eCQM QICore Content Implementation Guide
2024.0.0 - CI Build
eCQM QICore Content Implementation Guide
2024.0.0 - CI Build
eCQM QICore Content Implementation Guide, published by cqframework. This guide is not an authorized publication; it is the continuous build for version 2024.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/cqframework/ecqm-content-qicore-2024/ and changes regularly. See the Directory of published versions
| Draft as of 2024-12-18 |
<Measure xmlns="http://hl7.org/fhir">
<id value="VenousThromboembolismProphylaxisFHIR"/>
<meta>
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<profile
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<profile
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<text>
<status value="extensions"/>
<div xmlns="http://www.w3.org/1999/xhtml">
<table class="grid dict">
<tr>
<th scope="row"><b>Title: </b></th>
<td style="padding-left: 4px;">Venous Thromboembolism ProphylaxisFHIR</td>
</tr>
<tr>
<th scope="row"><b>Id: </b></th>
<td style="padding-left: 4px;">VenousThromboembolismProphylaxisFHIR</td>
</tr>
<tr>
<th scope="row"><b>Version: </b></th>
<td style="padding-left: 4px;">0.2.000</td>
</tr>
<tr>
<th scope="row"><b>Url: </b></th>
<td style="padding-left: 4px;"><a href="Measure-VenousThromboembolismProphylaxisFHIR.html">Venous Thromboembolism ProphylaxisFHIR</a></td>
</tr>
<tr>
<th scope="row">
<b>
short-name identifier:
</b>
</th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<span>CMS108FHIR</span>
</p>
</td>
</tr>
<tr>
<th scope="row">
<b>
version-independent identifier:
</b>
</th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<span>urn:uuid:fa570e9c-c75f-4972-a77e-9488816d14af</span>
</p>
</td>
</tr>
<tr>
<th scope="row">
<b>
version-specific identifier:
</b>
</th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<span>urn:uuid:1b60bbd2-6837-4b68-921c-ffeead0bc2ca</span>
</p>
</td>
</tr>
<tr>
<th scope="row">
<b>
publisher (CMS) identifier:
</b>
</th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<span>108FHIR</span>
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Effective Period: </b></th>
<td style="padding-left: 4px;">2025-01-01..2025-12-31</td>
</tr>
<tr>
<th scope="row"><b>Status: </b></th>
<td style="padding-left: 4px;">draft</td>
</tr>
<tr>
<th scope="row"><b>Publisher: </b></th>
<td style="padding-left: 4px;">The Joint Commission</td>
</tr>
<tr>
<th scope="row"><b>Author: </b></th>
<td style="padding-left: 4px;">The Joint Commission</td>
</tr>
<tr>
<th scope="row"><b>Description: </b></th>
<td style="padding-left: 4px;"><div><p>This measure assesses the number of patients who received Venous Thromboembolism (VTE) prophylaxis or have documentation why no VTE prophylaxis was given between the day of arrival to the day after hospital admission or surgery end date for surgeries that start the day of or the day after hospital admission</p>
</div></td>
</tr>
<tr>
<th scope="row"><b>Purpose: </b></th>
<td style="padding-left: 4px;"><div><p>UNKNOWN</p>
</div></td>
</tr>
<tr>
<th scope="row"><b>Copyright: </b></th>
<td style="padding-left: 4px;"><div><p>Measure specifications are in the Public Domain.</p>
<p>LOINC(R) copyright 2004-2023 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2023 International Health Terminology Standards Development Organisation. ICD-10 copyright 2023 World Health Organization. All Rights Reserved.</p>
</div></td>
</tr>
<tr>
<th scope="row"><b>Disclaimer: </b></th>
<td style="padding-left: 4px;"><div><p>These performance measures are not clinical guidelines and do not establish a standard of medical care and have not been tested for all potential applications. The measures and specifications are provided without warranty.</p>
</div></td>
</tr>
<tr>
<th scope="row"><b>Scoring: </b></th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<span>Proportion </span>
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Rationale: </b></th>
<td style="padding-left: 4px;"><div><p>The estimated annual incidence of deep-vein thrombosis (DVT) and pulmonary embolism (PE), known collectively as venous thromboembolism (VTE), ranges from 350,000 to 600,000 (Maynard, 2016). According to the Centers for Disease Control and Prevention (CDC) 2020 statistics, 1-2 per 1,000 adults in the United States are clinically diagnosed with VTE each year (CDC, 2020). Increased incidence is reported in the elderly (1 per 100) compared to young adults (1 per 10,000) (Henke et al., 2020).</p>
<p>VTE is a known complication of hospitalization, frequently extending the length of stay and increasing hospital mortality (Maynard, 2016). Approximately 20% of VTE are associated with a surgical procedure (Henke et al., 2020). Hospitalized patients at high-risk for VTE may develop an asymptomatic DVT, and die from PE even before the diagnosis is suspected. The majority of fatal events occur as sudden or abrupt death, underscoring the importance of prevention as the most critical action step for reducing death from PE (Geerts et al., 2008).</p>
<p>American Society of Hematology (ASH) 2018 VTE prophylaxis guidelines strongly recommend pharmacological prophylaxis using unfractionated heparin (UFH), low molecular weight heparin (LMWH) or fondaparinux for acutely and critically ill hospitalized medical patients, unless contraindicated. The use of mechanical prophylaxis is an acceptable alternative for patients with increased risk of bleeding and preferred over no prophylaxis. ASH 2019 guidelines for surgical patients similarly recommend pharmacological or mechanical prophylaxis over no VTE prophylaxis. (NOTE: Some select surgeries have previously been monitored in the Surgical Care Improvement Project; since performance on these surgeries has achieved very high levels, they are not included in this measure.)</p>
<p>Despite its proven effectiveness, VTE prophylaxis remains underused or inappropriately used in both medical and surgical patients (Kahn et al., 2018). The ENDORSE study evaluated prophylaxis rates in 17,084 major surgery patients and found that more than one third of patients at risk for VTE (38%) did not receive prophylaxis with various rates reported for different types of surgery (Cohen et al., 2008). More recently, a systemic review of multiple randomized controlled trials found that system-wide interventions, such as computer alerts to physicians and other healthcare professionals, increased the use of appropriate VTE prophylaxis while reducing the number of symptomatic VTE at three months (Kahn et al., 2018).</p>
</div></td>
</tr>
<tr>
<th scope="row"><b>Clinical recommendation statement: </b></th>
<td style="padding-left: 4px;"><div><p>Failure to recognize and protect patients at risk for venous thromboembolism (VTE) increases the chances for acutely ill hospitalized patients at high risk for developing a deep vein thrombosis or dying from a pulmonary embolism. Screening all patients is the only evidence based practice in reducing incidence of disease. All hospitalized patients should be evaluated for primary VTE prophylaxis, and given appropriate prophylaxis when indicated.</p>
</div></td>
</tr>
<tr>
<th scope="row"><b>Guidance (Usage): </b></th>
<td style="padding-left: 4px;">When low dose unfractionated heparin is administered for VTE prophylaxis, the intended administration route for low dose unfractionated heparin is subcutaneous.
Reasons for no pharmacological and no mechanical VTE prophylaxis must be explicitly documented by the MD/APN/PA or pharmacist and linked with VTE prophylaxis. Ambulation alone is not a sufficient reason for not administering VTE prophylaxis. In order for ambulation/patient ambulating to be considered as an acceptable reason, there needs to be explicit documentation, e.g., "patient out of bed and ambulating in halls - no VTE prophylaxis needed."
The denominator population includes patients with inpatient hospitalizations and patients from Acute Hospital Care at Home programs, who are treated and billed as inpatients but receive care in their home.
This eCQM is an episode-based measure. An episode is defined as each inpatient hospitalization or encounter that ends during the measurement period.
This FHIR-based measure has been derived from the QDM-based measure: CMS108v13.
Please refer to the HL7 QI-Core Implementation Guide (https://hl7.org/fhir/us/qicore/STU4.1.1/) for more information on QI-Core and mapping recommendations from QDM to QI-Core 4.1.1 (https://hl7.org/fhir/us/qicore/STU4.1.1/qdm-to-qicore.html).</td>
</tr>
<tr>
<th scope="row"><b>Population Criteria: </b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr>
<th><b>64f8bc45da013638e7b3d874</b></th>
</tr>
<tr>
<td>Initial Population:</td>
<td>Inpatient hospitalizations for patients age 18 and older, discharged from hospital inpatient acute care without a diagnosis of venous thromboembolism (VTE) or obstetrics that ends during the measurement period</td>
</tr>
<tr>
<td>Denominator:</td>
<td>Initial population</td>
</tr>
<tr>
<td>Denominator Exclusion:</td>
<td>- Inpatient hospitalizations for patients who have a length of stay less than 2 days
- Inpatient hospitalizations for patients who are direct admits to intensive care unit (ICU), or transferred to ICU the day of or the day after hospital admission with ICU length of stay greater than or equal to one day
- Inpatient hospitalizations for patients with a principal diagnosis of mental disorders or stroke
- Inpatient hospitalizations for patients with a principal procedure of Surgical Care Improvement Project (SCIP) VTE selected surgeries
- Inpatient hospitalizations for patients with comfort measures documented anytime between the day of arrival and the day after hospital admission
- Inpatient hospitalizations for patients with comfort measures documented by the day after surgery end date for surgeries that end the day of or the day after hospital admission</td>
</tr>
<tr>
<td>Numerator:</td>
<td>Inpatient hospitalizations for patients who received VTE prophylaxis:
- between the day of arrival and the day after hospital admission
- the day of or the day after surgery end date (for surgeries that end the day of or the day after hospital admission)
Inpatient hospitalizations for patients who have documentation of a reason why no VTE prophylaxis was given:
- between the day of arrival and the day after hospital admission
- the day of or the day after surgery end date (for surgeries that end the day of or the day after hospital admission)</td>
</tr>
</table>
</td>
</tr>
<tr>
<th scope="row"><b> Supplemental Data Elements: </b></th>
<td style="padding-left: 4px;">
<p>SDE Ethnicity</p>
<p>SDE Race</p>
<p>SDE Sex</p>
<p>SDE Payer</p>
</td>
</tr>
<tr>
<th scope="row">
<b> Supplemental Data Guidance
: </b></th>
<td style="padding-left: 4px;"> For every patient evaluated by this measure also identify payer, race, ethnicity and sex; SDE Ethnicity-Patient's Ethnicity:
Hispanic or Latino
Not Hispanic or Latino
SDE Race-Patient's Race:
Native Hawaiian or Other Pacific Islander
Asian
American Indian or Alaska Native
Other Race
White
Black or African American
SDE Sex-Patient's Sex:
Gender identity restricted to only Male and Female used in administrative situations requiring a restriction to these two categories.
SDE Payer
</td>
</tr>
<tr>
<th scope="row"><b>Libraries: </b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr>
<td><a href="Library-VenousThromboembolismProphylaxisFHIR.html">VenousThromboembolismProphylaxisFHIR</a></td>
</tr>
</table>
</td>
</tr>
<tr>
<th scope="row"><b>Terminology and Other Dependencies: </b></th>
<td style="padding-left: 4px;">
<li><code>Library/SupplementalDataElements|3.5.000</code></li>
<li><code>Library/VTE|8.8.000</code></li>
<li><code>Library/CQMCommon|2.2.000</code></li>
<li><code>Library/FHIRHelpers|4.4.000</code></li>
<li><code>Library/QICoreCommon|2.1.000</code></li>
<li><code>Library/TJCOverall|8.14.000</code></li>
<li><a href="http://hl7.org/fhir/R4/codesystem-administrative-gender.html">AdministrativeGender</a></li>
<li><a href="http://terminology.hl7.org/5.5.0/CodeSystem-condition-clinical.html">Condition Clinical Status Codes</a></li>
<li><a href="http://terminology.hl7.org/5.5.0/CodeSystem-condition-ver-status.html">ConditionVerificationStatus</a></li>
<li><a href="http://terminology.hl7.org/5.5.0/CodeSystem-v3-loinc.html">Logical Observation Identifiers, Names and Codes (LOINC)</a></li>
<li><a href="http://terminology.hl7.org/5.5.0/CodeSystem-diagnosis-role.html">Diagnosis Role</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.666.5.307/expansion">Encounter Inpatient</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.263/expansion">Obstetrics</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.279/expansion">Venous Thromboembolism</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.264/expansion">Obstetrics VTE</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1045.39/expansion">Low Dose Unfractionated Heparin for VTE Prophylaxis</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.223/expansion">Subcutaneous route</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.219/expansion">Low Molecular Weight Heparin for VTE Prophylaxis</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.211/expansion">Injectable Factor Xa Inhibitor for VTE Prophylaxis</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.232/expansion">Warfarin</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1110.50/expansion">Rivaroxaban and Betrixaban for VTE Prophylaxis</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1110.65/expansion">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.65</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1110.64/expansion">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.64</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1110.66/expansion">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.66</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1111.143/expansion">Observation Services</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.292/expansion">Emergency Department Visit</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.666.5.1743/expansion">General or Neuraxial Anesthesia</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.134/expansion">Oral Factor Xa Inhibitor for VTE Prophylaxis or VTE Treatment</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.202/expansion">Atrial Fibrillation/Flutter</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.259/expansion">Hip Replacement Surgery</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.261/expansion">Knee Replacement Surgery</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.400/expansion">Low Risk</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.213/expansion">INR</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.218/expansion">Unfractionated Heparin</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.222/expansion">Intravenous route</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.205/expansion">Direct Thrombin Inhibitor</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1045.41/expansion">Glycoprotein IIb/IIIa Inhibitors</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.473/expansion">Medical Reason</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.230/expansion">Venous foot pumps (VFP)</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.214/expansion">Intermittent pneumatic compression devices (IPC)</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.256/expansion">Graduated compression stockings (GCS)</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.93/expansion">Patient Refusal</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.114222.4.11.3591/expansion">Payer</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.206/expansion">Intensive Care Unit</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.105.12.1004/expansion">Mental Health Diagnoses</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.212/expansion">Hemorrhagic Stroke</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.247/expansion">Ischemic Stroke</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.255/expansion">General Surgery</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.257/expansion">Gynecological Surgery</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.258/expansion">Hip Fracture Surgery</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.260/expansion">Intracranial Neurosurgery</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.272/expansion">Urological Surgery</a></li>
<li><a href="https://vsac.nlm.nih.gov/valueset/1.3.6.1.4.1.33895.1.3.0.45/expansion">Comfort Measures</a></li>
</td>
</tr>
<tr>
<th scope="row"><b>Parameters:</b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr>
<th><b>name</b></th>
<th><b>use</b></th>
<th><b>min</b></th>
<th><b>max</b></th>
<th><b>type</b></th>
</tr>
<tr>
<td>Measurement Period</td>
<td>In</td>
<td>0</td>
<td>1</td>
<td>Period</td>
</tr>
<tr>
<td>SDE Sex</td>
<td>Out</td>
<td>0</td>
<td>1</td>
<td>Coding</td>
</tr>
<tr>
<td>Numerator</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Denominator</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>SDE Payer</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>Initial Population</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>SDE Ethnicity</td>
<td>Out</td>
<td>0</td>
<td>1</td>
<td>Resource</td>
</tr>
<tr>
<td>Denominator Exclusions</td>
<td>Out</td>
<td>0</td>
<td>*</td>
<td>Resource</td>
</tr>
<tr>
<td>SDE Race</td>
<td>Out</td>
<td>0</td>
<td>1</td>
<td>Resource</td>
</tr>
</table>
</td>
</tr>
<tr>
<th scope="row"><b>DataRequirements:</b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr>
<th><b>Resource Type</b></th>
<th><b>Resource Elements</b></th>
<th><b>Valueset Name</b></th>
<th><b>Valueset</b></th>
</tr>
<tr>
<td>Patient(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-patient.html">QICorePatient</a>)</td>
<td>
ethnicity
race
</td>
<td>
</td>
<td/>
</tr>
<tr>
<td>Encounter(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html">QICoreEncounter</a>)</td>
<td>
type
status
status.value
period
condition
condition.reference
condition.reference.value
period.low
period.lowClosed
period.high
period.highClosed
location
rank
rank.value
use
extension
</td>
<td>
Observation Services
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1111.143/expansion">Observation Services</a></td>
</tr>
<tr>
<td>Encounter(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html">QICoreEncounter</a>)</td>
<td>
type
status
status.value
period
condition
condition.reference
condition.reference.value
period.low
period.lowClosed
period.high
period.highClosed
location
rank
rank.value
use
extension
</td>
<td>
Emergency Department Visit
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.292/expansion">Emergency Department Visit</a></td>
</tr>
<tr>
<td>Encounter(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html">QICoreEncounter</a>)</td>
<td>
type
status
status.value
period
condition
condition.reference
condition.reference.value
period.low
period.lowClosed
period.high
period.highClosed
location
rank
rank.value
use
extension
</td>
<td>
Encounter Inpatient
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.666.5.307/expansion">Encounter Inpatient</a></td>
</tr>
<tr>
<td>Condition(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-condition.html">QICoreCondition</a>)</td>
<td>
code
verificationStatus
onset
</td>
<td>
Atrial Fibrillation or Flutter
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.202/expansion">Atrial Fibrillation/Flutter</a></td>
</tr>
<tr>
<td>Condition(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-condition.html">QICoreCondition</a>)</td>
<td>
code
clinicalStatus
verificationStatus
onset
</td>
<td>
Venous Thromboembolism
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.279/expansion">Venous Thromboembolism</a></td>
</tr>
<tr>
<td>Condition(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-condition.html">QICoreCondition</a>)</td>
<td>
id
id.value
code
</td>
<td>
</td>
<td/>
</tr>
<tr>
<td>MedicationAdministration(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-medicationadministration.html">QICoreMedicationAdministration</a>)</td>
<td>
medication
status
status.value
dosage
dosage.route
effective
id
id.value
</td>
<td>
Low Dose Unfractionated Heparin for VTE Prophylaxis
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1045.39/expansion">Low Dose Unfractionated Heparin for VTE Prophylaxis</a></td>
</tr>
<tr>
<td>MedicationAdministration(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-medicationadministration.html">QICoreMedicationAdministration</a>)</td>
<td>
medication
status
status.value
dosage
dosage.route
effective
id
id.value
</td>
<td>
Low Molecular Weight Heparin for VTE Prophylaxis
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.219/expansion">Low Molecular Weight Heparin for VTE Prophylaxis</a></td>
</tr>
<tr>
<td>MedicationAdministration(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-medicationadministration.html">QICoreMedicationAdministration</a>)</td>
<td>
medication
status
status.value
dosage
dosage.route
effective
id
id.value
</td>
<td>
Injectable Factor Xa Inhibitor for VTE Prophylaxis
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.211/expansion">Injectable Factor Xa Inhibitor for VTE Prophylaxis</a></td>
</tr>
<tr>
<td>MedicationAdministration(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-medicationadministration.html">QICoreMedicationAdministration</a>)</td>
<td>
medication
status
status.value
dosage
dosage.route
effective
id
id.value
</td>
<td>
Warfarin
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.232/expansion">Warfarin</a></td>
</tr>
<tr>
<td>MedicationAdministration(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-medicationadministration.html">QICoreMedicationAdministration</a>)</td>
<td>
medication
status
status.value
dosage
dosage.route
effective
id
id.value
</td>
<td>
Rivaroxaban for VTE Prophylaxis
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1110.50/expansion">Rivaroxaban and Betrixaban for VTE Prophylaxis</a></td>
</tr>
<tr>
<td>MedicationAdministration(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-medicationadministration.html">QICoreMedicationAdministration</a>)</td>
<td>
medication
status
status.value
dosage
dosage.route
effective
id
id.value
</td>
<td>
Oral Factor Xa Inhibitor for VTE Prophylaxis or VTE Treatment
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.134/expansion">Oral Factor Xa Inhibitor for VTE Prophylaxis or VTE Treatment</a></td>
</tr>
<tr>
<td>MedicationAdministration(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-medicationadministration.html">QICoreMedicationAdministration</a>)</td>
<td>
medication
status
status.value
dosage
dosage.route
effective
id
id.value
</td>
<td>
Unfractionated Heparin
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.218/expansion">Unfractionated Heparin</a></td>
</tr>
<tr>
<td>MedicationAdministration(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-medicationadministration.html">QICoreMedicationAdministration</a>)</td>
<td>
medication
status
status.value
dosage
dosage.route
effective
id
id.value
</td>
<td>
Direct Thrombin Inhibitor
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.205/expansion">Direct Thrombin Inhibitor</a></td>
</tr>
<tr>
<td>MedicationAdministration(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-medicationadministration.html">QICoreMedicationAdministration</a>)</td>
<td>
medication
status
status.value
dosage
dosage.route
effective
id
id.value
</td>
<td>
Glycoprotein IIb/IIIa Inhibitors
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1045.41/expansion">Glycoprotein IIb/IIIa Inhibitors</a></td>
</tr>
<tr>
<td>Procedure(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html">QICoreProcedure</a>)</td>
<td>
code
status
status.value
performed
id
id.value
</td>
<td>
Application of Intermittent Pneumatic Compression Devices
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1110.65/expansion">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.65</a></td>
</tr>
<tr>
<td>Procedure(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html">QICoreProcedure</a>)</td>
<td>
code
status
status.value
performed
id
id.value
</td>
<td>
Application of Venous Foot Pumps
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1110.64/expansion">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.64</a></td>
</tr>
<tr>
<td>Procedure(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html">QICoreProcedure</a>)</td>
<td>
code
status
status.value
performed
id
id.value
</td>
<td>
Application of Graduated Compression Stockings
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1110.66/expansion">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.66</a></td>
</tr>
<tr>
<td>Procedure(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html">QICoreProcedure</a>)</td>
<td>
code
status
status.value
performed
id
id.value
</td>
<td>
General Surgery
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.255/expansion">General Surgery</a></td>
</tr>
<tr>
<td>Procedure(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html">QICoreProcedure</a>)</td>
<td>
code
status
status.value
performed
id
id.value
</td>
<td>
Gynecological Surgery
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.257/expansion">Gynecological Surgery</a></td>
</tr>
<tr>
<td>Procedure(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html">QICoreProcedure</a>)</td>
<td>
code
status
status.value
performed
id
id.value
</td>
<td>
Hip Fracture Surgery
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.258/expansion">Hip Fracture Surgery</a></td>
</tr>
<tr>
<td>Procedure(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html">QICoreProcedure</a>)</td>
<td>
code
status
status.value
performed
id
id.value
</td>
<td>
Hip Replacement Surgery
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.259/expansion">Hip Replacement Surgery</a></td>
</tr>
<tr>
<td>Procedure(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html">QICoreProcedure</a>)</td>
<td>
code
status
status.value
performed
id
id.value
</td>
<td>
Intracranial Neurosurgery
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.260/expansion">Intracranial Neurosurgery</a></td>
</tr>
<tr>
<td>Procedure(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html">QICoreProcedure</a>)</td>
<td>
code
status
status.value
performed
id
id.value
</td>
<td>
Knee Replacement Surgery
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.261/expansion">Knee Replacement Surgery</a></td>
</tr>
<tr>
<td>Procedure(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html">QICoreProcedure</a>)</td>
<td>
code
status
status.value
performed
id
id.value
</td>
<td>
Urological Surgery
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.272/expansion">Urological Surgery</a></td>
</tr>
<tr>
<td>Procedure(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html">QICoreProcedure</a>)</td>
<td>
code
status
status.value
performed
id
id.value
</td>
<td>
Comfort Measures
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/1.3.6.1.4.1.33895.1.3.0.45/expansion">Comfort Measures</a></td>
</tr>
<tr>
<td>Procedure(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html">QICoreProcedure</a>)</td>
<td>
code
status
status.value
performed
performed.low
performed.lowClosed
performed.high
performed.highClosed
id
id.value
</td>
<td>
General or Neuraxial Anesthesia
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.666.5.1743/expansion">General or Neuraxial Anesthesia</a></td>
</tr>
<tr>
<td>Observation(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-observation.html">QICoreObservation</a>)</td>
<td>
code
value
status
status.value
id
id.value
effective
</td>
<td>
</td>
<td/>
</tr>
<tr>
<td>Observation(<a href="http://hl7.org/fhir/us/core/STU3.1.1/StructureDefinition-us-core-observation-lab.html">US Core Laboratory Result Observation Profile</a>)</td>
<td>
code
value
status
status.value
id
id.value
issued
issued.value
</td>
<td>
INR
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.213/expansion">INR</a></td>
</tr>
<tr>
<td>MedicationAdministration(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-mednotadministered.html">QICoreMedicationAdministrationNotDone</a>)</td>
<td>
medication
id
id.value
statusReason
extension
</td>
<td>
Low Dose Unfractionated Heparin for VTE Prophylaxis
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1045.39/expansion">Low Dose Unfractionated Heparin for VTE Prophylaxis</a></td>
</tr>
<tr>
<td>MedicationAdministration(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-mednotadministered.html">QICoreMedicationAdministrationNotDone</a>)</td>
<td>
medication
id
id.value
statusReason
extension
</td>
<td>
Low Dose Unfractionated Heparin for VTE Prophylaxis
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1045.39/expansion">Low Dose Unfractionated Heparin for VTE Prophylaxis</a></td>
</tr>
<tr>
<td>MedicationAdministration(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-mednotadministered.html">QICoreMedicationAdministrationNotDone</a>)</td>
<td>
medication
id
id.value
statusReason
extension
</td>
<td>
Low Molecular Weight Heparin for VTE Prophylaxis
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.219/expansion">Low Molecular Weight Heparin for VTE Prophylaxis</a></td>
</tr>
<tr>
<td>MedicationAdministration(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-mednotadministered.html">QICoreMedicationAdministrationNotDone</a>)</td>
<td>
medication
id
id.value
statusReason
extension
</td>
<td>
Low Molecular Weight Heparin for VTE Prophylaxis
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.219/expansion">Low Molecular Weight Heparin for VTE Prophylaxis</a></td>
</tr>
<tr>
<td>MedicationAdministration(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-mednotadministered.html">QICoreMedicationAdministrationNotDone</a>)</td>
<td>
medication
id
id.value
statusReason
extension
</td>
<td>
Injectable Factor Xa Inhibitor for VTE Prophylaxis
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.211/expansion">Injectable Factor Xa Inhibitor for VTE Prophylaxis</a></td>
</tr>
<tr>
<td>MedicationAdministration(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-mednotadministered.html">QICoreMedicationAdministrationNotDone</a>)</td>
<td>
medication
id
id.value
statusReason
extension
</td>
<td>
Injectable Factor Xa Inhibitor for VTE Prophylaxis
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.211/expansion">Injectable Factor Xa Inhibitor for VTE Prophylaxis</a></td>
</tr>
<tr>
<td>MedicationAdministration(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-mednotadministered.html">QICoreMedicationAdministrationNotDone</a>)</td>
<td>
medication
id
id.value
statusReason
extension
</td>
<td>
Warfarin
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.232/expansion">Warfarin</a></td>
</tr>
<tr>
<td>MedicationAdministration(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-mednotadministered.html">QICoreMedicationAdministrationNotDone</a>)</td>
<td>
medication
id
id.value
statusReason
extension
</td>
<td>
Warfarin
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.232/expansion">Warfarin</a></td>
</tr>
<tr>
<td>MedicationAdministration(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-mednotadministered.html">QICoreMedicationAdministrationNotDone</a>)</td>
<td>
medication
id
id.value
statusReason
extension
</td>
<td>
Rivaroxaban for VTE Prophylaxis
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1110.50/expansion">Rivaroxaban and Betrixaban for VTE Prophylaxis</a></td>
</tr>
<tr>
<td>MedicationAdministration(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-mednotadministered.html">QICoreMedicationAdministrationNotDone</a>)</td>
<td>
medication
id
id.value
statusReason
extension
</td>
<td>
Rivaroxaban for VTE Prophylaxis
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1110.50/expansion">Rivaroxaban and Betrixaban for VTE Prophylaxis</a></td>
</tr>
<tr>
<td>MedicationRequest(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-mednotrequested.html">QICoreMedicationNotRequested</a>)</td>
<td>
medication
intent
intent.value
id
id.value
reasonCode
authoredOn
authoredOn.value
</td>
<td>
Low Dose Unfractionated Heparin for VTE Prophylaxis
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1045.39/expansion">Low Dose Unfractionated Heparin for VTE Prophylaxis</a></td>
</tr>
<tr>
<td>MedicationRequest(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-mednotrequested.html">QICoreMedicationNotRequested</a>)</td>
<td>
medication
intent
intent.value
id
id.value
reasonCode
authoredOn
authoredOn.value
</td>
<td>
Low Dose Unfractionated Heparin for VTE Prophylaxis
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1045.39/expansion">Low Dose Unfractionated Heparin for VTE Prophylaxis</a></td>
</tr>
<tr>
<td>MedicationRequest(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-mednotrequested.html">QICoreMedicationNotRequested</a>)</td>
<td>
medication
intent
intent.value
id
id.value
reasonCode
authoredOn
authoredOn.value
</td>
<td>
Low Molecular Weight Heparin for VTE Prophylaxis
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.219/expansion">Low Molecular Weight Heparin for VTE Prophylaxis</a></td>
</tr>
<tr>
<td>MedicationRequest(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-mednotrequested.html">QICoreMedicationNotRequested</a>)</td>
<td>
medication
intent
intent.value
id
id.value
reasonCode
authoredOn
authoredOn.value
</td>
<td>
Low Molecular Weight Heparin for VTE Prophylaxis
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.219/expansion">Low Molecular Weight Heparin for VTE Prophylaxis</a></td>
</tr>
<tr>
<td>MedicationRequest(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-mednotrequested.html">QICoreMedicationNotRequested</a>)</td>
<td>
medication
intent
intent.value
id
id.value
reasonCode
authoredOn
authoredOn.value
</td>
<td>
Injectable Factor Xa Inhibitor for VTE Prophylaxis
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.211/expansion">Injectable Factor Xa Inhibitor for VTE Prophylaxis</a></td>
</tr>
<tr>
<td>MedicationRequest(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-mednotrequested.html">QICoreMedicationNotRequested</a>)</td>
<td>
medication
intent
intent.value
id
id.value
reasonCode
authoredOn
authoredOn.value
</td>
<td>
Injectable Factor Xa Inhibitor for VTE Prophylaxis
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.211/expansion">Injectable Factor Xa Inhibitor for VTE Prophylaxis</a></td>
</tr>
<tr>
<td>MedicationRequest(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-mednotrequested.html">QICoreMedicationNotRequested</a>)</td>
<td>
medication
intent
intent.value
id
id.value
reasonCode
authoredOn
authoredOn.value
</td>
<td>
Warfarin
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.232/expansion">Warfarin</a></td>
</tr>
<tr>
<td>MedicationRequest(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-mednotrequested.html">QICoreMedicationNotRequested</a>)</td>
<td>
medication
intent
intent.value
id
id.value
reasonCode
authoredOn
authoredOn.value
</td>
<td>
Warfarin
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.232/expansion">Warfarin</a></td>
</tr>
<tr>
<td>MedicationRequest(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-mednotrequested.html">QICoreMedicationNotRequested</a>)</td>
<td>
medication
intent
intent.value
id
id.value
reasonCode
authoredOn
authoredOn.value
</td>
<td>
Rivaroxaban for VTE Prophylaxis
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1110.50/expansion">Rivaroxaban and Betrixaban for VTE Prophylaxis</a></td>
</tr>
<tr>
<td>MedicationRequest(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-mednotrequested.html">QICoreMedicationNotRequested</a>)</td>
<td>
medication
intent
intent.value
id
id.value
reasonCode
authoredOn
authoredOn.value
</td>
<td>
Rivaroxaban for VTE Prophylaxis
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1110.50/expansion">Rivaroxaban and Betrixaban for VTE Prophylaxis</a></td>
</tr>
<tr>
<td>ServiceRequest(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-servicenotrequested.html">QICoreServiceNotRequested</a>)</td>
<td>
code
intent
intent.value
id
id.value
extension
authoredOn
authoredOn.value
</td>
<td>
Venous foot pumps
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.230/expansion">Venous foot pumps (VFP)</a></td>
</tr>
<tr>
<td>ServiceRequest(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-servicenotrequested.html">QICoreServiceNotRequested</a>)</td>
<td>
code
intent
intent.value
id
id.value
extension
authoredOn
authoredOn.value
</td>
<td>
Venous foot pumps
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.230/expansion">Venous foot pumps (VFP)</a></td>
</tr>
<tr>
<td>ServiceRequest(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-servicenotrequested.html">QICoreServiceNotRequested</a>)</td>
<td>
code
intent
intent.value
id
id.value
extension
authoredOn
authoredOn.value
</td>
<td>
Intermittent pneumatic compression devices
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.214/expansion">Intermittent pneumatic compression devices (IPC)</a></td>
</tr>
<tr>
<td>ServiceRequest(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-servicenotrequested.html">QICoreServiceNotRequested</a>)</td>
<td>
code
intent
intent.value
id
id.value
extension
authoredOn
authoredOn.value
</td>
<td>
Intermittent pneumatic compression devices
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.214/expansion">Intermittent pneumatic compression devices (IPC)</a></td>
</tr>
<tr>
<td>ServiceRequest(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-servicenotrequested.html">QICoreServiceNotRequested</a>)</td>
<td>
code
intent
intent.value
id
id.value
extension
authoredOn
authoredOn.value
</td>
<td>
Graduated compression stockings
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.256/expansion">Graduated compression stockings (GCS)</a></td>
</tr>
<tr>
<td>ServiceRequest(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-servicenotrequested.html">QICoreServiceNotRequested</a>)</td>
<td>
code
intent
intent.value
id
id.value
extension
authoredOn
authoredOn.value
</td>
<td>
Graduated compression stockings
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.256/expansion">Graduated compression stockings (GCS)</a></td>
</tr>
<tr>
<td>Procedure(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedurenotdone.html">QICoreProcedureNotDone</a>)</td>
<td>
code
extension
id
id.value
statusReason
</td>
<td>
Application of Intermittent Pneumatic Compression Devices
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1110.65/expansion">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.65</a></td>
</tr>
<tr>
<td>Procedure(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedurenotdone.html">QICoreProcedureNotDone</a>)</td>
<td>
code
extension
id
id.value
statusReason
</td>
<td>
Application of Intermittent Pneumatic Compression Devices
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1110.65/expansion">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.65</a></td>
</tr>
<tr>
<td>Procedure(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedurenotdone.html">QICoreProcedureNotDone</a>)</td>
<td>
code
extension
id
id.value
statusReason
</td>
<td>
Application of Venous Foot Pumps
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1110.64/expansion">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.64</a></td>
</tr>
<tr>
<td>Procedure(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedurenotdone.html">QICoreProcedureNotDone</a>)</td>
<td>
code
extension
id
id.value
statusReason
</td>
<td>
Application of Venous Foot Pumps
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1110.64/expansion">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.64</a></td>
</tr>
<tr>
<td>Procedure(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedurenotdone.html">QICoreProcedureNotDone</a>)</td>
<td>
code
extension
id
id.value
statusReason
</td>
<td>
Application of Graduated Compression Stockings
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1110.66/expansion">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.66</a></td>
</tr>
<tr>
<td>Procedure(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedurenotdone.html">QICoreProcedureNotDone</a>)</td>
<td>
code
extension
id
id.value
statusReason
</td>
<td>
Application of Graduated Compression Stockings
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1110.66/expansion">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.66</a></td>
</tr>
<tr>
<td>Coverage(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-coverage.html">QICoreCoverage</a>)</td>
<td>
type
period
</td>
<td>
Payer Type
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.114222.4.11.3591/expansion">Payer</a></td>
</tr>
<tr>
<td>Location(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-location.html">QICoreLocation</a>)</td>
<td>
id
id.value
</td>
<td>
</td>
<td/>
</tr>
<tr>
<td>ServiceRequest(<a href="http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-servicerequest.html">QICoreServiceRequest</a>)</td>
<td>
code
intent
intent.value
status
status.value
doNotPerform
doNotPerform.value
</td>
<td>
Comfort Measures
</td>
<td><a href="https://vsac.nlm.nih.gov/valueset/1.3.6.1.4.1.33895.1.3.0.45/expansion">Comfort Measures</a></td>
</tr>
</table>
</td>
</tr>
<tr>
<th scope="row"><b>Direct Reference Codes:</b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr>
<th><b>display</b></th>
<th><b>code</b></th>
<th><b>system</b></th>
</tr>
<tr>
<td>Male</td>
<td>M</td>
<td><a href="http://hl7.org/fhir/R4/codesystem-administrative-gender.html">http://hl7.org/fhir/administrative-gender</a></td>
</tr>
<tr>
<td>Female</td>
<td>F</td>
<td><a href="http://hl7.org/fhir/R4/codesystem-administrative-gender.html">http://hl7.org/fhir/administrative-gender</a></td>
</tr>
<tr>
<td>Active</td>
<td>active</td>
<td><a href="http://terminology.hl7.org/5.5.0/CodeSystem-condition-clinical.html">http://terminology.hl7.org/CodeSystem/condition-clinical</a></td>
</tr>
<tr>
<td>Recurrence</td>
<td>recurrence</td>
<td><a href="http://terminology.hl7.org/5.5.0/CodeSystem-condition-clinical.html">http://terminology.hl7.org/CodeSystem/condition-clinical</a></td>
</tr>
<tr>
<td>Relapse</td>
<td>relapse</td>
<td><a href="http://terminology.hl7.org/5.5.0/CodeSystem-condition-clinical.html">http://terminology.hl7.org/CodeSystem/condition-clinical</a></td>
</tr>
<tr>
<td>Confirmed</td>
<td>confirmed</td>
<td><a href="http://terminology.hl7.org/5.5.0/CodeSystem-condition-ver-status.html">http://terminology.hl7.org/CodeSystem/condition-ver-status</a></td>
</tr>
<tr>
<td>Inactive</td>
<td>inactive</td>
<td><a href="http://terminology.hl7.org/5.5.0/CodeSystem-condition-clinical.html">http://terminology.hl7.org/CodeSystem/condition-clinical</a></td>
</tr>
<tr>
<td>Remission</td>
<td>remission</td>
<td><a href="http://terminology.hl7.org/5.5.0/CodeSystem-condition-clinical.html">http://terminology.hl7.org/CodeSystem/condition-clinical</a></td>
</tr>
<tr>
<td>Resolved</td>
<td>resolved</td>
<td><a href="http://terminology.hl7.org/5.5.0/CodeSystem-condition-clinical.html">http://terminology.hl7.org/CodeSystem/condition-clinical</a></td>
</tr>
<tr>
<td>Risk for venous thromboembolism</td>
<td>72136-5</td>
<td><a href="https://loinc.org/">http://loinc.org</a></td>
</tr>
<tr>
<td>Billing</td>
<td>billing</td>
<td><a href="http://terminology.hl7.org/5.5.0/CodeSystem-diagnosis-role.html">http://terminology.hl7.org/CodeSystem/diagnosis-role</a></td>
</tr>
</table>
</td>
</tr>
<tr>
<th scope="row"><b>Logic Definitions:</b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr>
<th><b>Group</b></th>
<th><b>Scoring</b></th>
<th><b>Population Criteria</b></th>
<th><b>Expression</b></th>
</tr>
<tr>
<td> 64f8bc45da013638e7b3d874 </td>
<td colspan="3" style="padding-left: 4px;">
<b>Group scoring:</b>
<span> proportion </span>
<b>Measure scoring:</b>
<p style="margin-bottom: 5px;">
<span>Proportion</span>
</p>
<tr>
<th scope="row"><b>Type: </b></th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<span>Process </span>
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Rate Aggregation: </b></th>
<td colspan="3" style="padding-left: 4px;">None</td>
</tr>
<tr>
<th scope="row"><b>Improvement Notation: </b></th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<span>increase </span>
</p>
</td>
</tr>
</td>
<tr>
<td/>
<td/>
<td>Initial Population</td>
<td>
<pre><code class="language-cql">define "Initial Population":
VTE."Encounter with Age Range and without VTE Diagnosis or Obstetrical Conditions"</code></pre>
</td>
</tr>
<tr>
<td/>
<td/>
<td>Denominator</td>
<td>
<pre><code class="language-cql">define "Denominator":
"Initial Population"</code></pre>
</td>
</tr>
<tr>
<td/>
<td/>
<td>Denominator Exclusion</td>
<td>
<pre><code class="language-cql">define "Denominator Exclusions":
"Encounter Less Than 2 Days"
union "Encounter with ICU Location Stay 1 Day or More"
union "Encounter with Principal Diagnosis of Mental Disorder or Stroke"
union "Encounter with Principal Procedure of SCIP VTE Selected Surgery"
union "Encounter with Intervention Comfort Measures From Day of Start of Hospitalization To Day After Admission"
union "Encounter with Intervention Comfort Measures on Day of or Day After Procedure"</code></pre>
</td>
</tr>
<tr>
<td/>
<td/>
<td>Numerator</td>
<td>
<pre><code class="language-cql">define "Numerator":
"Encounter with VTE Prophylaxis Received From Day of Start of Hospitalization To Day After Admission or Procedure"
union ( "Encounter with Medication Oral Factor Xa Inhibitor Administered on Day of or Day After Admission or Procedure"
intersect ( "Encounter with Prior or Present Diagnosis of Atrial Fibrillation or Prior Diagnosis of VTE"
union "Encounter with Prior or Present Procedure of Hip or Knee Replacement Surgery"
)
)
union "Encounter with Low Risk for VTE or Anticoagulant Administered"
union "Encounter with No VTE Prophylaxis Due to Medical Reason"
union "Encounter with No VTE Prophylaxis Due to Patient Refusal"</code></pre>
</td>
</tr>
</tr>
</table>
<table class="grid-dict">
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SupplementalDataElements</td>
<td>SDE Sex</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "SDE Sex":
case
when Patient.gender = 'male' then "M"
when Patient.gender = 'female' then "F"
else null
end</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>VenousThromboembolismProphylaxisFHIR</td>
<td>SDE Sex</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "SDE Sex":
SDE."SDE Sex"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>CQMCommon</td>
<td>Inpatient Encounter</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Inpatient Encounter":
[Encounter: "Encounter Inpatient"] EncounterInpatient
where EncounterInpatient.status = 'finished'
and EncounterInpatient.period ends during day of "Measurement Period"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>VTE</td>
<td>Admission without VTE or Obstetrical Conditions</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Admission without VTE or Obstetrical Conditions":
CQMCommon."Inpatient Encounter" InpatientEncounter
where not (exists (InpatientEncounter.encounterDiagnosis()) EncDx
where (EncDx.code in "Obstetrical or Pregnancy Related Conditions"
or EncDx.code in "Venous Thromboembolism"
or EncDx.code in "Obstetrics VTE"
)
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>VTE</td>
<td>Encounter with Age Range and without VTE Diagnosis or Obstetrical Conditions</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Encounter with Age Range and without VTE Diagnosis or Obstetrical Conditions":
( CQMCommon."Inpatient Encounter" InpatientEncounter
where AgeInYearsAt(date from start of InpatientEncounter.period) >= 18 )
intersect "Admission without VTE or Obstetrical Conditions"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>VenousThromboembolismProphylaxisFHIR</td>
<td>Pharmacological or Mechanical VTE Prophylaxis Received</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Pharmacological or Mechanical VTE Prophylaxis Received":
( ["MedicationAdministration": "Low Dose Unfractionated Heparin for VTE Prophylaxis"] VTEMedication
where VTEMedication.status = 'completed'
and VTEMedication.dosage.route in "Subcutaneous route"
)
union ( ["MedicationAdministration": "Low Molecular Weight Heparin for VTE Prophylaxis"] LMWH
where LMWH.status = 'completed'
)
union ( ["MedicationAdministration": "Injectable Factor Xa Inhibitor for VTE Prophylaxis"] FactorXa
where FactorXa.status = 'completed'
)
union ( ["MedicationAdministration": "Warfarin"] Warfarin
where Warfarin.status = 'completed'
)
union ( ["MedicationAdministration": "Rivaroxaban for VTE Prophylaxis"] Rivaroxaban
where Rivaroxaban.status = 'completed'
)
union ( ( ["Procedure": "Application of Intermittent Pneumatic Compression Devices"]
union ["Procedure": "Application of Venous Foot Pumps"]
union ["Procedure": "Application of Graduated Compression Stockings"] ) DeviceApplied
where DeviceApplied.status = 'completed'
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>VenousThromboembolismProphylaxisFHIR</td>
<td>Encounter with VTE Prophylaxis Received From Day of Start of Hospitalization To Day After Admission or Procedure</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Encounter with VTE Prophylaxis Received From Day of Start of Hospitalization To Day After Admission or Procedure":
( from
VTE."Encounter with Age Range and without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter,
"Pharmacological or Mechanical VTE Prophylaxis Received" VTEProphylaxis
where Coalesce(VTEProphylaxis.effective.toInterval(), VTEProphylaxis.performed.toInterval()) starts during day of QualifyingEncounter.FromDayOfStartOfHospitalizationToDayAfterAdmission ( )
return QualifyingEncounter
)
union ( from
VTE."Encounter with Age Range and without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter,
["Procedure": "General or Neuraxial Anesthesia"] AnesthesiaProcedure,
"Pharmacological or Mechanical VTE Prophylaxis Received" VTEProphylaxis
where AnesthesiaProcedure.status = 'completed'
and AnesthesiaProcedure.performed.toInterval ( ) ends 1 day after day of start of QualifyingEncounter.period
and Coalesce(VTEProphylaxis.effective.toInterval(), VTEProphylaxis.performed.toInterval()) starts during day of ( end of AnesthesiaProcedure.performed.toInterval ( ) ).CalendarDayOfOrDayAfter ( )
return QualifyingEncounter
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>VenousThromboembolismProphylaxisFHIR</td>
<td>Encounter with Medication Oral Factor Xa Inhibitor Administered on Day of or Day After Admission or Procedure</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Encounter with Medication Oral Factor Xa Inhibitor Administered on Day of or Day After Admission or Procedure":
( from
VTE."Encounter with Age Range and without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter,
["MedicationAdministration": "Oral Factor Xa Inhibitor for VTE Prophylaxis or VTE Treatment"] FactorXaMedication
where FactorXaMedication.status = 'completed'
and FactorXaMedication.effective.toInterval ( ) starts during day of ( start of QualifyingEncounter.period ).CalendarDayOfOrDayAfter ( )
return QualifyingEncounter
)
union ( from
VTE."Encounter with Age Range and without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter,
["Procedure": "General or Neuraxial Anesthesia"] AnesthesiaProcedure,
["MedicationAdministration": "Oral Factor Xa Inhibitor for VTE Prophylaxis or VTE Treatment"] FactorXaMedication
where FactorXaMedication.status = 'completed'
and AnesthesiaProcedure.status = 'completed'
and AnesthesiaProcedure.performed.toInterval ( ) ends 1 day after day of start of QualifyingEncounter.period
and FactorXaMedication.effective.toInterval ( ) starts during day of ( end of AnesthesiaProcedure.performed.toInterval ( ) ).CalendarDayOfOrDayAfter ( )
return QualifyingEncounter
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>VenousThromboembolismProphylaxisFHIR</td>
<td>Encounter with Prior or Present Diagnosis of Atrial Fibrillation or Prior Diagnosis of VTE</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Encounter with Prior or Present Diagnosis of Atrial Fibrillation or Prior Diagnosis of VTE":
( VTE."Encounter with Age Range and without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter
with ["Condition": "Atrial Fibrillation or Flutter"] AtrialFibrillation
such that AtrialFibrillation.isActive ( )
and AtrialFibrillation.verificationStatus is not null
and AtrialFibrillation.verificationStatus ~ QICoreCommon."confirmed"
and AtrialFibrillation.onset.toInterval ( ) starts on or before end of QualifyingEncounter.period
)
union ( VTE."Encounter with Age Range and without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter
where QualifyingEncounter.encounterDiagnosis ( ).code in "Atrial Fibrillation or Flutter"
)
union ( VTE."Encounter with Age Range and without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter
with ["Condition": "Venous Thromboembolism"] VTEDiagnosis
such that ( VTEDiagnosis.clinicalStatus ~ QICoreCommon."inactive"
or VTEDiagnosis.clinicalStatus ~ QICoreCommon."remission"
or VTEDiagnosis.clinicalStatus ~ QICoreCommon."resolved"
)
and VTEDiagnosis.verificationStatus is not null
and VTEDiagnosis.verificationStatus ~ QICoreCommon."confirmed"
and VTEDiagnosis.onset.toInterval ( ) before start of QualifyingEncounter.period
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>VenousThromboembolismProphylaxisFHIR</td>
<td>Encounter with Prior or Present Procedure of Hip or Knee Replacement Surgery</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Encounter with Prior or Present Procedure of Hip or Knee Replacement Surgery":
VTE."Encounter with Age Range and without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter
with ( ["Procedure": "Hip Replacement Surgery"]
union ["Procedure": "Knee Replacement Surgery"] ) HipKneeProcedure
such that HipKneeProcedure.status = 'completed'
and HipKneeProcedure.performed.toInterval ( ) starts on or before end of QualifyingEncounter.period</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>VenousThromboembolismProphylaxisFHIR</td>
<td>Low Risk Indicator For VTE</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Low Risk Indicator For VTE":
( ["Observation": "Risk for venous thromboembolism"] VTERiskAssessment
where VTERiskAssessment.value as Concept in "Low Risk"
and VTERiskAssessment.status in { 'final', 'amended', 'corrected' }
return {
id: VTERiskAssessment.id,
LowRiskDatetime: VTERiskAssessment.effective.earliest ( )
}
)
union ( ["US Core Laboratory Result Observation Profile": "INR"] INRLabTest
where INRLabTest.value as Quantity > 3.0
and INRLabTest.status in { 'final', 'amended', 'corrected' }
return {
id: INRLabTest.id,
LowRiskDatetime: INRLabTest.issued
}
)
union ( ( ( ["MedicationAdministration": "Unfractionated Heparin"] UnfractionatedHeparin
where UnfractionatedHeparin.dosage.route in "Intravenous route"
)
union ["MedicationAdministration": "Direct Thrombin Inhibitor"]
union ["MedicationAdministration": "Glycoprotein IIb/IIIa Inhibitors"] ) AnticoagulantMedication
where AnticoagulantMedication.status = 'completed'
return {
id: AnticoagulantMedication.id,
LowRiskDatetime: start of AnticoagulantMedication.effective.toInterval ( )
}
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>VenousThromboembolismProphylaxisFHIR</td>
<td>Low Risk for VTE or Anticoagulant Administered From Day of Start of Hospitalization To Day After Admission</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Low Risk for VTE or Anticoagulant Administered From Day of Start of Hospitalization To Day After Admission":
VTE."Encounter with Age Range and without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter
with "Low Risk Indicator For VTE" LowRiskForVTE
such that LowRiskForVTE.LowRiskDatetime during day of QualifyingEncounter.FromDayOfStartOfHospitalizationToDayAfterAdmission ( )</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>VenousThromboembolismProphylaxisFHIR</td>
<td>Low Risk for VTE or Anticoagulant Administered on Day of or Day After Procedure</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Low Risk for VTE or Anticoagulant Administered on Day of or Day After Procedure":
from
VTE."Encounter with Age Range and without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter,
["Procedure": "General or Neuraxial Anesthesia"] AnesthesiaProcedure,
"Low Risk Indicator For VTE" LowRiskForVTE
where AnesthesiaProcedure.status = 'completed'
and AnesthesiaProcedure.performed.toInterval ( ) ends 1 day after day of start of QualifyingEncounter.period
and LowRiskForVTE.LowRiskDatetime during day of ( end of AnesthesiaProcedure.performed.toInterval ( ) ).CalendarDayOfOrDayAfter ( )
return QualifyingEncounter</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>VenousThromboembolismProphylaxisFHIR</td>
<td>Encounter with Low Risk for VTE or Anticoagulant Administered</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Encounter with Low Risk for VTE or Anticoagulant Administered":
"Low Risk for VTE or Anticoagulant Administered From Day of Start of Hospitalization To Day After Admission"
union "Low Risk for VTE or Anticoagulant Administered on Day of or Day After Procedure"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>VenousThromboembolismProphylaxisFHIR</td>
<td>No VTE Prophylaxis Medication Administered or Ordered</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "No VTE Prophylaxis Medication Administered or Ordered":
( ( [MedicationAdministrationNotDone: "Low Dose Unfractionated Heparin for VTE Prophylaxis"]
union [MedicationAdministrationNotDone: "Low Molecular Weight Heparin for VTE Prophylaxis"]
union [MedicationAdministrationNotDone: "Injectable Factor Xa Inhibitor for VTE Prophylaxis"]
union [MedicationAdministrationNotDone: "Warfarin"]
union [MedicationAdministrationNotDone: "Rivaroxaban for VTE Prophylaxis"] ) NoMedicationAdm
return {
id: NoMedicationAdm.id,
MedicationStatusReason: NoMedicationAdm.statusReason,
authoredOn: NoMedicationAdm.recorded
}
)
union ( ( ["MedicationNotRequested": "Low Dose Unfractionated Heparin for VTE Prophylaxis"]
union ["MedicationNotRequested": "Low Molecular Weight Heparin for VTE Prophylaxis"]
union ["MedicationNotRequested": "Injectable Factor Xa Inhibitor for VTE Prophylaxis"]
union ["MedicationNotRequested": "Warfarin"]
union ["MedicationNotRequested": "Rivaroxaban for VTE Prophylaxis"] ) NoMedicationOrder
where NoMedicationOrder.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }
return {
id: NoMedicationOrder.id,
MedicationStatusReason: NoMedicationOrder.reasonCode,
authoredOn: NoMedicationOrder.authoredOn
}
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>VenousThromboembolismProphylaxisFHIR</td>
<td>No VTE Prophylaxis Medication Due to Medical Reason From Day of Start of Hospitalization To Day After Admission</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "No VTE Prophylaxis Medication Due to Medical Reason From Day of Start of Hospitalization To Day After Admission":
VTE."Encounter with Age Range and without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter
with "No VTE Prophylaxis Medication Administered or Ordered" NoVTEMedication
such that NoVTEMedication.MedicationStatusReason in "Medical Reason For Not Providing Treatment"
and NoVTEMedication.authoredOn during day of QualifyingEncounter.FromDayOfStartOfHospitalizationToDayAfterAdmission ( )</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>VenousThromboembolismProphylaxisFHIR</td>
<td>No Mechanical VTE Prophylaxis Performed or Ordered</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "No Mechanical VTE Prophylaxis Performed or Ordered":
( ( [ServiceNotRequested: "Venous foot pumps"]
union [ServiceNotRequested: "Intermittent pneumatic compression devices"]
union [ServiceNotRequested: "Graduated compression stockings"] ) DeviceNotOrder
where DeviceNotOrder.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }
return {
id: DeviceNotOrder.id,
requestStatusReason: DeviceNotOrder.reasonRefused,
authoredOn: DeviceNotOrder.authoredOn
}
)
union ( ( [ProcedureNotDone: "Application of Intermittent Pneumatic Compression Devices"]
union [ProcedureNotDone: "Application of Venous Foot Pumps"]
union [ProcedureNotDone: "Application of Graduated Compression Stockings"] ) DeviceNotApplied
let DeviceNotDoneTiming: DeviceNotApplied.recorded
return {
id: DeviceNotApplied.id,
requestStatusReason: DeviceNotApplied.statusReason,
authoredOn: DeviceNotDoneTiming
}
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>VenousThromboembolismProphylaxisFHIR</td>
<td>No Mechanical VTE Prophylaxis Due to Medical Reason From Day of Start of Hospitalization To Day After Admission</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "No Mechanical VTE Prophylaxis Due to Medical Reason From Day of Start of Hospitalization To Day After Admission":
VTE."Encounter with Age Range and without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter
with "No Mechanical VTE Prophylaxis Performed or Ordered" NoVTEDevice
such that NoVTEDevice.requestStatusReason in "Medical Reason For Not Providing Treatment"
and NoVTEDevice.authoredOn during day of QualifyingEncounter.FromDayOfStartOfHospitalizationToDayAfterAdmission ( )</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>VenousThromboembolismProphylaxisFHIR</td>
<td>No VTE Prophylaxis Medication Due to Medical Reason on Day of or Day After Procedure</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "No VTE Prophylaxis Medication Due to Medical Reason on Day of or Day After Procedure":
from
VTE."Encounter with Age Range and without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter,
["Procedure": "General or Neuraxial Anesthesia"] AnesthesiaProcedure,
"No VTE Prophylaxis Medication Administered or Ordered" NoVTEMedication
where NoVTEMedication.MedicationStatusReason in "Medical Reason For Not Providing Treatment"
and AnesthesiaProcedure.status = 'completed'
and AnesthesiaProcedure.performed.toInterval ( ) ends 1 day after day of start of QualifyingEncounter.period
and NoVTEMedication.authoredOn during day of ( end of AnesthesiaProcedure.performed.toInterval ( ) ).CalendarDayOfOrDayAfter ( )
return QualifyingEncounter</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>VenousThromboembolismProphylaxisFHIR</td>
<td>No Mechanical VTE Prophylaxis Due to Medical Reason on Day of or Day After Procedure</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "No Mechanical VTE Prophylaxis Due to Medical Reason on Day of or Day After Procedure":
from
VTE."Encounter with Age Range and without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter,
["Procedure": "General or Neuraxial Anesthesia"] AnesthesiaProcedure,
"No Mechanical VTE Prophylaxis Performed or Ordered" NoVTEDevice
where NoVTEDevice.requestStatusReason in "Medical Reason For Not Providing Treatment"
and AnesthesiaProcedure.status = 'completed'
and AnesthesiaProcedure.performed.toInterval ( ) ends 1 day after day of start of QualifyingEncounter.period
and NoVTEDevice.authoredOn during day of ( end of AnesthesiaProcedure.performed.toInterval ( ) ).CalendarDayOfOrDayAfter ( )
return QualifyingEncounter</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>VenousThromboembolismProphylaxisFHIR</td>
<td>Encounter with No VTE Prophylaxis Due to Medical Reason</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Encounter with No VTE Prophylaxis Due to Medical Reason":
( "No VTE Prophylaxis Medication Due to Medical Reason From Day of Start of Hospitalization To Day After Admission"
intersect "No Mechanical VTE Prophylaxis Due to Medical Reason From Day of Start of Hospitalization To Day After Admission"
)
union ( "No VTE Prophylaxis Medication Due to Medical Reason on Day of or Day After Procedure"
intersect "No Mechanical VTE Prophylaxis Due to Medical Reason on Day of or Day After Procedure"
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>VenousThromboembolismProphylaxisFHIR</td>
<td>No Mechanical or Pharmacological VTE Prophylaxis Due to Patient Refusal</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "No Mechanical or Pharmacological VTE Prophylaxis Due to Patient Refusal":
( "No VTE Prophylaxis Medication Administered or Ordered" NoVTEMedication
where NoVTEMedication.MedicationStatusReason in "Patient Refusal"
)
union ( "No Mechanical VTE Prophylaxis Performed or Ordered" NoVTEDevice
where NoVTEDevice.requestStatusReason in "Patient Refusal"
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>VenousThromboembolismProphylaxisFHIR</td>
<td>No VTE Prophylaxis Due to Patient Refusal From Day of Start of Hospitalization To Day After Admission</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "No VTE Prophylaxis Due to Patient Refusal From Day of Start of Hospitalization To Day After Admission":
VTE."Encounter with Age Range and without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter
with "No Mechanical or Pharmacological VTE Prophylaxis Due to Patient Refusal" PatientRefusal
such that PatientRefusal.authoredOn during day of QualifyingEncounter.FromDayOfStartOfHospitalizationToDayAfterAdmission ( )</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>VenousThromboembolismProphylaxisFHIR</td>
<td>No VTE Prophylaxis Due to Patient Refusal on Day of or Day After Procedure</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "No VTE Prophylaxis Due to Patient Refusal on Day of or Day After Procedure":
from
VTE."Encounter with Age Range and without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter,
["Procedure": "General or Neuraxial Anesthesia"] AnesthesiaProcedure,
"No Mechanical or Pharmacological VTE Prophylaxis Due to Patient Refusal" PatientRefusal
where AnesthesiaProcedure.status = 'completed'
and QICoreCommon."ToInterval" ( AnesthesiaProcedure.performed ) ends 1 day after day of start of QualifyingEncounter.period
and PatientRefusal.authoredOn during day of ( end of AnesthesiaProcedure.performed.toInterval ( ) ).CalendarDayOfOrDayAfter ( )
return QualifyingEncounter</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>VenousThromboembolismProphylaxisFHIR</td>
<td>Encounter with No VTE Prophylaxis Due to Patient Refusal</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Encounter with No VTE Prophylaxis Due to Patient Refusal":
"No VTE Prophylaxis Due to Patient Refusal From Day of Start of Hospitalization To Day After Admission"
union "No VTE Prophylaxis Due to Patient Refusal on Day of or Day After Procedure"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>VenousThromboembolismProphylaxisFHIR</td>
<td>Numerator</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Numerator":
"Encounter with VTE Prophylaxis Received From Day of Start of Hospitalization To Day After Admission or Procedure"
union ( "Encounter with Medication Oral Factor Xa Inhibitor Administered on Day of or Day After Admission or Procedure"
intersect ( "Encounter with Prior or Present Diagnosis of Atrial Fibrillation or Prior Diagnosis of VTE"
union "Encounter with Prior or Present Procedure of Hip or Knee Replacement Surgery"
)
)
union "Encounter with Low Risk for VTE or Anticoagulant Administered"
union "Encounter with No VTE Prophylaxis Due to Medical Reason"
union "Encounter with No VTE Prophylaxis Due to Patient Refusal"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>VenousThromboembolismProphylaxisFHIR</td>
<td>Initial Population</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Initial Population":
VTE."Encounter with Age Range and without VTE Diagnosis or Obstetrical Conditions"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>VenousThromboembolismProphylaxisFHIR</td>
<td>Denominator</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Denominator":
"Initial Population"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SupplementalDataElements</td>
<td>SDE Payer</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "SDE Payer":
[Coverage: type in "Payer Type"] Payer
return {
code: Payer.type,
period: Payer.period
}</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>VenousThromboembolismProphylaxisFHIR</td>
<td>SDE Payer</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "SDE Payer":
SDE."SDE Payer"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SupplementalDataElements</td>
<td>SDE Ethnicity</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "SDE Ethnicity":
Patient.ethnicity E
return Tuple {
codes: { E.ombCategory } union E.detailed,
display: E.text
}</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>VenousThromboembolismProphylaxisFHIR</td>
<td>SDE Ethnicity</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "SDE Ethnicity":
SDE."SDE Ethnicity"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>VenousThromboembolismProphylaxisFHIR</td>
<td>Encounter Less Than 2 Days</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Encounter Less Than 2 Days":
VTE."Encounter with Age Range and without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter
where QualifyingEncounter.period.lengthInDays ( ) < 2</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>VenousThromboembolismProphylaxisFHIR</td>
<td>Encounter with ICU Location Stay 1 Day or More</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Encounter with ICU Location Stay 1 Day or More":
VTE."Encounter with Age Range and without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter
where exists ( QualifyingEncounter.location Location
where Location.location.getLocation ( ).type in "Intensive Care Unit"
and Location.period.lengthInDays ( ) >= 1
and Location.period starts on or after start of QualifyingEncounter.period
and date from ( start of Location.period ) during ( start of QualifyingEncounter.period ).CalendarDayOfOrDayAfter ( )
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>VenousThromboembolismProphylaxisFHIR</td>
<td>Encounter with Principal Diagnosis of Mental Disorder or Stroke</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Encounter with Principal Diagnosis of Mental Disorder or Stroke":
VTE."Encounter with Age Range and without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter
where QualifyingEncounter.principalDiagnosis ( ).code in "Mental Health Diagnoses"
or QualifyingEncounter.principalDiagnosis ( ).code in "Hemorrhagic Stroke"
or QualifyingEncounter.principalDiagnosis ( ).code in "Ischemic Stroke"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>VenousThromboembolismProphylaxisFHIR</td>
<td>SCIP VTE Selected Surgery</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "SCIP VTE Selected Surgery":
( ["Procedure": "General Surgery"]
union ["Procedure": "Gynecological Surgery"]
union ["Procedure": "Hip Fracture Surgery"]
union ["Procedure": "Hip Replacement Surgery"]
union ["Procedure": "Intracranial Neurosurgery"]
union ["Procedure": "Knee Replacement Surgery"]
union ["Procedure": "Urological Surgery"] ) Procedure
where Procedure.status = 'completed'</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>VenousThromboembolismProphylaxisFHIR</td>
<td>Encounter with Principal Procedure of SCIP VTE Selected Surgery</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Encounter with Principal Procedure of SCIP VTE Selected Surgery":
from
VTE."Encounter with Age Range and without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter,
"SCIP VTE Selected Surgery" SelectedProcedure
let EncounterProcedure: singleton from ( QualifyingEncounter.procedure P
where P.rank = 1
)
where EncounterProcedure.procedure.reference.getId ( ) = SelectedProcedure.id
and end of SelectedProcedure.performed.toInterval ( ) during QualifyingEncounter.period
return QualifyingEncounter</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>VenousThromboembolismProphylaxisFHIR</td>
<td>Intervention Comfort Measures</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Intervention Comfort Measures":
( ["ServiceRequest": "Comfort Measures"] InterventionRequest
where InterventionRequest.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }
and InterventionRequest.status in { 'active', 'on-hold', 'completed' }
and InterventionRequest.doNotPerform is not true
)
union ( ["Procedure": "Comfort Measures"] InterventionPerformed
where InterventionPerformed.status in { 'completed', 'in-progress' }
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>VenousThromboembolismProphylaxisFHIR</td>
<td>Encounter with Intervention Comfort Measures From Day of Start of Hospitalization To Day After Admission</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Encounter with Intervention Comfort Measures From Day of Start of Hospitalization To Day After Admission":
VTE."Encounter with Age Range and without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter
with "Intervention Comfort Measures" ComfortMeasure
such that Coalesce(start of ComfortMeasure.performed.toInterval(), ComfortMeasure.authoredOn) during day of QualifyingEncounter.FromDayOfStartOfHospitalizationToDayAfterAdmission ( )</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>VenousThromboembolismProphylaxisFHIR</td>
<td>Encounter with Intervention Comfort Measures on Day of or Day After Procedure</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Encounter with Intervention Comfort Measures on Day of or Day After Procedure":
from
VTE."Encounter with Age Range and without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter,
["Procedure": "General or Neuraxial Anesthesia"] AnesthesiaProcedure,
"Intervention Comfort Measures" ComfortMeasure
where AnesthesiaProcedure.status = 'completed'
and AnesthesiaProcedure.performed.toInterval ( ) ends 1 day after day of start of QualifyingEncounter.period
and Coalesce(start of ComfortMeasure.performed.toInterval(), ComfortMeasure.authoredOn) during day of ( end of AnesthesiaProcedure.performed.toInterval ( ) ).CalendarDayOfOrDayAfter ( )
return QualifyingEncounter</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>VenousThromboembolismProphylaxisFHIR</td>
<td>Denominator Exclusions</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "Denominator Exclusions":
"Encounter Less Than 2 Days"
union "Encounter with ICU Location Stay 1 Day or More"
union "Encounter with Principal Diagnosis of Mental Disorder or Stroke"
union "Encounter with Principal Procedure of SCIP VTE Selected Surgery"
union "Encounter with Intervention Comfort Measures From Day of Start of Hospitalization To Day After Admission"
union "Encounter with Intervention Comfort Measures on Day of or Day After Procedure"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>SupplementalDataElements</td>
<td>SDE Race</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "SDE Race":
Patient.race R
return Tuple {
codes: R.ombCategory union R.detailed,
display: R.text
}</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>VenousThromboembolismProphylaxisFHIR</td>
<td>SDE Race</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define "SDE Race":
SDE."SDE Race"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>CQMCommon</td>
<td>encounterDiagnosis</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">/*
@description: Returns the Condition resources referenced by the diagnosis element of the Encounter
*/
define fluent function encounterDiagnosis(Encounter Encounter ):
Encounter.diagnosis D
return singleton from ([Condition] C where C.id = D.condition.reference.getId())</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>QICoreCommon</td>
<td>getId</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">/*
@description: Returns the tail of the given uri (i.e. everything after the last slash in the URI).
@comment: This function can be used to determine the logical id of a given resource. It can be used in
a single-server environment to trace references. However, this function does not attempt to resolve
or distinguish the base of the given url, and so cannot be used safely in multi-server environments.
*/
define fluent function getId(uri String):
Last(Split(uri, '/'))</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>VTE</td>
<td>FromDayOfStartOfHospitalizationToDayAfterAdmission</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define fluent function "FromDayOfStartOfHospitalizationToDayAfterAdmission"(Encounter Encounter ):
Interval[ date from (start of Encounter.hospitalizationWithObservation()), date from (start of Encounter.period) + 1 days]</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>CQMCommon</td>
<td>hospitalizationWithObservation</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">/*
@description: Hospitalization with Observation returns the total interval from the start of any immediately prior emergency department visit through the observation visit to the discharge of the given encounter
*/
define fluent function hospitalizationWithObservation(TheEncounter Encounter ):
TheEncounter Visit
let ObsVisit: Last([Encounter: "Observation Services"] LastObs
where LastObs.status = 'finished'
and LastObs.period ends 1 hour or less on or before start of Visit.period
sort by end of period
),
VisitStart: Coalesce(start of ObsVisit.period, start of Visit.period),
EDVisit: Last([Encounter: "Emergency Department Visit"] LastED
where LastED.status = 'finished'
and LastED.period ends 1 hour or less on or before VisitStart
sort by end of period
)
return Interval[Coalesce(start of EDVisit.period, VisitStart), end of Visit.period]</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>TJCOverall</td>
<td>CalendarDayOfOrDayAfter</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define fluent function CalendarDayOfOrDayAfter(StartValue DateTime):
Interval [date from (StartValue), date from (StartValue) + 1 day]</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>QICoreCommon</td>
<td>isActive</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">/* Candidates for FHIRCommon */
/*
@description: Returns true if the given condition has a clinical status of active, recurrence, or relapse
*/
define fluent function isActive(condition Condition):
condition.clinicalStatus ~ "active"
or condition.clinicalStatus ~ "recurrence"
or condition.clinicalStatus ~ "relapse"</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>QICoreCommon</td>
<td>earliest</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">/*
@description: Given an interval, return the starting point if the interval has a starting boundary specified,
otherwise, return the ending point
*/
define fluent function earliest(choice Choice<DateTime, Quantity, Interval<DateTime>, Interval<Quantity>> ):
(choice.toInterval()) period
return
if (period."hasStart"()) then start of period
else end of period</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>FHIRHelpers</td>
<td>ToConcept</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">/*
@description: Converts the given FHIR [CodeableConcept](https://hl7.org/fhir/datatypes.html#CodeableConcept) value to a CQL Concept.
*/
define function ToConcept(concept FHIR.CodeableConcept):
if concept is null then
null
else
System.Concept {
codes: concept.coding C return ToCode(C),
display: concept.text.value
}</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>FHIRHelpers</td>
<td>ToString</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">define function ToString(value uri): value.value</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>FHIRHelpers</td>
<td>ToCode</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">/*
@description: Converts the given FHIR [Coding](https://hl7.org/fhir/datatypes.html#Coding) value to a CQL Code.
*/
define function ToCode(coding FHIR.Coding):
if coding is null then
null
else
System.Code {
code: coding.code.value,
system: coding.system.value,
version: coding.version.value,
display: coding.display.value
}</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>CQMCommon</td>
<td>lengthInDays</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">/*
@description: Calculates the difference in calendar days between the start and end of the given interval.
*/
define fluent function lengthInDays(Value Interval<DateTime> ):
difference in days between start of Value and end of Value</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>CQMCommon</td>
<td>getLocation</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">/*
@description: Returns the Location resource specified by the given reference.
*/
define fluent function getLocation(reference Reference ):
singleton from (
[Location] L where L.id = reference.reference.getId()
)</code></pre>
</td>
</tr>
<tr>
<th><b>Library Name</b></th>
<th><b>Name</b></th>
</tr>
<tr>
<td>CQMCommon</td>
<td>principalDiagnosis</td>
</tr>
<tr>
<td/>
<td>
<pre class="highlight language-cql"><code class="language-cql">/*
@description: Returns the condition that is specified as the principal diagnosis for the encounter
*/
define fluent function principalDiagnosis(Encounter Encounter ):
singleton from ((Encounter.diagnosis D where D.rank = 1 and D.use ~ "Billing") PD
return singleton from ([Condition] C where C.id = PD.condition.reference.getId())
)</code></pre>
</td>
</tr>
</table>
</td>
</tr>
</table>
</div>
</text>
<contained>
<Library>
<id value="effective-data-requirements"/>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
<valueCoding>
<system value="http://hl7.org/fhir/administrative-gender"/>
<code value="M"/>
<display value="Male"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
<valueCoding>
<system value="http://hl7.org/fhir/administrative-gender"/>
<code value="F"/>
<display value="Female"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
<valueCoding>
<system
value="http://terminology.hl7.org/CodeSystem/condition-clinical"/>
<code value="active"/>
<display value="Active"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
<valueCoding>
<system
value="http://terminology.hl7.org/CodeSystem/condition-clinical"/>
<code value="recurrence"/>
<display value="Recurrence"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
<valueCoding>
<system
value="http://terminology.hl7.org/CodeSystem/condition-clinical"/>
<code value="relapse"/>
<display value="Relapse"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
<valueCoding>
<system
value="http://terminology.hl7.org/CodeSystem/condition-ver-status"/>
<code value="confirmed"/>
<display value="Confirmed"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
<valueCoding>
<system
value="http://terminology.hl7.org/CodeSystem/condition-clinical"/>
<code value="inactive"/>
<display value="Inactive"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
<valueCoding>
<system
value="http://terminology.hl7.org/CodeSystem/condition-clinical"/>
<code value="remission"/>
<display value="Remission"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
<valueCoding>
<system
value="http://terminology.hl7.org/CodeSystem/condition-clinical"/>
<code value="resolved"/>
<display value="Resolved"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
<valueCoding>
<system value="http://loinc.org"/>
<code value="72136-5"/>
<display value="Risk for venous thromboembolism"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
<valueCoding>
<system
value="http://terminology.hl7.org/CodeSystem/diagnosis-role"/>
<code value="billing"/>
<display value="Billing"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SupplementalDataElements"/>
</extension>
<extension url="name">
<valueString value="SDE Sex"/>
</extension>
<extension url="statement">
<valueString
value="define "SDE Sex":
case
when Patient.gender = 'male' then "M"
when Patient.gender = 'female' then "F"
else null
end"/>
</extension>
<extension url="displaySequence">
<valueInteger value="0"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="VenousThromboembolismProphylaxisFHIR"/>
</extension>
<extension url="name">
<valueString value="SDE Sex"/>
</extension>
<extension url="statement">
<valueString
value="define "SDE Sex":
SDE."SDE Sex""/>
</extension>
<extension url="displaySequence">
<valueInteger value="1"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="CQMCommon"/>
</extension>
<extension url="name">
<valueString value="Inpatient Encounter"/>
</extension>
<extension url="statement">
<valueString
value="define "Inpatient Encounter":
[Encounter: "Encounter Inpatient"] EncounterInpatient
where EncounterInpatient.status = 'finished'
and EncounterInpatient.period ends during day of "Measurement Period""/>
</extension>
<extension url="displaySequence">
<valueInteger value="2"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="VTE"/>
</extension>
<extension url="name">
<valueString
value="Admission without VTE or Obstetrical Conditions"/>
</extension>
<extension url="statement">
<valueString
value="define "Admission without VTE or Obstetrical Conditions":
CQMCommon."Inpatient Encounter" InpatientEncounter
where not (exists (InpatientEncounter.encounterDiagnosis()) EncDx
where (EncDx.code in "Obstetrical or Pregnancy Related Conditions"
or EncDx.code in "Venous Thromboembolism"
or EncDx.code in "Obstetrics VTE"
)
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="3"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="VTE"/>
</extension>
<extension url="name">
<valueString
value="Encounter with Age Range and without VTE Diagnosis or Obstetrical Conditions"/>
</extension>
<extension url="statement">
<valueString
value="define "Encounter with Age Range and without VTE Diagnosis or Obstetrical Conditions":
( CQMCommon."Inpatient Encounter" InpatientEncounter
where AgeInYearsAt(date from start of InpatientEncounter.period) >= 18 )
intersect "Admission without VTE or Obstetrical Conditions""/>
</extension>
<extension url="displaySequence">
<valueInteger value="4"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="VenousThromboembolismProphylaxisFHIR"/>
</extension>
<extension url="name">
<valueString
value="Pharmacological or Mechanical VTE Prophylaxis Received"/>
</extension>
<extension url="statement">
<valueString
value="define "Pharmacological or Mechanical VTE Prophylaxis Received":
( ["MedicationAdministration": "Low Dose Unfractionated Heparin for VTE Prophylaxis"] VTEMedication
where VTEMedication.status = 'completed'
and VTEMedication.dosage.route in "Subcutaneous route"
)
union ( ["MedicationAdministration": "Low Molecular Weight Heparin for VTE Prophylaxis"] LMWH
where LMWH.status = 'completed'
)
union ( ["MedicationAdministration": "Injectable Factor Xa Inhibitor for VTE Prophylaxis"] FactorXa
where FactorXa.status = 'completed'
)
union ( ["MedicationAdministration": "Warfarin"] Warfarin
where Warfarin.status = 'completed'
)
union ( ["MedicationAdministration": "Rivaroxaban for VTE Prophylaxis"] Rivaroxaban
where Rivaroxaban.status = 'completed'
)
union ( ( ["Procedure": "Application of Intermittent Pneumatic Compression Devices"]
union ["Procedure": "Application of Venous Foot Pumps"]
union ["Procedure": "Application of Graduated Compression Stockings"] ) DeviceApplied
where DeviceApplied.status = 'completed'
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="5"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="VenousThromboembolismProphylaxisFHIR"/>
</extension>
<extension url="name">
<valueString
value="Encounter with VTE Prophylaxis Received From Day of Start of Hospitalization To Day After Admission or Procedure"/>
</extension>
<extension url="statement">
<valueString
value="define "Encounter with VTE Prophylaxis Received From Day of Start of Hospitalization To Day After Admission or Procedure":
( from
VTE."Encounter with Age Range and without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter,
"Pharmacological or Mechanical VTE Prophylaxis Received" VTEProphylaxis
where Coalesce(VTEProphylaxis.effective.toInterval(), VTEProphylaxis.performed.toInterval()) starts during day of QualifyingEncounter.FromDayOfStartOfHospitalizationToDayAfterAdmission ( )
return QualifyingEncounter
)
union ( from
VTE."Encounter with Age Range and without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter,
["Procedure": "General or Neuraxial Anesthesia"] AnesthesiaProcedure,
"Pharmacological or Mechanical VTE Prophylaxis Received" VTEProphylaxis
where AnesthesiaProcedure.status = 'completed'
and AnesthesiaProcedure.performed.toInterval ( ) ends 1 day after day of start of QualifyingEncounter.period
and Coalesce(VTEProphylaxis.effective.toInterval(), VTEProphylaxis.performed.toInterval()) starts during day of ( end of AnesthesiaProcedure.performed.toInterval ( ) ).CalendarDayOfOrDayAfter ( )
return QualifyingEncounter
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="6"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="VenousThromboembolismProphylaxisFHIR"/>
</extension>
<extension url="name">
<valueString
value="Encounter with Medication Oral Factor Xa Inhibitor Administered on Day of or Day After Admission or Procedure"/>
</extension>
<extension url="statement">
<valueString
value="define "Encounter with Medication Oral Factor Xa Inhibitor Administered on Day of or Day After Admission or Procedure":
( from
VTE."Encounter with Age Range and without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter,
["MedicationAdministration": "Oral Factor Xa Inhibitor for VTE Prophylaxis or VTE Treatment"] FactorXaMedication
where FactorXaMedication.status = 'completed'
and FactorXaMedication.effective.toInterval ( ) starts during day of ( start of QualifyingEncounter.period ).CalendarDayOfOrDayAfter ( )
return QualifyingEncounter
)
union ( from
VTE."Encounter with Age Range and without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter,
["Procedure": "General or Neuraxial Anesthesia"] AnesthesiaProcedure,
["MedicationAdministration": "Oral Factor Xa Inhibitor for VTE Prophylaxis or VTE Treatment"] FactorXaMedication
where FactorXaMedication.status = 'completed'
and AnesthesiaProcedure.status = 'completed'
and AnesthesiaProcedure.performed.toInterval ( ) ends 1 day after day of start of QualifyingEncounter.period
and FactorXaMedication.effective.toInterval ( ) starts during day of ( end of AnesthesiaProcedure.performed.toInterval ( ) ).CalendarDayOfOrDayAfter ( )
return QualifyingEncounter
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="7"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="VenousThromboembolismProphylaxisFHIR"/>
</extension>
<extension url="name">
<valueString
value="Encounter with Prior or Present Diagnosis of Atrial Fibrillation or Prior Diagnosis of VTE"/>
</extension>
<extension url="statement">
<valueString
value="define "Encounter with Prior or Present Diagnosis of Atrial Fibrillation or Prior Diagnosis of VTE":
( VTE."Encounter with Age Range and without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter
with ["Condition": "Atrial Fibrillation or Flutter"] AtrialFibrillation
such that AtrialFibrillation.isActive ( )
and AtrialFibrillation.verificationStatus is not null
and AtrialFibrillation.verificationStatus ~ QICoreCommon."confirmed"
and AtrialFibrillation.onset.toInterval ( ) starts on or before end of QualifyingEncounter.period
)
union ( VTE."Encounter with Age Range and without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter
where QualifyingEncounter.encounterDiagnosis ( ).code in "Atrial Fibrillation or Flutter"
)
union ( VTE."Encounter with Age Range and without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter
with ["Condition": "Venous Thromboembolism"] VTEDiagnosis
such that ( VTEDiagnosis.clinicalStatus ~ QICoreCommon."inactive"
or VTEDiagnosis.clinicalStatus ~ QICoreCommon."remission"
or VTEDiagnosis.clinicalStatus ~ QICoreCommon."resolved"
)
and VTEDiagnosis.verificationStatus is not null
and VTEDiagnosis.verificationStatus ~ QICoreCommon."confirmed"
and VTEDiagnosis.onset.toInterval ( ) before start of QualifyingEncounter.period
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="8"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="VenousThromboembolismProphylaxisFHIR"/>
</extension>
<extension url="name">
<valueString
value="Encounter with Prior or Present Procedure of Hip or Knee Replacement Surgery"/>
</extension>
<extension url="statement">
<valueString
value="define "Encounter with Prior or Present Procedure of Hip or Knee Replacement Surgery":
VTE."Encounter with Age Range and without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter
with ( ["Procedure": "Hip Replacement Surgery"]
union ["Procedure": "Knee Replacement Surgery"] ) HipKneeProcedure
such that HipKneeProcedure.status = 'completed'
and HipKneeProcedure.performed.toInterval ( ) starts on or before end of QualifyingEncounter.period"/>
</extension>
<extension url="displaySequence">
<valueInteger value="9"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="VenousThromboembolismProphylaxisFHIR"/>
</extension>
<extension url="name">
<valueString value="Low Risk Indicator For VTE"/>
</extension>
<extension url="statement">
<valueString
value="define "Low Risk Indicator For VTE":
( ["Observation": "Risk for venous thromboembolism"] VTERiskAssessment
where VTERiskAssessment.value as Concept in "Low Risk"
and VTERiskAssessment.status in { 'final', 'amended', 'corrected' }
return {
id: VTERiskAssessment.id,
LowRiskDatetime: VTERiskAssessment.effective.earliest ( )
}
)
union ( ["US Core Laboratory Result Observation Profile": "INR"] INRLabTest
where INRLabTest.value as Quantity > 3.0
and INRLabTest.status in { 'final', 'amended', 'corrected' }
return {
id: INRLabTest.id,
LowRiskDatetime: INRLabTest.issued
}
)
union ( ( ( ["MedicationAdministration": "Unfractionated Heparin"] UnfractionatedHeparin
where UnfractionatedHeparin.dosage.route in "Intravenous route"
)
union ["MedicationAdministration": "Direct Thrombin Inhibitor"]
union ["MedicationAdministration": "Glycoprotein IIb/IIIa Inhibitors"] ) AnticoagulantMedication
where AnticoagulantMedication.status = 'completed'
return {
id: AnticoagulantMedication.id,
LowRiskDatetime: start of AnticoagulantMedication.effective.toInterval ( )
}
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="10"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="VenousThromboembolismProphylaxisFHIR"/>
</extension>
<extension url="name">
<valueString
value="Low Risk for VTE or Anticoagulant Administered From Day of Start of Hospitalization To Day After Admission"/>
</extension>
<extension url="statement">
<valueString
value="define "Low Risk for VTE or Anticoagulant Administered From Day of Start of Hospitalization To Day After Admission":
VTE."Encounter with Age Range and without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter
with "Low Risk Indicator For VTE" LowRiskForVTE
such that LowRiskForVTE.LowRiskDatetime during day of QualifyingEncounter.FromDayOfStartOfHospitalizationToDayAfterAdmission ( )"/>
</extension>
<extension url="displaySequence">
<valueInteger value="11"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="VenousThromboembolismProphylaxisFHIR"/>
</extension>
<extension url="name">
<valueString
value="Low Risk for VTE or Anticoagulant Administered on Day of or Day After Procedure"/>
</extension>
<extension url="statement">
<valueString
value="define "Low Risk for VTE or Anticoagulant Administered on Day of or Day After Procedure":
from
VTE."Encounter with Age Range and without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter,
["Procedure": "General or Neuraxial Anesthesia"] AnesthesiaProcedure,
"Low Risk Indicator For VTE" LowRiskForVTE
where AnesthesiaProcedure.status = 'completed'
and AnesthesiaProcedure.performed.toInterval ( ) ends 1 day after day of start of QualifyingEncounter.period
and LowRiskForVTE.LowRiskDatetime during day of ( end of AnesthesiaProcedure.performed.toInterval ( ) ).CalendarDayOfOrDayAfter ( )
return QualifyingEncounter"/>
</extension>
<extension url="displaySequence">
<valueInteger value="12"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="VenousThromboembolismProphylaxisFHIR"/>
</extension>
<extension url="name">
<valueString
value="Encounter with Low Risk for VTE or Anticoagulant Administered"/>
</extension>
<extension url="statement">
<valueString
value="define "Encounter with Low Risk for VTE or Anticoagulant Administered":
"Low Risk for VTE or Anticoagulant Administered From Day of Start of Hospitalization To Day After Admission"
union "Low Risk for VTE or Anticoagulant Administered on Day of or Day After Procedure""/>
</extension>
<extension url="displaySequence">
<valueInteger value="13"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="VenousThromboembolismProphylaxisFHIR"/>
</extension>
<extension url="name">
<valueString
value="No VTE Prophylaxis Medication Administered or Ordered"/>
</extension>
<extension url="statement">
<valueString
value="define "No VTE Prophylaxis Medication Administered or Ordered":
( ( [MedicationAdministrationNotDone: "Low Dose Unfractionated Heparin for VTE Prophylaxis"]
union [MedicationAdministrationNotDone: "Low Molecular Weight Heparin for VTE Prophylaxis"]
union [MedicationAdministrationNotDone: "Injectable Factor Xa Inhibitor for VTE Prophylaxis"]
union [MedicationAdministrationNotDone: "Warfarin"]
union [MedicationAdministrationNotDone: "Rivaroxaban for VTE Prophylaxis"] ) NoMedicationAdm
return {
id: NoMedicationAdm.id,
MedicationStatusReason: NoMedicationAdm.statusReason,
authoredOn: NoMedicationAdm.recorded
}
)
union ( ( ["MedicationNotRequested": "Low Dose Unfractionated Heparin for VTE Prophylaxis"]
union ["MedicationNotRequested": "Low Molecular Weight Heparin for VTE Prophylaxis"]
union ["MedicationNotRequested": "Injectable Factor Xa Inhibitor for VTE Prophylaxis"]
union ["MedicationNotRequested": "Warfarin"]
union ["MedicationNotRequested": "Rivaroxaban for VTE Prophylaxis"] ) NoMedicationOrder
where NoMedicationOrder.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }
return {
id: NoMedicationOrder.id,
MedicationStatusReason: NoMedicationOrder.reasonCode,
authoredOn: NoMedicationOrder.authoredOn
}
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="14"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="VenousThromboembolismProphylaxisFHIR"/>
</extension>
<extension url="name">
<valueString
value="No VTE Prophylaxis Medication Due to Medical Reason From Day of Start of Hospitalization To Day After Admission"/>
</extension>
<extension url="statement">
<valueString
value="define "No VTE Prophylaxis Medication Due to Medical Reason From Day of Start of Hospitalization To Day After Admission":
VTE."Encounter with Age Range and without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter
with "No VTE Prophylaxis Medication Administered or Ordered" NoVTEMedication
such that NoVTEMedication.MedicationStatusReason in "Medical Reason For Not Providing Treatment"
and NoVTEMedication.authoredOn during day of QualifyingEncounter.FromDayOfStartOfHospitalizationToDayAfterAdmission ( )"/>
</extension>
<extension url="displaySequence">
<valueInteger value="15"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="VenousThromboembolismProphylaxisFHIR"/>
</extension>
<extension url="name">
<valueString
value="No Mechanical VTE Prophylaxis Performed or Ordered"/>
</extension>
<extension url="statement">
<valueString
value="define "No Mechanical VTE Prophylaxis Performed or Ordered":
( ( [ServiceNotRequested: "Venous foot pumps"]
union [ServiceNotRequested: "Intermittent pneumatic compression devices"]
union [ServiceNotRequested: "Graduated compression stockings"] ) DeviceNotOrder
where DeviceNotOrder.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }
return {
id: DeviceNotOrder.id,
requestStatusReason: DeviceNotOrder.reasonRefused,
authoredOn: DeviceNotOrder.authoredOn
}
)
union ( ( [ProcedureNotDone: "Application of Intermittent Pneumatic Compression Devices"]
union [ProcedureNotDone: "Application of Venous Foot Pumps"]
union [ProcedureNotDone: "Application of Graduated Compression Stockings"] ) DeviceNotApplied
let DeviceNotDoneTiming: DeviceNotApplied.recorded
return {
id: DeviceNotApplied.id,
requestStatusReason: DeviceNotApplied.statusReason,
authoredOn: DeviceNotDoneTiming
}
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="16"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="VenousThromboembolismProphylaxisFHIR"/>
</extension>
<extension url="name">
<valueString
value="No Mechanical VTE Prophylaxis Due to Medical Reason From Day of Start of Hospitalization To Day After Admission"/>
</extension>
<extension url="statement">
<valueString
value="define "No Mechanical VTE Prophylaxis Due to Medical Reason From Day of Start of Hospitalization To Day After Admission":
VTE."Encounter with Age Range and without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter
with "No Mechanical VTE Prophylaxis Performed or Ordered" NoVTEDevice
such that NoVTEDevice.requestStatusReason in "Medical Reason For Not Providing Treatment"
and NoVTEDevice.authoredOn during day of QualifyingEncounter.FromDayOfStartOfHospitalizationToDayAfterAdmission ( )"/>
</extension>
<extension url="displaySequence">
<valueInteger value="17"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="VenousThromboembolismProphylaxisFHIR"/>
</extension>
<extension url="name">
<valueString
value="No VTE Prophylaxis Medication Due to Medical Reason on Day of or Day After Procedure"/>
</extension>
<extension url="statement">
<valueString
value="define "No VTE Prophylaxis Medication Due to Medical Reason on Day of or Day After Procedure":
from
VTE."Encounter with Age Range and without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter,
["Procedure": "General or Neuraxial Anesthesia"] AnesthesiaProcedure,
"No VTE Prophylaxis Medication Administered or Ordered" NoVTEMedication
where NoVTEMedication.MedicationStatusReason in "Medical Reason For Not Providing Treatment"
and AnesthesiaProcedure.status = 'completed'
and AnesthesiaProcedure.performed.toInterval ( ) ends 1 day after day of start of QualifyingEncounter.period
and NoVTEMedication.authoredOn during day of ( end of AnesthesiaProcedure.performed.toInterval ( ) ).CalendarDayOfOrDayAfter ( )
return QualifyingEncounter"/>
</extension>
<extension url="displaySequence">
<valueInteger value="18"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="VenousThromboembolismProphylaxisFHIR"/>
</extension>
<extension url="name">
<valueString
value="No Mechanical VTE Prophylaxis Due to Medical Reason on Day of or Day After Procedure"/>
</extension>
<extension url="statement">
<valueString
value="define "No Mechanical VTE Prophylaxis Due to Medical Reason on Day of or Day After Procedure":
from
VTE."Encounter with Age Range and without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter,
["Procedure": "General or Neuraxial Anesthesia"] AnesthesiaProcedure,
"No Mechanical VTE Prophylaxis Performed or Ordered" NoVTEDevice
where NoVTEDevice.requestStatusReason in "Medical Reason For Not Providing Treatment"
and AnesthesiaProcedure.status = 'completed'
and AnesthesiaProcedure.performed.toInterval ( ) ends 1 day after day of start of QualifyingEncounter.period
and NoVTEDevice.authoredOn during day of ( end of AnesthesiaProcedure.performed.toInterval ( ) ).CalendarDayOfOrDayAfter ( )
return QualifyingEncounter"/>
</extension>
<extension url="displaySequence">
<valueInteger value="19"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="VenousThromboembolismProphylaxisFHIR"/>
</extension>
<extension url="name">
<valueString
value="Encounter with No VTE Prophylaxis Due to Medical Reason"/>
</extension>
<extension url="statement">
<valueString
value="define "Encounter with No VTE Prophylaxis Due to Medical Reason":
( "No VTE Prophylaxis Medication Due to Medical Reason From Day of Start of Hospitalization To Day After Admission"
intersect "No Mechanical VTE Prophylaxis Due to Medical Reason From Day of Start of Hospitalization To Day After Admission"
)
union ( "No VTE Prophylaxis Medication Due to Medical Reason on Day of or Day After Procedure"
intersect "No Mechanical VTE Prophylaxis Due to Medical Reason on Day of or Day After Procedure"
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="20"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="VenousThromboembolismProphylaxisFHIR"/>
</extension>
<extension url="name">
<valueString
value="No Mechanical or Pharmacological VTE Prophylaxis Due to Patient Refusal"/>
</extension>
<extension url="statement">
<valueString
value="define "No Mechanical or Pharmacological VTE Prophylaxis Due to Patient Refusal":
( "No VTE Prophylaxis Medication Administered or Ordered" NoVTEMedication
where NoVTEMedication.MedicationStatusReason in "Patient Refusal"
)
union ( "No Mechanical VTE Prophylaxis Performed or Ordered" NoVTEDevice
where NoVTEDevice.requestStatusReason in "Patient Refusal"
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="21"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="VenousThromboembolismProphylaxisFHIR"/>
</extension>
<extension url="name">
<valueString
value="No VTE Prophylaxis Due to Patient Refusal From Day of Start of Hospitalization To Day After Admission"/>
</extension>
<extension url="statement">
<valueString
value="define "No VTE Prophylaxis Due to Patient Refusal From Day of Start of Hospitalization To Day After Admission":
VTE."Encounter with Age Range and without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter
with "No Mechanical or Pharmacological VTE Prophylaxis Due to Patient Refusal" PatientRefusal
such that PatientRefusal.authoredOn during day of QualifyingEncounter.FromDayOfStartOfHospitalizationToDayAfterAdmission ( )"/>
</extension>
<extension url="displaySequence">
<valueInteger value="22"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="VenousThromboembolismProphylaxisFHIR"/>
</extension>
<extension url="name">
<valueString
value="No VTE Prophylaxis Due to Patient Refusal on Day of or Day After Procedure"/>
</extension>
<extension url="statement">
<valueString
value="define "No VTE Prophylaxis Due to Patient Refusal on Day of or Day After Procedure":
from
VTE."Encounter with Age Range and without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter,
["Procedure": "General or Neuraxial Anesthesia"] AnesthesiaProcedure,
"No Mechanical or Pharmacological VTE Prophylaxis Due to Patient Refusal" PatientRefusal
where AnesthesiaProcedure.status = 'completed'
and QICoreCommon."ToInterval" ( AnesthesiaProcedure.performed ) ends 1 day after day of start of QualifyingEncounter.period
and PatientRefusal.authoredOn during day of ( end of AnesthesiaProcedure.performed.toInterval ( ) ).CalendarDayOfOrDayAfter ( )
return QualifyingEncounter"/>
</extension>
<extension url="displaySequence">
<valueInteger value="23"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="VenousThromboembolismProphylaxisFHIR"/>
</extension>
<extension url="name">
<valueString
value="Encounter with No VTE Prophylaxis Due to Patient Refusal"/>
</extension>
<extension url="statement">
<valueString
value="define "Encounter with No VTE Prophylaxis Due to Patient Refusal":
"No VTE Prophylaxis Due to Patient Refusal From Day of Start of Hospitalization To Day After Admission"
union "No VTE Prophylaxis Due to Patient Refusal on Day of or Day After Procedure""/>
</extension>
<extension url="displaySequence">
<valueInteger value="24"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="VenousThromboembolismProphylaxisFHIR"/>
</extension>
<extension url="name">
<valueString value="Numerator"/>
</extension>
<extension url="statement">
<valueString
value="define "Numerator":
"Encounter with VTE Prophylaxis Received From Day of Start of Hospitalization To Day After Admission or Procedure"
union ( "Encounter with Medication Oral Factor Xa Inhibitor Administered on Day of or Day After Admission or Procedure"
intersect ( "Encounter with Prior or Present Diagnosis of Atrial Fibrillation or Prior Diagnosis of VTE"
union "Encounter with Prior or Present Procedure of Hip or Knee Replacement Surgery"
)
)
union "Encounter with Low Risk for VTE or Anticoagulant Administered"
union "Encounter with No VTE Prophylaxis Due to Medical Reason"
union "Encounter with No VTE Prophylaxis Due to Patient Refusal""/>
</extension>
<extension url="displaySequence">
<valueInteger value="25"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="VenousThromboembolismProphylaxisFHIR"/>
</extension>
<extension url="name">
<valueString value="Initial Population"/>
</extension>
<extension url="statement">
<valueString
value="define "Initial Population":
VTE."Encounter with Age Range and without VTE Diagnosis or Obstetrical Conditions""/>
</extension>
<extension url="displaySequence">
<valueInteger value="26"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="VenousThromboembolismProphylaxisFHIR"/>
</extension>
<extension url="name">
<valueString value="Denominator"/>
</extension>
<extension url="statement">
<valueString
value="define "Denominator":
"Initial Population""/>
</extension>
<extension url="displaySequence">
<valueInteger value="27"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SupplementalDataElements"/>
</extension>
<extension url="name">
<valueString value="SDE Payer"/>
</extension>
<extension url="statement">
<valueString
value="define "SDE Payer":
[Coverage: type in "Payer Type"] Payer
return {
code: Payer.type,
period: Payer.period
}"/>
</extension>
<extension url="displaySequence">
<valueInteger value="28"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="VenousThromboembolismProphylaxisFHIR"/>
</extension>
<extension url="name">
<valueString value="SDE Payer"/>
</extension>
<extension url="statement">
<valueString
value="define "SDE Payer":
SDE."SDE Payer""/>
</extension>
<extension url="displaySequence">
<valueInteger value="29"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SupplementalDataElements"/>
</extension>
<extension url="name">
<valueString value="SDE Ethnicity"/>
</extension>
<extension url="statement">
<valueString
value="define "SDE Ethnicity":
Patient.ethnicity E
return Tuple {
codes: { E.ombCategory } union E.detailed,
display: E.text
}"/>
</extension>
<extension url="displaySequence">
<valueInteger value="30"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="VenousThromboembolismProphylaxisFHIR"/>
</extension>
<extension url="name">
<valueString value="SDE Ethnicity"/>
</extension>
<extension url="statement">
<valueString
value="define "SDE Ethnicity":
SDE."SDE Ethnicity""/>
</extension>
<extension url="displaySequence">
<valueInteger value="31"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="VenousThromboembolismProphylaxisFHIR"/>
</extension>
<extension url="name">
<valueString value="Encounter Less Than 2 Days"/>
</extension>
<extension url="statement">
<valueString
value="define "Encounter Less Than 2 Days":
VTE."Encounter with Age Range and without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter
where QualifyingEncounter.period.lengthInDays ( ) < 2"/>
</extension>
<extension url="displaySequence">
<valueInteger value="32"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="VenousThromboembolismProphylaxisFHIR"/>
</extension>
<extension url="name">
<valueString
value="Encounter with ICU Location Stay 1 Day or More"/>
</extension>
<extension url="statement">
<valueString
value="define "Encounter with ICU Location Stay 1 Day or More":
VTE."Encounter with Age Range and without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter
where exists ( QualifyingEncounter.location Location
where Location.location.getLocation ( ).type in "Intensive Care Unit"
and Location.period.lengthInDays ( ) >= 1
and Location.period starts on or after start of QualifyingEncounter.period
and date from ( start of Location.period ) during ( start of QualifyingEncounter.period ).CalendarDayOfOrDayAfter ( )
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="33"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="VenousThromboembolismProphylaxisFHIR"/>
</extension>
<extension url="name">
<valueString
value="Encounter with Principal Diagnosis of Mental Disorder or Stroke"/>
</extension>
<extension url="statement">
<valueString
value="define "Encounter with Principal Diagnosis of Mental Disorder or Stroke":
VTE."Encounter with Age Range and without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter
where QualifyingEncounter.principalDiagnosis ( ).code in "Mental Health Diagnoses"
or QualifyingEncounter.principalDiagnosis ( ).code in "Hemorrhagic Stroke"
or QualifyingEncounter.principalDiagnosis ( ).code in "Ischemic Stroke""/>
</extension>
<extension url="displaySequence">
<valueInteger value="34"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="VenousThromboembolismProphylaxisFHIR"/>
</extension>
<extension url="name">
<valueString value="SCIP VTE Selected Surgery"/>
</extension>
<extension url="statement">
<valueString
value="define "SCIP VTE Selected Surgery":
( ["Procedure": "General Surgery"]
union ["Procedure": "Gynecological Surgery"]
union ["Procedure": "Hip Fracture Surgery"]
union ["Procedure": "Hip Replacement Surgery"]
union ["Procedure": "Intracranial Neurosurgery"]
union ["Procedure": "Knee Replacement Surgery"]
union ["Procedure": "Urological Surgery"] ) Procedure
where Procedure.status = 'completed'"/>
</extension>
<extension url="displaySequence">
<valueInteger value="35"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="VenousThromboembolismProphylaxisFHIR"/>
</extension>
<extension url="name">
<valueString
value="Encounter with Principal Procedure of SCIP VTE Selected Surgery"/>
</extension>
<extension url="statement">
<valueString
value="define "Encounter with Principal Procedure of SCIP VTE Selected Surgery":
from
VTE."Encounter with Age Range and without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter,
"SCIP VTE Selected Surgery" SelectedProcedure
let EncounterProcedure: singleton from ( QualifyingEncounter.procedure P
where P.rank = 1
)
where EncounterProcedure.procedure.reference.getId ( ) = SelectedProcedure.id
and end of SelectedProcedure.performed.toInterval ( ) during QualifyingEncounter.period
return QualifyingEncounter"/>
</extension>
<extension url="displaySequence">
<valueInteger value="36"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="VenousThromboembolismProphylaxisFHIR"/>
</extension>
<extension url="name">
<valueString value="Intervention Comfort Measures"/>
</extension>
<extension url="statement">
<valueString
value="define "Intervention Comfort Measures":
( ["ServiceRequest": "Comfort Measures"] InterventionRequest
where InterventionRequest.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }
and InterventionRequest.status in { 'active', 'on-hold', 'completed' }
and InterventionRequest.doNotPerform is not true
)
union ( ["Procedure": "Comfort Measures"] InterventionPerformed
where InterventionPerformed.status in { 'completed', 'in-progress' }
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="37"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="VenousThromboembolismProphylaxisFHIR"/>
</extension>
<extension url="name">
<valueString
value="Encounter with Intervention Comfort Measures From Day of Start of Hospitalization To Day After Admission"/>
</extension>
<extension url="statement">
<valueString
value="define "Encounter with Intervention Comfort Measures From Day of Start of Hospitalization To Day After Admission":
VTE."Encounter with Age Range and without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter
with "Intervention Comfort Measures" ComfortMeasure
such that Coalesce(start of ComfortMeasure.performed.toInterval(), ComfortMeasure.authoredOn) during day of QualifyingEncounter.FromDayOfStartOfHospitalizationToDayAfterAdmission ( )"/>
</extension>
<extension url="displaySequence">
<valueInteger value="38"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="VenousThromboembolismProphylaxisFHIR"/>
</extension>
<extension url="name">
<valueString
value="Encounter with Intervention Comfort Measures on Day of or Day After Procedure"/>
</extension>
<extension url="statement">
<valueString
value="define "Encounter with Intervention Comfort Measures on Day of or Day After Procedure":
from
VTE."Encounter with Age Range and without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter,
["Procedure": "General or Neuraxial Anesthesia"] AnesthesiaProcedure,
"Intervention Comfort Measures" ComfortMeasure
where AnesthesiaProcedure.status = 'completed'
and AnesthesiaProcedure.performed.toInterval ( ) ends 1 day after day of start of QualifyingEncounter.period
and Coalesce(start of ComfortMeasure.performed.toInterval(), ComfortMeasure.authoredOn) during day of ( end of AnesthesiaProcedure.performed.toInterval ( ) ).CalendarDayOfOrDayAfter ( )
return QualifyingEncounter"/>
</extension>
<extension url="displaySequence">
<valueInteger value="39"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="VenousThromboembolismProphylaxisFHIR"/>
</extension>
<extension url="name">
<valueString value="Denominator Exclusions"/>
</extension>
<extension url="statement">
<valueString
value="define "Denominator Exclusions":
"Encounter Less Than 2 Days"
union "Encounter with ICU Location Stay 1 Day or More"
union "Encounter with Principal Diagnosis of Mental Disorder or Stroke"
union "Encounter with Principal Procedure of SCIP VTE Selected Surgery"
union "Encounter with Intervention Comfort Measures From Day of Start of Hospitalization To Day After Admission"
union "Encounter with Intervention Comfort Measures on Day of or Day After Procedure""/>
</extension>
<extension url="displaySequence">
<valueInteger value="40"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="SupplementalDataElements"/>
</extension>
<extension url="name">
<valueString value="SDE Race"/>
</extension>
<extension url="statement">
<valueString
value="define "SDE Race":
Patient.race R
return Tuple {
codes: R.ombCategory union R.detailed,
display: R.text
}"/>
</extension>
<extension url="displaySequence">
<valueInteger value="41"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="VenousThromboembolismProphylaxisFHIR"/>
</extension>
<extension url="name">
<valueString value="SDE Race"/>
</extension>
<extension url="statement">
<valueString
value="define "SDE Race":
SDE."SDE Race""/>
</extension>
<extension url="displaySequence">
<valueInteger value="42"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="CQMCommon"/>
</extension>
<extension url="name">
<valueString value="encounterDiagnosis"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Returns the Condition resources referenced by the diagnosis element of the Encounter
*/
define fluent function encounterDiagnosis(Encounter Encounter ):
Encounter.diagnosis D
return singleton from ([Condition] C where C.id = D.condition.reference.getId())"/>
</extension>
<extension url="displaySequence">
<valueInteger value="43"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="QICoreCommon"/>
</extension>
<extension url="name">
<valueString value="getId"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Returns the tail of the given uri (i.e. everything after the last slash in the URI).
@comment: This function can be used to determine the logical id of a given resource. It can be used in
a single-server environment to trace references. However, this function does not attempt to resolve
or distinguish the base of the given url, and so cannot be used safely in multi-server environments.
*/
define fluent function getId(uri String):
Last(Split(uri, '/'))"/>
</extension>
<extension url="displaySequence">
<valueInteger value="44"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="VTE"/>
</extension>
<extension url="name">
<valueString
value="FromDayOfStartOfHospitalizationToDayAfterAdmission"/>
</extension>
<extension url="statement">
<valueString
value="define fluent function "FromDayOfStartOfHospitalizationToDayAfterAdmission"(Encounter Encounter ):
Interval[ date from (start of Encounter.hospitalizationWithObservation()), date from (start of Encounter.period) + 1 days]"/>
</extension>
<extension url="displaySequence">
<valueInteger value="45"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="CQMCommon"/>
</extension>
<extension url="name">
<valueString value="hospitalizationWithObservation"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Hospitalization with Observation returns the total interval from the start of any immediately prior emergency department visit through the observation visit to the discharge of the given encounter
*/
define fluent function hospitalizationWithObservation(TheEncounter Encounter ):
TheEncounter Visit
let ObsVisit: Last([Encounter: "Observation Services"] LastObs
where LastObs.status = 'finished'
and LastObs.period ends 1 hour or less on or before start of Visit.period
sort by end of period
),
VisitStart: Coalesce(start of ObsVisit.period, start of Visit.period),
EDVisit: Last([Encounter: "Emergency Department Visit"] LastED
where LastED.status = 'finished'
and LastED.period ends 1 hour or less on or before VisitStart
sort by end of period
)
return Interval[Coalesce(start of EDVisit.period, VisitStart), end of Visit.period]"/>
</extension>
<extension url="displaySequence">
<valueInteger value="46"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="TJCOverall"/>
</extension>
<extension url="name">
<valueString value="CalendarDayOfOrDayAfter"/>
</extension>
<extension url="statement">
<valueString
value="define fluent function CalendarDayOfOrDayAfter(StartValue DateTime):
Interval [date from (StartValue), date from (StartValue) + 1 day]"/>
</extension>
<extension url="displaySequence">
<valueInteger value="47"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="QICoreCommon"/>
</extension>
<extension url="name">
<valueString value="isActive"/>
</extension>
<extension url="statement">
<valueString
value="/* Candidates for FHIRCommon */
/*
@description: Returns true if the given condition has a clinical status of active, recurrence, or relapse
*/
define fluent function isActive(condition Condition):
condition.clinicalStatus ~ "active"
or condition.clinicalStatus ~ "recurrence"
or condition.clinicalStatus ~ "relapse""/>
</extension>
<extension url="displaySequence">
<valueInteger value="48"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="QICoreCommon"/>
</extension>
<extension url="name">
<valueString value="earliest"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Given an interval, return the starting point if the interval has a starting boundary specified,
otherwise, return the ending point
*/
define fluent function earliest(choice Choice<DateTime, Quantity, Interval<DateTime>, Interval<Quantity>> ):
(choice.toInterval()) period
return
if (period."hasStart"()) then start of period
else end of period"/>
</extension>
<extension url="displaySequence">
<valueInteger value="49"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="FHIRHelpers"/>
</extension>
<extension url="name">
<valueString value="ToConcept"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Converts the given FHIR [CodeableConcept](https://hl7.org/fhir/datatypes.html#CodeableConcept) value to a CQL Concept.
*/
define function ToConcept(concept FHIR.CodeableConcept):
if concept is null then
null
else
System.Concept {
codes: concept.coding C return ToCode(C),
display: concept.text.value
}"/>
</extension>
<extension url="displaySequence">
<valueInteger value="50"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="FHIRHelpers"/>
</extension>
<extension url="name">
<valueString value="ToString"/>
</extension>
<extension url="statement">
<valueString
value="define function ToString(value uri): value.value"/>
</extension>
<extension url="displaySequence">
<valueInteger value="51"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="FHIRHelpers"/>
</extension>
<extension url="name">
<valueString value="ToCode"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Converts the given FHIR [Coding](https://hl7.org/fhir/datatypes.html#Coding) value to a CQL Code.
*/
define function ToCode(coding FHIR.Coding):
if coding is null then
null
else
System.Code {
code: coding.code.value,
system: coding.system.value,
version: coding.version.value,
display: coding.display.value
}"/>
</extension>
<extension url="displaySequence">
<valueInteger value="52"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="CQMCommon"/>
</extension>
<extension url="name">
<valueString value="lengthInDays"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Calculates the difference in calendar days between the start and end of the given interval.
*/
define fluent function lengthInDays(Value Interval<DateTime> ):
difference in days between start of Value and end of Value"/>
</extension>
<extension url="displaySequence">
<valueInteger value="53"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="CQMCommon"/>
</extension>
<extension url="name">
<valueString value="getLocation"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Returns the Location resource specified by the given reference.
*/
define fluent function getLocation(reference Reference ):
singleton from (
[Location] L where L.id = reference.reference.getId()
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="54"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="CQMCommon"/>
</extension>
<extension url="name">
<valueString value="principalDiagnosis"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Returns the condition that is specified as the principal diagnosis for the encounter
*/
define fluent function principalDiagnosis(Encounter Encounter ):
singleton from ((Encounter.diagnosis D where D.rank = 1 and D.use ~ "Billing") PD
return singleton from ([Condition] C where C.id = PD.condition.reference.getId())
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="55"/>
</extension>
</extension>
<name value="EffectiveDataRequirements"/>
<status value="active"/>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/library-type"/>
<code value="module-definition"/>
</coding>
</type>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library SDE"/>
<resource value="Library/SupplementalDataElements|3.5.000"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library VTE"/>
<resource value="Library/VTE|8.8.000"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library CQMCommon"/>
<resource value="Library/CQMCommon|2.2.000"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library FHIRHelpers"/>
<resource value="Library/FHIRHelpers|4.4.000"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library QICoreCommon"/>
<resource value="Library/QICoreCommon|2.1.000"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library TJC"/>
<resource value="Library/TJCOverall|8.14.000"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Code system AdministrativeGender"/>
<resource value="http://hl7.org/fhir/administrative-gender"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Code system ConditionClinicalStatusCodes"/>
<resource
value="http://terminology.hl7.org/CodeSystem/condition-clinical"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Code system ConditionVerificationStatusCodes"/>
<resource
value="http://terminology.hl7.org/CodeSystem/condition-ver-status"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Code system LOINC"/>
<resource value="http://loinc.org"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Code system DiagnosisRole"/>
<resource
value="http://terminology.hl7.org/CodeSystem/diagnosis-role"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Encounter Inpatient"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display
value="Value set Obstetrical or Pregnancy Related Conditions"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.263"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Venous Thromboembolism"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.279"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Obstetrics VTE"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.264"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display
value="Value set Low Dose Unfractionated Heparin for VTE Prophylaxis"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.39"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Subcutaneous route"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.223"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display
value="Value set Low Molecular Weight Heparin for VTE Prophylaxis"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.219"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display
value="Value set Injectable Factor Xa Inhibitor for VTE Prophylaxis"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.211"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Warfarin"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.232"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Rivaroxaban for VTE Prophylaxis"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.50"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display
value="Value set Application of Intermittent Pneumatic Compression Devices"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.65"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Application of Venous Foot Pumps"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.64"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display
value="Value set Application of Graduated Compression Stockings"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.66"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Observation Services"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.143"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Emergency Department Visit"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set General or Neuraxial Anesthesia"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.1743"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display
value="Value set Oral Factor Xa Inhibitor for VTE Prophylaxis or VTE Treatment"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.134"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Atrial Fibrillation or Flutter"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.202"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Hip Replacement Surgery"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.259"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Knee Replacement Surgery"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.261"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Low Risk"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.400"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set INR"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.213"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Unfractionated Heparin"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.218"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Intravenous route"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.222"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Direct Thrombin Inhibitor"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.205"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Glycoprotein IIb/IIIa Inhibitors"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.41"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display
value="Value set Medical Reason For Not Providing Treatment"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.473"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Venous foot pumps"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.230"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display
value="Value set Intermittent pneumatic compression devices"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.214"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Graduated compression stockings"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.256"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Patient Refusal"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.93"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Payer Type"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Intensive Care Unit"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.206"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Mental Health Diagnoses"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.105.12.1004"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Hemorrhagic Stroke"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.212"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Ischemic Stroke"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.247"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set General Surgery"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.255"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Gynecological Surgery"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.257"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Hip Fracture Surgery"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.258"/>
</relatedArtifact>
<relatedArtifact>
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<codeFilter>
<path value="medication"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.211"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="MedicationAdministration"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-mednotadministered"/>
<mustSupport value="medication"/>
<mustSupport value="id"/>
<mustSupport value="id.value"/>
<mustSupport value="statusReason"/>
<mustSupport value="extension"/>
<codeFilter>
<path value="medication"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.232"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="MedicationAdministration"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-mednotadministered"/>
<mustSupport value="medication"/>
<mustSupport value="id"/>
<mustSupport value="id.value"/>
<mustSupport value="statusReason"/>
<mustSupport value="extension"/>
<codeFilter>
<path value="medication"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.232"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="MedicationAdministration"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-mednotadministered"/>
<mustSupport value="medication"/>
<mustSupport value="id"/>
<mustSupport value="id.value"/>
<mustSupport value="statusReason"/>
<mustSupport value="extension"/>
<codeFilter>
<path value="medication"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.50"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="MedicationAdministration"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-mednotadministered"/>
<mustSupport value="medication"/>
<mustSupport value="id"/>
<mustSupport value="id.value"/>
<mustSupport value="statusReason"/>
<mustSupport value="extension"/>
<codeFilter>
<path value="medication"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.50"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="MedicationRequest"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-mednotrequested"/>
<mustSupport value="medication"/>
<mustSupport value="intent"/>
<mustSupport value="intent.value"/>
<mustSupport value="id"/>
<mustSupport value="id.value"/>
<mustSupport value="reasonCode"/>
<mustSupport value="authoredOn"/>
<mustSupport value="authoredOn.value"/>
<codeFilter>
<path value="medication"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.39"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="MedicationRequest"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-mednotrequested"/>
<mustSupport value="medication"/>
<mustSupport value="intent"/>
<mustSupport value="intent.value"/>
<mustSupport value="id"/>
<mustSupport value="id.value"/>
<mustSupport value="reasonCode"/>
<mustSupport value="authoredOn"/>
<mustSupport value="authoredOn.value"/>
<codeFilter>
<path value="medication"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.39"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="MedicationRequest"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-mednotrequested"/>
<mustSupport value="medication"/>
<mustSupport value="intent"/>
<mustSupport value="intent.value"/>
<mustSupport value="id"/>
<mustSupport value="id.value"/>
<mustSupport value="reasonCode"/>
<mustSupport value="authoredOn"/>
<mustSupport value="authoredOn.value"/>
<codeFilter>
<path value="medication"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.219"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="MedicationRequest"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-mednotrequested"/>
<mustSupport value="medication"/>
<mustSupport value="intent"/>
<mustSupport value="intent.value"/>
<mustSupport value="id"/>
<mustSupport value="id.value"/>
<mustSupport value="reasonCode"/>
<mustSupport value="authoredOn"/>
<mustSupport value="authoredOn.value"/>
<codeFilter>
<path value="medication"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.219"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="MedicationRequest"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-mednotrequested"/>
<mustSupport value="medication"/>
<mustSupport value="intent"/>
<mustSupport value="intent.value"/>
<mustSupport value="id"/>
<mustSupport value="id.value"/>
<mustSupport value="reasonCode"/>
<mustSupport value="authoredOn"/>
<mustSupport value="authoredOn.value"/>
<codeFilter>
<path value="medication"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.211"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="MedicationRequest"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-mednotrequested"/>
<mustSupport value="medication"/>
<mustSupport value="intent"/>
<mustSupport value="intent.value"/>
<mustSupport value="id"/>
<mustSupport value="id.value"/>
<mustSupport value="reasonCode"/>
<mustSupport value="authoredOn"/>
<mustSupport value="authoredOn.value"/>
<codeFilter>
<path value="medication"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.211"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="MedicationRequest"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-mednotrequested"/>
<mustSupport value="medication"/>
<mustSupport value="intent"/>
<mustSupport value="intent.value"/>
<mustSupport value="id"/>
<mustSupport value="id.value"/>
<mustSupport value="reasonCode"/>
<mustSupport value="authoredOn"/>
<mustSupport value="authoredOn.value"/>
<codeFilter>
<path value="medication"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.232"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="MedicationRequest"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-mednotrequested"/>
<mustSupport value="medication"/>
<mustSupport value="intent"/>
<mustSupport value="intent.value"/>
<mustSupport value="id"/>
<mustSupport value="id.value"/>
<mustSupport value="reasonCode"/>
<mustSupport value="authoredOn"/>
<mustSupport value="authoredOn.value"/>
<codeFilter>
<path value="medication"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.232"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="MedicationRequest"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-mednotrequested"/>
<mustSupport value="medication"/>
<mustSupport value="intent"/>
<mustSupport value="intent.value"/>
<mustSupport value="id"/>
<mustSupport value="id.value"/>
<mustSupport value="reasonCode"/>
<mustSupport value="authoredOn"/>
<mustSupport value="authoredOn.value"/>
<codeFilter>
<path value="medication"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.50"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="MedicationRequest"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-mednotrequested"/>
<mustSupport value="medication"/>
<mustSupport value="intent"/>
<mustSupport value="intent.value"/>
<mustSupport value="id"/>
<mustSupport value="id.value"/>
<mustSupport value="reasonCode"/>
<mustSupport value="authoredOn"/>
<mustSupport value="authoredOn.value"/>
<codeFilter>
<path value="medication"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.50"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="ServiceRequest"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicenotrequested"/>
<mustSupport value="code"/>
<mustSupport value="intent"/>
<mustSupport value="intent.value"/>
<mustSupport value="id"/>
<mustSupport value="id.value"/>
<mustSupport value="extension"/>
<mustSupport value="authoredOn"/>
<mustSupport value="authoredOn.value"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.230"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="ServiceRequest"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicenotrequested"/>
<mustSupport value="code"/>
<mustSupport value="intent"/>
<mustSupport value="intent.value"/>
<mustSupport value="id"/>
<mustSupport value="id.value"/>
<mustSupport value="extension"/>
<mustSupport value="authoredOn"/>
<mustSupport value="authoredOn.value"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.230"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="ServiceRequest"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicenotrequested"/>
<mustSupport value="code"/>
<mustSupport value="intent"/>
<mustSupport value="intent.value"/>
<mustSupport value="id"/>
<mustSupport value="id.value"/>
<mustSupport value="extension"/>
<mustSupport value="authoredOn"/>
<mustSupport value="authoredOn.value"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.214"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="ServiceRequest"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicenotrequested"/>
<mustSupport value="code"/>
<mustSupport value="intent"/>
<mustSupport value="intent.value"/>
<mustSupport value="id"/>
<mustSupport value="id.value"/>
<mustSupport value="extension"/>
<mustSupport value="authoredOn"/>
<mustSupport value="authoredOn.value"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.214"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="ServiceRequest"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicenotrequested"/>
<mustSupport value="code"/>
<mustSupport value="intent"/>
<mustSupport value="intent.value"/>
<mustSupport value="id"/>
<mustSupport value="id.value"/>
<mustSupport value="extension"/>
<mustSupport value="authoredOn"/>
<mustSupport value="authoredOn.value"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.256"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="ServiceRequest"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicenotrequested"/>
<mustSupport value="code"/>
<mustSupport value="intent"/>
<mustSupport value="intent.value"/>
<mustSupport value="id"/>
<mustSupport value="id.value"/>
<mustSupport value="extension"/>
<mustSupport value="authoredOn"/>
<mustSupport value="authoredOn.value"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.256"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Procedure"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedurenotdone"/>
<mustSupport value="code"/>
<mustSupport value="extension"/>
<mustSupport value="id"/>
<mustSupport value="id.value"/>
<mustSupport value="statusReason"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.65"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Procedure"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedurenotdone"/>
<mustSupport value="code"/>
<mustSupport value="extension"/>
<mustSupport value="id"/>
<mustSupport value="id.value"/>
<mustSupport value="statusReason"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.65"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Procedure"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedurenotdone"/>
<mustSupport value="code"/>
<mustSupport value="extension"/>
<mustSupport value="id"/>
<mustSupport value="id.value"/>
<mustSupport value="statusReason"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.64"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Procedure"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedurenotdone"/>
<mustSupport value="code"/>
<mustSupport value="extension"/>
<mustSupport value="id"/>
<mustSupport value="id.value"/>
<mustSupport value="statusReason"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.64"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Procedure"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedurenotdone"/>
<mustSupport value="code"/>
<mustSupport value="extension"/>
<mustSupport value="id"/>
<mustSupport value="id.value"/>
<mustSupport value="statusReason"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.66"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Procedure"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedurenotdone"/>
<mustSupport value="code"/>
<mustSupport value="extension"/>
<mustSupport value="id"/>
<mustSupport value="id.value"/>
<mustSupport value="statusReason"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.66"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Coverage"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-coverage"/>
<mustSupport value="type"/>
<mustSupport value="period"/>
<codeFilter>
<path value="type"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Location"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-location"/>
<mustSupport value="id"/>
<mustSupport value="id.value"/>
</dataRequirement>
<dataRequirement>
<type value="ServiceRequest"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest"/>
<mustSupport value="code"/>
<mustSupport value="intent"/>
<mustSupport value="intent.value"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="doNotPerform"/>
<mustSupport value="doNotPerform.value"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/1.3.6.1.4.1.33895.1.3.0.45"/>
</codeFilter>
</dataRequirement>
</Library>
</contained>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-supplementalDataGuidance" id="supplementalDataGuidance">
<extension url="guidance">
<valueString
value="For every patient evaluated by this measure also identify payer, race, ethnicity and sex; SDE Ethnicity-Patient's Ethnicity:
Hispanic or Latino
Not Hispanic or Latino
SDE Race-Patient's Race:
Native Hawaiian or Other Pacific Islander
Asian
American Indian or Alaska Native
Other Race
White
Black or African American
SDE Sex-Patient's Sex:
Gender identity restricted to only Male and Female used in administrative situations requiring a restriction to these two categories.
SDE Payer
"/>
</extension>
<extension url="usage">
<valueCodeableConcept>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="supplemental-data"/>
<display value="Supplemental Data"/>
</coding>
<text value="Supplemental Data Guidance"/>
</valueCodeableConcept>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-softwaresystem">
<valueReference>
<reference value="Device/cqf-tooling"/>
</valueReference>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-effectiveDataRequirements" id="effective-data-requirements">
<valueReference>
<reference value="#effective-data-requirements"/>
</valueReference>
</extension>
<url
value="https://madie.cms.gov/Measure/VenousThromboembolismProphylaxisFHIR"/>
<identifier>
<use value="usual"/>
<type>
<coding>
<system
value="http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type"/>
<code value="short-name"/>
</coding>
</type>
<system value="https://madie.cms.gov/measure/shortName"/>
<value value="CMS108FHIR"/>
</identifier>
<identifier>
<use value="official"/>
<type>
<coding>
<system
value="http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type"/>
<code value="version-independent"/>
</coding>
</type>
<system value="urn:ietf:rfc:3986"/>
<value value="urn:uuid:fa570e9c-c75f-4972-a77e-9488816d14af"/>
</identifier>
<identifier>
<use value="official"/>
<type>
<coding>
<system
value="http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type"/>
<code value="version-specific"/>
</coding>
</type>
<system value="urn:ietf:rfc:3986"/>
<value value="urn:uuid:1b60bbd2-6837-4b68-921c-ffeead0bc2ca"/>
</identifier>
<identifier>
<use value="official"/>
<type>
<coding>
<system
value="http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type"/>
<code value="publisher"/>
</coding>
</type>
<system value="https://madie.cms.gov/measure/cmsId"/>
<value value="108FHIR"/>
<assigner>
<display value="CMS"/>
</assigner>
</identifier>
<version value="0.2.000"/>
<name value="VenousThromboembolismProphylaxisFHIR"/>
<title value="Venous Thromboembolism ProphylaxisFHIR"/>
<status value="draft"/>
<experimental value="false"/>
<date value="2024-12-18T16:19:08+00:00"/>
<publisher value="The Joint Commission"/>
<contact>
<telecom>
<system value="url"/>
<value value="https://www.jointcommission.org/"/>
</telecom>
</contact>
<description
value="This measure assesses the number of patients who received Venous Thromboembolism (VTE) prophylaxis or have documentation why no VTE prophylaxis was given between the day of arrival to the day after hospital admission or surgery end date for surgeries that start the day of or the day after hospital admission"/>
<purpose value="UNKNOWN"/>
<usage
value="When low dose unfractionated heparin is administered for VTE prophylaxis, the intended administration route for low dose unfractionated heparin is subcutaneous.
Reasons for no pharmacological and no mechanical VTE prophylaxis must be explicitly documented by the MD/APN/PA or pharmacist and linked with VTE prophylaxis. Ambulation alone is not a sufficient reason for not administering VTE prophylaxis. In order for ambulation/patient ambulating to be considered as an acceptable reason, there needs to be explicit documentation, e.g., "patient out of bed and ambulating in halls - no VTE prophylaxis needed."
The denominator population includes patients with inpatient hospitalizations and patients from Acute Hospital Care at Home programs, who are treated and billed as inpatients but receive care in their home.
This eCQM is an episode-based measure. An episode is defined as each inpatient hospitalization or encounter that ends during the measurement period.
This FHIR-based measure has been derived from the QDM-based measure: CMS108v13.
Please refer to the HL7 QI-Core Implementation Guide (https://hl7.org/fhir/us/qicore/STU4.1.1/) for more information on QI-Core and mapping recommendations from QDM to QI-Core 4.1.1 (https://hl7.org/fhir/us/qicore/STU4.1.1/qdm-to-qicore.html)."/>
<copyright
value="Measure specifications are in the Public Domain.
LOINC(R) copyright 2004-2023 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2023 International Health Terminology Standards Development Organisation. ICD-10 copyright 2023 World Health Organization. All Rights Reserved."/>
<effectivePeriod>
<start value="2025-01-01"/>
<end value="2025-12-31"/>
</effectivePeriod>
<author>
<name value="The Joint Commission"/>
<telecom>
<system value="url"/>
<value value="https://www.jointcommission.org/"/>
</telecom>
</author>
<library
value="https://madie.cms.gov/Library/VenousThromboembolismProphylaxisFHIR"/>
<disclaimer
value="These performance measures are not clinical guidelines and do not establish a standard of medical care and have not been tested for all potential applications. The measures and specifications are provided without warranty."/>
<scoring>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/measure-scoring"/>
<code value="proportion"/>
<display value="Proportion"/>
</coding>
</scoring>
<rationale
value="The estimated annual incidence of deep-vein thrombosis (DVT) and pulmonary embolism (PE), known collectively as venous thromboembolism (VTE), ranges from 350,000 to 600,000 (Maynard, 2016). According to the Centers for Disease Control and Prevention (CDC) 2020 statistics, 1-2 per 1,000 adults in the United States are clinically diagnosed with VTE each year (CDC, 2020). Increased incidence is reported in the elderly (1 per 100) compared to young adults (1 per 10,000) (Henke et al., 2020).
VTE is a known complication of hospitalization, frequently extending the length of stay and increasing hospital mortality (Maynard, 2016). Approximately 20% of VTE are associated with a surgical procedure (Henke et al., 2020). Hospitalized patients at high-risk for VTE may develop an asymptomatic DVT, and die from PE even before the diagnosis is suspected. The majority of fatal events occur as sudden or abrupt death, underscoring the importance of prevention as the most critical action step for reducing death from PE (Geerts et al., 2008).
American Society of Hematology (ASH) 2018 VTE prophylaxis guidelines strongly recommend pharmacological prophylaxis using unfractionated heparin (UFH), low molecular weight heparin (LMWH) or fondaparinux for acutely and critically ill hospitalized medical patients, unless contraindicated. The use of mechanical prophylaxis is an acceptable alternative for patients with increased risk of bleeding and preferred over no prophylaxis. ASH 2019 guidelines for surgical patients similarly recommend pharmacological or mechanical prophylaxis over no VTE prophylaxis. (NOTE: Some select surgeries have previously been monitored in the Surgical Care Improvement Project; since performance on these surgeries has achieved very high levels, they are not included in this measure.)
Despite its proven effectiveness, VTE prophylaxis remains underused or inappropriately used in both medical and surgical patients (Kahn et al., 2018). The ENDORSE study evaluated prophylaxis rates in 17,084 major surgery patients and found that more than one third of patients at risk for VTE (38%) did not receive prophylaxis with various rates reported for different types of surgery (Cohen et al., 2008). More recently, a systemic review of multiple randomized controlled trials found that system-wide interventions, such as computer alerts to physicians and other healthcare professionals, increased the use of appropriate VTE prophylaxis while reducing the number of symptomatic VTE at three months (Kahn et al., 2018)."/>
<clinicalRecommendationStatement
value="Failure to recognize and protect patients at risk for venous thromboembolism (VTE) increases the chances for acutely ill hospitalized patients at high risk for developing a deep vein thrombosis or dying from a pulmonary embolism. Screening all patients is the only evidence based practice in reducing incidence of disease. All hospitalized patients should be evaluated for primary VTE prophylaxis, and given appropriate prophylaxis when indicated."/>
<group id="64f8bc45da013638e7b3d874">
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring">
<valueCodeableConcept>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-scoring"/>
<code value="proportion"/>
<display value="Proportion"/>
</coding>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis">
<valueCode value="Encounter"/>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-type">
<valueCodeableConcept>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/measure-type"/>
<code value="process"/>
<display value="Process"/>
</coding>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-rateAggregation">
<valueCode value="None"/>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-improvementNotation">
<valueCodeableConcept>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-improvement-notation"/>
<code value="decrease"/>
<display value="increase"/>
</coding>
</valueCodeableConcept>
</extension>
<population id="97C2359B-EBFC-44FE-B4D5-A8D961468ACD">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="initial-population"/>
<display value="Initial Population"/>
</coding>
</code>
<description
value="Inpatient hospitalizations for patients age 18 and older, discharged from hospital inpatient acute care without a diagnosis of venous thromboembolism (VTE) or obstetrics that ends during the measurement period"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Initial Population"/>
</criteria>
</population>
<population id="9E8A9B37-BE83-4016-B3B6-3292843AED49">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="denominator"/>
<display value="Denominator"/>
</coding>
</code>
<description value="Initial population"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Denominator"/>
</criteria>
</population>
<population id="89FBDFC1-C17F-4351-89BC-0EAB887E9E01">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="denominator-exclusion"/>
<display value="Denominator Exclusion"/>
</coding>
</code>
<description
value="- Inpatient hospitalizations for patients who have a length of stay less than 2 days
- Inpatient hospitalizations for patients who are direct admits to intensive care unit (ICU), or transferred to ICU the day of or the day after hospital admission with ICU length of stay greater than or equal to one day
- Inpatient hospitalizations for patients with a principal diagnosis of mental disorders or stroke
- Inpatient hospitalizations for patients with a principal procedure of Surgical Care Improvement Project (SCIP) VTE selected surgeries
- Inpatient hospitalizations for patients with comfort measures documented anytime between the day of arrival and the day after hospital admission
- Inpatient hospitalizations for patients with comfort measures documented by the day after surgery end date for surgeries that end the day of or the day after hospital admission"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Denominator Exclusions"/>
</criteria>
</population>
<population id="A15A4A4F-D0C2-465E-9A39-BA83690F2108">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="numerator"/>
<display value="Numerator"/>
</coding>
</code>
<description
value="Inpatient hospitalizations for patients who received VTE prophylaxis:
- between the day of arrival and the day after hospital admission
- the day of or the day after surgery end date (for surgeries that end the day of or the day after hospital admission)
Inpatient hospitalizations for patients who have documentation of a reason why no VTE prophylaxis was given:
- between the day of arrival and the day after hospital admission
- the day of or the day after surgery end date (for surgeries that end the day of or the day after hospital admission)"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Numerator"/>
</criteria>
</population>
</group>
<supplementalData id="sde-ethnicity">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="supplemental-data"/>
</coding>
</usage>
<description value="SDE Ethnicity"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="SDE Ethnicity"/>
</criteria>
</supplementalData>
<supplementalData id="sde-race">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="supplemental-data"/>
</coding>
</usage>
<description value="SDE Race"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="SDE Race"/>
</criteria>
</supplementalData>
<supplementalData id="sde-sex">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="supplemental-data"/>
</coding>
</usage>
<description value="SDE Sex"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="SDE Sex"/>
</criteria>
</supplementalData>
<supplementalData id="sde-payer">
<usage>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="supplemental-data"/>
</coding>
</usage>
<description value="SDE Payer"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="SDE Payer"/>
</criteria>
</supplementalData>
</Measure>
IG © 2023+ cqframework. Package gov.healthit.ecqi.ecqms#2024.0.0 based on FHIR 4.0.1. Generated 2024-12-19
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