eCQM QICore Content Implementation Guide
2024.0.0 - CI Build
eCQM QICore Content Implementation Guide
2024.0.0 - CI Build
eCQM QICore Content Implementation Guide, published by cqframework. This guide is not an authorized publication; it is the continuous build for version 2024.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/cqframework/ecqm-content-qicore-2024/ and changes regularly. See the Directory of published versions
| Draft as of 2024-07-09 |
{
"resourceType" : "Measure",
"id" : "StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR",
"meta" : {
"profile" : [
🔗 "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-measure-cqfm"🔗 ,
"http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/publishable-measure-cqfm"🔗 ,
"http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/executable-measure-cqfm"
]
},
"text" : {
"status" : "extensions",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <table class=\"grid dict\">\n \n <tr>\n <th scope=\"row\"><b>Title: </b></th>\n <td style=\"padding-left: 4px;\">Statin Therapy for the Prevention and Treatment of Cardiovascular DiseaseFHIR</td>\n </tr>\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Id: </b></th>\n <td style=\"padding-left: 4px;\">StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR</td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Version: </b></th>\n <td style=\"padding-left: 4px;\">0.2.000</td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Url: </b></th>\n <td style=\"padding-left: 4px;\"><a href=\"Measure-StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR.html\">Statin Therapy for the Prevention and Treatment of Cardiovascular DiseaseFHIR</a></td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\">\n <b>\n \n \n short-name identifier:\n \n \n </b>\n </th>\n\n <td style=\"padding-left: 4px;\">\n \n <p style=\"margin-bottom: 5px;\">\n <span>CMS347FHIR</span>\n </p>\n \n </td>\n </tr>\n \n <tr>\n <th scope=\"row\">\n <b>\n \n \n version-independent identifier:\n \n \n </b>\n </th>\n\n <td style=\"padding-left: 4px;\">\n \n <p style=\"margin-bottom: 5px;\">\n <span>urn:uuid:4d3066c5-88f7-48d2-8a93-9f946e1a41a6</span>\n </p>\n \n </td>\n </tr>\n \n <tr>\n <th scope=\"row\">\n <b>\n \n \n version-specific identifier:\n \n \n </b>\n </th>\n\n <td style=\"padding-left: 4px;\">\n \n <p style=\"margin-bottom: 5px;\">\n <span>urn:uuid:be1257a3-a34e-4a7b-99df-345de63365a2</span>\n </p>\n \n </td>\n </tr>\n \n <tr>\n <th scope=\"row\">\n <b>\n \n \n publisher (CMS) identifier:\n \n \n </b>\n </th>\n\n <td style=\"padding-left: 4px;\">\n \n <p style=\"margin-bottom: 5px;\">\n <span>347FHIR</span>\n </p>\n \n </td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Effective Period: </b></th>\n <td style=\"padding-left: 4px;\">2025-01-01..2025-12-31</td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Status: </b></th>\n <td style=\"padding-left: 4px;\">draft</td>\n </tr>\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Publisher: </b></th>\n <td style=\"padding-left: 4px;\">Centers for Medicare & Medicaid Services (CMS)</td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Author: </b></th>\n <td style=\"padding-left: 4px;\">Mathematica</td>\n </tr>\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Description: </b></th>\n <td style=\"padding-left: 4px;\"><div><p>Percentage of the following patients - all considered at high risk of cardiovascular events - who were prescribed or were on statin therapy during the measurement period:</p>\n<ul>\n<li>All patients who were previously diagnosed with or currently have a diagnosis of clinical atherosclerotic cardiovascular disease (ASCVD), including an ASCVD procedure; OR</li>\n<li>Patients aged 20 - 75 years who have ever had a low-density lipoprotein cholesterol (LDL-C) level >= 190 mg/dL or were previously diagnosed with or currently have an active diagnosis of familial hypercholesterolemia; OR</li>\n<li>Patients aged 40 - 75 years with a diagnosis of diabetes; OR</li>\n<li>Patients aged 40 - 75 with a 10-year ASCVD risk score of >= 20 percent</li>\n</ul>\n</div></td>\n </tr>\n \n\n \n\n \n\n \n\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Purpose: </b></th>\n <td style=\"padding-left: 4px;\"><div><p>UNKNOWN</p>\n</div></td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Copyright: </b></th>\n <td style=\"padding-left: 4px;\"><div><p>Limited proprietary coding is contained in the measure specifications for convenience. Users of the proprietary code sets should obtain all necessary licenses from the owners of these code sets.</p>\n<p>CPT(R) contained in the Measure specifications is copyright 2004-2023 American Medical Association. LOINC(R) is copyright 2004-2023 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2023 International Health Terminology Standards Development Organisation. ICD-10 is copyright 2023 World Health Organization. All Rights Reserved.</p>\n</div></td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Disclaimer: </b></th>\n <td style=\"padding-left: 4px;\"><div><p>These performance measures are not clinical guidelines and do not establish a standard of medical care, and have not been tested for all potential applications.</p>\n<p>THE MEASURES AND SPECIFICATIONS ARE PROVIDED "AS IS" WITHOUT WARRANTY OF ANY KIND.</p>\n<p>Due to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM].</p>\n</div></td>\n </tr>\n \n\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Scoring: </b></th>\n <td style=\"padding-left: 4px;\">\n \n \n <p style=\"margin-bottom: 5px;\">\n <span>Proportion </span>\n </p>\n \n \n \n </td>\n </tr>\n \n\n \n\n \n\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Rationale: </b></th>\n <td style=\"padding-left: 4px;\"><div><p>"Cardiovascular disease (CVD) is the leading cause of death in the United States, causing approximately 1 of every 3 deaths in the United States in 2015. In 2015, stroke caused approximately 1 of every 19 deaths in the United States and the estimated annual costs for CVD and stroke were $329.7 billion, including $199.2 billion in direct costs (hospital services, physicians and other professionals, prescribed medications, home health care, and other medical durables) and $130.5 billion in indirect costs from lost future productivity (cardiovascular and stroke premature deaths). CVD costs more than any other diagnostic group" (Benjamin et al., 2018).</p>\n<p>Data collected between 2011 and 2014 indicates that more than 94.6 million U.S. adults, 20 years or older, had total cholesterol levels equal to 200 mg/dL or more, while almost 28.5 million had levels 240 mg/dL or more (Benjamin et al., 2018). Elevated blood cholesterol is a major risk factor for CVD and statin therapy has been associated with a reduced risk of CVD. Numerous randomized trials have demonstrated that treatment with a statin reduces LDL-C and reduces the risk of major cardiovascular events by approximately 20 percent (Ference, 2015).</p>\n<p>In 2018, updated guidelines on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults were published (Grundy et al., 2019). This guideline was published by an Expert Panel, which synthesized evidence from randomized controlled trials to identify people most likely to benefit from cholesterol-lowering therapy. The American College of Cardiology (ACC)/American Heart Association (AHA)/Multi-society (MS) Guideline recommendations are intended to provide a strong evidence-based foundation for the treatment of blood cholesterol for the primary and secondary prevention and treatment of ASCVD in patients of all ages. The document concludes that the addition of statin therapy reduces the risk of ASCVD among high-risk individuals, defined as follows: individuals with clinical ASCVD, with LDL-C >= 190 mg/dL, with diabetes, or individuals with >= 20 percent risk of ASCVD as determined via use of an ASCVD risk estimator derived from the Pooled Cohort Equations (Grundy et al., 2019).</p>\n<p>One study surveying U.S. cardiology, primary care, and endocrinology practices found that 1 in 4 guideline-eligible patients were not on a statin and less than half were on the recommended statin intensity. Untreated and undertreated patients had significantly higher LDL-C levels than those receiving guideline-directed statin treatment (Navar et al., 2017). In a follow-up study authored by Nanna et al., the same clinics were divided into tertiles based on the percentage of patients with guideline-recommended statin use. The researchers found that patients in the high-tertile clinics were more likely to achieve target LDL-C levels than patients at the low- or mid-tertile clinics, and this held true when patients were stratified by primary and secondary prevention (Nanna et al., 2019a).</p>\n<p>Research also indicates that certain populations are far less likely to receive guideline-recommended statin therapy than others. A retrospective study of the National Health and Nutrition Examination Survey found that Black and Hispanic race or ethnicity, low income, lack of health insurance coverage, poor health care access, young age, and female gender are predictors of lower statin utilization (Gu et al., 2018). In particular, there is extensive evidence that women are far less likely than men to be prescribed guideline-recommended statin therapy (Nanna et al., 2019b), despite research showing that female patients with cardiovascular disease derive the same or greater benefit from statin therapy as male patients with cardiovascular disease (Puri et al., 2014).</p>\n<p>The Statin Safety Expert Panel that participated in a National Lipid Association (NLA) Statin Safety Task Force meeting in October 2013 reaffirms the general safety of statin therapy. The panel members concluded that for most patients requiring statin therapy, the potential benefits of statin therapy outweigh the potential risks. In general terms, the benefits of statins to prevent non-fatal myocardial infarction, revascularization, stroke, and CVD mortality, far outweigh any potential harm related to the drug (Jacobson, 2014).</p>\n</div></td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Clinical recommendation statement: </b></th>\n <td style=\"padding-left: 4px;\"><div><p>This electronic clinical quality measure is intended to align with the 2018 ACC/AHA/MS Guideline on the Management of Blood Cholesterol (Grundy et al., 2019), which indicates the use of statins as the first line of cholesterol-lowering medication therapy to lower the risk of ASCVD among at-risk populations.</p>\n<p>Recommendations for Management of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults - Statin Treatment:\nSecondary Prevention:</p>\n<ol>\n<li>\n<p>In patients who are 75 years of age or younger with clinical ASCVD, high-intensity statin therapy should be initiated or continued with the aim of achieving a 50 percent or greater reduction in LDL-C levels (Class I Recommendation), (Grundy et al., 2019).</p>\n</li>\n<li>\n<p>In patients with clinical ASCVD in whom high-intensity statin therapy is contraindicated or who experience statin-associated side effects, moderate-intensity statin therapy should be initiated or continued with the aim of achieving a 30 to 49 percent reduction in LDL-C levels (Class I Recommendation), (Grundy et al., 2019).</p>\n</li>\n<li>\n<p>In patients older than 75 years of age with clinical ASCVD, it is reasonable to initiate moderate- or high-intensity statin therapy after evaluation of the potential for ASCVD risk reduction, adverse effects, and drug–drug interactions, as well as patient frailty and patient preferences (Class IIa Recommendation), (Grundy et al., 2019).</p>\n</li>\n</ol>\n<p>Primary Prevention</p>\n<ol>\n<li>\n<p>In patients 20 to 75 years of age with an LDL-C level of 190 mg/dL or higher (>= 4.9 mmol/L), maximally tolerated statin therapy is recommended. (Class I Recommendation), (Grundy et al., 2019).</p>\n</li>\n<li>\n<p>In adults 40 to 75 years of age with diabetes mellitus, regardless of estimated 10-year ASCVD risk, moderate-intensity statin therapy is indicated (Class I Recommendation), (Grundy et al., 2019).</p>\n</li>\n<li>\n<p>To facilitate decisions about preventive interventions, it is recommended to screen for traditional ASCVD risk factors and apply the race- and sex-specific Pooled Cohort Equations (PCE) to estimate 10-year ASCVD risk for asymptomatic adults 40 to 75 years of age. The higher the estimated risk, the more likely the patient is to benefit from statin treatment (Grundy et al., 2019).</p>\n</li>\n</ol>\n<p>The US Preventive Services Task Force (USPSTF) concludes with moderate certainty that statin use for the prevention of CVD events and all-cause mortality in adults aged 40 to 75 years with no history of CVD and who have 1 or more of these CVD risk factors and an estimated 10-year CVD event risk of 7.5 percent to less than 10 percent has at least a small net benefit (USPSTF 2022).</p>\n<p>Statin Safety and Statin-Associated Side Effects\nA clinician–patient risk discussion is recommended before initiation of statin therapy to review net clinical benefit, weighing the potential for ASCVD risk reduction against the potential for statin-associated side effects, statin–drug interactions, and safety, while emphasizing that side effects can be addressed successfully (Class I Recommendation), (Grundy et al., 2019).</p>\n</div></td>\n </tr>\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Guidance (Usage): </b></th>\n <td style=\"padding-left: 4px;\">Initial Population Guidance: \nThe initial population covers four distinct populations. Use the following process to prevent counting patients more than once.\n\nInitial Population 1: \nAll patients who were previously diagnosed with or currently have a diagnosis of clinical ASCVD, including an ASCVD procedure before the end of the measurement period.\n\n- If YES, meets Initial Population 1 risk category.\t\t \n- If NO, screen for next risk category.\n\nInitial Population 2: \nPatients aged 20 to 75 years at the beginning of the measurement period who have ever had a laboratory test result of LDL-C >= 190 mg/dL or were previously diagnosed with or currently have an active diagnosis of familial hypercholesterolemia.\n\n- If YES, meets Initial Population 2 risk category.\t\t \n- If NO, screen for next risk category.\n\nInitial Population 3:\nPatients aged 40 to 75 years at the beginning of the measurement period with an active diagnosis of Type 1 or Type 2 diabetes at any time during the measurement period.\n\n- If YES, meets Initial Population 3 risk category.\n- If NO, screen for next risk category.\n\nInitial Population 4: \nPatients aged 40 to 75 at the beginning of the measurement period with a 10-year ASCVD risk score of >= 20 percent during the measurement period.\n\n- If YES, meets Initial Population 4 risk category.\n- If NO, patient does NOT meet Initial Population criteria and is NOT eligible for measure inclusion.\n\nInitial Population Guidance for Encounter:\nIn order for the patient to be included in the Initial Population, the patient must have ONE initial population-eligible visit, defined as follows: outpatient visit, initial or established office visit, face-to-face interaction, preventive care services, or annual wellness visit.\n\nLDL-C Laboratory test result options:\nThe measure can be reported for all patients with a documented LDL-C level recorded as follows:\n\nTo meet Initial Population 1: \nThere is no LDL-C result required.\n\nTo meet Initial Population 2:\nIf a patient has ANY previous laboratory result of LDL-C >= 190 mg/dL, report the highest value >= 190 mg/dL.\n\nTo meet Initial Population 3: \nThere is no LDL-C result required.\n\nTo meet Initial Population 4: \nThere is no LDL-C result required.\n\nThe 10-year ASCVD risk assessment options:\nThe 10-year ASCVD risk score is calculated using the Pooled Cohort Equations: 1) the 2013 ACC/AHA ASCVD Risk Estimator (maps to LOINC Code 79423-0) OR 2) the ACC Risk Estimator Plus (maps to LOINC Code 99055-6). If your EHR does not have either of these risk calculators, we recommend that you use the on-line versions. The 10-year ASCVD risk score (quantitative result, i.e., result.value, "%") must be documented in a structured field. The 10-year ASCVD risk assessment must be performed during the measurement period. \n \nNumerator instructions and guidance:\n- Current statin therapy use must be documented in the patient's current medication list or ordered during the measurement period.\n- ONLY statin therapy meets the measure Numerator criteria (NOT other cholesterol lowering medications).\n- Prescription or order does NOT need to be linked to an encounter or visit; it may be called to the pharmacy.\n- Statin medication "samples" provided to patients can be documented as "current statin therapy" if documented in the medication list in health/medical record.\n- Patients who meet the denominator criteria for inclusion, but are not prescribed or using statin therapy, will NOT meet performance for this measure unless they have an allowable denominator exception. Patients with an allowable denominator exception should be removed from the denominator of the measure and reported as a valid exception. \n- There is only one performance rate calculated for this measure: the weighted average of the four populations.\n- Adherence to statin therapy is not calculated in this measure.\n- It may not be appropriate to prescribe statin therapy for some patients (see exceptions and exclusions for the complete list). \n\nIntensity of statin therapy in primary and secondary prevention:\nThe expert panel of the 2018 ACC/AHA/MS Guidelines (Grundy et al., 2019) defines recommended intensity of statin therapy on the basis of the average expected LDL-C response to specific statin and dose. Although intensity of statin therapy is important in managing cholesterol, this measure assesses prescription of ANY statin therapy, irrespective of intensity. Assessment of appropriate intensity and dosage documentation added too much complexity to allow inclusion of statin therapy intensity in the measure at this time.\n\nLifestyle modification coaching:\nA healthy lifestyle is important for the prevention of cardiovascular disease. However, lifestyle modification monitoring and documentation added too much complexity to allow its inclusion in the measure at this time.\n\nMillimoles per liter (mmol/L) should be converted to milligrams per deciliter (mg/dL) for reporting this measure.\n\nThis eCQM is a patient-based measure. \n\nThis FHIR-based measure has been derived from the QDM-based measure: CMS 347v8. Please refer to the HL7 QI-Core Implementation Guide (https://hl7.org/fhir/us/qicore/STU4.1.1/) for more information on QI-Core and mapping recommendations from QDM to QI-Core 4.1.1 (https://hl7.org/fhir/us/qicore/STU4.1.1/qdm-to-qicore.html).</td>\n </tr>\n \n\n \n \n <tr>\n <th scope=\"row\"><b>Population Criteria: </b></th>\n <td style=\"padding-left: 4px;\">\n \n <table class=\"grid-dict\">\n \n <tr>\n <th><b>64ef76a356d636294b157b96</b></th>\n </tr>\n \n \n <tr>\n <td>Initial Population:</td>\n\n \n \n <td>All patients who were previously diagnosed with or currently have a diagnosis of clinical ASCVD, including an ASCVD procedure.</td>\n \n \n\n </tr>\n \n <tr>\n <td>Denominator:</td>\n\n \n \n <td>Equals Initial Population</td>\n \n \n\n </tr>\n \n <tr>\n <td>Denominator Exclusion:</td>\n\n \n \n <td>Patients who are breastfeeding at any time during the measurement period.\nPatients who have a diagnosis of rhabdomyolysis at any time during the measurement period.</td>\n \n \n\n </tr>\n \n <tr>\n <td>Numerator:</td>\n\n \n \n <td>Patients who are actively using or who receive an order (prescription) for statin therapy at any time during the measurement period</td>\n \n \n\n </tr>\n \n <tr>\n <td>Denominator Exception:</td>\n\n \n \n <td>Patients with statin-associated muscle symptoms or an allergy to statin medication.\nPatients who are receiving palliative or hospice care.\nPatients with active liver disease or hepatic disease or insufficiency.\nPatients with end-stage renal disease (ESRD).\nPatients with documentation of a medical reason for not being prescribed statin therapy.</td>\n \n \n\n </tr>\n \n \n </table>\n \n <table class=\"grid-dict\">\n \n <tr>\n <th><b>64ef76a356d636294b157b97</b></th>\n </tr>\n \n \n <tr>\n <td>Initial Population:</td>\n\n \n \n <td>Patients aged 20 to 75 years at the beginning of the measurement period who have ever had a laboratory result of LDL-C >=190 mg/dL or were previously diagnosed with or currently have an active diagnosis of familial hypercholesterolemia.</td>\n \n \n\n </tr>\n \n <tr>\n <td>Denominator:</td>\n\n \n \n <td>Equals Initial Population</td>\n \n \n\n </tr>\n \n <tr>\n <td>Denominator Exclusion:</td>\n\n \n \n <td>Patients who are breastfeeding at any time during the measurement period.\nPatients who have a diagnosis of rhabdomyolysis at any time during the measurement period.</td>\n \n \n\n </tr>\n \n <tr>\n <td>Numerator:</td>\n\n \n \n <td>Patients who are actively using or who receive an order (prescription) for statin therapy at any time during the measurement period</td>\n \n \n\n </tr>\n \n <tr>\n <td>Denominator Exception:</td>\n\n \n \n <td>Patients with statin-associated muscle symptoms or an allergy to statin medication.\nPatients who are receiving palliative or hospice care.\nPatients with active liver disease or hepatic disease or insufficiency.\nPatients with end-stage renal disease (ESRD).\nPatients with documentation of a medical reason for not being prescribed statin therapy.</td>\n \n \n\n </tr>\n \n \n </table>\n \n <table class=\"grid-dict\">\n \n <tr>\n <th><b>64ef76a356d636294b157b98</b></th>\n </tr>\n \n \n <tr>\n <td>Initial Population:</td>\n\n \n \n <td>Patients aged 40 to 75 years at the beginning of the measurement period with Type 1 or Type 2 diabetes.</td>\n \n \n\n </tr>\n \n <tr>\n <td>Denominator:</td>\n\n \n \n <td>Equals Initial Population</td>\n \n \n\n </tr>\n \n <tr>\n <td>Denominator Exclusion:</td>\n\n \n \n <td>Patients who are breastfeeding at any time during the measurement period.\nPatients who have a diagnosis of rhabdomyolysis at any time during the measurement period.</td>\n \n \n\n </tr>\n \n <tr>\n <td>Numerator:</td>\n\n \n \n <td>Patients who are actively using or who receive an order (prescription) for statin therapy at any time during the measurement period</td>\n \n \n\n </tr>\n \n <tr>\n <td>Denominator Exception:</td>\n\n \n \n <td>Patients with statin-associated muscle symptoms or an allergy to statin medication.\nPatients who are receiving palliative or hospice care.\nPatients with active liver disease or hepatic disease or insufficiency.\nPatients with end-stage renal disease (ESRD).\nPatients with documentation of a medical reason for not being prescribed statin therapy.</td>\n \n \n\n </tr>\n \n \n </table>\n \n <table class=\"grid-dict\">\n \n <tr>\n <th><b>64ef76a356d636294b157b99</b></th>\n </tr>\n \n \n <tr>\n <td>Initial Population:</td>\n\n \n \n <td>Population 4: Patients aged 40 to 75 at the beginning of the measurement period with a 10-year ASCVD risk score (i.e., 2013 ACC/AHA ASCVD Risk Estimator or the ACC Risk Estimator Plus) of >= 20 percent during the measurement period.</td>\n \n \n\n </tr>\n \n <tr>\n <td>Denominator:</td>\n\n \n \n <td>Equals Initial Population</td>\n \n \n\n </tr>\n \n <tr>\n <td>Denominator Exclusion:</td>\n\n \n \n <td>Patients who are breastfeeding at any time during the measurement period.\nPatients who have a diagnosis of rhabdomyolysis at any time during the measurement period.</td>\n \n \n\n </tr>\n \n <tr>\n <td>Numerator:</td>\n\n \n \n <td>Patients who are actively using or who receive an order (prescription) for statin therapy at any time during the measurement period</td>\n \n \n\n </tr>\n \n <tr>\n <td>Denominator Exception:</td>\n\n \n \n <td>Patients with statin-associated muscle symptoms or an allergy to statin medication.\nPatients who are receiving palliative or hospice care.\nPatients with active liver disease or hepatic disease or insufficiency.\nPatients with end-stage renal disease (ESRD).\nPatients with documentation of a medical reason for not being prescribed statin therapy.</td>\n \n \n\n </tr>\n \n \n </table>\n \n </td>\n </tr>\n \n \n\n \n <tr>\n <th scope=\"row\"><b> Supplemental Data Elements: </b></th>\n <td style=\"padding-left: 4px;\">\n \n \n \n <p>SDE Ethnicity</p>\n \n \n \n \n \n <p>SDE Payer</p>\n \n \n \n \n \n <p>SDE Race</p>\n \n \n \n \n \n <p>SDE Sex</p>\n \n \n \n </td>\n </tr>\n \n\n \n\n \n <tr>\n <th scope=\"row\">\n <b> Supplemental Data Guidance\n : </b></th>\n <td style=\"padding-left: 4px;\"> For every patient evaluated by this measure also identify payer, race, ethnicity and sex; SDE Ethnicity \n SDE Payer \n SDE Race \n SDE Sex \n </td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Libraries: </b></th>\n <td style=\"padding-left: 4px;\">\n <table class=\"grid-dict\">\n \n <tr>\n <td><a href=\"Library-StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR.html\">StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR</a></td>\n </tr>\n \n </table>\n </td>\n </tr>\n \n\n \n\n \n \n <tr>\n <th scope=\"row\"><b>Terminology and Other Dependencies: </b></th>\n <td style=\"padding-left: 4px;\">\n \n <li><code>Library/QICoreCommon|2.1.000</code></li>\n \n <li><code>Library/FHIRHelpers|4.4.000</code></li>\n \n <li><code>Library/SupplementalDataElements|3.5.000</code></li>\n \n <li><code>Library/Hospice|6.12.000</code></li>\n \n <li><code>Library/Status|1.8.000</code></li>\n \n <li><code>Library/PalliativeCare|1.11.000</code></li>\n \n <li><a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-condition-category.html\">Condition Category Codes</a></li>\n \n <li><a href=\"http://hl7.org/fhir/us/core/STU3.1.1/CodeSystem-condition-category.html\">US Core Condition Category Extension Codes</a></li>\n \n <li><a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-icd10CM.html\">International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM)</a></li>\n \n <li><a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-v3-loinc.html\">Logical Observation Identifiers, Names and Codes (LOINC)</a></li>\n \n <li><a href=\"http://hl7.org/fhir/R4/codesystem-administrative-gender.html\">AdministrativeGender</a></li>\n \n <li><a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-allergyintolerance-clinical.html\">AllergyIntolerance Clinical Status Codes</a></li>\n \n <li><a href=\"http://hl7.org/fhir/R4/codesystem-snomedct.html\">SNOMED CT (all versions)</a></li>\n \n <li><a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-observation-category.html\">Observation Category Codes</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.403/expansion\">Myocardial Infarction</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1047.44/expansion\">Cerebrovascular Disease, Stroke, TIA</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1047.21/expansion\">Atherosclerosis and Peripheral Arterial Disease</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1047.46/expansion\">Ischemic Heart Disease or Other Related Diagnoses</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1047.47/expansion\">Stable and Unstable Angina</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1045.67/expansion\">PCI</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.666.5.694/expansion\">CABG Surgeries</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.204/expansion\">Carotid Intervention</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1138.566/expansion\">CABG, PCI Procedure</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1240/expansion\">Annual Wellness Visit</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1001/expansion\">Office Visit</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1008/expansion\">Outpatient Consultation</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1576/expansion\">Outpatient Encounters for Preventive Care</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1025/expansion\">Preventive Care Services - Established Office Visit, 18 and Up</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1026/expansion\">Preventive Care Services-Individual Counseling</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1023/expansion\">Preventive Care Services-Initial Office Visit, 18 and Up</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.11.1150/expansion\">Preventive Care Services - Other</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1573/expansion\">LDL Cholesterol</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1047.100/expansion\">Hypercholesterolemia</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.103.12.1001/expansion\">Diabetes</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1574/expansion\">Low Intensity Statin Therapy</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1575/expansion\">Moderate Intensity Statin Therapy</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1572/expansion\">High Intensity Statin Therapy</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.114222.4.11.3591/expansion\">Payer</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1047.73/expansion\">Breastfeeding</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1047.102/expansion\">Rhabdomyolysis</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1110.42/expansion\">Statin Allergen</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.666.5.307/expansion\">Encounter Inpatient</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.1003/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1003</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1584/expansion\">Hospice Care Ambulatory</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.1165/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1165</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.1167/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1167</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1090/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1090</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.198.12.1135/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1135</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.110.12.1024/expansion\">Hepatitis A</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.67.1.101.1.269/expansion\">Hepatitis B</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1047.42/expansion\">Liver Disease</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1108.85/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.85</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.353/expansion\">End Stage Renal Disease</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1007/expansion\">Medical Reason</a></li>\n \n </td>\n </tr>\n <tr>\n <th scope=\"row\"><b>Parameters:</b></th>\n <td style=\"padding-left: 4px;\">\n <table class=\"grid-dict\">\n <tr>\n <th><b>name</b></th>\n <th><b>use</b></th>\n <th><b>min</b></th>\n <th><b>max</b></th>\n <th><b>type</b></th>\n </tr>\n \n <tr>\n <td>Measurement Period</td>\n <td>In</td>\n <td>0</td>\n <td>1</td>\n <td>Period</td>\n </tr>\n \n <tr>\n <td>Initial Population 1</td>\n <td>Out</td>\n <td>0</td>\n <td>1</td>\n <td>boolean</td>\n </tr>\n \n <tr>\n <td>Initial Population 2</td>\n <td>Out</td>\n <td>0</td>\n <td>1</td>\n <td>boolean</td>\n </tr>\n \n <tr>\n <td>SDE Race</td>\n <td>Out</td>\n <td>0</td>\n <td>1</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Initial Population 3</td>\n <td>Out</td>\n <td>0</td>\n <td>1</td>\n <td>boolean</td>\n </tr>\n \n <tr>\n <td>Initial Population 4</td>\n <td>Out</td>\n <td>0</td>\n <td>1</td>\n <td>boolean</td>\n </tr>\n \n <tr>\n <td>SDE Sex</td>\n <td>Out</td>\n <td>0</td>\n <td>1</td>\n <td>Coding</td>\n </tr>\n \n <tr>\n <td>Denominator 3</td>\n <td>Out</td>\n <td>0</td>\n <td>1</td>\n <td>boolean</td>\n </tr>\n \n <tr>\n <td>Numerator</td>\n <td>Out</td>\n <td>0</td>\n <td>1</td>\n <td>boolean</td>\n </tr>\n \n <tr>\n <td>Denominator 2</td>\n <td>Out</td>\n <td>0</td>\n <td>1</td>\n <td>boolean</td>\n </tr>\n \n <tr>\n <td>Denominator 4</td>\n <td>Out</td>\n <td>0</td>\n <td>1</td>\n <td>boolean</td>\n </tr>\n \n <tr>\n <td>SDE Payer</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>SDE Ethnicity</td>\n <td>Out</td>\n <td>0</td>\n <td>1</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Denominator Exclusions</td>\n <td>Out</td>\n <td>0</td>\n <td>1</td>\n <td>boolean</td>\n </tr>\n \n <tr>\n <td>Denominator 1</td>\n <td>Out</td>\n <td>0</td>\n <td>1</td>\n <td>boolean</td>\n </tr>\n \n <tr>\n <td>Denominator Exceptions</td>\n <td>Out</td>\n <td>0</td>\n <td>1</td>\n <td>boolean</td>\n </tr>\n \n </table>\n </td>\n </tr>\n\n <tr>\n <th scope=\"row\"><b>DataRequirements:</b></th>\n <td style=\"padding-left: 4px;\">\n <table class=\"grid-dict\">\n <tr>\n <th><b>Resource Type</b></th>\n <th><b>Resource Elements</b></th>\n <th><b>Valueset Name</b></th>\n <th><b>Valueset</b></th>\n </tr>\n \n <tr>\n <td>Condition(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-condition.html\">QICoreCondition</a>)</td>\n <td>\n \n code\n \n </td>\n <td>\n \n \n Myocardial Infarction\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.403/expansion\">Myocardial Infarction</a></td>\n </tr>\n \n <tr>\n <td>Condition(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-condition.html\">QICoreCondition</a>)</td>\n <td>\n \n code\n \n </td>\n <td>\n \n \n Cerebrovascular Disease Stroke or TIA\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1047.44/expansion\">Cerebrovascular Disease, Stroke, TIA</a></td>\n </tr>\n \n <tr>\n <td>Condition(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-condition.html\">QICoreCondition</a>)</td>\n <td>\n \n code\n \n </td>\n <td>\n \n \n Atherosclerosis and Peripheral Arterial Disease\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1047.21/expansion\">Atherosclerosis and Peripheral Arterial Disease</a></td>\n </tr>\n \n <tr>\n <td>Condition(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-condition.html\">QICoreCondition</a>)</td>\n <td>\n \n code\n \n </td>\n <td>\n \n \n Ischemic Heart Disease or Other Related Diagnoses\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1047.46/expansion\">Ischemic Heart Disease or Other Related Diagnoses</a></td>\n </tr>\n \n <tr>\n <td>Condition(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-condition.html\">QICoreCondition</a>)</td>\n <td>\n \n code\n \n </td>\n <td>\n \n \n Stable and Unstable Angina\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1047.47/expansion\">Stable and Unstable Angina</a></td>\n </tr>\n \n <tr>\n <td>Condition(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-condition.html\">QICoreCondition</a>)</td>\n <td>\n \n code\n \n </td>\n <td>\n \n </td>\n <td/>\n </tr>\n \n <tr>\n <td>Condition(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-condition.html\">QICoreCondition</a>)</td>\n <td>\n \n code\n \n </td>\n <td>\n \n \n Familial Hypercholesterolemia\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1047.100/expansion\">Hypercholesterolemia</a></td>\n </tr>\n \n <tr>\n <td>Condition(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-condition.html\">QICoreCondition</a>)</td>\n <td>\n \n code\n \n </td>\n <td>\n \n \n Diabetes\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.103.12.1001/expansion\">Diabetes</a></td>\n </tr>\n \n <tr>\n <td>Condition(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-condition.html\">QICoreCondition</a>)</td>\n <td>\n \n code\n \n </td>\n <td>\n \n \n Breastfeeding\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1047.73/expansion\">Breastfeeding</a></td>\n </tr>\n \n <tr>\n <td>Condition(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-condition.html\">QICoreCondition</a>)</td>\n <td>\n \n code\n \n </td>\n <td>\n \n \n Rhabdomyolysis\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1047.102/expansion\">Rhabdomyolysis</a></td>\n </tr>\n \n <tr>\n <td>Condition(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-condition.html\">QICoreCondition</a>)</td>\n <td>\n \n code\n \n </td>\n <td>\n \n \n Hospice Diagnosis\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.1165/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1165</a></td>\n </tr>\n \n <tr>\n <td>Condition(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-condition.html\">QICoreCondition</a>)</td>\n <td>\n \n code\n \n </td>\n <td>\n \n \n Palliative Care Diagnosis\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.1167/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1167</a></td>\n </tr>\n \n <tr>\n <td>Condition(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-condition.html\">QICoreCondition</a>)</td>\n <td>\n \n code\n \n </td>\n <td>\n \n \n Hepatitis A\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.110.12.1024/expansion\">Hepatitis A</a></td>\n </tr>\n \n <tr>\n <td>Condition(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-condition.html\">QICoreCondition</a>)</td>\n <td>\n \n code\n \n </td>\n <td>\n \n \n Hepatitis B\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.67.1.101.1.269/expansion\">Hepatitis B</a></td>\n </tr>\n \n <tr>\n <td>Condition(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-condition.html\">QICoreCondition</a>)</td>\n <td>\n \n code\n \n </td>\n <td>\n \n \n Liver Disease\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1047.42/expansion\">Liver Disease</a></td>\n </tr>\n \n <tr>\n <td>Condition(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-condition.html\">QICoreCondition</a>)</td>\n <td>\n \n code\n \n </td>\n <td>\n \n \n Statin Associated Muscle Symptoms\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1108.85/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.85</a></td>\n </tr>\n \n <tr>\n <td>Condition(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-condition.html\">QICoreCondition</a>)</td>\n <td>\n \n code\n \n </td>\n <td>\n \n \n End Stage Renal Disease\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.353/expansion\">End Stage Renal Disease</a></td>\n </tr>\n \n <tr>\n <td>Procedure(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html\">QICoreProcedure</a>)</td>\n <td>\n \n code\n \n performed\n \n status\n \n status.value\n \n </td>\n <td>\n \n \n PCI\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1045.67/expansion\">PCI</a></td>\n </tr>\n \n <tr>\n <td>Procedure(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html\">QICoreProcedure</a>)</td>\n <td>\n \n code\n \n performed\n \n status\n \n status.value\n \n </td>\n <td>\n \n \n CABG Surgeries\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.666.5.694/expansion\">CABG Surgeries</a></td>\n </tr>\n \n <tr>\n <td>Procedure(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html\">QICoreProcedure</a>)</td>\n <td>\n \n code\n \n performed\n \n status\n \n status.value\n \n </td>\n <td>\n \n \n Carotid Intervention\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.204/expansion\">Carotid Intervention</a></td>\n </tr>\n \n <tr>\n <td>Procedure(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html\">QICoreProcedure</a>)</td>\n <td>\n \n code\n \n performed\n \n status\n \n status.value\n \n </td>\n <td>\n \n \n CABG or PCI Procedure\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1138.566/expansion\">CABG, PCI Procedure</a></td>\n </tr>\n \n <tr>\n <td>Procedure(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html\">QICoreProcedure</a>)</td>\n <td>\n \n code\n \n performed\n \n status\n \n status.value\n \n </td>\n <td>\n \n \n Hospice Care Ambulatory\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1584/expansion\">Hospice Care Ambulatory</a></td>\n </tr>\n \n <tr>\n <td>Procedure(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html\">QICoreProcedure</a>)</td>\n <td>\n \n code\n \n performed\n \n status\n \n status.value\n \n </td>\n <td>\n \n \n Palliative Care Intervention\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.198.12.1135/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1135</a></td>\n </tr>\n \n <tr>\n <td>Encounter(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html\">QICoreEncounter</a>)</td>\n <td>\n \n type\n \n period\n \n status\n \n status.value\n \n </td>\n <td>\n \n \n Annual Wellness Visit\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1240/expansion\">Annual Wellness Visit</a></td>\n </tr>\n \n <tr>\n <td>Encounter(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html\">QICoreEncounter</a>)</td>\n <td>\n \n type\n \n period\n \n status\n \n status.value\n \n </td>\n <td>\n \n \n Office Visit\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1001/expansion\">Office Visit</a></td>\n </tr>\n \n <tr>\n <td>Encounter(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html\">QICoreEncounter</a>)</td>\n <td>\n \n type\n \n period\n \n status\n \n status.value\n \n </td>\n <td>\n \n \n Outpatient Consultation\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1008/expansion\">Outpatient Consultation</a></td>\n </tr>\n \n <tr>\n <td>Encounter(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html\">QICoreEncounter</a>)</td>\n <td>\n \n type\n \n period\n \n status\n \n status.value\n \n </td>\n <td>\n \n \n Outpatient Encounters for Preventive Care\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1576/expansion\">Outpatient Encounters for Preventive Care</a></td>\n </tr>\n \n <tr>\n <td>Encounter(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html\">QICoreEncounter</a>)</td>\n <td>\n \n type\n \n period\n \n status\n \n status.value\n \n </td>\n <td>\n \n \n Preventive Care Services Established Office Visit, 18 and Up\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1025/expansion\">Preventive Care Services - Established Office Visit, 18 and Up</a></td>\n </tr>\n \n <tr>\n <td>Encounter(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html\">QICoreEncounter</a>)</td>\n <td>\n \n type\n \n period\n \n status\n \n status.value\n \n </td>\n <td>\n \n \n Preventive Care Services Individual Counseling\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1026/expansion\">Preventive Care Services-Individual Counseling</a></td>\n </tr>\n \n <tr>\n <td>Encounter(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html\">QICoreEncounter</a>)</td>\n <td>\n \n type\n \n period\n \n status\n \n status.value\n \n </td>\n <td>\n \n \n Preventive Care Services Initial Office Visit, 18 and Up\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1023/expansion\">Preventive Care Services-Initial Office Visit, 18 and Up</a></td>\n </tr>\n \n <tr>\n <td>Encounter(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html\">QICoreEncounter</a>)</td>\n <td>\n \n type\n \n period\n \n status\n \n status.value\n \n </td>\n <td>\n \n \n Preventive Care Services Other\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.11.1150/expansion\">Preventive Care Services - Other</a></td>\n </tr>\n \n <tr>\n <td>Encounter(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html\">QICoreEncounter</a>)</td>\n <td>\n \n type\n \n hospitalization\n \n hospitalization.dischargeDisposition\n \n period\n \n status\n \n status.value\n \n </td>\n <td>\n \n \n Encounter Inpatient\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.666.5.307/expansion\">Encounter Inpatient</a></td>\n </tr>\n \n <tr>\n <td>Encounter(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html\">QICoreEncounter</a>)</td>\n <td>\n \n type\n \n period\n \n status\n \n status.value\n \n </td>\n <td>\n \n \n Hospice Encounter\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.1003/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1003</a></td>\n </tr>\n \n <tr>\n <td>Encounter(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html\">QICoreEncounter</a>)</td>\n <td>\n \n type\n \n period\n \n status\n \n status.value\n \n </td>\n <td>\n \n \n Palliative Care Encounter\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1090/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1090</a></td>\n </tr>\n \n <tr>\n <td>Patient(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-patient.html\">QICorePatient</a>)</td>\n <td>\n \n race\n \n ethnicity\n \n </td>\n <td>\n \n </td>\n <td/>\n </tr>\n \n <tr>\n <td>Observation(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-observation.html\">QICoreObservation</a>)</td>\n <td>\n \n code\n \n value\n \n effective\n \n status\n \n status.value\n \n category\n \n </td>\n <td>\n \n \n LDL Cholesterol\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1573/expansion\">LDL Cholesterol</a></td>\n </tr>\n \n <tr>\n <td>Observation(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-observation.html\">QICoreObservation</a>)</td>\n <td>\n \n code\n \n value\n \n effective\n \n status\n \n status.value\n \n category\n \n </td>\n <td>\n \n </td>\n <td/>\n </tr>\n \n <tr>\n <td>Observation(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-observation.html\">QICoreObservation</a>)</td>\n <td>\n \n code\n \n value\n \n effective\n \n status\n \n status.value\n \n category\n \n </td>\n <td>\n \n </td>\n <td/>\n </tr>\n \n <tr>\n <td>Observation(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-observation.html\">QICoreObservation</a>)</td>\n <td>\n \n code\n \n value\n \n effective\n \n status\n \n status.value\n \n category\n \n </td>\n <td>\n \n </td>\n <td/>\n </tr>\n \n <tr>\n <td>Observation(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-observation.html\">QICoreObservation</a>)</td>\n <td>\n \n code\n \n effective\n \n value\n \n status\n \n status.value\n \n category\n \n </td>\n <td>\n \n </td>\n <td/>\n </tr>\n \n <tr>\n <td>Medication(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-medication.html\">QICoreMedication</a>)</td>\n <td>\n \n id\n \n </td>\n <td>\n \n </td>\n <td/>\n </tr>\n \n <tr>\n <td>Medication(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-medication.html\">QICoreMedication</a>)</td>\n <td>\n \n id\n \n </td>\n <td>\n \n </td>\n <td/>\n </tr>\n \n <tr>\n <td>Medication(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-medication.html\">QICoreMedication</a>)</td>\n <td>\n \n id\n \n </td>\n <td>\n \n </td>\n <td/>\n </tr>\n \n <tr>\n <td>MedicationRequest(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-medicationrequest.html\">QICoreMedicationRequest</a>)</td>\n <td>\n \n medication.reference\n \n status\n \n status.value\n \n intent\n \n intent.value\n \n authoredOn\n \n authoredOn.value\n \n dosageInstruction\n \n </td>\n <td>\n \n </td>\n <td/>\n </tr>\n \n <tr>\n <td>MedicationRequest(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-medicationrequest.html\">QICoreMedicationRequest</a>)</td>\n <td>\n \n medication\n \n status\n \n status.value\n \n intent\n \n intent.value\n \n authoredOn\n \n authoredOn.value\n \n dosageInstruction\n \n </td>\n <td>\n \n \n Low Intensity Statin Therapy\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1574/expansion\">Low Intensity Statin Therapy</a></td>\n </tr>\n \n <tr>\n <td>MedicationRequest(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-medicationrequest.html\">QICoreMedicationRequest</a>)</td>\n <td>\n \n medication\n \n status\n \n status.value\n \n intent\n \n intent.value\n \n authoredOn\n \n authoredOn.value\n \n dosageInstruction\n \n </td>\n <td>\n \n \n Moderate Intensity Statin Therapy\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1575/expansion\">Moderate Intensity Statin Therapy</a></td>\n </tr>\n \n <tr>\n <td>MedicationRequest(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-medicationrequest.html\">QICoreMedicationRequest</a>)</td>\n <td>\n \n medication\n \n status\n \n status.value\n \n intent\n \n intent.value\n \n authoredOn\n \n authoredOn.value\n \n dosageInstruction\n \n </td>\n <td>\n \n \n High Intensity Statin Therapy\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1572/expansion\">High Intensity Statin Therapy</a></td>\n </tr>\n \n <tr>\n <td>Coverage(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-coverage.html\">QICoreCoverage</a>)</td>\n <td>\n \n type\n \n period\n \n </td>\n <td>\n \n \n Payer Type\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.114222.4.11.3591/expansion\">Payer</a></td>\n </tr>\n \n <tr>\n <td>AllergyIntolerance(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-allergyintolerance.html\">QICoreAllergyIntolerance</a>)</td>\n <td>\n \n code\n \n onset\n \n clinicalStatus\n \n </td>\n <td>\n \n \n Statin Allergen\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1110.42/expansion\">Statin Allergen</a></td>\n </tr>\n \n <tr>\n <td>ServiceRequest(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-servicerequest.html\">QICoreServiceRequest</a>)</td>\n <td>\n \n code\n \n authoredOn\n \n authoredOn.value\n \n status\n \n status.value\n \n intent\n \n intent.value\n \n </td>\n <td>\n \n \n Hospice Care Ambulatory\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1584/expansion\">Hospice Care Ambulatory</a></td>\n </tr>\n \n <tr>\n <td>AdverseEvent(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-adverseevent.html\">QICoreAdverseEvent</a>)</td>\n <td>\n \n event\n \n recordedDate\n \n recordedDate.value\n \n </td>\n <td>\n \n \n Statin Allergen\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1110.42/expansion\">Statin Allergen</a></td>\n </tr>\n \n <tr>\n <td>MedicationRequest(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-mednotrequested.html\">QICoreMedicationNotRequested</a>)</td>\n <td>\n \n medication\n \n authoredOn\n \n authoredOn.value\n \n status\n \n status.value\n \n reasonCode\n \n </td>\n <td>\n \n \n Low Intensity Statin Therapy\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1574/expansion\">Low Intensity Statin Therapy</a></td>\n </tr>\n \n <tr>\n <td>MedicationRequest(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-mednotrequested.html\">QICoreMedicationNotRequested</a>)</td>\n <td>\n \n medication\n \n authoredOn\n \n authoredOn.value\n \n status\n \n status.value\n \n reasonCode\n \n </td>\n <td>\n \n \n Low Intensity Statin Therapy\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1574/expansion\">Low Intensity Statin Therapy</a></td>\n </tr>\n \n <tr>\n <td>MedicationRequest(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-mednotrequested.html\">QICoreMedicationNotRequested</a>)</td>\n <td>\n \n medication\n \n authoredOn\n \n authoredOn.value\n \n status\n \n status.value\n \n reasonCode\n \n </td>\n <td>\n \n \n Moderate Intensity Statin Therapy\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1575/expansion\">Moderate Intensity Statin Therapy</a></td>\n </tr>\n \n <tr>\n <td>MedicationRequest(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-mednotrequested.html\">QICoreMedicationNotRequested</a>)</td>\n <td>\n \n medication\n \n authoredOn\n \n authoredOn.value\n \n status\n \n status.value\n \n reasonCode\n \n </td>\n <td>\n \n \n Moderate Intensity Statin Therapy\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1575/expansion\">Moderate Intensity Statin Therapy</a></td>\n </tr>\n \n <tr>\n <td>MedicationRequest(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-mednotrequested.html\">QICoreMedicationNotRequested</a>)</td>\n <td>\n \n medication\n \n authoredOn\n \n authoredOn.value\n \n status\n \n status.value\n \n reasonCode\n \n </td>\n <td>\n \n \n High Intensity Statin Therapy\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1572/expansion\">High Intensity Statin Therapy</a></td>\n </tr>\n \n <tr>\n <td>MedicationRequest(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-mednotrequested.html\">QICoreMedicationNotRequested</a>)</td>\n <td>\n \n medication\n \n authoredOn\n \n authoredOn.value\n \n status\n \n status.value\n \n reasonCode\n \n </td>\n <td>\n \n \n High Intensity Statin Therapy\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1572/expansion\">High Intensity Statin Therapy</a></td>\n </tr>\n \n </table>\n </td>\n </tr>\n\n \n <tr>\n <th scope=\"row\"><b>Direct Reference Codes:</b></th>\n <td style=\"padding-left: 4px;\">\n <table class=\"grid-dict\">\n <tr>\n <th><b>display</b></th>\n <th><b>code</b></th>\n <th><b>system</b></th>\n </tr>\n \n <tr>\n <td>Problem List Item</td>\n <td>problem-list-item</td>\n <td><a href=\"http://hl7.org/fhir/R4/codesystem-condition-category.html\">http://terminology.hl7.org/CodeSystem/condition-category</a></td>\n </tr>\n \n <tr>\n <td>Health Concern</td>\n <td>health-concern</td>\n <td><a href=\"http://hl7.org/fhir/us/core/STU3.1.1/CodeSystem-condition-category.html\">http://hl7.org/fhir/us/core/CodeSystem/condition-category</a></td>\n </tr>\n \n <tr>\n <td>Subsequent non-ST elevation (NSTEMI) myocardial infarction</td>\n <td>I22.2</td>\n <td><a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-icd10CM.html\">http://hl7.org/fhir/sid/icd-10-cm</a></td>\n </tr>\n \n <tr>\n <td>Cardiovascular disease 10Y risk [Likelihood]</td>\n <td>99055-6</td>\n <td><a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-v3-loinc.html\">http://loinc.org</a></td>\n </tr>\n \n <tr>\n <td>Cardiovascular disease 10Y risk [Likelihood] ACC-AHA Pooled Cohort by Goff 2013</td>\n <td>79423-0</td>\n <td><a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-v3-loinc.html\">http://loinc.org</a></td>\n </tr>\n \n <tr>\n <td>Male</td>\n <td>M</td>\n <td><a href=\"http://hl7.org/fhir/R4/codesystem-administrative-gender.html\">http://hl7.org/fhir/administrative-gender</a></td>\n </tr>\n \n <tr>\n <td>Female</td>\n <td>F</td>\n <td><a href=\"http://hl7.org/fhir/R4/codesystem-administrative-gender.html\">http://hl7.org/fhir/administrative-gender</a></td>\n </tr>\n \n <tr>\n <td>Active</td>\n <td>active</td>\n <td><a href=\"http://hl7.org/fhir/R4/codesystem-allergyintolerance-clinical.html\">http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical</a></td>\n </tr>\n \n <tr>\n <td>Discharge to home for hospice care (procedure)</td>\n <td>428361000124107</td>\n <td><a href=\"http://hl7.org/fhir/R4/codesystem-snomedct.html\">http://snomed.info/sct</a></td>\n </tr>\n \n <tr>\n <td>Discharge to healthcare facility for hospice care (procedure)</td>\n <td>428371000124100</td>\n <td><a href=\"http://hl7.org/fhir/R4/codesystem-snomedct.html\">http://snomed.info/sct</a></td>\n </tr>\n \n <tr>\n <td>survey</td>\n <td>survey</td>\n <td><a href=\"http://hl7.org/fhir/R4/codesystem-observation-category.html\">http://terminology.hl7.org/CodeSystem/observation-category</a></td>\n </tr>\n \n <tr>\n <td>Yes (qualifier value)</td>\n <td>373066001</td>\n <td><a href=\"http://hl7.org/fhir/R4/codesystem-snomedct.html\">http://snomed.info/sct</a></td>\n </tr>\n \n <tr>\n <td>Hospice care [Minimum Data Set]</td>\n <td>45755-6</td>\n <td><a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-v3-loinc.html\">http://loinc.org</a></td>\n </tr>\n \n <tr>\n <td>Functional Assessment of Chronic Illness Therapy - Palliative Care Questionnaire (FACIT-Pal)</td>\n <td>71007-9</td>\n <td><a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-v3-loinc.html\">http://loinc.org</a></td>\n </tr>\n \n </table>\n </td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Logic Definitions:</b></th>\n <td style=\"padding-left: 4px;\">\n \n <table class=\"grid-dict\">\n <tr>\n <th><b>Group</b></th>\n <th><b>Scoring</b></th>\n <th><b>Population Criteria</b></th>\n <th><b>Expression</b></th>\n </tr>\n <tr>\n \n <td> 64ef76a356d636294b157b96 </td>\n <td colspan=\"3\" style=\"padding-left: 4px;\">\n \n <b>Group scoring:</b>\n \n <span> proportion </span>\n \n \n\n \n\n \n <b>Measure scoring:</b>\n \n <p style=\"margin-bottom: 5px;\">\n <span>Proportion</span>\n </p>\n \n \n\n \n\n \n <tr>\n \n <th scope=\"row\"><b>Type: </b></th>\n <td style=\"padding-left: 4px;\">\n \n \n <p style=\"margin-bottom: 5px;\">\n <span>Process </span>\n </p>\n \n \n \n </td>\n \n </tr>\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Rate Aggregation: </b></th>\n <td colspan=\"3\" style=\"padding-left: 4px;\">This measure is intended to have one reporting rate, which aggregates the following populations into a single performance rate for reporting purposes: Population 1: All patients who were previously diagnosed with or currently have a diagnosis of clinical ASCVD, including an ASCVD procedure. Population 2: Patients aged 20 to 75 years at the beginning of the measurement period who have ever had a laboratory result of LDL-C >= 190 mg/dL or were previously diagnosed with or currently have an active diagnosis of familial hypercholesterolemia. Population 3: Patients aged 40 to 75 years at the beginning of the measurement period with an active diagnosis of Type 1 or Type 2 diabetes at any time during the measurement period. Population 4: Patients aged 40 to 75 at the beginning of the measurement period with a 10-year ASCVD risk score of > = 20 percent during the measurement period. For the purposes of this measure, a single performance rate can be calculated as follows: Performance Rate = (Numerator 1 + Numerator 2 + Numerator 3 + Numerator 4)/ [(Denominator 1 - Denominator Exclusions 1- Denominator Exceptions 1) + (Denominator 2 - Denominator Exclusions 2 - Denominator Exceptions 2) + (Denominator 3 - Denominator Exclusions 3 - Denominator Exceptions 3) + (Denominator 4 - Denominator Exclusions 4 - Denominator Exceptions 4)]</td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Improvement Notation: </b></th>\n <td style=\"padding-left: 4px;\">\n \n \n \n <p style=\"margin-bottom: 5px;\">\n <span>increase </span>\n </p>\n \n \n \n \n </td>\n </tr>\n \n\n \n\n </td>\n \n <tr>\n <td/>\n <td/>\n <td>Initial Population</td>\n <td>\n \n <pre><code class=\"language-cql\">define "Initial Population 1":\n exists ( "ASVCD Diagnosis or Procedure before End of Measurement Period"\n union "Myocardial Infarction before End of Measurement Period"\n )\n and exists "Qualifying Encounter during day of Measurement Period"</code></pre>\n \n </td>\n </tr>\n \n <tr>\n <td/>\n <td/>\n <td>Denominator</td>\n <td>\n \n <pre><code class=\"language-cql\">define "Denominator 1":\n "Initial Population 1"</code></pre>\n \n </td>\n </tr>\n \n <tr>\n <td/>\n <td/>\n <td>Denominator Exclusion</td>\n <td>\n \n <pre><code class=\"language-cql\">define "Denominator Exclusions":\n exists ( ( [Condition: "Breastfeeding"]\n union [Condition: "Rhabdomyolysis"] ) ExclusionDiagnosis\n where ( ExclusionDiagnosis.isProblemListItem ( )\n or ExclusionDiagnosis.isHealthConcern ( )\n )\n and ExclusionDiagnosis.prevalenceInterval ( ) overlaps day of "Measurement Period"\n )</code></pre>\n \n </td>\n </tr>\n \n <tr>\n <td/>\n <td/>\n <td>Numerator</td>\n <td>\n \n <pre><code class=\"language-cql\">define "Numerator":\n exists "Statin Therapy Prescribed Anytime during day of Measurement Period"</code></pre>\n \n </td>\n </tr>\n \n <tr>\n <td/>\n <td/>\n <td>Denominator Exception</td>\n <td>\n \n <pre><code class=\"language-cql\">define "Denominator Exceptions":\n "Has Allergy to Statin"\n or Hospice."Has Hospice Services"\n or PalliativeCare."Has Palliative Care in the Measurement Period"\n or "Has Hepatitis or Liver Disease Diagnosis"\n or "Has Statin Associated Muscle Symptoms"\n or "Has ESRD Diagnosis"\n or "Has Adverse Reaction to Statin"\n or "Has Medical Reason for Not Ordering Statin Therapy"</code></pre>\n \n </td>\n </tr>\n \n \n \n <td> 64ef76a356d636294b157b97 </td>\n <td colspan=\"3\" style=\"padding-left: 4px;\">\n \n <b>Group scoring:</b>\n \n <span> proportion </span>\n \n \n\n \n\n \n <b>Measure scoring:</b>\n \n <p style=\"margin-bottom: 5px;\">\n <span>Proportion</span>\n </p>\n \n \n\n \n\n \n <tr>\n \n <th scope=\"row\"><b>Type: </b></th>\n <td style=\"padding-left: 4px;\">\n \n \n <p style=\"margin-bottom: 5px;\">\n <span>Process </span>\n </p>\n \n \n \n </td>\n \n </tr>\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Rate Aggregation: </b></th>\n <td colspan=\"3\" style=\"padding-left: 4px;\">This measure is intended to have one reporting rate, which aggregates the following populations into a single performance rate for reporting purposes: \n\nPopulation 1: All patients who have an active diagnosis of clinical ASCVD or ever had an ASCVD procedure.\n\nPopulation 2: Patients aged >= 20 years at the beginning of the measurement period who have ever had a laboratory result of LDL-C >= 190 mg/dL or were previously diagnosed with or currently have an active diagnosis of familial hypercholesterolemia.\n\nPopulation 3: Patients aged 40 to 75 years at the beginning of the measurement period with an active diagnosis of Type 1 or Type 2 diabetes at any time during the measurement period. \n\nFor the purposes of this measure, a single performance rate can be calculated as follows:\n\nPerformance Rate = (Numerator 1 + Numerator 2 +Numerator 3)/ [(Denominator 1 - Denominator Exclusions 1- Denominator Exceptions 1) + (Denominator 2 - Denominator Exclusions 2 - Denominator Exceptions 2) +(Denominator 3 - Denominator Exclusions 3 - Denominator Exceptions 3)]</td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Improvement Notation: </b></th>\n <td style=\"padding-left: 4px;\">\n \n \n \n <p style=\"margin-bottom: 5px;\">\n <span>increase </span>\n </p>\n \n \n \n \n </td>\n </tr>\n \n\n \n\n </td>\n \n <tr>\n <td/>\n <td/>\n <td>Initial Population</td>\n <td>\n \n <pre><code class=\"language-cql\">define "Initial Population 2":\n "Patients Aged 20 to 75 with LDL Cholesterol Result Greater than or Equal to 190 or Hypercholesterolemia without ASCVD"\n and exists "Qualifying Encounter during day of Measurement Period"</code></pre>\n \n </td>\n </tr>\n \n <tr>\n <td/>\n <td/>\n <td>Denominator</td>\n <td>\n \n <pre><code class=\"language-cql\">define "Denominator 2":\n "Initial Population 2"</code></pre>\n \n </td>\n </tr>\n \n <tr>\n <td/>\n <td/>\n <td>Denominator Exclusion</td>\n <td>\n \n <pre><code class=\"language-cql\">define "Denominator Exclusions":\n exists ( ( [Condition: "Breastfeeding"]\n union [Condition: "Rhabdomyolysis"] ) ExclusionDiagnosis\n where ( ExclusionDiagnosis.isProblemListItem ( )\n or ExclusionDiagnosis.isHealthConcern ( )\n )\n and ExclusionDiagnosis.prevalenceInterval ( ) overlaps day of "Measurement Period"\n )</code></pre>\n \n </td>\n </tr>\n \n <tr>\n <td/>\n <td/>\n <td>Numerator</td>\n <td>\n \n <pre><code class=\"language-cql\">define "Numerator":\n exists "Statin Therapy Prescribed Anytime during day of Measurement Period"</code></pre>\n \n </td>\n </tr>\n \n <tr>\n <td/>\n <td/>\n <td>Denominator Exception</td>\n <td>\n \n <pre><code class=\"language-cql\">define "Denominator Exceptions":\n "Has Allergy to Statin"\n or Hospice."Has Hospice Services"\n or PalliativeCare."Has Palliative Care in the Measurement Period"\n or "Has Hepatitis or Liver Disease Diagnosis"\n or "Has Statin Associated Muscle Symptoms"\n or "Has ESRD Diagnosis"\n or "Has Adverse Reaction to Statin"\n or "Has Medical Reason for Not Ordering Statin Therapy"</code></pre>\n \n </td>\n </tr>\n \n \n \n <td> 64ef76a356d636294b157b98 </td>\n <td colspan=\"3\" style=\"padding-left: 4px;\">\n \n <b>Group scoring:</b>\n \n <span> proportion </span>\n \n \n\n \n\n \n <b>Measure scoring:</b>\n \n <p style=\"margin-bottom: 5px;\">\n <span>Proportion</span>\n </p>\n \n \n\n \n\n \n <tr>\n \n <th scope=\"row\"><b>Type: </b></th>\n <td style=\"padding-left: 4px;\">\n \n \n <p style=\"margin-bottom: 5px;\">\n <span>Process </span>\n </p>\n \n \n \n </td>\n \n </tr>\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Rate Aggregation: </b></th>\n <td colspan=\"3\" style=\"padding-left: 4px;\">This measure is intended to have one reporting rate, which aggregates the following populations into a single performance rate for reporting purposes: \n\nPopulation 1: All patients who have an active diagnosis of clinical ASCVD or ever had an ASCVD procedure.\n\nPopulation 2: Patients aged >= 20 years at the beginning of the measurement period who have ever had a laboratory result of LDL-C >= 190 mg/dL or were previously diagnosed with or currently have an active diagnosis of familial hypercholesterolemia.\n\nPopulation 3: Patients aged 40 to 75 years at the beginning of the measurement period with an active diagnosis of Type 1 or Type 2 diabetes at any time during the measurement period. \n\nFor the purposes of this measure, a single performance rate can be calculated as follows:\n\nPerformance Rate = (Numerator 1 + Numerator 2 +Numerator 3)/ [(Denominator 1 - Denominator Exclusions 1- Denominator Exceptions 1) + (Denominator 2 - Denominator Exclusions 2 - Denominator Exceptions 2) +(Denominator 3 - Denominator Exclusions 3 - Denominator Exceptions 3)]</td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Improvement Notation: </b></th>\n <td style=\"padding-left: 4px;\">\n \n \n \n <p style=\"margin-bottom: 5px;\">\n <span>increase </span>\n </p>\n \n \n \n \n </td>\n </tr>\n \n\n \n\n </td>\n \n <tr>\n <td/>\n <td/>\n <td>Initial Population</td>\n <td>\n \n <pre><code class=\"language-cql\">define "Initial Population 3":\n "Patients Aged 40 to 75 Years with Diabetes without ASCVD or LDL Greater than 190 or Hypercholesterolemia"\n and exists "Qualifying Encounter during day of Measurement Period"</code></pre>\n \n </td>\n </tr>\n \n <tr>\n <td/>\n <td/>\n <td>Denominator</td>\n <td>\n \n <pre><code class=\"language-cql\">define "Denominator 3":\n "Initial Population 3"</code></pre>\n \n </td>\n </tr>\n \n <tr>\n <td/>\n <td/>\n <td>Denominator Exclusion</td>\n <td>\n \n <pre><code class=\"language-cql\">define "Denominator Exclusions":\n exists ( ( [Condition: "Breastfeeding"]\n union [Condition: "Rhabdomyolysis"] ) ExclusionDiagnosis\n where ( ExclusionDiagnosis.isProblemListItem ( )\n or ExclusionDiagnosis.isHealthConcern ( )\n )\n and ExclusionDiagnosis.prevalenceInterval ( ) overlaps day of "Measurement Period"\n )</code></pre>\n \n </td>\n </tr>\n \n <tr>\n <td/>\n <td/>\n <td>Numerator</td>\n <td>\n \n <pre><code class=\"language-cql\">define "Numerator":\n exists "Statin Therapy Prescribed Anytime during day of Measurement Period"</code></pre>\n \n </td>\n </tr>\n \n <tr>\n <td/>\n <td/>\n <td>Denominator Exception</td>\n <td>\n \n <pre><code class=\"language-cql\">define "Denominator Exceptions":\n "Has Allergy to Statin"\n or Hospice."Has Hospice Services"\n or PalliativeCare."Has Palliative Care in the Measurement Period"\n or "Has Hepatitis or Liver Disease Diagnosis"\n or "Has Statin Associated Muscle Symptoms"\n or "Has ESRD Diagnosis"\n or "Has Adverse Reaction to Statin"\n or "Has Medical Reason for Not Ordering Statin Therapy"</code></pre>\n \n </td>\n </tr>\n \n \n \n <td> 64ef76a356d636294b157b99 </td>\n <td colspan=\"3\" style=\"padding-left: 4px;\">\n \n <b>Group scoring:</b>\n \n <span> proportion </span>\n \n \n\n \n\n \n <b>Measure scoring:</b>\n \n <p style=\"margin-bottom: 5px;\">\n <span>Proportion</span>\n </p>\n \n \n\n \n\n \n <tr>\n \n <th scope=\"row\"><b>Type: </b></th>\n <td style=\"padding-left: 4px;\">\n \n \n <p style=\"margin-bottom: 5px;\">\n <span>Process </span>\n </p>\n \n \n \n </td>\n \n </tr>\n \n\n \n\n \n\n \n\n \n\n </td>\n \n <tr>\n <td/>\n <td/>\n <td>Initial Population</td>\n <td>\n \n <pre><code class=\"language-cql\">define "Initial Population 4":\n "Patients Age 40 to 75 Years and have a 10 Year CVD Risk of High without ASCVD and High LDL and Diabetes"\n and exists "Qualifying Encounter during day of Measurement Period"</code></pre>\n \n </td>\n </tr>\n \n <tr>\n <td/>\n <td/>\n <td>Denominator</td>\n <td>\n \n <pre><code class=\"language-cql\">define "Denominator 4":\n "Initial Population 4"</code></pre>\n \n </td>\n </tr>\n \n <tr>\n <td/>\n <td/>\n <td>Denominator Exclusion</td>\n <td>\n \n <pre><code class=\"language-cql\">define "Denominator Exclusions":\n exists ( ( [Condition: "Breastfeeding"]\n union [Condition: "Rhabdomyolysis"] ) ExclusionDiagnosis\n where ( ExclusionDiagnosis.isProblemListItem ( )\n or ExclusionDiagnosis.isHealthConcern ( )\n )\n and ExclusionDiagnosis.prevalenceInterval ( ) overlaps day of "Measurement Period"\n )</code></pre>\n \n </td>\n </tr>\n \n <tr>\n <td/>\n <td/>\n <td>Numerator</td>\n <td>\n \n <pre><code class=\"language-cql\">define "Numerator":\n exists "Statin Therapy Prescribed Anytime during day of Measurement Period"</code></pre>\n \n </td>\n </tr>\n \n <tr>\n <td/>\n <td/>\n <td>Denominator Exception</td>\n <td>\n \n <pre><code class=\"language-cql\">define "Denominator Exceptions":\n "Has Allergy to Statin"\n or Hospice."Has Hospice Services"\n or PalliativeCare."Has Palliative Care in the Measurement Period"\n or "Has Hepatitis or Liver Disease Diagnosis"\n or "Has Statin Associated Muscle Symptoms"\n or "Has ESRD Diagnosis"\n or "Has Adverse Reaction to Statin"\n or "Has Medical Reason for Not Ordering Statin Therapy"</code></pre>\n \n </td>\n </tr>\n \n \n \n </tr>\n </table>\n \n\n <table class=\"grid-dict\">\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR</td>\n \n \n <td>ASVCD Diagnosis or Procedure before End of Measurement Period</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "ASVCD Diagnosis or Procedure before End of Measurement Period":\n ( ( [Condition: "Myocardial Infarction"]\n union [Condition: "Cerebrovascular Disease Stroke or TIA"]\n union [Condition: "Atherosclerosis and Peripheral Arterial Disease"]\n union [Condition: "Ischemic Heart Disease or Other Related Diagnoses"]\n union [Condition: "Stable and Unstable Angina"] ) ASCVDDiagnosis\n where ( ASCVDDiagnosis.isProblemListItem ( )\n or ASCVDDiagnosis.isHealthConcern ( )\n )\n and ASCVDDiagnosis.prevalenceInterval ( ) starts on or before day of end of "Measurement Period"\n )\n union ( ( [Procedure: "PCI"]\n union [Procedure: "CABG Surgeries"]\n union [Procedure: "Carotid Intervention"]\n union [Procedure: "CABG or PCI Procedure"] ) ASCVDProcedure\n where ASCVDProcedure.performed.toInterval ( ) starts on or before day of end of "Measurement Period"\n and ASCVDProcedure.status = 'completed'\n )</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR</td>\n \n \n <td>Myocardial Infarction before End of Measurement Period</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Myocardial Infarction before End of Measurement Period":\n [Condition: "Subsequent non-ST elevation (NSTEMI) myocardial infarction"] SubsequentMI\n where ( SubsequentMI.isProblemListItem ( )\n or SubsequentMI.isHealthConcern ( )\n )\n and SubsequentMI.prevalenceInterval ( ) starts on or before day of end of "Measurement Period"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR</td>\n \n \n <td>Qualifying Encounter during day of Measurement Period</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Qualifying Encounter during day of Measurement Period":\n ( [Encounter: "Annual Wellness Visit"]\n union [Encounter: "Office Visit"]\n union [Encounter: "Outpatient Consultation"]\n union [Encounter: "Outpatient Encounters for Preventive Care"]\n union [Encounter: "Preventive Care Services Established Office Visit, 18 and Up"]\n union [Encounter: "Preventive Care Services Individual Counseling"]\n union [Encounter: "Preventive Care Services Initial Office Visit, 18 and Up"]\n union [Encounter: "Preventive Care Services Other"] ) QualifyingEncounter\n where QualifyingEncounter.period during day of "Measurement Period"\n and QualifyingEncounter.status = 'finished'</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR</td>\n \n \n <td>Initial Population 1</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Initial Population 1":\n exists ( "ASVCD Diagnosis or Procedure before End of Measurement Period"\n union "Myocardial Infarction before End of Measurement Period"\n )\n and exists "Qualifying Encounter during day of Measurement Period"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR</td>\n \n \n <td>Patients Aged 20 to 75 at Start of Measurement Period</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Patients Aged 20 to 75 at Start of Measurement Period":\n AgeInYearsAt(date from start of "Measurement Period") in Interval[20, 75]</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR</td>\n \n \n <td>LDL Result Greater Than or Equal To 190</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "LDL Result Greater Than or Equal To 190":\n [Observation: "LDL Cholesterol"] LDL190\n where LDL190.value as Quantity >= 190 'mg/dL'\n and LDL190.effective.toInterval ( ) starts on or before day of end of "Measurement Period"\n and LDL190.status in { 'final', 'amended', 'corrected', 'appended' }</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR</td>\n \n \n <td>Hypercholesterolemia Diagnosis</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Hypercholesterolemia Diagnosis":\n ( [Condition: "Familial Hypercholesterolemia"] Hypercholesterolemia\n where ( Hypercholesterolemia.isProblemListItem ( )\n or Hypercholesterolemia.isHealthConcern ( )\n )\n and Hypercholesterolemia.prevalenceInterval ( ) starts on or before day of end of "Measurement Period"\n )</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR</td>\n \n \n <td>Patients Aged 20 to 75 with LDL Cholesterol Result Greater than or Equal to 190 or Hypercholesterolemia without ASCVD</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Patients Aged 20 to 75 with LDL Cholesterol Result Greater than or Equal to 190 or Hypercholesterolemia without ASCVD":\n "Patients Aged 20 to 75 at Start of Measurement Period"\n and exists ( "LDL Result Greater Than or Equal To 190"\n union "Hypercholesterolemia Diagnosis"\n )\n and not exists ( "ASVCD Diagnosis or Procedure before End of Measurement Period" )</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR</td>\n \n \n <td>Initial Population 2</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Initial Population 2":\n "Patients Aged 20 to 75 with LDL Cholesterol Result Greater than or Equal to 190 or Hypercholesterolemia without ASCVD"\n and exists "Qualifying Encounter during day of Measurement Period"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SupplementalDataElements</td>\n \n \n <td>SDE Race</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "SDE Race":\n Patient.race R\n return Tuple {\n codes: R.ombCategory union R.detailed,\n display: R.text\n }</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR</td>\n \n \n <td>SDE Race</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "SDE Race":\n SDE."SDE Race"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR</td>\n \n \n <td>Has Diabetes Diagnosis</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Has Diabetes Diagnosis":\n exists ( [Condition: "Diabetes"] Diabetes\n where ( Diabetes.isProblemListItem ( )\n or Diabetes.isHealthConcern ( )\n )\n and Diabetes.prevalenceInterval ( ) overlaps day of "Measurement Period"\n )</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR</td>\n \n \n <td>Patients Aged 40 to 75 Years with Diabetes without ASCVD or LDL Greater than 190 or Hypercholesterolemia</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Patients Aged 40 to 75 Years with Diabetes without ASCVD or LDL Greater than 190 or Hypercholesterolemia":\n AgeInYearsAt(date from start of "Measurement Period") >= 40\n and AgeInYearsAt(date from start of "Measurement Period") <= 75\n and "Has Diabetes Diagnosis"\n and ( not exists "ASVCD Diagnosis or Procedure before End of Measurement Period"\n and not exists "LDL Result Greater Than or Equal To 190"\n and not exists "Hypercholesterolemia Diagnosis"\n )</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR</td>\n \n \n <td>Initial Population 3</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Initial Population 3":\n "Patients Aged 40 to 75 Years with Diabetes without ASCVD or LDL Greater than 190 or Hypercholesterolemia"\n and exists "Qualifying Encounter during day of Measurement Period"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR</td>\n \n \n <td>Ten Year CVD Risk is High</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Ten Year CVD Risk is High":\n ( exists ( [Observation: "Cardiovascular disease 10Y risk [Likelihood]"]\n union [Observation: "Cardiovascular disease 10Y risk [Likelihood] ACC-AHA Pooled Cohort by Goff 2013"] ) AtRiskCVD\n where AtRiskCVD.value as Quantity >= 20 '%'\n and AtRiskCVD.effective.toInterval ( ) during day of "Measurement Period"\n )</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR</td>\n \n \n <td>Patients Age 40 to 75 Years and have a 10 Year CVD Risk of High without ASCVD and High LDL and Diabetes</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Patients Age 40 to 75 Years and have a 10 Year CVD Risk of High without ASCVD and High LDL and Diabetes":\n AgeInYearsAt(date from start of "Measurement Period") in Interval[40, 75]\n and "Ten Year CVD Risk is High"\n and not ( exists "ASVCD Diagnosis or Procedure before End of Measurement Period"\n or exists "Hypercholesterolemia Diagnosis"\n or exists "LDL Result Greater Than or Equal To 190"\n or "Has Diabetes Diagnosis"\n )</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR</td>\n \n \n <td>Initial Population 4</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Initial Population 4":\n "Patients Age 40 to 75 Years and have a 10 Year CVD Risk of High without ASCVD and High LDL and Diabetes"\n and exists "Qualifying Encounter during day of Measurement Period"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SupplementalDataElements</td>\n \n \n <td>SDE Sex</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "SDE Sex":\n case\n when Patient.gender = 'male' then "M"\n when Patient.gender = 'female' then "F"\n else null\n end</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR</td>\n \n \n <td>SDE Sex</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "SDE Sex":\n SDE."SDE Sex"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR</td>\n \n \n <td>Denominator 3</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Denominator 3":\n "Initial Population 3"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR</td>\n \n \n <td>Statin Therapy Prescribed Anytime during day of Measurement Period</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Statin Therapy Prescribed Anytime during day of Measurement Period":\n ( [MedicationRequest: "Low Intensity Statin Therapy"]\n union [MedicationRequest: "Moderate Intensity Statin Therapy"]\n union [MedicationRequest: "High Intensity Statin Therapy"] ) StatinPrescribed\n where StatinPrescribed.status in { 'active', 'completed' }\n and StatinPrescribed.intent ~ 'order'\n and ( StatinPrescribed.authoredOn during day of "Measurement Period"\n or exists ( StatinPrescribed.dosageInstruction.timing T\n where T.repeat.bounds.toInterval ( ) overlaps day of "Measurement Period"\n )\n )</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR</td>\n \n \n <td>Numerator</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Numerator":\n exists "Statin Therapy Prescribed Anytime during day of Measurement Period"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR</td>\n \n \n <td>Denominator 2</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Denominator 2":\n "Initial Population 2"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR</td>\n \n \n <td>Denominator 4</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Denominator 4":\n "Initial Population 4"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SupplementalDataElements</td>\n \n \n <td>SDE Payer</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "SDE Payer":\n [Coverage: type in "Payer Type"] Payer\n return {\n code: Payer.type,\n period: Payer.period\n }</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR</td>\n \n \n <td>SDE Payer</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "SDE Payer":\n SDE."SDE Payer"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SupplementalDataElements</td>\n \n \n <td>SDE Ethnicity</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "SDE Ethnicity":\n Patient.ethnicity E\n return Tuple {\n codes: { E.ombCategory } union E.detailed,\n display: E.text\n }</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR</td>\n \n \n <td>SDE Ethnicity</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "SDE Ethnicity":\n SDE."SDE Ethnicity"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR</td>\n \n \n <td>Denominator Exclusions</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Denominator Exclusions":\n exists ( ( [Condition: "Breastfeeding"]\n union [Condition: "Rhabdomyolysis"] ) ExclusionDiagnosis\n where ( ExclusionDiagnosis.isProblemListItem ( )\n or ExclusionDiagnosis.isHealthConcern ( )\n )\n and ExclusionDiagnosis.prevalenceInterval ( ) overlaps day of "Measurement Period"\n )</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR</td>\n \n \n <td>Denominator 1</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Denominator 1":\n "Initial Population 1"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR</td>\n \n \n <td>Has Allergy to Statin</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Has Allergy to Statin":\n exists ( [AllergyIntolerance: "Statin Allergen"] StatinAllergy\n where StatinAllergy.onset.toInterval ( ) overlaps day of "Measurement Period"\n and StatinAllergy.clinicalStatus ~ QICoreCommon."allergy-active"\n )</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>Hospice</td>\n \n \n <td>Has Hospice Services</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Has Hospice Services":\n exists ((([Encounter: "Encounter Inpatient"]).isEncounterPerformed()) InpatientEncounter\n where (InpatientEncounter.hospitalization.dischargeDisposition ~ "Discharge to home for hospice care (procedure)"\n or InpatientEncounter.hospitalization.dischargeDisposition ~ "Discharge to healthcare facility for hospice care (procedure)"\n )\n and InpatientEncounter.period.toInterval() ends during day of "Measurement Period"\n )\n or exists ((([Encounter: "Hospice Encounter"]).isEncounterPerformed()) HospiceEncounter\n where HospiceEncounter.period.toInterval() overlaps day of "Measurement Period"\n )\n or exists ((([Observation: "Hospice care [Minimum Data Set]"]).isAssessmentPerformed()) HospiceAssessment\n where HospiceAssessment.value ~ "Yes (qualifier value)"\n and HospiceAssessment.effective.toInterval() overlaps day of "Measurement Period"\n )\n or exists ((([ServiceRequest: "Hospice Care Ambulatory"]).isInterventionOrder()) HospiceOrder\n where HospiceOrder.authoredOn.toInterval() during day of "Measurement Period"\n // and HospiceOrder.doNotPerform is not true\n // https://oncprojectracking.healthit.gov/support/browse/CQLIT-447\n )\n or exists ((([Procedure: "Hospice Care Ambulatory"]).isInterventionPerformed()) HospicePerformed\n where HospicePerformed.performed.toInterval() overlaps day of "Measurement Period"\n )\n or exists (([Condition: "Hospice Diagnosis"]) HospiceCareDiagnosis\n where HospiceCareDiagnosis.prevalenceInterval() overlaps day of "Measurement Period"\n )</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>PalliativeCare</td>\n \n \n <td>Has Palliative Care in the Measurement Period</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Has Palliative Care in the Measurement Period":\n exists ((([Observation: "Functional Assessment of Chronic Illness Therapy - Palliative Care Questionnaire (FACIT-Pal)"]).isAssessmentPerformed()) PalliativeAssessment\n where PalliativeAssessment.effective.toInterval() overlaps day of "Measurement Period"\n )\n or exists ([Condition: "Palliative Care Diagnosis"] PalliativeDiagnosis\n where PalliativeDiagnosis.prevalenceInterval() overlaps day of "Measurement Period"\n )\n or exists ((([Encounter: "Palliative Care Encounter"]).isEncounterPerformed()) PalliativeEncounter\n where PalliativeEncounter.period.toInterval() overlaps day of "Measurement Period"\n )\n or exists ((([Procedure: "Palliative Care Intervention"]).isInterventionPerformed()) PalliativeIntervention\n where PalliativeIntervention.performed.toInterval() overlaps day of "Measurement Period"\n )</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR</td>\n \n \n <td>Has Hepatitis or Liver Disease Diagnosis</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Has Hepatitis or Liver Disease Diagnosis":\n exists ( ( [Condition: "Hepatitis A"]\n union [Condition: "Hepatitis B"]\n union [Condition: "Liver Disease"] ) HepatitisLiverDisease\n where ( HepatitisLiverDisease.isProblemListItem ( )\n or HepatitisLiverDisease.isHealthConcern ( )\n )\n and HepatitisLiverDisease.prevalenceInterval ( ) overlaps day of "Measurement Period"\n )</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR</td>\n \n \n <td>Has Statin Associated Muscle Symptoms</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Has Statin Associated Muscle Symptoms":\n exists ( [Condition: "Statin Associated Muscle Symptoms"] StatinMuscleSymptom\n where ( StatinMuscleSymptom.isProblemListItem ( )\n or StatinMuscleSymptom.isHealthConcern ( )\n )\n and StatinMuscleSymptom.prevalenceInterval ( ) overlaps day of "Measurement Period"\n )</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR</td>\n \n \n <td>Has ESRD Diagnosis</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Has ESRD Diagnosis":\n exists ( [Condition: "End Stage Renal Disease"] ESRD\n where ( ESRD.isProblemListItem ( )\n or ESRD.isHealthConcern ( )\n )\n and ESRD.prevalenceInterval ( ) overlaps day of "Measurement Period"\n )</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR</td>\n \n \n <td>Has Adverse Reaction to Statin</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Has Adverse Reaction to Statin":\n exists ( [AdverseEvent: event in "Statin Allergen"] StatinReaction\n where StatinReaction.recordedDate during day of "Measurement Period"\n )</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR</td>\n \n \n <td>Has Medical Reason for Not Ordering Statin Therapy</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Has Medical Reason for Not Ordering Statin Therapy":\n exists ( ( [MedicationNotRequested: "Low Intensity Statin Therapy"]\n union [MedicationNotRequested: "Moderate Intensity Statin Therapy"]\n union [MedicationNotRequested: "High Intensity Statin Therapy"] ) NoStatinTherapyOrdered\n with "Qualifying Encounter during day of Measurement Period" QualifyingEncounter\n such that NoStatinTherapyOrdered.authoredOn during QualifyingEncounter.period\n and NoStatinTherapyOrdered.status = 'completed'\n and NoStatinTherapyOrdered.reasonCode in "Medical Reason"\n )</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR</td>\n \n \n <td>Denominator Exceptions</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Denominator Exceptions":\n "Has Allergy to Statin"\n or Hospice."Has Hospice Services"\n or PalliativeCare."Has Palliative Care in the Measurement Period"\n or "Has Hepatitis or Liver Disease Diagnosis"\n or "Has Statin Associated Muscle Symptoms"\n or "Has ESRD Diagnosis"\n or "Has Adverse Reaction to Statin"\n or "Has Medical Reason for Not Ordering Statin Therapy"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>QICoreCommon</td>\n \n \n <td>isProblemListItem</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">/*\n@description: Returns true if the given condition is a problem list item.\n*/\ndefine fluent function isProblemListItem(condition Condition):\n exists (condition.category C\n where C ~ "problem-list-item"\n )</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>FHIRHelpers</td>\n \n \n <td>ToConcept</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">/*\n@description: Converts the given FHIR [CodeableConcept](https://hl7.org/fhir/datatypes.html#CodeableConcept) value to a CQL Concept.\n*/\ndefine function ToConcept(concept FHIR.CodeableConcept):\n if concept is null then\n null\n else\n System.Concept {\n codes: concept.coding C return ToCode(C),\n display: concept.text.value\n }</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>QICoreCommon</td>\n \n \n <td>isHealthConcern</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">/*\n@description: Returns true if the given condition is a health concern\n*/\ndefine fluent function isHealthConcern(condition Condition):\n exists (condition.category C\n where C ~ "health-concern"\n )</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>QICoreCommon</td>\n \n \n <td>prevalenceInterval</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">/*\n@description: Returns an interval representing the normalized prevalence period of a given Condition.\n@comment: Uses the ToInterval and ToAbatementInterval functions to determine the widest potential interval from\nonset to abatement as specified in the given Condition. If the condition is active, or has an abatement date the resulting \ninterval will have a closed ending boundary. Otherwise, the resulting interval will have an open ending boundary.\n*/\ndefine fluent function prevalenceInterval(condition Condition):\nif condition.clinicalStatus ~ "active"\n or condition.clinicalStatus ~ "recurrence"\n or condition.clinicalStatus ~ "relapse" then\n Interval[start of condition.onset.toInterval(), end of condition.abatementInterval()]\nelse\n (end of condition.abatementInterval()) abatementDate\n return if abatementDate is null then\n Interval[start of condition.onset.toInterval(), abatementDate)\n else\n Interval[start of condition.onset.toInterval(), abatementDate]</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>FHIRHelpers</td>\n \n \n <td>ToString</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define function ToString(value uri): value.value</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>FHIRHelpers</td>\n \n \n <td>ToCode</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">/*\n@description: Converts the given FHIR [Coding](https://hl7.org/fhir/datatypes.html#Coding) value to a CQL Code.\n*/\ndefine function ToCode(coding FHIR.Coding):\n if coding is null then\n null\n else\n System.Code {\n code: coding.code.value,\n system: coding.system.value,\n version: coding.version.value,\n display: coding.display.value\n }</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>Status</td>\n \n \n <td>isEncounterPerformed</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">//Encounter, Performed\n//General usage unless required otherwise by measure intent (e.g., follow-up encounters)\ndefine fluent function isEncounterPerformed(Enc List<Encounter>):\n Enc E\n where E.status in {'finished', 'arrived', 'triaged', 'in-progress', 'onleave'}</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>QICoreCommon</td>\n \n \n <td>toInterval</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">/*\n@description: Normalizes a value that is a choice of timing-valued types to an equivalent interval\n@comment: Normalizes a choice type of DateTime, Quanitty, Interval<DateTime>, or Interval<Quantity> types\nto an equivalent interval. This selection of choice types is a superset of the majority of choice types that are used as possible\nrepresentations for timing-valued elements in QICore, allowing this function to be used across any resource.\nThe input can be provided as a DateTime, Quantity, Interval<DateTime> or Interval<Quantity>.\nThe intent of this function is to provide a clear and concise mechanism to treat single\nelements that have multiple possible representations as intervals so that logic doesn't have to account\nfor the variability. More complex calculations (such as medication request period or dispense period\ncalculation) need specific guidance and consideration. That guidance may make use of this function, but\nthe focus of this function is on single element calculations where the semantics are unambiguous.\nIf the input is a DateTime, the result a DateTime Interval beginning and ending on that DateTime.\nIf the input is a Quantity, the quantity is expected to be a calendar-duration interpreted as an Age,\nand the result is a DateTime Interval beginning on the Date the patient turned that age and ending immediately before one year later.\nIf the input is a DateTime Interval, the result is the input.\nIf the input is a Quantity Interval, the quantities are expected to be calendar-durations interpreted as an Age, and the result\nis a DateTime Interval beginning on the date the patient turned the age given as the start of the quantity interval, and ending\nimmediately before one year later than the date the patient turned the age given as the end of the quantity interval.\nIf the input is a Timing, an error will be thrown indicating that Timing calculations are not implemented. Any other input will reslt in a null DateTime Interval\n*/\ndefine fluent function toInterval(choice Choice<DateTime, Quantity, Interval<DateTime>, Interval<Quantity>, Timing>):\n case\n\t when choice is DateTime then\n \tInterval[choice as DateTime, choice as DateTime]\n\t\twhen choice is Interval<DateTime> then\n \t\tchoice as Interval<DateTime>\n\t\twhen choice is Quantity then\n\t\t Interval[Patient.birthDate + (choice as Quantity),\n\t\t\t Patient.birthDate + (choice as Quantity) + 1 year)\n\t\twhen choice is Interval<Quantity> then\n\t\t Interval[Patient.birthDate + (choice.low as Quantity),\n\t\t\t Patient.birthDate + (choice.high as Quantity) + 1 year)\n\t\twhen choice is Timing then\n Message(null, true, 'NOT_IMPLEMENTED', 'Error', 'Calculation of an interval from a Timing value is not supported') as Interval<DateTime>\n\t\telse\n\t\t\tnull as Interval<DateTime>\n\tend</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>Status</td>\n \n \n <td>isAssessmentPerformed</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">//This library contains functions that are based on QDM 5.6 to QICore 4.1.1 March 2023 (https://github.com/cqframework/CQL-Formatting-and-Usage-Wiki/wiki/Authoring-Patterns---QICore-v4.1.1). The functions may appear similar to some QICoreCommon functions but different in that they have constraints that are relevant for measures authored by NCQA.\n\n//Assessment, Performed\ndefine fluent function isAssessmentPerformed(Obs List<Observation>):\n Obs O\n where O.status in { 'final', 'amended', 'corrected' }\n and exists ( O.category ObservationCategory\n where ( ObservationCategory ) ~ "survey"\n )</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>Status</td>\n \n \n <td>isInterventionOrder</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">//Intervention, Order: active and completed only \ndefine fluent function isInterventionOrder(ServiceRequest List<ServiceRequest>):\n ServiceRequest S\n where S.status in { 'active', 'completed' }\n and S.intent = 'order'</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>Status</td>\n \n \n <td>isInterventionPerformed</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">//Intervention, Performed\ndefine fluent function isInterventionPerformed(Proc List<Procedure>):\n Proc P\n where P.status ~ 'completed'</code></pre>\n </td>\n \n </tr>\n \n </table>\n </td>\n </tr>\n \n \n \n\n </table>\n</div>"
},
"contained" : [
{
"resourceType" : "Library",
"id" : "effective-data-requirements",
"extension" : [
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
"valueCoding" : {
"system" : "http://terminology.hl7.org/CodeSystem/condition-category",
"code" : "problem-list-item",
"display" : "Problem List Item"
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
"valueCoding" : {
"system" : "http://hl7.org/fhir/us/core/CodeSystem/condition-category",
"code" : "health-concern",
"display" : "Health Concern"
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
"valueCoding" : {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "I22.2",
"display" : "Subsequent non-ST elevation (NSTEMI) myocardial infarction"
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "99055-6",
"display" : "Cardiovascular disease 10Y risk [Likelihood]"
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "79423-0",
"display" : "Cardiovascular disease 10Y risk [Likelihood] ACC-AHA Pooled Cohort by Goff 2013"
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
"valueCoding" : {
"system" : "http://hl7.org/fhir/administrative-gender",
"code" : "M",
"display" : "Male"
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
"valueCoding" : {
"system" : "http://hl7.org/fhir/administrative-gender",
"code" : "F",
"display" : "Female"
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
"valueCoding" : {
"system" : "http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical",
"code" : "active",
"display" : "Active"
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
"valueCoding" : {
"system" : "http://snomed.info/sct",
"code" : "428361000124107",
"display" : "Discharge to home for hospice care (procedure)"
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
"valueCoding" : {
"system" : "http://snomed.info/sct",
"code" : "428371000124100",
"display" : "Discharge to healthcare facility for hospice care (procedure)"
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
"valueCoding" : {
"system" : "http://terminology.hl7.org/CodeSystem/observation-category",
"code" : "survey",
"display" : "survey"
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
"valueCoding" : {
"system" : "http://snomed.info/sct",
"code" : "373066001",
"display" : "Yes (qualifier value)"
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "45755-6",
"display" : "Hospice care [Minimum Data Set]"
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "71007-9",
"display" : "Functional Assessment of Chronic Illness Therapy - Palliative Care Questionnaire (FACIT-Pal)"
}
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR"
},
{
"url" : "name",
"valueString" : "ASVCD Diagnosis or Procedure before End of Measurement Period"
},
{
"url" : "statement",
"valueString" : "define \"ASVCD Diagnosis or Procedure before End of Measurement Period\":\n ( ( [Condition: \"Myocardial Infarction\"]\n union [Condition: \"Cerebrovascular Disease Stroke or TIA\"]\n union [Condition: \"Atherosclerosis and Peripheral Arterial Disease\"]\n union [Condition: \"Ischemic Heart Disease or Other Related Diagnoses\"]\n union [Condition: \"Stable and Unstable Angina\"] ) ASCVDDiagnosis\n where ( ASCVDDiagnosis.isProblemListItem ( )\n or ASCVDDiagnosis.isHealthConcern ( )\n )\n and ASCVDDiagnosis.prevalenceInterval ( ) starts on or before day of end of \"Measurement Period\"\n )\n union ( ( [Procedure: \"PCI\"]\n union [Procedure: \"CABG Surgeries\"]\n union [Procedure: \"Carotid Intervention\"]\n union [Procedure: \"CABG or PCI Procedure\"] ) ASCVDProcedure\n where ASCVDProcedure.performed.toInterval ( ) starts on or before day of end of \"Measurement Period\"\n and ASCVDProcedure.status = 'completed'\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 0
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR"
},
{
"url" : "name",
"valueString" : "Myocardial Infarction before End of Measurement Period"
},
{
"url" : "statement",
"valueString" : "define \"Myocardial Infarction before End of Measurement Period\":\n [Condition: \"Subsequent non-ST elevation (NSTEMI) myocardial infarction\"] SubsequentMI\n where ( SubsequentMI.isProblemListItem ( )\n or SubsequentMI.isHealthConcern ( )\n )\n and SubsequentMI.prevalenceInterval ( ) starts on or before day of end of \"Measurement Period\""
},
{
"url" : "displaySequence",
"valueInteger" : 1
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR"
},
{
"url" : "name",
"valueString" : "Qualifying Encounter during day of Measurement Period"
},
{
"url" : "statement",
"valueString" : "define \"Qualifying Encounter during day of Measurement Period\":\n ( [Encounter: \"Annual Wellness Visit\"]\n union [Encounter: \"Office Visit\"]\n union [Encounter: \"Outpatient Consultation\"]\n union [Encounter: \"Outpatient Encounters for Preventive Care\"]\n union [Encounter: \"Preventive Care Services Established Office Visit, 18 and Up\"]\n union [Encounter: \"Preventive Care Services Individual Counseling\"]\n union [Encounter: \"Preventive Care Services Initial Office Visit, 18 and Up\"]\n union [Encounter: \"Preventive Care Services Other\"] ) QualifyingEncounter\n where QualifyingEncounter.period during day of \"Measurement Period\"\n and QualifyingEncounter.status = 'finished'"
},
{
"url" : "displaySequence",
"valueInteger" : 2
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR"
},
{
"url" : "name",
"valueString" : "Initial Population 1"
},
{
"url" : "statement",
"valueString" : "define \"Initial Population 1\":\n exists ( \"ASVCD Diagnosis or Procedure before End of Measurement Period\"\n union \"Myocardial Infarction before End of Measurement Period\"\n )\n and exists \"Qualifying Encounter during day of Measurement Period\""
},
{
"url" : "displaySequence",
"valueInteger" : 3
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR"
},
{
"url" : "name",
"valueString" : "Patients Aged 20 to 75 at Start of Measurement Period"
},
{
"url" : "statement",
"valueString" : "define \"Patients Aged 20 to 75 at Start of Measurement Period\":\n AgeInYearsAt(date from start of \"Measurement Period\") in Interval[20, 75]"
},
{
"url" : "displaySequence",
"valueInteger" : 4
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR"
},
{
"url" : "name",
"valueString" : "LDL Result Greater Than or Equal To 190"
},
{
"url" : "statement",
"valueString" : "define \"LDL Result Greater Than or Equal To 190\":\n [Observation: \"LDL Cholesterol\"] LDL190\n where LDL190.value as Quantity >= 190 'mg/dL'\n and LDL190.effective.toInterval ( ) starts on or before day of end of \"Measurement Period\"\n and LDL190.status in { 'final', 'amended', 'corrected', 'appended' }"
},
{
"url" : "displaySequence",
"valueInteger" : 5
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR"
},
{
"url" : "name",
"valueString" : "Hypercholesterolemia Diagnosis"
},
{
"url" : "statement",
"valueString" : "define \"Hypercholesterolemia Diagnosis\":\n ( [Condition: \"Familial Hypercholesterolemia\"] Hypercholesterolemia\n where ( Hypercholesterolemia.isProblemListItem ( )\n or Hypercholesterolemia.isHealthConcern ( )\n )\n and Hypercholesterolemia.prevalenceInterval ( ) starts on or before day of end of \"Measurement Period\"\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 6
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR"
},
{
"url" : "name",
"valueString" : "Patients Aged 20 to 75 with LDL Cholesterol Result Greater than or Equal to 190 or Hypercholesterolemia without ASCVD"
},
{
"url" : "statement",
"valueString" : "define \"Patients Aged 20 to 75 with LDL Cholesterol Result Greater than or Equal to 190 or Hypercholesterolemia without ASCVD\":\n \"Patients Aged 20 to 75 at Start of Measurement Period\"\n and exists ( \"LDL Result Greater Than or Equal To 190\"\n union \"Hypercholesterolemia Diagnosis\"\n )\n and not exists ( \"ASVCD Diagnosis or Procedure before End of Measurement Period\" )"
},
{
"url" : "displaySequence",
"valueInteger" : 7
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR"
},
{
"url" : "name",
"valueString" : "Initial Population 2"
},
{
"url" : "statement",
"valueString" : "define \"Initial Population 2\":\n \"Patients Aged 20 to 75 with LDL Cholesterol Result Greater than or Equal to 190 or Hypercholesterolemia without ASCVD\"\n and exists \"Qualifying Encounter during day of Measurement Period\""
},
{
"url" : "displaySequence",
"valueInteger" : 8
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SupplementalDataElements"
},
{
"url" : "name",
"valueString" : "SDE Race"
},
{
"url" : "statement",
"valueString" : "define \"SDE Race\":\n Patient.race R\n return Tuple {\n codes: R.ombCategory union R.detailed,\n display: R.text\n }"
},
{
"url" : "displaySequence",
"valueInteger" : 9
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR"
},
{
"url" : "name",
"valueString" : "SDE Race"
},
{
"url" : "statement",
"valueString" : "define \"SDE Race\":\n SDE.\"SDE Race\""
},
{
"url" : "displaySequence",
"valueInteger" : 10
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR"
},
{
"url" : "name",
"valueString" : "Has Diabetes Diagnosis"
},
{
"url" : "statement",
"valueString" : "define \"Has Diabetes Diagnosis\":\n exists ( [Condition: \"Diabetes\"] Diabetes\n where ( Diabetes.isProblemListItem ( )\n or Diabetes.isHealthConcern ( )\n )\n and Diabetes.prevalenceInterval ( ) overlaps day of \"Measurement Period\"\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 11
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR"
},
{
"url" : "name",
"valueString" : "Patients Aged 40 to 75 Years with Diabetes without ASCVD or LDL Greater than 190 or Hypercholesterolemia"
},
{
"url" : "statement",
"valueString" : "define \"Patients Aged 40 to 75 Years with Diabetes without ASCVD or LDL Greater than 190 or Hypercholesterolemia\":\n AgeInYearsAt(date from start of \"Measurement Period\") >= 40\n and AgeInYearsAt(date from start of \"Measurement Period\") <= 75\n and \"Has Diabetes Diagnosis\"\n and ( not exists \"ASVCD Diagnosis or Procedure before End of Measurement Period\"\n and not exists \"LDL Result Greater Than or Equal To 190\"\n and not exists \"Hypercholesterolemia Diagnosis\"\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 12
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR"
},
{
"url" : "name",
"valueString" : "Initial Population 3"
},
{
"url" : "statement",
"valueString" : "define \"Initial Population 3\":\n \"Patients Aged 40 to 75 Years with Diabetes without ASCVD or LDL Greater than 190 or Hypercholesterolemia\"\n and exists \"Qualifying Encounter during day of Measurement Period\""
},
{
"url" : "displaySequence",
"valueInteger" : 13
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR"
},
{
"url" : "name",
"valueString" : "Ten Year CVD Risk is High"
},
{
"url" : "statement",
"valueString" : "define \"Ten Year CVD Risk is High\":\n ( exists ( [Observation: \"Cardiovascular disease 10Y risk [Likelihood]\"]\n union [Observation: \"Cardiovascular disease 10Y risk [Likelihood] ACC-AHA Pooled Cohort by Goff 2013\"] ) AtRiskCVD\n where AtRiskCVD.value as Quantity >= 20 '%'\n and AtRiskCVD.effective.toInterval ( ) during day of \"Measurement Period\"\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 14
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR"
},
{
"url" : "name",
"valueString" : "Patients Age 40 to 75 Years and have a 10 Year CVD Risk of High without ASCVD and High LDL and Diabetes"
},
{
"url" : "statement",
"valueString" : "define \"Patients Age 40 to 75 Years and have a 10 Year CVD Risk of High without ASCVD and High LDL and Diabetes\":\n AgeInYearsAt(date from start of \"Measurement Period\") in Interval[40, 75]\n and \"Ten Year CVD Risk is High\"\n and not ( exists \"ASVCD Diagnosis or Procedure before End of Measurement Period\"\n or exists \"Hypercholesterolemia Diagnosis\"\n or exists \"LDL Result Greater Than or Equal To 190\"\n or \"Has Diabetes Diagnosis\"\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 15
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR"
},
{
"url" : "name",
"valueString" : "Initial Population 4"
},
{
"url" : "statement",
"valueString" : "define \"Initial Population 4\":\n \"Patients Age 40 to 75 Years and have a 10 Year CVD Risk of High without ASCVD and High LDL and Diabetes\"\n and exists \"Qualifying Encounter during day of Measurement Period\""
},
{
"url" : "displaySequence",
"valueInteger" : 16
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SupplementalDataElements"
},
{
"url" : "name",
"valueString" : "SDE Sex"
},
{
"url" : "statement",
"valueString" : "define \"SDE Sex\":\n case\n when Patient.gender = 'male' then \"M\"\n when Patient.gender = 'female' then \"F\"\n else null\n end"
},
{
"url" : "displaySequence",
"valueInteger" : 17
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR"
},
{
"url" : "name",
"valueString" : "SDE Sex"
},
{
"url" : "statement",
"valueString" : "define \"SDE Sex\":\n SDE.\"SDE Sex\""
},
{
"url" : "displaySequence",
"valueInteger" : 18
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR"
},
{
"url" : "name",
"valueString" : "Denominator 3"
},
{
"url" : "statement",
"valueString" : "define \"Denominator 3\":\n \"Initial Population 3\""
},
{
"url" : "displaySequence",
"valueInteger" : 19
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR"
},
{
"url" : "name",
"valueString" : "Statin Therapy Prescribed Anytime during day of Measurement Period"
},
{
"url" : "statement",
"valueString" : "define \"Statin Therapy Prescribed Anytime during day of Measurement Period\":\n ( [MedicationRequest: \"Low Intensity Statin Therapy\"]\n union [MedicationRequest: \"Moderate Intensity Statin Therapy\"]\n union [MedicationRequest: \"High Intensity Statin Therapy\"] ) StatinPrescribed\n where StatinPrescribed.status in { 'active', 'completed' }\n and StatinPrescribed.intent ~ 'order'\n and ( StatinPrescribed.authoredOn during day of \"Measurement Period\"\n or exists ( StatinPrescribed.dosageInstruction.timing T\n where T.repeat.bounds.toInterval ( ) overlaps day of \"Measurement Period\"\n )\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 20
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR"
},
{
"url" : "name",
"valueString" : "Numerator"
},
{
"url" : "statement",
"valueString" : "define \"Numerator\":\n exists \"Statin Therapy Prescribed Anytime during day of Measurement Period\""
},
{
"url" : "displaySequence",
"valueInteger" : 21
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR"
},
{
"url" : "name",
"valueString" : "Denominator 2"
},
{
"url" : "statement",
"valueString" : "define \"Denominator 2\":\n \"Initial Population 2\""
},
{
"url" : "displaySequence",
"valueInteger" : 22
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR"
},
{
"url" : "name",
"valueString" : "Denominator 4"
},
{
"url" : "statement",
"valueString" : "define \"Denominator 4\":\n \"Initial Population 4\""
},
{
"url" : "displaySequence",
"valueInteger" : 23
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SupplementalDataElements"
},
{
"url" : "name",
"valueString" : "SDE Payer"
},
{
"url" : "statement",
"valueString" : "define \"SDE Payer\":\n [Coverage: type in \"Payer Type\"] Payer\n return {\n code: Payer.type,\n period: Payer.period\n }"
},
{
"url" : "displaySequence",
"valueInteger" : 24
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR"
},
{
"url" : "name",
"valueString" : "SDE Payer"
},
{
"url" : "statement",
"valueString" : "define \"SDE Payer\":\n SDE.\"SDE Payer\""
},
{
"url" : "displaySequence",
"valueInteger" : 25
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SupplementalDataElements"
},
{
"url" : "name",
"valueString" : "SDE Ethnicity"
},
{
"url" : "statement",
"valueString" : "define \"SDE Ethnicity\":\n Patient.ethnicity E\n return Tuple {\n codes: { E.ombCategory } union E.detailed,\n display: E.text\n }"
},
{
"url" : "displaySequence",
"valueInteger" : 26
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR"
},
{
"url" : "name",
"valueString" : "SDE Ethnicity"
},
{
"url" : "statement",
"valueString" : "define \"SDE Ethnicity\":\n SDE.\"SDE Ethnicity\""
},
{
"url" : "displaySequence",
"valueInteger" : 27
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR"
},
{
"url" : "name",
"valueString" : "Denominator Exclusions"
},
{
"url" : "statement",
"valueString" : "define \"Denominator Exclusions\":\n exists ( ( [Condition: \"Breastfeeding\"]\n union [Condition: \"Rhabdomyolysis\"] ) ExclusionDiagnosis\n where ( ExclusionDiagnosis.isProblemListItem ( )\n or ExclusionDiagnosis.isHealthConcern ( )\n )\n and ExclusionDiagnosis.prevalenceInterval ( ) overlaps day of \"Measurement Period\"\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 28
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR"
},
{
"url" : "name",
"valueString" : "Denominator 1"
},
{
"url" : "statement",
"valueString" : "define \"Denominator 1\":\n \"Initial Population 1\""
},
{
"url" : "displaySequence",
"valueInteger" : 29
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR"
},
{
"url" : "name",
"valueString" : "Has Allergy to Statin"
},
{
"url" : "statement",
"valueString" : "define \"Has Allergy to Statin\":\n exists ( [AllergyIntolerance: \"Statin Allergen\"] StatinAllergy\n where StatinAllergy.onset.toInterval ( ) overlaps day of \"Measurement Period\"\n and StatinAllergy.clinicalStatus ~ QICoreCommon.\"allergy-active\"\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 30
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "Hospice"
},
{
"url" : "name",
"valueString" : "Has Hospice Services"
},
{
"url" : "statement",
"valueString" : "define \"Has Hospice Services\":\n exists ((([Encounter: \"Encounter Inpatient\"]).isEncounterPerformed()) InpatientEncounter\n where (InpatientEncounter.hospitalization.dischargeDisposition ~ \"Discharge to home for hospice care (procedure)\"\n or InpatientEncounter.hospitalization.dischargeDisposition ~ \"Discharge to healthcare facility for hospice care (procedure)\"\n )\n and InpatientEncounter.period.toInterval() ends during day of \"Measurement Period\"\n )\n or exists ((([Encounter: \"Hospice Encounter\"]).isEncounterPerformed()) HospiceEncounter\n where HospiceEncounter.period.toInterval() overlaps day of \"Measurement Period\"\n )\n or exists ((([Observation: \"Hospice care [Minimum Data Set]\"]).isAssessmentPerformed()) HospiceAssessment\n where HospiceAssessment.value ~ \"Yes (qualifier value)\"\n and HospiceAssessment.effective.toInterval() overlaps day of \"Measurement Period\"\n )\n or exists ((([ServiceRequest: \"Hospice Care Ambulatory\"]).isInterventionOrder()) HospiceOrder\n where HospiceOrder.authoredOn.toInterval() during day of \"Measurement Period\"\n // and HospiceOrder.doNotPerform is not true\n // https://oncprojectracking.healthit.gov/support/browse/CQLIT-447\n )\n or exists ((([Procedure: \"Hospice Care Ambulatory\"]).isInterventionPerformed()) HospicePerformed\n where HospicePerformed.performed.toInterval() overlaps day of \"Measurement Period\"\n )\n or exists (([Condition: \"Hospice Diagnosis\"]) HospiceCareDiagnosis\n where HospiceCareDiagnosis.prevalenceInterval() overlaps day of \"Measurement Period\"\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 31
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "PalliativeCare"
},
{
"url" : "name",
"valueString" : "Has Palliative Care in the Measurement Period"
},
{
"url" : "statement",
"valueString" : "define \"Has Palliative Care in the Measurement Period\":\n exists ((([Observation: \"Functional Assessment of Chronic Illness Therapy - Palliative Care Questionnaire (FACIT-Pal)\"]).isAssessmentPerformed()) PalliativeAssessment\n where PalliativeAssessment.effective.toInterval() overlaps day of \"Measurement Period\"\n )\n or exists ([Condition: \"Palliative Care Diagnosis\"] PalliativeDiagnosis\n where PalliativeDiagnosis.prevalenceInterval() overlaps day of \"Measurement Period\"\n )\n or exists ((([Encounter: \"Palliative Care Encounter\"]).isEncounterPerformed()) PalliativeEncounter\n where PalliativeEncounter.period.toInterval() overlaps day of \"Measurement Period\"\n )\n or exists ((([Procedure: \"Palliative Care Intervention\"]).isInterventionPerformed()) PalliativeIntervention\n where PalliativeIntervention.performed.toInterval() overlaps day of \"Measurement Period\"\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 32
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR"
},
{
"url" : "name",
"valueString" : "Has Hepatitis or Liver Disease Diagnosis"
},
{
"url" : "statement",
"valueString" : "define \"Has Hepatitis or Liver Disease Diagnosis\":\n exists ( ( [Condition: \"Hepatitis A\"]\n union [Condition: \"Hepatitis B\"]\n union [Condition: \"Liver Disease\"] ) HepatitisLiverDisease\n where ( HepatitisLiverDisease.isProblemListItem ( )\n or HepatitisLiverDisease.isHealthConcern ( )\n )\n and HepatitisLiverDisease.prevalenceInterval ( ) overlaps day of \"Measurement Period\"\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 33
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR"
},
{
"url" : "name",
"valueString" : "Has Statin Associated Muscle Symptoms"
},
{
"url" : "statement",
"valueString" : "define \"Has Statin Associated Muscle Symptoms\":\n exists ( [Condition: \"Statin Associated Muscle Symptoms\"] StatinMuscleSymptom\n where ( StatinMuscleSymptom.isProblemListItem ( )\n or StatinMuscleSymptom.isHealthConcern ( )\n )\n and StatinMuscleSymptom.prevalenceInterval ( ) overlaps day of \"Measurement Period\"\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 34
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR"
},
{
"url" : "name",
"valueString" : "Has ESRD Diagnosis"
},
{
"url" : "statement",
"valueString" : "define \"Has ESRD Diagnosis\":\n exists ( [Condition: \"End Stage Renal Disease\"] ESRD\n where ( ESRD.isProblemListItem ( )\n or ESRD.isHealthConcern ( )\n )\n and ESRD.prevalenceInterval ( ) overlaps day of \"Measurement Period\"\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 35
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR"
},
{
"url" : "name",
"valueString" : "Has Adverse Reaction to Statin"
},
{
"url" : "statement",
"valueString" : "define \"Has Adverse Reaction to Statin\":\n exists ( [AdverseEvent: event in \"Statin Allergen\"] StatinReaction\n where StatinReaction.recordedDate during day of \"Measurement Period\"\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 36
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR"
},
{
"url" : "name",
"valueString" : "Has Medical Reason for Not Ordering Statin Therapy"
},
{
"url" : "statement",
"valueString" : "define \"Has Medical Reason for Not Ordering Statin Therapy\":\n exists ( ( [MedicationNotRequested: \"Low Intensity Statin Therapy\"]\n union [MedicationNotRequested: \"Moderate Intensity Statin Therapy\"]\n union [MedicationNotRequested: \"High Intensity Statin Therapy\"] ) NoStatinTherapyOrdered\n with \"Qualifying Encounter during day of Measurement Period\" QualifyingEncounter\n such that NoStatinTherapyOrdered.authoredOn during QualifyingEncounter.period\n and NoStatinTherapyOrdered.status = 'completed'\n and NoStatinTherapyOrdered.reasonCode in \"Medical Reason\"\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 37
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR"
},
{
"url" : "name",
"valueString" : "Denominator Exceptions"
},
{
"url" : "statement",
"valueString" : "define \"Denominator Exceptions\":\n \"Has Allergy to Statin\"\n or Hospice.\"Has Hospice Services\"\n or PalliativeCare.\"Has Palliative Care in the Measurement Period\"\n or \"Has Hepatitis or Liver Disease Diagnosis\"\n or \"Has Statin Associated Muscle Symptoms\"\n or \"Has ESRD Diagnosis\"\n or \"Has Adverse Reaction to Statin\"\n or \"Has Medical Reason for Not Ordering Statin Therapy\""
},
{
"url" : "displaySequence",
"valueInteger" : 38
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "QICoreCommon"
},
{
"url" : "name",
"valueString" : "isProblemListItem"
},
{
"url" : "statement",
"valueString" : "/*\n@description: Returns true if the given condition is a problem list item.\n*/\ndefine fluent function isProblemListItem(condition Condition):\n exists (condition.category C\n where C ~ \"problem-list-item\"\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 39
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "FHIRHelpers"
},
{
"url" : "name",
"valueString" : "ToConcept"
},
{
"url" : "statement",
"valueString" : "/*\n@description: Converts the given FHIR [CodeableConcept](https://hl7.org/fhir/datatypes.html#CodeableConcept) value to a CQL Concept.\n*/\ndefine function ToConcept(concept FHIR.CodeableConcept):\n if concept is null then\n null\n else\n System.Concept {\n codes: concept.coding C return ToCode(C),\n display: concept.text.value\n }"
},
{
"url" : "displaySequence",
"valueInteger" : 40
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "QICoreCommon"
},
{
"url" : "name",
"valueString" : "isHealthConcern"
},
{
"url" : "statement",
"valueString" : "/*\n@description: Returns true if the given condition is a health concern\n*/\ndefine fluent function isHealthConcern(condition Condition):\n exists (condition.category C\n where C ~ \"health-concern\"\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 41
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "QICoreCommon"
},
{
"url" : "name",
"valueString" : "prevalenceInterval"
},
{
"url" : "statement",
"valueString" : "/*\n@description: Returns an interval representing the normalized prevalence period of a given Condition.\n@comment: Uses the ToInterval and ToAbatementInterval functions to determine the widest potential interval from\nonset to abatement as specified in the given Condition. If the condition is active, or has an abatement date the resulting \ninterval will have a closed ending boundary. Otherwise, the resulting interval will have an open ending boundary.\n*/\ndefine fluent function prevalenceInterval(condition Condition):\nif condition.clinicalStatus ~ \"active\"\n or condition.clinicalStatus ~ \"recurrence\"\n or condition.clinicalStatus ~ \"relapse\" then\n Interval[start of condition.onset.toInterval(), end of condition.abatementInterval()]\nelse\n (end of condition.abatementInterval()) abatementDate\n return if abatementDate is null then\n Interval[start of condition.onset.toInterval(), abatementDate)\n else\n Interval[start of condition.onset.toInterval(), abatementDate]"
},
{
"url" : "displaySequence",
"valueInteger" : 42
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "FHIRHelpers"
},
{
"url" : "name",
"valueString" : "ToString"
},
{
"url" : "statement",
"valueString" : "define function ToString(value uri): value.value"
},
{
"url" : "displaySequence",
"valueInteger" : 43
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "FHIRHelpers"
},
{
"url" : "name",
"valueString" : "ToCode"
},
{
"url" : "statement",
"valueString" : "/*\n@description: Converts the given FHIR [Coding](https://hl7.org/fhir/datatypes.html#Coding) value to a CQL Code.\n*/\ndefine function ToCode(coding FHIR.Coding):\n if coding is null then\n null\n else\n System.Code {\n code: coding.code.value,\n system: coding.system.value,\n version: coding.version.value,\n display: coding.display.value\n }"
},
{
"url" : "displaySequence",
"valueInteger" : 44
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "Status"
},
{
"url" : "name",
"valueString" : "isEncounterPerformed"
},
{
"url" : "statement",
"valueString" : "//Encounter, Performed\n//General usage unless required otherwise by measure intent (e.g., follow-up encounters)\ndefine fluent function isEncounterPerformed(Enc List<Encounter>):\n Enc E\n where E.status in {'finished', 'arrived', 'triaged', 'in-progress', 'onleave'}"
},
{
"url" : "displaySequence",
"valueInteger" : 45
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "QICoreCommon"
},
{
"url" : "name",
"valueString" : "toInterval"
},
{
"url" : "statement",
"valueString" : "/*\n@description: Normalizes a value that is a choice of timing-valued types to an equivalent interval\n@comment: Normalizes a choice type of DateTime, Quanitty, Interval<DateTime>, or Interval<Quantity> types\nto an equivalent interval. This selection of choice types is a superset of the majority of choice types that are used as possible\nrepresentations for timing-valued elements in QICore, allowing this function to be used across any resource.\nThe input can be provided as a DateTime, Quantity, Interval<DateTime> or Interval<Quantity>.\nThe intent of this function is to provide a clear and concise mechanism to treat single\nelements that have multiple possible representations as intervals so that logic doesn't have to account\nfor the variability. More complex calculations (such as medication request period or dispense period\ncalculation) need specific guidance and consideration. That guidance may make use of this function, but\nthe focus of this function is on single element calculations where the semantics are unambiguous.\nIf the input is a DateTime, the result a DateTime Interval beginning and ending on that DateTime.\nIf the input is a Quantity, the quantity is expected to be a calendar-duration interpreted as an Age,\nand the result is a DateTime Interval beginning on the Date the patient turned that age and ending immediately before one year later.\nIf the input is a DateTime Interval, the result is the input.\nIf the input is a Quantity Interval, the quantities are expected to be calendar-durations interpreted as an Age, and the result\nis a DateTime Interval beginning on the date the patient turned the age given as the start of the quantity interval, and ending\nimmediately before one year later than the date the patient turned the age given as the end of the quantity interval.\nIf the input is a Timing, an error will be thrown indicating that Timing calculations are not implemented. Any other input will reslt in a null DateTime Interval\n*/\ndefine fluent function toInterval(choice Choice<DateTime, Quantity, Interval<DateTime>, Interval<Quantity>, Timing>):\n case\n\t when choice is DateTime then\n \tInterval[choice as DateTime, choice as DateTime]\n\t\twhen choice is Interval<DateTime> then\n \t\tchoice as Interval<DateTime>\n\t\twhen choice is Quantity then\n\t\t Interval[Patient.birthDate + (choice as Quantity),\n\t\t\t Patient.birthDate + (choice as Quantity) + 1 year)\n\t\twhen choice is Interval<Quantity> then\n\t\t Interval[Patient.birthDate + (choice.low as Quantity),\n\t\t\t Patient.birthDate + (choice.high as Quantity) + 1 year)\n\t\twhen choice is Timing then\n Message(null, true, 'NOT_IMPLEMENTED', 'Error', 'Calculation of an interval from a Timing value is not supported') as Interval<DateTime>\n\t\telse\n\t\t\tnull as Interval<DateTime>\n\tend"
},
{
"url" : "displaySequence",
"valueInteger" : 46
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "Status"
},
{
"url" : "name",
"valueString" : "isAssessmentPerformed"
},
{
"url" : "statement",
"valueString" : "//This library contains functions that are based on QDM 5.6 to QICore 4.1.1 March 2023 (https://github.com/cqframework/CQL-Formatting-and-Usage-Wiki/wiki/Authoring-Patterns---QICore-v4.1.1). The functions may appear similar to some QICoreCommon functions but different in that they have constraints that are relevant for measures authored by NCQA.\n\n//Assessment, Performed\ndefine fluent function isAssessmentPerformed(Obs List<Observation>):\n Obs O\n where O.status in { 'final', 'amended', 'corrected' }\n and exists ( O.category ObservationCategory\n where ( ObservationCategory ) ~ \"survey\"\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 47
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "Status"
},
{
"url" : "name",
"valueString" : "isInterventionOrder"
},
{
"url" : "statement",
"valueString" : "//Intervention, Order: active and completed only \ndefine fluent function isInterventionOrder(ServiceRequest List<ServiceRequest>):\n ServiceRequest S\n where S.status in { 'active', 'completed' }\n and S.intent = 'order'"
},
{
"url" : "displaySequence",
"valueInteger" : 48
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "Status"
},
{
"url" : "name",
"valueString" : "isInterventionPerformed"
},
{
"url" : "statement",
"valueString" : "//Intervention, Performed\ndefine fluent function isInterventionPerformed(Proc List<Procedure>):\n Proc P\n where P.status ~ 'completed'"
},
{
"url" : "displaySequence",
"valueInteger" : 49
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
}
],
"name" : "EffectiveDataRequirements",
"status" : "active",
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/library-type",
"code" : "module-definition"
}
]
},
"relatedArtifact" : [
{
"type" : "depends-on",
"display" : "Library QICoreCommon",
"resource" : "Library/QICoreCommon|2.1.000"
},
{
"type" : "depends-on",
"display" : "Library FHIRHelpers",
"resource" : "Library/FHIRHelpers|4.4.000"
},
{
"type" : "depends-on",
"display" : "Library SDE",
"resource" : "Library/SupplementalDataElements|3.5.000"
},
{
"type" : "depends-on",
"display" : "Library Hospice",
"resource" : "Library/Hospice|6.12.000"
},
{
"type" : "depends-on",
"display" : "Library Status",
"resource" : "Library/Status|1.8.000"
},
{
"type" : "depends-on",
"display" : "Library PalliativeCare",
"resource" : "Library/PalliativeCare|1.11.000"
},
{
"type" : "depends-on",
"display" : "Code system ConditionCategory",
"resource" : "http://terminology.hl7.org/CodeSystem/condition-category"
},
{
"type" : "depends-on",
"display" : "Code system USCoreConditionCategoryExtensionCodes",
"resource" : "http://hl7.org/fhir/us/core/CodeSystem/condition-category"
},
{
"type" : "depends-on",
"display" : "Code system ICD10CM",
"resource" : "http://hl7.org/fhir/sid/icd-10-cm"
},
{
"type" : "depends-on",
"display" : "Code system LOINC",
"resource" : "http://loinc.org"
},
{
"type" : "depends-on",
"display" : "Code system AdministrativeGender",
"resource" : "http://hl7.org/fhir/administrative-gender"
},
{
"type" : "depends-on",
"display" : "Code system AllergyIntoleranceClinicalStatusCodes",
"resource" : "http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical"
},
{
"type" : "depends-on",
"display" : "Code system SNOMEDCT",
"resource" : "http://snomed.info/sct"
},
{
"type" : "depends-on",
"display" : "Code system ObservationCategoryCodes",
"resource" : "http://terminology.hl7.org/CodeSystem/observation-category"
},
{
"type" : "depends-on",
"display" : "Value set Myocardial Infarction",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.403"
},
{
"type" : "depends-on",
"display" : "Value set Cerebrovascular Disease Stroke or TIA",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1047.44"
},
{
"type" : "depends-on",
"display" : "Value set Atherosclerosis and Peripheral Arterial Disease",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1047.21"
},
{
"type" : "depends-on",
"display" : "Value set Ischemic Heart Disease or Other Related Diagnoses",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1047.46"
},
{
"type" : "depends-on",
"display" : "Value set Stable and Unstable Angina",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1047.47"
},
{
"type" : "depends-on",
"display" : "Value set PCI",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.67"
},
{
"type" : "depends-on",
"display" : "Value set CABG Surgeries",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.694"
},
{
"type" : "depends-on",
"display" : "Value set Carotid Intervention",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.204"
},
{
"type" : "depends-on",
"display" : "Value set CABG or PCI Procedure",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1138.566"
},
{
"type" : "depends-on",
"display" : "Value set Annual Wellness Visit",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240"
},
{
"type" : "depends-on",
"display" : "Value set Office Visit",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001"
},
{
"type" : "depends-on",
"display" : "Value set Outpatient Consultation",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1008"
},
{
"type" : "depends-on",
"display" : "Value set Outpatient Encounters for Preventive Care",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1576"
},
{
"type" : "depends-on",
"display" : "Value set Preventive Care Services Established Office Visit, 18 and Up",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025"
},
{
"type" : "depends-on",
"display" : "Value set Preventive Care Services Individual Counseling",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1026"
},
{
"type" : "depends-on",
"display" : "Value set Preventive Care Services Initial Office Visit, 18 and Up",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023"
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"display" : "Value set Preventive Care Services Other",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.11.1150"
},
{
"type" : "depends-on",
"display" : "Value set LDL Cholesterol",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1573"
},
{
"type" : "depends-on",
"display" : "Value set Familial Hypercholesterolemia",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1047.100"
},
{
"type" : "depends-on",
"display" : "Value set Diabetes",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.103.12.1001"
},
{
"type" : "depends-on",
"display" : "Value set Low Intensity Statin Therapy",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1574"
},
{
"type" : "depends-on",
"display" : "Value set Moderate Intensity Statin Therapy",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1575"
},
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"type" : "depends-on",
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},
{
"type" : "depends-on",
"display" : "Value set Payer Type",
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},
{
"type" : "depends-on",
"display" : "Value set Breastfeeding",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1047.73"
},
{
"type" : "depends-on",
"display" : "Value set Rhabdomyolysis",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1047.102"
},
{
"type" : "depends-on",
"display" : "Value set Statin Allergen",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.42"
},
{
"type" : "depends-on",
"display" : "Value set Encounter Inpatient",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307"
},
{
"type" : "depends-on",
"display" : "Value set Hospice Encounter",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1003"
},
{
"type" : "depends-on",
"display" : "Value set Hospice Care Ambulatory",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1584"
},
{
"type" : "depends-on",
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"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1165"
},
{
"type" : "depends-on",
"display" : "Value set Palliative Care Diagnosis",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1167"
},
{
"type" : "depends-on",
"display" : "Value set Palliative Care Encounter",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1090"
},
{
"type" : "depends-on",
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"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1135"
},
{
"type" : "depends-on",
"display" : "Value set Hepatitis A",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1024"
},
{
"type" : "depends-on",
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},
{
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{
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"display" : "Value set Statin Associated Muscle Symptoms",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.85"
},
{
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},
{
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}
],
"parameter" : [
{
"name" : "Measurement Period",
"use" : "in",
"min" : 0,
"max" : "1",
"type" : "Period"
},
{
"name" : "Initial Population 1",
"use" : "out",
"min" : 0,
"max" : "1",
"type" : "boolean"
},
{
"name" : "Initial Population 2",
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"max" : "1",
"type" : "boolean"
},
{
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{
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{
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},
{
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"use" : "out",
"min" : 0,
"max" : "1",
"type" : "Coding"
},
{
"name" : "Denominator 3",
"use" : "out",
"min" : 0,
"max" : "1",
"type" : "boolean"
},
{
"name" : "Numerator",
"use" : "out",
"min" : 0,
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},
{
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"max" : "1",
"type" : "boolean"
},
{
"name" : "Denominator 4",
"use" : "out",
"min" : 0,
"max" : "1",
"type" : "boolean"
},
{
"name" : "SDE Payer",
"use" : "out",
"min" : 0,
"max" : "*",
"type" : "Resource"
},
{
"name" : "SDE Ethnicity",
"use" : "out",
"min" : 0,
"max" : "1",
"type" : "Resource"
},
{
"name" : "Denominator Exclusions",
"use" : "out",
"min" : 0,
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"type" : "boolean"
},
{
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"type" : "boolean"
},
{
"name" : "Denominator Exceptions",
"use" : "out",
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"type" : "boolean"
}
],
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🔗 "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition"
],
"mustSupport" : [
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{
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🔗 "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition"
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"code" : [
{
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"code" : "I22.2",
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}
]
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"code" : "version-specific"
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"system" : "urn:ietf:rfc:3986",
"value" : "urn:uuid:be1257a3-a34e-4a7b-99df-345de63365a2"
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{
"use" : "official",
"type" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type",
"code" : "publisher"
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},
"system" : "https://madie.cms.gov/measure/cmsId",
"value" : "347FHIR",
"assigner" : {
"display" : "CMS"
}
}
],
"version" : "0.2.000",
"name" : "StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR",
"title" : "Statin Therapy for the Prevention and Treatment of Cardiovascular DiseaseFHIR",
"status" : "draft",
"experimental" : false,
"date" : "2024-07-09T14:53:56+00:00",
"publisher" : "Centers for Medicare & Medicaid Services (CMS)",
"contact" : [
{
"telecom" : [
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"value" : "https://www.cms.gov/"
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],
"description" : "Percentage of the following patients - all considered at high risk of cardiovascular events - who were prescribed or were on statin therapy during the measurement period: \n- All patients who were previously diagnosed with or currently have a diagnosis of clinical atherosclerotic cardiovascular disease (ASCVD), including an ASCVD procedure; OR \n- Patients aged 20 - 75 years who have ever had a low-density lipoprotein cholesterol (LDL-C) level >= 190 mg/dL or were previously diagnosed with or currently have an active diagnosis of familial hypercholesterolemia; OR \n- Patients aged 40 - 75 years with a diagnosis of diabetes; OR\n- Patients aged 40 - 75 with a 10-year ASCVD risk score of >= 20 percent",
"purpose" : "UNKNOWN",
"usage" : "Initial Population Guidance: \nThe initial population covers four distinct populations. Use the following process to prevent counting patients more than once.\n\nInitial Population 1: \nAll patients who were previously diagnosed with or currently have a diagnosis of clinical ASCVD, including an ASCVD procedure before the end of the measurement period.\n\n- If YES, meets Initial Population 1 risk category.\t\t \n- If NO, screen for next risk category.\n\nInitial Population 2: \nPatients aged 20 to 75 years at the beginning of the measurement period who have ever had a laboratory test result of LDL-C >= 190 mg/dL or were previously diagnosed with or currently have an active diagnosis of familial hypercholesterolemia.\n\n- If YES, meets Initial Population 2 risk category.\t\t \n- If NO, screen for next risk category.\n\nInitial Population 3:\nPatients aged 40 to 75 years at the beginning of the measurement period with an active diagnosis of Type 1 or Type 2 diabetes at any time during the measurement period.\n\n- If YES, meets Initial Population 3 risk category.\n- If NO, screen for next risk category.\n\nInitial Population 4: \nPatients aged 40 to 75 at the beginning of the measurement period with a 10-year ASCVD risk score of >= 20 percent during the measurement period.\n\n- If YES, meets Initial Population 4 risk category.\n- If NO, patient does NOT meet Initial Population criteria and is NOT eligible for measure inclusion.\n\nInitial Population Guidance for Encounter:\nIn order for the patient to be included in the Initial Population, the patient must have ONE initial population-eligible visit, defined as follows: outpatient visit, initial or established office visit, face-to-face interaction, preventive care services, or annual wellness visit.\n\nLDL-C Laboratory test result options:\nThe measure can be reported for all patients with a documented LDL-C level recorded as follows:\n\nTo meet Initial Population 1: \nThere is no LDL-C result required.\n\nTo meet Initial Population 2:\nIf a patient has ANY previous laboratory result of LDL-C >= 190 mg/dL, report the highest value >= 190 mg/dL.\n\nTo meet Initial Population 3: \nThere is no LDL-C result required.\n\nTo meet Initial Population 4: \nThere is no LDL-C result required.\n\nThe 10-year ASCVD risk assessment options:\nThe 10-year ASCVD risk score is calculated using the Pooled Cohort Equations: 1) the 2013 ACC/AHA ASCVD Risk Estimator (maps to LOINC Code 79423-0) OR 2) the ACC Risk Estimator Plus (maps to LOINC Code 99055-6). If your EHR does not have either of these risk calculators, we recommend that you use the on-line versions. The 10-year ASCVD risk score (quantitative result, i.e., result.value, \"%\") must be documented in a structured field. The 10-year ASCVD risk assessment must be performed during the measurement period. \n \nNumerator instructions and guidance:\n- Current statin therapy use must be documented in the patient's current medication list or ordered during the measurement period.\n- ONLY statin therapy meets the measure Numerator criteria (NOT other cholesterol lowering medications).\n- Prescription or order does NOT need to be linked to an encounter or visit; it may be called to the pharmacy.\n- Statin medication \"samples\" provided to patients can be documented as \"current statin therapy\" if documented in the medication list in health/medical record.\n- Patients who meet the denominator criteria for inclusion, but are not prescribed or using statin therapy, will NOT meet performance for this measure unless they have an allowable denominator exception. Patients with an allowable denominator exception should be removed from the denominator of the measure and reported as a valid exception. \n- There is only one performance rate calculated for this measure: the weighted average of the four populations.\n- Adherence to statin therapy is not calculated in this measure.\n- It may not be appropriate to prescribe statin therapy for some patients (see exceptions and exclusions for the complete list). \n\nIntensity of statin therapy in primary and secondary prevention:\nThe expert panel of the 2018 ACC/AHA/MS Guidelines (Grundy et al., 2019) defines recommended intensity of statin therapy on the basis of the average expected LDL-C response to specific statin and dose. Although intensity of statin therapy is important in managing cholesterol, this measure assesses prescription of ANY statin therapy, irrespective of intensity. Assessment of appropriate intensity and dosage documentation added too much complexity to allow inclusion of statin therapy intensity in the measure at this time.\n\nLifestyle modification coaching:\nA healthy lifestyle is important for the prevention of cardiovascular disease. However, lifestyle modification monitoring and documentation added too much complexity to allow its inclusion in the measure at this time.\n\nMillimoles per liter (mmol/L) should be converted to milligrams per deciliter (mg/dL) for reporting this measure.\n\nThis eCQM is a patient-based measure. \n\nThis FHIR-based measure has been derived from the QDM-based measure: CMS 347v8. Please refer to the HL7 QI-Core Implementation Guide (https://hl7.org/fhir/us/qicore/STU4.1.1/) for more information on QI-Core and mapping recommendations from QDM to QI-Core 4.1.1 (https://hl7.org/fhir/us/qicore/STU4.1.1/qdm-to-qicore.html).",
"copyright" : "Limited proprietary coding is contained in the measure specifications for convenience. Users of the proprietary code sets should obtain all necessary licenses from the owners of these code sets. \n\nCPT(R) contained in the Measure specifications is copyright 2004-2023 American Medical Association. LOINC(R) is copyright 2004-2023 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2023 International Health Terminology Standards Development Organisation. ICD-10 is copyright 2023 World Health Organization. All Rights Reserved.",
"effectivePeriod" : {
"start" : "2025-01-01",
"end" : "2025-12-31"
},
"author" : [
{
"name" : "Mathematica",
"telecom" : [
{
"system" : "url",
"value" : "https://www.mathematica.org/"
}
]
}
],
"library" : [
🔗 "https://madie.cms.gov/Library/StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIR"
],
"disclaimer" : "These performance measures are not clinical guidelines and do not establish a standard of medical care, and have not been tested for all potential applications.\n\nTHE MEASURES AND SPECIFICATIONS ARE PROVIDED \"AS IS\" WITHOUT WARRANTY OF ANY KIND.\n\nDue to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM].",
"scoring" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-scoring",
"code" : "proportion",
"display" : "Proportion"
}
]
},
"rationale" : "\"Cardiovascular disease (CVD) is the leading cause of death in the United States, causing approximately 1 of every 3 deaths in the United States in 2015. In 2015, stroke caused approximately 1 of every 19 deaths in the United States and the estimated annual costs for CVD and stroke were $329.7 billion, including $199.2 billion in direct costs (hospital services, physicians and other professionals, prescribed medications, home health care, and other medical durables) and $130.5 billion in indirect costs from lost future productivity (cardiovascular and stroke premature deaths). CVD costs more than any other diagnostic group\" (Benjamin et al., 2018).\n\nData collected between 2011 and 2014 indicates that more than 94.6 million U.S. adults, 20 years or older, had total cholesterol levels equal to 200 mg/dL or more, while almost 28.5 million had levels 240 mg/dL or more (Benjamin et al., 2018). Elevated blood cholesterol is a major risk factor for CVD and statin therapy has been associated with a reduced risk of CVD. Numerous randomized trials have demonstrated that treatment with a statin reduces LDL-C and reduces the risk of major cardiovascular events by approximately 20 percent (Ference, 2015).\n\nIn 2018, updated guidelines on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults were published (Grundy et al., 2019). This guideline was published by an Expert Panel, which synthesized evidence from randomized controlled trials to identify people most likely to benefit from cholesterol-lowering therapy. The American College of Cardiology (ACC)/American Heart Association (AHA)/Multi-society (MS) Guideline recommendations are intended to provide a strong evidence-based foundation for the treatment of blood cholesterol for the primary and secondary prevention and treatment of ASCVD in patients of all ages. The document concludes that the addition of statin therapy reduces the risk of ASCVD among high-risk individuals, defined as follows: individuals with clinical ASCVD, with LDL-C >= 190 mg/dL, with diabetes, or individuals with >= 20 percent risk of ASCVD as determined via use of an ASCVD risk estimator derived from the Pooled Cohort Equations (Grundy et al., 2019).\n\nOne study surveying U.S. cardiology, primary care, and endocrinology practices found that 1 in 4 guideline-eligible patients were not on a statin and less than half were on the recommended statin intensity. Untreated and undertreated patients had significantly higher LDL-C levels than those receiving guideline-directed statin treatment (Navar et al., 2017). In a follow-up study authored by Nanna et al., the same clinics were divided into tertiles based on the percentage of patients with guideline-recommended statin use. The researchers found that patients in the high-tertile clinics were more likely to achieve target LDL-C levels than patients at the low- or mid-tertile clinics, and this held true when patients were stratified by primary and secondary prevention (Nanna et al., 2019a). \n\nResearch also indicates that certain populations are far less likely to receive guideline-recommended statin therapy than others. A retrospective study of the National Health and Nutrition Examination Survey found that Black and Hispanic race or ethnicity, low income, lack of health insurance coverage, poor health care access, young age, and female gender are predictors of lower statin utilization (Gu et al., 2018). In particular, there is extensive evidence that women are far less likely than men to be prescribed guideline-recommended statin therapy (Nanna et al., 2019b), despite research showing that female patients with cardiovascular disease derive the same or greater benefit from statin therapy as male patients with cardiovascular disease (Puri et al., 2014). \n\nThe Statin Safety Expert Panel that participated in a National Lipid Association (NLA) Statin Safety Task Force meeting in October 2013 reaffirms the general safety of statin therapy. The panel members concluded that for most patients requiring statin therapy, the potential benefits of statin therapy outweigh the potential risks. In general terms, the benefits of statins to prevent non-fatal myocardial infarction, revascularization, stroke, and CVD mortality, far outweigh any potential harm related to the drug (Jacobson, 2014).",
"clinicalRecommendationStatement" : "This electronic clinical quality measure is intended to align with the 2018 ACC/AHA/MS Guideline on the Management of Blood Cholesterol (Grundy et al., 2019), which indicates the use of statins as the first line of cholesterol-lowering medication therapy to lower the risk of ASCVD among at-risk populations.\n\nRecommendations for Management of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults - Statin Treatment:\nSecondary Prevention:\n1. In patients who are 75 years of age or younger with clinical ASCVD, high-intensity statin therapy should be initiated or continued with the aim of achieving a 50 percent or greater reduction in LDL-C levels (Class I Recommendation), (Grundy et al., 2019).\n\n2. In patients with clinical ASCVD in whom high-intensity statin therapy is contraindicated or who experience statin-associated side effects, moderate-intensity statin therapy should be initiated or continued with the aim of achieving a 30 to 49 percent reduction in LDL-C levels (Class I Recommendation), (Grundy et al., 2019).\n\n3. In patients older than 75 years of age with clinical ASCVD, it is reasonable to initiate moderate- or high-intensity statin therapy after evaluation of the potential for ASCVD risk reduction, adverse effects, and drug–drug interactions, as well as patient frailty and patient preferences (Class IIa Recommendation), (Grundy et al., 2019). \n\nPrimary Prevention \n1. In patients 20 to 75 years of age with an LDL-C level of 190 mg/dL or higher (>= 4.9 mmol/L), maximally tolerated statin therapy is recommended. (Class I Recommendation), (Grundy et al., 2019). \n\n2. In adults 40 to 75 years of age with diabetes mellitus, regardless of estimated 10-year ASCVD risk, moderate-intensity statin therapy is indicated (Class I Recommendation), (Grundy et al., 2019).\n\n3. To facilitate decisions about preventive interventions, it is recommended to screen for traditional ASCVD risk factors and apply the race- and sex-specific Pooled Cohort Equations (PCE) to estimate 10-year ASCVD risk for asymptomatic adults 40 to 75 years of age. The higher the estimated risk, the more likely the patient is to benefit from statin treatment (Grundy et al., 2019). \n\nThe US Preventive Services Task Force (USPSTF) concludes with moderate certainty that statin use for the prevention of CVD events and all-cause mortality in adults aged 40 to 75 years with no history of CVD and who have 1 or more of these CVD risk factors and an estimated 10-year CVD event risk of 7.5 percent to less than 10 percent has at least a small net benefit (USPSTF 2022).\n\nStatin Safety and Statin-Associated Side Effects\nA clinician–patient risk discussion is recommended before initiation of statin therapy to review net clinical benefit, weighing the potential for ASCVD risk reduction against the potential for statin-associated side effects, statin–drug interactions, and safety, while emphasizing that side effects can be addressed successfully (Class I Recommendation), (Grundy et al., 2019).",
"group" : [
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"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-rateAggregation",
"valueCode" : "This measure is intended to have one reporting rate, which aggregates the following populations into a single performance rate for reporting purposes: Population 1: All patients who were previously diagnosed with or currently have a diagnosis of clinical ASCVD, including an ASCVD procedure. Population 2: Patients aged 20 to 75 years at the beginning of the measurement period who have ever had a laboratory result of LDL-C >= 190 mg/dL or were previously diagnosed with or currently have an active diagnosis of familial hypercholesterolemia. Population 3: Patients aged 40 to 75 years at the beginning of the measurement period with an active diagnosis of Type 1 or Type 2 diabetes at any time during the measurement period. Population 4: Patients aged 40 to 75 at the beginning of the measurement period with a 10-year ASCVD risk score of > = 20 percent during the measurement period. For the purposes of this measure, a single performance rate can be calculated as follows: Performance Rate = (Numerator 1 + Numerator 2 + Numerator 3 + Numerator 4)/ [(Denominator 1 - Denominator Exclusions 1- Denominator Exceptions 1) + (Denominator 2 - Denominator Exclusions 2 - Denominator Exceptions 2) + (Denominator 3 - Denominator Exclusions 3 - Denominator Exceptions 3) + (Denominator 4 - Denominator Exclusions 4 - Denominator Exceptions 4)]"
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-improvementNotation",
"valueCodeableConcept" : {
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"code" : "decrease",
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"description" : "Percentage of the following patients - all considered at high risk of cardiovascular events - who were prescribed or were on statin therapy during the measurement period: \n- All patients who were previously diagnosed with or currently have a diagnosis of clinical atherosclerotic cardiovascular disease (ASCVD), including an ASCVD procedure; \n",
"population" : [
{
"id" : "BB8354EA-BB6C-479C-8E83-E7B390A559B7",
"code" : {
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"code" : "initial-population",
"display" : "Initial Population"
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"description" : "All patients who were previously diagnosed with or currently have a diagnosis of clinical ASCVD, including an ASCVD procedure.",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Initial Population 1"
}
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{
"id" : "645C2B7E-D180-4C6C-A12D-FA742CEE6236",
"code" : {
"coding" : [
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"code" : "denominator",
"display" : "Denominator"
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"description" : "Equals Initial Population",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Denominator 1"
}
},
{
"id" : "2F05449B-CB3A-411E-B806-C17BB0834E70",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "denominator-exclusion",
"display" : "Denominator Exclusion"
}
]
},
"description" : "Patients who are breastfeeding at any time during the measurement period.\nPatients who have a diagnosis of rhabdomyolysis at any time during the measurement period.",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Denominator Exclusions"
}
},
{
"id" : "92DFF13B-6E00-4ACD-8098-0B41F9E1B38F",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "numerator",
"display" : "Numerator"
}
]
},
"description" : "Patients who are actively using or who receive an order (prescription) for statin therapy at any time during the measurement period",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Numerator"
}
},
{
"id" : "6683E1DB-3E65-452A-90CD-F6FCA9CD1036",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "denominator-exception",
"display" : "Denominator Exception"
}
]
},
"description" : "Patients with statin-associated muscle symptoms or an allergy to statin medication.\nPatients who are receiving palliative or hospice care.\nPatients with active liver disease or hepatic disease or insufficiency.\nPatients with end-stage renal disease (ESRD).\nPatients with documentation of a medical reason for not being prescribed statin therapy.",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Denominator Exceptions"
}
}
]
},
{
"id" : "64ef76a356d636294b157b97",
"extension" : [
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-scoring",
"code" : "proportion",
"display" : "Proportion"
}
]
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis",
"valueCode" : "boolean"
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-type",
"valueCodeableConcept" : {
"coding" : [
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"system" : "http://terminology.hl7.org/CodeSystem/measure-type",
"code" : "process",
"display" : "Process"
}
]
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-rateAggregation",
"valueCode" : "This measure is intended to have one reporting rate, which aggregates the following populations into a single performance rate for reporting purposes: \n\nPopulation 1: All patients who have an active diagnosis of clinical ASCVD or ever had an ASCVD procedure.\n\nPopulation 2: Patients aged >= 20 years at the beginning of the measurement period who have ever had a laboratory result of LDL-C >= 190 mg/dL or were previously diagnosed with or currently have an active diagnosis of familial hypercholesterolemia.\n\nPopulation 3: Patients aged 40 to 75 years at the beginning of the measurement period with an active diagnosis of Type 1 or Type 2 diabetes at any time during the measurement period. \n\nFor the purposes of this measure, a single performance rate can be calculated as follows:\n\nPerformance Rate = (Numerator 1 + Numerator 2 +Numerator 3)/ [(Denominator 1 - Denominator Exclusions 1- Denominator Exceptions 1) + (Denominator 2 - Denominator Exclusions 2 - Denominator Exceptions 2) +(Denominator 3 - Denominator Exclusions 3 - Denominator Exceptions 3)]"
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-improvementNotation",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-improvement-notation",
"code" : "decrease",
"display" : "increase"
}
]
}
}
],
"description" : "Patients aged 20 to 75 years at the beginning of the measurement period who have ever had a laboratory result of LDL-C >=190 mg/dL or were previously diagnosed with or currently have an active diagnosis of familial hypercholesterolemia and were taking a statin medication during the measure period. ",
"population" : [
{
"id" : "AE92716B-9295-4FD4-9EC5-5F371EF7BB54",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "initial-population",
"display" : "Initial Population"
}
]
},
"description" : "Patients aged 20 to 75 years at the beginning of the measurement period who have ever had a laboratory result of LDL-C >=190 mg/dL or were previously diagnosed with or currently have an active diagnosis of familial hypercholesterolemia.",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Initial Population 2"
}
},
{
"id" : "019787D8-0265-4238-86D8-516E52640DE8",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "denominator",
"display" : "Denominator"
}
]
},
"description" : "Equals Initial Population",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Denominator 2"
}
},
{
"id" : "88A24FDD-B20E-4C48-8990-41602699FBE0",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "denominator-exclusion",
"display" : "Denominator Exclusion"
}
]
},
"description" : "Patients who are breastfeeding at any time during the measurement period.\nPatients who have a diagnosis of rhabdomyolysis at any time during the measurement period.",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Denominator Exclusions"
}
},
{
"id" : "61962C3B-A066-489F-8D24-130DD235A93E",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "numerator",
"display" : "Numerator"
}
]
},
"description" : "Patients who are actively using or who receive an order (prescription) for statin therapy at any time during the measurement period",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Numerator"
}
},
{
"id" : "B65C7F11-C2BF-4347-B192-7478FB3E449C",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "denominator-exception",
"display" : "Denominator Exception"
}
]
},
"description" : "Patients with statin-associated muscle symptoms or an allergy to statin medication.\nPatients who are receiving palliative or hospice care.\nPatients with active liver disease or hepatic disease or insufficiency.\nPatients with end-stage renal disease (ESRD).\nPatients with documentation of a medical reason for not being prescribed statin therapy.",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Denominator Exceptions"
}
}
]
},
{
"id" : "64ef76a356d636294b157b98",
"extension" : [
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-scoring",
"code" : "proportion",
"display" : "Proportion"
}
]
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis",
"valueCode" : "boolean"
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-type",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-type",
"code" : "process",
"display" : "Process"
}
]
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-rateAggregation",
"valueCode" : "This measure is intended to have one reporting rate, which aggregates the following populations into a single performance rate for reporting purposes: \n\nPopulation 1: All patients who have an active diagnosis of clinical ASCVD or ever had an ASCVD procedure.\n\nPopulation 2: Patients aged >= 20 years at the beginning of the measurement period who have ever had a laboratory result of LDL-C >= 190 mg/dL or were previously diagnosed with or currently have an active diagnosis of familial hypercholesterolemia.\n\nPopulation 3: Patients aged 40 to 75 years at the beginning of the measurement period with an active diagnosis of Type 1 or Type 2 diabetes at any time during the measurement period. \n\nFor the purposes of this measure, a single performance rate can be calculated as follows:\n\nPerformance Rate = (Numerator 1 + Numerator 2 +Numerator 3)/ [(Denominator 1 - Denominator Exclusions 1- Denominator Exceptions 1) + (Denominator 2 - Denominator Exclusions 2 - Denominator Exceptions 2) +(Denominator 3 - Denominator Exclusions 3 - Denominator Exceptions 3)]"
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-improvementNotation",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-improvement-notation",
"code" : "decrease",
"display" : "increase"
}
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}
}
],
"description" : " Patients aged 40 to 75 years at the beginning of the measurement period with Type 1 or Type 2 diabetes and were taking a statin medication during the measure period. ",
"population" : [
{
"id" : "90593E26-2AE7-44E5-8F16-13F8BB8AF3FE",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "initial-population",
"display" : "Initial Population"
}
]
},
"description" : "Patients aged 40 to 75 years at the beginning of the measurement period with Type 1 or Type 2 diabetes.",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Initial Population 3"
}
},
{
"id" : "58989F74-4389-40EF-81C8-8FD66E61A012",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "denominator",
"display" : "Denominator"
}
]
},
"description" : "Equals Initial Population",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Denominator 3"
}
},
{
"id" : "DCC4B2BF-D52D-4E0B-A977-C662A8C777D5",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "denominator-exclusion",
"display" : "Denominator Exclusion"
}
]
},
"description" : "Patients who are breastfeeding at any time during the measurement period.\nPatients who have a diagnosis of rhabdomyolysis at any time during the measurement period.",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Denominator Exclusions"
}
},
{
"id" : "50E2C566-36E6-4A9B-8469-7AD5610C4371",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "numerator",
"display" : "Numerator"
}
]
},
"description" : "Patients who are actively using or who receive an order (prescription) for statin therapy at any time during the measurement period",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Numerator"
}
},
{
"id" : "F497D54E-9D85-46E5-8C24-16758DDD84AC",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "denominator-exception",
"display" : "Denominator Exception"
}
]
},
"description" : "Patients with statin-associated muscle symptoms or an allergy to statin medication.\nPatients who are receiving palliative or hospice care.\nPatients with active liver disease or hepatic disease or insufficiency.\nPatients with end-stage renal disease (ESRD).\nPatients with documentation of a medical reason for not being prescribed statin therapy.",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Denominator Exceptions"
}
}
]
},
{
"id" : "64ef76a356d636294b157b99",
"extension" : [
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-scoring",
"code" : "proportion",
"display" : "Proportion"
}
]
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis",
"valueCode" : "boolean"
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-type",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-type",
"code" : "process",
"display" : "Process"
}
]
}
}
],
"description" : " Patients aged 40 to 75 at the beginning of the measurement period with a 10-year ASCVD risk score (i.e., 2013 ACC/AHA ASCVD Risk Estimator or the ACC Risk Estimator Plus) of >= 20 percent and were taking a statin medication during the measure period. ",
"population" : [
{
"id" : "df956c44-5be1-4cef-b9ce-230e9a54a264",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "initial-population",
"display" : "Initial Population"
}
]
},
"description" : "Population 4: Patients aged 40 to 75 at the beginning of the measurement period with a 10-year ASCVD risk score (i.e., 2013 ACC/AHA ASCVD Risk Estimator or the ACC Risk Estimator Plus) of >= 20 percent during the measurement period.",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Initial Population 4"
}
},
{
"id" : "45503796-0f10-4d1a-a8c0-85021b78d76e",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "denominator",
"display" : "Denominator"
}
]
},
"description" : "Equals Initial Population",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Denominator 4"
}
},
{
"id" : "ab1c1241-4f4e-49b1-893e-fb9e09878b48",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "denominator-exclusion",
"display" : "Denominator Exclusion"
}
]
},
"description" : "Patients who are breastfeeding at any time during the measurement period.\nPatients who have a diagnosis of rhabdomyolysis at any time during the measurement period.",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Denominator Exclusions"
}
},
{
"id" : "0ee14e92-4198-4941-8f45-42491c038128",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "numerator",
"display" : "Numerator"
}
]
},
"description" : "Patients who are actively using or who receive an order (prescription) for statin therapy at any time during the measurement period",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Numerator"
}
},
{
"id" : "bea2c1e7-c5ff-4e6d-bffd-c5c8f81413a7",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "denominator-exception",
"display" : "Denominator Exception"
}
]
},
"description" : "Patients with statin-associated muscle symptoms or an allergy to statin medication.\nPatients who are receiving palliative or hospice care.\nPatients with active liver disease or hepatic disease or insufficiency.\nPatients with end-stage renal disease (ESRD).\nPatients with documentation of a medical reason for not being prescribed statin therapy.",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Denominator Exceptions"
}
}
]
}
],
"supplementalData" : [
{
"id" : "sde-ethnicity",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "supplemental-data"
}
]
}
],
"description" : "SDE Ethnicity",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "SDE Ethnicity"
}
},
{
"id" : "sde-payer",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "supplemental-data"
}
]
}
],
"description" : "SDE Payer",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "SDE Payer"
}
},
{
"id" : "sde-race",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "supplemental-data"
}
]
}
],
"description" : "SDE Race",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "SDE Race"
}
},
{
"id" : "sde-sex",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "supplemental-data"
}
]
}
],
"description" : "SDE Sex",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "SDE Sex"
}
}
]
}
IG © 2023+ cqframework. Package gov.healthit.ecqi.ecqms#2024.0.0 based on FHIR 4.0.1. Generated 2024-11-07
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