Your User Friendly Name for MyContentIG Here
0.4.6 - CI Build
Your User Friendly Name for MyContentIG Here, published by HL7 International - [Some] Work Group. This guide is not an authorized publication; it is the continuous build for version 0.4.6 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/cqframework/sample-content-ig/ and changes regularly. See the Directory of published versions
Official URL: http://somewhere.org/fhir/uv/mycontentig/Measure/HIVViralSuppressionFHIRExample | Version: 0.4.6 | |||
Draft as of 2024-05-06 | Computable Name: HIVViralSuppressionFHIRExample | |||
Other Identifiers: Short Name: CMS314FHIR (use: usual, ), UUID:b8aa1302-d225-4dc7-9a3b-ffec45976a3e (use: official, ), UUID:2c92808287dd6f640188b022a80a1e8d (use: official, ), Publisher: 314FHIR (use: official, ) | ||||
Usage:Program: EP/EC |
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Copyright/Legal: This measure was developed by the Health Resources & Services Administration (HRSA) of the U.S. Department of Health & Human Services (HHS). It is in the public domain. Citation of HRSA as the source of the original measure is appreciated. Any modified versions may not be represented as approved, endorsed, or authorized by HRSA or HHS. 42 U.S.C. Section 1320b-10. Users of modified versions should clearly explain how they deviate from HRSA’s original measure. Limited proprietary coding is contained in the Measure specifications for user convenience. Users of proprietary code sets should obtain all necessary licenses from the owners of the code sets. CPT(R) contained in the Measure specifications is copyright 2004-2022 American Medical Association. LOINC(R) is copyright 2004-2022 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2022 International Health Terminology Standards Development Organisation. ICD-10 is copyright 2022 World Health Organization. All Rights Reserved. Due to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM]. |
Percentage of patients, regardless of age, diagnosed with HIV prior to or during the first 90 days of the measurement period, with an eligible encounter in the first 240 days of the measurement period, whose last HIV viral load test result was less than 200 copies/mL during the measurement period
UNKNOWN
Knowledge Artifact Metadata | |
---|---|
Name (machine-readable) | HIVViralSuppressionFHIRExample |
Title (human-readable) | HIV Viral Suppression FHIR Example |
Status | Draft |
Experimental | false |
Description | Percentage of patients, regardless of age, diagnosed with HIV prior to or during the first 90 days of the measurement period, with an eligible encounter in the first 240 days of the measurement period, whose last HIV viral load test result was less than 200 copies/mL during the measurement period |
Purpose | UNKNOWN |
Clinical Usage | HIV viral load data should be captured either as a numeric value or as a character/text value, depending on whether a given viral load result falls above or below the lab's lower limit of detection. For viral loads at or above the lower limit of detection, the viral load should be captured as a numeric value (expressed as the number of copies/mL). For viral loads below the lower limit of detection, the viral load should be populated with a character/text value equivalent to "Below lower limit of detection." The EHR need not record this character value using this exact wording (for example, the character value could be recorded as "<20 copies/mL" or "not detected"), but values below the lower limit of detection should be documented to allow the submitter to accurately map them to a value of "Below lower limit of detection" for reporting purposes. This eCQM is a patient-based measure. This FHIR-based measure has been derived from the QDM-based measure: CMS314v1. Please refer to the HL7 QI-Core Implementation Guide (http://hl7.org/fhir/us/qicore/index.html) for more information on QI-Core and mapping recommendations from QDM to QI-Core 4.1.1 (http://hl7.org/fhir/us/qicore/qdm-to-qicore.html). |
Approval Date | 2023-08-14 |
Effective Period | 2024-01-01..2024-12-31 |
Use Context | Program (Details: UsageContextType code program = ' Program ', stated as ' null '): EP/EC |
Measure Developer | Health Resources & Services Administration: https://www.hrsa.gov/ |
Measure Steward | HL7 International - [Some] Work Group |
Steward Contact Details | http://hl7.org/Special/committees/[something] |
Copyright | This measure was developed by the Health Resources & Services Administration (HRSA) of the U.S. Department of Health & Human Services (HHS). It is in the public domain. Citation of HRSA as the source of the original measure is appreciated. Any modified versions may not be represented as approved, endorsed, or authorized by HRSA or HHS. 42 U.S.C. Section 1320b-10. Users of modified versions should clearly explain how they deviate from HRSA's original measure. Limited proprietary coding is contained in the Measure specifications for user convenience. Users of proprietary code sets should obtain all necessary licenses from the owners of the code sets. CPT(R) contained in the Measure specifications is copyright 2004-2022 American Medical Association. LOINC(R) is copyright 2004-2022 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2022 International Health Terminology Standards Development Organisation. ICD-10 is copyright 2022 World Health Organization. All Rights Reserved. Due to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM]. |
Measure Metadata | |
Short Name Identifier | CMS314FHIR |
Version Independent Identifier | urn:uuid:b8aa1302-d225-4dc7-9a3b-ffec45976a3e |
Version Specific Identifier | urn:uuid:2c92808287dd6f640188b022a80a1e8d |
Publisher (CMS) Identifier | 314FHIR |
Version Number | 0.4.6 |
Rationale | HIV is a communicable infection that leads to a progressive disease with a long asymptomatic period. Approximately 40,000 persons in the United States are newly infected with HIV each year (Centers for Disease Control and Prevention, 2021, p. 51). Without treatment, most persons develop acquired immunodeficiency syndrome (AIDS) within 10 years of HIV infection. HIV viral suppression is a long-standing priority outcome among the HIV community in the United States and around the world. The National HIV/AIDS Strategy for the United States from 2022-2025, developed by the White House Office of National AIDS Policy with input from the HIV community across the United States, prioritizes increasing HIV viral suppression rates to 95% (The White House, 2020). The DHHS Panel on Antiretroviral Guidelines for Adults and Adolescents defines viral suppression as a viral load below the lower limits of detection in its guidelines on virologic failure, and it defines viral suppression as a viral load of less than 200 copies/mL as part of its guidelines for the use of antiretroviral therapy to prevent HIV transmission (Panel on Antiretroviral Guidelines for Adults and Adolescents, 2022). Antiretroviral therapy (ART) delays the progression to AIDS and increases the length of survival. ART reduces HIV-associated morbidity and mortality by maximally inhibiting HIV replication to achieve viral suppression (Hogg et al., 2001; Lundgern et al., 2015). ART has also been shown to reduce transmission of HIV (Rodger et al., 2019). Studies show disparities in rates of viral suppression by race and ethnicity among MSM and among women, with Black and Hispanic or Latino/a study participants having lower rates of viral suppression than White participants (Buchacz et al., 2020; Buchacz et al., 2018; Geter et al., 2018). This measure will help providers direct their attention and quality improvement efforts towards improving HIV viral suppression rates. |
Clinical Recommendation Statement | Adult guidelines: "The primary goal of antiretroviral therapy (ART) is to prevent HIV-associated morbidity and mortality. This goal is accomplished by using effective ART to achieve and maintain a plasma HIV-1 RNA (viral load) below the quantification limits of commercially available assays. Durable viral suppression improves immune function and overall quality of life, lowers the risk of both AIDS-defining and non-AIDS–defining complications, and allows persons with HIV to live a lifespan approaching that of persons without HIV" (Panel on Antiretroviral Guidelines for Adults and Adolescents, 2022, p. E-1). "ART is recommended for all individuals with HIV to reduce the morbidity and mortality associated with HIV infection and to prevent HIV transmission to sexual partners and infants (AI). ART should be initiated as soon as possible after HIV diagnosis (AI)" (Panel on Antiretroviral Guidelines for Adults and Adolescents, 2022, p. E-2). "The guidelines and the AIDS Clinical Trials Group (ACTG) now define virologic failure as a confirmed viral load >200 copies/mL- a threshold that eliminates most cases of apparent viremia caused by viral load blips or assay variability" (Panel on Antiretroviral Guidelines for Adults and Adolescents, 2022, p. C-6). "Individuals who are adherent to their ARV regimen and do not harbor resistance mutations to the component drugs can generally achieve suppression 8 to 24 weeks after ART initiation; rarely, in some patients it may take longer" (Panel on Antiretroviral Guidelines for Adults and Adolescents, 2022, p. C-6). Pediatric guidelines: "Based on accumulated experience with currently available assays, the current definition of virologic suppression is a plasma viral load below the detection limit of the assay used (generally <20 to 75 copies/mL)" (Panel on Antiretroviral Therapy and Medical Management of Children Living with HIV, 2022, p. D-5). "Temporary viral load elevations ("blips") that are between the level of detection and 200 copies/mL to 500 copies/mL are often detected in adults and children who are on ART; these temporary elevations do not represent virologic failure, as long as the values have returned to below the level of detection when testing is repeated" (Panel on Antiretroviral Therapy and Medical Management of Children Living with HIV, 2022, p. D-5). |
Measure Population Criteria (ID: 64873a03be23a058642d5816) | |
Initial Population |
ID: DF999E50-BAB8-409F-922D-E8FA0E0BD92E
Description: All patients, regardless of age, diagnosed with HIV prior to or during the first 90 days of the measurement period with at least one eligible encounter in the first 240 days of the measurement period Logic Definition: Initial Population |
Denominator |
ID: 2D69A89B-E60C-4878-B1DD-9F27450D603B
Description: Equals Initial Population Logic Definition: Denominator |
Denominator Exclusion |
ID: 02767a1a-3174-47b6-8c31-84e10114824f
Description: No description provided |
Numerator |
ID: E492BC05-FD48-4459-8574-5CF67CC14C66
Description: Patients with a last HIV viral load test result of less than 200 copies/mL during the measurement period Logic Definition: Numerator |
Numerator Exclusion |
ID: c5d8edbc-2566-4a49-b298-f39723e037c6
Description: No description provided |
Denominator Exception |
ID: 4e8d7586-8625-42d1-9cff-c02d3d4b87f3
Description: No description provided |
Population Basis | boolean |
Scoring | Proportion |
Type | Outcome |
Measure Logic | |
Primary Library | HIV Viral Suppression FHIR Example |
Dependency |
Description: Library FHIRHelpers
Resource: http://hl7.org/fhir/Library/FHIRHelpers|4.0.1
Canonical URL: http://hl7.org/fhir/Library/FHIRHelpers|4.0.1 |
Dependency |
Description: Library QICoreCommon
Resource: QICore Common Example Canonical URL: http://somewhere.org/fhir/uv/mycontentig/Library/QICoreCommonExample |
Dependency |
Description: Code system SNOMEDCT
Resource: SNOMED CT (all versions) Canonical URL: http://snomed.info/sct |
Dependency |
Description: Value set HIV Viral Load
Resource: HIV Viral Load Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.120.12.1002 |
Dependency |
Description: Value set HIV
Resource: HIV Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.120.12.1003 |
Dependency |
Description: Value set Office Visit
Resource: Office Visit Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001 |
Dependency |
Description: Value set Outpatient Consultation
Resource: Outpatient Consultation Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1008 |
Dependency |
Description: Value set Annual Wellness Visit
Resource: Annual Wellness Visit Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240 |
Dependency |
Description: Value set Face-to-Face Interaction
Resource: Face-to-Face Interaction Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1048 |
Dependency |
Description: Value set Home Healthcare Services
Resource: Home Healthcare Services Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016 |
Dependency |
Description: Value set Preventive Care Services Established Office Visit, 18 and Up
Resource: Preventive Care Services Established Office Visit, 18 and Up Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025 |
Dependency |
Description: Value set Preventive Care Services Initial Office Visit, 18 and Up
Resource: Preventive Care Services Initial Office Visit, 18 and Up Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023 |
Dependency |
Description: Value set Preventive Care Services, Initial Office Visit, 0 to 17
Resource: Preventive Care Services, Initial Office Visit, 0 to 17 Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1022 |
Dependency |
Description: Value set Preventive Care, Established Office Visit, 0 to 17
Resource: Preventive Care, Established Office Visit, 0 to 17 Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1024 |
Dependency |
Description: Value set Telephone Visits
Resource: Telephone Visits Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1080 |
Dependency |
Description: Value set Preventive Care Services Other
Resource: Preventive Care Services Other Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1030 |
Direct Reference Code |
Display: Below threshold level (qualifier value)
Code: 260988000 System: http://snomed.info/sct |
Direct Reference Code |
Display: Not detected (qualifier value)
Code: 260415000 System: http://snomed.info/sct |
Parameter |
Name: Measurement Period
Use: In Min Cardinality: 0 Max Cardinality: 1 Type: Period |
Parameter |
Name: Numerator
Use: Out Min Cardinality: 0 Max Cardinality: 1 Type: boolean |
Parameter |
Name: Denominator
Use: Out Min Cardinality: 0 Max Cardinality: 1 Type: boolean |
Parameter |
Name: Initial Population
Use: Out Min Cardinality: 0 Max Cardinality: 1 Type: boolean |
Measure Logic Data Requirements | |
Data Requirement |
Type: Patient
Profile(s): QICore Patient |
Data Requirement |
Type: Observation
Profile(s): QICore Observation Must Support Elements: code, effective Code Filter(s): Path: code ValueSet: HIV Viral Load |
Data Requirement |
Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition
Must Support Elements: code Code Filter(s): Path: code ValueSet: HIV |
Data Requirement |
Type: Encounter
Profile(s): QICore Encounter Must Support Elements: type, period Code Filter(s): Path: type ValueSet: Office Visit |
Data Requirement |
Type: Encounter
Profile(s): QICore Encounter Must Support Elements: type, period Code Filter(s): Path: type ValueSet: Outpatient Consultation |
Data Requirement |
Type: Encounter
Profile(s): QICore Encounter Must Support Elements: type, period Code Filter(s): Path: type ValueSet: Annual Wellness Visit |
Data Requirement |
Type: Encounter
Profile(s): QICore Encounter Must Support Elements: type, period Code Filter(s): Path: type ValueSet: Face-to-Face Interaction |
Data Requirement |
Type: Encounter
Profile(s): QICore Encounter Must Support Elements: type, period Code Filter(s): Path: type ValueSet: Home Healthcare Services |
Data Requirement |
Type: Encounter
Profile(s): QICore Encounter Must Support Elements: type, period Code Filter(s): Path: type ValueSet: Preventive Care Services Established Office Visit, 18 and Up |
Data Requirement |
Type: Encounter
Profile(s): QICore Encounter Must Support Elements: type, period Code Filter(s): Path: type ValueSet: Preventive Care Services Initial Office Visit, 18 and Up |
Data Requirement |
Type: Encounter
Profile(s): QICore Encounter Must Support Elements: type, period Code Filter(s): Path: type ValueSet: Preventive Care Services, Initial Office Visit, 0 to 17 |
Data Requirement |
Type: Encounter
Profile(s): QICore Encounter Must Support Elements: type, period Code Filter(s): Path: type ValueSet: Preventive Care, Established Office Visit, 0 to 17 |
Data Requirement |
Type: Encounter
Profile(s): QICore Encounter Must Support Elements: type, period Code Filter(s): Path: type ValueSet: Telephone Visits |
Data Requirement |
Type: Encounter
Profile(s): QICore Encounter Must Support Elements: type, period Code Filter(s): Path: type ValueSet: Preventive Care Services Other |
Measure Logic Definitions | |
Logic Definition | Library Name: HIVViralSuppressionFHIRExample |
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Logic Definition | Library Name: HIVViralSuppressionFHIRExample |
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Logic Definition | Library Name: HIVViralSuppressionFHIRExample |
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Logic Definition | Library Name: HIVViralSuppressionFHIRExample |
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Logic Definition | Library Name: HIVViralSuppressionFHIRExample |
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Logic Definition | Library Name: HIVViralSuppressionFHIRExample |
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Logic Definition | Library Name: QICoreCommonExample |
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Logic Definition | Library Name: QICoreCommonExample |
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Logic Definition | Library Name: QICoreCommonExample |
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Logic Definition | Library Name: QICoreCommonExample |
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