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 |
<Measure xmlns="http://hl7.org/fhir">
<id value="SevereObstetricComplicationsFHIR"/>
<meta>
<profile
value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-measure-cqfm"/>
<profile
value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/publishable-measure-cqfm"/>
<profile
value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/executable-measure-cqfm"/>
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<text>
<status value="extensions"/>
<div xmlns="http://www.w3.org/1999/xhtml">
<table class="grid dict">
<tr>
<th scope="row"><b>Title: </b></th>
<td style="padding-left: 4px;">Severe Obstetric ComplicationsFHIR</td>
</tr>
<tr>
<th scope="row"><b>Id: </b></th>
<td style="padding-left: 4px;">SevereObstetricComplicationsFHIR</td>
</tr>
<tr>
<th scope="row"><b>Version: </b></th>
<td style="padding-left: 4px;">0.1.000</td>
</tr>
<tr>
<th scope="row"><b>Url: </b></th>
<td style="padding-left: 4px;"><a href="Measure-SevereObstetricComplicationsFHIR.html">Severe Obstetric ComplicationsFHIR</a></td>
</tr>
<tr>
<th scope="row">
<b>
short-name identifier:
</b>
</th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<span>CMS1028FHIR</span>
</p>
</td>
</tr>
<tr>
<th scope="row">
<b>
version-independent identifier:
</b>
</th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<span>urn:uuid:6cf03fe2-b962-4f83-ac37-26d7477183c7</span>
</p>
</td>
</tr>
<tr>
<th scope="row">
<b>
version-specific identifier:
</b>
</th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<span>urn:uuid:3efa7f95-1d8e-45fa-af68-023d3554e8c1</span>
</p>
</td>
</tr>
<tr>
<th scope="row">
<b>
publisher (CMS) identifier:
</b>
</th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<span>1028FHIR</span>
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Effective Period: </b></th>
<td style="padding-left: 4px;">2025-01-01..2025-12-31</td>
</tr>
<tr>
<th scope="row"><b>Status: </b></th>
<td style="padding-left: 4px;">draft</td>
</tr>
<tr>
<th scope="row"><b>Experimental: </b></th>
<td style="padding-left: 4px;">true</td>
</tr>
<tr>
<th scope="row"><b>Publisher: </b></th>
<td style="padding-left: 4px;">The Joint Commission</td>
</tr>
<tr>
<th scope="row"><b>Author: </b></th>
<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>
</tr>
<tr>
<th scope="row"><b>Description: </b></th>
<td style="padding-left: 4px;"><div><p>Patients with severe obstetric complications that occur during the inpatient delivery hospitalization</p>
</div></td>
</tr>
<tr>
<th scope="row"><b>Purpose: </b></th>
<td style="padding-left: 4px;"><div><p>UNKNOWN</p>
</div></td>
</tr>
<tr>
<th scope="row"><b>Copyright: </b></th>
<td style="padding-left: 4px;"><div><p>Measure specifications are in the Public Domain.</p>
<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>
</div></td>
</tr>
<tr>
<th scope="row"><b>Disclaimer: </b></th>
<td style="padding-left: 4px;"><div><p>These performance measures are not clinical guidelines and do not establish a standard of medical care, and have not been tested for all potential applications. The measures and specifications are provided without warranty.</p>
</div></td>
</tr>
<tr>
<th scope="row"><b>Scoring: </b></th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<span>Proportion </span>
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Rationale: </b></th>
<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>
<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>
</div></td>
</tr>
<tr>
<th scope="row"><b>Clinical recommendation statement: </b></th>
<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>
<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>
</div></td>
</tr>
<tr>
<th scope="row"><b>Guidance (Usage): </b></th>
<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:
1. The GA is calculated using the American College of Obstetricians and Gynecologists ReVITALize guidelines.*
2. 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.
3. 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.
Wherever 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.
*ACOG ReVITALize Guidelines for Calculating Gestational Age (ACOG, 2014):
Gestational Age = (280-(Estimated Due Date minus Reference Date))/7
--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)
--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.
Note 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.
Definition:
For 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).
This eCQM is an episode-based measure. An episode is defined as each inpatient hospitalization or encounter that ends during the measurement period.
This FHIR-based measure has been derived from the QDM-based measure CMS1028v3.
Please refer to the HL7 QI-Core Implementation Guide (https://hl7.org/fhir/us/qicore/STU4.1.1/) for more information on QI-Core and mapping recommendations from QDM to QI-Core 4.1.1 (https://hl7.org/fhir/us/qicore/STU4.1.1/qdm-to-qicore.html).</td>
</tr>
<tr>
<th scope="row"><b>Population Criteria: </b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr>
<th><b>64efa90856d636294b157c9a</b></th>
</tr>
<tr>
<td>Initial Population:</td>
<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>
</tr>
<tr>
<td>Denominator:</td>
<td>Inpatient hospitalizations for patients delivering stillborn or live birth with greater than or equal to 20 weeks, 0 days gestation completed</td>
</tr>
<tr>
<td>Denominator Exclusion:</td>
<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>
</tr>
<tr>
<td>Numerator:</td>
<td>Two numerator populations are defined for this measure:
1. All Severe Obstetric Complications (SOC).
2. SOC excluding encounters where transfusion was the only SOC.
Inpatient hospitalizations for patients with severe obstetric complications (not present on admission that occur during the current delivery encounter) including the following:
- Severe maternal morbidity diagnoses (see list below)
- Severe maternal morbidity procedures (see list below)
- Discharge disposition of expired
Please note that present on admission codes may be extracted from billing/claims data that was entered by coding staff.
Severe Maternal Morbidity Diagnoses:
- Cardiac
Acute heart failure
Acute myocardial infarction
Aortic aneurysm
Cardiac arrest/ventricular fibrillation
Heart failure/arrest during procedure or surgery
- Hemorrhage
Disseminated intravascular coagulation
Shock
- Renal
Acute renal failure
- Respiratory
Adult respiratory distress syndrome
Pulmonary edema
- Sepsis
- Other OB
Air and thrombotic embolism
Amniotic fluid embolism
Eclampsia
Severe anesthesia complications
- Other Medical
Puerperal cerebrovascular disorder
Sickle cell disease with crisis
Severe Maternal Morbidity Procedures:
- Blood transfusion
- Conversion of cardiac rhythm
- Hysterectomy
- Temporary tracheostomy
- Ventilation</td>
</tr>
<tr>
<td>Numerator Exclusion:</td>
<td>Inpatient hospitalizations with blood transfusion or hysterectomy with a diagnosis of placenta percreta or placenta increta and no additional severe obstetrical complications.</td>
</tr>
<tr><b>Stratifier Criteria: </b></tr>
<tr>
<td>Stratum:</td>
<td>This measure will be stratified by race/ethnicity and payer after measure submission.</td>
</tr>
</table>
<table class="grid-dict">
<tr>
<th><b>658b2eadd4b024647cc00341</b></th>
</tr>
<tr>
<td>Initial Population:</td>
<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>
</tr>
<tr>
<td>Denominator:</td>
<td>Inpatient hospitalizations for patients delivering stillborn or live birth with >= 20 weeks, 0 days gestation completed</td>
</tr>
<tr>
<td>Denominator Exclusion:</td>
<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>
</tr>
<tr>
<td>Numerator:</td>
<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.
Please note that present on admission codes may be those entered by coding staff, extracted from billing/claims data.
Severe Maternal Morbidity Diagnoses:
- Cardiac
Acute heart failure
Acute myocardial infarction
Aortic aneurysm
Cardiac arrest/ventricular fibrillation
Heart failure/arrest during procedure or surgery
- Hemorrhage
Disseminated intravascular coagulation
Shock
- Renal
Acute renal failure
- Respiratory
Adult respiratory distress syndrome
Pulmonary edema
- Sepsis
- Other OB
Air and thrombotic embolism
Amniotic fluid embolism
Eclampsia
Severe anesthesia complications
- Other Medical
Puerperal cerebrovascular disorder
Sickle cell disease with crisis
Severe Maternal Morbidity Procedures:
- Blood transfusion
- Conversion of cardiac rhythm
- Hysterectomy
- Temporary tracheostomy
- Ventilation</td>
</tr>
<tr>
<td>Numerator Exclusion:</td>
<td>Inpatient hospitalizations with blood transfusion or hysterectomy with a diagnosis of placenta percreta or placenta increta and no additional severe obstetrical complications.</td>
</tr>
</table>
</td>
</tr>
<tr>
<th scope="row"><b> Supplemental Data Elements: </b></th>
<td style="padding-left: 4px;">
<p>SDE Ethnicity</p>
<p>SDE Payer</p>
<p>SDE Race</p>
<p>SDE Sex</p>
<p>SDE Variable Calculated Gestational Age</p>
</td>
</tr>
<tr>
<th scope="row"><b>Risk Adjustment Variable: </b></th>
<td style="padding-left: 4px;">
<p>Risk Variable Lab and Physical Exam Results</p>
<p>Risk Variable Asthma</p>
<p>Risk Variable Autoimmune Disease</p>
<p>Risk Variable Bariatric Surgery</p>
<p>Risk Variable Bleeding Disorder</p>
<p>Risk Variable Morbid Obesity</p>
<p>Risk Variable Cardiac Disease</p>
<p>Risk Variable Economic Housing Instability</p>
<p>Risk Variable Gastrointestinal Disease</p>
<p>Risk Variable Gestational Diabetes</p>
<p>Risk Variable HIV</p>
<p>Risk Variable Hypertension</p>
<p>Risk Variable Long Term Anticoagulant Use</p>
<p>Risk Variable Mental Health Disorder</p>
<p>Risk Variable Multiple Pregnancy</p>
<p>Risk Variable Neuromuscular</p>
<p>Risk Variable Obstetrical VTE</p>
<p>Risk Variable Placenta Previa</p>
<p>Risk Variable Placental Abruption</p>
<p>Risk Variable Placental Accreta Spectrum</p>
<p>Risk Variable Preexisting Diabetes</p>
<p>Risk Variable Previous Cesarean</p>
<p>Risk Variable Pulmonary Hypertension</p>
<p>Risk Variable Renal Disease</p>
<p>Risk Variable Severe Preeclampsia</p>
<p>Risk Variable Substance Abuse</p>
<p>Risk Variable Thyrotoxicosis</p>
<p>Risk Variable Other Preeclampsia</p>
<p>Risk Variable Preterm Birth</p>
<p>Risk Variable Anemia</p>
<p>Risk Variable Systolic Blood Pressure</p>
<p>Risk Variable Heart Rate</p>
<p>Risk Variable First White Blood Cell Count Lab Test</p>
<p>Risk Variable First Hematocrit Lab Test</p>
<p>Delivery Encounters with Blood Transfusion</p>
<p>Risk Variable Maternal Age</p>
</td>
</tr>
<tr>
<th scope="row">
<b> Supplemental Data Guidance
: </b></th>
<td style="padding-left: 4px;"> For every patient evaluated by this measure also identify payer, race, ethnicity, sex, variable calculated gestational age, SOC diagnosis details, and SOC procedure details
</td>
</tr>
<tr>
<th scope="row">
<b> Risk Adjustment Variable Guidance
: </b></th>
<td style="padding-left: 4px;"> The Severe Obstetric Complications Risk Adjustment Methodology Report is available on the eCQI Resource Center (https://ecqi.healthit.gov).
Pre-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).
- Anemia (includes sickle cell disease)
- Asthma
- Autoimmune Disease
- Bariatric Surgery
- Bleeding Disorder
- Cardiac Disease
- Economic Housing Instability
- Gastrointestinal Disease
- Gestational Diabetes
- HIV
- Hypertension
- Long-term Anticoagulant Use
- Maternal Age (derived from birthdate)
- Mental Health Disorder
- Morbid Obesity
- Multiple Pregnancy
- Neuromuscular Disease
- Obstetric VTE
- Other Pre-eclampsia
- Placenta Previa
- Placental Abruption
- Placental Accreta Spectrum
- Pre-existing Diabetes
- Preterm Birth
- Previous Cesarean
- Pulmonary Hypertension
- Renal Disease
- Severe Pre-eclampsia
- Substance Abuse
- Thyrotoxicosis
Lab and Physical Exam Results:
Report the first resulted value 24 hours prior to start of encounter and before time of delivery in UCUM units specified:
- Heart rate: {beats}/min
- Systolic blood pressure: mm[Hg]
- Hematocrit: %
- White blood cell count: 10*3/uL
Note 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>
</tr>
<tr>
<th scope="row"><b>Libraries: </b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr>
<td><a href="Library-SevereObstetricComplicationsFHIR.html">SevereObstetricComplicationsFHIR</a></td>
</tr>
</table>
</td>
</tr>
<tr>
<th scope="row"><b>Terminology and Other Dependencies: </b></th>
<td style="padding-left: 4px;">
<li><code>Library/PCMaternal|5.19.000</code></li>
<li><code>Library/CQMCommon|2.2.000</code></li>
<li><code>Library/FHIRHelpers|4.4.000</code></li>
<li><code>Library/QICoreCommon|2.1.000</code></li>
<li><code>Library/SupplementalDataElements|3.5.000</code></li>
<li><a href="http://terminology.hl7.org/5.5.0/CodeSystem-v3-loinc.html">Logical Observation Identifiers, Names and Codes (LOINC)</a></li>
<li><a href="http://hl7.org/fhir/R4/codesystem-administrative-gender.html">AdministrativeGender</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.666.5.307/expansion">Encounter Inpatient</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1045.59/expansion">Delivery Procedures</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1111.143/expansion">Observation Services</a></li>
<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>
<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>
<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>
<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>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.271/expansion">Asthma</a></li>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.114222.4.11.3591/expansion">Payer</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.305/expansion">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.305</a></li>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1045.114/expansion">Hematocrit lab test</a></li>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
</td>
</tr>
<tr>
<th scope="row"><b>Parameters:</b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr>
<th><b>name</b></th>
<th><b>use</b></th>
<th><b>min</b></th>
<th><b>max</b></th>
<th><b>type</b></th>
</tr>
<tr>
<td>Measurement Period</td>
<td>In</td>
<td>0</td>
<td>1</td>
<td>Period</td>
</tr>
<tr>
<td>Risk Variable Asthma</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Risk Variable Placental Accreta Spectrum</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Risk Variable Neuromuscular</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Risk Variable Hypertension</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>SOC with Hysterectomy or Blood Transfusion with Placenta Increta or Placenta Percreta Without Additional SOC</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Risk Variable Preterm Birth</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>SDE Payer</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Risk Variable Placental Abruption</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Denominator Exclusion</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Risk Variable Morbid Obesity</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Risk Variable Preexisting Diabetes</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Risk Variable Bariatric Surgery</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>SDE Race</td>
<td>Out</td>
<td>0</td>
<td>1</td>
<td>Resource</td>
</tr>
<tr>
<td>Risk Variable Placenta Previa</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>SDE Sex</td>
<td>Out</td>
<td>0</td>
<td>1</td>
<td>Coding</td>
</tr>
<tr>
<td>Risk Variable Bleeding Disorder</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Risk Variable First White Blood Cell Count Lab Test</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Risk Variable First Hematocrit Lab Test</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Delivery Encounters with Severe Obstetric Complications</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Risk Variable Severe Preeclampsia</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Risk Variable Anemia</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Risk Variable Cardiac Disease</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Risk Variable Long Term Anticoagulant Use</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Risk Variable Systolic Blood Pressure</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Risk Variable Substance Abuse</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Risk Variable Renal Disease</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>SDE Variable Calculated Gestational Age</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Risk Variable Gastrointestinal Disease</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions Only</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Risk Variable Pulmonary Hypertension</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Risk Variable Thyrotoxicosis</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Risk Variable Other Preeclampsia</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Initial Population</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Risk Variable Economic Housing Instability</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Risk Variable HIV</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>SOC Excluding Blood Transfusions Only with Hysterectomy or Blood Transfusion with Placenta Increta or Placenta Percreta Without Additional SOC</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Risk Variable Heart Rate</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Risk Variable Maternal Age</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Risk Variable Mental Health Disorder</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Risk Variable Obstetrical VTE</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Risk Variable Autoimmune Disease</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Risk Variable Previous Cesarean</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Risk Variable Gestational Diabetes</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Risk Variable Multiple Pregnancy</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Denominator</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Delivery Encounters with Blood Transfusion</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>SDE Ethnicity</td>
<td>Out</td>
<td>0</td>
<td>1</td>
<td>Resource</td>
</tr>
</table>
</td>
</tr>
<tr>
<th scope="row"><b>DataRequirements:</b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr>
<th><b>Resource Type</b></th>
<th><b>Resource Elements</b></th>
<th><b>Valueset Name</b></th>
<th><b>Valueset</b></th>
</tr>
<tr>
<td>Encounter(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html">QICoreEncounter</a>)</td>
<td>
type
period
status
status.value
condition
condition.reference
condition.reference.value
extension
condition.code
hospitalization
hospitalization.dischargeDisposition
id
id.value
</td>
<td>
Observation Services
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1111.143/expansion">Observation Services</a></td>
</tr>
<tr>
<td>Encounter(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html">QICoreEncounter</a>)</td>
<td>
type
period
status
status.value
condition
condition.reference
condition.reference.value
extension
condition.code
hospitalization
hospitalization.dischargeDisposition
id
id.value
</td>
<td>
ED Visit and OB Triage
</td>
<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>
</tr>
<tr>
<td>Encounter(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html">QICoreEncounter</a>)</td>
<td>
type
status
status.value
period
condition
condition.reference
condition.reference.value
extension
condition.code
hospitalization
hospitalization.dischargeDisposition
id
id.value
</td>
<td>
Encounter Inpatient
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.666.5.307/expansion">Encounter Inpatient</a></td>
</tr>
<tr>
<td>Patient(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-patient.html">QICorePatient</a>)</td>
<td>
race
ethnicity
</td>
<td>
</td>
<td/>
</tr>
<tr>
<td>Procedure(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html">QICoreProcedure</a>)</td>
<td>
code
status
status.value
performed
</td>
<td>
Delivery Procedures
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1045.59/expansion">Delivery Procedures</a></td>
</tr>
<tr>
<td>Procedure(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html">QICoreProcedure</a>)</td>
<td>
code
status
status.value
performed
</td>
<td>
Severe Maternal Morbidity Procedures
</td>
<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>
</tr>
<tr>
<td>Procedure(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html">QICoreProcedure</a>)</td>
<td>
code
status
status.value
performed
</td>
<td>
Hysterectomy
</td>
<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>
</tr>
<tr>
<td>Procedure(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html">QICoreProcedure</a>)</td>
<td>
code
status
status.value
performed
</td>
<td>
Conversion of Cardiac Rhythm
</td>
<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>
</tr>
<tr>
<td>Procedure(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html">QICoreProcedure</a>)</td>
<td>
code
status
status.value
performed
</td>
<td>
Tracheostomy
</td>
<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>
</tr>
<tr>
<td>Procedure(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html">QICoreProcedure</a>)</td>
<td>
code
status
status.value
performed
</td>
<td>
Ventilation
</td>
<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>
</tr>
<tr>
<td>Procedure(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html">QICoreProcedure</a>)</td>
<td>
code
status
status.value
performed
</td>
<td>
Respiratory Support Procedures Related to COVID 19
</td>
<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>
</tr>
<tr>
<td>Procedure(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html">QICoreProcedure</a>)</td>
<td>
code
status
status.value
performed
</td>
<td>
Blood Transfusion
</td>
<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>
</tr>
<tr>
<td>Observation(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-observation.html">QICoreObservation</a>)</td>
<td>
code
value
status
status.value
effective
</td>
<td>
</td>
<td/>
</tr>
<tr>
<td>Observation(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-observation.html">QICoreObservation</a>)</td>
<td>
code
value
status
status.value
effective
</td>
<td>
</td>
<td/>
</tr>
<tr>
<td>Observation(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-observation.html">QICoreObservation</a>)</td>
<td>
code
effective
value
status
status.value
</td>
<td>
Estimated Gestational Age at Delivery
</td>
<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>
</tr>
<tr>
<td>Condition(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-condition.html">QICoreCondition</a>)</td>
<td>
id
id.value
code
</td>
<td>
</td>
<td/>
</tr>
<tr>
<td>Coverage(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-coverage.html">QICoreCoverage</a>)</td>
<td>
type
period
</td>
<td>
Payer Type
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.114222.4.11.3591/expansion">Payer</a></td>
</tr>
<tr>
<td>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>
<td>
code
issued
issued.value
status
status.value
value
</td>
<td>
White blood cells count lab test
</td>
<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>
</tr>
<tr>
<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>
<td>
code
issued
issued.value
status
status.value
value
</td>
<td>
Hematocrit lab test
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1045.114/expansion">Hematocrit lab test</a></td>
</tr>
<tr>
<td>Observation(<a href="http://hl7.org/fhir/R4/bp.html">Observation Blood Pressure Profile</a>)</td>
<td>
effective
status
status.value
component
</td>
<td>
</td>
<td/>
</tr>
<tr>
<td>Observation(<a href="http://hl7.org/fhir/R4/heartrate.html">Observation Heart Rate Profile</a>)</td>
<td>
effective
status
status.value
value
</td>
<td>
</td>
<td/>
</tr>
</table>
</td>
</tr>
<tr>
<th scope="row"><b>Direct Reference Codes:</b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr>
<th><b>display</b></th>
<th><b>code</b></th>
<th><b>system</b></th>
</tr>
<tr>
<td>Date and time of obstetric delivery</td>
<td>93857-1</td>
<td><a href="https://loinc.org/">http://loinc.org</a></td>
</tr>
<tr>
<td>Delivery date Estimated</td>
<td>11778-8</td>
<td><a href="https://loinc.org/">http://loinc.org</a></td>
</tr>
<tr>
<td>Male</td>
<td>M</td>
<td><a href="http://hl7.org/fhir/R4/codesystem-administrative-gender.html">http://hl7.org/fhir/administrative-gender</a></td>
</tr>
<tr>
<td>Female</td>
<td>F</td>
<td><a href="http://hl7.org/fhir/R4/codesystem-administrative-gender.html">http://hl7.org/fhir/administrative-gender</a></td>
</tr>
<tr>
<td>Systolic BP</td>
<td>8480-6</td>
<td><a href="https://loinc.org/">http://loinc.org</a></td>
</tr>
</table>
</td>
</tr>
<tr>
<th scope="row"><b>Logic Definitions:</b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr>
<th><b>Group</b></th>
<th><b>Scoring</b></th>
<th><b>Population Criteria</b></th>
<th><b>Expression</b></th>
</tr>
<tr>
<td> 64efa90856d636294b157c9a </td>
<td colspan="3" style="padding-left: 4px;">
<b>Group scoring:</b>
<span> proportion </span>
<b>Measure scoring:</b>
<p style="margin-bottom: 5px;">
<span>Proportion</span>
</p>
<tr>
<th scope="row"><b>Type: </b></th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<span>Outcome </span>
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Rate Aggregation: </b></th>
<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>
</tr>
<tr>
<th scope="row"><b>Improvement Notation: </b></th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<span>Decreased score indicates improvement </span>
</p>
</td>
</tr>
</td>
<tr>
<td/>
<td/>
<td>Initial Population</td>
<td>
<pre><code class="language-cql">define "Initial Population":
PCMaternal."Delivery Encounter with Age Range"</code></pre>
</td>
</tr>
<tr>
<td/>
<td/>
<td>Denominator</td>
<td>
<pre><code class="language-cql">define "Denominator":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation"</code></pre>
</td>
</tr>
<tr>
<td/>
<td/>
<td>Denominator Exclusion</td>
<td>
<pre><code class="language-cql">define "Denominator Exclusion":
"Delivery Encounters with COVID and Respiratory Condition or Procedure"</code></pre>
</td>
</tr>
<tr>
<td/>
<td/>
<td>Numerator</td>
<td>
<pre><code class="language-cql">define "Delivery Encounters with Severe Obstetric Complications":
"Delivery Encounters with Severe Obstetric Complications Diagnosis or Procedure Excluding Blood Transfusion"
union "Delivery Encounters with Expiration"
union "Delivery Encounters with Blood Transfusion"</code></pre>
</td>
</tr>
<tr>
<td/>
<td/>
<td>Numerator Exclusion</td>
<td>
<pre><code class="language-cql">define "SOC with Hysterectomy or Blood Transfusion with Placenta Increta or Placenta Percreta Without Additional SOC":
( "Delivery Encounters with Severe Obstetric Complications" SOCEncounter
where exists ( ( SOCEncounter.encounterDiagnosis ( ) ) EncounterDiagnosis
where EncounterDiagnosis.code in "Placenta Increta or Percreta"
)
and ( exists "Delivery Encounters with Blood Transfusion"
or exists "Delivery Encounters with Hysterectomy"
)
)
//The following logic keeps encounter in the numerator if there is an additional SOC besides Blood Transfusion or Hysterectomy
except ( ( "Delivery Encounters with Severe Obstetric Complications" SOCEncounter
where ( SOCEncounter.pOAIsNoOrUTD ( ) in "Severe Maternal Morbidity Diagnoses" )
)
union "Delivery Encounters with Cardiac Conversion, Tracheostomy or Ventilation Procedures"
union "Delivery Encounters with Expiration"
)</code></pre>
</td>
</tr>
<tr>
<td/>
<td/>
<td/>
<td>
None
</td>
</tr>
<td> 658b2eadd4b024647cc00341 </td>
<td colspan="3" style="padding-left: 4px;">
<b>Group scoring:</b>
<span> proportion </span>
<b>Measure scoring:</b>
<p style="margin-bottom: 5px;">
<span>Proportion</span>
</p>
<tr>
<th scope="row"><b>Type: </b></th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<span>Outcome </span>
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Rate Aggregation: </b></th>
<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>
</tr>
</td>
<tr>
<td/>
<td/>
<td>Initial Population</td>
<td>
<pre><code class="language-cql">define "Initial Population":
PCMaternal."Delivery Encounter with Age Range"</code></pre>
</td>
</tr>
<tr>
<td/>
<td/>
<td>Denominator</td>
<td>
<pre><code class="language-cql">define "Denominator":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation"</code></pre>
</td>
</tr>
<tr>
<td/>
<td/>
<td>Denominator Exclusion</td>
<td>
<pre><code class="language-cql">define "Denominator Exclusion":
"Delivery Encounters with COVID and Respiratory Condition or Procedure"</code></pre>
</td>
</tr>
<tr>
<td/>
<td/>
<td>Numerator</td>
<td>
<pre><code class="language-cql">define "Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions Only":
"Delivery Encounters with Severe Obstetric Complications"
intersect "Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions"</code></pre>
</td>
</tr>
<tr>
<td/>
<td/>
<td>Numerator Exclusion</td>
<td>
<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":
( "Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions Only" SOCExcludingTransfusion
where exists ( ( SOCExcludingTransfusion.encounterDiagnosis ( ) ) EncounterDiagnoses
where EncounterDiagnoses.code in "Placenta Increta or Percreta"
)
and ( exists "Delivery Encounters with Blood Transfusion"
or exists "Delivery Encounters with Hysterectomy"
)
)
//The following logic keeps encounter in the numerator if there is an additional SOC besides Blood Transfusion or Hysterectomy
except ( ( "Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions Only" SOCExcludingTransfusion
where SOCExcludingTransfusion.pOAIsNoOrUTD ( ) in "Severe Maternal Morbidity Diagnoses"
)
union "Delivery Encounters with Cardiac Conversion, Tracheostomy or Ventilation Procedures"
union "Delivery Encounters with Expiration"
)</code></pre>
</td>
</tr>
</tr>
</table>
<table class="grid-dict">
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>CQMCommon</td>
<td>Inpatient Encounter</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Inpatient Encounter":
[Encounter: "Encounter Inpatient"] EncounterInpatient
where EncounterInpatient.status = 'finished'
and EncounterInpatient.period ends during day of "Measurement Period"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>PCMaternal</td>
<td>Encounter with Age Range</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Encounter with Age Range":
CQMCommon."Inpatient Encounter" InpatientEncounter
where AgeInYearsAt(date from start of InpatientEncounter.period) in Interval[ 8, 65 )</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>PCMaternal</td>
<td>Delivery Encounter with Age Range</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Delivery Encounter with Age Range":
"Encounter with Age Range" EncounterWithAge
with ["Procedure": "Delivery Procedures"] DeliveryProcedure
such that DeliveryProcedure.status = 'completed'
and DeliveryProcedure.performed.toInterval ( ) starts during EncounterWithAge.hospitalizationWithEDOBTriageObservation ()</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Delivery Encounters with Calculated Gestational Age Greater than or Equal to 20 Weeks</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Delivery Encounters with Calculated Gestational Age Greater than or Equal to 20 Weeks":
PCMaternal."Delivery Encounter with Age Range" DeliveryEncounter
where DeliveryEncounter.calculatedGestationalAge ( ) >= 20</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Delivery Encounters with Estimated Gestational Age Assessment Greater than or Equal to 20 Weeks</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Delivery Encounters with Estimated Gestational Age Assessment Greater than or Equal to 20 Weeks":
PCMaternal."Delivery Encounter with Age Range" DeliveryEncounter
where DeliveryEncounter.calculatedGestationalAge ( ) is null
and ( DeliveryEncounter.lastEstimatedGestationalAge ( ) >= 20 weeks )</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Delivery Encounters with Gestational Age Greater than or Equal to 20 Weeks Based on Coding</td>
</tr>
<tr>
<td/>
<td>
<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":
PCMaternal."Delivery Encounter with Age Range" DeliveryEncounter
let CGA: DeliveryEncounter.calculatedGestationalAge ( ),
EGA: DeliveryEncounter.lastEstimatedGestationalAge ( )
where CGA is null
and EGA is null
and exists ( ( DeliveryEncounter.encounterDiagnosis ( ) ) EncounterDiagnosis
where EncounterDiagnosis.code in "20 to 42 Plus Weeks Gestation"
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Delivery Encounters At Greater than or Equal to 20 Weeks Gestation</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation":
"Delivery Encounters with Calculated Gestational Age Greater than or Equal to 20 Weeks"
union "Delivery Encounters with Estimated Gestational Age Assessment Greater than or Equal to 20 Weeks"
union "Delivery Encounters with Gestational Age Greater than or Equal to 20 Weeks Based on Coding"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Risk Variable Asthma</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Risk Variable Asthma":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Acute or Persistent Asthma"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Risk Variable Placental Accreta Spectrum</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Risk Variable Placental Accreta Spectrum":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Placenta Accreta"
or TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Placenta Increta or Percreta"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Risk Variable Neuromuscular</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Risk Variable Neuromuscular":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Neuromuscular Disease"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Risk Variable Hypertension</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Risk Variable Hypertension":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Hypertension"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Delivery Encounters with Severe Obstetric Complications Diagnosis or Procedure Excluding Blood Transfusion</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Delivery Encounters with Severe Obstetric Complications Diagnosis or Procedure Excluding Blood Transfusion":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where TwentyWeeksPlusEncounter.pOAIsNoOrUTD ( ) in "Severe Maternal Morbidity Diagnoses"
or exists ( ["Procedure": "Severe Maternal Morbidity Procedures"] SMMProcedures
where SMMProcedures.status = 'completed'
and SMMProcedures.performed.toInterval ( ) starts during day of TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation ( )
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Delivery Encounters with Expiration</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Delivery Encounters with Expiration":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where TwentyWeeksPlusEncounter.hospitalization.dischargeDisposition in "Patient Expired"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Delivery Encounters with Blood Transfusion</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Delivery Encounters with Blood Transfusion":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
with ["Procedure": "Blood Transfusion"] BloodTransfusion
such that BloodTransfusion.status = 'completed'
and BloodTransfusion.performed.toInterval ( ) starts during day of TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation ( )</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Delivery Encounters with Severe Obstetric Complications</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Delivery Encounters with Severe Obstetric Complications":
"Delivery Encounters with Severe Obstetric Complications Diagnosis or Procedure Excluding Blood Transfusion"
union "Delivery Encounters with Expiration"
union "Delivery Encounters with Blood Transfusion"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Delivery Encounters with Hysterectomy</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Delivery Encounters with Hysterectomy":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
with ["Procedure": "Hysterectomy"] Hysterectomy
such that Hysterectomy.status = 'completed'
and Hysterectomy.performed.toInterval ( ) starts during day of TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation ( )</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Cardiac Conversion, Tracheostomy or Ventilation Procedures</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Cardiac Conversion, Tracheostomy or Ventilation Procedures":
["Procedure": "Conversion of Cardiac Rhythm"]
union ["Procedure": "Tracheostomy"]
union ["Procedure": "Ventilation"]</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Delivery Encounters with Cardiac Conversion, Tracheostomy or Ventilation Procedures</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Delivery Encounters with Cardiac Conversion, Tracheostomy or Ventilation Procedures":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
with "Cardiac Conversion, Tracheostomy or Ventilation Procedures" ConvTrachVentProcedures
such that ConvTrachVentProcedures.status = 'completed'
and ConvTrachVentProcedures.performed.toInterval ( ) starts during day of TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation ( )</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>SOC with Hysterectomy or Blood Transfusion with Placenta Increta or Placenta Percreta Without Additional SOC</td>
</tr>
<tr>
<td/>
<td>
<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":
( "Delivery Encounters with Severe Obstetric Complications" SOCEncounter
where exists ( ( SOCEncounter.encounterDiagnosis ( ) ) EncounterDiagnosis
where EncounterDiagnosis.code in "Placenta Increta or Percreta"
)
and ( exists "Delivery Encounters with Blood Transfusion"
or exists "Delivery Encounters with Hysterectomy"
)
)
//The following logic keeps encounter in the numerator if there is an additional SOC besides Blood Transfusion or Hysterectomy
except ( ( "Delivery Encounters with Severe Obstetric Complications" SOCEncounter
where ( SOCEncounter.pOAIsNoOrUTD ( ) in "Severe Maternal Morbidity Diagnoses" )
)
union "Delivery Encounters with Cardiac Conversion, Tracheostomy or Ventilation Procedures"
union "Delivery Encounters with Expiration"
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Risk Variable Preterm Birth</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Risk Variable Preterm Birth":
/* CGA = Calculated Gestational Age. EGA = Estimated Gestational Age. */
( PCMaternal."Delivery Encounter with Age Range" DeliveryEncounter
let CGA: DeliveryEncounter.calculatedGestationalAge ( ),
EGA: DeliveryEncounter.lastEstimatedGestationalAge ( )
where CGA in Interval[20, 36]
or ( CGA is null
and ( EGA >= 20 weeks
and EGA <= 36 weeks
)
)
)
union ( PCMaternal."Delivery Encounter with Age Range" DeliveryEncounter
let CGA: DeliveryEncounter.calculatedGestationalAge ( ),
EGA: DeliveryEncounter.lastEstimatedGestationalAge ( )
where CGA is null
and EGA is null
and DeliveryEncounter.pOAIsYesOrExempt ( ) in "Preterm Birth"
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SupplementalDataElements</td>
<td>SDE Payer</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "SDE Payer":
[Coverage: type in "Payer Type"] Payer
return {
code: Payer.type,
period: Payer.period
}</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>SDE Payer</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "SDE Payer":
SDE."SDE Payer"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Risk Variable Placental Abruption</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Risk Variable Placental Abruption":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Placental Abruption"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Delivery Encounters with COVID and Respiratory Condition or Procedure</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Delivery Encounters with COVID and Respiratory Condition or Procedure":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where exists ( ( TwentyWeeksPlusEncounter.encounterDiagnosis ( ) ) EncounterDiagnosis
where EncounterDiagnosis.code in "COVID 19 Confirmed"
)
and ( exists ( ( TwentyWeeksPlusEncounter.encounterDiagnosis ( ) ) EncounterDiagnosis
where EncounterDiagnosis.code in "Respiratory Conditions Related to COVID 19"
)
or exists ( ["Procedure": "Respiratory Support Procedures Related to COVID 19"] COVIDRespiratoryProcedure
where COVIDRespiratoryProcedure.status = 'completed'
and COVIDRespiratoryProcedure.performed.toInterval ( ) starts during day of TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation ( )
)
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Denominator Exclusion</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Denominator Exclusion":
"Delivery Encounters with COVID and Respiratory Condition or Procedure"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Risk Variable Morbid Obesity</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Risk Variable Morbid Obesity":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Morbid or Severe Obesity"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Risk Variable Preexisting Diabetes</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Risk Variable Preexisting Diabetes":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Preexisting Diabetes"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Risk Variable Bariatric Surgery</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Risk Variable Bariatric Surgery":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Bariatric Surgery"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SupplementalDataElements</td>
<td>SDE Race</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "SDE Race":
Patient.race R
return Tuple {
codes: R.ombCategory union R.detailed,
display: R.text
}</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>SDE Race</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "SDE Race":
SDE."SDE Race"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Risk Variable Placenta Previa</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Risk Variable Placenta Previa":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Placenta Previa"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SupplementalDataElements</td>
<td>SDE Sex</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "SDE Sex":
case
when Patient.gender = 'male' then "M"
when Patient.gender = 'female' then "F"
else null
end</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>SDE Sex</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "SDE Sex":
SDE."SDE Sex"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Risk Variable Bleeding Disorder</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Risk Variable Bleeding Disorder":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Bleeding Disorder"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Risk Variable First White Blood Cell Count Lab Test</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">//First resulted value 24 hours prior to start of encounter and before time of delivery
//Report white blood cell count as 10*3/uL
define "Risk Variable First White Blood Cell Count Lab Test":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
let FirstWBC: First(["USCoreLaboratoryResultObservationProfile": "White blood cells count lab test"] WBC
where WBC.issued during Interval[start of TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation() - 1440 minutes, TwentyWeeksPlusEncounter.lastTimeOfDelivery())
and WBC.status in { 'final', 'amended', 'corrected' }
and WBC.value is not null
sort by issued.earliest()
)
return {
EncounterId: TwentyWeeksPlusEncounter.id,
FirstWBCResult: FirstWBC.value as Quantity,
Timing: FirstWBC.issued
}</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Risk Variable First Hematocrit Lab Test</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">//First resulted value 24 hours prior to start of encounter and before time of delivery
//Report hematocrit as %
define "Risk Variable First Hematocrit Lab Test":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
let FirstHematocrit: First(["USCoreLaboratoryResultObservationProfile": "Hematocrit lab test"] Hematocrit
where Hematocrit.issued during Interval[start of TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation() - 1440 minutes, TwentyWeeksPlusEncounter.lastTimeOfDelivery())
and Hematocrit.status in { 'final', 'amended', 'corrected' }
and Hematocrit.value is not null
sort by issued.earliest()
)
return {
EncounterId: TwentyWeeksPlusEncounter.id,
FirstHematocritResult: FirstHematocrit.value as Quantity,
Timing: FirstHematocrit.issued
}</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Risk Variable Severe Preeclampsia</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Risk Variable Severe Preeclampsia":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Severe Preeclampsia"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Risk Variable Anemia</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Risk Variable Anemia":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Anemia"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Risk Variable Cardiac Disease</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Risk Variable Cardiac Disease":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Cardiac Disease"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Risk Variable Long Term Anticoagulant Use</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Risk Variable Long Term Anticoagulant Use":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Long Term Anticoagulant Use"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Risk Variable Systolic Blood Pressure</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">//First resulted value 24 hours prior to start of encounter and before time of delivery
//Report systolic blood pressure as mm[Hg]
//Systolic blood pressure value cannot be null per QICore profile requirement.
define "Risk Variable Systolic Blood Pressure":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
let FirstSystolicBP: First(["observation-bp"] BP
where BP.effective.earliest() during Interval[start of TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation() - 1440 minutes, TwentyWeeksPlusEncounter.lastTimeOfDelivery())
and BP.status in { 'final', 'amended', 'corrected' }
and BP.component.value is not null
sort by effective.earliest()
)
return {
EncounterId: TwentyWeeksPlusEncounter.id,
FirstSBPResult: FirstSystolicBP.component C
where C.code ~ "Systolic blood pressure"
return C.value as Quantity,
Timing: FirstSystolicBP.effective.earliest ( )
}</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Risk Variable Substance Abuse</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Risk Variable Substance Abuse":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Substance Abuse"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Risk Variable Renal Disease</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Risk Variable Renal Disease":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Renal Disease"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>PCMaternal</td>
<td>Variable Calculated Gestational Age</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Variable Calculated Gestational Age":
// 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
"Delivery Encounter with Age Range" DeliveryEncounter
let CGA: DeliveryEncounter.calculatedGestationalAge()
// return { QualifyingEncounter, CGA }
return {
EncounterID: DeliveryEncounter.id,
CalculatedCGA: CGA
}</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>SDE Variable Calculated Gestational Age</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "SDE Variable Calculated Gestational Age":
//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.
PCMaternal."Variable Calculated Gestational Age"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Risk Variable Gastrointestinal Disease</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Risk Variable Gastrointestinal Disease":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Gastrointestinal Disease"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions":
"Delivery Encounters with Severe Obstetric Complications Diagnosis or Procedure Excluding Blood Transfusion"
union "Delivery Encounters with Expiration"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions Only</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions Only":
"Delivery Encounters with Severe Obstetric Complications"
intersect "Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Risk Variable Pulmonary Hypertension</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Risk Variable Pulmonary Hypertension":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Pulmonary Hypertension"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Risk Variable Thyrotoxicosis</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Risk Variable Thyrotoxicosis":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Thyrotoxicosis"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Risk Variable Other Preeclampsia</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Risk Variable Other Preeclampsia":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Mild or Moderate Preeclampsia"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Initial Population</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Initial Population":
PCMaternal."Delivery Encounter with Age Range"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Risk Variable Economic Housing Instability</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Risk Variable Economic Housing Instability":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Economic Housing Instability"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Risk Variable HIV</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Risk Variable HIV":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "HIV in Pregnancy Childbirth and Puerperium"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>SOC Excluding Blood Transfusions Only with Hysterectomy or Blood Transfusion with Placenta Increta or Placenta Percreta Without Additional SOC</td>
</tr>
<tr>
<td/>
<td>
<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":
( "Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions Only" SOCExcludingTransfusion
where exists ( ( SOCExcludingTransfusion.encounterDiagnosis ( ) ) EncounterDiagnoses
where EncounterDiagnoses.code in "Placenta Increta or Percreta"
)
and ( exists "Delivery Encounters with Blood Transfusion"
or exists "Delivery Encounters with Hysterectomy"
)
)
//The following logic keeps encounter in the numerator if there is an additional SOC besides Blood Transfusion or Hysterectomy
except ( ( "Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions Only" SOCExcludingTransfusion
where SOCExcludingTransfusion.pOAIsNoOrUTD ( ) in "Severe Maternal Morbidity Diagnoses"
)
union "Delivery Encounters with Cardiac Conversion, Tracheostomy or Ventilation Procedures"
union "Delivery Encounters with Expiration"
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Risk Variable Heart Rate</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">//First resulted value 24 hours prior to start of encounter and before time of delivery
//Report heart rate as beats/min
//Heart rate value cannot be null per QICore profile requirement.
define "Risk Variable Heart Rate":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
let FirstHeartRate: First(["observation-heartrate"] HeartRate
where HeartRate.effective.earliest() during Interval[start of TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation() - 1440 minutes, TwentyWeeksPlusEncounter.lastTimeOfDelivery())
and HeartRate.status in { 'final', 'amended', 'corrected' }
sort by effective.earliest()
)
return {
EncounterId: TwentyWeeksPlusEncounter.id,
FirstHRResult: FirstHeartRate.value as Quantity,
Timing: FirstHeartRate.effective.earliest ( )
}</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Risk Variable Maternal Age</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Risk Variable Maternal Age":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
let MaternalAge: AgeInYearsAt(date from start of TwentyWeeksPlusEncounter.period)
return { TwentyWeeksPlusEncounter, MaternalAge }</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Risk Variable Mental Health Disorder</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Risk Variable Mental Health Disorder":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Mental Health Disorder"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Risk Variable Obstetrical VTE</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Risk Variable Obstetrical VTE":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Venous Thromboembolism in Pregnancy"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Risk Variable Autoimmune Disease</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Risk Variable Autoimmune Disease":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Autoimmune Disease"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Risk Variable Previous Cesarean</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Risk Variable Previous Cesarean":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Previous Cesarean"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Risk Variable Gestational Diabetes</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Risk Variable Gestational Diabetes":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Gestational Diabetes"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Risk Variable Multiple Pregnancy</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Risk Variable Multiple Pregnancy":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Multiple Pregnancy"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>Denominator</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Denominator":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SupplementalDataElements</td>
<td>SDE Ethnicity</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "SDE Ethnicity":
Patient.ethnicity E
return Tuple {
codes: { E.ombCategory } union E.detailed,
display: E.text
}</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>SDE Ethnicity</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "SDE Ethnicity":
SDE."SDE Ethnicity"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>PCMaternal</td>
<td>hospitalizationWithEDOBTriageObservation</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">/*define function "HospitalizationWithEDOBTriageObservation"(Encounter Encounter ):
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
Encounter Visit
let ObsVisit: Last(["Encounter": "Observation Services"] LastObs
where LastObs.period ends 1 hour or less on or before start of Visit.period
and LastObs.status = 'finished'
sort by
end of period
),
VisitStart: Coalesce(start of ObsVisit.period, start of Visit.period),
EDOBTriageVisit: Last(["Encounter": "ED Visit and OB Triage"] LastEDOBTriage
where LastEDOBTriage.period ends 1 hour or less on or before VisitStart
and LastEDOBTriage.status = 'finished'
sort by
end of period
)
return Interval[Coalesce(start of EDOBTriageVisit.period, VisitStart),
end of Visit.period]*/
define fluent function hospitalizationWithEDOBTriageObservation (TheEncounter Encounter ):
/*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*/
TheEncounter Visit
let ObsVisit: Last(["Encounter": "Observation Services"] LastObs
where LastObs.period ends 1 hour or less on or before start of Visit.period
and LastObs.status = 'finished'
sort by
end of period
),
VisitStart: Coalesce(start of ObsVisit.period, start of Visit.period),
EDOBTriageVisit: Last(["Encounter": "ED Visit and OB Triage"] LastEDOBTriage
where LastEDOBTriage.period ends 1 hour or less on or before VisitStart
and LastEDOBTriage.status = 'finished'
sort by
end of period
)
return Interval[Coalesce(start of EDOBTriageVisit.period, VisitStart),
end of Visit.period]</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>PCMaternal</td>
<td>calculatedGestationalAge</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define fluent function calculatedGestationalAge (TheEncounter Encounter ):
//Gestational Age = (280-(Estimated Delivery Date minus Reference Date/Delivery Date))/7
( 280 - ( difference in days between TheEncounter.lastTimeOfDelivery () and TheEncounter.lastEstimatedDeliveryDate( )) ) div 7</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>PCMaternal</td>
<td>lastTimeOfDelivery</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define fluent function lastTimeOfDelivery (TheEncounter Encounter ):
Last(["Observation": "Date and time of obstetric delivery"] TimeOfDelivery
where TimeOfDelivery.value as DateTime is not null
and TimeOfDelivery.status in { 'final', 'amended', 'corrected' }
and TimeOfDelivery.effective.earliest () during TheEncounter.hospitalizationWithEDOBTriageObservation ()
and TimeOfDelivery.value as DateTime during TheEncounter.hospitalizationWithEDOBTriageObservation()
sort by effective.earliest()
).value as DateTime</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>QICoreCommon</td>
<td>earliest</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">/*
@description: Given an interval, return the starting point if the interval has a starting boundary specified,
otherwise, return the ending point
*/
define fluent function earliest(choice Choice<DateTime, Quantity, Interval<DateTime>, Interval<Quantity>> ):
(choice.toInterval()) period
return
if (period."hasStart"()) then start of period
else end of period</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>PCMaternal</td>
<td>lastEstimatedDeliveryDate</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">/*===============================================================*/
/* 03/14/2022 from MATGlobalCommonFunctionsv7.000 - latest QDM */
/* even though this PCMaternalFHIR was derived from */
/* PCMaternal=2.1.000 cql, to make next update easier. */
/* Will need to re-insert "Global". in front of these */
/* function names later (whereever they are directly used.*/
define fluent function lastEstimatedDeliveryDate (TheEncounter Encounter ):
/*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.*/
Last(["Observation": "Delivery date Estimated"] EstimatedDateOfDelivery
where EstimatedDateOfDelivery.value as DateTime is not null
and EstimatedDateOfDelivery.status in { 'final', 'amended', 'corrected' }
and EstimatedDateOfDelivery.effective.earliest ( ) 42 weeks or less before or on TheEncounter.lastTimeOfDelivery ()
sort by effective.earliest ( )
).value as DateTime</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>PCMaternal</td>
<td>lastEstimatedGestationalAge</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">/*define fluent function lastEstimatedGestationalAge (TheEncounter Encounter ):
Last(["Observation": "Estimated Gestational Age at Delivery"] EstimatedGestationalAge
where EstimatedGestationalAge.value is not null
and EstimatedGestationalAge.status in { 'final', 'amended', 'corrected' }
and EstimatedGestationalAge.effective.earliest() 24 hours or less before or on TheEncounter.lastTimeOfDelivery ()
sort by effective.earliest ()
).value as Quantity*/
define fluent function lastEstimatedGestationalAge (TheEncounter Encounter ):
Last(["Observation": "Estimated Gestational Age at Delivery"] EstimatedGestationalAge
let EGATiming: EstimatedGestationalAge.effective.earliest() where
(EGATiming 24 hours or less before or on TheEncounter.lastTimeOfDelivery ()
and EstimatedGestationalAge.value is not null
and EstimatedGestationalAge.status in { 'final', 'amended', 'corrected' }) or
(EGATiming same day as TheEncounter.lastTimeOfDelivery ()
and EGATiming during TheEncounter.hospitalizationWithEDOBTriageObservation()
and EstimatedGestationalAge.value is not null)
sort by effective.earliest ())
.value as Quantity</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>CQMCommon</td>
<td>encounterDiagnosis</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">/*
@description: Returns the Condition resources referenced by the diagnosis element of the Encounter
*/
define fluent function encounterDiagnosis(Encounter Encounter ):
Encounter.diagnosis D
return singleton from ([Condition] C where C.id = D.condition.reference.getId())</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>QICoreCommon</td>
<td>getId</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">/*
@description: Returns the tail of the given uri (i.e. everything after the last slash in the URI).
@comment: This function can be used to determine the logical id of a given resource. It can be used in
a single-server environment to trace references. However, this function does not attempt to resolve
or distinguish the base of the given url, and so cannot be used safely in multi-server environments.
*/
define fluent function getId(uri String):
Last(Split(uri, '/'))</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>pOAIsYesOrExempt</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define fluent function pOAIsYesOrExempt(TheEncounter Encounter):
TheEncounter.diagnosis EncounterDiagnoses
where EncounterDiagnoses.diagnosisPresentOnAdmission in "Present On Admission is Yes or Exempt"
return EncounterDiagnoses.condition.getCondition ( ).code</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>FHIRHelpers</td>
<td>ToString</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define function ToString(value uri): value.value</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>CQMCommon</td>
<td>getCondition</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">/*
@description: Returns the Condition resource for the given reference
*/
define fluent function getCondition(reference Reference):
singleton from ([Condition] C where C.id = reference.reference.getId())</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SevereObstetricComplicationsFHIR</td>
<td>pOAIsNoOrUTD</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">/*define function "FirstLabTestWithEncounterId"(LabList List<Observation>, CCDE String ):
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
let FirstLab: First(LabList Lab
//(first resulted value 24 hours prior to start of encounter and before time of delivery)
where Lab.issued.earliest() during Interval[start of TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation()- 1440 minutes, TwentyWeeksPlusEncounter.lastTimeOfDelivery())
and Lab.status in {'final', 'amended', 'corrected'}
and Lab.value is not null
sort by issued.earliest())
return {
EncounterId: TwentyWeeksPlusEncounter.id,
FirstResult: FirstLab.value as Quantity,
Timing: FirstLab.issued
}
define function "FirstPhysicalExamWithEncounterId"(ExamList List<Observation>, CCDE String):
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
let FirstExam: First(ExamList Exam
where Exam.effective.earliest() during Interval[start of TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation()- 1440 minutes, TwentyWeeksPlusEncounter.lastTimeOfDelivery())
and Exam.status in {'final', 'amended', 'corrected'}
and Exam.value is not null
sort by effective.earliest() )
return {
EncounterId: TwentyWeeksPlusEncounter.id,
FirstResult: FirstExam.value as Quantity,
Timing: FirstExam.effective.earliest()
}
define "Risk Variable Lab and Physical Exam Results":
flatten{
// First physical exams (vital signs): Report heart rate as {beats}/min, systolic blood pressure as mm[Hg]
"FirstPhysicalExamWithEncounterId"([Observation: "Heart rate"], 'FirstHeartRate'),
"FirstPhysicalExamWithEncounterId"([Observation: "Systolic blood pressure"], 'FirstSystolicBP'),
//First lab tests: Report hematocrit as %, white blood cell count as 10*3/uL
"FirstLabTestWithEncounterId"([Observation: "Hematocrit lab test"], 'FirstHematocrit'),
"FirstLabTestWithEncounterId"([Observation: "White blood cells count lab test"], 'FirstWhiteBloodCell')
}*/
define fluent function pOAIsNoOrUTD(TheEncounter Encounter):
TheEncounter.diagnosis EncounterDiagnoses
where EncounterDiagnoses.diagnosisPresentOnAdmission in "Present on Admission is No or Unable To Determine"
return EncounterDiagnoses.condition.getCondition ( ).code</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>FHIRHelpers</td>
<td>ToCode</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">/*
@description: Converts the given FHIR [Coding](https://hl7.org/fhir/datatypes.html#Coding) value to a CQL Code.
*/
define function ToCode(coding FHIR.Coding):
if coding is null then
null
else
System.Code {
code: coding.code.value,
system: coding.system.value,
version: coding.version.value,
display: coding.display.value
}</code></pre>
</td>
</tr>
</table>
</td>
</tr>
</table>
</div>
</text>
<contained>
<Library>
<id value="effective-data-requirements"/>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
<valueCoding>
<system value="http://loinc.org"/>
<code value="93857-1"/>
<display value="Date and time of obstetric delivery"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
<valueCoding>
<system value="http://loinc.org"/>
<code value="11778-8"/>
<display value="Delivery date Estimated"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
<valueCoding>
<system value="http://hl7.org/fhir/administrative-gender"/>
<code value="M"/>
<display value="Male"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
<valueCoding>
<system value="http://hl7.org/fhir/administrative-gender"/>
<code value="F"/>
<display value="Female"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
<valueCoding>
<system value="http://loinc.org"/>
<code value="8480-6"/>
<display value="Systolic BP"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="CQMCommon"/>
</extension>
<extension url="name">
<valueString value="Inpatient Encounter"/>
</extension>
<extension url="statement">
<valueString
value="define "Inpatient Encounter":
[Encounter: "Encounter Inpatient"] EncounterInpatient
where EncounterInpatient.status = 'finished'
and EncounterInpatient.period ends during day of "Measurement Period""/>
</extension>
<extension url="displaySequence">
<valueInteger value="0"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="PCMaternal"/>
</extension>
<extension url="name">
<valueString value="Encounter with Age Range"/>
</extension>
<extension url="statement">
<valueString
value="define "Encounter with Age Range":
CQMCommon."Inpatient Encounter" InpatientEncounter
where AgeInYearsAt(date from start of InpatientEncounter.period) in Interval[ 8, 65 )"/>
</extension>
<extension url="displaySequence">
<valueInteger value="1"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="PCMaternal"/>
</extension>
<extension url="name">
<valueString value="Delivery Encounter with Age Range"/>
</extension>
<extension url="statement">
<valueString
value="define "Delivery Encounter with Age Range":
"Encounter with Age Range" EncounterWithAge
with ["Procedure": "Delivery Procedures"] DeliveryProcedure
such that DeliveryProcedure.status = 'completed'
and DeliveryProcedure.performed.toInterval ( ) starts during EncounterWithAge.hospitalizationWithEDOBTriageObservation ()"/>
</extension>
<extension url="displaySequence">
<valueInteger value="2"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString
value="Delivery Encounters with Calculated Gestational Age Greater than or Equal to 20 Weeks"/>
</extension>
<extension url="statement">
<valueString
value="define "Delivery Encounters with Calculated Gestational Age Greater than or Equal to 20 Weeks":
PCMaternal."Delivery Encounter with Age Range" DeliveryEncounter
where DeliveryEncounter.calculatedGestationalAge ( ) >= 20"/>
</extension>
<extension url="displaySequence">
<valueInteger value="3"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString
value="Delivery Encounters with Estimated Gestational Age Assessment Greater than or Equal to 20 Weeks"/>
</extension>
<extension url="statement">
<valueString
value="define "Delivery Encounters with Estimated Gestational Age Assessment Greater than or Equal to 20 Weeks":
PCMaternal."Delivery Encounter with Age Range" DeliveryEncounter
where DeliveryEncounter.calculatedGestationalAge ( ) is null
and ( DeliveryEncounter.lastEstimatedGestationalAge ( ) >= 20 weeks )"/>
</extension>
<extension url="displaySequence">
<valueInteger value="4"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString
value="Delivery Encounters with Gestational Age Greater than or Equal to 20 Weeks Based on Coding"/>
</extension>
<extension url="statement">
<valueString
value="define "Delivery Encounters with Gestational Age Greater than or Equal to 20 Weeks Based on Coding":
PCMaternal."Delivery Encounter with Age Range" DeliveryEncounter
let CGA: DeliveryEncounter.calculatedGestationalAge ( ),
EGA: DeliveryEncounter.lastEstimatedGestationalAge ( )
where CGA is null
and EGA is null
and exists ( ( DeliveryEncounter.encounterDiagnosis ( ) ) EncounterDiagnosis
where EncounterDiagnosis.code in "20 to 42 Plus Weeks Gestation"
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="5"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString
value="Delivery Encounters At Greater than or Equal to 20 Weeks Gestation"/>
</extension>
<extension url="statement">
<valueString
value="define "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation":
"Delivery Encounters with Calculated Gestational Age Greater than or Equal to 20 Weeks"
union "Delivery Encounters with Estimated Gestational Age Assessment Greater than or Equal to 20 Weeks"
union "Delivery Encounters with Gestational Age Greater than or Equal to 20 Weeks Based on Coding""/>
</extension>
<extension url="displaySequence">
<valueInteger value="6"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Risk Variable Asthma"/>
</extension>
<extension url="statement">
<valueString
value="define "Risk Variable Asthma":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Acute or Persistent Asthma""/>
</extension>
<extension url="displaySequence">
<valueInteger value="7"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Risk Variable Placental Accreta Spectrum"/>
</extension>
<extension url="statement">
<valueString
value="define "Risk Variable Placental Accreta Spectrum":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Placenta Accreta"
or TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Placenta Increta or Percreta""/>
</extension>
<extension url="displaySequence">
<valueInteger value="8"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Risk Variable Neuromuscular"/>
</extension>
<extension url="statement">
<valueString
value="define "Risk Variable Neuromuscular":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Neuromuscular Disease""/>
</extension>
<extension url="displaySequence">
<valueInteger value="9"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Risk Variable Hypertension"/>
</extension>
<extension url="statement">
<valueString
value="define "Risk Variable Hypertension":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Hypertension""/>
</extension>
<extension url="displaySequence">
<valueInteger value="10"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString
value="Delivery Encounters with Severe Obstetric Complications Diagnosis or Procedure Excluding Blood Transfusion"/>
</extension>
<extension url="statement">
<valueString
value="define "Delivery Encounters with Severe Obstetric Complications Diagnosis or Procedure Excluding Blood Transfusion":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where TwentyWeeksPlusEncounter.pOAIsNoOrUTD ( ) in "Severe Maternal Morbidity Diagnoses"
or exists ( ["Procedure": "Severe Maternal Morbidity Procedures"] SMMProcedures
where SMMProcedures.status = 'completed'
and SMMProcedures.performed.toInterval ( ) starts during day of TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation ( )
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="11"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Delivery Encounters with Expiration"/>
</extension>
<extension url="statement">
<valueString
value="define "Delivery Encounters with Expiration":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where TwentyWeeksPlusEncounter.hospitalization.dischargeDisposition in "Patient Expired""/>
</extension>
<extension url="displaySequence">
<valueInteger value="12"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Delivery Encounters with Blood Transfusion"/>
</extension>
<extension url="statement">
<valueString
value="define "Delivery Encounters with Blood Transfusion":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
with ["Procedure": "Blood Transfusion"] BloodTransfusion
such that BloodTransfusion.status = 'completed'
and BloodTransfusion.performed.toInterval ( ) starts during day of TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation ( )"/>
</extension>
<extension url="displaySequence">
<valueInteger value="13"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString
value="Delivery Encounters with Severe Obstetric Complications"/>
</extension>
<extension url="statement">
<valueString
value="define "Delivery Encounters with Severe Obstetric Complications":
"Delivery Encounters with Severe Obstetric Complications Diagnosis or Procedure Excluding Blood Transfusion"
union "Delivery Encounters with Expiration"
union "Delivery Encounters with Blood Transfusion""/>
</extension>
<extension url="displaySequence">
<valueInteger value="14"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Delivery Encounters with Hysterectomy"/>
</extension>
<extension url="statement">
<valueString
value="define "Delivery Encounters with Hysterectomy":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
with ["Procedure": "Hysterectomy"] Hysterectomy
such that Hysterectomy.status = 'completed'
and Hysterectomy.performed.toInterval ( ) starts during day of TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation ( )"/>
</extension>
<extension url="displaySequence">
<valueInteger value="15"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString
value="Cardiac Conversion, Tracheostomy or Ventilation Procedures"/>
</extension>
<extension url="statement">
<valueString
value="define "Cardiac Conversion, Tracheostomy or Ventilation Procedures":
["Procedure": "Conversion of Cardiac Rhythm"]
union ["Procedure": "Tracheostomy"]
union ["Procedure": "Ventilation"]"/>
</extension>
<extension url="displaySequence">
<valueInteger value="16"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString
value="Delivery Encounters with Cardiac Conversion, Tracheostomy or Ventilation Procedures"/>
</extension>
<extension url="statement">
<valueString
value="define "Delivery Encounters with Cardiac Conversion, Tracheostomy or Ventilation Procedures":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
with "Cardiac Conversion, Tracheostomy or Ventilation Procedures" ConvTrachVentProcedures
such that ConvTrachVentProcedures.status = 'completed'
and ConvTrachVentProcedures.performed.toInterval ( ) starts during day of TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation ( )"/>
</extension>
<extension url="displaySequence">
<valueInteger value="17"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString
value="SOC with Hysterectomy or Blood Transfusion with Placenta Increta or Placenta Percreta Without Additional SOC"/>
</extension>
<extension url="statement">
<valueString
value="define "SOC with Hysterectomy or Blood Transfusion with Placenta Increta or Placenta Percreta Without Additional SOC":
( "Delivery Encounters with Severe Obstetric Complications" SOCEncounter
where exists ( ( SOCEncounter.encounterDiagnosis ( ) ) EncounterDiagnosis
where EncounterDiagnosis.code in "Placenta Increta or Percreta"
)
and ( exists "Delivery Encounters with Blood Transfusion"
or exists "Delivery Encounters with Hysterectomy"
)
)
//The following logic keeps encounter in the numerator if there is an additional SOC besides Blood Transfusion or Hysterectomy
except ( ( "Delivery Encounters with Severe Obstetric Complications" SOCEncounter
where ( SOCEncounter.pOAIsNoOrUTD ( ) in "Severe Maternal Morbidity Diagnoses" )
)
union "Delivery Encounters with Cardiac Conversion, Tracheostomy or Ventilation Procedures"
union "Delivery Encounters with Expiration"
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="18"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Risk Variable Preterm Birth"/>
</extension>
<extension url="statement">
<valueString
value="define "Risk Variable Preterm Birth":
/* CGA = Calculated Gestational Age. EGA = Estimated Gestational Age. */
( PCMaternal."Delivery Encounter with Age Range" DeliveryEncounter
let CGA: DeliveryEncounter.calculatedGestationalAge ( ),
EGA: DeliveryEncounter.lastEstimatedGestationalAge ( )
where CGA in Interval[20, 36]
or ( CGA is null
and ( EGA >= 20 weeks
and EGA <= 36 weeks
)
)
)
union ( PCMaternal."Delivery Encounter with Age Range" DeliveryEncounter
let CGA: DeliveryEncounter.calculatedGestationalAge ( ),
EGA: DeliveryEncounter.lastEstimatedGestationalAge ( )
where CGA is null
and EGA is null
and DeliveryEncounter.pOAIsYesOrExempt ( ) in "Preterm Birth"
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="19"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SupplementalDataElements"/>
</extension>
<extension url="name">
<valueString value="SDE Payer"/>
</extension>
<extension url="statement">
<valueString
value="define "SDE Payer":
[Coverage: type in "Payer Type"] Payer
return {
code: Payer.type,
period: Payer.period
}"/>
</extension>
<extension url="displaySequence">
<valueInteger value="20"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="SDE Payer"/>
</extension>
<extension url="statement">
<valueString
value="define "SDE Payer":
SDE."SDE Payer""/>
</extension>
<extension url="displaySequence">
<valueInteger value="21"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Risk Variable Placental Abruption"/>
</extension>
<extension url="statement">
<valueString
value="define "Risk Variable Placental Abruption":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Placental Abruption""/>
</extension>
<extension url="displaySequence">
<valueInteger value="22"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString
value="Delivery Encounters with COVID and Respiratory Condition or Procedure"/>
</extension>
<extension url="statement">
<valueString
value="define "Delivery Encounters with COVID and Respiratory Condition or Procedure":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where exists ( ( TwentyWeeksPlusEncounter.encounterDiagnosis ( ) ) EncounterDiagnosis
where EncounterDiagnosis.code in "COVID 19 Confirmed"
)
and ( exists ( ( TwentyWeeksPlusEncounter.encounterDiagnosis ( ) ) EncounterDiagnosis
where EncounterDiagnosis.code in "Respiratory Conditions Related to COVID 19"
)
or exists ( ["Procedure": "Respiratory Support Procedures Related to COVID 19"] COVIDRespiratoryProcedure
where COVIDRespiratoryProcedure.status = 'completed'
and COVIDRespiratoryProcedure.performed.toInterval ( ) starts during day of TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation ( )
)
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="23"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Denominator Exclusion"/>
</extension>
<extension url="statement">
<valueString
value="define "Denominator Exclusion":
"Delivery Encounters with COVID and Respiratory Condition or Procedure""/>
</extension>
<extension url="displaySequence">
<valueInteger value="24"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Risk Variable Morbid Obesity"/>
</extension>
<extension url="statement">
<valueString
value="define "Risk Variable Morbid Obesity":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Morbid or Severe Obesity""/>
</extension>
<extension url="displaySequence">
<valueInteger value="25"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Risk Variable Preexisting Diabetes"/>
</extension>
<extension url="statement">
<valueString
value="define "Risk Variable Preexisting Diabetes":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Preexisting Diabetes""/>
</extension>
<extension url="displaySequence">
<valueInteger value="26"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Risk Variable Bariatric Surgery"/>
</extension>
<extension url="statement">
<valueString
value="define "Risk Variable Bariatric Surgery":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Bariatric Surgery""/>
</extension>
<extension url="displaySequence">
<valueInteger value="27"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SupplementalDataElements"/>
</extension>
<extension url="name">
<valueString value="SDE Race"/>
</extension>
<extension url="statement">
<valueString
value="define "SDE Race":
Patient.race R
return Tuple {
codes: R.ombCategory union R.detailed,
display: R.text
}"/>
</extension>
<extension url="displaySequence">
<valueInteger value="28"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="SDE Race"/>
</extension>
<extension url="statement">
<valueString
value="define "SDE Race":
SDE."SDE Race""/>
</extension>
<extension url="displaySequence">
<valueInteger value="29"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Risk Variable Placenta Previa"/>
</extension>
<extension url="statement">
<valueString
value="define "Risk Variable Placenta Previa":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Placenta Previa""/>
</extension>
<extension url="displaySequence">
<valueInteger value="30"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SupplementalDataElements"/>
</extension>
<extension url="name">
<valueString value="SDE Sex"/>
</extension>
<extension url="statement">
<valueString
value="define "SDE Sex":
case
when Patient.gender = 'male' then "M"
when Patient.gender = 'female' then "F"
else null
end"/>
</extension>
<extension url="displaySequence">
<valueInteger value="31"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="SDE Sex"/>
</extension>
<extension url="statement">
<valueString
value="define "SDE Sex":
SDE."SDE Sex""/>
</extension>
<extension url="displaySequence">
<valueInteger value="32"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Risk Variable Bleeding Disorder"/>
</extension>
<extension url="statement">
<valueString
value="define "Risk Variable Bleeding Disorder":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Bleeding Disorder""/>
</extension>
<extension url="displaySequence">
<valueInteger value="33"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString
value="Risk Variable First White Blood Cell Count Lab Test"/>
</extension>
<extension url="statement">
<valueString
value="//First resulted value 24 hours prior to start of encounter and before time of delivery
//Report white blood cell count as 10*3/uL
define "Risk Variable First White Blood Cell Count Lab Test":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
let FirstWBC: First(["USCoreLaboratoryResultObservationProfile": "White blood cells count lab test"] WBC
where WBC.issued during Interval[start of TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation() - 1440 minutes, TwentyWeeksPlusEncounter.lastTimeOfDelivery())
and WBC.status in { 'final', 'amended', 'corrected' }
and WBC.value is not null
sort by issued.earliest()
)
return {
EncounterId: TwentyWeeksPlusEncounter.id,
FirstWBCResult: FirstWBC.value as Quantity,
Timing: FirstWBC.issued
}"/>
</extension>
<extension url="displaySequence">
<valueInteger value="34"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Risk Variable First Hematocrit Lab Test"/>
</extension>
<extension url="statement">
<valueString
value="//First resulted value 24 hours prior to start of encounter and before time of delivery
//Report hematocrit as %
define "Risk Variable First Hematocrit Lab Test":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
let FirstHematocrit: First(["USCoreLaboratoryResultObservationProfile": "Hematocrit lab test"] Hematocrit
where Hematocrit.issued during Interval[start of TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation() - 1440 minutes, TwentyWeeksPlusEncounter.lastTimeOfDelivery())
and Hematocrit.status in { 'final', 'amended', 'corrected' }
and Hematocrit.value is not null
sort by issued.earliest()
)
return {
EncounterId: TwentyWeeksPlusEncounter.id,
FirstHematocritResult: FirstHematocrit.value as Quantity,
Timing: FirstHematocrit.issued
}"/>
</extension>
<extension url="displaySequence">
<valueInteger value="35"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Risk Variable Severe Preeclampsia"/>
</extension>
<extension url="statement">
<valueString
value="define "Risk Variable Severe Preeclampsia":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Severe Preeclampsia""/>
</extension>
<extension url="displaySequence">
<valueInteger value="36"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Risk Variable Anemia"/>
</extension>
<extension url="statement">
<valueString
value="define "Risk Variable Anemia":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Anemia""/>
</extension>
<extension url="displaySequence">
<valueInteger value="37"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Risk Variable Cardiac Disease"/>
</extension>
<extension url="statement">
<valueString
value="define "Risk Variable Cardiac Disease":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Cardiac Disease""/>
</extension>
<extension url="displaySequence">
<valueInteger value="38"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Risk Variable Long Term Anticoagulant Use"/>
</extension>
<extension url="statement">
<valueString
value="define "Risk Variable Long Term Anticoagulant Use":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Long Term Anticoagulant Use""/>
</extension>
<extension url="displaySequence">
<valueInteger value="39"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Risk Variable Systolic Blood Pressure"/>
</extension>
<extension url="statement">
<valueString
value="//First resulted value 24 hours prior to start of encounter and before time of delivery
//Report systolic blood pressure as mm[Hg]
//Systolic blood pressure value cannot be null per QICore profile requirement.
define "Risk Variable Systolic Blood Pressure":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
let FirstSystolicBP: First(["observation-bp"] BP
where BP.effective.earliest() during Interval[start of TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation() - 1440 minutes, TwentyWeeksPlusEncounter.lastTimeOfDelivery())
and BP.status in { 'final', 'amended', 'corrected' }
and BP.component.value is not null
sort by effective.earliest()
)
return {
EncounterId: TwentyWeeksPlusEncounter.id,
FirstSBPResult: FirstSystolicBP.component C
where C.code ~ "Systolic blood pressure"
return C.value as Quantity,
Timing: FirstSystolicBP.effective.earliest ( )
}"/>
</extension>
<extension url="displaySequence">
<valueInteger value="40"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Risk Variable Substance Abuse"/>
</extension>
<extension url="statement">
<valueString
value="define "Risk Variable Substance Abuse":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Substance Abuse""/>
</extension>
<extension url="displaySequence">
<valueInteger value="41"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Risk Variable Renal Disease"/>
</extension>
<extension url="statement">
<valueString
value="define "Risk Variable Renal Disease":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Renal Disease""/>
</extension>
<extension url="displaySequence">
<valueInteger value="42"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="PCMaternal"/>
</extension>
<extension url="name">
<valueString value="Variable Calculated Gestational Age"/>
</extension>
<extension url="statement">
<valueString
value="define "Variable Calculated Gestational Age":
// 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
"Delivery Encounter with Age Range" DeliveryEncounter
let CGA: DeliveryEncounter.calculatedGestationalAge()
// return { QualifyingEncounter, CGA }
return {
EncounterID: DeliveryEncounter.id,
CalculatedCGA: CGA
}"/>
</extension>
<extension url="displaySequence">
<valueInteger value="43"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="SDE Variable Calculated Gestational Age"/>
</extension>
<extension url="statement">
<valueString
value="define "SDE Variable Calculated Gestational Age":
//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.
PCMaternal."Variable Calculated Gestational Age""/>
</extension>
<extension url="displaySequence">
<valueInteger value="44"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Risk Variable Gastrointestinal Disease"/>
</extension>
<extension url="statement">
<valueString
value="define "Risk Variable Gastrointestinal Disease":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Gastrointestinal Disease""/>
</extension>
<extension url="displaySequence">
<valueInteger value="45"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString
value="Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions"/>
</extension>
<extension url="statement">
<valueString
value="define "Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions":
"Delivery Encounters with Severe Obstetric Complications Diagnosis or Procedure Excluding Blood Transfusion"
union "Delivery Encounters with Expiration""/>
</extension>
<extension url="displaySequence">
<valueInteger value="46"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString
value="Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions Only"/>
</extension>
<extension url="statement">
<valueString
value="define "Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions Only":
"Delivery Encounters with Severe Obstetric Complications"
intersect "Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions""/>
</extension>
<extension url="displaySequence">
<valueInteger value="47"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Risk Variable Pulmonary Hypertension"/>
</extension>
<extension url="statement">
<valueString
value="define "Risk Variable Pulmonary Hypertension":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Pulmonary Hypertension""/>
</extension>
<extension url="displaySequence">
<valueInteger value="48"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Risk Variable Thyrotoxicosis"/>
</extension>
<extension url="statement">
<valueString
value="define "Risk Variable Thyrotoxicosis":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Thyrotoxicosis""/>
</extension>
<extension url="displaySequence">
<valueInteger value="49"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Risk Variable Other Preeclampsia"/>
</extension>
<extension url="statement">
<valueString
value="define "Risk Variable Other Preeclampsia":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Mild or Moderate Preeclampsia""/>
</extension>
<extension url="displaySequence">
<valueInteger value="50"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Initial Population"/>
</extension>
<extension url="statement">
<valueString
value="define "Initial Population":
PCMaternal."Delivery Encounter with Age Range""/>
</extension>
<extension url="displaySequence">
<valueInteger value="51"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Risk Variable Economic Housing Instability"/>
</extension>
<extension url="statement">
<valueString
value="define "Risk Variable Economic Housing Instability":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Economic Housing Instability""/>
</extension>
<extension url="displaySequence">
<valueInteger value="52"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Risk Variable HIV"/>
</extension>
<extension url="statement">
<valueString
value="define "Risk Variable HIV":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "HIV in Pregnancy Childbirth and Puerperium""/>
</extension>
<extension url="displaySequence">
<valueInteger value="53"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString
value="SOC Excluding Blood Transfusions Only with Hysterectomy or Blood Transfusion with Placenta Increta or Placenta Percreta Without Additional SOC"/>
</extension>
<extension url="statement">
<valueString
value="define "SOC Excluding Blood Transfusions Only with Hysterectomy or Blood Transfusion with Placenta Increta or Placenta Percreta Without Additional SOC":
( "Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions Only" SOCExcludingTransfusion
where exists ( ( SOCExcludingTransfusion.encounterDiagnosis ( ) ) EncounterDiagnoses
where EncounterDiagnoses.code in "Placenta Increta or Percreta"
)
and ( exists "Delivery Encounters with Blood Transfusion"
or exists "Delivery Encounters with Hysterectomy"
)
)
//The following logic keeps encounter in the numerator if there is an additional SOC besides Blood Transfusion or Hysterectomy
except ( ( "Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions Only" SOCExcludingTransfusion
where SOCExcludingTransfusion.pOAIsNoOrUTD ( ) in "Severe Maternal Morbidity Diagnoses"
)
union "Delivery Encounters with Cardiac Conversion, Tracheostomy or Ventilation Procedures"
union "Delivery Encounters with Expiration"
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="54"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Risk Variable Heart Rate"/>
</extension>
<extension url="statement">
<valueString
value="//First resulted value 24 hours prior to start of encounter and before time of delivery
//Report heart rate as beats/min
//Heart rate value cannot be null per QICore profile requirement.
define "Risk Variable Heart Rate":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
let FirstHeartRate: First(["observation-heartrate"] HeartRate
where HeartRate.effective.earliest() during Interval[start of TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation() - 1440 minutes, TwentyWeeksPlusEncounter.lastTimeOfDelivery())
and HeartRate.status in { 'final', 'amended', 'corrected' }
sort by effective.earliest()
)
return {
EncounterId: TwentyWeeksPlusEncounter.id,
FirstHRResult: FirstHeartRate.value as Quantity,
Timing: FirstHeartRate.effective.earliest ( )
}"/>
</extension>
<extension url="displaySequence">
<valueInteger value="55"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Risk Variable Maternal Age"/>
</extension>
<extension url="statement">
<valueString
value="define "Risk Variable Maternal Age":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
let MaternalAge: AgeInYearsAt(date from start of TwentyWeeksPlusEncounter.period)
return { TwentyWeeksPlusEncounter, MaternalAge }"/>
</extension>
<extension url="displaySequence">
<valueInteger value="56"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Risk Variable Mental Health Disorder"/>
</extension>
<extension url="statement">
<valueString
value="define "Risk Variable Mental Health Disorder":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Mental Health Disorder""/>
</extension>
<extension url="displaySequence">
<valueInteger value="57"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Risk Variable Obstetrical VTE"/>
</extension>
<extension url="statement">
<valueString
value="define "Risk Variable Obstetrical VTE":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Venous Thromboembolism in Pregnancy""/>
</extension>
<extension url="displaySequence">
<valueInteger value="58"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Risk Variable Autoimmune Disease"/>
</extension>
<extension url="statement">
<valueString
value="define "Risk Variable Autoimmune Disease":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Autoimmune Disease""/>
</extension>
<extension url="displaySequence">
<valueInteger value="59"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Risk Variable Previous Cesarean"/>
</extension>
<extension url="statement">
<valueString
value="define "Risk Variable Previous Cesarean":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Previous Cesarean""/>
</extension>
<extension url="displaySequence">
<valueInteger value="60"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Risk Variable Gestational Diabetes"/>
</extension>
<extension url="statement">
<valueString
value="define "Risk Variable Gestational Diabetes":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Gestational Diabetes""/>
</extension>
<extension url="displaySequence">
<valueInteger value="61"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Risk Variable Multiple Pregnancy"/>
</extension>
<extension url="statement">
<valueString
value="define "Risk Variable Multiple Pregnancy":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Multiple Pregnancy""/>
</extension>
<extension url="displaySequence">
<valueInteger value="62"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="Denominator"/>
</extension>
<extension url="statement">
<valueString
value="define "Denominator":
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation""/>
</extension>
<extension url="displaySequence">
<valueInteger value="63"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SupplementalDataElements"/>
</extension>
<extension url="name">
<valueString value="SDE Ethnicity"/>
</extension>
<extension url="statement">
<valueString
value="define "SDE Ethnicity":
Patient.ethnicity E
return Tuple {
codes: { E.ombCategory } union E.detailed,
display: E.text
}"/>
</extension>
<extension url="displaySequence">
<valueInteger value="64"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="SDE Ethnicity"/>
</extension>
<extension url="statement">
<valueString
value="define "SDE Ethnicity":
SDE."SDE Ethnicity""/>
</extension>
<extension url="displaySequence">
<valueInteger value="65"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="PCMaternal"/>
</extension>
<extension url="name">
<valueString value="hospitalizationWithEDOBTriageObservation"/>
</extension>
<extension url="statement">
<valueString
value="/*define function "HospitalizationWithEDOBTriageObservation"(Encounter Encounter ):
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
Encounter Visit
let ObsVisit: Last(["Encounter": "Observation Services"] LastObs
where LastObs.period ends 1 hour or less on or before start of Visit.period
and LastObs.status = 'finished'
sort by
end of period
),
VisitStart: Coalesce(start of ObsVisit.period, start of Visit.period),
EDOBTriageVisit: Last(["Encounter": "ED Visit and OB Triage"] LastEDOBTriage
where LastEDOBTriage.period ends 1 hour or less on or before VisitStart
and LastEDOBTriage.status = 'finished'
sort by
end of period
)
return Interval[Coalesce(start of EDOBTriageVisit.period, VisitStart),
end of Visit.period]*/
define fluent function hospitalizationWithEDOBTriageObservation (TheEncounter Encounter ):
/*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*/
TheEncounter Visit
let ObsVisit: Last(["Encounter": "Observation Services"] LastObs
where LastObs.period ends 1 hour or less on or before start of Visit.period
and LastObs.status = 'finished'
sort by
end of period
),
VisitStart: Coalesce(start of ObsVisit.period, start of Visit.period),
EDOBTriageVisit: Last(["Encounter": "ED Visit and OB Triage"] LastEDOBTriage
where LastEDOBTriage.period ends 1 hour or less on or before VisitStart
and LastEDOBTriage.status = 'finished'
sort by
end of period
)
return Interval[Coalesce(start of EDOBTriageVisit.period, VisitStart),
end of Visit.period]"/>
</extension>
<extension url="displaySequence">
<valueInteger value="66"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="PCMaternal"/>
</extension>
<extension url="name">
<valueString value="calculatedGestationalAge"/>
</extension>
<extension url="statement">
<valueString
value="define fluent function calculatedGestationalAge (TheEncounter Encounter ):
//Gestational Age = (280-(Estimated Delivery Date minus Reference Date/Delivery Date))/7
( 280 - ( difference in days between TheEncounter.lastTimeOfDelivery () and TheEncounter.lastEstimatedDeliveryDate( )) ) div 7"/>
</extension>
<extension url="displaySequence">
<valueInteger value="67"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="PCMaternal"/>
</extension>
<extension url="name">
<valueString value="lastTimeOfDelivery"/>
</extension>
<extension url="statement">
<valueString
value="define fluent function lastTimeOfDelivery (TheEncounter Encounter ):
Last(["Observation": "Date and time of obstetric delivery"] TimeOfDelivery
where TimeOfDelivery.value as DateTime is not null
and TimeOfDelivery.status in { 'final', 'amended', 'corrected' }
and TimeOfDelivery.effective.earliest () during TheEncounter.hospitalizationWithEDOBTriageObservation ()
and TimeOfDelivery.value as DateTime during TheEncounter.hospitalizationWithEDOBTriageObservation()
sort by effective.earliest()
).value as DateTime"/>
</extension>
<extension url="displaySequence">
<valueInteger value="68"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="QICoreCommon"/>
</extension>
<extension url="name">
<valueString value="earliest"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Given an interval, return the starting point if the interval has a starting boundary specified,
otherwise, return the ending point
*/
define fluent function earliest(choice Choice<DateTime, Quantity, Interval<DateTime>, Interval<Quantity>> ):
(choice.toInterval()) period
return
if (period."hasStart"()) then start of period
else end of period"/>
</extension>
<extension url="displaySequence">
<valueInteger value="69"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="PCMaternal"/>
</extension>
<extension url="name">
<valueString value="lastEstimatedDeliveryDate"/>
</extension>
<extension url="statement">
<valueString
value="/*===============================================================*/
/* 03/14/2022 from MATGlobalCommonFunctionsv7.000 - latest QDM */
/* even though this PCMaternalFHIR was derived from */
/* PCMaternal=2.1.000 cql, to make next update easier. */
/* Will need to re-insert "Global". in front of these */
/* function names later (whereever they are directly used.*/
define fluent function lastEstimatedDeliveryDate (TheEncounter Encounter ):
/*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.*/
Last(["Observation": "Delivery date Estimated"] EstimatedDateOfDelivery
where EstimatedDateOfDelivery.value as DateTime is not null
and EstimatedDateOfDelivery.status in { 'final', 'amended', 'corrected' }
and EstimatedDateOfDelivery.effective.earliest ( ) 42 weeks or less before or on TheEncounter.lastTimeOfDelivery ()
sort by effective.earliest ( )
).value as DateTime"/>
</extension>
<extension url="displaySequence">
<valueInteger value="70"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="PCMaternal"/>
</extension>
<extension url="name">
<valueString value="lastEstimatedGestationalAge"/>
</extension>
<extension url="statement">
<valueString
value="/*define fluent function lastEstimatedGestationalAge (TheEncounter Encounter ):
Last(["Observation": "Estimated Gestational Age at Delivery"] EstimatedGestationalAge
where EstimatedGestationalAge.value is not null
and EstimatedGestationalAge.status in { 'final', 'amended', 'corrected' }
and EstimatedGestationalAge.effective.earliest() 24 hours or less before or on TheEncounter.lastTimeOfDelivery ()
sort by effective.earliest ()
).value as Quantity*/
define fluent function lastEstimatedGestationalAge (TheEncounter Encounter ):
Last(["Observation": "Estimated Gestational Age at Delivery"] EstimatedGestationalAge
let EGATiming: EstimatedGestationalAge.effective.earliest() where
(EGATiming 24 hours or less before or on TheEncounter.lastTimeOfDelivery ()
and EstimatedGestationalAge.value is not null
and EstimatedGestationalAge.status in { 'final', 'amended', 'corrected' }) or
(EGATiming same day as TheEncounter.lastTimeOfDelivery ()
and EGATiming during TheEncounter.hospitalizationWithEDOBTriageObservation()
and EstimatedGestationalAge.value is not null)
sort by effective.earliest ())
.value as Quantity"/>
</extension>
<extension url="displaySequence">
<valueInteger value="71"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="CQMCommon"/>
</extension>
<extension url="name">
<valueString value="encounterDiagnosis"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Returns the Condition resources referenced by the diagnosis element of the Encounter
*/
define fluent function encounterDiagnosis(Encounter Encounter ):
Encounter.diagnosis D
return singleton from ([Condition] C where C.id = D.condition.reference.getId())"/>
</extension>
<extension url="displaySequence">
<valueInteger value="72"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="QICoreCommon"/>
</extension>
<extension url="name">
<valueString value="getId"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Returns the tail of the given uri (i.e. everything after the last slash in the URI).
@comment: This function can be used to determine the logical id of a given resource. It can be used in
a single-server environment to trace references. However, this function does not attempt to resolve
or distinguish the base of the given url, and so cannot be used safely in multi-server environments.
*/
define fluent function getId(uri String):
Last(Split(uri, '/'))"/>
</extension>
<extension url="displaySequence">
<valueInteger value="73"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="pOAIsYesOrExempt"/>
</extension>
<extension url="statement">
<valueString
value="define fluent function pOAIsYesOrExempt(TheEncounter Encounter):
TheEncounter.diagnosis EncounterDiagnoses
where EncounterDiagnoses.diagnosisPresentOnAdmission in "Present On Admission is Yes or Exempt"
return EncounterDiagnoses.condition.getCondition ( ).code"/>
</extension>
<extension url="displaySequence">
<valueInteger value="74"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="FHIRHelpers"/>
</extension>
<extension url="name">
<valueString value="ToString"/>
</extension>
<extension url="statement">
<valueString
value="define function ToString(value uri): value.value"/>
</extension>
<extension url="displaySequence">
<valueInteger value="75"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="CQMCommon"/>
</extension>
<extension url="name">
<valueString value="getCondition"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Returns the Condition resource for the given reference
*/
define fluent function getCondition(reference Reference):
singleton from ([Condition] C where C.id = reference.reference.getId())"/>
</extension>
<extension url="displaySequence">
<valueInteger value="76"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SevereObstetricComplicationsFHIR"/>
</extension>
<extension url="name">
<valueString value="pOAIsNoOrUTD"/>
</extension>
<extension url="statement">
<valueString
value="/*define function "FirstLabTestWithEncounterId"(LabList List<Observation>, CCDE String ):
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
let FirstLab: First(LabList Lab
//(first resulted value 24 hours prior to start of encounter and before time of delivery)
where Lab.issued.earliest() during Interval[start of TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation()- 1440 minutes, TwentyWeeksPlusEncounter.lastTimeOfDelivery())
and Lab.status in {'final', 'amended', 'corrected'}
and Lab.value is not null
sort by issued.earliest())
return {
EncounterId: TwentyWeeksPlusEncounter.id,
FirstResult: FirstLab.value as Quantity,
Timing: FirstLab.issued
}
define function "FirstPhysicalExamWithEncounterId"(ExamList List<Observation>, CCDE String):
"Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
let FirstExam: First(ExamList Exam
where Exam.effective.earliest() during Interval[start of TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation()- 1440 minutes, TwentyWeeksPlusEncounter.lastTimeOfDelivery())
and Exam.status in {'final', 'amended', 'corrected'}
and Exam.value is not null
sort by effective.earliest() )
return {
EncounterId: TwentyWeeksPlusEncounter.id,
FirstResult: FirstExam.value as Quantity,
Timing: FirstExam.effective.earliest()
}
define "Risk Variable Lab and Physical Exam Results":
flatten{
// First physical exams (vital signs): Report heart rate as {beats}/min, systolic blood pressure as mm[Hg]
"FirstPhysicalExamWithEncounterId"([Observation: "Heart rate"], 'FirstHeartRate'),
"FirstPhysicalExamWithEncounterId"([Observation: "Systolic blood pressure"], 'FirstSystolicBP'),
//First lab tests: Report hematocrit as %, white blood cell count as 10*3/uL
"FirstLabTestWithEncounterId"([Observation: "Hematocrit lab test"], 'FirstHematocrit'),
"FirstLabTestWithEncounterId"([Observation: "White blood cells count lab test"], 'FirstWhiteBloodCell')
}*/
define fluent function pOAIsNoOrUTD(TheEncounter Encounter):
TheEncounter.diagnosis EncounterDiagnoses
where EncounterDiagnoses.diagnosisPresentOnAdmission in "Present on Admission is No or Unable To Determine"
return EncounterDiagnoses.condition.getCondition ( ).code"/>
</extension>
<extension url="displaySequence">
<valueInteger value="77"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="FHIRHelpers"/>
</extension>
<extension url="name">
<valueString value="ToCode"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Converts the given FHIR [Coding](https://hl7.org/fhir/datatypes.html#Coding) value to a CQL Code.
*/
define function ToCode(coding FHIR.Coding):
if coding is null then
null
else
System.Code {
code: coding.code.value,
system: coding.system.value,
version: coding.version.value,
display: coding.display.value
}"/>
</extension>
<extension url="displaySequence">
<valueInteger value="78"/>
</extension>
</extension>
<name value="EffectiveDataRequirements"/>
<status value="active"/>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/library-type"/>
<code value="module-definition"/>
</coding>
</type>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library PCMaternal"/>
<resource value="Library/PCMaternal|5.19.000"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library CQMCommon"/>
<resource value="Library/CQMCommon|2.2.000"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library FHIRHelpers"/>
<resource value="Library/FHIRHelpers|4.4.000"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library QICoreCommon"/>
<resource value="Library/QICoreCommon|2.1.000"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library SDE"/>
<resource value="Library/SupplementalDataElements|3.5.000"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Code system LOINC"/>
<resource value="http://loinc.org"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Code system AdministrativeGender"/>
<resource value="http://hl7.org/fhir/administrative-gender"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Encounter Inpatient"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Delivery Procedures"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.59"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Observation Services"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.143"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set ED Visit and OB Triage"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.369"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Estimated Gestational Age at Delivery"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.26"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set 20 to 42 Plus Weeks Gestation"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.67"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Present On Admission is Yes or Exempt"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.63"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Acute or Persistent Asthma"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.271"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Placenta Accreta"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.302"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Placenta Increta or Percreta"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.388"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Neuromuscular Disease"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.308"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Hypertension"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.332"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display
value="Value set Present on Admission is No or Unable To Determine"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.370"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Severe Maternal Morbidity Diagnoses"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.255"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Severe Maternal Morbidity Procedures"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.256"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Patient Expired"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.309"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Blood Transfusion"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.213"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Hysterectomy"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.358"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Conversion of Cardiac Rhythm"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.357"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Tracheostomy"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.359"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Ventilation"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.360"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Preterm Birth"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.299"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Payer Type"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Placental Abruption"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.305"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set COVID 19 Confirmed"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.373"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display
value="Value set Respiratory Conditions Related to COVID 19"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.376"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display
value="Value set Respiratory Support Procedures Related to COVID 19"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.379"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Morbid or Severe Obesity"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.290"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Preexisting Diabetes"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.275"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Bariatric Surgery"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.317"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Placenta Previa"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.78"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Bleeding Disorder"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.287"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set White blood cells count lab test"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.129"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Hematocrit lab test"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.114"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Severe Preeclampsia"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.327"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Anemia"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.323"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Cardiac Disease"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.341"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Long Term Anticoagulant Use"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.366"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Substance Abuse"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.320"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Renal Disease"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.335"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Gastrointestinal Disease"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.338"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Pulmonary Hypertension"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.281"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Thyrotoxicosis"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.296"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Mild or Moderate Preeclampsia"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.329"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Economic Housing Instability"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.292"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display
value="Value set HIV in Pregnancy Childbirth and Puerperium"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.272"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Mental Health Disorder"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.314"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Venous Thromboembolism in Pregnancy"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.363"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Autoimmune Disease"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.311"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Previous Cesarean"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.278"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Gestational Diabetes"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.269"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Multiple Pregnancy"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.284"/>
</relatedArtifact>
<parameter>
<name value="Measurement Period"/>
<use value="in"/>
<min value="0"/>
<max value="1"/>
<type value="Period"/>
</parameter>
<parameter>
<name value="Risk Variable Asthma"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Resource"/>
</parameter>
<parameter>
<name value="Risk Variable Placental Accreta Spectrum"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Resource"/>
</parameter>
<parameter>
<name value="Risk Variable Neuromuscular"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Resource"/>
</parameter>
<parameter>
<name value="Risk Variable Hypertension"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Resource"/>
</parameter>
<parameter>
<name
value="SOC with Hysterectomy or Blood Transfusion with Placenta Increta or Placenta Percreta Without Additional SOC"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Resource"/>
</parameter>
<parameter>
<name value="Risk Variable Preterm Birth"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Resource"/>
</parameter>
<parameter>
<name value="SDE Payer"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Resource"/>
</parameter>
<parameter>
<name value="Risk Variable Placental Abruption"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Resource"/>
</parameter>
<parameter>
<name value="Denominator Exclusion"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Resource"/>
</parameter>
<parameter>
<name value="Risk Variable Morbid Obesity"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Resource"/>
</parameter>
<parameter>
<name value="Risk Variable Preexisting Diabetes"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Resource"/>
</parameter>
<parameter>
<name value="Risk Variable Bariatric Surgery"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Resource"/>
</parameter>
<parameter>
<name value="SDE Race"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="Resource"/>
</parameter>
<parameter>
<name value="Risk Variable Placenta Previa"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Resource"/>
</parameter>
<parameter>
<name value="SDE Sex"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="Coding"/>
</parameter>
<parameter>
<name value="Risk Variable Bleeding Disorder"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Resource"/>
</parameter>
<parameter>
<name value="Risk Variable First White Blood Cell Count Lab Test"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Resource"/>
</parameter>
<parameter>
<name value="Risk Variable First Hematocrit Lab Test"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Resource"/>
</parameter>
<parameter>
<name
value="Delivery Encounters with Severe Obstetric Complications"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Resource"/>
</parameter>
<parameter>
<name value="Risk Variable Severe Preeclampsia"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Resource"/>
</parameter>
<parameter>
<name value="Risk Variable Anemia"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Resource"/>
</parameter>
<parameter>
<name value="Risk Variable Cardiac Disease"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Resource"/>
</parameter>
<parameter>
<name value="Risk Variable Long Term Anticoagulant Use"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Resource"/>
</parameter>
<parameter>
<name value="Risk Variable Systolic Blood Pressure"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Resource"/>
</parameter>
<parameter>
<name value="Risk Variable Substance Abuse"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Resource"/>
</parameter>
<parameter>
<name value="Risk Variable Renal Disease"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Resource"/>
</parameter>
<parameter>
<name value="SDE Variable Calculated Gestational Age"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Resource"/>
</parameter>
<parameter>
<name value="Risk Variable Gastrointestinal Disease"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Resource"/>
</parameter>
<parameter>
<name
value="Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions Only"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Resource"/>
</parameter>
<parameter>
<name value="Risk Variable Pulmonary Hypertension"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Resource"/>
</parameter>
<parameter>
<name value="Risk Variable Thyrotoxicosis"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Resource"/>
</parameter>
<parameter>
<name value="Risk Variable Other Preeclampsia"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Resource"/>
</parameter>
<parameter>
<name value="Initial Population"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Resource"/>
</parameter>
<parameter>
<name value="Risk Variable Economic Housing Instability"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Resource"/>
</parameter>
<parameter>
<name value="Risk Variable HIV"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Resource"/>
</parameter>
<parameter>
<name
value="SOC Excluding Blood Transfusions Only with Hysterectomy or Blood Transfusion with Placenta Increta or Placenta Percreta Without Additional SOC"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Resource"/>
</parameter>
<parameter>
<name value="Risk Variable Heart Rate"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Resource"/>
</parameter>
<parameter>
<name value="Risk Variable Maternal Age"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Resource"/>
</parameter>
<parameter>
<name value="Risk Variable Mental Health Disorder"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Resource"/>
</parameter>
<parameter>
<name value="Risk Variable Obstetrical VTE"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Resource"/>
</parameter>
<parameter>
<name value="Risk Variable Autoimmune Disease"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Resource"/>
</parameter>
<parameter>
<name value="Risk Variable Previous Cesarean"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Resource"/>
</parameter>
<parameter>
<name value="Risk Variable Gestational Diabetes"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Resource"/>
</parameter>
<parameter>
<name value="Risk Variable Multiple Pregnancy"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Resource"/>
</parameter>
<parameter>
<name value="Denominator"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Resource"/>
</parameter>
<parameter>
<name value="Delivery Encounters with Blood Transfusion"/>
<use value="out"/>
<min value="0"/>
<max value="*"/>
<type value="Resource"/>
</parameter>
<parameter>
<name value="SDE Ethnicity"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="Resource"/>
</parameter>
<dataRequirement>
<type value="Encounter"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"/>
<mustSupport value="type"/>
<mustSupport value="period"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="condition"/>
<mustSupport value="condition.reference"/>
<mustSupport value="condition.reference.value"/>
<mustSupport value="extension"/>
<mustSupport value="condition.code"/>
<mustSupport value="hospitalization"/>
<mustSupport value="hospitalization.dischargeDisposition"/>
<mustSupport value="id"/>
<mustSupport value="id.value"/>
<codeFilter>
<path value="type"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.143"/>
</codeFilter>
<codeFilter>
<path value="status.value"/>
<code>
<code value="finished"/>
</code>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Encounter"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"/>
<mustSupport value="type"/>
<mustSupport value="period"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="condition"/>
<mustSupport value="condition.reference"/>
<mustSupport value="condition.reference.value"/>
<mustSupport value="extension"/>
<mustSupport value="condition.code"/>
<mustSupport value="hospitalization"/>
<mustSupport value="hospitalization.dischargeDisposition"/>
<mustSupport value="id"/>
<mustSupport value="id.value"/>
<codeFilter>
<path value="type"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.369"/>
</codeFilter>
<codeFilter>
<path value="status.value"/>
<code>
<code value="finished"/>
</code>
</codeFilter>
<dateFilter>
<path value="period"/>
<valuePeriod>
<extension url="http://hl7.org/fhir/uv/crmi-analysisException">
<valueString
value="Error attempting to determine filter value: toFhirValue not implemented for Subtract"/>
</extension>
</valuePeriod>
</dateFilter>
</dataRequirement>
<dataRequirement>
<type value="Encounter"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"/>
<mustSupport value="type"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="period"/>
<mustSupport value="condition"/>
<mustSupport value="condition.reference"/>
<mustSupport value="condition.reference.value"/>
<mustSupport value="extension"/>
<mustSupport value="condition.code"/>
<mustSupport value="hospitalization"/>
<mustSupport value="hospitalization.dischargeDisposition"/>
<mustSupport value="id"/>
<mustSupport value="id.value"/>
<codeFilter>
<path value="type"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307"/>
</codeFilter>
<codeFilter>
<path value="status.value"/>
<code>
<code value="finished"/>
</code>
</codeFilter>
<dateFilter>
<path value="period"/>
<valuePeriod>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-expression">
<valueExpression>
<language value="text/cql-identifier"/>
<expression value="Measurement Period"/>
</valueExpression>
</extension>
</valuePeriod>
</dateFilter>
</dataRequirement>
<dataRequirement>
<type value="Patient"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"/>
<mustSupport value="race"/>
<mustSupport value="ethnicity"/>
</dataRequirement>
<dataRequirement>
<type value="Procedure"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure"/>
<mustSupport value="code"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="performed"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.59"/>
</codeFilter>
<codeFilter>
<path value="status.value"/>
<code>
<code value="completed"/>
</code>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Procedure"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure"/>
<mustSupport value="code"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="performed"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.256"/>
</codeFilter>
<codeFilter>
<path value="status.value"/>
<code>
<code value="completed"/>
</code>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Procedure"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure"/>
<mustSupport value="code"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="performed"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.358"/>
</codeFilter>
<codeFilter>
<path value="status.value"/>
<code>
<code value="completed"/>
</code>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Procedure"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure"/>
<mustSupport value="code"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="performed"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.357"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Procedure"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure"/>
<mustSupport value="code"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="performed"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.359"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Procedure"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure"/>
<mustSupport value="code"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="performed"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.360"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Procedure"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure"/>
<mustSupport value="code"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="performed"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.379"/>
</codeFilter>
<codeFilter>
<path value="status.value"/>
<code>
<code value="completed"/>
</code>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Procedure"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure"/>
<mustSupport value="code"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="performed"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.213"/>
</codeFilter>
<codeFilter>
<path value="status.value"/>
<code>
<code value="completed"/>
</code>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Observation"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation"/>
<mustSupport value="code"/>
<mustSupport value="value"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="effective"/>
<codeFilter>
<path value="code"/>
<code>
<system value="http://loinc.org"/>
<code value="93857-1"/>
<display value="Date and time of obstetric delivery"/>
</code>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Observation"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation"/>
<mustSupport value="code"/>
<mustSupport value="value"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="effective"/>
<codeFilter>
<path value="code"/>
<code>
<system value="http://loinc.org"/>
<code value="11778-8"/>
<display value="Delivery date Estimated"/>
</code>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Observation"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation"/>
<mustSupport value="code"/>
<mustSupport value="effective"/>
<mustSupport value="value"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.26"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Condition"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition"/>
<mustSupport value="id"/>
<mustSupport value="id.value"/>
<mustSupport value="code"/>
</dataRequirement>
<dataRequirement>
<type value="Coverage"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-coverage"/>
<mustSupport value="type"/>
<mustSupport value="period"/>
<codeFilter>
<path value="type"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Observation"/>
<profile
value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab"/>
<mustSupport value="code"/>
<mustSupport value="issued"/>
<mustSupport value="issued.value"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="value"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.129"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Observation"/>
<profile
value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab"/>
<mustSupport value="code"/>
<mustSupport value="issued"/>
<mustSupport value="issued.value"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="value"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.114"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Observation"/>
<profile value="http://hl7.org/fhir/StructureDefinition/bp"/>
<mustSupport value="effective"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="component"/>
</dataRequirement>
<dataRequirement>
<type value="Observation"/>
<profile value="http://hl7.org/fhir/StructureDefinition/heartrate"/>
<mustSupport value="effective"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="value"/>
</dataRequirement>
</Library>
</contained>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-supplementalDataGuidance" id="supplementalDataGuidance">
<extension url="guidance">
<valueString
value="For every patient evaluated by this measure also identify payer, race, ethnicity, sex, variable calculated gestational age, SOC diagnosis details, and SOC procedure details
"/>
</extension>
<extension url="usage">
<valueCodeableConcept>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="supplemental-data"/>
<display value="Supplemental Data"/>
</coding>
<text value="Supplemental Data Guidance"/>
</valueCodeableConcept>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-supplementalDataGuidance" id="riskAdjustmentVariableGuidance">
<extension url="guidance">
<valueString
value="The Severe Obstetric Complications Risk Adjustment Methodology Report is available on the eCQI Resource Center (https://ecqi.healthit.gov).
Pre-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).
- Anemia (includes sickle cell disease)
- Asthma
- Autoimmune Disease
- Bariatric Surgery
- Bleeding Disorder
- Cardiac Disease
- Economic Housing Instability
- Gastrointestinal Disease
- Gestational Diabetes
- HIV
- Hypertension
- Long-term Anticoagulant Use
- Maternal Age (derived from birthdate)
- Mental Health Disorder
- Morbid Obesity
- Multiple Pregnancy
- Neuromuscular Disease
- Obstetric VTE
- Other Pre-eclampsia
- Placenta Previa
- Placental Abruption
- Placental Accreta Spectrum
- Pre-existing Diabetes
- Preterm Birth
- Previous Cesarean
- Pulmonary Hypertension
- Renal Disease
- Severe Pre-eclampsia
- Substance Abuse
- Thyrotoxicosis
Lab and Physical Exam Results:
Report the first resulted value 24 hours prior to start of encounter and before time of delivery in UCUM units specified:
- Heart rate: {beats}/min
- Systolic blood pressure: mm[Hg]
- Hematocrit: %
- White blood cell count: 10*3/uL
Note 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."/>
</extension>
<extension url="usage">
<valueCodeableConcept>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
<display value="Risk Adjustment Factor"/>
</coding>
<text value="Risk Adjustment Variable Guidance"/>
</valueCodeableConcept>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-softwaresystem">
<valueReference>
<reference value="Device/cqf-tooling"/>
</valueReference>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-effectiveDataRequirements" id="effective-data-requirements">
<valueReference>
<reference value="#effective-data-requirements"/>
</valueReference>
</extension>
<url
value="https://madie.cms.gov/Measure/SevereObstetricComplicationsFHIR"/>
<identifier>
<use value="usual"/>
<type>
<coding>
<system
value="http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type"/>
<code value="short-name"/>
</coding>
</type>
<system value="https://madie.cms.gov/measure/shortName"/>
<value value="CMS1028FHIR"/>
</identifier>
<identifier>
<use value="official"/>
<type>
<coding>
<system
value="http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type"/>
<code value="version-independent"/>
</coding>
</type>
<system value="urn:ietf:rfc:3986"/>
<value value="urn:uuid:6cf03fe2-b962-4f83-ac37-26d7477183c7"/>
</identifier>
<identifier>
<use value="official"/>
<type>
<coding>
<system
value="http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type"/>
<code value="version-specific"/>
</coding>
</type>
<system value="urn:ietf:rfc:3986"/>
<value value="urn:uuid:3efa7f95-1d8e-45fa-af68-023d3554e8c1"/>
</identifier>
<identifier>
<use value="official"/>
<type>
<coding>
<system
value="http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type"/>
<code value="publisher"/>
</coding>
</type>
<system value="https://madie.cms.gov/measure/cmsId"/>
<value value="1028FHIR"/>
<assigner>
<display value="CMS"/>
</assigner>
</identifier>
<version value="0.1.000"/>
<name value="SevereObstetricComplicationsFHIR"/>
<title value="Severe Obstetric ComplicationsFHIR"/>
<status value="draft"/>
<experimental value="true"/>
<date value="2024-12-18T21:25:49+00:00"/>
<publisher value="The Joint Commission"/>
<contact>
<telecom>
<system value="url"/>
<value value="https://www.jointcommission.org/"/>
</telecom>
</contact>
<description
value="Patients with severe obstetric complications that occur during the inpatient delivery hospitalization"/>
<purpose value="UNKNOWN"/>
<usage
value="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:
1. The GA is calculated using the American College of Obstetricians and Gynecologists ReVITALize guidelines.*
2. 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.
3. 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.
Wherever 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.
*ACOG ReVITALize Guidelines for Calculating Gestational Age (ACOG, 2014):
Gestational Age = (280-(Estimated Due Date minus Reference Date))/7
--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)
--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.
Note 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.
Definition:
For 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).
This eCQM is an episode-based measure. An episode is defined as each inpatient hospitalization or encounter that ends during the measurement period.
This FHIR-based measure has been derived from the QDM-based measure CMS1028v3.
Please refer to the HL7 QI-Core Implementation Guide (https://hl7.org/fhir/us/qicore/STU4.1.1/) for more information on QI-Core and mapping recommendations from QDM to QI-Core 4.1.1 (https://hl7.org/fhir/us/qicore/STU4.1.1/qdm-to-qicore.html)."/>
<copyright
value="Measure specifications are in the Public Domain.
LOINC(R) copyright 2004-2023 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2023 International Health Terminology Standards Development Organisation. ICD-10 copyright 2023 World Health Organization. All Rights Reserved."/>
<effectivePeriod>
<start value="2025-01-01"/>
<end value="2025-12-31"/>
</effectivePeriod>
<author>
<name value="The Joint Commission"/>
<telecom>
<system value="url"/>
<value value="https://www.jointcommission.org/"/>
</telecom>
</author>
<author>
<name value="Centers for Medicare & Medicaid Services (CMS)"/>
<telecom>
<system value="url"/>
<value value="https://www.cms.gov/"/>
</telecom>
</author>
<author>
<name
value="Yale New Haven Health Service Corporation/ Center for Outcomes Research and Evaluation"/>
<telecom>
<system value="url"/>
<value value="https://medicine.yale.edu/core/"/>
</telecom>
</author>
<library
value="https://madie.cms.gov/Library/SevereObstetricComplicationsFHIR"/>
<disclaimer
value="These performance measures are not clinical guidelines and do not establish a standard of medical care, and have not been tested for all potential applications. The measures and specifications are provided without warranty."/>
<scoring>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/measure-scoring"/>
<code value="proportion"/>
<display value="Proportion"/>
</coding>
</scoring>
<rationale
value="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).
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."/>
<clinicalRecommendationStatement
value="Healthy People 2030 Measure (MICH-05): Reduce severe maternal complications identified during delivery hospitalizations (U.S. Department of Health and Human Services, n.d.).
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)."/>
<group id="64efa90856d636294b157c9a">
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring">
<valueCodeableConcept>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-scoring"/>
<code value="proportion"/>
<display value="Proportion"/>
</coding>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis">
<valueCode value="Encounter"/>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-type">
<valueCodeableConcept>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/measure-type"/>
<code value="outcome"/>
<display value="Outcome"/>
</coding>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-rateAggregation">
<valueCode
value="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"/>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-improvementNotation">
<valueCodeableConcept>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-improvement-notation"/>
<code value="decrease"/>
<display value="Decreased score indicates improvement"/>
</coding>
</valueCodeableConcept>
</extension>
<description value="All Severe Obstetric Complications (SOC)"/>
<population id="8D56845B-BA26-4F6A-8D23-BBFD696C9450">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="initial-population"/>
<display value="Initial Population"/>
</coding>
</code>
<description
value="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 value="text/cql-identifier"/>
<expression value="Initial Population"/>
</criteria>
</population>
<population id="8542DE86-6114-4575-9A2B-D09A0FA7C671">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="denominator"/>
<display value="Denominator"/>
</coding>
</code>
<description
value="Inpatient hospitalizations for patients delivering stillborn or live birth with greater than or equal to 20 weeks, 0 days gestation completed"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Denominator"/>
</criteria>
</population>
<population id="16605347-8AF3-47AA-B230-65B7208909B9">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="denominator-exclusion"/>
<display value="Denominator Exclusion"/>
</coding>
</code>
<description
value="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 value="text/cql-identifier"/>
<expression value="Denominator Exclusion"/>
</criteria>
</population>
<population id="05AD3648-8C60-4938-96C4-82385B9C4F91">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="numerator"/>
<display value="Numerator"/>
</coding>
</code>
<description
value="Two numerator populations are defined for this measure:
1. All Severe Obstetric Complications (SOC).
2. SOC excluding encounters where transfusion was the only SOC.
Inpatient hospitalizations for patients with severe obstetric complications (not present on admission that occur during the current delivery encounter) including the following:
- Severe maternal morbidity diagnoses (see list below)
- Severe maternal morbidity procedures (see list below)
- Discharge disposition of expired
Please note that present on admission codes may be extracted from billing/claims data that was entered by coding staff.
Severe Maternal Morbidity Diagnoses:
- Cardiac
Acute heart failure
Acute myocardial infarction
Aortic aneurysm
Cardiac arrest/ventricular fibrillation
Heart failure/arrest during procedure or surgery
- Hemorrhage
Disseminated intravascular coagulation
Shock
- Renal
Acute renal failure
- Respiratory
Adult respiratory distress syndrome
Pulmonary edema
- Sepsis
- Other OB
Air and thrombotic embolism
Amniotic fluid embolism
Eclampsia
Severe anesthesia complications
- Other Medical
Puerperal cerebrovascular disorder
Sickle cell disease with crisis
Severe Maternal Morbidity Procedures:
- Blood transfusion
- Conversion of cardiac rhythm
- Hysterectomy
- Temporary tracheostomy
- Ventilation"/>
<criteria>
<language value="text/cql-identifier"/>
<expression
value="Delivery Encounters with Severe Obstetric Complications"/>
</criteria>
</population>
<population id="e29f29ee-889e-4314-983c-e0ddc189a16c">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="numerator-exclusion"/>
<display value="Numerator Exclusion"/>
</coding>
</code>
<description
value="Inpatient hospitalizations with blood transfusion or hysterectomy with a diagnosis of placenta percreta or placenta increta and no additional severe obstetrical complications."/>
<criteria>
<language value="text/cql-identifier"/>
<expression
value="SOC with Hysterectomy or Blood Transfusion with Placenta Increta or Placenta Percreta Without Additional SOC"/>
</criteria>
</population>
<stratifier id="75faa812-7f77-45d4-bed1-a5d92837e8f4">
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo">
<valueCodeableConcept>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="initial-population"/>
<display value="Initial Population"/>
</coding>
</valueCodeableConcept>
</extension>
<description
value="This measure will be stratified by race/ethnicity and payer after measure submission."/>
<criteria>
<language value="text/cql-identifier"/>
</criteria>
</stratifier>
</group>
<group id="658b2eadd4b024647cc00341">
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring">
<valueCodeableConcept>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-scoring"/>
<code value="proportion"/>
<display value="Proportion"/>
</coding>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis">
<valueCode value="Encounter"/>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-type">
<valueCodeableConcept>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/measure-type"/>
<code value="outcome"/>
<display value="Outcome"/>
</coding>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-rateAggregation">
<valueCode
value="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"/>
</extension>
<description
value="SOC excluding encounters where transfusion was the only SOC"/>
<population id="4e1478e6-a3d4-42e5-a5cd-0026cc5617ed">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="initial-population"/>
<display value="Initial Population"/>
</coding>
</code>
<description
value="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 value="text/cql-identifier"/>
<expression value="Initial Population"/>
</criteria>
</population>
<population id="e4a80a9b-190c-4cd1-bc7b-8d6d9e5720cd">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="denominator"/>
<display value="Denominator"/>
</coding>
</code>
<description
value="Inpatient hospitalizations for patients delivering stillborn or live birth with >= 20 weeks, 0 days gestation completed"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Denominator"/>
</criteria>
</population>
<population id="4db4aa26-e64c-4d09-81fd-d119e14fee05">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="denominator-exclusion"/>
<display value="Denominator Exclusion"/>
</coding>
</code>
<description
value="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 value="text/cql-identifier"/>
<expression value="Denominator Exclusion"/>
</criteria>
</population>
<population id="0d5818b3-43e6-4d06-991f-adcc939f01b8">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="numerator"/>
<display value="Numerator"/>
</coding>
</code>
<description
value="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.
Please note that present on admission codes may be those entered by coding staff, extracted from billing/claims data.
Severe Maternal Morbidity Diagnoses:
- Cardiac
Acute heart failure
Acute myocardial infarction
Aortic aneurysm
Cardiac arrest/ventricular fibrillation
Heart failure/arrest during procedure or surgery
- Hemorrhage
Disseminated intravascular coagulation
Shock
- Renal
Acute renal failure
- Respiratory
Adult respiratory distress syndrome
Pulmonary edema
- Sepsis
- Other OB
Air and thrombotic embolism
Amniotic fluid embolism
Eclampsia
Severe anesthesia complications
- Other Medical
Puerperal cerebrovascular disorder
Sickle cell disease with crisis
Severe Maternal Morbidity Procedures:
- Blood transfusion
- Conversion of cardiac rhythm
- Hysterectomy
- Temporary tracheostomy
- Ventilation"/>
<criteria>
<language value="text/cql-identifier"/>
<expression
value="Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions Only"/>
</criteria>
</population>
<population id="b5aef46b-f0d5-442b-b1d4-564444fd471a">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="numerator-exclusion"/>
<display value="Numerator Exclusion"/>
</coding>
</code>
<description
value="Inpatient hospitalizations with blood transfusion or hysterectomy with a diagnosis of placenta percreta or placenta increta and no additional severe obstetrical complications."/>
<criteria>
<language value="text/cql-identifier"/>
<expression
value="SOC Excluding Blood Transfusions Only with Hysterectomy or Blood Transfusion with Placenta Increta or Placenta Percreta Without Additional SOC"/>
</criteria>
</population>
</group>
<supplementalData id="sde-ethnicity">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="supplemental-data"/>
</coding>
</usage>
<description value="SDE Ethnicity"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="SDE Ethnicity"/>
</criteria>
</supplementalData>
<supplementalData id="sde-payer">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="supplemental-data"/>
</coding>
</usage>
<description value="SDE Payer"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="SDE Payer"/>
</criteria>
</supplementalData>
<supplementalData id="sde-race">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="supplemental-data"/>
</coding>
</usage>
<description value="SDE Race"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="SDE Race"/>
</criteria>
</supplementalData>
<supplementalData id="sde-sex">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="supplemental-data"/>
</coding>
</usage>
<description value="SDE Sex"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="SDE Sex"/>
</criteria>
</supplementalData>
<supplementalData id="sde-variable-calculated-gestational-age">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="supplemental-data"/>
</coding>
</usage>
<description value="SDE Variable Calculated Gestational Age"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="SDE Variable Calculated Gestational Age"/>
</criteria>
</supplementalData>
<supplementalData id="risk-variable-lab-and-physical-exam-results">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
</coding>
</usage>
<description value="Risk Variable Lab and Physical Exam Results"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Risk Variable Lab and Physical Exam Results"/>
</criteria>
</supplementalData>
<supplementalData id="risk-variable-asthma">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
</coding>
</usage>
<description value="Risk Variable Asthma"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Risk Variable Asthma"/>
</criteria>
</supplementalData>
<supplementalData id="risk-variable-autoimmune-disease">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
</coding>
</usage>
<description value="Risk Variable Autoimmune Disease"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Risk Variable Autoimmune Disease"/>
</criteria>
</supplementalData>
<supplementalData id="risk-variable-bariatric-surgery">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
</coding>
</usage>
<description value="Risk Variable Bariatric Surgery"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Risk Variable Bariatric Surgery"/>
</criteria>
</supplementalData>
<supplementalData id="risk-variable-bleeding-disorder">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
</coding>
</usage>
<description value="Risk Variable Bleeding Disorder"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Risk Variable Bleeding Disorder"/>
</criteria>
</supplementalData>
<supplementalData id="risk-variable-morbid-obesity">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
</coding>
</usage>
<description value="Risk Variable Morbid Obesity"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Risk Variable Morbid Obesity"/>
</criteria>
</supplementalData>
<supplementalData id="risk-variable-cardiac-disease">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
</coding>
</usage>
<description value="Risk Variable Cardiac Disease"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Risk Variable Cardiac Disease"/>
</criteria>
</supplementalData>
<supplementalData id="risk-variable-economic-housing-instability">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
</coding>
</usage>
<description value="Risk Variable Economic Housing Instability"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Risk Variable Economic Housing Instability"/>
</criteria>
</supplementalData>
<supplementalData id="risk-variable-gastrointestinal-disease">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
</coding>
</usage>
<description value="Risk Variable Gastrointestinal Disease"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Risk Variable Gastrointestinal Disease"/>
</criteria>
</supplementalData>
<supplementalData id="risk-variable-gestational-diabetes">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
</coding>
</usage>
<description value="Risk Variable Gestational Diabetes"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Risk Variable Gestational Diabetes"/>
</criteria>
</supplementalData>
<supplementalData id="risk-variable-hiv">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
</coding>
</usage>
<description value="Risk Variable HIV"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Risk Variable HIV"/>
</criteria>
</supplementalData>
<supplementalData id="risk-variable-hypertension">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
</coding>
</usage>
<description value="Risk Variable Hypertension"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Risk Variable Hypertension"/>
</criteria>
</supplementalData>
<supplementalData id="risk-variable-long-term-anticoagulant-use">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
</coding>
</usage>
<description value="Risk Variable Long Term Anticoagulant Use"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Risk Variable Long Term Anticoagulant Use"/>
</criteria>
</supplementalData>
<supplementalData id="risk-variable-mental-health-disorder">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
</coding>
</usage>
<description value="Risk Variable Mental Health Disorder"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Risk Variable Mental Health Disorder"/>
</criteria>
</supplementalData>
<supplementalData id="risk-variable-multiple-pregnancy">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
</coding>
</usage>
<description value="Risk Variable Multiple Pregnancy"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Risk Variable Multiple Pregnancy"/>
</criteria>
</supplementalData>
<supplementalData id="risk-variable-neuromuscular">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
</coding>
</usage>
<description value="Risk Variable Neuromuscular"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Risk Variable Neuromuscular"/>
</criteria>
</supplementalData>
<supplementalData id="risk-variable-obstetrical-vte">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
</coding>
</usage>
<description value="Risk Variable Obstetrical VTE"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Risk Variable Obstetrical VTE"/>
</criteria>
</supplementalData>
<supplementalData id="risk-variable-placenta-previa">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
</coding>
</usage>
<description value="Risk Variable Placenta Previa"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Risk Variable Placenta Previa"/>
</criteria>
</supplementalData>
<supplementalData id="risk-variable-placental-abruption">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
</coding>
</usage>
<description value="Risk Variable Placental Abruption"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Risk Variable Placental Abruption"/>
</criteria>
</supplementalData>
<supplementalData id="risk-variable-placental-accreta-spectrum">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
</coding>
</usage>
<description value="Risk Variable Placental Accreta Spectrum"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Risk Variable Placental Accreta Spectrum"/>
</criteria>
</supplementalData>
<supplementalData id="risk-variable-preexisting-diabetes">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
</coding>
</usage>
<description value="Risk Variable Preexisting Diabetes"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Risk Variable Preexisting Diabetes"/>
</criteria>
</supplementalData>
<supplementalData id="risk-variable-previous-cesarean">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
</coding>
</usage>
<description value="Risk Variable Previous Cesarean"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Risk Variable Previous Cesarean"/>
</criteria>
</supplementalData>
<supplementalData id="risk-variable-pulmonary-hypertension">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
</coding>
</usage>
<description value="Risk Variable Pulmonary Hypertension"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Risk Variable Pulmonary Hypertension"/>
</criteria>
</supplementalData>
<supplementalData id="risk-variable-renal-disease">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
</coding>
</usage>
<description value="Risk Variable Renal Disease"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Risk Variable Renal Disease"/>
</criteria>
</supplementalData>
<supplementalData id="risk-variable-severe-preeclampsia">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
</coding>
</usage>
<description value="Risk Variable Severe Preeclampsia"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Risk Variable Severe Preeclampsia"/>
</criteria>
</supplementalData>
<supplementalData id="risk-variable-substance-abuse">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
</coding>
</usage>
<description value="Risk Variable Substance Abuse"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Risk Variable Substance Abuse"/>
</criteria>
</supplementalData>
<supplementalData id="risk-variable-thyrotoxicosis">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
</coding>
</usage>
<description value="Risk Variable Thyrotoxicosis"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Risk Variable Thyrotoxicosis"/>
</criteria>
</supplementalData>
<supplementalData id="risk-variable-other-preeclampsia">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
</coding>
</usage>
<description value="Risk Variable Other Preeclampsia"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Risk Variable Other Preeclampsia"/>
</criteria>
</supplementalData>
<supplementalData id="risk-variable-preterm-birth">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
</coding>
</usage>
<description value="Risk Variable Preterm Birth"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Risk Variable Preterm Birth"/>
</criteria>
</supplementalData>
<supplementalData id="risk-variable-anemia">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
</coding>
</usage>
<description value="Risk Variable Anemia"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Risk Variable Anemia"/>
</criteria>
</supplementalData>
<supplementalData id="risk-variable-systolic-blood-pressure">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
</coding>
</usage>
<description value="Risk Variable Systolic Blood Pressure"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Risk Variable Systolic Blood Pressure"/>
</criteria>
</supplementalData>
<supplementalData id="risk-variable-heart-rate">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
</coding>
</usage>
<description value="Risk Variable Heart Rate"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Risk Variable Heart Rate"/>
</criteria>
</supplementalData>
<supplementalData id="risk-variable-first-white-blood-cell-count-lab-test">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
</coding>
</usage>
<description value="Risk Variable First White Blood Cell Count Lab Test"/>
<criteria>
<language value="text/cql-identifier"/>
<expression
value="Risk Variable First White Blood Cell Count Lab Test"/>
</criteria>
</supplementalData>
<supplementalData id="risk-variable-first-hematocrit-lab-test">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
</coding>
</usage>
<description value="Risk Variable First Hematocrit Lab Test"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Risk Variable First Hematocrit Lab Test"/>
</criteria>
</supplementalData>
<supplementalData id="delivery-encounters-with-blood-transfusion">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
</coding>
</usage>
<description value="Delivery Encounters with Blood Transfusion"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Delivery Encounters with Blood Transfusion"/>
</criteria>
</supplementalData>
<supplementalData id="risk-variable-maternal-age">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="risk-adjustment-factor"/>
</coding>
</usage>
<description value="Risk Variable Maternal Age"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Risk Variable Maternal Age"/>
</criteria>
</supplementalData>
</Measure>
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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