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Package gov.healthit.ecqi.ecqms
Type Measure
Id Id
FHIR Version R4
Source http://ecqi.healthit.gov/ecqms/https://build.fhir.org/ig/cqframework/ecqm-content-qicore-2024/Measure-CMS1028FHIRPCSevereOBComps.html
Url https://madie.cms.gov/Measure/CMS1028FHIRPCSevereOBComps
Version 0.1.002
Status active
Date 2025-01-14T15:54:05+00:00
Name CMS1028FHIRPCSevereOBComps
Title Severe Obstetric ComplicationsFHIR
Experimental True
Description Patients with severe obstetric complications that occur during the inpatient delivery hospitalization
Purpose UNKNOWN
Copyright Measure specifications are in the Public Domain. LOINC(R) copyright 2004-2024 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2024 International Health Terminology Standards Development Organisation. ICD-10 copyright 2024 World Health Organization. All Rights Reserved.

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Narrative

Note: links and images are rebased to the (stated) source

Title: Severe Obstetric ComplicationsFHIR
Id: CMS1028FHIRPCSevereOBComps
Version: 0.1.002
Url: Severe Obstetric ComplicationsFHIR
Short Name Identifier:

CMS1028FHIR

Version Independent Identifier:

urn:uuid:6cf03fe2-b962-4f83-ac37-26d7477183c7

Version Specific Identifier:

urn:uuid:d11a564b-0516-4ed0-9a27-45fdd06a8064

Endorser (CMS Consensus Based Entity) Identifier:

3687e

Publisher (CMS) Identifier:

1028FHIR

Effective Period: 2025-01-01..2025-12-31
Experimental: true
Publisher: The Joint Commission
Author: The Joint Commission, Centers for Medicare & Medicaid Services (CMS), Yale New Haven Health Service Corporation/ Center for Outcomes Research and Evaluation
Description:

Patients with severe obstetric complications that occur during the inpatient delivery hospitalization

Purpose:

UNKNOWN

Copyright:

Measure specifications are in the Public Domain.

LOINC(R) copyright 2004-2024 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2024 International Health Terminology Standards Development Organisation. ICD-10 copyright 2024 World Health Organization. All Rights Reserved.

Disclaimer:

These performance measures are not clinical guidelines, 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.

Rationale:

The United States (US) experiences higher rates of maternal morbidity and mortality than most other developed countries. The Centers for Disease Control and Prevention (CDC) (2021) report that these rates have continued to trend upward in recent decades. Research indicates that the overall rate of severe maternal morbidity (SMM) increased by almost 200% between 1993 and 2014 to 144 per 10,000 delivery hospitalizations (CDC, 2021), with more than 25,000 women per year experiencing obstetric complications (U.S. Department of Health and Human Services, 2020). Recent maternal mortality data from 2018 reveal that 658 women in the US died from maternal causes, resulting in a rate of 17.4 deaths per 100,000 live births, with 77% of the deaths attributed to direct obstetric causes like hemorrhage, preeclampsia, obstetric embolism, and other complications (Hoyert & Minino, 2020). 144 per 10,000 women hospitalized for delivery have experienced SMM, including hemorrhage, embolism, hypertension, stroke, and other serious complications (CDC, 2021). Racial and ethnic disparities exist: Black women and Hispanic women are at a significantly higher risk for developing these complications than are Non-Hispanic White women (Leonard, Main, Scott, Profit, & Carmichael, 2019). Increasing rates of SMM are resulting in increased healthcare costs, longer hospitalization stays and impacts on a woman's health (Callaghan, Creanga, & Kuklina, 2012).

There is limited national evaluation of hospitals' performance on maternal morbidity and mortality although SMM is widely used at the population level. SMM is linked to maternal mortality, varies significantly among hospitals, and has significant racial/ethnic and urban/rural disparities. SMM is a cost driver for both Medicaid and commercial plans. This measure is important as it will assist in the discovery and understanding of SMM patterns that can lead to improvements in the safety and quality of maternal care necessary to reduce SMM rates.

Clinical recommendation statement:

Healthy People 2030 Measure (MICH-05): Reduce severe maternal complications identified during delivery hospitalizations (U.S. Department of Health and Human Services, n.d.).

The American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine recommend identifying potential cases of severe maternal morbidity for further review, with a focus on outcomes and complications, and consider this an important step toward promoting safe obstetric care (American College of Obstetricians and Gynecologists and the Society for Maternal–Fetal Medicine, Kilpatrick, & Ecker, 2016).

Guidance (Usage): Note: This measure will be stratified by race/ethnicity and payer after measure submission. In the case of multiple births, map the first delivery date/time (Baby A) as the delivery date/time for the encounter. This measure allows for 3 approaches to determine gestational age (GA) in the following order of precedence: 1. The GA is calculated using the American College of Obstetricians and Gynecologists ReVITALize guidelines.* 2. When the calculated GA is not available, the GA is obtained from a discrete field in the electronic health record. The intent is to capture the last estimated GA in the interval starting 24 hours or less prior to delivery and ending before midnight on the same day of delivery. 3. The GA is based on ICD10 or SNOMED codes indicative of weeks gestation. This option is only used when results from items #1 and #2 (see above) are not available. *ACOG ReVITALize Guidelines for Calculating Gestational Age (ACOG, 2014): Gestational Age = (280-(Estimated Due Date minus Reference Date))/7 --Estimated Due Date (EDD): The best obstetrical EDD is determined by last menstrual period if confirmed by early ultrasound or no ultrasound performed, or early ultrasound if no known last menstrual period or the ultrasound is not consistent with last menstrual period, or known date of fertilization (e.g., assisted reproductive technology) --Reference Date is the date on which you are trying to determine gestational age. For purposes of this eCQM, Reference Date would be the Date of Delivery. Note however the calculation may yield a non-whole number, and gestational age should be rounded down to the nearest completed week. For example, an infant born on the 5th day of the 36th week (35 weeks and 5/7 days) is at a gestational age of 35 weeks, not 36 weeks. Definition: For this measure, specifications are modeled after the nationally available and adopted CDC definition for Severe Maternal Morbidity (SMM) with the addition of maternal mortality. At times, we may refer to the CDC indicators of morbidity as SMM, but the outcome of the measure, which includes morbidity and mortality, is referred to as Severe Obstetric Complications (SOC). This eCQM is an episode-based measure. An episode is defined as each inpatient hospitalization or encounter that ends during the measurement period. This FHIR-based measure has been derived from the QDM-based measure CMS1028v4. 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).
Population Criteria:
6750921446b6174510cfeb95
Initial Population: IPop1: Inpatient hospitalizations for patients age greater than or equal to 8 years and less than 65 admitted to the hospital for inpatient acute care who undergo a delivery procedure with a discharge date during the measurement period
Denominator: Den1: Inpatient hospitalizations for patients delivering stillborn or live birth with greater than or equal to 20 weeks, 0 days gestation completed
Numerator: Num1: All Severe Obstetric Complications (SOC). Inpatient hospitalizations for patients with severe obstetric complications (not present on admission that occur during the current delivery encounter) including the following: - Severe maternal morbidity diagnoses (see list below) - Severe maternal morbidity procedures (see list below) - Discharge disposition of expired Please note that present on admission codes may be extracted from billing/claims data that was entered by coding staff. Severe Maternal Morbidity Diagnoses: - Cardiac Acute heart failure Acute myocardial infarction Aortic aneurysm Cardiac arrest/ventricular fibrillation Heart failure/arrest during procedure or surgery - Hemorrhage Disseminated intravascular coagulation Shock - Renal Acute renal failure - Respiratory Adult respiratory distress syndrome Pulmonary edema - Sepsis - Other OB Air and thrombotic embolism Amniotic fluid embolism Eclampsia Severe anesthesia complications - Other Medical Puerperal cerebrovascular disorder Sickle cell disease with crisis Severe Maternal Morbidity Procedures: - Blood transfusion - Conversion of cardiac rhythm - Hysterectomy - Temporary tracheostomy - Ventilation
Numerator Exclusion: NumExcl1: Inpatient hospitalizations with blood transfusion or hysterectomy with a diagnosis of placenta percreta or placenta increta and no additional severe obstetrical complications
6750921446b6174510cfeb96
Initial Population: IPop2 is the same inpatient hospitalizations as IPop1
Denominator: Den2 is the same inpatient hospitalizations as Den1
Numerator: Num2: Delivery encounters with SOC excluding encounters where transfusion was the only SOC. Inpatient hospitalizations for patients with severe obstetric complications (not present on admission that occur during the current delivery encounter) including severe maternal morbidity diagnoses (see following list), severe maternal morbidity procedures (see following list), and discharge disposition of expired, yet excluding encounters where transfusion was the only SOC. Please note that present on admission codes may be those entered by coding staff, extracted from billing/claims data. Severe Maternal Morbidity Diagnoses: - Cardiac Acute heart failure Acute myocardial infarction Aortic aneurysm Cardiac arrest/ventricular fibrillation Heart failure/arrest during procedure or surgery - Hemorrhage Disseminated intravascular coagulation Shock - Renal Acute renal failure - Respiratory Adult respiratory distress syndrome Pulmonary edema - Sepsis - Other OB Air and thrombotic embolism Amniotic fluid embolism Eclampsia Severe anesthesia complications - Other Medical Puerperal cerebrovascular disorder Sickle cell disease with crisis Severe Maternal Morbidity Procedures: - Blood transfusion - Conversion of cardiac rhythm - Hysterectomy - Temporary tracheostomy - Ventilation
Numerator Exclusion: NumExcl2: Inpatient hospitalizations with SOC excluding encounters where transfusion was the only SOC with a hysterectomy or blood transfusion with a diagnosis of placenta percreta or placenta increta and no additional severe obstetrical complications
Supplemental Data Elements:

SDE Ethnicity

SDE Payer

SDE Race

SDE Sex

SDE Variable Calculated Gestational Age

SDE SOC Diagnoses Detail

SDE SOC Procedure Detail

SDE Delivery Encounters with Severe Obstetric Complication Diagnosis

SDE Delivery Encounters with Severe Obstetric Complication Procedures

Risk Adjustment Variable:

Risk Variable Lab and Physical Exam Results

Risk Variable Asthma

Risk Variable Autoimmune Disease

Risk Variable Bariatric Surgery

Risk Variable Bleeding Disorder

Risk Variable Morbid Obesity

Risk Variable Cardiac Disease

Risk Variable Economic Housing Instability

Risk Variable Gastrointestinal Disease

Risk Variable Gestational Diabetes

Risk Variable HIV

Risk Variable Hypertension

Risk Variable Long Term Anticoagulant Use

Risk Variable Mental Health Disorder

Risk Variable Multiple Pregnancy

Risk Variable Neuromuscular

Risk Variable Obstetrical VTE

Risk Variable Placenta Previa

Risk Variable Placental Abruption

Risk Variable Placental Accreta Spectrum

Risk Variable Preexisting Diabetes

Risk Variable Previous Cesarean

Risk Variable Pulmonary Hypertension

Risk Variable Renal Disease

Risk Variable Severe Preeclampsia

Risk Variable Substance Abuse

Risk Variable Thyrotoxicosis

Risk Variable Other Preeclampsia

Risk Variable Preterm Birth

Risk Variable Anemia

Risk Variable Systolic Blood Pressure

Risk Variable Heart Rate

Risk Variable First White Blood Cell Count Lab Test

Risk Variable First Hematocrit Lab Test

Delivery Encounters with Blood Transfusion

Risk Variable Maternal Age

Supplemental Data Guidance : For every patient evaluated by this measure also identify payer, race, ethnicity and sex for stratified hospital-specific reports after data submission. The variable calculated gestational age, SOC diagnosis details, and SOC procedure details are derived or calculated from diagnosis and encounter data provided in the QRDA I on the receiving end and thus, are not additionally submitted by hospitals.
Risk Adjustment Variable Guidance : The Severe Obstetric Complications Risk Adjustment Methodology Report is available on the eCQI Resource Center (https://ecqi.healthit.gov). Pre-existing conditions and variables must be present on admission. Please note that present on admission codes may be extracted from billing/claims data that was entered by coding staff (Leonard, Kennedy, Carmichael, Lyell, & Main, 2020; Main, Leonard, & Menard, 2020). - Anemia (includes sickle cell disease) - Asthma - Autoimmune Disease - Bariatric Surgery - Bleeding Disorder - Cardiac Disease - Economic Housing Instability - Gastrointestinal Disease - Gestational Diabetes - HIV - Hypertension - Long-term Anticoagulant Use - Maternal Age (derived from birthdate) - Mental Health Disorder - Morbid Obesity - Multiple Pregnancy - Neuromuscular Disease - Obstetric VTE - Other Pre-eclampsia - Placenta Previa - Placental Abruption - Placental Accreta Spectrum - Pre-existing Diabetes - Preterm Birth - Previous Cesarean - Pulmonary Hypertension - Renal Disease - Severe Pre-eclampsia - Substance Abuse - Thyrotoxicosis Lab and Physical Exam Results: Report the first resulted value 24 hours prior to start of encounter and before time of delivery in UCUM units specified: - Heart rate: {beats}/min - Systolic blood pressure: mm[Hg] - Hematocrit: % - White blood cell count: 10*3/uL Note regarding submission of risk variable data: The risk variable definitions are included in the specifications and risk variable data should be sent with eCQM data in the QRDA I file. Specific risk variable templates are not needed in the QRDA I files.
Libraries:
CMS1028FHIRPCSevereOBComps
Terminology and Other Dependencies:
  • Library/PCMaternal|5.19.000
  • Library/CQMCommon|2.2.000
  • Library/FHIRHelpers|4.4.000
  • Library/QICoreCommon|2.1.000
  • Library/SupplementalDataElements|3.5.000
  • Logical Observation Identifiers, Names and Codes (LOINC)
  • AdministrativeGender
  • Encounter Inpatient
  • Delivery Procedures
  • Observation Services
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.369
  • Estimated Gestational Age at Delivery
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.67
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.63
  • Asthma
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.370
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.255
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.256
  • Patient Expired
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.213
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.388
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.358
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.357
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.359
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.360
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.302
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.308
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.332
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.299
  • Payer
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.305
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.290
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.275
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.317
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.78
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.287
  • White blood cells count lab test
  • Hematocrit lab test
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.327
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.323
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.341
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.366
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.233
  • Acute Myocardial Infarction (AMI)
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.53
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.214
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.243
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.217
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.219
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.221
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.223
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.225
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.227
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.229
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.231
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.237
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.235
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.239
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.241
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.320
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.335
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.338
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.281
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.296
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.329
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.292
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.272
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.314
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.363
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.311
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.278
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.269
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.284
  • Parameters:
    name use min max type
    Measurement Period In 0 1 Period
    Risk Variable Asthma Out 0 * Resource
    SDE Delivery Encounters with Severe Obstetric Complication Diagnosis Out 0 * Resource
    Risk Variable Placental Accreta Spectrum Out 0 * Resource
    Risk Variable Neuromuscular Out 0 * Resource
    Risk Variable Hypertension Out 0 * Resource
    SOC with Hysterectomy or Blood Transfusion with Placenta Increta or Placenta Percreta Without Additional SOC Out 0 * Resource
    Risk Variable Preterm Birth Out 0 * Resource
    SDE Payer Out 0 * Resource
    Risk Variable Placental Abruption Out 0 * Resource
    Risk Variable Morbid Obesity Out 0 * Resource
    Risk Variable Preexisting Diabetes Out 0 * Resource
    Risk Variable Bariatric Surgery Out 0 * Resource
    SDE Race Out 0 1 Resource
    Risk Variable Placenta Previa Out 0 * Resource
    SDE Sex Out 0 1 Coding
    Risk Variable Bleeding Disorder Out 0 * Resource
    Risk Variable First White Blood Cell Count Lab Test Out 0 * Resource
    Risk Variable First Hematocrit Lab Test Out 0 * Resource
    Risk Variable Severe Preeclampsia Out 0 * Resource
    Risk Variable Anemia Out 0 * Resource
    Risk Variable Cardiac Disease Out 0 * Resource
    Risk Variable Long Term Anticoagulant Use Out 0 * Resource
    Risk Variable Systolic Blood Pressure Out 0 * Resource
    SDE SOC Diagnoses Detail Out 0 * Resource
    Risk Variable Substance Abuse Out 0 * Resource
    Risk Variable Renal Disease Out 0 * Resource
    SDE Variable Calculated Gestational Age Out 0 * Resource
    Risk Variable Gastrointestinal Disease Out 0 * Resource
    Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions Only Out 0 * Resource
    Risk Variable Pulmonary Hypertension Out 0 * Resource
    Risk Variable Thyrotoxicosis Out 0 * Resource
    Risk Variable Other Preeclampsia Out 0 * Resource
    Initial Population Out 0 * Resource
    Risk Variable Economic Housing Instability Out 0 * Resource
    Risk Variable HIV Out 0 * Resource
    SDE Delivery Encounters with Severe Obstetric Complication Procedures Out 0 * Resource
    SOC Excluding Blood Transfusions Only with Hysterectomy or Blood Transfusion with Placenta Increta or Placenta Percreta Without Additional SOC Out 0 * Resource
    Risk Variable Heart Rate Out 0 * Resource
    Risk Variable Maternal Age Out 0 * Resource
    Risk Variable Mental Health Disorder Out 0 * Resource
    Risk Variable Obstetrical VTE Out 0 * Resource
    Risk Variable Autoimmune Disease Out 0 * Resource
    Risk Variable Previous Cesarean Out 0 * Resource
    Risk Variable Gestational Diabetes Out 0 * Resource
    SDE SOC Procedure Detail Out 0 * Resource
    Numerator Out 0 * Resource
    Risk Variable Multiple Pregnancy Out 0 * Resource
    Denominator Out 0 * Resource
    Delivery Encounters with Blood Transfusion Out 0 * Resource
    SDE Ethnicity Out 0 1 Resource
    DataRequirements:
    Resource Type Resource Elements Valueset Name Valueset
    Encounter(QICoreEncounter) type period status status.value condition condition.reference condition.reference.value extension condition.code hospitalization hospitalization.dischargeDisposition id id.value Observation Services Observation Services
    Encounter(QICoreEncounter) type period status status.value condition condition.reference condition.reference.value extension condition.code hospitalization hospitalization.dischargeDisposition id id.value ED Visit and OB Triage http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.369
    Encounter(QICoreEncounter) type status status.value period condition condition.reference condition.reference.value extension condition.code hospitalization hospitalization.dischargeDisposition id id.value Encounter Inpatient Encounter Inpatient
    Patient(QICorePatient) race ethnicity
    Procedure(QICoreProcedure) code status status.value performed Delivery Procedures Delivery Procedures
    Procedure(QICoreProcedure) code status status.value performed Severe Maternal Morbidity Procedures http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.256
    Procedure(QICoreProcedure) code status status.value performed Hysterectomy http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.358
    Procedure(QICoreProcedure) code status status.value performed Conversion of Cardiac Rhythm http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.357
    Procedure(QICoreProcedure) code status status.value performed Tracheostomy http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.359
    Procedure(QICoreProcedure) code status status.value performed Ventilation http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.360
    Procedure(QICoreProcedure) code status status.value performed Severe Maternal Morbidity Procedures http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.256
    Procedure(QICoreProcedure) code status status.value performed Blood Transfusion http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.213
    Procedure(QICoreProcedure) code status status.value performed Blood Transfusion http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.213
    Observation(QICoreObservation) code value status status.value effective
    Observation(QICoreObservation) code value status status.value effective
    Observation(QICoreObservation) code effective value status status.value Estimated Gestational Age at Delivery Estimated Gestational Age at Delivery
    Condition(QICoreCondition) id id.value code
    Coverage(QICoreCoverage) type period Payer Type Payer
    Observation(US Core Laboratory Result Observation Profile) code issued issued.value status status.value value White blood cells count lab test White blood cells count lab test
    Observation(US Core Laboratory Result Observation Profile) code issued issued.value status status.value value Hematocrit lab test Hematocrit lab test
    Observation(Observation Blood Pressure Profile) effective status status.value component
    Observation(Observation Heart Rate Profile) effective status status.value value
    Direct Reference Codes:
    display code system
    Date and time of obstetric delivery 93857-1 http://loinc.org
    Delivery date Estimated 11778-8 http://loinc.org
    Male M http://hl7.org/fhir/administrative-gender
    Female F http://hl7.org/fhir/administrative-gender
    Systolic BP 8480-6 http://loinc.org
    Logic Definitions:
    Group Scoring Population Criteria Expression
    6750921446b6174510cfeb95 Group scoring: proportion
    Type:

    Outcome

    Rate Aggregation: Two hospital-level measure scores are calculated as a risk-adjusted proportion reported as a rate per 10,000 delivery hospitalizations: 1. All Severe Obstetric Complications (SOC). ((Num1 – NumExcl1) / Den) * 10,000 2. SOC excluding encounters where transfusion was the only SOC. ((Num2 – NumExcl2) / Den) * 10,000 Num1: Delivery encounters with SOC Num2: Delivery encounters with SOC excluding encounters where transfusion was the only SOC NumExcl1: Delivery encounters with blood transfusion or hysterectomy with placenta percreta or placenta increta and no additional SOCs NumExcl2: Delivery encounters with SOC excluding encounters where transfusion was the only SOC with a hysterectomy or blood transfusion with a diagnosis of placenta percreta or placenta increta and no additional SOCs Den: Delivery encounters with > or = 20 weeks' gestation completed
    Improvement Notation:

    Decreased score indicates improvement

    Initial Population
    define "Initial Population":
      PCMaternal."Delivery Encounter with Age Range"
    Denominator
    define "Denominator":
      "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation"
    Numerator
    define "Numerator":
      "Delivery Encounters with Severe Obstetric Complications"
    Numerator Exclusion
    define "SOC with Hysterectomy or Blood Transfusion with Placenta Increta or Placenta Percreta Without Additional SOC":
      ( "Delivery Encounters with Severe Obstetric Complications" SOCEncounter
          where exists ( ( SOCEncounter.encounterDiagnosis ( ) ) EncounterDiagnosis
              where EncounterDiagnosis.code in "Placenta Increta or Percreta"
          )
            and ( exists "Delivery Encounters with Blood Transfusion"
                or exists "Delivery Encounters with Hysterectomy"
            )
      )
    	//The following logic keeps encounter in the numerator if there is an additional SOC besides Blood Transfusion or Hysterectomy
        
        except ( ( "Delivery Encounters with Severe Obstetric Complications" SOCEncounter
              where ( SOCEncounter.pOAIsNoOrUTD ( ) in "Severe Maternal Morbidity Diagnoses" )
          )
            union "Delivery Encounters with Cardiac Conversion, Tracheostomy or Ventilation Procedures"
            union "Delivery Encounters with Expiration"
        )
    6750921446b6174510cfeb96 Group scoring: proportion
    Type:

    Outcome

    Rate Aggregation: Two hospital-level measure scores are calculated as a risk-adjusted proportion reported as a rate per 10,000 delivery hospitalizations: 1. All Severe Obstetric Complications (SOC). ((Num1 – NumExcl1) / Den) * 10,000 2. SOC excluding encounters where transfusion was the only SOC. ((Num2 – NumExcl2) / Den) * 10,000 Num1: Delivery encounters with SOC Num2: Delivery encounters with SOC excluding encounters where transfusion was the only SOC NumExcl1: Delivery encounters with blood transfusion or hysterectomy with placenta percreta or placenta increta and no additional SOCs NumExcl2: Delivery encounters with SOC excluding encounters where transfusion was the only SOC with a hysterectomy or blood transfusion with a diagnosis of placenta percreta or placenta increta and no additional SOCs Den: Delivery encounters with > or = 20 weeks' gestation completed
    Improvement Notation:

    Decreased score indicates improvement

    Initial Population
    define "Initial Population":
      PCMaternal."Delivery Encounter with Age Range"
    Denominator
    define "Denominator":
      "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation"
    Numerator
    define "Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions Only":
      "Delivery Encounters with Severe Obstetric Complications"
        intersect "Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions"
    Numerator Exclusion
    define "SOC Excluding Blood Transfusions Only with Hysterectomy or Blood Transfusion with Placenta Increta or Placenta Percreta Without Additional SOC":
      ( "Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions Only" SOCExcludingTransfusion
          where exists ( ( SOCExcludingTransfusion.encounterDiagnosis ( ) ) EncounterDiagnoses
              where EncounterDiagnoses.code in "Placenta Increta or Percreta"
          )
            and ( exists "Delivery Encounters with Blood Transfusion"
                or exists "Delivery Encounters with Hysterectomy"
            )
      )
    	
    	//The following logic keeps encounter in the numerator if there is an additional SOC besides Blood Transfusion or Hysterectomy
        
        except ( ( "Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions Only" SOCExcludingTransfusion
              where SOCExcludingTransfusion.pOAIsNoOrUTD ( ) in "Severe Maternal Morbidity Diagnoses"
          )
            union "Delivery Encounters with Cardiac Conversion, Tracheostomy or Ventilation Procedures"
            union "Delivery Encounters with Expiration"
        )
    Library Name Name
    CQMCommon Inpatient Encounter
    define "Inpatient Encounter":
      [Encounter: "Encounter Inpatient"] EncounterInpatient
    		where EncounterInpatient.status = 'finished'
    		and EncounterInpatient.period ends during day of "Measurement Period"
    Library Name Name
    PCMaternal Encounter with Age Range
    define "Encounter with Age Range":
     CQMCommon."Inpatient Encounter" InpatientEncounter
                          where AgeInYearsAt(date from start of InpatientEncounter.period) in Interval[ 8, 65 )
    Library Name Name
    PCMaternal Delivery Encounter with Age Range
    define "Delivery Encounter with Age Range":
      "Encounter with Age Range" EncounterWithAge
                    with ["Procedure": "Delivery Procedures"] DeliveryProcedure
                    such that DeliveryProcedure.status = 'completed'
                    and DeliveryProcedure.performed.toInterval  ( ) starts during EncounterWithAge.hospitalizationWithEDOBTriageObservation ()
    Library Name Name
    CMS1028FHIRPCSevereOBComps Delivery Encounters with Calculated Gestational Age Greater than or Equal to 20 Weeks
    define "Delivery Encounters with Calculated Gestational Age Greater than or Equal to 20 Weeks":
      PCMaternal."Delivery Encounter with Age Range" DeliveryEncounter
        where DeliveryEncounter.calculatedGestationalAge ( ) >= 20
    Library Name Name
    CMS1028FHIRPCSevereOBComps Delivery Encounters with Estimated Gestational Age Assessment Greater than or Equal to 20 Weeks
    define "Delivery Encounters with Estimated Gestational Age Assessment Greater than or Equal to 20 Weeks":
      PCMaternal."Delivery Encounter with Age Range" DeliveryEncounter
        where DeliveryEncounter.calculatedGestationalAge ( ) is null
          and ( DeliveryEncounter.lastEstimatedGestationalAge ( ) >= 20 weeks )
    Library Name Name
    CMS1028FHIRPCSevereOBComps Delivery Encounters with Gestational Age Greater than or Equal to 20 Weeks Based on Coding
    define "Delivery Encounters with Gestational Age Greater than or Equal to 20 Weeks Based on Coding":
      PCMaternal."Delivery Encounter with Age Range" DeliveryEncounter
        let CGA: DeliveryEncounter.calculatedGestationalAge ( ),
        EGA: DeliveryEncounter.lastEstimatedGestationalAge ( )
        where CGA is null
          and EGA is null
          and exists ( ( DeliveryEncounter.encounterDiagnosis ( ) ) EncounterDiagnosis
              where EncounterDiagnosis.code in "20 to 42 Plus Weeks Gestation"
          )
    Library Name Name
    CMS1028FHIRPCSevereOBComps Delivery Encounters At Greater than or Equal to 20 Weeks Gestation
    define "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation":
      "Delivery Encounters with Calculated Gestational Age Greater than or Equal to 20 Weeks"
        union "Delivery Encounters with Estimated Gestational Age Assessment Greater than or Equal to 20 Weeks"
        union "Delivery Encounters with Gestational Age Greater than or Equal to 20 Weeks Based on Coding"
    Library Name Name
    CMS1028FHIRPCSevereOBComps Risk Variable Asthma
    define "Risk Variable Asthma":
      "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
        where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Acute or Persistent Asthma"
    Library Name Name
    CMS1028FHIRPCSevereOBComps Delivery Encounters with Severe Obstetric Complications Diagnosis or Procedure Excluding Blood Transfusion
    define "Delivery Encounters with Severe Obstetric Complications Diagnosis or Procedure Excluding Blood Transfusion":
      "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
        where TwentyWeeksPlusEncounter.pOAIsNoOrUTD ( ) in "Severe Maternal Morbidity Diagnoses"
          or exists ( ["Procedure": "Severe Maternal Morbidity Procedures"] SMMProcedures
              where SMMProcedures.status = 'completed'
                and SMMProcedures.performed.toInterval ( ) starts during day of TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation ( )
          )
    Library Name Name
    CMS1028FHIRPCSevereOBComps Delivery Encounters with Expiration
    define "Delivery Encounters with Expiration":
      "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
        where TwentyWeeksPlusEncounter.hospitalization.dischargeDisposition in "Patient Expired"
    Library Name Name
    CMS1028FHIRPCSevereOBComps Delivery Encounters with Blood Transfusion
    define "Delivery Encounters with Blood Transfusion":
      "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
        with ["Procedure": "Blood Transfusion"] BloodTransfusion
          such that BloodTransfusion.status = 'completed'
            and BloodTransfusion.performed.toInterval ( ) starts during day of TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation ( )
    Library Name Name
    CMS1028FHIRPCSevereOBComps Delivery Encounters with Severe Obstetric Complications
    define "Delivery Encounters with Severe Obstetric Complications":
      "Delivery Encounters with Severe Obstetric Complications Diagnosis or Procedure Excluding Blood Transfusion"
        union "Delivery Encounters with Expiration"
        union "Delivery Encounters with Blood Transfusion"
    Library Name Name
    CMS1028FHIRPCSevereOBComps Delivery Encounters with Hysterectomy
    define "Delivery Encounters with Hysterectomy":
      "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
        with ["Procedure": "Hysterectomy"] Hysterectomy
          such that Hysterectomy.status = 'completed'
            and Hysterectomy.performed.toInterval ( ) starts during day of TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation ( )
    Library Name Name
    CMS1028FHIRPCSevereOBComps Cardiac Conversion, Tracheostomy or Ventilation Procedures
    define "Cardiac Conversion, Tracheostomy or Ventilation Procedures":
      ["Procedure": "Conversion of Cardiac Rhythm"]
        union ["Procedure": "Tracheostomy"]
        union ["Procedure": "Ventilation"]
    Library Name Name
    CMS1028FHIRPCSevereOBComps Delivery Encounters with Cardiac Conversion, Tracheostomy or Ventilation Procedures
    define "Delivery Encounters with Cardiac Conversion, Tracheostomy or Ventilation Procedures":
      "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
        with "Cardiac Conversion, Tracheostomy or Ventilation Procedures" ConvTrachVentProcedures
          such that ConvTrachVentProcedures.status = 'completed'
            and ConvTrachVentProcedures.performed.toInterval ( ) starts during day of TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation ( )
    Library Name Name
    CMS1028FHIRPCSevereOBComps SOC with Hysterectomy or Blood Transfusion with Placenta Increta or Placenta Percreta Without Additional SOC
    define "SOC with Hysterectomy or Blood Transfusion with Placenta Increta or Placenta Percreta Without Additional SOC":
      ( "Delivery Encounters with Severe Obstetric Complications" SOCEncounter
          where exists ( ( SOCEncounter.encounterDiagnosis ( ) ) EncounterDiagnosis
              where EncounterDiagnosis.code in "Placenta Increta or Percreta"
          )
            and ( exists "Delivery Encounters with Blood Transfusion"
                or exists "Delivery Encounters with Hysterectomy"
            )
      )
    	//The following logic keeps encounter in the numerator if there is an additional SOC besides Blood Transfusion or Hysterectomy
        
        except ( ( "Delivery Encounters with Severe Obstetric Complications" SOCEncounter
              where ( SOCEncounter.pOAIsNoOrUTD ( ) in "Severe Maternal Morbidity Diagnoses" )
          )
            union "Delivery Encounters with Cardiac Conversion, Tracheostomy or Ventilation Procedures"
            union "Delivery Encounters with Expiration"
        )
    Library Name Name
    CMS1028FHIRPCSevereOBComps SDE Delivery Encounters with Severe Obstetric Complication Diagnosis
    define "SDE Delivery Encounters with Severe Obstetric Complication Diagnosis":
      ( "Delivery Encounters with Severe Obstetric Complications"
        except "SOC with Hysterectomy or Blood Transfusion with Placenta Increta or Placenta Percreta Without Additional SOC" ) Encounter
        where Encounter.pOAIsNoOrUTD ( ) in "Severe Maternal Morbidity Diagnoses"
    Library Name Name
    CMS1028FHIRPCSevereOBComps Risk Variable Placental Accreta Spectrum
    define "Risk Variable Placental Accreta Spectrum":
      "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
        where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Placenta Accreta"
          or TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Placenta Increta or Percreta"
    Library Name Name
    CMS1028FHIRPCSevereOBComps Risk Variable Neuromuscular
    define "Risk Variable Neuromuscular":
      "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
        where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Neuromuscular Disease"
    Library Name Name
    CMS1028FHIRPCSevereOBComps Risk Variable Hypertension
    define "Risk Variable Hypertension":
      "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
        where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Hypertension"
    Library Name Name
    CMS1028FHIRPCSevereOBComps Risk Variable Preterm Birth
    define "Risk Variable Preterm Birth":
    /*  CGA = Calculated Gestational Age.  EGA = Estimated Gestational Age. */
      
      ( PCMaternal."Delivery Encounter with Age Range" DeliveryEncounter
          let CGA: DeliveryEncounter.calculatedGestationalAge ( ),
          EGA: DeliveryEncounter.lastEstimatedGestationalAge ( )
          where CGA in Interval[20, 36]
            or ( CGA is null
                and ( EGA >= 20 weeks
                    and EGA <= 36 weeks
                )
            )
      )
        union ( PCMaternal."Delivery Encounter with Age Range" DeliveryEncounter
            let CGA: DeliveryEncounter.calculatedGestationalAge ( ),
            EGA: DeliveryEncounter.lastEstimatedGestationalAge ( )
            where CGA is null
              and EGA is null
              and DeliveryEncounter.pOAIsYesOrExempt ( ) in "Preterm Birth"
        )
    Library Name Name
    SupplementalDataElements SDE Payer
    define "SDE Payer":
      [Coverage: type in "Payer Type"] Payer
        return {
          code: Payer.type,
          period: Payer.period
        }
    Library Name Name
    CMS1028FHIRPCSevereOBComps SDE Payer
    define "SDE Payer":
      SDE."SDE Payer"
    Library Name Name
    CMS1028FHIRPCSevereOBComps Risk Variable Placental Abruption
    define "Risk Variable Placental Abruption":
      "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
        where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Placental Abruption"
    Library Name Name
    CMS1028FHIRPCSevereOBComps Risk Variable Morbid Obesity
    define "Risk Variable Morbid Obesity":
      "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
        where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Morbid or Severe Obesity"
    Library Name Name
    CMS1028FHIRPCSevereOBComps Risk Variable Preexisting Diabetes
    define "Risk Variable Preexisting Diabetes":
      "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
        where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Preexisting Diabetes"
    Library Name Name
    CMS1028FHIRPCSevereOBComps Risk Variable Bariatric Surgery
    define "Risk Variable Bariatric Surgery":
      "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
        where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Bariatric Surgery"
    Library Name Name
    SupplementalDataElements SDE Race
    define "SDE Race":
      Patient.race R
        return Tuple {
          codes: R.ombCategory union R.detailed,
          display: R.text
        }
    Library Name Name
    CMS1028FHIRPCSevereOBComps SDE Race
    define "SDE Race":
      SDE."SDE Race"
    Library Name Name
    CMS1028FHIRPCSevereOBComps Risk Variable Placenta Previa
    define "Risk Variable Placenta Previa":
      "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
        where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Placenta Previa"
    Library Name Name
    SupplementalDataElements SDE Sex
    define "SDE Sex":
      case
        when Patient.gender = 'male' then "M"
        when Patient.gender = 'female' then "F"
        else null
      end
    Library Name Name
    CMS1028FHIRPCSevereOBComps SDE Sex
    define "SDE Sex":
      SDE."SDE Sex"
    Library Name Name
    CMS1028FHIRPCSevereOBComps Risk Variable Bleeding Disorder
    define "Risk Variable Bleeding Disorder":
      "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
        where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Bleeding Disorder"
    Library Name Name
    CMS1028FHIRPCSevereOBComps Risk Variable First White Blood Cell Count Lab Test
    //First resulted value 24 hours prior to start of encounter and before time of delivery
     //Report white blood cell count as 10*3/uL
    
    
    
    define "Risk Variable First White Blood Cell Count Lab Test":
      "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
        let FirstWBC: First(["USCoreLaboratoryResultObservationProfile": "White blood cells count lab test"] WBC
            where WBC.issued during Interval[start of TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation() - 1440 minutes, TwentyWeeksPlusEncounter.lastTimeOfDelivery()]
              and WBC.status in { 'final', 'amended', 'corrected' }
              and WBC.value is not null
            sort by issued.earliest()
        )
        return {
          EncounterId: TwentyWeeksPlusEncounter.id,
          FirstWBCResult: FirstWBC.value as Quantity,
          Timing: FirstWBC.issued
        }
    Library Name Name
    CMS1028FHIRPCSevereOBComps Risk Variable First Hematocrit Lab Test
    //First resulted value 24 hours prior to start of encounter and before time of delivery
     //Report hematocrit as %
    
    
    
    define "Risk Variable First Hematocrit Lab Test":
      "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
        let FirstHematocrit: First(["USCoreLaboratoryResultObservationProfile": "Hematocrit lab test"] Hematocrit
            where Hematocrit.issued during Interval[start of TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation() - 1440 minutes, TwentyWeeksPlusEncounter.lastTimeOfDelivery()]
              and Hematocrit.status in { 'final', 'amended', 'corrected' }
              and Hematocrit.value is not null
            sort by issued.earliest()
        )
        return {
          EncounterId: TwentyWeeksPlusEncounter.id,
          FirstHematocritResult: FirstHematocrit.value as Quantity,
          Timing: FirstHematocrit.issued
        }
    Library Name Name
    CMS1028FHIRPCSevereOBComps Risk Variable Severe Preeclampsia
    define "Risk Variable Severe Preeclampsia":
      "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
        where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Severe Preeclampsia"
    Library Name Name
    CMS1028FHIRPCSevereOBComps Risk Variable Anemia
    define "Risk Variable Anemia":
      "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
        where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Anemia"
    Library Name Name
    CMS1028FHIRPCSevereOBComps Risk Variable Cardiac Disease
    define "Risk Variable Cardiac Disease":
      "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
        where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Cardiac Disease"
    Library Name Name
    CMS1028FHIRPCSevereOBComps Risk Variable Long Term Anticoagulant Use
    define "Risk Variable Long Term Anticoagulant Use":
      "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
        where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Long Term Anticoagulant Use"
    Library Name Name
    CMS1028FHIRPCSevereOBComps Risk Variable Systolic Blood Pressure
    //First resulted value 24 hours prior to start of encounter and before time of delivery
    //Report systolic blood pressure as mm[Hg]
    //Systolic blood pressure value cannot be null per QICore profile requirement.
    
    
    
    
    define "Risk Variable Systolic Blood Pressure":
      "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
        let FirstSystolicBP: First(["observation-bp"] BP
            where BP.effective.earliest() during Interval[start of TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation() - 1440 minutes, TwentyWeeksPlusEncounter.lastTimeOfDelivery()]
              and BP.status in { 'final', 'amended', 'corrected' }
              and BP.component.value is not null
            sort by effective.earliest()
        )
        return {
          EncounterId: TwentyWeeksPlusEncounter.id,
          FirstSBPResult: FirstSystolicBP.component C
            where C.code ~ "Systolic blood pressure"
            return C.value as Quantity,
          Timing: FirstSystolicBP.effective.earliest ( )
        }
    Library Name Name
    CMS1028FHIRPCSevereOBComps SDE SOC Diagnoses Detail
    define "SDE SOC Diagnoses Detail":
      "SDE Delivery Encounters with Severe Obstetric Complication Diagnosis" Encounter
        let complication: Encounter.pOAIsNoOrUTD ( )
        return {
          id: Encounter.id,
    	  //  code: Encounter.type,
          
          complications: complication C
            where C in "Severe Maternal Morbidity Diagnoses"
            return {
              code: C,
              SOCDxCategory: C.sOCDxCategory ( )
            }
        }
    Library Name Name
    CMS1028FHIRPCSevereOBComps Risk Variable Substance Abuse
    define "Risk Variable Substance Abuse":
      "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
        where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Substance Abuse"
    Library Name Name
    CMS1028FHIRPCSevereOBComps Risk Variable Renal Disease
    define "Risk Variable Renal Disease":
      "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
        where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Renal Disease"
    Library Name Name
    PCMaternal Variable Calculated Gestational Age
    define "Variable Calculated Gestational Age":
     // This definition establishes a variable of CGA (Calculated Gestational Age).  CGA is a supplemental data element to store the calculated gestational age result from the "CalculatedGestationalAge" function.  The data element enables the capturing and saving of the CGA for data analysis post data receipt. Hospitals do not need to submit any additional data to comply with this definition
      "Delivery Encounter with Age Range" DeliveryEncounter
        let CGA: DeliveryEncounter.calculatedGestationalAge()
      //  return { QualifyingEncounter, CGA }
        return {
          EncounterID: DeliveryEncounter.id,
          CalculatedCGA: CGA
        }
    Library Name Name
    CMS1028FHIRPCSevereOBComps SDE Variable Calculated Gestational Age
    define "SDE Variable Calculated Gestational Age":
      //This definition establishes a variable of CGA (Calculated Gestational Age).  CGA is a supplemental data element to store the calculated gestational age result from the "CalculatedGestationalAge" function.  The data element enables the capturing and saving of the CGA for data analysis post data receipt. Hospitals do not need to submit any additional data to comply with this definition. 
      
      PCMaternal."Variable Calculated Gestational Age"
    Library Name Name
    CMS1028FHIRPCSevereOBComps Risk Variable Gastrointestinal Disease
    define "Risk Variable Gastrointestinal Disease":
      "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
        where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Gastrointestinal Disease"
    Library Name Name
    CMS1028FHIRPCSevereOBComps Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions
    define "Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions":
      "Delivery Encounters with Severe Obstetric Complications Diagnosis or Procedure Excluding Blood Transfusion"
        union "Delivery Encounters with Expiration"
    Library Name Name
    CMS1028FHIRPCSevereOBComps Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions Only
    define "Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions Only":
      "Delivery Encounters with Severe Obstetric Complications"
        intersect "Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions"
    Library Name Name
    CMS1028FHIRPCSevereOBComps Risk Variable Pulmonary Hypertension
    define "Risk Variable Pulmonary Hypertension":
      "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
        where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Pulmonary Hypertension"
    Library Name Name
    CMS1028FHIRPCSevereOBComps Risk Variable Thyrotoxicosis
    define "Risk Variable Thyrotoxicosis":
      "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
        where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Thyrotoxicosis"
    Library Name Name
    CMS1028FHIRPCSevereOBComps Risk Variable Other Preeclampsia
    define "Risk Variable Other Preeclampsia":
      "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
        where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Mild or Moderate Preeclampsia"
    Library Name Name
    CMS1028FHIRPCSevereOBComps Initial Population
    define "Initial Population":
      PCMaternal."Delivery Encounter with Age Range"
    Library Name Name
    CMS1028FHIRPCSevereOBComps Risk Variable Economic Housing Instability
    define "Risk Variable Economic Housing Instability":
      "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
        where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Economic Housing Instability"
    Library Name Name
    CMS1028FHIRPCSevereOBComps Risk Variable HIV
    define "Risk Variable HIV":
      "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
        where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "HIV in Pregnancy Childbirth and Puerperium"
    Library Name Name
    CMS1028FHIRPCSevereOBComps SDE Delivery Encounters with Severe Obstetric Complication Procedures
    define "SDE Delivery Encounters with Severe Obstetric Complication Procedures":
      ( "Delivery Encounters with Severe Obstetric Complications"
        except "SOC with Hysterectomy or Blood Transfusion with Placenta Increta or Placenta Percreta Without Additional SOC" ) Encounter
        where exists ( ["Procedure": "Severe Maternal Morbidity Procedures"]
          union ["Procedure": "Blood Transfusion"] ) SMMProcedures
          where SMMProcedures.status = 'completed'
            and SMMProcedures.performed.toInterval ( ) starts during day of Encounter.hospitalizationWithEDOBTriageObservation ( )
    Library Name Name
    CMS1028FHIRPCSevereOBComps SOC Excluding Blood Transfusions Only with Hysterectomy or Blood Transfusion with Placenta Increta or Placenta Percreta Without Additional SOC
    define "SOC Excluding Blood Transfusions Only with Hysterectomy or Blood Transfusion with Placenta Increta or Placenta Percreta Without Additional SOC":
      ( "Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions Only" SOCExcludingTransfusion
          where exists ( ( SOCExcludingTransfusion.encounterDiagnosis ( ) ) EncounterDiagnoses
              where EncounterDiagnoses.code in "Placenta Increta or Percreta"
          )
            and ( exists "Delivery Encounters with Blood Transfusion"
                or exists "Delivery Encounters with Hysterectomy"
            )
      )
    	
    	//The following logic keeps encounter in the numerator if there is an additional SOC besides Blood Transfusion or Hysterectomy
        
        except ( ( "Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions Only" SOCExcludingTransfusion
              where SOCExcludingTransfusion.pOAIsNoOrUTD ( ) in "Severe Maternal Morbidity Diagnoses"
          )
            union "Delivery Encounters with Cardiac Conversion, Tracheostomy or Ventilation Procedures"
            union "Delivery Encounters with Expiration"
        )
    Library Name Name
    CMS1028FHIRPCSevereOBComps Risk Variable Heart Rate
    //First resulted value 24 hours prior to start of encounter and before time of delivery
     //Report heart rate as beats/min
     //Heart rate value cannot be null per QICore profile requirement.
    
    
    
    
    define "Risk Variable Heart Rate":
      "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
        let FirstHeartRate: First(["observation-heartrate"] HeartRate
            where HeartRate.effective.earliest() during Interval[start of TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation() - 1440 minutes, TwentyWeeksPlusEncounter.lastTimeOfDelivery()]
              and HeartRate.status in { 'final', 'amended', 'corrected' }
            sort by effective.earliest()
        )
        return {
          EncounterId: TwentyWeeksPlusEncounter.id,
          FirstHRResult: FirstHeartRate.value as Quantity,
          Timing: FirstHeartRate.effective.earliest ( )
        }
    Library Name Name
    CMS1028FHIRPCSevereOBComps Risk Variable Maternal Age
    define "Risk Variable Maternal Age":
      "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
        let MaternalAge: AgeInYearsAt(date from start of TwentyWeeksPlusEncounter.period)
        return { TwentyWeeksPlusEncounter, MaternalAge }
    Library Name Name
    CMS1028FHIRPCSevereOBComps Risk Variable Mental Health Disorder
    define "Risk Variable Mental Health Disorder":
      "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
        where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Mental Health Disorder"
    Library Name Name
    CMS1028FHIRPCSevereOBComps Risk Variable Obstetrical VTE
    define "Risk Variable Obstetrical VTE":
      "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
        where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Venous Thromboembolism in Pregnancy"
    Library Name Name
    CMS1028FHIRPCSevereOBComps Risk Variable Autoimmune Disease
    define "Risk Variable Autoimmune Disease":
      "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
        where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Autoimmune Disease"
    Library Name Name
    CMS1028FHIRPCSevereOBComps Risk Variable Previous Cesarean
    define "Risk Variable Previous Cesarean":
      "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
        where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Previous Cesarean"
    Library Name Name
    CMS1028FHIRPCSevereOBComps Risk Variable Gestational Diabetes
    define "Risk Variable Gestational Diabetes":
      "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
        where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Gestational Diabetes"
    Library Name Name
    CMS1028FHIRPCSevereOBComps SDE SOC Procedure Detail
    define "SDE SOC Procedure Detail":
      "SDE Delivery Encounters with Severe Obstetric Complication Procedures" Encounter
        let procedure: Encounter.sOCProcedures ( )
        return {
          id: Encounter.id,
     //   code: Encounter.code,
          
          procedures: procedure P
            return {
              code: P,
              SOCProcedureCategory: P.sOCProcedureCategory ( )
            }
        }
    Library Name Name
    CMS1028FHIRPCSevereOBComps Numerator
    define "Numerator":
      "Delivery Encounters with Severe Obstetric Complications"
    Library Name Name
    CMS1028FHIRPCSevereOBComps Risk Variable Multiple Pregnancy
    define "Risk Variable Multiple Pregnancy":
      "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
        where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in "Multiple Pregnancy"
    Library Name Name
    CMS1028FHIRPCSevereOBComps Denominator
    define "Denominator":
      "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation"
    Library Name Name
    SupplementalDataElements SDE Ethnicity
    define "SDE Ethnicity":
      Patient.ethnicity E
        return Tuple {
          codes: { E.ombCategory } union E.detailed,
          display: E.text
        }
    Library Name Name
    CMS1028FHIRPCSevereOBComps SDE Ethnicity
    define "SDE Ethnicity":
      SDE."SDE Ethnicity"
    Library Name Name
    PCMaternal hospitalizationWithEDOBTriageObservation
    /*define function "HospitalizationWithEDOBTriageObservation"(Encounter Encounter ):
      HospitalizationWithEDOBTriageObservation returns the total interval from the start of any immediately prior emergency department visit or OB Triage visit through the observation visit to the discharge of the given encounter
      Encounter Visit
        let ObsVisit: Last(["Encounter": "Observation Services"] LastObs
            where LastObs.period ends 1 hour or less on or before start of Visit.period
              and LastObs.status = 'finished'
            sort by 
            end of period
        ),
        VisitStart: Coalesce(start of ObsVisit.period, start of Visit.period),
        EDOBTriageVisit: Last(["Encounter": "ED Visit and OB Triage"] LastEDOBTriage
            where LastEDOBTriage.period ends 1 hour or less on or before VisitStart
              and LastEDOBTriage.status = 'finished'
            sort by 
            end of period
        )
        return Interval[Coalesce(start of EDOBTriageVisit.period, VisitStart), 
        end of Visit.period]*/
        
        
    define fluent function hospitalizationWithEDOBTriageObservation (TheEncounter Encounter ):
      /*hospitalizationWithEDOBTriageObservation returns the total interval from the start of any immediately prior emergency department visit or OB Triage visit through the observation visit to the discharge of the given encounter*/
      TheEncounter Visit
        let ObsVisit: Last(["Encounter": "Observation Services"] LastObs
            where LastObs.period ends 1 hour or less on or before start of Visit.period
              and LastObs.status = 'finished'
            sort by 
            end of period
        ),
        VisitStart: Coalesce(start of ObsVisit.period, start of Visit.period),
        EDOBTriageVisit: Last(["Encounter": "ED Visit and OB Triage"] LastEDOBTriage
            where LastEDOBTriage.period ends 1 hour or less on or before VisitStart
              and LastEDOBTriage.status = 'finished'
            sort by 
            end of period
        )
        return Interval[Coalesce(start of EDOBTriageVisit.period, VisitStart), 
        end of Visit.period]
    Library Name Name
    PCMaternal calculatedGestationalAge
    define fluent function calculatedGestationalAge (TheEncounter Encounter ):
      //Gestational Age = (280-(Estimated Delivery Date minus Reference Date/Delivery Date))/7
     ( 280 - ( difference in days between TheEncounter.lastTimeOfDelivery () and TheEncounter.lastEstimatedDeliveryDate( )) ) div 7
    Library Name Name
    PCMaternal lastTimeOfDelivery
    define fluent function lastTimeOfDelivery (TheEncounter Encounter ):
      Last(["Observation": "Date and time of obstetric delivery"] TimeOfDelivery
          where TimeOfDelivery.value as DateTime is not null
            and TimeOfDelivery.status in { 'final', 'amended', 'corrected' }
            and TimeOfDelivery.effective.earliest () during TheEncounter.hospitalizationWithEDOBTriageObservation ()
            and TimeOfDelivery.value as DateTime during TheEncounter.hospitalizationWithEDOBTriageObservation()
          sort by effective.earliest()
      ).value as DateTime
    Library Name Name
    QICoreCommon earliest
    /*
    @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
    Library Name Name
    PCMaternal lastEstimatedDeliveryDate
    /*===============================================================*/
      /*  03/14/2022 from MATGlobalCommonFunctionsv7.000 - latest QDM  */
      /*     even though this PCMaternalFHIR was derived from          */
      /*     PCMaternal=2.1.000 cql, to make next update easier.       */
      /*     Will need to re-insert "Global". in front of these        */
      /*     function names later (whereever they are directly used.*/
    
    define fluent function lastEstimatedDeliveryDate (TheEncounter Encounter ):
      /*This function identifies the last time the EDD was assessed 42 weeks or less prior to or on delivery and stores the result of that assessment.*/
      Last(["Observation": "Delivery date Estimated"] EstimatedDateOfDelivery
          where EstimatedDateOfDelivery.value as DateTime is not null
            and EstimatedDateOfDelivery.status in { 'final', 'amended', 'corrected' }
            and EstimatedDateOfDelivery.effective.earliest ( ) 42 weeks or less before or on TheEncounter.lastTimeOfDelivery ()
          sort by effective.earliest ( )
      ).value as DateTime
    Library Name Name
    PCMaternal lastEstimatedGestationalAge
    /*define fluent function lastEstimatedGestationalAge (TheEncounter Encounter ):
      Last(["Observation": "Estimated Gestational Age at Delivery"] EstimatedGestationalAge
          where EstimatedGestationalAge.value is not null
            and EstimatedGestationalAge.status in { 'final', 'amended', 'corrected' }
            and EstimatedGestationalAge.effective.earliest() 24 hours or less before or on TheEncounter.lastTimeOfDelivery ()
          sort by effective.earliest ()
      ).value as Quantity*/
      
      define fluent function lastEstimatedGestationalAge (TheEncounter Encounter ):
      Last(["Observation": "Estimated Gestational Age at Delivery"] EstimatedGestationalAge
      let EGATiming:  EstimatedGestationalAge.effective.earliest() where 
      (EGATiming 24 hours or less before or on TheEncounter.lastTimeOfDelivery () 
      and EstimatedGestationalAge.value is not null 
      and EstimatedGestationalAge.status in { 'final', 'amended', 'corrected' }) or 
          (EGATiming same day as TheEncounter.lastTimeOfDelivery () 
          and EGATiming during TheEncounter.hospitalizationWithEDOBTriageObservation() 
          and EstimatedGestationalAge.value is not null)
     sort by effective.earliest ())
             .value as Quantity
    Library Name Name
    CQMCommon encounterDiagnosis
    /*
    @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())
    Library Name Name
    QICoreCommon getId
    /*
    @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, '/'))
    Library Name Name
    CMS1028FHIRPCSevereOBComps pOAIsYesOrExempt
    define fluent function pOAIsYesOrExempt(TheEncounter Encounter):
      TheEncounter.diagnosis EncounterDiagnoses
        where EncounterDiagnoses.diagnosisPresentOnAdmission in "Present On Admission is Yes or Exempt"
        return EncounterDiagnoses.condition.getCondition ( ).code
    Library Name Name
    FHIRHelpers ToString
    define function ToString(value uri): value.value
    Library Name Name
    CQMCommon getCondition
    /*
    @description: Returns the Condition resource for the given reference
    */
    define fluent function getCondition(reference Reference):
      singleton from ([Condition] C where C.id = reference.reference.getId())
    Library Name Name
    CMS1028FHIRPCSevereOBComps pOAIsNoOrUTD
    define fluent function pOAIsNoOrUTD(TheEncounter Encounter):
      TheEncounter.diagnosis EncounterDiagnoses
        where EncounterDiagnoses.diagnosisPresentOnAdmission in "Present on Admission is No or Unable To Determine"
        return EncounterDiagnoses.condition.getCondition ( ).code
    Library Name Name
    FHIRHelpers ToCode
    /*
    @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
            }
    Library Name Name
    CMS1028FHIRPCSevereOBComps sOCDxCategory
    define fluent function sOCDxCategory(Dx Concept):
      case
        when Dx in "Acute Heart Failure" then 'Acute Heart Failure'
        when Dx in "Acute Myocardial Infarction" then 'Acute Myocardial Infarction'
        when Dx in "Acute Renal Failure" then 'Acute Renal Failure'
        when Dx in "Acute Respiratory Distress Syndrome" then 'Acute Respiratory Distress Syndrome'
        when Dx in "Air and Thrombotic Embolism" then 'Air and Thrombotic Embolism'
        when Dx in "Amniotic Fluid Embolism" then 'Amniotic Fluid Embolism'
        when Dx in "Aortic Aneurysm" then 'Aortic Aneurysm'
        when Dx in "Cardiac Arrest Ventricular Fibrillation" then 'Cardiac Arrest Ventricular Fibrillation'
        when Dx in "Disseminated Intravascular Coagulation" then 'Disseminated Intravascular Coagulation'
        when Dx in "Eclampsia" then 'Eclampsia'
        when Dx in "Heart Failure Cardiac Arrest Related to Procedure or Surgery" then 'Heart Failure Cardiac Arrest Related to Procedure or Surgery'
        when Dx in "Puerperal Cerebrovascular Disorder" then 'Puerperal Cerebrovascular Disorder'
        when Dx in "Pulmonary Edema" then 'Pulmonary Edema'
        when Dx in "Sepsis" then 'Sepsis'
        when Dx in "Severe Anesthesia Complications" then 'Severe Anesthesia Complications'
        when Dx in "Shock" then 'Shock'
        when Dx in "Sickle Cell Disease with Crisis" then 'Sickle Cell Disease with Crisis' 
        else null end
    Library Name Name
    CMS1028FHIRPCSevereOBComps sOCProcedures
    define fluent function sOCProcedures(TheEncounter Encounter):
      ( ["Procedure": "Severe Maternal Morbidity Procedures"]
        union ["Procedure": "Blood Transfusion"] ) SMMProcedures
        where SMMProcedures.status = 'completed'
          and SMMProcedures.performed.toInterval ( ) starts during day of TheEncounter.hospitalizationWithEDOBTriageObservation ( )
    Library Name Name
    CMS1028FHIRPCSevereOBComps sOCProcedureCategory
    define fluent function sOCProcedureCategory(TheProcedure Procedure):
      case
        when TheProcedure.code in "Blood Transfusion" then 'Blood Transfusion'
        when TheProcedure.code in "Conversion of Cardiac Rhythm" then 'Conversion of cardiac rhythm'
        when TheProcedure.code in "Hysterectomy" then 'Hysterectomy'
        when TheProcedure.code in "Tracheostomy" then 'Tracheostomy'
        when TheProcedure.code in "Ventilation" then 'Ventilation' 
        else null end

    Source

    {
      "resourceType" : "Measure",
      "id" : "CMS1028FHIRPCSevereOBComps",
      "meta" : {
        "profile" : [
          "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-measure-cqfm",
          "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/publishable-measure-cqfm",
          "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/executable-measure-cqfm"
        ]
      },
      "text" : {
        "status" : "extensions",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <table class=\"grid dict\">\n \n <tr>\n <th scope=\"row\"><b>Title: </b></th>\n <td style=\"padding-left: 4px;\">Severe Obstetric ComplicationsFHIR</td>\n </tr>\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Id: </b></th>\n <td style=\"padding-left: 4px;\">CMS1028FHIRPCSevereOBComps</td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Version: </b></th>\n <td style=\"padding-left: 4px;\">0.1.002</td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Url: </b></th>\n <td style=\"padding-left: 4px;\"><a href=\"Measure-CMS1028FHIRPCSevereOBComps.html\">Severe Obstetric ComplicationsFHIR</a></td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\">\n <b>\n \n \n Short Name Identifier:\n \n \n </b>\n </th>\n\n <td style=\"padding-left: 4px;\">\n \n <p style=\"margin-bottom: 5px;\">\n <span>CMS1028FHIR</span>\n </p>\n \n </td>\n </tr>\n \n <tr>\n <th scope=\"row\">\n <b>\n \n \n Version Independent Identifier:\n \n \n </b>\n </th>\n\n <td style=\"padding-left: 4px;\">\n \n <p style=\"margin-bottom: 5px;\">\n <span>urn:uuid:6cf03fe2-b962-4f83-ac37-26d7477183c7</span>\n </p>\n \n </td>\n </tr>\n \n <tr>\n <th scope=\"row\">\n <b>\n \n \n Version Specific Identifier:\n \n \n </b>\n </th>\n\n <td style=\"padding-left: 4px;\">\n \n <p style=\"margin-bottom: 5px;\">\n <span>urn:uuid:d11a564b-0516-4ed0-9a27-45fdd06a8064</span>\n </p>\n \n </td>\n </tr>\n \n <tr>\n <th scope=\"row\">\n <b>\n \n \n Endorser (CMS Consensus Based Entity) Identifier:\n \n \n </b>\n </th>\n\n <td style=\"padding-left: 4px;\">\n \n <p style=\"margin-bottom: 5px;\">\n <span>3687e</span>\n </p>\n \n </td>\n </tr>\n \n <tr>\n <th scope=\"row\">\n <b>\n \n \n Publisher (CMS) Identifier:\n \n \n </b>\n </th>\n\n <td style=\"padding-left: 4px;\">\n \n <p style=\"margin-bottom: 5px;\">\n <span>1028FHIR</span>\n </p>\n \n </td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Effective Period: </b></th>\n <td style=\"padding-left: 4px;\">2025-01-01..2025-12-31</td>\n </tr>\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Experimental: </b></th>\n <td style=\"padding-left: 4px;\">true</td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Publisher: </b></th>\n <td style=\"padding-left: 4px;\">The Joint Commission</td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Author: </b></th>\n <td style=\"padding-left: 4px;\">The Joint Commission, Centers for Medicare &amp; Medicaid Services (CMS), Yale New Haven Health Service Corporation/ Center for Outcomes Research and Evaluation</td>\n </tr>\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Description: </b></th>\n <td style=\"padding-left: 4px;\"><div><p>Patients with severe obstetric complications that occur during the inpatient delivery hospitalization</p>\n</div></td>\n </tr>\n \n\n \n\n \n\n \n\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Purpose: </b></th>\n <td style=\"padding-left: 4px;\"><div><p>UNKNOWN</p>\n</div></td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Copyright: </b></th>\n <td style=\"padding-left: 4px;\"><div><p>Measure specifications are in the Public Domain.</p>\n<p>LOINC(R) copyright 2004-2024 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2024 International Health Terminology Standards Development Organisation. ICD-10 copyright 2024 World Health Organization. All Rights Reserved.</p>\n</div></td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Disclaimer: </b></th>\n <td style=\"padding-left: 4px;\"><div><p>These performance measures are not clinical guidelines, do not establish a standard of medical care, and have not been tested for all potential applications. The measures and specifications are provided without warranty.</p>\n</div></td>\n </tr>\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Rationale: </b></th>\n <td style=\"padding-left: 4px;\"><div><p>The United States (US) experiences higher rates of maternal morbidity and mortality than most other developed countries. The Centers for Disease Control and Prevention (CDC) (2021) report that these rates have continued to trend upward in recent decades. Research indicates that the overall rate of severe maternal morbidity (SMM) increased by almost 200% between 1993 and 2014 to 144 per 10,000 delivery hospitalizations (CDC, 2021), with more than 25,000 women per year experiencing obstetric complications (U.S. Department of Health and Human Services, 2020). Recent maternal mortality data from 2018 reveal that 658 women in the US died from maternal causes, resulting in a rate of 17.4 deaths per 100,000 live births, with 77% of the deaths attributed to direct obstetric causes like hemorrhage, preeclampsia, obstetric embolism, and other complications (Hoyert &amp; Minino, 2020). 144 per 10,000 women hospitalized for delivery have experienced SMM, including hemorrhage, embolism, hypertension, stroke, and other serious complications (CDC, 2021). Racial and ethnic disparities exist: Black women and Hispanic women are at a significantly higher risk for developing these complications than are Non-Hispanic White women (Leonard, Main, Scott, Profit, &amp; Carmichael, 2019). Increasing rates of SMM are resulting in increased healthcare costs, longer hospitalization stays and impacts on a woman's health (Callaghan, Creanga, &amp; Kuklina, 2012).</p>\n<p>There is limited national evaluation of hospitals' performance on maternal morbidity and mortality although SMM is widely used at the population level. SMM is linked to maternal mortality, varies significantly among hospitals, and has significant racial/ethnic and urban/rural disparities. SMM is a cost driver for both Medicaid and commercial plans. This measure is important as it will assist in the discovery and understanding of SMM patterns that can lead to improvements in the safety and quality of maternal care necessary to reduce SMM rates.</p>\n</div></td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Clinical recommendation statement: </b></th>\n <td style=\"padding-left: 4px;\"><div><p>Healthy People 2030 Measure (MICH-05): Reduce severe maternal complications identified during delivery hospitalizations (U.S. Department of Health and Human Services, n.d.).</p>\n<p>The American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine recommend identifying potential cases of severe maternal morbidity for further review, with a focus on outcomes and complications, and consider this an important step toward promoting safe obstetric care (American College of Obstetricians and Gynecologists and the Society for Maternal–Fetal Medicine, Kilpatrick, &amp; Ecker, 2016).</p>\n</div></td>\n </tr>\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Guidance (Usage): </b></th>\n <td style=\"padding-left: 4px;\">Note: This measure will be stratified by race/ethnicity and payer after measure submission.\n\nIn the case of multiple births, map the first delivery date/time (Baby A) as the delivery date/time for the encounter. This measure allows for 3 approaches to determine gestational age (GA) in the following order of precedence:\n\n1. The GA is calculated using the American College of Obstetricians and Gynecologists ReVITALize guidelines.*\n2. When the calculated GA is not available, the GA is obtained from a discrete field in the electronic health record. The intent is to capture the last estimated GA in the interval starting 24 hours or less prior to delivery and ending before midnight on the same day of delivery.\n3. The GA is based on ICD10 or SNOMED codes indicative of weeks gestation. This option is only used when results from items #1 and #2 (see above) are not available.\n \n*ACOG ReVITALize Guidelines for Calculating Gestational Age (ACOG, 2014): \n \n Gestational Age = (280-(Estimated Due Date minus Reference Date))/7\n\n--Estimated Due Date (EDD): The best obstetrical EDD is determined by last menstrual period if confirmed by early ultrasound or no ultrasound performed, or early ultrasound if no known last menstrual period or the ultrasound is not consistent with last menstrual period, or known date of fertilization (e.g., assisted reproductive technology) \n--Reference Date is the date on which you are trying to determine gestational age. For purposes of this eCQM, Reference Date would be the Date of Delivery. \n\nNote however the calculation may yield a non-whole number, and gestational age should be rounded down to the nearest completed week. For example, an infant born on the 5th day of the 36th week (35 weeks and 5/7 days) is at a gestational age of 35 weeks, not 36 weeks.\n\nDefinition:\nFor this measure, specifications are modeled after the nationally available and adopted CDC definition for Severe Maternal Morbidity (SMM) with the addition of maternal mortality. At times, we may refer to the CDC indicators of morbidity as SMM, but the outcome of the measure, which includes morbidity and mortality, is referred to as Severe Obstetric Complications (SOC).\n\nThis eCQM is an episode-based measure. An episode is defined as each inpatient hospitalization or encounter that ends during the measurement period.\n\nThis FHIR-based measure has been derived from the QDM-based measure CMS1028v4. Please refer to the HL7 QI-Core Implementation Guide (https://hl7.org/fhir/us/qicore/STU4.1.1/) for more information on QI-Core and mapping recommendations from QDM to QI-Core 4.1.1 (https://hl7.org/fhir/us/qicore/STU4.1.1/qdm-to-qicore.html).</td>\n </tr>\n \n\n \n \n <tr>\n <th scope=\"row\"><b>Population Criteria: </b></th>\n <td style=\"padding-left: 4px;\">\n \n <table class=\"grid-dict\">\n \n <tr>\n <th><b>6750921446b6174510cfeb95</b></th>\n </tr>\n \n \n <tr>\n <td>Initial Population:</td>\n\n \n \n <td>IPop1: Inpatient hospitalizations for patients age greater than or equal to 8 years and less than 65 admitted to the hospital for inpatient acute care who undergo a delivery procedure with a discharge date during the measurement period</td>\n \n \n\n </tr>\n \n <tr>\n <td>Denominator:</td>\n\n \n \n <td>Den1: Inpatient hospitalizations for patients delivering stillborn or live birth with greater than or equal to 20 weeks, 0 days gestation completed</td>\n \n \n\n </tr>\n \n <tr>\n <td>Numerator:</td>\n\n \n \n <td>Num1: All Severe Obstetric Complications (SOC).\n\nInpatient hospitalizations for patients with severe obstetric complications (not present on admission that occur during the current delivery encounter) including the following: \n- Severe maternal morbidity diagnoses (see list below)\n- Severe maternal morbidity procedures (see list below)\n- Discharge disposition of expired\nPlease note that present on admission codes may be extracted from billing/claims data that was entered by coding staff.\n\nSevere Maternal Morbidity Diagnoses:\n- Cardiac\n\t Acute heart failure \n\t Acute myocardial infarction\n\t Aortic aneurysm\n\t Cardiac arrest/ventricular fibrillation\n\t Heart failure/arrest during procedure or surgery\n- Hemorrhage\n\t Disseminated intravascular coagulation\n\t Shock\n- Renal\n Acute renal failure\n- Respiratory\n\t Adult respiratory distress syndrome\n\t Pulmonary edema\n- Sepsis\n- Other OB\n\t Air and thrombotic embolism\n\t Amniotic fluid embolism\n\t Eclampsia\n\t Severe anesthesia complications\n- Other Medical\n\t Puerperal cerebrovascular disorder\n\t Sickle cell disease with crisis\n\nSevere Maternal Morbidity Procedures:\n- Blood transfusion\n- Conversion of cardiac rhythm\n- Hysterectomy\n- Temporary tracheostomy\n- Ventilation\n</td>\n \n \n\n </tr>\n \n <tr>\n <td>Numerator Exclusion:</td>\n\n \n \n <td>NumExcl1: Inpatient hospitalizations with blood transfusion or hysterectomy with a diagnosis of placenta percreta or placenta increta and no additional severe obstetrical complications</td>\n \n \n\n </tr>\n \n \n </table>\n \n <table class=\"grid-dict\">\n \n <tr>\n <th><b>6750921446b6174510cfeb96</b></th>\n </tr>\n \n \n <tr>\n <td>Initial Population:</td>\n\n \n \n <td>IPop2 is the same inpatient hospitalizations as IPop1</td>\n \n \n\n </tr>\n \n <tr>\n <td>Denominator:</td>\n\n \n \n <td>Den2 is the same inpatient hospitalizations as Den1</td>\n \n \n\n </tr>\n \n <tr>\n <td>Numerator:</td>\n\n \n \n <td>Num2: Delivery encounters with SOC excluding encounters where transfusion was the only SOC.\n\nInpatient hospitalizations for patients with severe obstetric complications (not present on admission that occur during the current delivery encounter) including severe maternal morbidity diagnoses (see following list), severe maternal morbidity procedures (see following list), and discharge disposition of expired, yet excluding encounters where transfusion was the only SOC. \nPlease note that present on admission codes may be those entered by coding staff, extracted from billing/claims data.\n\nSevere Maternal Morbidity Diagnoses:\n- Cardiac\n\t Acute heart failure \n\t Acute myocardial infarction\n\t Aortic aneurysm\n\t Cardiac arrest/ventricular fibrillation\n\t Heart failure/arrest during procedure or surgery\n- Hemorrhage\n\t Disseminated intravascular coagulation\n\t Shock\n- Renal\n Acute renal failure\n- Respiratory\n\t Adult respiratory distress syndrome\n\t Pulmonary edema\n- Sepsis\n- Other OB\n\t Air and thrombotic embolism\n\t Amniotic fluid embolism\n\t Eclampsia\n\t Severe anesthesia complications\n- Other Medical\n\t Puerperal cerebrovascular disorder\n\t Sickle cell disease with crisis\n\nSevere Maternal Morbidity Procedures:\n- Blood transfusion\n- Conversion of cardiac rhythm\n- Hysterectomy\n- Temporary tracheostomy\n- Ventilation</td>\n \n \n\n </tr>\n \n <tr>\n <td>Numerator Exclusion:</td>\n\n \n \n <td>NumExcl2: Inpatient hospitalizations with SOC excluding encounters where transfusion was the only SOC with a hysterectomy or blood transfusion with a diagnosis of placenta percreta or placenta increta and no additional severe obstetrical complications</td>\n \n \n\n </tr>\n \n \n </table>\n \n </td>\n </tr>\n \n \n\n \n <tr>\n <th scope=\"row\"><b> Supplemental Data Elements: </b></th>\n <td style=\"padding-left: 4px;\">\n \n \n \n <p>SDE Ethnicity</p>\n \n \n \n \n \n <p>SDE Payer</p>\n \n \n \n \n \n <p>SDE Race</p>\n \n \n \n \n \n <p>SDE Sex</p>\n \n \n \n \n \n <p>SDE Variable Calculated Gestational Age</p>\n \n \n \n \n \n <p>SDE SOC Diagnoses Detail</p>\n \n \n \n \n \n <p>SDE SOC Procedure Detail</p>\n \n \n \n \n \n <p>SDE Delivery Encounters with Severe Obstetric Complication Diagnosis</p>\n \n \n \n \n \n <p>SDE Delivery Encounters with Severe Obstetric Complication Procedures</p>\n \n \n \n </td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Risk Adjustment Variable: </b></th>\n <td style=\"padding-left: 4px;\">\n \n \n \n <p>Risk Variable Lab and Physical Exam Results</p>\n \n \n \n \n \n <p>Risk Variable Asthma</p>\n \n \n \n \n \n <p>Risk Variable Autoimmune Disease</p>\n \n \n \n \n \n <p>Risk Variable Bariatric Surgery</p>\n \n \n \n \n \n <p>Risk Variable Bleeding Disorder</p>\n \n \n \n \n \n <p>Risk Variable Morbid Obesity</p>\n \n \n \n \n \n <p>Risk Variable Cardiac Disease</p>\n \n \n \n \n \n <p>Risk Variable Economic Housing Instability</p>\n \n \n \n \n \n <p>Risk Variable Gastrointestinal Disease</p>\n \n \n \n \n \n <p>Risk Variable Gestational Diabetes</p>\n \n \n \n \n \n <p>Risk Variable HIV</p>\n \n \n \n \n \n <p>Risk Variable Hypertension</p>\n \n \n \n \n \n <p>Risk Variable Long Term Anticoagulant Use</p>\n \n \n \n \n \n <p>Risk Variable Mental Health Disorder</p>\n \n \n \n \n \n <p>Risk Variable Multiple Pregnancy</p>\n \n \n \n \n \n <p>Risk Variable Neuromuscular</p>\n \n \n \n \n \n <p>Risk Variable Obstetrical VTE</p>\n \n \n \n \n \n <p>Risk Variable Placenta Previa</p>\n \n \n \n \n \n <p>Risk Variable Placental Abruption</p>\n \n \n \n \n \n <p>Risk Variable Placental Accreta Spectrum</p>\n \n \n \n \n \n <p>Risk Variable Preexisting Diabetes</p>\n \n \n \n \n \n <p>Risk Variable Previous Cesarean</p>\n \n \n \n \n \n <p>Risk Variable Pulmonary Hypertension</p>\n \n \n \n \n \n <p>Risk Variable Renal Disease</p>\n \n \n \n \n \n <p>Risk Variable Severe Preeclampsia</p>\n \n \n \n \n \n <p>Risk Variable Substance Abuse</p>\n \n \n \n \n \n <p>Risk Variable Thyrotoxicosis</p>\n \n \n \n \n \n <p>Risk Variable Other Preeclampsia</p>\n \n \n \n \n \n <p>Risk Variable Preterm Birth</p>\n \n \n \n \n \n <p>Risk Variable Anemia</p>\n \n \n \n \n \n <p>Risk Variable Systolic Blood Pressure</p>\n \n \n \n \n \n <p>Risk Variable Heart Rate</p>\n \n \n \n \n \n <p>Risk Variable First White Blood Cell Count Lab Test</p>\n \n \n \n \n \n <p>Risk Variable First Hematocrit Lab Test</p>\n \n \n \n \n \n <p>Delivery Encounters with Blood Transfusion</p>\n \n \n \n \n \n <p>Risk Variable Maternal Age</p>\n \n \n \n </td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\">\n <b> Supplemental Data Guidance\n : </b></th>\n <td style=\"padding-left: 4px;\"> For every patient evaluated by this measure also identify payer, race, ethnicity and sex for stratified hospital-specific reports after data submission. The variable calculated gestational age, SOC diagnosis details, and SOC procedure details are derived or calculated from diagnosis and encounter data provided in the QRDA I on the receiving end and thus, are not additionally submitted by hospitals.\n\n \n </td>\n </tr>\n \n <tr>\n <th scope=\"row\">\n <b> Risk Adjustment Variable Guidance\n : </b></th>\n <td style=\"padding-left: 4px;\"> The Severe Obstetric Complications Risk Adjustment Methodology Report is available on the eCQI Resource Center (https://ecqi.healthit.gov).\nPre-existing conditions and variables must be present on admission. Please note that present on admission codes may be extracted from billing/claims data that was entered by coding staff (Leonard, Kennedy, Carmichael, Lyell, &amp; Main, 2020; Main, Leonard, &amp; Menard, 2020).\n- Anemia (includes sickle cell disease)\n- Asthma \n- Autoimmune Disease\n- Bariatric Surgery\n- Bleeding Disorder\n- Cardiac Disease\n- Economic Housing Instability\n- Gastrointestinal Disease \n- Gestational Diabetes\n- HIV\n- Hypertension\n- Long-term Anticoagulant Use\n- Maternal Age (derived from birthdate)\n- Mental Health Disorder\n- Morbid Obesity\n- Multiple Pregnancy\t\n- Neuromuscular Disease\n- Obstetric VTE\n- Other Pre-eclampsia\n- Placenta Previa\n- Placental Abruption\n- Placental Accreta Spectrum\n- Pre-existing Diabetes \n- Preterm Birth\n- Previous Cesarean \n- Pulmonary Hypertension\n- Renal Disease \n- Severe Pre-eclampsia\n- Substance Abuse\n- Thyrotoxicosis \n\nLab and Physical Exam Results:\nReport the first resulted value 24 hours prior to start of encounter and before time of delivery in UCUM units specified:\n- Heart rate: {beats}/min\n- Systolic blood pressure: mm[Hg]\n- Hematocrit: %\n- White blood cell count: 10*3/uL \n\n\nNote regarding submission of risk variable data: The risk variable definitions are included in the specifications and risk variable data should be sent with eCQM data in the QRDA I file. Specific risk variable templates are not needed in the QRDA I files. </td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Libraries: </b></th>\n <td style=\"padding-left: 4px;\">\n <table class=\"grid-dict\">\n \n <tr>\n <td><a href=\"Library-CMS1028FHIRPCSevereOBComps.html\">CMS1028FHIRPCSevereOBComps</a></td>\n </tr>\n \n </table>\n </td>\n </tr>\n \n\n \n\n \n \n <tr>\n <th scope=\"row\"><b>Terminology and Other Dependencies: </b></th>\n <td style=\"padding-left: 4px;\">\n \n <li><code>Library/PCMaternal|5.19.000</code></li>\n \n <li><code>Library/CQMCommon|2.2.000</code></li>\n \n <li><code>Library/FHIRHelpers|4.4.000</code></li>\n \n <li><code>Library/QICoreCommon|2.1.000</code></li>\n \n <li><code>Library/SupplementalDataElements|3.5.000</code></li>\n \n <li><a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-v3-loinc.html\">Logical Observation Identifiers, Names and Codes (LOINC)</a></li>\n \n <li><a href=\"http://hl7.org/fhir/R4/codesystem-administrative-gender.html\">AdministrativeGender</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.666.5.307/expansion\">Encounter Inpatient</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1045.59/expansion\">Delivery Procedures</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1111.143/expansion\">Observation Services</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.369/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.369</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1045.26/expansion\">Estimated Gestational Age at Delivery</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1110.67/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.67</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1110.63/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.63</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.271/expansion\">Asthma</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.370/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.370</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.255/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.255</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.256/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.256</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.309/expansion\">Patient Expired</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.213/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.213</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.388/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.388</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.358/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.358</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.357/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.357</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.359/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.359</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.360/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.360</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.302/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.302</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.308/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.308</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.332/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.332</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.299/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.299</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.114222.4.11.3591/expansion\">Payer</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.305/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.305</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.290/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.290</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.275/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.275</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.317/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.317</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1110.78/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.78</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.287/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.287</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1045.129/expansion\">White blood cells count lab test</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1045.114/expansion\">Hematocrit lab test</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.327/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.327</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.323/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.323</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.341/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.341</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.366/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.366</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.233/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.233</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.666.5.623/expansion\">Acute Myocardial Infarction (AMI)</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1110.53/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.53</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.214/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.214</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.243/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.243</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.217/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.217</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.219/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.219</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.221/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.221</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.223/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.223</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.225/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.225</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.227/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.227</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.229/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.229</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.231/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.231</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.237/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.237</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.235/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.235</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.239/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.239</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.241/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.241</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.320/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.320</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.335/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.335</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.338/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.338</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.281/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.281</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.296/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.296</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.329/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.329</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.292/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.292</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.272/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.272</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.314/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.314</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.363/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.363</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.311/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.311</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.278/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.278</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.269/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.269</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.284/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.284</a></li>\n \n </td>\n </tr>\n <tr>\n <th scope=\"row\"><b>Parameters:</b></th>\n <td style=\"padding-left: 4px;\">\n <table class=\"grid-dict\">\n <tr>\n <th><b>name</b></th>\n <th><b>use</b></th>\n <th><b>min</b></th>\n <th><b>max</b></th>\n <th><b>type</b></th>\n </tr>\n \n <tr>\n <td>Measurement Period</td>\n <td>In</td>\n <td>0</td>\n <td>1</td>\n <td>Period</td>\n </tr>\n \n <tr>\n <td>Risk Variable Asthma</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>SDE Delivery Encounters with Severe Obstetric Complication Diagnosis</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Risk Variable Placental Accreta Spectrum</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Risk Variable Neuromuscular</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Risk Variable Hypertension</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>SOC with Hysterectomy or Blood Transfusion with Placenta Increta or Placenta Percreta Without Additional SOC</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Risk Variable Preterm Birth</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>SDE Payer</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Risk Variable Placental Abruption</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Risk Variable Morbid Obesity</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Risk Variable Preexisting Diabetes</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Risk Variable Bariatric Surgery</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>SDE Race</td>\n <td>Out</td>\n <td>0</td>\n <td>1</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Risk Variable Placenta Previa</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>SDE Sex</td>\n <td>Out</td>\n <td>0</td>\n <td>1</td>\n <td>Coding</td>\n </tr>\n \n <tr>\n <td>Risk Variable Bleeding Disorder</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Risk Variable First White Blood Cell Count Lab Test</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Risk Variable First Hematocrit Lab Test</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Risk Variable Severe Preeclampsia</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Risk Variable Anemia</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Risk Variable Cardiac Disease</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Risk Variable Long Term Anticoagulant Use</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Risk Variable Systolic Blood Pressure</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>SDE SOC Diagnoses Detail</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Risk Variable Substance Abuse</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Risk Variable Renal Disease</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>SDE Variable Calculated Gestational Age</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Risk Variable Gastrointestinal Disease</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions Only</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Risk Variable Pulmonary Hypertension</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Risk Variable Thyrotoxicosis</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Risk Variable Other Preeclampsia</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Initial Population</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Risk Variable Economic Housing Instability</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Risk Variable HIV</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>SDE Delivery Encounters with Severe Obstetric Complication Procedures</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>SOC Excluding Blood Transfusions Only with Hysterectomy or Blood Transfusion with Placenta Increta or Placenta Percreta Without Additional SOC</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Risk Variable Heart Rate</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Risk Variable Maternal Age</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Risk Variable Mental Health Disorder</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Risk Variable Obstetrical VTE</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Risk Variable Autoimmune Disease</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Risk Variable Previous Cesarean</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Risk Variable Gestational Diabetes</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>SDE SOC Procedure Detail</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Numerator</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Risk Variable Multiple Pregnancy</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Denominator</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Delivery Encounters with Blood Transfusion</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>SDE Ethnicity</td>\n <td>Out</td>\n <td>0</td>\n <td>1</td>\n <td>Resource</td>\n </tr>\n \n </table>\n </td>\n </tr>\n\n <tr>\n <th scope=\"row\"><b>DataRequirements:</b></th>\n <td style=\"padding-left: 4px;\">\n <table class=\"grid-dict\">\n <tr>\n <th><b>Resource Type</b></th>\n <th><b>Resource Elements</b></th>\n <th><b>Valueset Name</b></th>\n <th><b>Valueset</b></th>\n </tr>\n \n <tr>\n <td>Encounter(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html\">QICoreEncounter</a>)</td>\n <td>\n \n type\n \n period\n \n status\n \n status.value\n \n condition\n \n condition.reference\n \n condition.reference.value\n \n extension\n \n condition.code\n \n hospitalization\n \n hospitalization.dischargeDisposition\n \n id\n \n id.value\n \n </td>\n <td>\n \n \n Observation Services\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1111.143/expansion\">Observation Services</a></td>\n </tr>\n \n <tr>\n <td>Encounter(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html\">QICoreEncounter</a>)</td>\n <td>\n \n type\n \n period\n \n status\n \n status.value\n \n condition\n \n condition.reference\n \n condition.reference.value\n \n extension\n \n condition.code\n \n hospitalization\n \n hospitalization.dischargeDisposition\n \n id\n \n id.value\n \n </td>\n <td>\n \n \n ED Visit and OB Triage\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.369/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.369</a></td>\n </tr>\n \n <tr>\n <td>Encounter(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html\">QICoreEncounter</a>)</td>\n <td>\n \n type\n \n status\n \n status.value\n \n period\n \n condition\n \n condition.reference\n \n condition.reference.value\n \n extension\n \n condition.code\n \n hospitalization\n \n hospitalization.dischargeDisposition\n \n id\n \n id.value\n \n </td>\n <td>\n \n \n Encounter Inpatient\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.666.5.307/expansion\">Encounter Inpatient</a></td>\n </tr>\n \n <tr>\n <td>Patient(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-patient.html\">QICorePatient</a>)</td>\n <td>\n \n race\n \n ethnicity\n \n </td>\n <td>\n \n </td>\n <td/>\n </tr>\n \n <tr>\n <td>Procedure(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html\">QICoreProcedure</a>)</td>\n <td>\n \n code\n \n status\n \n status.value\n \n performed\n \n </td>\n <td>\n \n \n Delivery Procedures\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1045.59/expansion\">Delivery Procedures</a></td>\n </tr>\n \n <tr>\n <td>Procedure(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html\">QICoreProcedure</a>)</td>\n <td>\n \n code\n \n status\n \n status.value\n \n performed\n \n </td>\n <td>\n \n \n Severe Maternal Morbidity Procedures\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.256/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.256</a></td>\n </tr>\n \n <tr>\n <td>Procedure(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html\">QICoreProcedure</a>)</td>\n <td>\n \n code\n \n status\n \n status.value\n \n performed\n \n </td>\n <td>\n \n \n Hysterectomy\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.358/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.358</a></td>\n </tr>\n \n <tr>\n <td>Procedure(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html\">QICoreProcedure</a>)</td>\n <td>\n \n code\n \n status\n \n status.value\n \n performed\n \n </td>\n <td>\n \n \n Conversion of Cardiac Rhythm\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.357/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.357</a></td>\n </tr>\n \n <tr>\n <td>Procedure(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html\">QICoreProcedure</a>)</td>\n <td>\n \n code\n \n status\n \n status.value\n \n performed\n \n </td>\n <td>\n \n \n Tracheostomy\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.359/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.359</a></td>\n </tr>\n \n <tr>\n <td>Procedure(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html\">QICoreProcedure</a>)</td>\n <td>\n \n code\n \n status\n \n status.value\n \n performed\n \n </td>\n <td>\n \n \n Ventilation\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.360/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.360</a></td>\n </tr>\n \n <tr>\n <td>Procedure(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html\">QICoreProcedure</a>)</td>\n <td>\n \n code\n \n status\n \n status.value\n \n performed\n \n </td>\n <td>\n \n \n Severe Maternal Morbidity Procedures\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.256/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.256</a></td>\n </tr>\n \n <tr>\n <td>Procedure(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html\">QICoreProcedure</a>)</td>\n <td>\n \n code\n \n status\n \n status.value\n \n performed\n \n </td>\n <td>\n \n \n Blood Transfusion\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.213/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.213</a></td>\n </tr>\n \n <tr>\n <td>Procedure(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-procedure.html\">QICoreProcedure</a>)</td>\n <td>\n \n code\n \n status\n \n status.value\n \n performed\n \n </td>\n <td>\n \n \n Blood Transfusion\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1029.213/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.213</a></td>\n </tr>\n \n <tr>\n <td>Observation(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-observation.html\">QICoreObservation</a>)</td>\n <td>\n \n code\n \n value\n \n status\n \n status.value\n \n effective\n \n </td>\n <td>\n \n </td>\n <td/>\n </tr>\n \n <tr>\n <td>Observation(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-observation.html\">QICoreObservation</a>)</td>\n <td>\n \n code\n \n value\n \n status\n \n status.value\n \n effective\n \n </td>\n <td>\n \n </td>\n <td/>\n </tr>\n \n <tr>\n <td>Observation(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-observation.html\">QICoreObservation</a>)</td>\n <td>\n \n code\n \n effective\n \n value\n \n status\n \n status.value\n \n </td>\n <td>\n \n \n Estimated Gestational Age at Delivery\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1045.26/expansion\">Estimated Gestational Age at Delivery</a></td>\n </tr>\n \n <tr>\n <td>Condition(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-condition.html\">QICoreCondition</a>)</td>\n <td>\n \n id\n \n id.value\n \n code\n \n </td>\n <td>\n \n </td>\n <td/>\n </tr>\n \n <tr>\n <td>Coverage(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-coverage.html\">QICoreCoverage</a>)</td>\n <td>\n \n type\n \n period\n \n </td>\n <td>\n \n \n Payer Type\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.114222.4.11.3591/expansion\">Payer</a></td>\n </tr>\n \n <tr>\n <td>Observation(<a href=\"http://hl7.org/fhir/us/core/STU3.1.1/StructureDefinition-us-core-observation-lab.html\">US Core Laboratory Result Observation Profile</a>)</td>\n <td>\n \n code\n \n issued\n \n issued.value\n \n status\n \n status.value\n \n value\n \n </td>\n <td>\n \n \n White blood cells count lab test\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1045.129/expansion\">White blood cells count lab test</a></td>\n </tr>\n \n <tr>\n <td>Observation(<a href=\"http://hl7.org/fhir/us/core/STU3.1.1/StructureDefinition-us-core-observation-lab.html\">US Core Laboratory Result Observation Profile</a>)</td>\n <td>\n \n code\n \n issued\n \n issued.value\n \n status\n \n status.value\n \n value\n \n </td>\n <td>\n \n \n Hematocrit lab test\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1045.114/expansion\">Hematocrit lab test</a></td>\n </tr>\n \n <tr>\n <td>Observation(<a href=\"http://hl7.org/fhir/R4/bp.html\">Observation Blood Pressure Profile</a>)</td>\n <td>\n \n effective\n \n status\n \n status.value\n \n component\n \n </td>\n <td>\n \n </td>\n <td/>\n </tr>\n \n <tr>\n <td>Observation(<a href=\"http://hl7.org/fhir/R4/heartrate.html\">Observation Heart Rate Profile</a>)</td>\n <td>\n \n effective\n \n status\n \n status.value\n \n value\n \n </td>\n <td>\n \n </td>\n <td/>\n </tr>\n \n </table>\n </td>\n </tr>\n\n \n <tr>\n <th scope=\"row\"><b>Direct Reference Codes:</b></th>\n <td style=\"padding-left: 4px;\">\n <table class=\"grid-dict\">\n <tr>\n <th><b>display</b></th>\n <th><b>code</b></th>\n <th><b>system</b></th>\n </tr>\n \n <tr>\n <td>Date and time of obstetric delivery</td>\n <td>93857-1</td>\n <td><a href=\"https://loinc.org/\">http://loinc.org</a></td>\n </tr>\n \n <tr>\n <td>Delivery date Estimated</td>\n <td>11778-8</td>\n <td><a href=\"https://loinc.org/\">http://loinc.org</a></td>\n </tr>\n \n <tr>\n <td>Male</td>\n <td>M</td>\n <td><a href=\"http://hl7.org/fhir/R4/codesystem-administrative-gender.html\">http://hl7.org/fhir/administrative-gender</a></td>\n </tr>\n \n <tr>\n <td>Female</td>\n <td>F</td>\n <td><a href=\"http://hl7.org/fhir/R4/codesystem-administrative-gender.html\">http://hl7.org/fhir/administrative-gender</a></td>\n </tr>\n \n <tr>\n <td>Systolic BP</td>\n <td>8480-6</td>\n <td><a href=\"https://loinc.org/\">http://loinc.org</a></td>\n </tr>\n \n </table>\n </td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Logic Definitions:</b></th>\n <td style=\"padding-left: 4px;\">\n \n <table class=\"grid-dict\">\n <tr>\n <th><b>Group</b></th>\n <th><b>Scoring</b></th>\n <th><b>Population Criteria</b></th>\n <th><b>Expression</b></th>\n </tr>\n <tr>\n \n <td> 6750921446b6174510cfeb95 </td>\n <td colspan=\"3\" style=\"padding-left: 4px;\">\n \n <b>Group scoring:</b>\n \n <span> proportion </span>\n \n \n\n \n\n \n\n \n\n \n <tr>\n \n <th scope=\"row\"><b>Type: </b></th>\n <td style=\"padding-left: 4px;\">\n \n \n <p style=\"margin-bottom: 5px;\">\n <span>Outcome </span>\n </p>\n \n \n \n </td>\n \n </tr>\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Rate Aggregation: </b></th>\n <td colspan=\"3\" style=\"padding-left: 4px;\">Two hospital-level measure scores are calculated as a risk-adjusted proportion reported as a rate per 10,000 delivery hospitalizations: 1. All Severe Obstetric Complications (SOC). ((Num1 – NumExcl1) / Den) * 10,000 2. SOC excluding encounters where transfusion was the only SOC. ((Num2 – NumExcl2) / Den) * 10,000 Num1: Delivery encounters with SOC Num2: Delivery encounters with SOC excluding encounters where transfusion was the only SOC NumExcl1: Delivery encounters with blood transfusion or hysterectomy with placenta percreta or placenta increta and no additional SOCs NumExcl2: Delivery encounters with SOC excluding encounters where transfusion was the only SOC with a hysterectomy or blood transfusion with a diagnosis of placenta percreta or placenta increta and no additional SOCs Den: Delivery encounters with &gt; or = 20 weeks' gestation completed</td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Improvement Notation: </b></th>\n <td style=\"padding-left: 4px;\">\n \n \n \n <p style=\"margin-bottom: 5px;\">\n <span>Decreased score indicates improvement </span>\n </p>\n \n \n \n \n </td>\n </tr>\n \n\n \n\n </td>\n \n <tr>\n <td/>\n <td/>\n <td>Initial Population</td>\n <td>\n \n <pre><code class=\"language-cql\">define &quot;Initial Population&quot;:\n PCMaternal.&quot;Delivery Encounter with Age Range&quot;</code></pre>\n \n </td>\n </tr>\n \n <tr>\n <td/>\n <td/>\n <td>Denominator</td>\n <td>\n \n <pre><code class=\"language-cql\">define &quot;Denominator&quot;:\n &quot;Delivery Encounters At Greater than or Equal to 20 Weeks Gestation&quot;</code></pre>\n \n </td>\n </tr>\n \n <tr>\n <td/>\n <td/>\n <td>Numerator</td>\n <td>\n \n <pre><code class=\"language-cql\">define &quot;Numerator&quot;:\n &quot;Delivery Encounters with Severe Obstetric Complications&quot;</code></pre>\n \n </td>\n </tr>\n \n <tr>\n <td/>\n <td/>\n <td>Numerator Exclusion</td>\n <td>\n \n <pre><code class=\"language-cql\">define &quot;SOC with Hysterectomy or Blood Transfusion with Placenta Increta or Placenta Percreta Without Additional SOC&quot;:\n ( &quot;Delivery Encounters with Severe Obstetric Complications&quot; SOCEncounter\n where exists ( ( SOCEncounter.encounterDiagnosis ( ) ) EncounterDiagnosis\n where EncounterDiagnosis.code in &quot;Placenta Increta or Percreta&quot;\n )\n and ( exists &quot;Delivery Encounters with Blood Transfusion&quot;\n or exists &quot;Delivery Encounters with Hysterectomy&quot;\n )\n )\n\t//The following logic keeps encounter in the numerator if there is an additional SOC besides Blood Transfusion or Hysterectomy\n \n except ( ( &quot;Delivery Encounters with Severe Obstetric Complications&quot; SOCEncounter\n where ( SOCEncounter.pOAIsNoOrUTD ( ) in &quot;Severe Maternal Morbidity Diagnoses&quot; )\n )\n union &quot;Delivery Encounters with Cardiac Conversion, Tracheostomy or Ventilation Procedures&quot;\n union &quot;Delivery Encounters with Expiration&quot;\n )</code></pre>\n \n </td>\n </tr>\n \n \n \n <td> 6750921446b6174510cfeb96 </td>\n <td colspan=\"3\" style=\"padding-left: 4px;\">\n \n <b>Group scoring:</b>\n \n <span> proportion </span>\n \n \n\n \n\n \n\n \n\n \n <tr>\n \n <th scope=\"row\"><b>Type: </b></th>\n <td style=\"padding-left: 4px;\">\n \n \n <p style=\"margin-bottom: 5px;\">\n <span>Outcome </span>\n </p>\n \n \n \n </td>\n \n </tr>\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Rate Aggregation: </b></th>\n <td colspan=\"3\" style=\"padding-left: 4px;\">Two hospital-level measure scores are calculated as a risk-adjusted proportion reported as a rate per 10,000 delivery hospitalizations: 1. All Severe Obstetric Complications (SOC). ((Num1 – NumExcl1) / Den) * 10,000 2. SOC excluding encounters where transfusion was the only SOC. ((Num2 – NumExcl2) / Den) * 10,000 Num1: Delivery encounters with SOC Num2: Delivery encounters with SOC excluding encounters where transfusion was the only SOC NumExcl1: Delivery encounters with blood transfusion or hysterectomy with placenta percreta or placenta increta and no additional SOCs NumExcl2: Delivery encounters with SOC excluding encounters where transfusion was the only SOC with a hysterectomy or blood transfusion with a diagnosis of placenta percreta or placenta increta and no additional SOCs Den: Delivery encounters with &gt; or = 20 weeks' gestation completed</td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Improvement Notation: </b></th>\n <td style=\"padding-left: 4px;\">\n \n \n \n <p style=\"margin-bottom: 5px;\">\n <span>Decreased score indicates improvement </span>\n </p>\n \n \n \n \n </td>\n </tr>\n \n\n \n\n </td>\n \n <tr>\n <td/>\n <td/>\n <td>Initial Population</td>\n <td>\n \n <pre><code class=\"language-cql\">define &quot;Initial Population&quot;:\n PCMaternal.&quot;Delivery Encounter with Age Range&quot;</code></pre>\n \n </td>\n </tr>\n \n <tr>\n <td/>\n <td/>\n <td>Denominator</td>\n <td>\n \n <pre><code class=\"language-cql\">define &quot;Denominator&quot;:\n &quot;Delivery Encounters At Greater than or Equal to 20 Weeks Gestation&quot;</code></pre>\n \n </td>\n </tr>\n \n <tr>\n <td/>\n <td/>\n <td>Numerator</td>\n <td>\n \n <pre><code class=\"language-cql\">define &quot;Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions Only&quot;:\n &quot;Delivery Encounters with Severe Obstetric Complications&quot;\n intersect &quot;Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions&quot;</code></pre>\n \n </td>\n </tr>\n \n <tr>\n <td/>\n <td/>\n <td>Numerator Exclusion</td>\n <td>\n \n <pre><code class=\"language-cql\">define &quot;SOC Excluding Blood Transfusions Only with Hysterectomy or Blood Transfusion with Placenta Increta or Placenta Percreta Without Additional SOC&quot;:\n ( &quot;Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions Only&quot; SOCExcludingTransfusion\n where exists ( ( SOCExcludingTransfusion.encounterDiagnosis ( ) ) EncounterDiagnoses\n where EncounterDiagnoses.code in &quot;Placenta Increta or Percreta&quot;\n )\n and ( exists &quot;Delivery Encounters with Blood Transfusion&quot;\n or exists &quot;Delivery Encounters with Hysterectomy&quot;\n )\n )\n\t\n\t//The following logic keeps encounter in the numerator if there is an additional SOC besides Blood Transfusion or Hysterectomy\n \n except ( ( &quot;Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions Only&quot; SOCExcludingTransfusion\n where SOCExcludingTransfusion.pOAIsNoOrUTD ( ) in &quot;Severe Maternal Morbidity Diagnoses&quot;\n )\n union &quot;Delivery Encounters with Cardiac Conversion, Tracheostomy or Ventilation Procedures&quot;\n union &quot;Delivery Encounters with Expiration&quot;\n )</code></pre>\n \n </td>\n </tr>\n \n \n \n </tr>\n </table>\n \n\n <table class=\"grid-dict\">\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CQMCommon</td>\n \n \n <td>Inpatient Encounter</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Inpatient Encounter&quot;:\n [Encounter: &quot;Encounter Inpatient&quot;] EncounterInpatient\n\t\twhere EncounterInpatient.status = 'finished'\n\t\tand EncounterInpatient.period ends during day of &quot;Measurement Period&quot;</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>PCMaternal</td>\n \n \n <td>Encounter with Age Range</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Encounter with Age Range&quot;:\n CQMCommon.&quot;Inpatient Encounter&quot; InpatientEncounter\n where AgeInYearsAt(date from start of InpatientEncounter.period) in Interval[ 8, 65 )</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>PCMaternal</td>\n \n \n <td>Delivery Encounter with Age Range</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Delivery Encounter with Age Range&quot;:\n &quot;Encounter with Age Range&quot; EncounterWithAge\n with [&quot;Procedure&quot;: &quot;Delivery Procedures&quot;] DeliveryProcedure\n such that DeliveryProcedure.status = 'completed'\n and DeliveryProcedure.performed.toInterval ( ) starts during EncounterWithAge.hospitalizationWithEDOBTriageObservation ()</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1028FHIRPCSevereOBComps</td>\n \n \n <td>Delivery Encounters with Calculated Gestational Age Greater than or Equal to 20 Weeks</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Delivery Encounters with Calculated Gestational Age Greater than or Equal to 20 Weeks&quot;:\n PCMaternal.&quot;Delivery Encounter with Age Range&quot; DeliveryEncounter\n where DeliveryEncounter.calculatedGestationalAge ( ) &gt;= 20</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1028FHIRPCSevereOBComps</td>\n \n \n <td>Delivery Encounters with Estimated Gestational Age Assessment Greater than or Equal to 20 Weeks</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Delivery Encounters with Estimated Gestational Age Assessment Greater than or Equal to 20 Weeks&quot;:\n PCMaternal.&quot;Delivery Encounter with Age Range&quot; DeliveryEncounter\n where DeliveryEncounter.calculatedGestationalAge ( ) is null\n and ( DeliveryEncounter.lastEstimatedGestationalAge ( ) &gt;= 20 weeks )</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1028FHIRPCSevereOBComps</td>\n \n \n <td>Delivery Encounters with Gestational Age Greater than or Equal to 20 Weeks Based on Coding</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Delivery Encounters with Gestational Age Greater than or Equal to 20 Weeks Based on Coding&quot;:\n PCMaternal.&quot;Delivery Encounter with Age Range&quot; DeliveryEncounter\n let CGA: DeliveryEncounter.calculatedGestationalAge ( ),\n EGA: DeliveryEncounter.lastEstimatedGestationalAge ( )\n where CGA is null\n and EGA is null\n and exists ( ( DeliveryEncounter.encounterDiagnosis ( ) ) EncounterDiagnosis\n where EncounterDiagnosis.code in &quot;20 to 42 Plus Weeks Gestation&quot;\n )</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1028FHIRPCSevereOBComps</td>\n \n \n <td>Delivery Encounters At Greater than or Equal to 20 Weeks Gestation</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Delivery Encounters At Greater than or Equal to 20 Weeks Gestation&quot;:\n &quot;Delivery Encounters with Calculated Gestational Age Greater than or Equal to 20 Weeks&quot;\n union &quot;Delivery Encounters with Estimated Gestational Age Assessment Greater than or Equal to 20 Weeks&quot;\n union &quot;Delivery Encounters with Gestational Age Greater than or Equal to 20 Weeks Based on Coding&quot;</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1028FHIRPCSevereOBComps</td>\n \n \n <td>Risk Variable Asthma</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Risk Variable Asthma&quot;:\n &quot;Delivery Encounters At Greater than or Equal to 20 Weeks Gestation&quot; TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in &quot;Acute or Persistent Asthma&quot;</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1028FHIRPCSevereOBComps</td>\n \n \n <td>Delivery Encounters with Severe Obstetric Complications Diagnosis or Procedure Excluding Blood Transfusion</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Delivery Encounters with Severe Obstetric Complications Diagnosis or Procedure Excluding Blood Transfusion&quot;:\n &quot;Delivery Encounters At Greater than or Equal to 20 Weeks Gestation&quot; TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsNoOrUTD ( ) in &quot;Severe Maternal Morbidity Diagnoses&quot;\n or exists ( [&quot;Procedure&quot;: &quot;Severe Maternal Morbidity Procedures&quot;] SMMProcedures\n where SMMProcedures.status = 'completed'\n and SMMProcedures.performed.toInterval ( ) starts during day of TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation ( )\n )</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1028FHIRPCSevereOBComps</td>\n \n \n <td>Delivery Encounters with Expiration</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Delivery Encounters with Expiration&quot;:\n &quot;Delivery Encounters At Greater than or Equal to 20 Weeks Gestation&quot; TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.hospitalization.dischargeDisposition in &quot;Patient Expired&quot;</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1028FHIRPCSevereOBComps</td>\n \n \n <td>Delivery Encounters with Blood Transfusion</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Delivery Encounters with Blood Transfusion&quot;:\n &quot;Delivery Encounters At Greater than or Equal to 20 Weeks Gestation&quot; TwentyWeeksPlusEncounter\n with [&quot;Procedure&quot;: &quot;Blood Transfusion&quot;] BloodTransfusion\n such that BloodTransfusion.status = 'completed'\n and BloodTransfusion.performed.toInterval ( ) starts during day of TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation ( )</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1028FHIRPCSevereOBComps</td>\n \n \n <td>Delivery Encounters with Severe Obstetric Complications</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Delivery Encounters with Severe Obstetric Complications&quot;:\n &quot;Delivery Encounters with Severe Obstetric Complications Diagnosis or Procedure Excluding Blood Transfusion&quot;\n union &quot;Delivery Encounters with Expiration&quot;\n union &quot;Delivery Encounters with Blood Transfusion&quot;</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1028FHIRPCSevereOBComps</td>\n \n \n <td>Delivery Encounters with Hysterectomy</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Delivery Encounters with Hysterectomy&quot;:\n &quot;Delivery Encounters At Greater than or Equal to 20 Weeks Gestation&quot; TwentyWeeksPlusEncounter\n with [&quot;Procedure&quot;: &quot;Hysterectomy&quot;] Hysterectomy\n such that Hysterectomy.status = 'completed'\n and Hysterectomy.performed.toInterval ( ) starts during day of TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation ( )</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1028FHIRPCSevereOBComps</td>\n \n \n <td>Cardiac Conversion, Tracheostomy or Ventilation Procedures</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Cardiac Conversion, Tracheostomy or Ventilation Procedures&quot;:\n [&quot;Procedure&quot;: &quot;Conversion of Cardiac Rhythm&quot;]\n union [&quot;Procedure&quot;: &quot;Tracheostomy&quot;]\n union [&quot;Procedure&quot;: &quot;Ventilation&quot;]</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1028FHIRPCSevereOBComps</td>\n \n \n <td>Delivery Encounters with Cardiac Conversion, Tracheostomy or Ventilation Procedures</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Delivery Encounters with Cardiac Conversion, Tracheostomy or Ventilation Procedures&quot;:\n &quot;Delivery Encounters At Greater than or Equal to 20 Weeks Gestation&quot; TwentyWeeksPlusEncounter\n with &quot;Cardiac Conversion, Tracheostomy or Ventilation Procedures&quot; ConvTrachVentProcedures\n such that ConvTrachVentProcedures.status = 'completed'\n and ConvTrachVentProcedures.performed.toInterval ( ) starts during day of TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation ( )</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1028FHIRPCSevereOBComps</td>\n \n \n <td>SOC with Hysterectomy or Blood Transfusion with Placenta Increta or Placenta Percreta Without Additional SOC</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;SOC with Hysterectomy or Blood Transfusion with Placenta Increta or Placenta Percreta Without Additional SOC&quot;:\n ( &quot;Delivery Encounters with Severe Obstetric Complications&quot; SOCEncounter\n where exists ( ( SOCEncounter.encounterDiagnosis ( ) ) EncounterDiagnosis\n where EncounterDiagnosis.code in &quot;Placenta Increta or Percreta&quot;\n )\n and ( exists &quot;Delivery Encounters with Blood Transfusion&quot;\n or exists &quot;Delivery Encounters with Hysterectomy&quot;\n )\n )\n\t//The following logic keeps encounter in the numerator if there is an additional SOC besides Blood Transfusion or Hysterectomy\n \n except ( ( &quot;Delivery Encounters with Severe Obstetric Complications&quot; SOCEncounter\n where ( SOCEncounter.pOAIsNoOrUTD ( ) in &quot;Severe Maternal Morbidity Diagnoses&quot; )\n )\n union &quot;Delivery Encounters with Cardiac Conversion, Tracheostomy or Ventilation Procedures&quot;\n union &quot;Delivery Encounters with Expiration&quot;\n )</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1028FHIRPCSevereOBComps</td>\n \n \n <td>SDE Delivery Encounters with Severe Obstetric Complication Diagnosis</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;SDE Delivery Encounters with Severe Obstetric Complication Diagnosis&quot;:\n ( &quot;Delivery Encounters with Severe Obstetric Complications&quot;\n except &quot;SOC with Hysterectomy or Blood Transfusion with Placenta Increta or Placenta Percreta Without Additional SOC&quot; ) Encounter\n where Encounter.pOAIsNoOrUTD ( ) in &quot;Severe Maternal Morbidity Diagnoses&quot;</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1028FHIRPCSevereOBComps</td>\n \n \n <td>Risk Variable Placental Accreta Spectrum</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Risk Variable Placental Accreta Spectrum&quot;:\n &quot;Delivery Encounters At Greater than or Equal to 20 Weeks Gestation&quot; TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in &quot;Placenta Accreta&quot;\n or TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in &quot;Placenta Increta or Percreta&quot;</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1028FHIRPCSevereOBComps</td>\n \n \n <td>Risk Variable Neuromuscular</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Risk Variable Neuromuscular&quot;:\n &quot;Delivery Encounters At Greater than or Equal to 20 Weeks Gestation&quot; TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in &quot;Neuromuscular Disease&quot;</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1028FHIRPCSevereOBComps</td>\n \n \n <td>Risk Variable Hypertension</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Risk Variable Hypertension&quot;:\n &quot;Delivery Encounters At Greater than or Equal to 20 Weeks Gestation&quot; TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in &quot;Hypertension&quot;</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1028FHIRPCSevereOBComps</td>\n \n \n <td>Risk Variable Preterm Birth</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Risk Variable Preterm Birth&quot;:\n/* CGA = Calculated Gestational Age. EGA = Estimated Gestational Age. */\n \n ( PCMaternal.&quot;Delivery Encounter with Age Range&quot; DeliveryEncounter\n let CGA: DeliveryEncounter.calculatedGestationalAge ( ),\n EGA: DeliveryEncounter.lastEstimatedGestationalAge ( )\n where CGA in Interval[20, 36]\n or ( CGA is null\n and ( EGA &gt;= 20 weeks\n and EGA &lt;= 36 weeks\n )\n )\n )\n union ( PCMaternal.&quot;Delivery Encounter with Age Range&quot; DeliveryEncounter\n let CGA: DeliveryEncounter.calculatedGestationalAge ( ),\n EGA: DeliveryEncounter.lastEstimatedGestationalAge ( )\n where CGA is null\n and EGA is null\n and DeliveryEncounter.pOAIsYesOrExempt ( ) in &quot;Preterm Birth&quot;\n )</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SupplementalDataElements</td>\n \n \n <td>SDE Payer</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;SDE Payer&quot;:\n [Coverage: type in &quot;Payer Type&quot;] Payer\n return {\n code: Payer.type,\n period: Payer.period\n }</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1028FHIRPCSevereOBComps</td>\n \n \n <td>SDE Payer</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;SDE Payer&quot;:\n SDE.&quot;SDE Payer&quot;</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1028FHIRPCSevereOBComps</td>\n \n \n <td>Risk Variable Placental Abruption</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Risk Variable Placental Abruption&quot;:\n &quot;Delivery Encounters At Greater than or Equal to 20 Weeks Gestation&quot; TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in &quot;Placental Abruption&quot;</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1028FHIRPCSevereOBComps</td>\n \n \n <td>Risk Variable Morbid Obesity</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Risk Variable Morbid Obesity&quot;:\n &quot;Delivery Encounters At Greater than or Equal to 20 Weeks Gestation&quot; TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in &quot;Morbid or Severe Obesity&quot;</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1028FHIRPCSevereOBComps</td>\n \n \n <td>Risk Variable Preexisting Diabetes</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Risk Variable Preexisting Diabetes&quot;:\n &quot;Delivery Encounters At Greater than or Equal to 20 Weeks Gestation&quot; TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in &quot;Preexisting Diabetes&quot;</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1028FHIRPCSevereOBComps</td>\n \n \n <td>Risk Variable Bariatric Surgery</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Risk Variable Bariatric Surgery&quot;:\n &quot;Delivery Encounters At Greater than or Equal to 20 Weeks Gestation&quot; TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in &quot;Bariatric Surgery&quot;</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SupplementalDataElements</td>\n \n \n <td>SDE Race</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;SDE Race&quot;:\n Patient.race R\n return Tuple {\n codes: R.ombCategory union R.detailed,\n display: R.text\n }</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1028FHIRPCSevereOBComps</td>\n \n \n <td>SDE Race</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;SDE Race&quot;:\n SDE.&quot;SDE Race&quot;</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1028FHIRPCSevereOBComps</td>\n \n \n <td>Risk Variable Placenta Previa</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Risk Variable Placenta Previa&quot;:\n &quot;Delivery Encounters At Greater than or Equal to 20 Weeks Gestation&quot; TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in &quot;Placenta Previa&quot;</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SupplementalDataElements</td>\n \n \n <td>SDE Sex</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;SDE Sex&quot;:\n case\n when Patient.gender = 'male' then &quot;M&quot;\n when Patient.gender = 'female' then &quot;F&quot;\n else null\n end</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1028FHIRPCSevereOBComps</td>\n \n \n <td>SDE Sex</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;SDE Sex&quot;:\n SDE.&quot;SDE Sex&quot;</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1028FHIRPCSevereOBComps</td>\n \n \n <td>Risk Variable Bleeding Disorder</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Risk Variable Bleeding Disorder&quot;:\n &quot;Delivery Encounters At Greater than or Equal to 20 Weeks Gestation&quot; TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in &quot;Bleeding Disorder&quot;</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1028FHIRPCSevereOBComps</td>\n \n \n <td>Risk Variable First White Blood Cell Count Lab Test</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">//First resulted value 24 hours prior to start of encounter and before time of delivery\n //Report white blood cell count as 10*3/uL\n\n\n\ndefine &quot;Risk Variable First White Blood Cell Count Lab Test&quot;:\n &quot;Delivery Encounters At Greater than or Equal to 20 Weeks Gestation&quot; TwentyWeeksPlusEncounter\n let FirstWBC: First([&quot;USCoreLaboratoryResultObservationProfile&quot;: &quot;White blood cells count lab test&quot;] WBC\n where WBC.issued during Interval[start of TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation() - 1440 minutes, TwentyWeeksPlusEncounter.lastTimeOfDelivery()]\n and WBC.status in { 'final', 'amended', 'corrected' }\n and WBC.value is not null\n sort by issued.earliest()\n )\n return {\n EncounterId: TwentyWeeksPlusEncounter.id,\n FirstWBCResult: FirstWBC.value as Quantity,\n Timing: FirstWBC.issued\n }</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1028FHIRPCSevereOBComps</td>\n \n \n <td>Risk Variable First Hematocrit Lab Test</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">//First resulted value 24 hours prior to start of encounter and before time of delivery\n //Report hematocrit as %\n\n\n\ndefine &quot;Risk Variable First Hematocrit Lab Test&quot;:\n &quot;Delivery Encounters At Greater than or Equal to 20 Weeks Gestation&quot; TwentyWeeksPlusEncounter\n let FirstHematocrit: First([&quot;USCoreLaboratoryResultObservationProfile&quot;: &quot;Hematocrit lab test&quot;] Hematocrit\n where Hematocrit.issued during Interval[start of TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation() - 1440 minutes, TwentyWeeksPlusEncounter.lastTimeOfDelivery()]\n and Hematocrit.status in { 'final', 'amended', 'corrected' }\n and Hematocrit.value is not null\n sort by issued.earliest()\n )\n return {\n EncounterId: TwentyWeeksPlusEncounter.id,\n FirstHematocritResult: FirstHematocrit.value as Quantity,\n Timing: FirstHematocrit.issued\n }</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1028FHIRPCSevereOBComps</td>\n \n \n <td>Risk Variable Severe Preeclampsia</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Risk Variable Severe Preeclampsia&quot;:\n &quot;Delivery Encounters At Greater than or Equal to 20 Weeks Gestation&quot; TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in &quot;Severe Preeclampsia&quot;</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1028FHIRPCSevereOBComps</td>\n \n \n <td>Risk Variable Anemia</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Risk Variable Anemia&quot;:\n &quot;Delivery Encounters At Greater than or Equal to 20 Weeks Gestation&quot; TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in &quot;Anemia&quot;</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1028FHIRPCSevereOBComps</td>\n \n \n <td>Risk Variable Cardiac Disease</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Risk Variable Cardiac Disease&quot;:\n &quot;Delivery Encounters At Greater than or Equal to 20 Weeks Gestation&quot; TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in &quot;Cardiac Disease&quot;</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1028FHIRPCSevereOBComps</td>\n \n \n <td>Risk Variable Long Term Anticoagulant Use</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Risk Variable Long Term Anticoagulant Use&quot;:\n &quot;Delivery Encounters At Greater than or Equal to 20 Weeks Gestation&quot; TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in &quot;Long Term Anticoagulant Use&quot;</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1028FHIRPCSevereOBComps</td>\n \n \n <td>Risk Variable Systolic Blood Pressure</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">//First resulted value 24 hours prior to start of encounter and before time of delivery\n//Report systolic blood pressure as mm[Hg]\n//Systolic blood pressure value cannot be null per QICore profile requirement.\n\n\n\n\ndefine &quot;Risk Variable Systolic Blood Pressure&quot;:\n &quot;Delivery Encounters At Greater than or Equal to 20 Weeks Gestation&quot; TwentyWeeksPlusEncounter\n let FirstSystolicBP: First([&quot;observation-bp&quot;] BP\n where BP.effective.earliest() during Interval[start of TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation() - 1440 minutes, TwentyWeeksPlusEncounter.lastTimeOfDelivery()]\n and BP.status in { 'final', 'amended', 'corrected' }\n and BP.component.value is not null\n sort by effective.earliest()\n )\n return {\n EncounterId: TwentyWeeksPlusEncounter.id,\n FirstSBPResult: FirstSystolicBP.component C\n where C.code ~ &quot;Systolic blood pressure&quot;\n return C.value as Quantity,\n Timing: FirstSystolicBP.effective.earliest ( )\n }</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1028FHIRPCSevereOBComps</td>\n \n \n <td>SDE SOC Diagnoses Detail</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;SDE SOC Diagnoses Detail&quot;:\n &quot;SDE Delivery Encounters with Severe Obstetric Complication Diagnosis&quot; Encounter\n let complication: Encounter.pOAIsNoOrUTD ( )\n return {\n id: Encounter.id,\n\t // code: Encounter.type,\n \n complications: complication C\n where C in &quot;Severe Maternal Morbidity Diagnoses&quot;\n return {\n code: C,\n SOCDxCategory: C.sOCDxCategory ( )\n }\n }</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1028FHIRPCSevereOBComps</td>\n \n \n <td>Risk Variable Substance Abuse</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Risk Variable Substance Abuse&quot;:\n &quot;Delivery Encounters At Greater than or Equal to 20 Weeks Gestation&quot; TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in &quot;Substance Abuse&quot;</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1028FHIRPCSevereOBComps</td>\n \n \n <td>Risk Variable Renal Disease</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Risk Variable Renal Disease&quot;:\n &quot;Delivery Encounters At Greater than or Equal to 20 Weeks Gestation&quot; TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in &quot;Renal Disease&quot;</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>PCMaternal</td>\n \n \n <td>Variable Calculated Gestational Age</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Variable Calculated Gestational Age&quot;:\n // This definition establishes a variable of CGA (Calculated Gestational Age). CGA is a supplemental data element to store the calculated gestational age result from the &quot;CalculatedGestationalAge&quot; function. The data element enables the capturing and saving of the CGA for data analysis post data receipt. Hospitals do not need to submit any additional data to comply with this definition\n &quot;Delivery Encounter with Age Range&quot; DeliveryEncounter\n let CGA: DeliveryEncounter.calculatedGestationalAge()\n // return { QualifyingEncounter, CGA }\n return {\n EncounterID: DeliveryEncounter.id,\n CalculatedCGA: CGA\n }</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1028FHIRPCSevereOBComps</td>\n \n \n <td>SDE Variable Calculated Gestational Age</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;SDE Variable Calculated Gestational Age&quot;:\n //This definition establishes a variable of CGA (Calculated Gestational Age). CGA is a supplemental data element to store the calculated gestational age result from the &quot;CalculatedGestationalAge&quot; function. The data element enables the capturing and saving of the CGA for data analysis post data receipt. Hospitals do not need to submit any additional data to comply with this definition. \n \n PCMaternal.&quot;Variable Calculated Gestational Age&quot;</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1028FHIRPCSevereOBComps</td>\n \n \n <td>Risk Variable Gastrointestinal Disease</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Risk Variable Gastrointestinal Disease&quot;:\n &quot;Delivery Encounters At Greater than or Equal to 20 Weeks Gestation&quot; TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in &quot;Gastrointestinal Disease&quot;</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1028FHIRPCSevereOBComps</td>\n \n \n <td>Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions&quot;:\n &quot;Delivery Encounters with Severe Obstetric Complications Diagnosis or Procedure Excluding Blood Transfusion&quot;\n union &quot;Delivery Encounters with Expiration&quot;</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1028FHIRPCSevereOBComps</td>\n \n \n <td>Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions Only</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions Only&quot;:\n &quot;Delivery Encounters with Severe Obstetric Complications&quot;\n intersect &quot;Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions&quot;</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1028FHIRPCSevereOBComps</td>\n \n \n <td>Risk Variable Pulmonary Hypertension</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Risk Variable Pulmonary Hypertension&quot;:\n &quot;Delivery Encounters At Greater than or Equal to 20 Weeks Gestation&quot; TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in &quot;Pulmonary Hypertension&quot;</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1028FHIRPCSevereOBComps</td>\n \n \n <td>Risk Variable Thyrotoxicosis</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Risk Variable Thyrotoxicosis&quot;:\n &quot;Delivery Encounters At Greater than or Equal to 20 Weeks Gestation&quot; TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in &quot;Thyrotoxicosis&quot;</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1028FHIRPCSevereOBComps</td>\n \n \n <td>Risk Variable Other Preeclampsia</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Risk Variable Other Preeclampsia&quot;:\n &quot;Delivery Encounters At Greater than or Equal to 20 Weeks Gestation&quot; TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in &quot;Mild or Moderate Preeclampsia&quot;</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1028FHIRPCSevereOBComps</td>\n \n \n <td>Initial Population</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Initial Population&quot;:\n PCMaternal.&quot;Delivery Encounter with Age Range&quot;</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1028FHIRPCSevereOBComps</td>\n \n \n <td>Risk Variable Economic Housing Instability</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Risk Variable Economic Housing Instability&quot;:\n &quot;Delivery Encounters At Greater than or Equal to 20 Weeks Gestation&quot; TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in &quot;Economic Housing Instability&quot;</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1028FHIRPCSevereOBComps</td>\n \n \n <td>Risk Variable HIV</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Risk Variable HIV&quot;:\n &quot;Delivery Encounters At Greater than or Equal to 20 Weeks Gestation&quot; TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in &quot;HIV in Pregnancy Childbirth and Puerperium&quot;</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1028FHIRPCSevereOBComps</td>\n \n \n <td>SDE Delivery Encounters with Severe Obstetric Complication Procedures</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;SDE Delivery Encounters with Severe Obstetric Complication Procedures&quot;:\n ( &quot;Delivery Encounters with Severe Obstetric Complications&quot;\n except &quot;SOC with Hysterectomy or Blood Transfusion with Placenta Increta or Placenta Percreta Without Additional SOC&quot; ) Encounter\n where exists ( [&quot;Procedure&quot;: &quot;Severe Maternal Morbidity Procedures&quot;]\n union [&quot;Procedure&quot;: &quot;Blood Transfusion&quot;] ) SMMProcedures\n where SMMProcedures.status = 'completed'\n and SMMProcedures.performed.toInterval ( ) starts during day of Encounter.hospitalizationWithEDOBTriageObservation ( )</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1028FHIRPCSevereOBComps</td>\n \n \n <td>SOC Excluding Blood Transfusions Only with Hysterectomy or Blood Transfusion with Placenta Increta or Placenta Percreta Without Additional SOC</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;SOC Excluding Blood Transfusions Only with Hysterectomy or Blood Transfusion with Placenta Increta or Placenta Percreta Without Additional SOC&quot;:\n ( &quot;Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions Only&quot; SOCExcludingTransfusion\n where exists ( ( SOCExcludingTransfusion.encounterDiagnosis ( ) ) EncounterDiagnoses\n where EncounterDiagnoses.code in &quot;Placenta Increta or Percreta&quot;\n )\n and ( exists &quot;Delivery Encounters with Blood Transfusion&quot;\n or exists &quot;Delivery Encounters with Hysterectomy&quot;\n )\n )\n\t\n\t//The following logic keeps encounter in the numerator if there is an additional SOC besides Blood Transfusion or Hysterectomy\n \n except ( ( &quot;Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions Only&quot; SOCExcludingTransfusion\n where SOCExcludingTransfusion.pOAIsNoOrUTD ( ) in &quot;Severe Maternal Morbidity Diagnoses&quot;\n )\n union &quot;Delivery Encounters with Cardiac Conversion, Tracheostomy or Ventilation Procedures&quot;\n union &quot;Delivery Encounters with Expiration&quot;\n )</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1028FHIRPCSevereOBComps</td>\n \n \n <td>Risk Variable Heart Rate</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">//First resulted value 24 hours prior to start of encounter and before time of delivery\n //Report heart rate as beats/min\n //Heart rate value cannot be null per QICore profile requirement.\n\n\n\n\ndefine &quot;Risk Variable Heart Rate&quot;:\n &quot;Delivery Encounters At Greater than or Equal to 20 Weeks Gestation&quot; TwentyWeeksPlusEncounter\n let FirstHeartRate: First([&quot;observation-heartrate&quot;] HeartRate\n where HeartRate.effective.earliest() during Interval[start of TwentyWeeksPlusEncounter.hospitalizationWithEDOBTriageObservation() - 1440 minutes, TwentyWeeksPlusEncounter.lastTimeOfDelivery()]\n and HeartRate.status in { 'final', 'amended', 'corrected' }\n sort by effective.earliest()\n )\n return {\n EncounterId: TwentyWeeksPlusEncounter.id,\n FirstHRResult: FirstHeartRate.value as Quantity,\n Timing: FirstHeartRate.effective.earliest ( )\n }</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1028FHIRPCSevereOBComps</td>\n \n \n <td>Risk Variable Maternal Age</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Risk Variable Maternal Age&quot;:\n &quot;Delivery Encounters At Greater than or Equal to 20 Weeks Gestation&quot; TwentyWeeksPlusEncounter\n let MaternalAge: AgeInYearsAt(date from start of TwentyWeeksPlusEncounter.period)\n return { TwentyWeeksPlusEncounter, MaternalAge }</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1028FHIRPCSevereOBComps</td>\n \n \n <td>Risk Variable Mental Health Disorder</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Risk Variable Mental Health Disorder&quot;:\n &quot;Delivery Encounters At Greater than or Equal to 20 Weeks Gestation&quot; TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in &quot;Mental Health Disorder&quot;</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1028FHIRPCSevereOBComps</td>\n \n \n <td>Risk Variable Obstetrical VTE</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Risk Variable Obstetrical VTE&quot;:\n &quot;Delivery Encounters At Greater than or Equal to 20 Weeks Gestation&quot; TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in &quot;Venous Thromboembolism in Pregnancy&quot;</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1028FHIRPCSevereOBComps</td>\n \n \n <td>Risk Variable Autoimmune Disease</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Risk Variable Autoimmune Disease&quot;:\n &quot;Delivery Encounters At Greater than or Equal to 20 Weeks Gestation&quot; TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in &quot;Autoimmune Disease&quot;</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1028FHIRPCSevereOBComps</td>\n \n \n <td>Risk Variable Previous Cesarean</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Risk Variable Previous Cesarean&quot;:\n &quot;Delivery Encounters At Greater than or Equal to 20 Weeks Gestation&quot; TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in &quot;Previous Cesarean&quot;</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1028FHIRPCSevereOBComps</td>\n \n \n <td>Risk Variable Gestational Diabetes</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Risk Variable Gestational Diabetes&quot;:\n &quot;Delivery Encounters At Greater than or Equal to 20 Weeks Gestation&quot; TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in &quot;Gestational Diabetes&quot;</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1028FHIRPCSevereOBComps</td>\n \n \n <td>SDE SOC Procedure Detail</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;SDE SOC Procedure Detail&quot;:\n &quot;SDE Delivery Encounters with Severe Obstetric Complication Procedures&quot; Encounter\n let procedure: Encounter.sOCProcedures ( )\n return {\n id: Encounter.id,\n // code: Encounter.code,\n \n procedures: procedure P\n return {\n code: P,\n SOCProcedureCategory: P.sOCProcedureCategory ( )\n }\n }</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1028FHIRPCSevereOBComps</td>\n \n \n <td>Numerator</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Numerator&quot;:\n &quot;Delivery Encounters with Severe Obstetric Complications&quot;</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1028FHIRPCSevereOBComps</td>\n \n \n <td>Risk Variable Multiple Pregnancy</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Risk Variable Multiple Pregnancy&quot;:\n &quot;Delivery Encounters At Greater than or Equal to 20 Weeks Gestation&quot; TwentyWeeksPlusEncounter\n where TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in &quot;Multiple Pregnancy&quot;</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1028FHIRPCSevereOBComps</td>\n \n \n <td>Denominator</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;Denominator&quot;:\n &quot;Delivery Encounters At Greater than or Equal to 20 Weeks Gestation&quot;</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SupplementalDataElements</td>\n \n \n <td>SDE Ethnicity</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;SDE Ethnicity&quot;:\n Patient.ethnicity E\n return Tuple {\n codes: { E.ombCategory } union E.detailed,\n display: E.text\n }</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1028FHIRPCSevereOBComps</td>\n \n \n <td>SDE Ethnicity</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define &quot;SDE Ethnicity&quot;:\n SDE.&quot;SDE Ethnicity&quot;</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>PCMaternal</td>\n \n \n <td>hospitalizationWithEDOBTriageObservation</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">/*define function &quot;HospitalizationWithEDOBTriageObservation&quot;(Encounter Encounter ):\n HospitalizationWithEDOBTriageObservation returns the total interval from the start of any immediately prior emergency department visit or OB Triage visit through the observation visit to the discharge of the given encounter\n Encounter Visit\n let ObsVisit: Last([&quot;Encounter&quot;: &quot;Observation Services&quot;] LastObs\n where LastObs.period ends 1 hour or less on or before start of Visit.period\n and LastObs.status = 'finished'\n sort by \n end of period\n ),\n VisitStart: Coalesce(start of ObsVisit.period, start of Visit.period),\n EDOBTriageVisit: Last([&quot;Encounter&quot;: &quot;ED Visit and OB Triage&quot;] LastEDOBTriage\n where LastEDOBTriage.period ends 1 hour or less on or before VisitStart\n and LastEDOBTriage.status = 'finished'\n sort by \n end of period\n )\n return Interval[Coalesce(start of EDOBTriageVisit.period, VisitStart), \n end of Visit.period]*/\n \n \ndefine fluent function hospitalizationWithEDOBTriageObservation (TheEncounter Encounter ):\n /*hospitalizationWithEDOBTriageObservation returns the total interval from the start of any immediately prior emergency department visit or OB Triage visit through the observation visit to the discharge of the given encounter*/\n TheEncounter Visit\n let ObsVisit: Last([&quot;Encounter&quot;: &quot;Observation Services&quot;] LastObs\n where LastObs.period ends 1 hour or less on or before start of Visit.period\n and LastObs.status = 'finished'\n sort by \n end of period\n ),\n VisitStart: Coalesce(start of ObsVisit.period, start of Visit.period),\n EDOBTriageVisit: Last([&quot;Encounter&quot;: &quot;ED Visit and OB Triage&quot;] LastEDOBTriage\n where LastEDOBTriage.period ends 1 hour or less on or before VisitStart\n and LastEDOBTriage.status = 'finished'\n sort by \n end of period\n )\n return Interval[Coalesce(start of EDOBTriageVisit.period, VisitStart), \n end of Visit.period]</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>PCMaternal</td>\n \n \n <td>calculatedGestationalAge</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define fluent function calculatedGestationalAge (TheEncounter Encounter ):\n //Gestational Age = (280-(Estimated Delivery Date minus Reference Date/Delivery Date))/7\n ( 280 - ( difference in days between TheEncounter.lastTimeOfDelivery () and re TwentyWeeksPlusEncounter.pOAIsYesOrExempt ( ) in \"Morbid or Severe Obesity\""
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 24
                }
              ],
              "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "CMS1028FHIRPCSevereOBComps"
                },
                {
                  "url" : "name",
                  "valueString" : "Risk Variable Preexisting Diabetes"
                },
                {
              &nb              "url" : "displaySequence",
                  "valueInteger" : 75
                }
              ],
              "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "QICoreCommon"
                },
                {
                  "url" : "name",
                  "valueString" : "getId"
                },
                {
                  "url" : "statement",
                  "valueString" : "/*\n@description: Returns the tail of the given uri (i.e. everything after the last slash in the URI).\n@comment: This function can be used to determine the logical id of a given resource. It can be used in\na single-server environment to trace references. However, this function does not attempt to resolve\nor distinguish the base of the given url, and so cannot be used safely in multi-server environments.\n*/\ndefine fluent function getId(uri String):\n Last(Split(uri, '/'))"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 76
                }
              ],
              "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "CMS1028FHIRPCSevereOBComps"
                },
                {
                  "url" : "name",
                  "valueString" : "pOAIsYesOrExempt"
                },
                {
                  "url" : "statement",
                  "valueString" : "define fluent function pOAIsYesOrExempt(TheEncounter Encounter):\n TheEncounter.diagnosis EncounterDiagnoses\n where EncounterDiagnoses.diagnosisPresentOnAdmission in \"Present On Admission is Yes or Exempt\"\n return EncounterDiagnoses.condition.getCondition ( ).code"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 77
                }
              ],
              "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "FHIRHelpers"
                },
                {
                  "url" : "name",
                  "valueString" : "ToString"
                },
                {
                  "url" : "statement",
                  "valueString" : "define function ToString(value uri): value.value"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 78
                }
              ],
              "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "CQMCommon"
                },
                {
                  "url" : "name",
                  "valueString" : "getCondition"
                },
                {
                  "url" : "statement",
                  "valueString" : "/*\n@description: Returns the Condition resource for the given reference\n*/\ndefine fluent function getCondition(reference Reference):\n singleton from ([Condition] C where C.id = reference.reference.getId())"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 79
                }
              ],
              "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "CMS1028FHIRPCSevereOBComps"
                },
                {
                  "url" : "name",
                  "valueString" : "pOAIsNoOrUTD"
                },
                {
                  "url" : "statement",
                  "valueString" : "define fluent function pOAIsNoOrUTD(TheEncounter Encounter):\n TheEncounter.diagnosis EncounterDiagnoses\n where EncounterDiagnoses.diagnosisPresentOnAdmission in \"Present on Admission is No or Unable To Determine\"\n return EncounterDiagnoses.condition.getCondition ( ).code"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 80
                }
              ],
              "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "FHIRHelpers"
                },
                {
                  "url" : "name",
                  "valueString" : "ToCode"
                },
                {
                  "url" : "statement",
                  "valueString" : "/*\n@description: Converts the given FHIR [Coding](https://hl7.org/fhir/datatypes.html#Coding) value to a CQL Code.\n*/\ndefine function ToCode(coding FHIR.Coding):\n if coding is null then\n null\n else\n System.Code {\n code: coding.code.value,\n system: coding.system.value,\n version: coding.version.value,\n display: coding.display.value\n }"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 81
                }
              ],
              "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "CMS1028FHIRPCSevereOBComps"
                },
                {
                  "url" : "name",
                  "valueString" : "sOCDxCategory"
                },
                {
                  "url" : "statement",
                  "valueString" : "define fluent function sOCDxCategory(Dx Concept):\n case\n when Dx in \"Acute Heart Failure\" then 'Acute Heart Failure'\n when Dx in \"Acute Myocardial Infarction\" then 'Acute Myocardial Infarction'\n when Dx in \"Acute Renal Failure\" then 'Acute Renal Failure'\n when Dx in \"Acute Respiratory Distress Syndrome\" then 'Acute Respiratory Distress Syndrome'\n when Dx in \"Air and Thrombotic Embolism\" then 'Air and Thrombotic Embolism'\n when Dx in \"Amniotic Fluid Embolism\" then 'Amniotic Fluid Embolism'\n when Dx in \"Aortic Aneurysm\" then 'Aortic Aneurysm'\n when Dx in \"Cardiac Arrest Ventricular Fibrillation\" then 'Cardiac Arrest Ventricular Fibrillation'\n when Dx in \"Disseminated Intravascular Coagulation\" then 'Disseminated Intravascular Coagulation'\n when Dx in \"Eclampsia\" then 'Eclampsia'\n when Dx in \"Heart Failure Cardiac Arrest Related to Procedure or Surgery\" then 'Heart Failure Cardiac Arrest Related to Procedure or Surgery'\n when Dx in \"Puerperal Cerebrovascular Disorder\" then 'Puerperal Cerebrovascular Disorder'\n when Dx in \"Pulmonary Edema\" then 'Pulmonary Edema'\n when Dx in \"Sepsis\" then 'Sepsis'\n when Dx in \"Severe Anesthesia Complications\" then 'Severe Anesthesia Complications'\n when Dx in \"Shock\" then 'Shock'\n when Dx in \"Sickle Cell Disease with Crisis\" then 'Sickle Cell Disease with Crisis' \n else null end"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 82
                }
              ],
              "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "CMS1028FHIRPCSevereOBComps"
                },
                {
                  "url" : "name",
                  "valueString" : "sOCProcedures"
                },
                {
                  "url" : "statement",
                  "valueString" : "define fluent function sOCProcedures(TheEncounter Encounter):\n ( [\"Procedure\": \"Severe Maternal Morbidity Procedures\"]\n union [\"Procedure\": \"Blood Transfusion\"] ) SMMProcedures\n where SMMProcedures.status = 'completed'\n and SMMProcedures.performed.toInterval ( ) starts during day of TheEncounter.hospitalizationWithEDOBTriageObservation ( )"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 83
                }
              ],
              "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "CMS1028FHIRPCSevereOBComps"
                },
                {
                  "url" : "name",
                  "valueString" : "sOCProcedureCategory"
                },
                {
                  "url" : "statement",
                  "valueString" : "define fluent function sOCProcedureCategory(TheProcedure Procedure):\n case\n when TheProcedure.code in \"Blood Transfusion\" then 'Blood Transfusion'\n when TheProcedure.code in \"Conversion of Cardiac Rhythm\" then 'Conversion of cardiac rhythm'\n when TheProcedure.code in \"Hysterectomy\" then 'Hysterectomy'\n when TheProcedure.code in \"Tracheostomy\" then 'Tracheostomy'\n when TheProcedure.code in \"Ventilation\" then 'Ventilation' \n else null end"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 84
                }
              ],
              "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
            }
          ],
          "name" : "EffectiveDataRequirements",
          "status" : "active",
          "type" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/library-type",
                "code" : "module-definition"
              }
            ]
          },
          "relatedArtifact" : [
            {
              "type" : "depends-on",
              "display" : "Library PCMaternal",
              "resource" : "Library/PCMaternal|5.19.000"
            },
            {
              "type" : "depends-on",
              "display" : "Library CQMCommon",
              "resource" : "Library/CQMCommon|2.2.000"
            },
            {
              "type" : "depends-on",
              "display" : "Library FHIRHelpers",
              "resource" : "Library/FHIRHelpers|4.4.000"
            },
            {
              "type" : "depends-on",
              "display" : "Library QICoreCommon",
              "resource" : "Library/QICoreCommon|2.1.000"
            },
            {
              "type" : "depends-on",
              "display" : "Library SDE",
              "resource" : "Library/SupplementalDataElements|3.5.000"
            },
            {
              "type" : "depends-on",
              "display" : "Code system LOINC",
              "resource" : "http://loinc.org"
            },
            {
              "type" : "depends-on",
              "display" : "Code system AdministrativeGender",
              "resource" : "http://hl7.org/fhir/administrative-gender"
            },
            {
              "type" : "depends-on",
              "display" : "Value set Encounter Inpatient",
              "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307"
            },
            {
              "type" : "depends-on",
              "display" : "Value set Delivery Procedures",
              "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.59"
            },
            {
              "type" : "depends-on",
              "display" : "Value set Observation Services",
              "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.143"
            },
            {
              "type" : "depends-on",
              "display" : "Value set ED Visit and OB Triage",
              "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.369"
            },
            {
              "type" : "depends-on",
              "display" : "Value set Estimated Gestational Age at Delivery",
              "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.26"
            },
            {
              "type" : "depends-on",
              "display" : "Value set 20 to 42 Plus Weeks Gestation",
              "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.67"
            },
            {
              "type" : "depends-on",
              "display" : "Value set Present On Admission is Yes or Exempt",
              "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.63"
            },
            {
              "type" : "depends-on",
              "display" : "Value set Acute or Persistent Asthma",
              "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.271"
            },
            {
              "type" : "depends-on",
              "display" : "Value set Present on Admission is No or Unable To Determine",
              "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.370"
            },
            {
              "type" : "depends-on",
              "display" : "Value set Severe Maternal Morbidity Diagnoses",
              "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.255"
            },
            {
              "type" : "depends-on",
              "display" : "Value set Severe Maternal Morbidity Procedures",
              "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.256"
            },
            {
              "type" : "depends-on",
              "display" : "Value set Patient Expired",
              "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.309"
            },
            {
              "type" : "depends-on",
              "display" : "Value set Blood Transfusion",
              "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.213"
            },
            {
              "type" : "depends-on",
              "display" : "Value set Placenta Increta or Percreta",
              "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.388"
            },
            {
              "type" : "depends-on",
              "display" : "Value set Hysterectomy",
              "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.358"
            },
            {
              "type" : "depends-on",
              "display" : "Value set Conversion of Cardiac Rhythm",
              "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.357"
            },
            {
              "type" : "depends-on",
              "display" : "Value set Tracheostomy",
              "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.359"
            },
            {
              "type" : "depends-on",
              "display" : "Value set Ventilation",
              "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.360"
            },
            {
              "type" : "depends-on",
              "display" : "Value set Placenta Accreta",
              "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.302"
            },
            {
              "type" : "depends-on",
              "display" : "Value set Neuromuscular Disease",
              "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.308"
            },
            {
              "type" : "depends-on",
              "display" : "Value set Hypertension",
              "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.332"
            },
            {
              "type" : "depends-on",
              "display" : "Value set Preterm Birth",
              "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.299"
            },
            {
              "type" : "depends-on",
              "display" : "Value set Payer Type",
              "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"
            },
            {
              "type" : "depends-on",
              "display" : "Value set Placental Abruption",
              "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.305"
            },
            {
              "type" : "depends-on",
              "display" : "Value set Morbid or Severe Obesity",
              "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.290"
            },
            {
              "type" : "depends-on",
              "display" : "Value set Preexisting Diabetes",
              "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.275"
            },
            {
              "type" : "depends-on",
              "display" : "Value set Bariatric Surgery",
              "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.317"
            },
            {
              "type" : "depends-on",
              "display" : "Value set Placenta Previa",
              "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.78"
            },
            {
              "type" : "depends-on",
              "display" : "Value set Bleeding Disorder",
              "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.287"
            },
            {
              "type" : "depends-on",
              "display" : "Value set White blood cells count lab test",
              "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.129"
            },
            {
              "type" : "depends-on",
              "display" : "Value set Hematocrit lab test",
              "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.114"
            },
            {
              "type" : "depends-on",
              "display" : "Value set Severe Preeclampsia",
              "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.327"
            },
            {
              "type" : "depends-on",
              "display" : "Value set Anemia",
              "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.323"
            },
            {
              "type" : "depends-on",
              "display" : "Value set Cardiac Disease",
              "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.341"
            },
            {
              "type" : "depends-on",
              "display" : "Value set Long Term Anticoagulant Use",
              "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.366"
            },
            {
              "type" : "depends-on",
              "display" : "Value set Acute Heart Failure",
              "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.233"
            },
            {
              "type" : "depends-on",
              "display" : "Value set Acute Myocardial Infarction",
              "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.623"
            },
            {
              "type" : "depends-on",
              "display" : "Value set Acute Renal Failure",
              "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.53"
            },
            {
              "type" : "depends-on",
              "display" : "Value set Acute Respiratory Distress Syndrome",
              "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.214"
            },
            {
              "type" : "depends-on",
              "display" : "Value set Air and Thrombotic Embolism",
              "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.243"
            },
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                  ]
                }
              ],
              "dateFilter" : [
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                      {
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                        "valueExpression" : {
                          "language" : "text/cql-identifier",
                          "expression" : "Measurement Period"
                        }
                      }
                    ]
                  }
                }
              ]
            },
            {
              "type" : "Patient",
              "profile" : [
                "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"
              ],
              "mustSupport" : [
                "race",
                "ethnicity"
              ]
            },
            {
              "type" : "Procedure",
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                "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure"
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                },
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                  "code" : [
                    {
                      "code" : "completed"
                    }
                  ]
                }
              ]
            },
            {
              "type" : "Procedure",
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                {
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                },
                {
                  "path" : "status.value",
                  "code" : [
                    {
                      "code" : "completed"
                    }
                  ]
                }
              ]
            },
            {
              "type" : "Procedure",
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            },
            {
              "type" : "Procedure",
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              "type" : "Procedure",
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              "type" : "Procedure",
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              "type" : "Procedure",
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              "type" : "Procedure",
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                {
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            {
              "type" : "Procedure",
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                "performed"
              ],
              "codeFilter" : [
                {
                  "path" : "code",
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                },
                {
                  "path" : "status.value",
                  "code" : [
                    {
                      "code" : "completed"
                    }
                  ]
                }
              ]
            },
            {
              "type" : "Observation",
              "profile" : [
                "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation"
              ],
              "mustSupport" : [
                "code",
                "value",
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                "status.value",
                "effective"
              ],
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                {
                  "path" : "code",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "93857-1",
                      "display" : "Date and time of obstetric delivery"
                    }
                  ]
                }
              ]
            },
            {
              "type" : "Observation",
              "profile" : [
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                    }
                  ]
                }
              ]
            },
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                "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab"
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                "code",
                "issued",
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              ]
            },
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                "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab"
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                {
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              ]
            },
            {
              "type" : "Observation",
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                "http://hl7.org/fhir/StructureDefinition/bp"
              ],
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                "effective",
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                "component"
              ]
            },
            {
              "type" : "Observation",
              "profile" : [
                "http://hl7.org/fhir/StructureDefinition/heartrate"
              ],
              "mustSupport" : [
                "effective",
                "status",
                "status.value",
                "value"
              ]
            }
          ]
        }
      ],
      "extension" : [
        {
          "id" : "supplementalDataGuidance",
          "extension" : [
            {
              "url" : "guidance",
              "valueString" : "For every patient evaluated by this measure also identify payer, race, ethnicity and sex for stratified hospital-specific reports after data submission. The variable calculated gestational age, SOC diagnosis details, and SOC procedure details are derived or calculated from diagnosis and encounter data provided in the QRDA I on the receiving end and thus, are not additionally submitted by hospitals.\n\n \n "
            },
            {
              "url" : "usage",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
                    "code" : "supplemental-data",
                    "display" : "Supplemental Data"
                  }
                ],
                "text" : "Supplemental Data Guidance"
              }
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-supplementalDataGuidance"
        },
        {
          "id" : "riskAdjustmentVariableGuidance",
          "extension" : [
            {
              "url" : "guidance",
              "valueString" : "The Severe Obstetric Complications Risk Adjustment Methodology Report is available on the eCQI Resource Center (https://ecqi.healthit.gov).\nPre-existing conditions and variables must be present on admission. Please note that present on admission codes may be extracted from billing/claims data that was entered by coding staff (Leonard, Kennedy, Carmichael, Lyell, & Main, 2020; Main, Leonard, & Menard, 2020).\n- Anemia (includes sickle cell disease)\n- Asthma \n- Autoimmune Disease\n- Bariatric Surgery\n- Bleeding Disorder\n- Cardiac Disease\n- Economic Housing Instability\n- Gastrointestinal Disease \n- Gestational Diabetes\n- HIV\n- Hypertension\n- Long-term Anticoagulant Use\n- Maternal Age (derived from birthdate)\n- Mental Health Disorder\n- Morbid Obesity\n- Multiple Pregnancy\t\n- Neuromuscular Disease\n- Obstetric VTE\n- Other Pre-eclampsia\n- Placenta Previa\n- Placental Abruption\n- Placental Accreta Spectrum\n- Pre-existing Diabetes \n- Preterm Birth\n- Previous Cesarean \n- Pulmonary Hypertension\n- Renal Disease \n- Severe Pre-eclampsia\n- Substance Abuse\n- Thyrotoxicosis \n\nLab and Physical Exam Results:\nReport the first resulted value 24 hours prior to start of encounter and before time of delivery in UCUM units specified:\n- Heart rate: {beats}/min\n- Systolic blood pressure: mm[Hg]\n- Hematocrit: %\n- White blood cell count: 10*3/uL \n\n\nNote regarding submission of risk variable data: The risk variable definitions are included in the specifications and risk variable data should be sent with eCQM data in the QRDA I file. Specific risk variable templates are not needed in the QRDA I files."
            },
            {
              "url" : "usage",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
                    "code" : "risk-adjustment-factor",
                    "display" : "Risk Adjustment Factor"
                  }
                ],
                "text" : "Risk Adjustment Variable Guidance"
              }
            }
          ],
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-supplementalDataGuidance"
        },
        {
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-softwaresystem",
          "valueReference" : {
            "reference" : "Device/cqf-tooling"
          }
        },
        {
          "id" : "effective-data-requirements",
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-effectiveDataRequirements",
          "valueReference" : {
            "reference" : "#effective-data-requirements"
          }
        }
      ],
      "url" : "https://madie.cms.gov/Measure/CMS1028FHIRPCSevereOBComps",
      "identifier" : [
        {
          "use" : "usual",
          "type" : {
            "coding" : [
              {
                "system" : "http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type",
                "code" : "short-name",
                "display" : "Short Name"
              }
            ]
          },
          "system" : "https://madie.cms.gov/measure/shortName",
          "value" : "CMS1028FHIR"
        },
        {
          "use" : "official",
          "type" : {
            "coding" : [
              {
                "system" : "http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type",
                "code" : "version-independent",
                "display" : "Version Independent"
              }
            ]
          },
          "system" : "urn:ietf:rfc:3986",
          "value" : "urn:uuid:6cf03fe2-b962-4f83-ac37-26d7477183c7"
        },
        {
          "use" : "official",
          "type" : {
            "coding" : [
              {
                "system" : "http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type",
                "code" : "version-specific",
                "display" : "Version Specific"
              }
            ]
          },
          "system" : "urn:ietf:rfc:3986",
          "value" : "urn:uuid:d11a564b-0516-4ed0-9a27-45fdd06a8064"
        },
        {
          "use" : "official",
          "type" : {
            "coding" : [
              {
                "system" : "http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type",
                "code" : "endorser",
                "display" : "Endorser"
              }
            ]
          },
          "system" : "https://madie.cms.gov/measure/cbeId",
          "value" : "3687e",
          "assigner" : {
            "display" : "CMS Consensus Based Entity"
          }
        },
        {
          "use" : "official",
          "type" : {
            "coding" : [
              {
                "system" : "http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type",
                "code" : "publisher",
                "display" : "Publisher"
              }
            ]
          },
          "system" : "https://madie.cms.gov/measure/cmsId",
          "value" : "1028FHIR",
          "assigner" : {
            "display" : "CMS"
          }
        }
      ],
      "version" : "0.1.002",
      "name" : "CMS1028FHIRPCSevereOBComps",
      "title" : "Severe Obstetric ComplicationsFHIR",
      "status" : "active",
      "experimental" : true,
      "date" : "2025-01-14T15:54:05+00:00",
      "publisher" : "The Joint Commission",
      "contact" : [
        {
          "telecom" : [
            {
              "system" : "url",
              "value" : "https://www.jointcommission.org/"
            }
          ]
        }
      ],
      "description" : "Patients with severe obstetric complications that occur during the inpatient delivery hospitalization",
      "purpose" : "UNKNOWN",
      "usage" : "Note: This measure will be stratified by race/ethnicity and payer after measure submission.\n\nIn the case of multiple births, map the first delivery date/time (Baby A) as the delivery date/time for the encounter. This measure allows for 3 approaches to determine gestational age (GA) in the following order of precedence:\n\n1. The GA is calculated using the American College of Obstetricians and Gynecologists ReVITALize guidelines.*\n2. When the calculated GA is not available, the GA is obtained from a discrete field in the electronic health record. The intent is to capture the last estimated GA in the interval starting 24 hours or less prior to delivery and ending before midnight on the same day of delivery.\n3. The GA is based on ICD10 or SNOMED codes indicative of weeks gestation. This option is only used when results from items #1 and #2 (see above) are not available.\n \n*ACOG ReVITALize Guidelines for Calculating Gestational Age (ACOG, 2014): \n \n Gestational Age = (280-(Estimated Due Date minus Reference Date))/7\n\n--Estimated Due Date (EDD): The best obstetrical EDD is determined by last menstrual period if confirmed by early ultrasound or no ultrasound performed, or early ultrasound if no known last menstrual period or the ultrasound is not consistent with last menstrual period, or known date of fertilization (e.g., assisted reproductive technology) \n--Reference Date is the date on which you are trying to determine gestational age. For purposes of this eCQM, Reference Date would be the Date of Delivery. \n\nNote however the calculation may yield a non-whole number, and gestational age should be rounded down to the nearest completed week. For example, an infant born on the 5th day of the 36th week (35 weeks and 5/7 days) is at a gestational age of 35 weeks, not 36 weeks.\n\nDefinition:\nFor this measure, specifications are modeled after the nationally available and adopted CDC definition for Severe Maternal Morbidity (SMM) with the addition of maternal mortality. At times, we may refer to the CDC indicators of morbidity as SMM, but the outcome of the measure, which includes morbidity and mortality, is referred to as Severe Obstetric Complications (SOC).\n\nThis eCQM is an episode-based measure. An episode is defined as each inpatient hospitalization or encounter that ends during the measurement period.\n\nThis FHIR-based measure has been derived from the QDM-based measure CMS1028v4. 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" : "Measure specifications are in the Public Domain.\n\nLOINC(R) copyright 2004-2024 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2024 International Health Terminology Standards Development Organisation. ICD-10 copyright 2024 World Health Organization. All Rights Reserved.",
      "effectivePeriod" : {
        "start" : "2025-01-01",
        "end" : "2025-12-31"
      },
      "author" : [
        {
          "name" : "The Joint Commission",
          "telecom" : [
            {
              "system" : "url",
              "value" : "https://www.jointcommission.org/"
            }
          ]
        },
        {
          "name" : "Centers for Medicare & Medicaid Services (CMS)",
          "telecom" : [
            {
              "system" : "url",
              "value" : "https://www.cms.gov/"
            }
          ]
        },
        {
          "name" : "Yale New Haven Health Service Corporation/ Center for Outcomes Research and Evaluation",
          "telecom" : [
            {
              "system" : "url",
              "value" : "https://medicine.yale.edu/core/"
            }
          ]
        }
      ],
      "library" : [
        "https://madie.cms.gov/Library/CMS1028FHIRPCSevereOBComps"
      ],
      "disclaimer" : "These performance measures are not clinical guidelines, 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.",
      "rationale" : "The United States (US) experiences higher rates of maternal morbidity and mortality than most other developed countries. The Centers for Disease Control and Prevention (CDC) (2021) report that these rates have continued to trend upward in recent decades. Research indicates that the overall rate of severe maternal morbidity (SMM) increased by almost 200% between 1993 and 2014 to 144 per 10,000 delivery hospitalizations (CDC, 2021), with more than 25,000 women per year experiencing obstetric complications (U.S. Department of Health and Human Services, 2020). Recent maternal mortality data from 2018 reveal that 658 women in the US died from maternal causes, resulting in a rate of 17.4 deaths per 100,000 live births, with 77% of the deaths attributed to direct obstetric causes like hemorrhage, preeclampsia, obstetric embolism, and other complications (Hoyert & Minino, 2020). 144 per 10,000 women hospitalized for delivery have experienced SMM, including hemorrhage, embolism, hypertension, stroke, and other serious complications (CDC, 2021). Racial and ethnic disparities exist: Black women and Hispanic women are at a significantly higher risk for developing these complications than are Non-Hispanic White women (Leonard, Main, Scott, Profit, & Carmichael, 2019). Increasing rates of SMM are resulting in increased healthcare costs, longer hospitalization stays and impacts on a woman's health (Callaghan, Creanga, & Kuklina, 2012). \n\nThere is limited national evaluation of hospitals' performance on maternal morbidity and mortality although SMM is widely used at the population level. SMM is linked to maternal mortality, varies significantly among hospitals, and has significant racial/ethnic and urban/rural disparities. SMM is a cost driver for both Medicaid and commercial plans. This measure is important as it will assist in the discovery and understanding of SMM patterns that can lead to improvements in the safety and quality of maternal care necessary to reduce SMM rates.",
      "clinicalRecommendationStatement" : "Healthy People 2030 Measure (MICH-05): Reduce severe maternal complications identified during delivery hospitalizations (U.S. Department of Health and Human Services, n.d.).\n\nThe American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine recommend identifying potential cases of severe maternal morbidity for further review, with a focus on outcomes and complications, and consider this an important step toward promoting safe obstetric care (American College of Obstetricians and Gynecologists and the Society for Maternal–Fetal Medicine, Kilpatrick, & Ecker, 2016).",
      "guidance" : "Note: This measure will be stratified by race/ethnicity and payer after measure submission.\n\nIn the case of multiple births, map the first delivery date/time (Baby A) as the delivery date/time for the encounter. This measure allows for 3 approaches to determine gestational age (GA) in the following order of precedence:\n\n1. The GA is calculated using the American College of Obstetricians and Gynecologists ReVITALize guidelines.*\n2. When the calculated GA is not available, the GA is obtained from a discrete field in the electronic health record. The intent is to capture the last estimated GA in the interval starting 24 hours or less prior to delivery and ending before midnight on the same day of delivery.\n3. The GA is based on ICD10 or SNOMED codes indicative of weeks gestation. This option is only used when results from items #1 and #2 (see above) are not available.\n \n*ACOG ReVITALize Guidelines for Calculating Gestational Age (ACOG, 2014): \n \n Gestational Age = (280-(Estimated Due Date minus Reference Date))/7\n\n--Estimated Due Date (EDD): The best obstetrical EDD is determined by last menstrual period if confirmed by early ultrasound or no ultrasound performed, or early ultrasound if no known last menstrual period or the ultrasound is not consistent with last menstrual period, or known date of fertilization (e.g., assisted reproductive technology) \n--Reference Date is the date on which you are trying to determine gestational age. For purposes of this eCQM, Reference Date would be the Date of Delivery. \n\nNote however the calculation may yield a non-whole number, and gestational age should be rounded down to the nearest completed week. For example, an infant born on the 5th day of the 36th week (35 weeks and 5/7 days) is at a gestational age of 35 weeks, not 36 weeks.\n\nDefinition:\nFor this measure, specifications are modeled after the nationally available and adopted CDC definition for Severe Maternal Morbidity (SMM) with the addition of maternal mortality. At times, we may refer to the CDC indicators of morbidity as SMM, but the outcome of the measure, which includes morbidity and mortality, is referred to as Severe Obstetric Complications (SOC).\n\nThis eCQM is an episode-based measure. An episode is defined as each inpatient hospitalization or encounter that ends during the measurement period.\n\nThis FHIR-based measure has been derived from the QDM-based measure CMS1028v4. 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).",
      "group" : [
        {
          "id" : "6750921446b6174510cfeb95",
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://terminology.hl7.org/CodeSystem/measure-scoring",
                    "code" : "proportion",
                    "display" : "Proportion"
                  }
                ]
              }
            },
            {
              "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis",
              "valueCode" : "Encounter"
            },
            {
              "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-type",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://terminology.hl7.org/CodeSystem/measure-type",
                    "code" : "outcome",
                    "display" : "Outcome"
                  }
                ]
              }
            },
            {
              "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-rateAggregation",
              "valueCode" : "Two hospital-level measure scores are calculated as a risk-adjusted proportion reported as a rate per 10,000 delivery hospitalizations: 1. All Severe Obstetric Complications (SOC). ((Num1 – NumExcl1) / Den) * 10,000 2. SOC excluding encounters where transfusion was the only SOC. ((Num2 – NumExcl2) / Den) * 10,000 Num1: Delivery encounters with SOC Num2: Delivery encounters with SOC excluding encounters where transfusion was the only SOC NumExcl1: Delivery encounters with blood transfusion or hysterectomy with placenta percreta or placenta increta and no additional SOCs NumExcl2: Delivery encounters with SOC excluding encounters where transfusion was the only SOC with a hysterectomy or blood transfusion with a diagnosis of placenta percreta or placenta increta and no additional SOCs Den: Delivery encounters with > or = 20 weeks' gestation completed"
            },
            {
              "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-improvementNotation",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://terminology.hl7.org/CodeSystem/measure-improvement-notation",
                    "code" : "decrease",
                    "display" : "Decreased score indicates improvement"
                  }
                ]
              }
            }
          ],
          "description" : "All Severe Obstetric Complications (SOC)",
          "population" : [
            {
              "id" : "8D56845B-BA26-4F6A-8D23-BBFD696C9450",
              "code" : {
                "coding" : [
                  {
                    "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                    "code" : "initial-population",
                    "display" : "Initial Population"
                  }
                ]
              },
              "description" : "IPop1: Inpatient hospitalizations for patients age greater than or equal to 8 years and less than 65 admitted to the hospital for inpatient acute care who undergo a delivery procedure with a discharge date during the measurement period",
              "criteria" : {
                "language" : "text/cql-identifier",
                "expression" : "Initial Population"
              }
            },
            {
              "id" : "8542DE86-6114-4575-9A2B-D09A0FA7C671",
              "code" : {
                "coding" : [
                  {
                    "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                    "code" : "denominator",
                    "display" : "Denominator"
                  }
                ]
              },
              "description" : "Den1: Inpatient hospitalizations for patients delivering stillborn or live birth with greater than or equal to 20 weeks, 0 days gestation completed",
              "criteria" : {
                "language" : "text/cql-identifier",
                "expression" : "Denominator"
              }
            },
            {
              "id" : "05AD3648-8C60-4938-96C4-82385B9C4F91",
              "code" : {
                "coding" : [
                  {
                    "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                    "code" : "numerator",
                    "display" : "Numerator"
                  }
                ]
              },
              "description" : "Num1: All Severe Obstetric Complications (SOC).\n\nInpatient hospitalizations for patients with severe obstetric complications (not present on admission that occur during the current delivery encounter) including the following: \n- Severe maternal morbidity diagnoses (see list below)\n- Severe maternal morbidity procedures (see list below)\n- Discharge disposition of expired\nPlease note that present on admission codes may be extracted from billing/claims data that was entered by coding staff.\n\nSevere Maternal Morbidity Diagnoses:\n- Cardiac\n\t Acute heart failure \n\t Acute myocardial infarction\n\t Aortic aneurysm\n\t Cardiac arrest/ventricular fibrillation\n\t Heart failure/arrest during procedure or surgery\n- Hemorrhage\n\t Disseminated intravascular coagulation\n\t Shock\n- Renal\n Acute renal failure\n- Respiratory\n\t Adult respiratory distress syndrome\n\t Pulmonary edema\n- Sepsis\n- Other OB\n\t Air and thrombotic embolism\n\t Amniotic fluid embolism\n\t Eclampsia\n\t Severe anesthesia complications\n- Other Medical\n\t Puerperal cerebrovascular disorder\n\t Sickle cell disease with crisis\n\nSevere Maternal Morbidity Procedures:\n- Blood transfusion\n- Conversion of cardiac rhythm\n- Hysterectomy\n- Temporary tracheostomy\n- Ventilation\n",
              "criteria" : {
                "language" : "text/cql-identifier",
                "expression" : "Numerator"
              }
            },
            {
              "id" : "e29f29ee-889e-4314-983c-e0ddc189a16c",
              "code" : {
                "coding" : [
                  {
                    "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                    "code" : "numerator-exclusion",
                    "display" : "Numerator Exclusion"
                  }
                ]
              },
              "description" : "NumExcl1: Inpatient hospitalizations with blood transfusion or hysterectomy with a diagnosis of placenta percreta or placenta increta and no additional severe obstetrical complications",
              "criteria" : {
                "language" : "text/cql-identifier",
                "expression" : "SOC with Hysterectomy or Blood Transfusion with Placenta Increta or Placenta Percreta Without Additional SOC"
              }
            }
          ]
        },
        {
          "id" : "6750921446b6174510cfeb96",
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://terminology.hl7.org/CodeSystem/measure-scoring",
                    "code" : "proportion",
                    "display" : "Proportion"
                  }
                ]
              }
            },
            {
              "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis",
              "valueCode" : "Encounter"
            },
            {
              "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-type",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://terminology.hl7.org/CodeSystem/measure-type",
                    "code" : "outcome",
                    "display" : "Outcome"
                  }
                ]
              }
            },
            {
              "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-rateAggregation",
              "valueCode" : "Two hospital-level measure scores are calculated as a risk-adjusted proportion reported as a rate per 10,000 delivery hospitalizations: 1. All Severe Obstetric Complications (SOC). ((Num1 – NumExcl1) / Den) * 10,000 2. SOC excluding encounters where transfusion was the only SOC. ((Num2 – NumExcl2) / Den) * 10,000 Num1: Delivery encounters with SOC Num2: Delivery encounters with SOC excluding encounters where transfusion was the only SOC NumExcl1: Delivery encounters with blood transfusion or hysterectomy with placenta percreta or placenta increta and no additional SOCs NumExcl2: Delivery encounters with SOC excluding encounters where transfusion was the only SOC with a hysterectomy or blood transfusion with a diagnosis of placenta percreta or placenta increta and no additional SOCs Den: Delivery encounters with > or = 20 weeks' gestation completed"
            },
            {
              "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-improvementNotation",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://terminology.hl7.org/CodeSystem/measure-improvement-notation",
                    "code" : "decrease",
                    "display" : "Decreased score indicates improvement"
                  }
                ]
              }
            }
          ],
          "description" : "SOC excluding encounters where transfusion was the only SOC",
          "population" : [
            {
              "id" : "4e1478e6-a3d4-42e5-a5cd-0026cc5617ed",
              "code" : {
                "coding" : [
                  {
                    "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                    "code" : "initial-population",
                    "display" : "Initial Population"
                  }
                ]
              },
              "description" : "IPop2 is the same inpatient hospitalizations as IPop1",
              "criteria" : {
                "language" : "text/cql-identifier",
                "expression" : "Initial Population"
              }
            },
            {
              "id" : "e4a80a9b-190c-4cd1-bc7b-8d6d9e5720cd",
              "code" : {
                "coding" : [
                  {
                    "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                    "code" : "denominator",
                    "display" : "Denominator"
                  }
                ]
              },
              "description" : "Den2 is the same inpatient hospitalizations as Den1",
              "criteria" : {
                "language" : "text/cql-identifier",
                "expression" : "Denominator"
              }
            },
            {
              "id" : "0d5818b3-43e6-4d06-991f-adcc939f01b8",
              "code" : {
                "coding" : [
                  {
                    "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                    "code" : "numerator",
                    "display" : "Numerator"
                  }
                ]
              },
              "description" : "Num2: Delivery encounters with SOC excluding encounters where transfusion was the only SOC.\n\nInpatient hospitalizations for patients with severe obstetric complications (not present on admission that occur during the current delivery encounter) including severe maternal morbidity diagnoses (see following list), severe maternal morbidity procedures (see following list), and discharge disposition of expired, yet excluding encounters where transfusion was the only SOC. \nPlease note that present on admission codes may be those entered by coding staff, extracted from billing/claims data.\n\nSevere Maternal Morbidity Diagnoses:\n- Cardiac\n\t Acute heart failure \n\t Acute myocardial infarction\n\t Aortic aneurysm\n\t Cardiac arrest/ventricular fibrillation\n\t Heart failure/arrest during procedure or surgery\n- Hemorrhage\n\t Disseminated intravascular coagulation\n\t Shock\n- Renal\n Acute renal failure\n- Respiratory\n\t Adult respiratory distress syndrome\n\t Pulmonary edema\n- Sepsis\n- Other OB\n\t Air and thrombotic embolism\n\t Amniotic fluid embolism\n\t Eclampsia\n\t Severe anesthesia complications\n- Other Medical\n\t Puerperal cerebrovascular disorder\n\t Sickle cell disease with crisis\n\nSevere Maternal Morbidity Procedures:\n- Blood transfusion\n- Conversion of cardiac rhythm\n- Hysterectomy\n- Temporary tracheostomy\n- Ventilation",
              "criteria" : {
                "language" : "text/cql-identifier",
                "expression" : "Delivery Encounters with Severe Obstetric Complications Excluding Blood Transfusions Only"
              }
            },
            {
              "id" : "b5aef46b-f0d5-442b-b1d4-564444fd471a",
              "code" : {
                "coding" : [
                  {
                    "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                    "code" : "numerator-exclusion",
                    "display" : "Numerator Exclusion"
                  }
                ]
              },
              "description" : "NumExcl2: Inpatient hospitalizations with SOC excluding encounters where transfusion was the only SOC with a hysterectomy or blood transfusion with a diagnosis of placenta percreta or placenta increta and no additional severe obstetrical complications",
              "criteria" : {
                "language" : "text/cql-identifier",
                "expression" : "SOC Excluding Blood Transfusions Only with Hysterectomy or Blood Transfusion with Placenta Increta or Placenta Percreta Without Additional SOC"
              }
            }
          ]
        }
      ],
      "supplementalData" : [
        {
          "id" : "sde-ethnicity",
          "usage" : [
            {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
                  "code" : "supplemental-data"
                }
              ]
            }
          ],
          "description" : "SDE Ethnicity",
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "SDE Ethnicity"
          }
        },
        {
          "id" : "sde-payer",
          "usage" : [
            {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
                  "code" : "supplemental-data"
                }
              ]
            }
          ],
          "description" : "SDE Payer",
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "SDE Payer"
          }
        },
        {
          "id" : "sde-race",
          "usage" : [
            {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
                  "code" : "supplemental-data"
                }
              ]
            }
          ],
          "description" : "SDE Race",
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "SDE Race"
          }
        },
        {
          "id" : "sde-sex",
          "usage" : [
            {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
                  "code" : "supplemental-data"
                }
              ]
            }
          ],
          "description" : "SDE Sex",
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "SDE Sex"
          }
        },
        {
          "id" : "sde-variable-calculated-gestational-age",
          "usage" : [
            {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
                  "code" : "supplemental-data"
                }
              ]
            }
          ],
          "description" : "SDE Variable Calculated Gestational Age",
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "SDE Variable Calculated Gestational Age"
          }
        },
        {
          "id" : "sde-soc-diagnoses-detail",
          "usage" : [
            {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
                  "code" : "supplemental-data"
                }
              ]
            }
          ],
          "description" : "SDE SOC Diagnoses Detail",
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "SDE SOC Diagnoses Detail"
          }
        },
        {
          "id" : "sde-soc-procedure-detail",
          "usage" : [
            {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
                  "code" : "supplemental-data"
                }
              ]
            }
          ],
          "description" : "SDE SOC Procedure Detail",
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "SDE SOC Procedure Detail"
          }
        },
        {
          "id" : "sde-delivery-encounters-with-severe-obstetric-complication-diagnosis",
          "usage" : [
            {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
                  "code" : "supplemental-data"
                }
              ]
            }
          ],
          "description" : "SDE Delivery Encounters with Severe Obstetric Complication Diagnosis",
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "SDE Delivery Encounters with Severe Obstetric Complication Diagnosis"
          }
        },
        {
          "id" : "sde-delivery-encounters-with-severe-obstetric-complication-procedures",
          "usage" : [
            {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
                  "code" : "supplemental-data"
                }
              ]
            }
          ],
          "description" : "SDE Delivery Encounters with Severe Obstetric Complication Procedures",
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "SDE Delivery Encounters with Severe Obstetric Complication Procedures"
          }
        },
        {
          "id" : "risk-variable-lab-and-physical-exam-results",
          "usage" : [
            {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
                  "code" : "risk-adjustment-factor"
                }
              ]
            }
          ],
          "description" : "Risk Variable Lab and Physical Exam Results",
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Risk Variable Lab and Physical Exam Results"
          }
        },
        {
          "id" : "risk-variable-asthma",
          "usage" : [
            {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
                  "code" : "risk-adjustment-factor"
                }
              ]
            }
          ],
          "description" : "Risk Variable Asthma",
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Risk Variable Asthma"
          }
        },
        {
          "id" : "risk-variable-autoimmune-disease",
          "usage" : [
            {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
                  "code" : "risk-adjustment-factor"
                }
              ]
            }
          ],
          "description" : "Risk Variable Autoimmune Disease",
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Risk Variable Autoimmune Disease"
          }
        },
        {
          "id" : "risk-variable-bariatric-surgery",
          "usage" : [
            {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
                  "code" : "risk-adjustment-factor"
                }
              ]
            }
          ],
          "description" : "Risk Variable Bariatric Surgery",
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Risk Variable Bariatric Surgery"
          }
        },
        {
          "id" : "risk-variable-bleeding-disorder",
          "usage" : [
            {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
                  "code" : "risk-adjustment-factor"
                }
              ]
            }
          ],
          "description" : "Risk Variable Bleeding Disorder",
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Risk Variable Bleeding Disorder"
          }
        },
        {
          "id" : "risk-variable-morbid-obesity",
          "usage" : [
            {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
                  "code" : "risk-adjustment-factor"
                }
              ]
            }
          ],
          "description" : "Risk Variable Morbid Obesity",
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Risk Variable Morbid Obesity"
          }
        },
        {
          "id" : "risk-variable-cardiac-disease",
          "usage" : [
            {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
                  "code" : "risk-adjustment-factor"
                }
              ]
            }
          ],
          "description" : "Risk Variable Cardiac Disease",
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Risk Variable Cardiac Disease"
          }
        },
        {
          "id" : "risk-variable-economic-housing-instability",
          "usage" : [
            {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
                  "code" : "risk-adjustment-factor"
                }
              ]
            }
          ],
          "description" : "Risk Variable Economic Housing Instability",
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Risk Variable Economic Housing Instability"
          }
        },
        {
          "id" : "risk-variable-gastrointestinal-disease",
          "usage" : [
            {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
                  "code" : "risk-adjustment-factor"
                }
              ]
            }
          ],
          "description" : "Risk Variable Gastrointestinal Disease",
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Risk Variable Gastrointestinal Disease"
          }
        },
        {
          "id" : "risk-variable-gestational-diabetes",
          "usage" : [
            {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
                  "code" : "risk-adjustment-factor"
                }
              ]
            }
          ],
          "description" : "Risk Variable Gestational Diabetes",
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Risk Variable Gestational Diabetes"
          }
        },
        {
          "id" : "risk-variable-hiv",
          "usage" : [
            {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
                  "code" : "risk-adjustment-factor"
                }
              ]
            }
          ],
          "description" : "Risk Variable HIV",
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Risk Variable HIV"
          }
        },
        {
          "id" : "risk-variable-hypertension",
          "usage" : [
            {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
                  "code" : "risk-adjustment-factor"
                }
              ]
            }
          ],
          "description" : "Risk Variable Hypertension",
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Risk Variable Hypertension"
          }
        },
        {
          "id" : "risk-variable-long-term-anticoagulant-use",
          "usage" : [
            {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
                  "code" : "risk-adjustment-factor"
                }
              ]
            }
          ],
          "description" : "Risk Variable Long Term Anticoagulant Use",
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Risk Variable Long Term Anticoagulant Use"
          }
        },
        {
          "id" : "risk-variable-mental-health-disorder",
          "usage" : [
            {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
                  "code" : "risk-adjustment-factor"
                }
              ]
            }
          ],
          "description" : "Risk Variable Mental Health Disorder",
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Risk Variable Mental Health Disorder"
          }
        },
        {
          "id" : "risk-variable-multiple-pregnancy",
          "usage" : [
            {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
                  "code" : "risk-adjustment-factor"
                }
              ]
            }
          ],
          "description" : "Risk Variable Multiple Pregnancy",
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Risk Variable Multiple Pregnancy"
          }
        },
        {
          "id" : "risk-variable-neuromuscular",
          "usage" : [
            {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
                  "code" : "risk-adjustment-factor"
                }
              ]
            }
          ],
          "description" : "Risk Variable Neuromuscular",
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Risk Variable Neuromuscular"
          }
        },
        {
          "id" : "risk-variable-obstetrical-vte",
          "usage" : [
            {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
                  "code" : "risk-adjustment-factor"
                }
              ]
            }
          ],
          "description" : "Risk Variable Obstetrical VTE",
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Risk Variable Obstetrical VTE"
          }
        },
        {
          "id" : "risk-variable-placenta-previa",
          "usage" : [
            {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
                  "code" : "risk-adjustment-factor"
                }
              ]
            }
          ],
          "description" : "Risk Variable Placenta Previa",
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Risk Variable Placenta Previa"
          }
        },
        {
          "id" : "risk-variable-placental-abruption",
          "usage" : [
            {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
                  "code" : "risk-adjustment-factor"
                }
              ]
            }
          ],
          "description" : "Risk Variable Placental Abruption",
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Risk Variable Placental Abruption"
          }
        },
        {
          "id" : "risk-variable-placental-accreta-spectrum",
          "usage" : [
            {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
                  "code" : "risk-adjustment-factor"
                }
              ]
            }
          ],
          "description" : "Risk Variable Placental Accreta Spectrum",
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Risk Variable Placental Accreta Spectrum"
          }
        },
        {
          "id" : "risk-variable-preexisting-diabetes",
          "usage" : [
            {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
                  "code" : "risk-adjustment-factor"
                }
              ]
            }
          ],
          "description" : "Risk Variable Preexisting Diabetes",
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Risk Variable Preexisting Diabetes"
          }
        },
        {
          "id" : "risk-variable-previous-cesarean",
          "usage" : [
            {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
                  "code" : "risk-adjustment-factor"
                }
              ]
            }
          ],
          "description" : "Risk Variable Previous Cesarean",
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Risk Variable Previous Cesarean"
          }
        },
        {
          "id" : "risk-variable-pulmonary-hypertension",
          "usage" : [
            {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
                  "code" : "risk-adjustment-factor"
                }
              ]
            }
          ],
          "description" : "Risk Variable Pulmonary Hypertension",
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Risk Variable Pulmonary Hypertension"
          }
        },
        {
          "id" : "risk-variable-renal-disease",
          "usage" : [
            {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
                  "code" : "risk-adjustment-factor"
                }
              ]
            }
          ],
          "description" : "Risk Variable Renal Disease",
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Risk Variable Renal Disease"
          }
        },
        {
          "id" : "risk-variable-severe-preeclampsia",
          "usage" : [
            {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
                  "code" : "risk-adjustment-factor"
                }
              ]
            }
          ],
          "description" : "Risk Variable Severe Preeclampsia",
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Risk Variable Severe Preeclampsia"
          }
        },
        {
          "id" : "risk-variable-substance-abuse",
          "usage" : [
            {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
                  "code" : "risk-adjustment-factor"
                }
              ]
            }
          ],
          "description" : "Risk Variable Substance Abuse",
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Risk Variable Substance Abuse"
          }
        },
        {
          "id" : "risk-variable-thyrotoxicosis",
          "usage" : [
            {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
                  "code" : "risk-adjustment-factor"
                }
              ]
            }
          ],
          "description" : "Risk Variable Thyrotoxicosis",
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Risk Variable Thyrotoxicosis"
          }
        },
        {
          "id" : "risk-variable-other-preeclampsia",
          "usage" : [
            {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
                  "code" : "risk-adjustment-factor"
                }
              ]
            }
          ],
          "description" : "Risk Variable Other Preeclampsia",
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Risk Variable Other Preeclampsia"
          }
        },
        {
          "id" : "risk-variable-preterm-birth",
          "usage" : [
            {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
                  "code" : "risk-adjustment-factor"
                }
              ]
            }
          ],
          "description" : "Risk Variable Preterm Birth",
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Risk Variable Preterm Birth"
          }
        },
        {
          "id" : "risk-variable-anemia",
          "usage" : [
            {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
                  "code" : "risk-adjustment-factor"
                }
              ]
            }
          ],
          "description" : "Risk Variable Anemia",
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Risk Variable Anemia"
          }
        },
        {
          "id" : "risk-variable-systolic-blood-pressure",
          "usage" : [
            {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
                  "code" : "risk-adjustment-factor"
                }
              ]
            }
          ],
          "description" : "Risk Variable Systolic Blood Pressure",
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Risk Variable Systolic Blood Pressure"
          }
        },
        {
          "id" : "risk-variable-heart-rate",
          "usage" : [
            {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
                  "code" : "risk-adjustment-factor"
                }
              ]
            }
          ],
          "description" : "Risk Variable Heart Rate",
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Risk Variable Heart Rate"
          }
        },
        {
          "id" : "risk-variable-first-white-blood-cell-count-lab-test",
          "usage" : [
            {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
                  "code" : "risk-adjustment-factor"
                }
              ]
            }
          ],
          "description" : "Risk Variable First White Blood Cell Count Lab Test",
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Risk Variable First White Blood Cell Count Lab Test"
          }
        },
        {
          "id" : "risk-variable-first-hematocrit-lab-test",
          "usage" : [
            {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
                  "code" : "risk-adjustment-factor"
                }
              ]
            }
          ],
          "description" : "Risk Variable First Hematocrit Lab Test",
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Risk Variable First Hematocrit Lab Test"
          }
        },
        {
          "id" : "delivery-encounters-with-blood-transfusion",
          "usage" : [
            {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
                  "code" : "risk-adjustment-factor"
                }
              ]
            }
          ],
          "description" : "Delivery Encounters with Blood Transfusion",
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Delivery Encounters with Blood Transfusion"
          }
        },
        {
          "id" : "risk-variable-maternal-age",
          "usage" : [
            {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
                  "code" : "risk-adjustment-factor"
                }
              ]
            }
          ],
          "description" : "Risk Variable Maternal Age",
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Risk Variable Maternal Age"
          }
        }
      ]
    }

    XIG built as of ??metadata-date??. Found ??metadata-resources?? resources in ??metadata-packages?? packages.