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Delivery Encounters with Hysterectomy":\n "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter\n with ["Procedure": "Hysterectomy"] Hysterectomy\n such that Hysterectomy.status = 'completed'\n and Hysterectomy.performed.toInterval ( ) starts during day of TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation ( )</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SevereObstetricComplicationsFHIR</td>\n \n \n <td>Cardiac Conversion, Tracheostomy or Ventilation Procedures</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Cardiac Conversion, Tracheostomy or Ventilation Procedures":\n ["Procedure": "Conversion of Cardiac Rhythm"]\n union ["Procedure": "Tracheostomy"]\n union ["Procedure": "Ventilation"]</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SevereObstetricComplicationsFHIR</td>\n \n \n <td>Delivery Encounters with Cardiac Conversion, Tracheostomy or Ventilation Procedures</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Delivery Encounters with Cardiac Conversion, Tracheostomy or Ventilation Procedures":\n "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter\n with "Cardiac Conversion, Tracheostomy or Ventilation Procedures" ConvTrachVentProcedures\n such that ConvTrachVentProcedures.status = 'completed'\n and ConvTrachVentProcedures.performed.toInterval ( ) starts during day of TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation ( )</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SevereObstetricComplicationsFHIR</td>\n \n \n <td>SOC with Hysterectomy or Blood Transfusion with Placenta Increta or Placenta Percreta Without Additional SOC</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "SOC with Hysterectomy or Blood Transfusion with Placenta Increta or Placenta Percreta Without Additional SOC":\n ( "Delivery Encounters with Severe Obstetric Complications" SOCEncounter\n where exists ( ( SOCEncounter.encounterDiagnosis ( ) ) EncounterDiagnosis\n where EncounterDiagnosis.code in "Placenta Increta or Percreta"\n )\n and ( exists "Delivery Encounters with Blood Transfusion"\n or exists "Delivery Encounters with Hysterectomy"\n )\n )\n\t//The following logic keeps encounter in the numerator if there is an additional SOC besides Blood Transfusion or Hysterectomy\n \n except ( ( "Delivery Encounters with Severe Obstetric Complications" SOCEncounter\n where ( SOCEncounter.pOAIsNoOrUTD ( ) in "Severe Maternal Morbidity Diagnoses" )\n )\n union "Delivery Encounters with Cardiac Conversion, Tracheostomy or Ventilation Procedures"\n union "Delivery Encounters with Expiration"\n )</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SevereObstetricComplicationsFHIR</td>\n \n \n <td>Risk Variable Preterm Birth</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Risk Variable Preterm Birth":\n/* CGA = Calculated Gestational Age. EGA = Estimated Gestational Age. */\n \n ( PCMaternal."Delivery Encounter with Age Range" DeliveryEncounter\n let CGA: DeliveryEncounter.calculatedGestationalAge ( ),\n EGA: DeliveryEncounter.lastEstimatedGestationalAge ( )\n where CGA in Interval[20, 36]\n or ( CGA is null\n and ( EGA >= 20 weeks\n and EGA <= 36 weeks\n )\n )\n )\n union ( PCMaternal."Delivery Encounter with Age Range" DeliveryEncounter\n let CGA: DeliveryEncounter.calculatedGestationalAge ( ),\n EGA: DeliveryEncounter.lastEstimatedGestationalAge ( )\n where CGA is null\n and EGA is null\n and DeliveryEncounter.pOAIsYesOrExempt ( ) in "Preterm Birth"\n )</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SupplementalDataElements</td>\n \n \n <td>SDE Payer</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "SDE Payer":\n [Coverage: type in "Payer Type"] Payer\n return {\n code: Payer.type,\n period: Payer.period\n }</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SevereObstetricComplicationsFHIR</td>\n \n \n <td>SDE Payer</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "SDE Payer":\n SDE."SDE Payer"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SevereObstetricComplicationsFHIR</td>\n \n \n <td>Risk Variable Placental Abruption</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Risk Variable Placental Abruption":\n "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Placental Abruption"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SevereObstetricComplicationsFHIR</td>\n \n \n <td>Delivery Encounters with COVID and Respiratory Condition or Procedure</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Delivery Encounters with COVID and Respiratory Condition or Procedure":\n "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter\n where exists ( ( TwentyWeeksPlusEncounter.encounterDiagnosis ( ) ) EncounterDiagnosis\n where EncounterDiagnosis.code in "COVID 19 Confirmed"\n )\n and ( exists ( ( TwentyWeeksPlusEncounter.encounterDiagnosis ( ) ) EncounterDiagnosis\n where EncounterDiagnosis.code in "Respiratory Conditions Related to COVID 19"\n )\n or exists ( ["Procedure": "Respiratory Support Procedures Related to COVID 19"] COVIDRespiratoryProcedure\n where COVIDRespiratoryProcedure.status = 'completed'\n and COVIDRespiratoryProcedure.performed.toInterval ( ) starts during day of TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation ( )\n )\n )</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SevereObstetricComplicationsFHIR</td>\n \n \n <td>Denominator Exclusion</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Denominator Exclusion":\n "Delivery Encounters with COVID and Respiratory Condition or Procedure"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SevereObstetricComplicationsFHIR</td>\n \n \n <td>Risk Variable Morbid Obesity</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Risk Variable Morbid Obesity":\n "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Morbid or Severe Obesity"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SevereObstetricComplicationsFHIR</td>\n \n \n <td>Risk Variable Preexisting Diabetes</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Risk Variable Preexisting Diabetes":\n "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Preexisting Diabetes"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SevereObstetricComplicationsFHIR</td>\n \n \n <td>Risk Variable Bariatric Surgery</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Risk Variable Bariatric Surgery":\n "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Bariatric Surgery"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SupplementalDataElements</td>\n \n \n <td>SDE Race</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "SDE Race":\n Patient.race R\n return Tuple {\n codes: R.ombCategory union R.detailed,\n display: R.text\n }</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SevereObstetricComplicationsFHIR</td>\n \n \n <td>SDE Race</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "SDE Race":\n SDE."SDE Race"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SevereObstetricComplicationsFHIR</td>\n \n \n <td>Risk Variable Placenta Previa</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Risk Variable Placenta Previa":\n "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Placenta Previa"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SupplementalDataElements</td>\n \n \n <td>SDE Sex</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "SDE Sex":\n case\n when Patient.gender = 'male' then "M"\n when Patient.gender = 'female' then "F"\n else null\n end</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SevereObstetricComplicationsFHIR</td>\n \n \n <td>SDE Sex</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "SDE Sex":\n SDE."SDE Sex"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SevereObstetricComplicationsFHIR</td>\n \n \n <td>Risk Variable Bleeding Disorder</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Risk Variable Bleeding Disorder":\n "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Bleeding Disorder"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SevereObstetricComplicationsFHIR</td>\n \n \n <td>Risk Variable First White Blood Cell Count Lab Test</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">//First resulted value 24 hours prior to start of encounter and before time of delivery\n //Report white blood cell count as 10*3/uL\n\n\n\ndefine "Risk Variable First White Blood Cell Count Lab Test":\n "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter\n let FirstWBC: First(["USCoreLaboratoryResultObservationProfile": "White blood cells count lab test"] WBC\n where WBC.issued during Interval[start of TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation() - 1440 minutes, TwentyWeeksPlusEncounter.lastTimeOfDelivery())\n and WBC.status in { 'final', 'amended', 'corrected' }\n and WBC.value is not null\n sort by issued.earliest()\n )\n return {\n EncounterId: TwentyWeeksPlusEncounter.id,\n FirstWBCResult: FirstWBC.value as Quantity,\n Timing: FirstWBC.issued\n }</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SevereObstetricComplicationsFHIR</td>\n \n \n <td>Risk Variable First Hematocrit Lab Test</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">//First resulted value 24 hours prior to start of encounter and before time of delivery\n //Report hematocrit as %\n\n\n\ndefine "Risk Variable First Hematocrit Lab Test":\n "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter\n let FirstHematocrit: First(["USCoreLaboratoryResultObservationProfile": "Hematocrit lab test"] Hematocrit\n where Hematocrit.issued during Interval[start of TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation() - 1440 minutes, TwentyWeeksPlusEncounter.lastTimeOfDelivery())\n and Hematocrit.status in { 'final', 'amended', 'corrected' }\n and Hematocrit.value is not null\n sort by issued.earliest()\n )\n return {\n EncounterId: TwentyWeeksPlusEncounter.id,\n FirstHematocritResult: FirstHematocrit.value as Quantity,\n Timing: FirstHematocrit.issued\n }</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SevereObstetricComplicationsFHIR</td>\n \n \n <td>Risk Variable Severe Preeclampsia</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Risk Variable Severe Preeclampsia":\n "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Severe Preeclampsia"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SevereObstetricComplicationsFHIR</td>\n \n \n <td>Risk Variable Anemia</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Risk Variable Anemia":\n "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Anemia"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SevereObstetricComplicationsFHIR</td>\n \n \n <td>Risk Variable Cardiac Disease</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Risk Variable Cardiac Disease":\n "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Cardiac Disease"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SevereObstetricComplicationsFHIR</td>\n \n \n <td>Risk Variable Long Term Anticoagulant Use</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Risk Variable Long Term Anticoagulant Use":\n "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Long Term Anticoagulant Use"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SevereObstetricComplicationsFHIR</td>\n \n \n <td>Risk Variable Systolic Blood Pressure</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">//First resulted value 24 hours prior to start of encounter and before time of delivery\n//Report systolic blood pressure as mm[Hg]\n//Systolic blood pressure value cannot be null per QICore profile requirement.\n\n\n\n\ndefine "Risk Variable Systolic Blood Pressure":\n "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter\n let FirstSystolicBP: First(["observation-bp"] BP\n where BP.effective.earliest() during Interval[start of TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation() - 1440 minutes, TwentyWeeksPlusEncounter.lastTimeOfDelivery())\n and BP.status in { 'final', 'amended', 'corrected' }\n and BP.component.value is not null\n sort by effective.earliest()\n )\n return {\n EncounterId: TwentyWeeksPlusEncounter.id,\n FirstSBPResult: FirstSystolicBP.component C\n where C.code ~ "Systolic blood pressure"\n return C.value as Quantity,\n Timing: FirstSystolicBP.effective.earliest ( )\n }</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SevereObstetricComplicationsFHIR</td>\n \n \n <td>Risk Variable Substance Abuse</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Risk Variable Substance Abuse":\n "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Substance Abuse"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SevereObstetricComplicationsFHIR</td>\n \n \n <td>Risk Variable Renal Disease</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Risk Variable Renal Disease":\n "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Renal Disease"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>PCMaternal</td>\n \n \n <td>Variable Calculated Gestational Age</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Variable Calculated Gestational Age":\n // This definition establishes a variable of CGA (Calculated Gestational Age). CGA is a supplemental data element to store the calculated gestational age result from the "CalculatedGestationalAge" function. The data element enables the capturing and saving of the CGA for data analysis post data receipt. Hospitals do not need to submit any additional data to comply with this definition\n "Delivery Encounter with Age Range" DeliveryEncounter\n let CGA: DeliveryEncounter.calculatedGestationalAge()\n // return { QualifyingEncounter, CGA }\n return {\n EncounterID: DeliveryEncounter.id,\n CalculatedCGA: CGA\n }</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SevereObstetricComplicationsFHIR</td>\n \n \n <td>SDE Variable Calculated Gestational Age</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "SDE Variable Calculated Gestational Age":\n //This definition establishes a variable of CGA (Calculated Gestational Age). CGA is a supplemental data element to store the calculated gestational age result from the "CalculatedGestationalAge" function. The data element enables the capturing and saving of the CGA for data analysis post data receipt. Hospitals do not need to submit any additional data to comply with this definition. \n \n PCMaternal."Variable Calculated Gestational Age"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SevereObstetricComplicationsFHIR</td>\n \n \n <td>Risk Variable Gastrointestinal Disease</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Risk Variable Gastrointestinal Disease":\n "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Gastrointestinal Disease"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SevereObstetricComplicationsFHIR</td>\n \n \n <td>Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions":\n "Delivery Encounters with Severe Obstetric Complications Diagnosis or Procedure Excluding Blood Transfusion"\n union "Delivery Encounters with Expiration"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SevereObstetricComplicationsFHIR</td>\n \n \n <td>Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions Only</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions Only":\n "Delivery Encounters with Severe Obstetric Complications"\n intersect "Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SevereObstetricComplicationsFHIR</td>\n \n \n <td>Risk Variable Pulmonary Hypertension</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Risk Variable Pulmonary Hypertension":\n "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Pulmonary Hypertension"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SevereObstetricComplicationsFHIR</td>\n \n \n <td>Risk Variable Thyrotoxicosis</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Risk Variable Thyrotoxicosis":\n "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Thyrotoxicosis"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SevereObstetricComplicationsFHIR</td>\n \n \n <td>Risk Variable Other Preeclampsia</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Risk Variable Other Preeclampsia":\n "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Mild or Moderate Preeclampsia"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SevereObstetricComplicationsFHIR</td>\n \n \n <td>Initial Population</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Initial Population":\n PCMaternal."Delivery Encounter with Age Range"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SevereObstetricComplicationsFHIR</td>\n \n \n <td>Risk Variable Economic Housing Instability</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Risk Variable Economic Housing Instability":\n "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Economic Housing Instability"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SevereObstetricComplicationsFHIR</td>\n \n \n <td>Risk Variable HIV</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Risk Variable HIV":\n "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "HIV in Pregnancy Childbirth and Puerperium"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SevereObstetricComplicationsFHIR</td>\n \n \n <td>SOC Excluding Blood Transfusions Only with Hysterectomy or Blood Transfusion with Placenta Increta or Placenta Percreta Without Additional SOC</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "SOC Excluding Blood Transfusions Only with Hysterectomy or Blood Transfusion with Placenta Increta or Placenta Percreta Without Additional SOC":\n ( "Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions Only" SOCExcludingTransfusion\n where exists ( ( SOCExcludingTransfusion.encounterDiagnosis ( ) ) EncounterDiagnoses\n where EncounterDiagnoses.code in "Placenta Increta or Percreta"\n )\n and ( exists "Delivery Encounters with Blood Transfusion"\n or exists "Delivery Encounters with Hysterectomy"\n )\n )\n\t\n\t//The following logic keeps encounter in the numerator if there is an additional SOC besides Blood Transfusion or Hysterectomy\n \n except ( ( "Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions Only" SOCExcludingTransfusion\n where SOCExcludingTransfusion.pOAIsNoOrUTD ( ) in "Severe Maternal Morbidity Diagnoses"\n )\n union "Delivery Encounters with Cardiac Conversion, Tracheostomy or Ventilation Procedures"\n union "Delivery Encounters with Expiration"\n )</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SevereObstetricComplicationsFHIR</td>\n \n \n <td>Risk Variable Heart Rate</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">//First resulted value 24 hours prior to start of encounter and before time of delivery\n //Report heart rate as beats/min\n //Heart rate value cannot be null per QICore profile requirement.\n\n\n\n\ndefine "Risk Variable Heart Rate":\n "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter\n let FirstHeartRate: First(["observation-heartrate"] HeartRate\n where HeartRate.effective.earliest() during Interval[start of TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation() - 1440 minutes, TwentyWeeksPlusEncounter.lastTimeOfDelivery())\n and HeartRate.status in { 'final', 'amended', 'corrected' }\n sort by effective.earliest()\n )\n return {\n EncounterId: TwentyWeeksPlusEncounter.id,\n FirstHRResult: FirstHeartRate.value as Quantity,\n Timing: FirstHeartRate.effective.earliest ( )\n }</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SevereObstetricComplicationsFHIR</td>\n \n \n <td>Risk Variable Maternal Age</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Risk Variable Maternal Age":\n "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter\n let MaternalAge: AgeInYearsAt(date from start of TwentyWeeksPlusEncounter.period)\n return { TwentyWeeksPlusEncounter, MaternalAge }</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SevereObstetricComplicationsFHIR</td>\n \n \n <td>Risk Variable Mental Health Disorder</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Risk Variable Mental Health Disorder":\n "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Mental Health Disorder"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SevereObstetricComplicationsFHIR</td>\n \n \n <td>Risk Variable Obstetrical VTE</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Risk Variable Obstetrical VTE":\n "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Venous Thromboembolism in Pregnancy"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SevereObstetricComplicationsFHIR</td>\n \n \n <td>Risk Variable Autoimmune Disease</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Risk Variable Autoimmune Disease":\n "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Autoimmune Disease"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SevereObstetricComplicationsFHIR</td>\n \n \n <td>Risk Variable Previous Cesarean</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Risk Variable Previous Cesarean":\n "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Previous Cesarean"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SevereObstetricComplicationsFHIR</td>\n \n \n <td>Risk Variable Gestational Diabetes</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Risk Variable Gestational Diabetes":\n "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Gestational Diabetes"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SevereObstetricComplicationsFHIR</td>\n \n \n <td>Risk Variable Multiple Pregnancy</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Risk Variable Multiple Pregnancy":\n "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Multiple Pregnancy"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SevereObstetricComplicationsFHIR</td>\n \n \n <td>Denominator</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Denominator":\n "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SupplementalDataElements</td>\n \n \n <td>SDE Ethnicity</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "SDE Ethnicity":\n Patient.ethnicity E\n return Tuple {\n codes: { E.ombCategory } union E.detailed,\n display: E.text\n }</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SevereObstetricComplicationsFHIR</td>\n \n \n <td>SDE Ethnicity</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "SDE Ethnicity":\n SDE."SDE Ethnicity"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>PCMaternal</td>\n \n \n <td>hospitalizationWithEDOBTriageObservation</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">/*define function "HospitalizationWithEDOBTriageObservation"(Encounter Encounter ):\n HospitalizationWithEDOBTriageObservation returns the total interval from the start of any immediately prior emergency department visit or OB Triage visit through the observation visit to the discharge of the given encounter\n Encounter Visit\n let ObsVisit: Last(["Encounter": "Observation Services"] LastObs\n where LastObs.period ends 1 hour or less on or before start of Visit.period\n and LastObs.status = 'finished'\n sort by \n end of period\n ),\n VisitStart: Coalesce(start of ObsVisit.period, start of Visit.period),\n EDOBTriageVisit: Last(["Encounter": "ED Visit and OB Triage"] LastEDOBTriage\n where LastEDOBTriage.period ends 1 hour or less on or before VisitStart\n and LastEDOBTriage.status = 'finished'\n sort by \n end of period\n )\n return Interval[Coalesce(start of EDOBTriageVisit.period, VisitStart), \n end of Visit.period]*/\n \n \ndefine fluent function hospitalizationWithEDOBTriageObservation (TheEncounter Encounter ):\n /*hospitalizationWithEDOBTriageObservation returns the total interval from the start of any immediately prior emergency department visit or OB Triage visit through the observation visit to the discharge of the given encounter*/\n TheEncounter Visit\n let ObsVisit: Last(["Encounter": "Observation Services"] LastObs\n where LastObs.period ends 1 hour or less on or before start of Visit.period\n and LastObs.status = 'finished'\n sort by \n end of period\n ),\n VisitStart: Coalesce(start of ObsVisit.period, start of Visit.period),\n EDOBTriageVisit: Last(["Encounter": "ED Visit and OB Triage"] LastEDOBTriage\n where LastEDOBTriage.period ends 1 hour or less on or before VisitStart\n and LastEDOBTriage.status = 'finished'\n sort by \n end of period\n )\n return Interval[Coalesce(start of EDOBTriageVisit.period, VisitStart), \n end of Visit.period]</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>PCMaternal</td>\n \n \n <td>calculatedGestationalAge</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define fluent function calculatedGestationalAge (TheEncounter Encounter ):\n //Gestational Age = (280-(Estimated Delivery Date minus Reference Date/Delivery Date))/7\n ( 280 - ( difference in days between TheEncounter.lastTimeOfDelivery () and TheEncounter.lastEstimatedDeliveryDate( )) ) div 7</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>PCMaternal</td>\n \n \n <td>lastTimeOfDelivery</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define fluent function lastTimeOfDelivery (TheEncounter Encounter ):\n Last(["Observation": "Date and time of obstetric delivery"] TimeOfDelivery\n where TimeOfDelivery.value as DateTime is not null\n and TimeOfDelivery.status in { 'final', 'amended', 'corrected' }\n and TimeOfDelivery.effective.earliest () during TheEncounter.hospitalizationWithEDOBTriageObservation ()\n and TimeOfDelivery.value as DateTime during TheEncounter.hospitalizationWithEDOBTriageObservation()\n sort by effective.earliest()\n ).value as DateTime</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>QICoreCommon</td>\n \n \n <td>earliest</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">/*\n@description: Given an interval, return the starting point if the interval has a starting boundary specified,\notherwise, return the ending point\n*/\ndefine fluent function earliest(choice Choice<DateTime, Quantity, Interval<DateTime>, Interval<Quantity>> ):\n (choice.toInterval()) period\n return\n if (period."hasStart"()) then start of period\n else end of period</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>PCMaternal</td>\n \n \n <td>lastEstimatedDeliveryDate</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">/*===============================================================*/\n /* 03/14/2022 from MATGlobalCommonFunctionsv7.000 - latest QDM */\n /* even though this PCMaternalFHIR was derived from */\n /* PCMaternal=2.1.000 cql, to make next update easier. */\n /* Will need to re-insert "Global". in front of these */\n /* function names later (whereever they are directly used.*/\n\ndefine fluent function lastEstimatedDeliveryDate (TheEncounter Encounter ):\n /*This function identifies the last time the EDD was assessed 42 weeks or less prior to or on delivery and stores the result of that assessment.*/\n Last(["Observation": "Delivery date Estimated"] EstimatedDateOfDelivery\n where EstimatedDateOfDelivery.value as DateTime is not null\n and EstimatedDateOfDelivery.status in { 'final', 'amended', 'corrected' }\n and EstimatedDateOfDelivery.effective.earliest ( ) 42 weeks or less before or on TheEncounter.lastTimeOfDelivery ()\n sort by effective.earliest ( )\n ).value as DateTime</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>PCMaternal</td>\n \n \n <td>lastEstimatedGestationalAge</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">/*define fluent function lastEstimatedGestationalAge (TheEncounter Encounter ):\n Last(["Observation": "Estimated Gestational Age at Delivery"] EstimatedGestationalAge\n where EstimatedGestationalAge.value is not null\n and EstimatedGestationalAge.status in { 'final', 'amended', 'corrected' }\n and EstimatedGestationalAge.effective.earliest() 24 hours or less before or on TheEncounter.lastTimeOfDelivery ()\n sort by effective.earliest ()\n ).value as Quantity*/\n \n define fluent function lastEstimatedGestationalAge (TheEncounter Encounter ):\n Last(["Observation": "Estimated Gestational Age at Delivery"] EstimatedGestationalAge\n let EGATiming: EstimatedGestationalAge.effective.earliest() where \n (EGATiming 24 hours or less before or on TheEncounter.lastTimeOfDelivery () \n and EstimatedGestationalAge.value is not null \n and EstimatedGestationalAge.status in { 'final', 'amended', 'corrected' }) or \n (EGATiming same day as TheEncounter.lastTimeOfDelivery () \n and EGATiming during TheEncounter.hospitalizationWithEDOBTriageObservation() \n and EstimatedGestationalAge.value is not null)\n sort by effective.earliest ())\n .value as Quantity</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CQMCommon</td>\n \n \n <td>encounterDiagnosis</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">/*\n@description: Returns the Condition resources referenced by the diagnosis element of the Encounter\n*/\ndefine fluent function encounterDiagnosis(Encounter Encounter ):\n Encounter.diagnosis D\n return singleton from ([Condition] C where C.id = D.condition.reference.getId())</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>QICoreCommon</td>\n \n \n <td>getId</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">/*\n@description: Returns the tail of the given uri (i.e. everything after the last slash in the URI).\n@comment: This function can be used to determine the logical id of a given resource. It can be used in\na single-server environment to trace references. However, this function does not attempt to resolve\nor distinguish the base of the given url, and so cannot be used safely in multi-server environments.\n*/\ndefine fluent function getId(uri String):\n Last(Split(uri, '/'))</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SevereObstetricComplicationsFHIR</td>\n \n \n <td>pOAIsYesOrExempt</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define fluent function pOAIsYesOrExempt(TheEncounter Encounter):\n TheEncounter.diagnosis EncounterDiagnoses\n where EncounterDiagnoses.diagnosisPresentOnAdmission in "Present On Admission is Yes or Exempt"\n return EncounterDiagnoses.condition.getCondition ( ).code</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>FHIRHelpers</td>\n \n \n <td>ToString</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define function ToString(value uri): value.value</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CQMCommon</td>\n \n \n <td>getCondition</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">/*\n@description: Returns the Condition resource for the given reference\n*/\ndefine fluent function getCondition(reference Reference):\n singleton from ([Condition] C where C.id = reference.reference.getId())</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SevereObstetricComplicationsFHIR</td>\n \n \n <td>pOAIsNoOrUTD</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">/*define function "FirstLabTestWithEncounterId"(LabList List<Observation>, CCDE String ):\n "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter\n let FirstLab: First(LabList Lab\n //(first resulted value 24 hours prior to start of encounter and before time of delivery)\n where Lab.issued.earliest() during Interval[start of TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation()- 1440 minutes, TwentyWeeksPlusEncounter.lastTimeOfDelivery()) \n and Lab.status in {'final', 'amended', 'corrected'}\n and Lab.value is not null\n sort by issued.earliest())\n return {\n EncounterId: TwentyWeeksPlusEncounter.id,\n FirstResult: FirstLab.value as Quantity,\n Timing: FirstLab.issued\n }\n\ndefine function "FirstPhysicalExamWithEncounterId"(ExamList List<Observation>, CCDE String):\n "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter\n let FirstExam: First(ExamList Exam\n where Exam.effective.earliest() during Interval[start of TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation()- 1440 minutes, TwentyWeeksPlusEncounter.lastTimeOfDelivery()) \n and Exam.status in {'final', 'amended', 'corrected'}\n and Exam.value is not null\n sort by effective.earliest() )\n return {\n EncounterId: TwentyWeeksPlusEncounter.id,\n FirstResult: FirstExam.value as Quantity,\n Timing: FirstExam.effective.earliest()\n }\n \ndefine "Risk Variable Lab and Physical Exam Results":\n flatten{\n // First physical exams (vital signs): Report heart rate as {beats}/min, systolic blood pressure as mm[Hg]\n "FirstPhysicalExamWithEncounterId"([Observation: "Heart rate"], 'FirstHeartRate'),\n "FirstPhysicalExamWithEncounterId"([Observation: "Systolic blood pressure"], 'FirstSystolicBP'),\n //First lab tests: Report hematocrit as %, white blood cell count as 10*3/uL\n "FirstLabTestWithEncounterId"([Observation: "Hematocrit lab test"], 'FirstHematocrit'),\n "FirstLabTestWithEncounterId"([Observation: "White blood cells count lab test"], 'FirstWhiteBloodCell') \n }*/\n\n\ndefine fluent function pOAIsNoOrUTD(TheEncounter Encounter):\n TheEncounter.diagnosis EncounterDiagnoses\n where EncounterDiagnoses.diagnosisPresentOnAdmission in "Present on Admission is No or Unable To Determine"\n return EncounterDiagnoses.condition.getCondition ( ).code</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>FHIRHelpers</td>\n \n \n <td>ToCode</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">/*\n@description: Converts the given FHIR [Coding](https://hl7.org/fhir/datatypes.html#Coding) value to a CQL Code.\n*/\ndefine function ToCode(coding FHIR.Coding):\n if coding is null then\n null\n else\n System.Code {\n code: coding.code.value,\n system: coding.system.value,\n version: coding.version.value,\n display: coding.display.value\n }</code></pre>\n </td>\n \n </tr>\n \n </table>\n </td>\n </tr>\n \n \n \n\n </table>\n</div>"
},
"contained" : [
{
"resourceType" : "Library",
"id" : "effective-data-requirements",
"extension" : [
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "93857-1",
"display" : "Date and time of obstetric delivery"
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "11778-8",
"display" : "Delivery date Estimated"
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
"valueCoding" : {
"system" : "http://hl7.org/fhir/administrative-gender",
"code" : "M",
"display" : "Male"
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
"valueCoding" : {
"system" : "http://hl7.org/fhir/administrative-gender",
"code" : "F",
"display" : "Female"
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "8480-6",
"display" : "Systolic BP"
}
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CQMCommon"
},
{
"url" : "name",
"valueString" : "Inpatient Encounter"
},
{
"url" : "statement",
"valueString" : "define \"Inpatient Encounter\":\n [Encounter: \"Encounter Inpatient\"] EncounterInpatient\n\t\twhere EncounterInpatient.status = 'finished'\n\t\tand EncounterInpatient.period ends during day of \"Measurement Period\""
},
{
"url" : "displaySequence",
"valueInteger" : 0
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "PCMaternal"
},
{
"url" : "name",
"valueString" : "Encounter with Age Range"
},
{
"url" : "statement",
"valueString" : "define \"Encounter with Age Range\":\n CQMCommon.\"Inpatient Encounter\" InpatientEncounter\n where AgeInYearsAt(date from start of InpatientEncounter.period) in Interval[ 8, 65 )"
},
{
"url" : "displaySequence",
"valueInteger" : 1
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "PCMaternal"
},
{
"url" : "name",
"valueString" : "Delivery Encounter with Age Range"
},
{
"url" : "statement",
"valueString" : "define \"Delivery Encounter with Age Range\":\n \"Encounter with Age Range\" EncounterWithAge\n with [\"Procedure\": \"Delivery Procedures\"] DeliveryProcedure\n such that DeliveryProcedure.status = 'completed'\n and DeliveryProcedure.performed.toInterval ( ) starts during EncounterWithAge.hospitalizationWithEDOBTriageObservation ()"
},
{
"url" : "displaySequence",
"valueInteger" : 2
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SevereObstetricComplicationsFHIR"
},
{
"url" : "name",
"valueString" : "Delivery Encounters with Calculated Gestational Age Greater than or Equal to 20 Weeks"
},
{
"url" : "statement",
"valueString" : "define \"Delivery Encounters with Calculated Gestational Age Greater than or Equal to 20 Weeks\":\n PCMaternal.\"Delivery Encounter with Age Range\" DeliveryEncounter\n where DeliveryEncounter.calculatedGestationalAge ( ) >= 20"
},
{
"url" : "displaySequence",
"valueInteger" : 3
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SevereObstetricComplicationsFHIR"
},
{
"url" : "name",
"valueString" : "Delivery Encounters with Estimated Gestational Age Assessment Greater than or Equal to 20 Weeks"
},
{
"url" : "statement",
"valueString" : "define \"Delivery Encounters with Estimated Gestational Age Assessment Greater than or Equal to 20 Weeks\":\n PCMaternal.\"Delivery Encounter with Age Range\" DeliveryEncounter\n where DeliveryEncounter.calculatedGestationalAge ( ) is null\n and ( DeliveryEncounter.lastEstimatedGestationalAge ( ) >= 20 weeks )"
},
{
"url" : "displaySequence",
"valueInteger" : 4
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SevereObstetricComplicationsFHIR"
},
{
"url" : "name",
"valueString" : "Delivery Encounters with Gestational Age Greater than or Equal to 20 Weeks Based on Coding"
},
{
"url" : "statement",
"valueString" : "define \"Delivery Encounters with Gestational Age Greater than or Equal to 20 Weeks Based on Coding\":\n PCMaternal.\"Delivery Encounter with Age Range\" DeliveryEncounter\n let CGA: DeliveryEncounter.calculatedGestationalAge ( ),\n EGA: DeliveryEncounter.lastEstimatedGestationalAge ( )\n where CGA is null\n and EGA is null\n and exists ( ( DeliveryEncounter.encounterDiagnosis ( ) ) EncounterDiagnosis\n where EncounterDiagnosis.code in \"20 to 42 Plus Weeks Gestation\"\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 5
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SevereObstetricComplicationsFHIR"
},
{
"url" : "name",
"valueString" : "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation"
},
{
"url" : "statement",
"valueString" : "define \"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation\":\n \"Delivery Encounters with Calculated Gestational Age Greater than or Equal to 20 Weeks\"\n union \"Delivery Encounters with Estimated Gestational Age Assessment Greater than or Equal to 20 Weeks\"\n union \"Delivery Encounters with Gestational Age Greater than or Equal to 20 Weeks Based on Coding\""
},
{
"url" : "displaySequence",
"valueInteger" : 6
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SevereObstetricComplicationsFHIR"
},
{
"url" : "name",
"valueString" : "Risk Variable Asthma"
},
{
"url" : "statement",
"valueString" : "define \"Risk Variable Asthma\":\n \"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation\" TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in \"Acute or Persistent Asthma\""
},
{
"url" : "displaySequence",
"valueInteger" : 7
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SevereObstetricComplicationsFHIR"
},
{
"url" : "name",
"valueString" : "Risk Variable Placental Accreta Spectrum"
},
{
"url" : "statement",
"valueString" : "define \"Risk Variable Placental Accreta Spectrum\":\n \"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation\" TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in \"Placenta Accreta\"\n or TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in \"Placenta Increta or Percreta\""
},
{
"url" : "displaySequence",
"valueInteger" : 8
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SevereObstetricComplicationsFHIR"
},
{
"url" : "name",
"valueString" : "Risk Variable Neuromuscular"
},
{
"url" : "statement",
"valueString" : "define \"Risk Variable Neuromuscular\":\n \"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation\" TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in \"Neuromuscular Disease\""
},
{
"url" : "displaySequence",
"valueInteger" : 9
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SevereObstetricComplicationsFHIR"
},
{
"url" : "name",
"valueString" : "Risk Variable Hypertension"
},
{
"url" : "statement",
"valueString" : "define \"Risk Variable Hypertension\":\n \"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation\" TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in \"Hypertension\""
},
{
"url" : "displaySequence",
"valueInteger" : 10
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SevereObstetricComplicationsFHIR"
},
{
"url" : "name",
"valueString" : "Delivery Encounters with Severe Obstetric Complications Diagnosis or Procedure Excluding Blood Transfusion"
},
{
"url" : "statement",
"valueString" : "define \"Delivery Encounters with Severe Obstetric Complications Diagnosis or Procedure Excluding Blood Transfusion\":\n \"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation\" TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsNoOrUTD ( ) in \"Severe Maternal Morbidity Diagnoses\"\n or exists ( [\"Procedure\": \"Severe Maternal Morbidity Procedures\"] SMMProcedures\n where SMMProcedures.status = 'completed'\n and SMMProcedures.performed.toInterval ( ) starts during day of TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation ( )\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 11
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SevereObstetricComplicationsFHIR"
},
{
"url" : "name",
"valueString" : "Delivery Encounters with Expiration"
},
{
"url" : "statement",
"valueString" : "define \"Delivery Encounters with Expiration\":\n \"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation\" TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.hospitalization.dischargeDisposition in \"Patient Expired\""
},
{
"url" : "displaySequence",
"valueInteger" : 12
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SevereObstetricComplicationsFHIR"
},
{
"url" : "name",
"valueString" : "Delivery Encounters with Blood Transfusion"
},
{
"url" : "statement",
"valueString" : "define \"Delivery Encounters with Blood Transfusion\":\n \"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation\" TwentyWeeksPlusEncounter\n with [\"Procedure\": \"Blood Transfusion\"] BloodTransfusion\n such that BloodTransfusion.status = 'completed'\n and BloodTransfusion.performed.toInterval ( ) starts during day of TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation ( )"
},
{
"url" : "displaySequence",
"valueInteger" : 13
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SevereObstetricComplicationsFHIR"
},
{
"url" : "name",
"valueString" : "Delivery Encounters with Severe Obstetric Complications"
},
{
"url" : "statement",
"valueString" : "define \"Delivery Encounters with Severe Obstetric Complications\":\n \"Delivery Encounters with Severe Obstetric Complications Diagnosis or Procedure Excluding Blood Transfusion\"\n union \"Delivery Encounters with Expiration\"\n union \"Delivery Encounters with Blood Transfusion\""
},
{
"url" : "displaySequence",
"valueInteger" : 14
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SevereObstetricComplicationsFHIR"
},
{
"url" : "name",
"valueString" : "Delivery Encounters with Hysterectomy"
},
{
"url" : "statement",
"valueString" : "define \"Delivery Encounters with Hysterectomy\":\n \"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation\" TwentyWeeksPlusEncounter\n with [\"Procedure\": \"Hysterectomy\"] Hysterectomy\n such that Hysterectomy.status = 'completed'\n and Hysterectomy.performed.toInterval ( ) starts during day of TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation ( )"
},
{
"url" : "displaySequence",
"valueInteger" : 15
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SevereObstetricComplicationsFHIR"
},
{
"url" : "name",
"valueString" : "Cardiac Conversion, Tracheostomy or Ventilation Procedures"
},
{
"url" : "statement",
"valueString" : "define \"Cardiac Conversion, Tracheostomy or Ventilation Procedures\":\n [\"Procedure\": \"Conversion of Cardiac Rhythm\"]\n union [\"Procedure\": \"Tracheostomy\"]\n union [\"Procedure\": \"Ventilation\"]"
},
{
"url" : "displaySequence",
"valueInteger" : 16
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SevereObstetricComplicationsFHIR"
},
{
"url" : "name",
"valueString" : "Delivery Encounters with Cardiac Conversion, Tracheostomy or Ventilation Procedures"
},
{
"url" : "statement",
"valueString" : "define \"Delivery Encounters with Cardiac Conversion, Tracheostomy or Ventilation Procedures\":\n \"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation\" TwentyWeeksPlusEncounter\n with \"Cardiac Conversion, Tracheostomy or Ventilation Procedures\" ConvTrachVentProcedures\n such that ConvTrachVentProcedures.status = 'completed'\n and ConvTrachVentProcedures.performed.toInterval ( ) starts during day of TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation ( )"
},
{
"url" : "displaySequence",
"valueInteger" : 17
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SevereObstetricComplicationsFHIR"
},
{
"url" : "name",
"valueString" : "SOC with Hysterectomy or Blood Transfusion with Placenta Increta or Placenta Percreta Without Additional SOC"
},
{
"url" : "statement",
"valueString" : "define \"SOC with Hysterectomy or Blood Transfusion with Placenta Increta or Placenta Percreta Without Additional SOC\":\n ( \"Delivery Encounters with Severe Obstetric Complications\" SOCEncounter\n where exists ( ( SOCEncounter.encounterDiagnosis ( ) ) EncounterDiagnosis\n where EncounterDiagnosis.code in \"Placenta Increta or Percreta\"\n )\n and ( exists \"Delivery Encounters with Blood Transfusion\"\n or exists \"Delivery Encounters with Hysterectomy\"\n )\n )\n\t//The following logic keeps encounter in the numerator if there is an additional SOC besides Blood Transfusion or Hysterectomy\n \n except ( ( \"Delivery Encounters with Severe Obstetric Complications\" SOCEncounter\n where ( SOCEncounter.pOAIsNoOrUTD ( ) in \"Severe Maternal Morbidity Diagnoses\" )\n )\n union \"Delivery Encounters with Cardiac Conversion, Tracheostomy or Ventilation Procedures\"\n union \"Delivery Encounters with Expiration\"\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 18
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SevereObstetricComplicationsFHIR"
},
{
"url" : "name",
"valueString" : "Risk Variable Preterm Birth"
},
{
"url" : "statement",
"valueString" : "define \"Risk Variable Preterm Birth\":\n/* CGA = Calculated Gestational Age. EGA = Estimated Gestational Age. */\n \n ( PCMaternal.\"Delivery Encounter with Age Range\" DeliveryEncounter\n let CGA: DeliveryEncounter.calculatedGestationalAge ( ),\n EGA: DeliveryEncounter.lastEstimatedGestationalAge ( )\n where CGA in Interval[20, 36]\n or ( CGA is null\n and ( EGA >= 20 weeks\n and EGA <= 36 weeks\n )\n )\n )\n union ( PCMaternal.\"Delivery Encounter with Age Range\" DeliveryEncounter\n let CGA: DeliveryEncounter.calculatedGestationalAge ( ),\n EGA: DeliveryEncounter.lastEstimatedGestationalAge ( )\n where CGA is null\n and EGA is null\n and DeliveryEncounter.pOAIsYesOrExempt ( ) in \"Preterm Birth\"\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 19
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SupplementalDataElements"
},
{
"url" : "name",
"valueString" : "SDE Payer"
},
{
"url" : "statement",
"valueString" : "define \"SDE Payer\":\n [Coverage: type in \"Payer Type\"] Payer\n return {\n code: Payer.type,\n period: Payer.period\n }"
},
{
"url" : "displaySequence",
"valueInteger" : 20
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SevereObstetricComplicationsFHIR"
},
{
"url" : "name",
"valueString" : "SDE Payer"
},
{
"url" : "statement",
"valueString" : "define \"SDE Payer\":\n SDE.\"SDE Payer\""
},
{
"url" : "displaySequence",
"valueInteger" : 21
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SevereObstetricComplicationsFHIR"
},
{
"url" : "name",
"valueString" : "Risk Variable Placental Abruption"
},
{
"url" : "statement",
"valueString" : "define \"Risk Variable Placental Abruption\":\n \"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation\" TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in \"Placental Abruption\""
},
{
"url" : "displaySequence",
"valueInteger" : 22
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SevereObstetricComplicationsFHIR"
},
{
"url" : "name",
"valueString" : "Delivery Encounters with COVID and Respiratory Condition or Procedure"
},
{
"url" : "statement",
"valueString" : "define \"Delivery Encounters with COVID and Respiratory Condition or Procedure\":\n \"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation\" TwentyWeeksPlusEncounter\n where exists ( ( TwentyWeeksPlusEncounter.encounterDiagnosis ( ) ) EncounterDiagnosis\n where EncounterDiagnosis.code in \"COVID 19 Confirmed\"\n )\n and ( exists ( ( TwentyWeeksPlusEncounter.encounterDiagnosis ( ) ) EncounterDiagnosis\n where EncounterDiagnosis.code in \"Respiratory Conditions Related to COVID 19\"\n )\n or exists ( [\"Procedure\": \"Respiratory Support Procedures Related to COVID 19\"] COVIDRespiratoryProcedure\n where COVIDRespiratoryProcedure.status = 'completed'\n and COVIDRespiratoryProcedure.performed.toInterval ( ) starts during day of TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation ( )\n )\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 23
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SevereObstetricComplicationsFHIR"
},
{
"url" : "name",
"valueString" : "Denominator Exclusion"
},
{
"url" : "statement",
"valueString" : "define \"Denominator Exclusion\":\n \"Delivery Encounters with COVID and Respiratory Condition or Procedure\""
},
{
"url" : "displaySequence",
"valueInteger" : 24
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SevereObstetricComplicationsFHIR"
},
{
"url" : "name",
"valueString" : "Risk Variable Morbid Obesity"
},
{
"url" : "statement",
"valueString" : "define \"Risk Variable Morbid Obesity\":\n \"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation\" TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in \"Morbid or Severe Obesity\""
},
{
"url" : "displaySequence",
"valueInteger" : 25
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SevereObstetricComplicationsFHIR"
},
{
"url" : "name",
"valueString" : "Risk Variable Preexisting Diabetes"
},
{
"url" : "statement",
"valueString" : "define \"Risk Variable Preexisting Diabetes\":\n \"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation\" TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in \"Preexisting Diabetes\""
},
{
"url" : "displaySequence",
"valueInteger" : 26
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SevereObstetricComplicationsFHIR"
},
{
"url" : "name",
"valueString" : "Risk Variable Bariatric Surgery"
},
{
"url" : "statement",
"valueString" : "define \"Risk Variable Bariatric Surgery\":\n \"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation\" TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in \"Bariatric Surgery\""
},
{
"url" : "displaySequence",
"valueInteger" : 27
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SupplementalDataElements"
},
{
"url" : "name",
"valueString" : "SDE Race"
},
{
"url" : "statement",
"valueString" : "define \"SDE Race\":\n Patient.race R\n return Tuple {\n codes: R.ombCategory union R.detailed,\n display: R.text\n }"
},
{
"url" : "displaySequence",
"valueInteger" : 28
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SevereObstetricComplicationsFHIR"
},
{
"url" : "name",
"valueString" : "SDE Race"
},
{
"url" : "statement",
"valueString" : "define \"SDE Race\":\n SDE.\"SDE Race\""
},
{
"url" : "displaySequence",
"valueInteger" : 29
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SevereObstetricComplicationsFHIR"
},
{
"url" : "name",
"valueString" : "Risk Variable Placenta Previa"
},
{
"url" : "statement",
"valueString" : "define \"Risk Variable Placenta Previa\":\n \"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation\" TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in \"Placenta Previa\""
},
{
"url" : "displaySequence",
"valueInteger" : 30
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SupplementalDataElements"
},
{
"url" : "name",
"valueString" : "SDE Sex"
},
{
"url" : "statement",
"valueString" : "define \"SDE Sex\":\n case\n when Patient.gender = 'male' then \"M\"\n when Patient.gender = 'female' then \"F\"\n else null\n end"
},
{
"url" : "displaySequence",
"valueInteger" : 31
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SevereObstetricComplicationsFHIR"
},
{
"url" : "name",
"valueString" : "SDE Sex"
},
{
"url" : "statement",
"valueString" : "define \"SDE Sex\":\n SDE.\"SDE Sex\""
},
{
"url" : "displaySequence",
"valueInteger" : 32
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SevereObstetricComplicationsFHIR"
},
{
"url" : "name",
"valueString" : "Risk Variable Bleeding Disorder"
},
{
"url" : "statement",
"valueString" : "define \"Risk Variable Bleeding Disorder\":\n \"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation\" TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in \"Bleeding Disorder\""
},
{
"url" : "displaySequence",
"valueInteger" : 33
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SevereObstetricComplicationsFHIR"
},
{
"url" : "name",
"valueString" : "Risk Variable First White Blood Cell Count Lab Test"
},
{
"url" : "statement",
"valueString" : "//First resulted value 24 hours prior to start of encounter and before time of delivery\n //Report white blood cell count as 10*3/uL\n\n\n\ndefine \"Risk Variable First White Blood Cell Count Lab Test\":\n \"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation\" TwentyWeeksPlusEncounter\n let FirstWBC: First([\"USCoreLaboratoryResultObservationProfile\": \"White blood cells count lab test\"] WBC\n where WBC.issued during Interval[start of TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation() - 1440 minutes, TwentyWeeksPlusEncounter.lastTimeOfDelivery())\n and WBC.status in { 'final', 'amended', 'corrected' }\n and WBC.value is not null\n sort by issued.earliest()\n )\n return {\n EncounterId: TwentyWeeksPlusEncounter.id,\n FirstWBCResult: FirstWBC.value as Quantity,\n Timing: FirstWBC.issued\n }"
},
{
"url" : "displaySequence",
"valueInteger" : 34
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SevereObstetricComplicationsFHIR"
},
{
"url" : "name",
"valueString" : "Risk Variable First Hematocrit Lab Test"
},
{
"url" : "statement",
"valueString" : "//First resulted value 24 hours prior to start of encounter and before time of delivery\n //Report hematocrit as %\n\n\n\ndefine \"Risk Variable First Hematocrit Lab Test\":\n \"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation\" TwentyWeeksPlusEncounter\n let FirstHematocrit: First([\"USCoreLaboratoryResultObservationProfile\": \"Hematocrit lab test\"] Hematocrit\n where Hematocrit.issued during Interval[start of TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation() - 1440 minutes, TwentyWeeksPlusEncounter.lastTimeOfDelivery())\n and Hematocrit.status in { 'final', 'amended', 'corrected' }\n and Hematocrit.value is not null\n sort by issued.earliest()\n )\n return {\n EncounterId: TwentyWeeksPlusEncounter.id,\n FirstHematocritResult: FirstHematocrit.value as Quantity,\n Timing: FirstHematocrit.issued\n }"
},
{
"url" : "displaySequence",
"valueInteger" : 35
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SevereObstetricComplicationsFHIR"
},
{
"url" : "name",
"valueString" : "Risk Variable Severe Preeclampsia"
},
{
"url" : "statement",
"valueString" : "define \"Risk Variable Severe Preeclampsia\":\n \"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation\" TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in \"Severe Preeclampsia\""
},
{
"url" : "displaySequence",
"valueInteger" : 36
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SevereObstetricComplicationsFHIR"
},
{
"url" : "name",
"valueString" : "Risk Variable Anemia"
},
{
"url" : "statement",
"valueString" : "define \"Risk Variable Anemia\":\n \"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation\" TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in \"Anemia\""
},
{
"url" : "displaySequence",
"valueInteger" : 37
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SevereObstetricComplicationsFHIR"
},
{
"url" : "name",
"valueString" : "Risk Variable Cardiac Disease"
},
{
"url" : "statement",
"valueString" : "define \"Risk Variable Cardiac Disease\":\n \"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation\" TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in \"Cardiac Disease\""
},
{
"url" : "displaySequence",
"valueInteger" : 38
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SevereObstetricComplicationsFHIR"
},
{
"url" : "name",
"valueString" : "Risk Variable Long Term Anticoagulant Use"
},
{
"url" : "statement",
"valueString" : "define \"Risk Variable Long Term Anticoagulant Use\":\n \"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation\" TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in \"Long Term Anticoagulant Use\""
},
{
"url" : "displaySequence",
"valueInteger" : 39
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SevereObstetricComplicationsFHIR"
},
{
"url" : "name",
"valueString" : "Risk Variable Systolic Blood Pressure"
},
{
"url" : "statement",
"valueString" : "//First resulted value 24 hours prior to start of encounter and before time of delivery\n//Report systolic blood pressure as mm[Hg]\n//Systolic blood pressure value cannot be null per QICore profile requirement.\n\n\n\n\ndefine \"Risk Variable Systolic Blood Pressure\":\n \"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation\" TwentyWeeksPlusEncounter\n let FirstSystolicBP: First([\"observation-bp\"] BP\n where BP.effective.earliest() during Interval[start of TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation() - 1440 minutes, TwentyWeeksPlusEncounter.lastTimeOfDelivery())\n and BP.status in { 'final', 'amended', 'corrected' }\n and BP.component.value is not null\n sort by effective.earliest()\n )\n return {\n EncounterId: TwentyWeeksPlusEncounter.id,\n FirstSBPResult: FirstSystolicBP.component C\n where C.code ~ \"Systolic blood pressure\"\n return C.value as Quantity,\n Timing: FirstSystolicBP.effective.earliest ( )\n }"
},
{
"url" : "displaySequence",
"valueInteger" : 40
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SevereObstetricComplicationsFHIR"
},
{
"url" : "name",
"valueString" : "Risk Variable Substance Abuse"
},
{
"url" : "statement",
"valueString" : "define \"Risk Variable Substance Abuse\":\n \"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation\" TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in \"Substance Abuse\""
},
{
"url" : "displaySequence",
"valueInteger" : 41
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SevereObstetricComplicationsFHIR"
},
{
"url" : "name",
"valueString" : "Risk Variable Renal Disease"
},
{
"url" : "statement",
"valueString" : "define \"Risk Variable Renal Disease\":\n \"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation\" TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in \"Renal Disease\""
},
{
"url" : "displaySequence",
"valueInteger" : 42
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "PCMaternal"
},
{
"url" : "name",
"valueString" : "Variable Calculated Gestational Age"
},
{
"url" : "statement",
"valueString" : "define \"Variable Calculated Gestational Age\":\n // This definition establishes a variable of CGA (Calculated Gestational Age). CGA is a supplemental data element to store the calculated gestational age result from the \"CalculatedGestationalAge\" function. The data element enables the capturing and saving of the CGA for data analysis post data receipt. Hospitals do not need to submit any additional data to comply with this definition\n \"Delivery Encounter with Age Range\" DeliveryEncounter\n let CGA: DeliveryEncounter.calculatedGestationalAge()\n // return { QualifyingEncounter, CGA }\n return {\n EncounterID: DeliveryEncounter.id,\n CalculatedCGA: CGA\n }"
},
{
"url" : "displaySequence",
"valueInteger" : 43
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SevereObstetricComplicationsFHIR"
},
{
"url" : "name",
"valueString" : "SDE Variable Calculated Gestational Age"
},
{
"url" : "statement",
"valueString" : "define \"SDE Variable Calculated Gestational Age\":\n //This definition establishes a variable of CGA (Calculated Gestational Age). CGA is a supplemental data element to store the calculated gestational age result from the \"CalculatedGestationalAge\" function. The data element enables the capturing and saving of the CGA for data analysis post data receipt. Hospitals do not need to submit any additional data to comply with this definition. \n \n PCMaternal.\"Variable Calculated Gestational Age\""
},
{
"url" : "displaySequence",
"valueInteger" : 44
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SevereObstetricComplicationsFHIR"
},
{
"url" : "name",
"valueString" : "Risk Variable Gastrointestinal Disease"
},
{
"url" : "statement",
"valueString" : "define \"Risk Variable Gastrointestinal Disease\":\n \"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation\" TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in \"Gastrointestinal Disease\""
},
{
"url" : "displaySequence",
"valueInteger" : 45
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SevereObstetricComplicationsFHIR"
},
{
"url" : "name",
"valueString" : "Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions"
},
{
"url" : "statement",
"valueString" : "define \"Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions\":\n \"Delivery Encounters with Severe Obstetric Complications Diagnosis or Procedure Excluding Blood Transfusion\"\n union \"Delivery Encounters with Expiration\""
},
{
"url" : "displaySequence",
"valueInteger" : 46
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SevereObstetricComplicationsFHIR"
},
{
"url" : "name",
"valueString" : "Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions Only"
},
{
"url" : "statement",
"valueString" : "define \"Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions Only\":\n \"Delivery Encounters with Severe Obstetric Complications\"\n intersect \"Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions\""
},
{
"url" : "displaySequence",
"valueInteger" : 47
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SevereObstetricComplicationsFHIR"
},
{
"url" : "name",
"valueString" : "Risk Variable Pulmonary Hypertension"
},
{
"url" : "statement",
"valueString" : "define \"Risk Variable Pulmonary Hypertension\":\n \"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation\" TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in \"Pulmonary Hypertension\""
},
{
"url" : "displaySequence",
"valueInteger" : 48
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SevereObstetricComplicationsFHIR"
},
{
"url" : "name",
"valueString" : "Risk Variable Thyrotoxicosis"
},
{
"url" : "statement",
"valueString" : "define \"Risk Variable Thyrotoxicosis\":\n \"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation\" TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in \"Thyrotoxicosis\""
},
{
"url" : "displaySequence",
"valueInteger" : 49
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SevereObstetricComplicationsFHIR"
},
{
"url" : "name",
"valueString" : "Risk Variable Other Preeclampsia"
},
{
"url" : "statement",
"valueString" : "define \"Risk Variable Other Preeclampsia\":\n \"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation\" TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in \"Mild or Moderate Preeclampsia\""
},
{
"url" : "displaySequence",
"valueInteger" : 50
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SevereObstetricComplicationsFHIR"
},
{
"url" : "name",
"valueString" : "Initial Population"
},
{
"url" : "statement",
"valueString" : "define \"Initial Population\":\n PCMaternal.\"Delivery Encounter with Age Range\""
},
{
"url" : "displaySequence",
"valueInteger" : 51
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SevereObstetricComplicationsFHIR"
},
{
"url" : "name",
"valueString" : "Risk Variable Economic Housing Instability"
},
{
"url" : "statement",
"valueString" : "define \"Risk Variable Economic Housing Instability\":\n \"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation\" TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in \"Economic Housing Instability\""
},
{
"url" : "displaySequence",
"valueInteger" : 52
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SevereObstetricComplicationsFHIR"
},
{
"url" : "name",
"valueString" : "Risk Variable HIV"
},
{
"url" : "statement",
"valueString" : "define \"Risk Variable HIV\":\n \"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation\" TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in \"HIV in Pregnancy Childbirth and Puerperium\""
},
{
"url" : "displaySequence",
"valueInteger" : 53
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SevereObstetricComplicationsFHIR"
},
{
"url" : "name",
"valueString" : "SOC Excluding Blood Transfusions Only with Hysterectomy or Blood Transfusion with Placenta Increta or Placenta Percreta Without Additional SOC"
},
{
"url" : "statement",
"valueString" : "define \"SOC Excluding Blood Transfusions Only with Hysterectomy or Blood Transfusion with Placenta Increta or Placenta Percreta Without Additional SOC\":\n ( \"Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions Only\" SOCExcludingTransfusion\n where exists ( ( SOCExcludingTransfusion.encounterDiagnosis ( ) ) EncounterDiagnoses\n where EncounterDiagnoses.code in \"Placenta Increta or Percreta\"\n )\n and ( exists \"Delivery Encounters with Blood Transfusion\"\n or exists \"Delivery Encounters with Hysterectomy\"\n )\n )\n\t\n\t//The following logic keeps encounter in the numerator if there is an additional SOC besides Blood Transfusion or Hysterectomy\n \n except ( ( \"Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions Only\" SOCExcludingTransfusion\n where SOCExcludingTransfusion.pOAIsNoOrUTD ( ) in \"Severe Maternal Morbidity Diagnoses\"\n )\n union \"Delivery Encounters with Cardiac Conversion, Tracheostomy or Ventilation Procedures\"\n union \"Delivery Encounters with Expiration\"\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 54
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SevereObstetricComplicationsFHIR"
},
{
"url" : "name",
"valueString" : "Risk Variable Heart Rate"
},
{
"url" : "statement",
"valueString" : "//First resulted value 24 hours prior to start of encounter and before time of delivery\n //Report heart rate as beats/min\n //Heart rate value cannot be null per QICore profile requirement.\n\n\n\n\ndefine \"Risk Variable Heart Rate\":\n \"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation\" TwentyWeeksPlusEncounter\n let FirstHeartRate: First([\"observation-heartrate\"] HeartRate\n where HeartRate.effective.earliest() during Interval[start of TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation() - 1440 minutes, TwentyWeeksPlusEncounter.lastTimeOfDelivery())\n and HeartRate.status in { 'final', 'amended', 'corrected' }\n sort by effective.earliest()\n )\n return {\n EncounterId: TwentyWeeksPlusEncounter.id,\n FirstHRResult: FirstHeartRate.value as Quantity,\n Timing: FirstHeartRate.effective.earliest ( )\n }"
},
{
"url" : "displaySequence",
"valueInteger" : 55
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SevereObstetricComplicationsFHIR"
},
{
"url" : "name",
"valueString" : "Risk Variable Maternal Age"
},
{
"url" : "statement",
"valueString" : "define \"Risk Variable Maternal Age\":\n \"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation\" TwentyWeeksPlusEncounter\n let MaternalAge: AgeInYearsAt(date from start of TwentyWeeksPlusEncounter.period)\n return { TwentyWeeksPlusEncounter, MaternalAge }"
},
{
"url" : "displaySequence",
"valueInteger" : 56
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SevereObstetricComplicationsFHIR"
},
{
"url" : "name",
"valueString" : "Risk Variable Mental Health Disorder"
},
{
"url" : "statement",
"valueString" : "define \"Risk Variable Mental Health Disorder\":\n \"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation\" TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in \"Mental Health Disorder\""
},
{
"url" : "displaySequence",
"valueInteger" : 57
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SevereObstetricComplicationsFHIR"
},
{
"url" : "name",
"valueString" : "Risk Variable Obstetrical VTE"
},
{
"url" : "statement",
"valueString" : "define \"Risk Variable Obstetrical VTE\":\n \"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation\" TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in \"Venous Thromboembolism in Pregnancy\""
},
{
"url" : "displaySequence",
"valueInteger" : 58
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SevereObstetricComplicationsFHIR"
},
{
"url" : "name",
"valueString" : "Risk Variable Autoimmune Disease"
},
{
"url" : "statement",
"valueString" : "define \"Risk Variable Autoimmune Disease\":\n \"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation\" TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in \"Autoimmune Disease\""
},
{
"url" : "displaySequence",
"valueInteger" : 59
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SevereObstetricComplicationsFHIR"
},
{
"url" : "name",
"valueString" : "Risk Variable Previous Cesarean"
},
{
"url" : "statement",
"valueString" : "define \"Risk Variable Previous Cesarean\":\n \"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation\" TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in \"Previous Cesarean\""
},
{
"url" : "displaySequence",
"valueInteger" : 60
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SevereObstetricComplicationsFHIR"
},
{
"url" : "name",
"valueString" : "Risk Variable Gestational Diabetes"
},
{
"url" : "statement",
"valueString" : "define \"Risk Variable Gestational Diabetes\":\n \"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation\" TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in \"Gestational Diabetes\""
},
{
"url" : "displaySequence",
"valueInteger" : 61
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SevereObstetricComplicationsFHIR"
},
{
"url" : "name",
"valueString" : "Risk Variable Multiple Pregnancy"
},
{
"url" : "statement",
"valueString" : "define \"Risk Variable Multiple Pregnancy\":\n \"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation\" TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in \"Multiple Pregnancy\""
},
{
"url" : "displaySequence",
"valueInteger" : 62
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SevereObstetricComplicationsFHIR"
},
{
"url" : "name",
"valueString" : "Denominator"
},
{
"url" : "statement",
"valueString" : "define \"Denominator\":\n \"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation\""
},
{
"url" : "displaySequence",
"valueInteger" : 63
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SupplementalDataElements"
},
{
"url" : "name",
"valueString" : "SDE Ethnicity"
},
{
"url" : "statement",
"valueString" : "define \"SDE Ethnicity\":\n Patient.ethnicity E\n return Tuple {\n codes: { E.ombCategory } union E.detailed,\n display: E.text\n }"
},
{
"url" : "displaySequence",
"valueInteger" : 64
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SevereObstetricComplicationsFHIR"
},
{
"url" : "name",
"valueString" : "SDE Ethnicity"
},
{
"url" : "statement",
"valueString" : "define \"SDE Ethnicity\":\n SDE.\"SDE Ethnicity\""
},
{
"url" : "displaySequence",
"valueInteger" : 65
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "PCMaternal"
},
{
"url" : "name",
"valueString" : "hospitalizationWithEDOBTriageObservation"
},
{
"url" : "statement",
"valueString" : "/*define function \"HospitalizationWithEDOBTriageObservation\"(Encounter Encounter ):\n HospitalizationWithEDOBTriageObservation returns the total interval from the start of any immediately prior emergency department visit or OB Triage visit through the observation visit to the discharge of the given encounter\n Encounter Visit\n let ObsVisit: Last([\"Encounter\": \"Observation Services\"] LastObs\n where LastObs.period ends 1 hour or less on or before start of Visit.period\n and LastObs.status = 'finished'\n sort by \n end of period\n ),\n VisitStart: Coalesce(start of ObsVisit.period, start of Visit.period),\n EDOBTriageVisit: Last([\"Encounter\": \"ED Visit and OB Triage\"] LastEDOBTriage\n where LastEDOBTriage.period ends 1 hour or less on or before VisitStart\n and LastEDOBTriage.status = 'finished'\n sort by \n end of period\n )\n return Interval[Coalesce(start of EDOBTriageVisit.period, VisitStart), \n end of Visit.period]*/\n \n \ndefine fluent function hospitalizationWithEDOBTriageObservation (TheEncounter Encounter ):\n /*hospitalizationWithEDOBTriageObservation returns the total interval from the start of any immediately prior emergency department visit or OB Triage visit through the observation visit to the discharge of the given encounter*/\n TheEncounter Visit\n let ObsVisit: Last([\"Encounter\": \"Observation Services\"] LastObs\n where LastObs.period ends 1 hour or less on or before start of Visit.period\n and LastObs.status = 'finished'\n sort by \n end of period\n ),\n VisitStart: Coalesce(start of ObsVisit.period, start of Visit.period),\n EDOBTriageVisit: Last([\"Encounter\": \"ED Visit and OB Triage\"] LastEDOBTriage\n where LastEDOBTriage.period ends 1 hour or less on or before VisitStart\n and LastEDOBTriage.status = 'finished'\n sort by \n end of period\n )\n return Interval[Coalesce(start of EDOBTriageVisit.period, VisitStart), \n end of Visit.period]"
},
{
"url" : "displaySequence",
"valueInteger" : 66
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "PCMaternal"
},
{
"url" : "name",
"valueString" : "calculatedGestationalAge"
},
{
"url" : "statement",
"valueString" : "define fluent function calculatedGestationalAge (TheEncounter Encounter ):\n //Gestational Age = (280-(Estimated Delivery Date minus Reference Date/Delivery Date))/7\n ( 280 - ( difference in days between TheEncounter.lastTimeOfDelivery () and TheEncounter.lastEstimatedDeliveryDate( )) ) div 7"
},
{
"url" : "displaySequence",
"valueInteger" : 67
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "PCMaternal"
},
{
"url" : "name",
"valueString" : "lastTimeOfDelivery"
},
{
"url" : "statement",
"valueString" : "define fluent function lastTimeOfDelivery (TheEncounter Encounter ):\n Last([\"Observation\": \"Date and time of obstetric delivery\"] TimeOfDelivery\n where TimeOfDelivery.value as DateTime is not null\n and TimeOfDelivery.status in { 'final', 'amended', 'corrected' }\n and TimeOfDelivery.effective.earliest () during TheEncounter.hospitalizationWithEDOBTriageObservation ()\n and TimeOfDelivery.value as DateTime during TheEncounter.hospitalizationWithEDOBTriageObservation()\n sort by effective.earliest()\n ).value as DateTime"
},
{
"url" : "displaySequence",
"valueInteger" : 68
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "QICoreCommon"
},
{
"url" : "name",
"valueString" : "earliest"
},
{
"url" : "statement",
"valueString" : "/*\n@description: Given an interval, return the starting point if the interval has a starting boundary specified,\notherwise, return the ending point\n*/\ndefine fluent function earliest(choice Choice<DateTime, Quantity, Interval<DateTime>, Interval<Quantity>> ):\n (choice.toInterval()) period\n return\n if (period.\"hasStart\"()) then start of period\n else end of period"
},
{
"url" : "displaySequence",
"valueInteger" : 69
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "PCMaternal"
},
{
"url" : "name",
"valueString" : "lastEstimatedDeliveryDate"
},
{
"url" : "statement",
"valueString" : "/*===============================================================*/\n /* 03/14/2022 from MATGlobalCommonFunctionsv7.000 - latest QDM */\n /* even though this PCMaternalFHIR was derived from */\n /* PCMaternal=2.1.000 cql, to make next update easier. */\n /* Will need to re-insert \"Global\". in front of these */\n /* function names later (whereever they are directly used.*/\n\ndefine fluent function lastEstimatedDeliveryDate (TheEncounter Encounter ):\n /*This function identifies the last time the EDD was assessed 42 weeks or less prior to or on delivery and stores the result of that assessment.*/\n Last([\"Observation\": \"Delivery date Estimated\"] EstimatedDateOfDelivery\n where EstimatedDateOfDelivery.value as DateTime is not null\n and EstimatedDateOfDelivery.status in { 'final', 'amended', 'corrected' }\n and EstimatedDateOfDelivery.effective.earliest ( ) 42 weeks or less before or on TheEncounter.lastTimeOfDelivery ()\n sort by effective.earliest ( )\n ).value as DateTime"
},
{
"url" : "displaySequence",
"valueInteger" : 70
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "PCMaternal"
},
{
"url" : "name",
"valueString" : "lastEstimatedGestationalAge"
},
{
"url" : "statement",
"valueString" : "/*define fluent function lastEstimatedGestationalAge (TheEncounter Encounter ):\n Last([\"Observation\": \"Estimated Gestational Age at Delivery\"] EstimatedGestationalAge\n where EstimatedGestationalAge.value is not null\n and EstimatedGestationalAge.status in { 'final', 'amended', 'corrected' }\n and EstimatedGestationalAge.effective.earliest() 24 hours or less before or on TheEncounter.lastTimeOfDelivery ()\n sort by effective.earliest ()\n ).value as Quantity*/\n \n define fluent function lastEstimatedGestationalAge (TheEncounter Encounter ):\n Last([\"Observation\": \"Estimated Gestational Age at Delivery\"] EstimatedGestationalAge\n let EGATiming: EstimatedGestationalAge.effective.earliest() where \n (EGATiming 24 hours or less before or on TheEncounter.lastTimeOfDelivery () \n and EstimatedGestationalAge.value is not null \n and EstimatedGestationalAge.status in { 'final', 'amended', 'corrected' }) or \n (EGATiming same day as TheEncounter.lastTimeOfDelivery () \n and EGATiming during TheEncounter.hospitalizationWithEDOBTriageObservation() \n and EstimatedGestationalAge.value is not null)\n sort by effective.earliest ())\n .value as Quantity"
},
{
"url" : "displaySequence",
"valueInteger" : 71
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CQMCommon"
},
{
"url" : "name",
"valueString" : "encounterDiagnosis"
},
{
"url" : "statement",
"valueString" : "/*\n@description: Returns the Condition resources referenced by the diagnosis element of the Encounter\n*/\ndefine fluent function encounterDiagnosis(Encounter Encounter ):\n Encounter.diagnosis D\n return singleton from ([Condition] C where C.id = D.condition.reference.getId())"
},
{
"url" : "displaySequence",
"valueInteger" : 72
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "QICoreCommon"
},
{
"url" : "name",
"valueString" : "getId"
},
{
"url" : "statement",
"valueString" : "/*\n@description: Returns the tail of the given uri (i.e. everything after the last slash in the URI).\n@comment: This function can be used to determine the logical id of a given resource. It can be used in\na single-server environment to trace references. However, this function does not attempt to resolve\nor distinguish the base of the given url, and so cannot be used safely in multi-server environments.\n*/\ndefine fluent function getId(uri String):\n Last(Split(uri, '/'))"
},
{
"url" : "displaySequence",
"valueInteger" : 73
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SevereObstetricComplicationsFHIR"
},
{
"url" : "name",
"valueString" : "pOAIsYesOrExempt"
},
{
"url" : "statement",
"valueString" : "define fluent function pOAIsYesOrExempt(TheEncounter Encounter):\n TheEncounter.diagnosis EncounterDiagnoses\n where EncounterDiagnoses.diagnosisPresentOnAdmission in \"Present On Admission is Yes or Exempt\"\n return EncounterDiagnoses.condition.getCondition ( ).code"
},
{
"url" : "displaySequence",
"valueInteger" : 74
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "FHIRHelpers"
},
{
"url" : "name",
"valueString" : "ToString"
},
{
"url" : "statement",
"valueString" : "define function ToString(value uri): value.value"
},
{
"url" : "displaySequence",
"valueInteger" : 75
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CQMCommon"
},
{
"url" : "name",
"valueString" : "getCondition"
},
{
"url" : "statement",
"valueString" : "/*\n@description: Returns the Condition resource for the given reference\n*/\ndefine fluent function getCondition(reference Reference):\n singleton from ([Condition] C where C.id = reference.reference.getId())"
},
{
"url" : "displaySequence",
"valueInteger" : 76
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SevereObstetricComplicationsFHIR"
},
{
"url" : "name",
"valueString" : "pOAIsNoOrUTD"
},
{
"url" : "statement",
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],
"extension" : [
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"extension" : [
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"url" : "guidance",
"valueString" : "For every patient evaluated by this measure also identify payer, race, ethnicity, sex, variable calculated gestational age, SOC diagnosis details, and SOC procedure details\n\n \n "
},
{
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"valueCodeableConcept" : {
"coding" : [
{
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}
],
"text" : "Supplemental Data Guidance"
}
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-supplementalDataGuidance"
},
{
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"extension" : [
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"valueString" : "The Severe Obstetric Complications Risk Adjustment Methodology Report is available on the eCQI Resource Center (https://ecqi.healthit.gov).\nPre-existing conditions and variables must be present on admission. Please note that present on admission codes may be extracted from billing/claims data that was entered by coding staff (Leonard, Kennedy, Carmichael, Lyell, & Main, 2020; Main, Leonard, & Menard, 2020).\n- Anemia (includes sickle cell disease)\n- Asthma \n- Autoimmune Disease\n- Bariatric Surgery\n- Bleeding Disorder\n- Cardiac Disease\n- Economic Housing Instability\n- Gastrointestinal Disease \n- Gestational Diabetes\n- HIV\n- Hypertension\n- Long-term Anticoagulant Use\n- Maternal Age (derived from birthdate)\n- Mental Health Disorder\n- Morbid Obesity\n- Multiple Pregnancy\t\n- Neuromuscular Disease\n- Obstetric VTE\n- Other Pre-eclampsia\n- Placenta Previa\n- Placental Abruption\n- Placental Accreta Spectrum\n- Pre-existing Diabetes \n- Preterm Birth\n- Previous Cesarean \n- Pulmonary Hypertension\n- Renal Disease \n- Severe Pre-eclampsia\n- Substance Abuse\n- Thyrotoxicosis \n\nLab and Physical Exam Results:\nReport the first resulted value 24 hours prior to start of encounter and before time of delivery in UCUM units specified:\n- Heart rate: {beats}/min\n- Systolic blood pressure: mm[Hg]\n- Hematocrit: %\n- White blood cell count: 10*3/uL \n\n\nNote regarding submission of risk variable data: The risk variable definitions are included in the specifications and risk variable data should be sent with eCQM data in the QRDA1 file. Specific risk variable templates are not needed in the QRDA1 files."
},
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"display" : "Risk Adjustment Factor"
}
],
"text" : "Risk Adjustment Variable Guidance"
}
}
],
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},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-softwaresystem",
"valueReference" : {
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}
},
{
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"valueReference" : {
"reference" : "#effective-data-requirements"
}
}
],
"url" : "https://madie.cms.gov/Measure/SevereObstetricComplicationsFHIR",
"identifier" : [
{
"use" : "usual",
"type" : {
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"system" : "http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type",
"code" : "short-name"
}
]
},
"system" : "https://madie.cms.gov/measure/shortName",
"value" : "CMS1028FHIR"
},
{
"use" : "official",
"type" : {
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"system" : "http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type",
"code" : "version-independent"
}
]
},
"system" : "urn:ietf:rfc:3986",
"value" : "urn:uuid:6cf03fe2-b962-4f83-ac37-26d7477183c7"
},
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"type" : {
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"code" : "version-specific"
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},
"system" : "urn:ietf:rfc:3986",
"value" : "urn:uuid:3efa7f95-1d8e-45fa-af68-023d3554e8c1"
},
{
"use" : "official",
"type" : {
"coding" : [
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"system" : "http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type",
"code" : "publisher"
}
]
},
"system" : "https://madie.cms.gov/measure/cmsId",
"value" : "1028FHIR",
"assigner" : {
"display" : "CMS"
}
}
],
"version" : "0.1.000",
"name" : "SevereObstetricComplicationsFHIR",
"title" : "Severe Obstetric ComplicationsFHIR",
"status" : "draft",
"experimental" : true,
"date" : "2024-12-18T21:25:49+00:00",
"publisher" : "The Joint Commission",
"contact" : [
{
"telecom" : [
{
"system" : "url",
"value" : "https://www.jointcommission.org/"
}
]
}
],
"description" : "Patients with severe obstetric complications that occur during the inpatient delivery hospitalization",
"purpose" : "UNKNOWN",
"usage" : "In the case of multiple births, map the first delivery date/time (Baby A) as the delivery date/time for the encounter. This measure allows for 3 approaches to determine gestational age (GA) in the following order of precedence:\n\n1. The GA is calculated using the American College of Obstetricians and Gynecologists ReVITALize guidelines.*\n2. The GA is obtained from a discrete field in the electronic health record. This option is only used when the calculated GA is not available.\n3. The GA is based on ICD10 or SNOMED codes indicative of weeks gestation. This option is only used when results from items #1 and #2 (see above) are not available.\n\nWherever gestational age is mentioned, relative to the delivery, the intent is to capture the last estimated gestational age prior to or at the time of delivery. \n \n*ACOG ReVITALize Guidelines for Calculating Gestational Age (ACOG, 2014): \n \n Gestational Age = (280-(Estimated Due Date minus Reference Date))/7\n\n--Estimated Due Date (EDD): The best obstetrical EDD is determined by last menstrual period if confirmed by early ultrasound or no ultrasound performed, or early ultrasound if no known last menstrual period or the ultrasound is not consistent with last menstrual period, or known date of fertilization (e.g., assisted reproductive technology) \n--Reference Date is the date on which you are trying to determine gestational age. For purposes of this eCQM, Reference Date would be the Date of Delivery. \n\nNote however the calculation may yield a non-whole number and gestational age should be rounded down to the nearest completed week. For example, an infant born on the 5th day of the 36th week (35 weeks and 5/7 days) is at a gestational age of 35 weeks, not 36 weeks.\n\nDefinition:\nFor this measure, specifications are modeled after the nationally available and adopted CDC definition for Severe Maternal Morbidity (SMM) with the addition of maternal mortality. At times, we may refer to the CDC indicators of morbidity as SMM, but the outcome of the measure, which includes morbidity and mortality, is referred to as Severe Obstetric Complications (SOC).\n\nThis eCQM is an episode-based measure. An episode is defined as each inpatient hospitalization or encounter that ends during the measurement period.\n\nThis FHIR-based measure has been derived from the QDM-based measure CMS1028v3.\n\nPlease refer to the HL7 QI-Core Implementation Guide (https://hl7.org/fhir/us/qicore/STU4.1.1/) for more information on QI-Core and mapping recommendations from QDM to QI-Core 4.1.1 (https://hl7.org/fhir/us/qicore/STU4.1.1/qdm-to-qicore.html).",
"copyright" : "Measure specifications are in the Public Domain.\n\nLOINC(R) copyright 2004-2023 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2023 International Health Terminology Standards Development Organisation. ICD-10 copyright 2023 World Health Organization. All Rights Reserved.",
"effectivePeriod" : {
"start" : "2025-01-01",
"end" : "2025-12-31"
},
"author" : [
{
"name" : "The Joint Commission",
"telecom" : [
{
"system" : "url",
"value" : "https://www.jointcommission.org/"
}
]
},
{
"name" : "Centers for Medicare & Medicaid Services (CMS)",
"telecom" : [
{
"system" : "url",
"value" : "https://www.cms.gov/"
}
]
},
{
"name" : "Yale New Haven Health Service Corporation/ Center for Outcomes Research and Evaluation",
"telecom" : [
{
"system" : "url",
"value" : "https://medicine.yale.edu/core/"
}
]
}
],
"library" : [
🔗 "https://madie.cms.gov/Library/SevereObstetricComplicationsFHIR"
],
"disclaimer" : "These performance measures are not clinical guidelines and do not establish a standard of medical care, and have not been tested for all potential applications. The measures and specifications are provided without warranty.",
"scoring" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-scoring",
"code" : "proportion",
"display" : "Proportion"
}
]
},
"rationale" : "The United States (US) experiences higher rates of maternal morbidity and mortality than most other developed countries. These rates have continued to trend upward in recent decades (CDC, 2021). Research indicates that the overall rate of severe maternal morbidity (SMM) increased by almost 200% between 1993 and 2014 to 144 per 10,000 delivery hospitalizations (CDC, 2021), with more than 25,000 women per year experiencing obstetric complications (U.S. Department of Health and Human Services, 2020). Recent maternal mortality data from 2018 reveal that 658 women in the US died from maternal causes, resulting in a rate of 17.4 deaths per 100,000 live births, with 77% of the deaths attributed to direct obstetric causes like hemorrhage, preeclampsia, obstetric embolism, and other complications (Hoyert & Minino, 2018). 144 per 10,000 women hospitalized for delivery have experienced SMM, including hemorrhage, embolism, hypertension, stroke, and other serious complications (CDC, 2021). Racial and ethnic disparities exist: Black women and Hispanic women are at a significantly higher risk for developing these complications than are Non-Hispanic White women (Leonard, Main, Scott, Profit, & Carmichael, 2019). Increasing rates of SMM are resulting in increased healthcare costs, longer hospitalization stays and impacts on a woman's health (Callaghan, Creanga, & Kuklina, 2012). \n\nThere is limited national evaluation of hospitals' performance on maternal morbidity and mortality although SMM is widely used at the population level. SMM is linked to maternal mortality, varies significantly among hospitals, and has significant racial/ethnic and urban/rural disparities. SMM is a cost driver for both Medicaid and commercial plans. This measure is important as it will assist in the discovery and understanding of SMM patterns that can lead to improvements in the safety and quality of maternal care necessary to reduce SMM rates.",
"clinicalRecommendationStatement" : "Healthy People 2030 Measure (MICH-05): Reduce severe maternal complications identified during delivery hospitalizations (U.S. Department of Health and Human Services, n.d.).\n\nThe American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine recommend identifying potential cases of severe maternal morbidity for further review, with a focus on outcomes and complications, and consider this an important step toward promoting safe obstetric care (American College of Obstetricians and Gynecologists and the Society for Maternal–Fetal Medicine, Kilpatrick, & Ecker, 2016).",
"group" : [
{
"id" : "64efa90856d636294b157c9a",
"extension" : [
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"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-scoring",
"code" : "proportion",
"display" : "Proportion"
}
]
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis",
"valueCode" : "Encounter"
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-type",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-type",
"code" : "outcome",
"display" : "Outcome"
}
]
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-rateAggregation",
"valueCode" : "Two hospital-level measure scores are calculated as a risk-adjusted proportion reported as a rate per 10,000 delivery hospitalizations: 1. All Severe Obstetric Complications (SOC). ((Num1 – NumExcl) / (Den-DenExcl)) * 10,000 2. SOC excluding encounters where transfusion was the only SOC. ((Num2 – NumExcl) / (Den-DenExcl)) * 10,000 Num1: Number of delivery encounters with SOC Num2: Number of delivery encounters with SOC excluding encounters where transfusion was the only SOC NumExcl: Delivery encounters with blood transfusion or hysterectomy with Placenta Percreta or Placenta Increta Den: Delivery encounters with > or = 20 weeks gestation completed DenExcl: Delivery encounters for patients with a COVID diagnosis and COVID-related respiratory condition or a COVID diagnosis and COVID-related respiratory procedure"
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-improvementNotation",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-improvement-notation",
"code" : "decrease",
"display" : "Decreased score indicates improvement"
}
]
}
}
],
"description" : "All Severe Obstetric Complications (SOC)",
"population" : [
{
"id" : "8D56845B-BA26-4F6A-8D23-BBFD696C9450",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "initial-population",
"display" : "Initial Population"
}
]
},
"description" : "Inpatient hospitalizations for patients age greater than or equal to 8 years and less than 65 admitted to the hospital for inpatient acute care who undergo a delivery procedure with a discharge date during the measurement period",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Initial Population"
}
},
{
"id" : "8542DE86-6114-4575-9A2B-D09A0FA7C671",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "denominator",
"display" : "Denominator"
}
]
},
"description" : "Inpatient hospitalizations for patients delivering stillborn or live birth with greater than or equal to 20 weeks, 0 days gestation completed",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Denominator"
}
},
{
"id" : "16605347-8AF3-47AA-B230-65B7208909B9",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "denominator-exclusion",
"display" : "Denominator Exclusion"
}
]
},
"description" : "Inpatient hospitalizations for patients with confirmed diagnosis of COVID with COVID-related respiratory condition or patients with confirmed diagnosis of COVID with COVID-related respiratory procedure during the encounter",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Denominator Exclusion"
}
},
{
"id" : "05AD3648-8C60-4938-96C4-82385B9C4F91",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "numerator",
"display" : "Numerator"
}
]
},
"description" : "Two numerator populations are defined for this measure:\n\n1. All Severe Obstetric Complications (SOC).\n2. SOC excluding encounters where transfusion was the only SOC.\n\nInpatient hospitalizations for patients with severe obstetric complications (not present on admission that occur during the current delivery encounter) including the following: \n- Severe maternal morbidity diagnoses (see list below)\n- Severe maternal morbidity procedures (see list below)\n- Discharge disposition of expired\nPlease note that present on admission codes may be extracted from billing/claims data that was entered by coding staff.\n\nSevere Maternal Morbidity Diagnoses:\n- Cardiac\n\t Acute heart failure \n\t Acute myocardial infarction\n\t Aortic aneurysm\n\t Cardiac arrest/ventricular fibrillation\n\t Heart failure/arrest during procedure or surgery\n- Hemorrhage\n\t Disseminated intravascular coagulation\n\t Shock\n- Renal\n Acute renal failure\n- Respiratory\n\t Adult respiratory distress syndrome\n\t Pulmonary edema\n- Sepsis\n- Other OB\n\t Air and thrombotic embolism\n\t Amniotic fluid embolism\n\t Eclampsia\n\t Severe anesthesia complications\n- Other Medical\n\t Puerperal cerebrovascular disorder\n\t Sickle cell disease with crisis\n\nSevere Maternal Morbidity Procedures:\n- Blood transfusion\n- Conversion of cardiac rhythm\n- Hysterectomy\n- Temporary tracheostomy\n- Ventilation",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Delivery Encounters with Severe Obstetric Complications"
}
},
{
"id" : "e29f29ee-889e-4314-983c-e0ddc189a16c",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "numerator-exclusion",
"display" : "Numerator Exclusion"
}
]
},
"description" : "Inpatient hospitalizations with blood transfusion or hysterectomy with a diagnosis of placenta percreta or placenta increta and no additional severe obstetrical complications.",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "SOC with Hysterectomy or Blood Transfusion with Placenta Increta or Placenta Percreta Without Additional SOC"
}
}
],
"stratifier" : [
{
"id" : "75faa812-7f77-45d4-bed1-a5d92837e8f4",
"extension" : [
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "initial-population",
"display" : "Initial Population"
}
]
}
}
],
"description" : "This measure will be stratified by race/ethnicity and payer after measure submission.",
"criteria" : {
"language" : "text/cql-identifier"
}
}
]
},
{
"id" : "658b2eadd4b024647cc00341",
"extension" : [
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-scoring",
"code" : "proportion",
"display" : "Proportion"
}
]
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis",
"valueCode" : "Encounter"
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-type",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-type",
"code" : "outcome",
"display" : "Outcome"
}
]
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-rateAggregation",
"valueCode" : "SOC excluding encounters where transfusion was the only SOC, calculated as a risk-adjusted proportion reported as a rate per 10,000 delivery hospitalizations: ((Num2 – NumExcl) / (Den-DenExcl)) * 10,000 Num2: Number of delivery encounters with SOC excluding encounters where transfusion was the only SOC; NumExcl: Delivery encounters with blood transfusion or hysterectomy with Placenta Percreta or Placenta Increta; Den: Delivery encounters with > or = 20 weeks gestation completed; DenExcl: Delivery encounters for patients with a COVID diagnosis and COVID-related respiratory condition or a COVID diagnosis and COVID-related respiratory procedure"
}
],
"description" : "SOC excluding encounters where transfusion was the only SOC",
"population" : [
{
"id" : "4e1478e6-a3d4-42e5-a5cd-0026cc5617ed",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "initial-population",
"display" : "Initial Population"
}
]
},
"description" : "Inpatient hospitalizations for patients age >= 8 years and < 65 admitted to the hospital for inpatient acute care who undergo a delivery procedure with a discharge date that ends during the measurement period",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Initial Population"
}
},
{
"id" : "e4a80a9b-190c-4cd1-bc7b-8d6d9e5720cd",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "denominator",
"display" : "Denominator"
}
]
},
"description" : "Inpatient hospitalizations for patients delivering stillborn or live birth with >= 20 weeks, 0 days gestation completed",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Denominator"
}
},
{
"id" : "4db4aa26-e64c-4d09-81fd-d119e14fee05",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "denominator-exclusion",
"display" : "Denominator Exclusion"
}
]
},
"description" : "Inpatient hospitalizations for patients with confirmed diagnosis of COVID with COVID-related respiratory condition or patients with confirmed diagnosis of COVID with COVID-related respiratory procedure during the encounter",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Denominator Exclusion"
}
},
{
"id" : "0d5818b3-43e6-4d06-991f-adcc939f01b8",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "numerator",
"display" : "Numerator"
}
]
},
"description" : "Inpatient hospitalizations for patients with severe obstetric complications (not present on admission that occur during the current delivery encounter) including severe maternal morbidity diagnoses (see following list), severe maternal morbidity procedures (see following list), and discharge disposition of expired, yet excluding encounters where transfusion was the only SOC. \nPlease note that present on admission codes may be those entered by coding staff, extracted from billing/claims data.\n\nSevere Maternal Morbidity Diagnoses:\n- Cardiac\n\t Acute heart failure \n\t Acute myocardial infarction\n\t Aortic aneurysm\n\t Cardiac arrest/ventricular fibrillation\n\t Heart failure/arrest during procedure or surgery\n- Hemorrhage\n\t Disseminated intravascular coagulation\n\t Shock\n- Renal\n Acute renal failure\n- Respiratory\n\t Adult respiratory distress syndrome\n\t Pulmonary edema\n- Sepsis\n- Other OB\n\t Air and thrombotic embolism\n\t Amniotic fluid embolism\n\t Eclampsia\n\t Severe anesthesia complications\n- Other Medical\n\t Puerperal cerebrovascular disorder\n\t Sickle cell disease with crisis\n\nSevere Maternal Morbidity Procedures:\n- Blood transfusion\n- Conversion of cardiac rhythm\n- Hysterectomy\n- Temporary tracheostomy\n- Ventilation",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions Only"
}
},
{
"id" : "b5aef46b-f0d5-442b-b1d4-564444fd471a",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "numerator-exclusion",
"display" : "Numerator Exclusion"
}
]
},
"description" : "Inpatient hospitalizations with blood transfusion or hysterectomy with a diagnosis of placenta percreta or placenta increta and no additional severe obstetrical complications.",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "SOC Excluding Blood Transfusions Only with Hysterectomy or Blood Transfusion with Placenta Increta or Placenta Percreta Without Additional SOC"
}
}
]
}
],
"supplementalData" : [
{
"id" : "sde-ethnicity",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "supplemental-data"
}
]
}
],
"description" : "SDE Ethnicity",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "SDE Ethnicity"
}
},
{
"id" : "sde-payer",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "supplemental-data"
}
]
}
],
"description" : "SDE Payer",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "SDE Payer"
}
},
{
"id" : "sde-race",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "supplemental-data"
}
]
}
],
"description" : "SDE Race",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "SDE Race"
}
},
{
"id" : "sde-sex",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "supplemental-data"
}
]
}
],
"description" : "SDE Sex",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "SDE Sex"
}
},
{
"id" : "sde-variable-calculated-gestational-age",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "supplemental-data"
}
]
}
],
"description" : "SDE Variable Calculated Gestational Age",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "SDE Variable Calculated Gestational Age"
}
},
{
"id" : "risk-variable-lab-and-physical-exam-results",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "risk-adjustment-factor"
}
]
}
],
"description" : "Risk Variable Lab and Physical Exam Results",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Risk Variable Lab and Physical Exam Results"
}
},
{
"id" : "risk-variable-asthma",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "risk-adjustment-factor"
}
]
}
],
"description" : "Risk Variable Asthma",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Risk Variable Asthma"
}
},
{
"id" : "risk-variable-autoimmune-disease",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "risk-adjustment-factor"
}
]
}
],
"description" : "Risk Variable Autoimmune Disease",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Risk Variable Autoimmune Disease"
}
},
{
"id" : "risk-variable-bariatric-surgery",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "risk-adjustment-factor"
}
]
}
],
"description" : "Risk Variable Bariatric Surgery",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Risk Variable Bariatric Surgery"
}
},
{
"id" : "risk-variable-bleeding-disorder",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "risk-adjustment-factor"
}
]
}
],
"description" : "Risk Variable Bleeding Disorder",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Risk Variable Bleeding Disorder"
}
},
{
"id" : "risk-variable-morbid-obesity",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "risk-adjustment-factor"
}
]
}
],
"description" : "Risk Variable Morbid Obesity",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Risk Variable Morbid Obesity"
}
},
{
"id" : "risk-variable-cardiac-disease",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "risk-adjustment-factor"
}
]
}
],
"description" : "Risk Variable Cardiac Disease",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Risk Variable Cardiac Disease"
}
},
{
"id" : "risk-variable-economic-housing-instability",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "risk-adjustment-factor"
}
]
}
],
"description" : "Risk Variable Economic Housing Instability",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Risk Variable Economic Housing Instability"
}
},
{
"id" : "risk-variable-gastrointestinal-disease",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "risk-adjustment-factor"
}
]
}
],
"description" : "Risk Variable Gastrointestinal Disease",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Risk Variable Gastrointestinal Disease"
}
},
{
"id" : "risk-variable-gestational-diabetes",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "risk-adjustment-factor"
}
]
}
],
"description" : "Risk Variable Gestational Diabetes",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Risk Variable Gestational Diabetes"
}
},
{
"id" : "risk-variable-hiv",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "risk-adjustment-factor"
}
]
}
],
"description" : "Risk Variable HIV",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Risk Variable HIV"
}
},
{
"id" : "risk-variable-hypertension",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "risk-adjustment-factor"
}
]
}
],
"description" : "Risk Variable Hypertension",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Risk Variable Hypertension"
}
},
{
"id" : "risk-variable-long-term-anticoagulant-use",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "risk-adjustment-factor"
}
]
}
],
"description" : "Risk Variable Long Term Anticoagulant Use",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Risk Variable Long Term Anticoagulant Use"
}
},
{
"id" : "risk-variable-mental-health-disorder",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "risk-adjustment-factor"
}
]
}
],
"description" : "Risk Variable Mental Health Disorder",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Risk Variable Mental Health Disorder"
}
},
{
"id" : "risk-variable-multiple-pregnancy",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "risk-adjustment-factor"
}
]
}
],
"description" : "Risk Variable Multiple Pregnancy",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Risk Variable Multiple Pregnancy"
}
},
{
"id" : "risk-variable-neuromuscular",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "risk-adjustment-factor"
}
]
}
],
"description" : "Risk Variable Neuromuscular",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Risk Variable Neuromuscular"
}
},
{
"id" : "risk-variable-obstetrical-vte",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "risk-adjustment-factor"
}
]
}
],
"description" : "Risk Variable Obstetrical VTE",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Risk Variable Obstetrical VTE"
}
},
{
"id" : "risk-variable-placenta-previa",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "risk-adjustment-factor"
}
]
}
],
"description" : "Risk Variable Placenta Previa",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Risk Variable Placenta Previa"
}
},
{
"id" : "risk-variable-placental-abruption",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "risk-adjustment-factor"
}
]
}
],
"description" : "Risk Variable Placental Abruption",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Risk Variable Placental Abruption"
}
},
{
"id" : "risk-variable-placental-accreta-spectrum",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "risk-adjustment-factor"
}
]
}
],
"description" : "Risk Variable Placental Accreta Spectrum",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Risk Variable Placental Accreta Spectrum"
}
},
{
"id" : "risk-variable-preexisting-diabetes",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "risk-adjustment-factor"
}
]
}
],
"description" : "Risk Variable Preexisting Diabetes",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Risk Variable Preexisting Diabetes"
}
},
{
"id" : "risk-variable-previous-cesarean",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "risk-adjustment-factor"
}
]
}
],
"description" : "Risk Variable Previous Cesarean",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Risk Variable Previous Cesarean"
}
},
{
"id" : "risk-variable-pulmonary-hypertension",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "risk-adjustment-factor"
}
]
}
],
"description" : "Risk Variable Pulmonary Hypertension",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Risk Variable Pulmonary Hypertension"
}
},
{
"id" : "risk-variable-renal-disease",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "risk-adjustment-factor"
}
]
}
],
"description" : "Risk Variable Renal Disease",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Risk Variable Renal Disease"
}
},
{
"id" : "risk-variable-severe-preeclampsia",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "risk-adjustment-factor"
}
]
}
],
"description" : "Risk Variable Severe Preeclampsia",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Risk Variable Severe Preeclampsia"
}
},
{
"id" : "risk-variable-substance-abuse",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "risk-adjustment-factor"
}
]
}
],
"description" : "Risk Variable Substance Abuse",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Risk Variable Substance Abuse"
}
},
{
"id" : "risk-variable-thyrotoxicosis",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "risk-adjustment-factor"
}
]
}
],
"description" : "Risk Variable Thyrotoxicosis",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Risk Variable Thyrotoxicosis"
}
},
{
"id" : "risk-variable-other-preeclampsia",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "risk-adjustment-factor"
}
]
}
],
"description" : "Risk Variable Other Preeclampsia",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Risk Variable Other Preeclampsia"
}
},
{
"id" : "risk-variable-preterm-birth",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "risk-adjustment-factor"
}
]
}
],
"description" : "Risk Variable Preterm Birth",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Risk Variable Preterm Birth"
}
},
{
"id" : "risk-variable-anemia",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "risk-adjustment-factor"
}
]
}
],
"description" : "Risk Variable Anemia",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Risk Variable Anemia"
}
},
{
"id" : "risk-variable-systolic-blood-pressure",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "risk-adjustment-factor"
}
]
}
],
"description" : "Risk Variable Systolic Blood Pressure",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Risk Variable Systolic Blood Pressure"
}
},
{
"id" : "risk-variable-heart-rate",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "risk-adjustment-factor"
}
]
}
],
"description" : "Risk Variable Heart Rate",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Risk Variable Heart Rate"
}
},
{
"id" : "risk-variable-first-white-blood-cell-count-lab-test",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "risk-adjustment-factor"
}
]
}
],
"description" : "Risk Variable First White Blood Cell Count Lab Test",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Risk Variable First White Blood Cell Count Lab Test"
}
},
{
"id" : "risk-variable-first-hematocrit-lab-test",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "risk-adjustment-factor"
}
]
}
],
"description" : "Risk Variable First Hematocrit Lab Test",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Risk Variable First Hematocrit Lab Test"
}
},
{
"id" : "delivery-encounters-with-blood-transfusion",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "risk-adjustment-factor"
}
]
}
],
"description" : "Delivery Encounters with Blood Transfusion",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Delivery Encounters with Blood Transfusion"
}
},
{
"id" : "risk-variable-maternal-age",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "risk-adjustment-factor"
}
]
}
],
"description" : "Risk Variable Maternal Age",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Risk Variable Maternal Age"
}
}
]
}
IG © 2023+ cqframework. Package gov.healthit.ecqi.ecqms#2024.0.0 based on FHIR 4.0.1. Generated 2024-12-19
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