| 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-CMS1264ECCQREHQRFHIR.html |
| Url | https://madie.cms.gov/Measure/CMS1264ECCQREHQRFHIR |
| Version | 0.3.001 |
| Status | active |
| Date | 2025-01-14T15:54:08+00:00 |
| Name | CMS1264ECCQREHQRFHIR |
| Title | Emergency Care Capacity and Quality (REHQR) FHIR |
| Experimental | False |
| Description | This measure assesses the variation in capacity and quality of emergency care to support rural emergency hospital (REH) quality improvement for patients requiring emergency care in an emergency department (ED). This measure is designed to align with incentives to promote improved care both in EDs and the broader health system to help identify where patients do not receive appropriate or timely access to emergency care. Emergency care capacity and quality gaps are inclusive of several concepts pertaining to boarding and crowding in an ED, including significantly longer ED wait times, higher left without being seen rates, longer boarding times, and longer total length of stay in the ED. |
| Purpose | UNKNOWN |
| Copyright | Limited proprietary coding is contained in these specifications for user convenience. Users of proprietary code sets should obtain all necessary licenses from the owners of the code sets. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2024 International Health Terminology Standards Development Organisation. All rights reserved. ICD-10 copyright 2024 World Health Organization. All Rights Reserved. CPT(R) contained in the measure specifications is copyright 2004-2024 American Medical Association. |
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No resources found
Note: links and images are rebased to the (stated) source
| Title: | Emergency Care Capacity and Quality (REHQR) FHIR | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Id: | CMS1264ECCQREHQRFHIR | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Version: | 0.3.001 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Url: | Emergency Care Capacity and Quality (REHQR) FHIR | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Short Name Identifier: |
CMS1264FHIR |
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| Version Independent Identifier: |
urn:uuid:eb3e269b-97ef-4548-9e87-c89b25789184 |
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| Version Specific Identifier: |
urn:uuid:2074450c-e3eb-49a0-bc87-0f63344a1962 |
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| Publisher (CMS) Identifier: |
1264FHIR |
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| Effective Period: | 2026-01-01..2026-12-31 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Publisher: | Centers for Medicare & Medicaid Services (CMS) | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Author: | Acumen, LLC | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Description: | This measure assesses the variation in capacity and quality of emergency care to support rural emergency hospital (REH) quality improvement for patients requiring emergency care in an emergency department (ED). This measure is designed to align with incentives to promote improved care both in EDs and the broader health system to help identify where patients do not receive appropriate or timely access to emergency care. Emergency care capacity and quality gaps are inclusive of several concepts pertaining to boarding and crowding in an ED, including significantly longer ED wait times, higher left without being seen rates, longer boarding times, and longer total length of stay in the ED. |
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| Purpose: | UNKNOWN |
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| Copyright: | Limited proprietary coding is contained in these specifications for user convenience. Users of proprietary code sets should obtain all necessary licenses from the owners of the code sets. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2024 International Health Terminology Standards Development Organisation. All rights reserved. ICD-10 copyright 2024 World Health Organization. All Rights Reserved. CPT(R) contained in the measure specifications is copyright 2004-2024 American Medical Association. |
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| Disclaimer: | These performance specifications 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 "AS IS" WITHOUT WARRANTY OF ANY KIND. Due to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM]. |
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| Rationale: | This measure aims to reduce patient harm and improve outcomes for patients requiring emergency care in an ED by addressing the variation in emergency care and measuring the capacity and quality of emergency care. There are long-standing concerns about parameters that impact the quality and timeliness of care in the ED. Currently, there are no national metrics to assess the proportion of patients impacted by the quality of timely ED care. |
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| Clinical recommendation statement: | Changes in care provision and workflow are anticipated from implementing this Emergency Care Capacity and Quality (ECCQ) REH eCQM. To improve time to place a patient in a treatment space (as defined by the numerator below), changes in care may include improving patient flow processes, triaging interventions (such as inclusion of predictive models or different clinical deployment), or increased availability and access to outpatient clinical and social services. Other changes in care may include increases in local healthcare capacity including mental health care (mental health liaisons, co-located mental health services, or specialist psychiatry services), and use of ‘hospital home’ care models. Furthermore, changes to the following may also be considered: staffing models, ED observation units, diagnostic testing and imaging processes, or physical changes to ED layout. Such changes may result in the following: decreased waiting room time, decreased door to provider times, higher proportion of patients seen within 1 hour, decrease in proportion of patients who leave without being evaluated, better management of mental health diagnoses, reduced length of stay in the ED, decreased turnaround time for diagnostic tests and imaging, improved time to treatment, and decreased ambulance diversion. Changes in clinician or patient-reported outcomes and costs may include the following: improved patient experience, decrease in morbidity and mortality, increased ED revenue, and improved patient outcomes. |
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| Guidance (Usage): | Measure Score Calculation The measure score is calculated at the individual ED level as the proportion of ED visits where any one of the four outcomes occurred, as defined by the numerator. For CMS Certification Numbers (CCNs) with more than one ED, scores are combined as a weighted average for that CCN. This eCQM is an episode-based measure. An episode is defined as an ED visit that ends during the measurement period. This FHIR-based measure has been derived from the QDM-based measure: CMS1264v1. 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: |
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| Supplemental Data Elements: |
SDE Ethnicity SDE Payer SDE Race SDE Sex SDE Address |
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| Supplemental Data Guidance : | For every patient evaluated by this measure also identify payer, race, ethnicity and sex | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Libraries: |
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| Terminology and Other Dependencies: |
Library/SupplementalDataElements|3.5.000Library/FHIRHelpers|4.4.000Library/CQMCommon|2.2.000Library/QICoreCommon|2.1.000 |
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| Parameters: |
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| DataRequirements: |
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| Direct Reference Codes: |
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| Logic Definitions: |
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"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;\">Emergency Care Capacity and Quality (REHQR) FHIR</td>\n </tr>\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Id: </b></th>\n <td style=\"padding-left: 4px;\">CMS1264ECCQREHQRFHIR</td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Version: </b></th>\n <td style=\"padding-left: 4px;\">0.3.001</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-CMS1264ECCQREHQRFHIR.html\">Emergency Care Capacity and Quality (REHQR) FHIR</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>CMS1264FHIR</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:eb3e269b-97ef-4548-9e87-c89b25789184</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:2074450c-e3eb-49a0-bc87-0f63344a1962</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>1264FHIR</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;\">2026-01-01..2026-12-31</td>\n </tr>\n \n\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Publisher: </b></th>\n <td style=\"padding-left: 4px;\">Centers for Medicare & Medicaid Services (CMS)</td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Author: </b></th>\n <td style=\"padding-left: 4px;\">Acumen, LLC</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>This measure assesses the variation in capacity and quality of emergency care to support rural emergency hospital (REH) quality improvement for patients requiring emergency care in an emergency department (ED). This measure is designed to align with incentives to promote improved care both in EDs and the broader health system to help identify where patients do not receive appropriate or timely access to emergency care.</p>\n<p>Emergency care capacity and quality gaps are inclusive of several concepts pertaining to boarding and crowding in an ED, including significantly longer ED wait times, higher left without being seen rates, longer boarding times, and longer total length of stay in the ED.</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>Limited proprietary coding is contained in these specifications for user convenience. Users of proprietary code sets should obtain all necessary licenses from the owners of the code sets.</p>\n<p>This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2024 International Health Terminology Standards Development Organisation. All rights reserved.</p>\n<p>ICD-10 copyright 2024 World Health Organization. All Rights Reserved.</p>\n<p>CPT(R) contained in the measure specifications is copyright 2004-2024 American Medical Association.</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 specifications are not clinical guidelines, do not establish a standard of medical care, and have not been tested for all potential applications.</p>\n<p>THE MEASURES AND SPECIFICATIONS ARE PROVIDED "AS IS" WITHOUT WARRANTY OF ANY KIND.</p>\n<p>Due to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM].</p>\n</div></td>\n </tr>\n \n\n \n\n \n\n \n\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>This measure aims to reduce patient harm and improve outcomes for patients requiring emergency care in an ED by addressing the variation in emergency care and measuring the capacity and quality of emergency care. There are long-standing concerns about parameters that impact the quality and timeliness of care in the ED. Currently, there are no national metrics to assess the proportion of patients impacted by the quality of timely ED care.</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>Changes in care provision and workflow are anticipated from implementing this Emergency Care Capacity and Quality (ECCQ) REH eCQM. To improve time to place a patient in a treatment space (as defined by the numerator below), changes in care may include improving patient flow processes, triaging interventions (such as inclusion of predictive models or different clinical deployment), or increased availability and access to outpatient clinical and social services. Other changes in care may include increases in local healthcare capacity including mental health care (mental health liaisons, co-located mental health services, or specialist psychiatry services), and use of ‘hospital home’ care models. Furthermore, changes to the following may also be considered: staffing models, ED observation units, diagnostic testing and imaging processes, or physical changes to ED layout.</p>\n<p>Such changes may result in the following: decreased waiting room time, decreased door to provider times, higher proportion of patients seen within 1 hour, decrease in proportion of patients who leave without being evaluated, better management of mental health diagnoses, reduced length of stay in the ED, decreased turnaround time for diagnostic tests and imaging, improved time to treatment, and decreased ambulance diversion.</p>\n<p>Changes in clinician or patient-reported outcomes and costs may include the following: improved patient experience, decrease in morbidity and mortality, increased ED revenue, and improved patient outcomes.</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;\">Measure Score Calculation\nThe measure score is calculated at the individual ED level as the proportion of ED visits where any one of the four outcomes occurred, as defined by the numerator. For CMS Certification Numbers (CCNs) with more than one ED, scores are combined as a weighted average for that CCN. \n\nThis eCQM is an episode-based measure. An episode is defined as an ED visit that ends during the measurement period. \n\nThis FHIR-based measure has been derived from the QDM-based measure: CMS1264v1. \n\nPlease 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>6758b76046b6174510cfef6e</b></th>\n </tr>\n \n \n <tr>\n <td>Initial Population:</td>\n\n \n \n <td>All ED visits at REHs that end during the measurement period for all patients.</td>\n \n \n\n </tr>\n \n <tr>\n <td>Denominator:</td>\n\n \n \n <td>Equals Initial Population</td>\n \n \n\n </tr>\n \n <tr>\n <td>Numerator:</td>\n\n \n \n <td>The numerator is comprised of any ED visit in the denominator with any quality gap in access; if the patient experiences any of the following during a visit, the visit is included in the numerator:\n1. The patient waited longer than 60 minutes (1 hour) after arrival to ED to be placed in a treatment room or dedicated treatment area that allows for audiovisual privacy during history-taking and physical examination, or\n2. The patient left the ED without being evaluated, or\n3. The patient, if transferred, boarded for longer than 240 minutes (4 hours), or\n4. The patient had an ED length of stay (LOS) (time from ED arrival to ED departure as defined by the ED departure timestamp indicating when the patient physically left the ED) of longer than 480 minutes (8 hours).\n\nED encounters with ED observation stays are excluded from criteria #3 (boarded) and #4 (ED LOS)</td>\n \n \n\n </tr>\n \n \n <tr><b>Stratifier Criteria: </b></tr>\n \n <tr>\n \n <td>Stratum:</td>\n \n\n \n <td>All patients aged less than 18 years seen in the ED who do not have an ED encounter principal diagnosis consistent with mental health diagnosis. Patients who have an ED encounter principal diagnosis consistent with substance use disorders will be included in this stratification.</td>\n \n </tr>\n \n <tr>\n \n <td>Stratum:</td>\n \n\n \n <td>All patients aged 18 years and older seen in the ED who do not have an ED encounter principal diagnosis consistent with mental health diagnosis. Patients who have an ED encounter principal diagnosis consistent with substance use disorders will be included in this stratification.</td>\n \n </tr>\n \n <tr>\n \n <td>Stratum:</td>\n \n\n \n <td>All patients aged less than 18 years seen in the ED who have an ED encounter principal diagnosis consistent with mental health diagnosis.</td>\n \n </tr>\n \n <tr>\n \n <td>Stratum:</td>\n \n\n \n <td>All patients aged 18 years and older seen in the ED who have an ED encounter principal diagnosis consistent with mental health diagnosis.</td>\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 Address</p>\n \n \n \n </td>\n </tr>\n \n\n \n\n \n <tr>\n <th scope=\"row\">\n <b> Supplemental Data Guidance\n : </b></th>\n <td style=\"padding-left: 4px;\"> For every patient evaluated by this measure also identify payer, race, ethnicity and sex </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-CMS1264ECCQREHQRFHIR.html\">CMS1264ECCQREHQRFHIR</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/SupplementalDataElements|3.5.000</code></li>\n \n <li><code>Library/FHIRHelpers|4.4.000</code></li>\n \n <li><code>Library/CQMCommon|2.2.000</code></li>\n \n <li><code>Library/QICoreCommon|2.1.000</code></li>\n \n <li><a href=\"http://hl7.org/fhir/R4/codesystem-administrative-gender.html\">AdministrativeGender</a></li>\n \n <li><a href=\"http://hl7.org/fhir/R4/codesystem-snomedct.html\">SNOMED CT (all versions)</a></li>\n \n <li><a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-diagnosis-role.html\">Diagnosis Role</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1010/expansion\">Emergency Department Visit</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1046.279/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.279</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1046.284/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.284</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1046.278/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.278</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1046.286/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.286</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1170.22/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1170.22</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1046.285/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.285</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 </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>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>Numerator</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Stratification 1: Pediatric With No Mental Health Diagnosis</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>Stratification 4: Adult With Mental Health Diagnosis</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Stratification 2: Adult With No Mental Health Diagnosis</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>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>Stratification 3: Pediatric With Mental Health Diagnosis</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>SDE Ethnicity</td>\n <td>Out</td>\n <td>0</td>\n <td>1</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>SDE Race</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>Patient(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-patient.html\">QICorePatient</a>)</td>\n <td>\n \n ethnicity\n \n race\n \n </td>\n <td>\n \n </td>\n <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 location\n \n location.type\n \n status\n \n status.value\n \n rank\n \n rank.value\n \n use\n \n condition\n \n condition.reference\n \n condition.reference.value\n \n </td>\n <td>\n \n \n Emergency Department Evaluation and Management Visit\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1010/expansion\">Emergency Department Visit</a></td>\n </tr>\n \n <tr>\n <td>Encounter(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html\">QICoreEncounter</a>)</td>\n <td>\n \n type\n \n period\n \n location\n \n location.type\n \n status\n \n status.value\n \n rank\n \n rank.value\n \n use\n \n condition\n \n condition.reference\n \n condition.reference.value\n \n </td>\n <td>\n \n \n Triage\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1046.279/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.279</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 hospitalization\n \n hospitalization.dischargeDisposition\n \n location\n \n location.type\n \n status\n \n status.value\n \n rank\n \n rank.value\n \n use\n \n condition\n \n condition.reference\n \n condition.reference.value\n \n </td>\n <td>\n \n \n Triage\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1046.279/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.279</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 location\n \n location.type\n \n rank\n \n rank.value\n \n use\n \n condition\n \n condition.reference\n \n condition.reference.value\n \n </td>\n <td>\n \n \n Emergency Department Evaluation and Management Visit\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1010/expansion\">Emergency Department Visit</a></td>\n </tr>\n \n <tr>\n <td>Encounter(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html\">QICoreEncounter</a>)</td>\n <td>\n \n type\n \n period\n \n status\n \n status.value\n \n location\n \n location.type\n \n rank\n \n rank.value\n \n use\n \n condition\n \n condition.reference\n \n condition.reference.value\n \n </td>\n <td>\n \n \n Emergency Department Observation\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1170.22/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1170.22</a></td>\n </tr>\n \n <tr>\n <td>Location(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-location.html\">QICoreLocation</a>)</td>\n <td>\n \n id\n \n id.value\n \n </td>\n <td>\n \n </td>\n <td/>\n </tr>\n \n <tr>\n <td>ServiceRequest(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-servicerequest.html\">QICoreServiceRequest</a>)</td>\n <td>\n \n code\n \n authoredOn\n \n authoredOn.value\n \n intent\n \n intent.value\n \n status\n \n status.value\n \n </td>\n <td>\n \n \n Decision to Transfer\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1046.286/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.286</a></td>\n </tr>\n \n <tr>\n <td>ServiceRequest(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-servicerequest.html\">QICoreServiceRequest</a>)</td>\n <td>\n \n code\n \n authoredOn\n \n authoredOn.value\n \n status\n \n status.value\n \n </td>\n <td>\n \n \n Emergency Department Observation\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1170.22/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1170.22</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 </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 </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>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>Patient left without being seen (finding)</td>\n <td>21541000119102</td>\n <td><a href=\"https://browser.ihtsdotools.org/\">http://snomed.info/sct</a></td>\n </tr>\n \n <tr>\n <td>Billing</td>\n <td>billing</td>\n <td><a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-diagnosis-role.html\">http://terminology.hl7.org/CodeSystem/diagnosis-role</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> 6758b76046b6174510cfef6e </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;\">None</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 "Initial Population":\n "ED Encounter"\n union "ED Triage"</code></pre>\n \n </td>\n </tr>\n \n <tr>\n <td/>\n <td/>\n <td>Denominator</td>\n <td>\n \n <pre><code class=\"language-cql\">define "Denominator":\n "Initial Population"</code></pre>\n \n </td>\n </tr>\n \n <tr>\n <td/>\n <td/>\n <td>Numerator</td>\n <td>\n \n <pre><code class=\"language-cql\">define "Numerator":\n "Time to Treatment Room Greater Than 60 Minutes"\n union "ED Arrival Left Without Being Seen"\n union "Boarded Time Greater Than 240 Minutes and No Observation Stay"\n union "ED Length of Stay Greater Than 480 Minutes and No Observation Stay"</code></pre>\n \n </td>\n </tr>\n \n \n <tr>\n <td/>\n <td/>\n <td/>\n <td>\n \n <pre><code class=\"language-cql\"/></pre>\n \n </td>\n </tr>\n \n <tr>\n <td/>\n <td/>\n <td/>\n <td>\n \n <pre><code class=\"language-cql\"/></pre>\n \n </td>\n </tr>\n \n <tr>\n <td/>\n <td/>\n <td/>\n <td>\n \n <pre><code class=\"language-cql\"/></pre>\n \n </td>\n </tr>\n \n <tr>\n <td/>\n <td/>\n <td/>\n <td>\n \n <pre><code class=\"language-cql\"/></pre>\n \n </td>\n </tr>\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>SupplementalDataElements</td>\n \n \n <td>SDE Sex</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "SDE Sex":\n case\n when Patient.gender = 'male' then "M"\n when Patient.gender = 'female' then "F"\n else null\n end</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1264ECCQREHQRFHIR</td>\n \n \n <td>SDE Sex</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "SDE Sex":\n SDE."SDE Sex"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1264ECCQREHQRFHIR</td>\n \n \n <td>ED Encounter</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "ED Encounter":\n [Encounter: "Emergency Department Evaluation and Management Visit"] EDEncounter\n where EDEncounter.period ends during day of "Measurement Period"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1264ECCQREHQRFHIR</td>\n \n \n <td>ED Triage</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "ED Triage":\n [Encounter: "Triage"] EDTriage\n where EDTriage.period ends during day of "Measurement Period"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1264ECCQREHQRFHIR</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 "Initial Population":\n "ED Encounter"\n union "ED Triage"</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>CMS1264ECCQREHQRFHIR</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 "Denominator":\n "Initial Population"</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>CMS1264ECCQREHQRFHIR</td>\n \n \n <td>Time to Treatment Room Greater Than 60 Minutes</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Time to Treatment Room Greater Than 60 Minutes":\n "Denominator" EDEncounter\n where "EDArrivalTime"(EDEncounter) 61 minutes or more before "EDTreatmentRoomTimeArrivalTime"(EDEncounter)</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>CMS1264ECCQREHQRFHIR</td>\n \n \n <td>ED Arrival Left Without Being Seen</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "ED Arrival Left Without Being Seen":\n "ED Triage" EDTriage\n where EDTriage.hospitalization.dischargeDisposition ~ "Patient left without being seen (finding)"</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>CMS1264ECCQREHQRFHIR</td>\n \n \n <td>Boarded Time Greater Than 240 Minutes</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Boarded Time Greater Than 240 Minutes":\n "Denominator" EDEncounter\n where "TransferDecisionUsingOrder"() 241 minutes or more before "EDDepartureTime"(EDEncounter)</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>CMS1264ECCQREHQRFHIR</td>\n \n \n <td>ED Observation Encounter Status</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "ED Observation Encounter Status":\n [Encounter: "Emergency Department Observation"] EDObsEncounter\n with "Denominator" EDEncounter\n such that start of EDObsEncounter.period during EDEncounter.period\n and EDEncounter.status = 'finished'\n and EDObsEncounter.status = 'finished'</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1264ECCQREHQRFHIR</td>\n \n \n <td>ED Observation Order Status</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "ED Observation Order Status":\n [ServiceRequest: code in "Emergency Department Observation"] EDObsOrder\n with "Denominator" EDEncounter\n such that EDObsOrder.authoredOn during EDEncounter.period\n and EDEncounter.status = 'finished'\n and EDObsOrder.status = 'active'</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>CMS1264ECCQREHQRFHIR</td>\n \n \n <td>ED Observation Status</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "ED Observation Status":\n ( "ED Observation Encounter Status"\n union "ED Observation Order Status" ) EDObservation\n with "Denominator" EDStay\n such that EDObservation.period during EDStay.period\n or ( EDObservation.authoredOn during EDStay.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>CMS1264ECCQREHQRFHIR</td>\n \n \n <td>Boarded Time Greater Than 240 Minutes and No Observation Stay</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Boarded Time Greater Than 240 Minutes and No Observation Stay":\n ( "Boarded Time Greater Than 240 Minutes" Boarding\n where not exists ( "ED Observation Status" EDO\n where ( EDO.period starts during Boarding.period\n or EDO.authoredOn during Boarding.period\n )\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>CMS1264ECCQREHQRFHIR</td>\n \n \n <td>ED Length of Stay Greater Than 480 Minutes</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "ED Length of Stay Greater Than 480 Minutes":\n "Denominator" EDEncounter\n where "EDArrivalTime"(EDEncounter) 481 minutes or more before "EDDepartureTime"(EDEncounter)</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>CMS1264ECCQREHQRFHIR</td>\n \n \n <td>ED Length of Stay Greater Than 480 Minutes and No Observation Stay</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "ED Length of Stay Greater Than 480 Minutes and No Observation Stay":\n ( "ED Length of Stay Greater Than 480 Minutes" EDStay\n where not exists ( "ED Observation Status" EDO\n where ( EDO.period starts during EDStay.period\n or EDO.authoredOn during EDStay.period\n )\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>CMS1264ECCQREHQRFHIR</td>\n \n \n <td>Numerator</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Numerator":\n "Time to Treatment Room Greater Than 60 Minutes"\n union "ED Arrival Left Without Being Seen"\n union "Boarded Time Greater Than 240 Minutes and No Observation Stay"\n union "ED Length of Stay Greater Than 480 Minutes and No Observation Stay"</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>CMS1264ECCQREHQRFHIR</td>\n \n \n <td>ED Encounter or Triage of Patients Less Than 18 Years</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "ED Encounter or Triage of Patients Less Than 18 Years":\n "Denominator" EDEncounter\n where AgeInYearsAt(date from start of EDEncounter.period) < 18</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>CMS1264ECCQREHQRFHIR</td>\n \n \n <td>Stratification 1: Pediatric With No Mental Health Diagnosis</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Stratification 1: Pediatric With No Mental Health Diagnosis":\n ( "ED Encounter or Triage of Patients Less Than 18 Years" EDEncounter\n let ConditionCode: EDEncounter.principalDiagnosis ( ).code\n where not ( ConditionCode in "Mental Health Diagnosis without Substance Use Disorders" )\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>CMS1264ECCQREHQRFHIR</td>\n \n \n <td>ED Encounter or Triage of Patients 18 Years and Older</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "ED Encounter or Triage of Patients 18 Years and Older":\n "Denominator" EDEncounter\n where AgeInYearsAt(date from start of EDEncounter.period) >= 18</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>CMS1264ECCQREHQRFHIR</td>\n \n \n <td>Stratification 4: Adult With Mental Health Diagnosis</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Stratification 4: Adult With Mental Health Diagnosis":\n ( "ED Encounter or Triage of Patients 18 Years and Older" EDEncounter\n let ConditionCode: EDEncounter.principalDiagnosis ( ).code\n where ( ConditionCode in "Mental Health Diagnosis without Substance Use Disorders" )\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>CMS1264ECCQREHQRFHIR</td>\n \n \n <td>Stratification 2: Adult With No Mental Health Diagnosis</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Stratification 2: Adult With No Mental Health Diagnosis":\n ( "ED Encounter or Triage of Patients 18 Years and Older" EDEncounter\n let ConditionCode: EDEncounter.principalDiagnosis ( ).code\n where not ( ConditionCode in "Mental Health Diagnosis without Substance Use Disorders" )\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 "SDE Payer":\n [Coverage: type in "Payer Type"] Payer\n return {\n code: Payer.type,\n period: Payer.period\n }</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1264ECCQREHQRFHIR</td>\n \n \n <td>SDE Payer</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "SDE Payer":\n SDE."SDE Payer"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1264ECCQREHQRFHIR</td>\n \n \n <td>Stratification 3: Pediatric With Mental Health Diagnosis</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Stratification 3: Pediatric With Mental Health Diagnosis":\n ( "ED Encounter or Triage of Patients Less Than 18 Years" EDEncounter\n let ConditionCode: EDEncounter.principalDiagnosis ( ).code\n where ( ConditionCode in "Mental Health Diagnosis without Substance Use Disorders" )\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 Ethnicity</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "SDE Ethnicity":\n Patient.ethnicity E\n return Tuple {\n codes: { E.ombCategory } union E.detailed,\n display: E.text\n }</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1264ECCQREHQRFHIR</td>\n \n \n <td>SDE Ethnicity</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "SDE Ethnicity":\n SDE."SDE Ethnicity"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SupplementalDataElements</td>\n \n \n <td>SDE Race</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "SDE Race":\n Patient.race R\n return Tuple {\n codes: R.ombCategory union R.detailed,\n display: R.text\n }</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1264ECCQREHQRFHIR</td>\n \n \n <td>SDE Race</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "SDE Race":\n SDE."SDE Race"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1264ECCQREHQRFHIR</td>\n \n \n <td>EDArrivalTime</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define function "EDArrivalTime"(EDEncounter Encounter):\n Last(EDEncounter.location Location\n where Location.location.getLocation().type in "Emergency Department Location"\n and start of Location.period is not null\n return start of Location.period\n sort ascending\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>CQMCommon</td>\n \n \n <td>getLocation</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">/*\n@description: Returns the Location resource specified by the given reference.\n*/\ndefine fluent function getLocation(reference Reference ):\n singleton from (\n [Location] L where L.id = reference.reference.getId()\n )</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>QICoreCommon</td>\n \n \n <td>getId</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">/*\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, '/'))</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>FHIRHelpers</td>\n \n \n <td>ToConcept</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">/*\n@description: Converts the given FHIR [CodeableConcept](https://hl7.org/fhir/datatypes.html#CodeableConcept) value to a CQL Concept.\n*/\ndefine function ToConcept(concept FHIR.CodeableConcept):\n if concept is null then\n null\n else\n System.Concept {\n codes: concept.coding C return ToCode(C),\n display: concept.text.value\n }</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>CMS1264ECCQREHQRFHIR</td>\n \n \n <td>EDTreatmentRoomTimeArrivalTime</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define function "EDTreatmentRoomTimeArrivalTime"(EDEncounter Encounter):\n Last(EDEncounter.location Location\n where Location.location.getLocation().type in "Emergency Department Treatment Location"\n and start of Location.period is not null\n return start of Location.period\n sort ascending\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>CMS1264ECCQREHQRFHIR</td>\n \n \n <td>TransferDecisionUsingOrder</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define function "TransferDecisionUsingOrder"():\n Last([ServiceRequest: code in "Decision to Transfer"] TransferOrder\n with [Encounter: "Emergency Department Evaluation and Management Visit"] EDVisit\n such that TransferOrder.authoredOn during EDVisit.period\n and TransferOrder.intent = 'order'\n and TransferOrder.status = 'completed'\n and EDVisit.status = 'finished'\n return TransferOrder.authoredOn\n sort ascending\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>CMS1264ECCQREHQRFHIR</td>\n \n \n <td>EDDepartureTime</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define function "EDDepartureTime"(EDEncounter Encounter):\n Last(EDEncounter.location Location\n where Location.location.getLocation().type in "Emergency Department Location"\n and \n end of Location.period is not null\n return \n end of Location.period\n sort ascending\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>CQMCommon</td>\n \n \n <td>principalDiagnosis</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">/*\n@description: Returns the condition that is specified as the principal diagnosis for the encounter\n*/\ndefine fluent function principalDiagnosis(Encounter Encounter ):\n\tsingleton from ((Encounter.diagnosis D where D.rank = 1 and D.use ~ "Billing") PD\n return singleton from ([Condition] C where C.id = PD.condition.reference.getId())\n\t)</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>FHIRHelpers</td>\n \n \n <td>ToString</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define function ToString(value uri): value.value</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>FHIRHelpers</td>\n \n \n <td>ToCode</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">/*\n@description: Converts the given FHIR [Coding](https://hl7.org/fhir/datatypes.html#Coding) value to a CQL Code.\n*/\ndefine function ToCode(coding FHIR.Coding):\n if coding is null then\n null\n else\n System.Code {\n code: coding.code.value,\n system: coding.system.value,\n version: coding.version.value,\n display: coding.display.value\n }</code></pre>\n </td>\n \n </tr>\n \n </table>\n </td>\n </tr>\n \n \n \n\n </table>\n</div>"
},
"contained" : [
{
"resourceType" : "Library",
"id" : "effective-data-requirements",
"extension" : [
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
"valueCoding" : {
"system" : "http://hl7.org/fhir/administrative-gender",
"code" : "M",
"display" : "Male"
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
"valueCoding" : {
"system" : "http://hl7.org/fhir/administrative-gender",
"code" : "F",
"display" : "Female"
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
"valueCoding" : {
"system" : "http://snomed.info/sct",
"code" : "21541000119102",
"display" : "Patient left without being seen (finding)"
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
"valueCoding" : {
"system" : "http://terminology.hl7.org/CodeSystem/diagnosis-role",
"code" : "billing",
"display" : "Billing"
}
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SupplementalDataElements"
},
{
"url" : "name",
"valueString" : "SDE Sex"
},
{
"url" : "statement",
"valueString" : "define \"SDE Sex\":\n case\n when Patient.gender = 'male' then \"M\"\n when Patient.gender = 'female' then \"F\"\n else null\n end"
},
{
"url" : "displaySequence",
"valueInteger" : 0
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS1264ECCQREHQRFHIR"
},
{
"url" : "name",
"valueString" : "SDE Sex"
},
{
"url" : "statement",
"valueString" : "define \"SDE Sex\":\n SDE.\"SDE Sex\""
},
{
"url" : "displaySequence",
"valueInteger" : 1
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS1264ECCQREHQRFHIR"
},
{
"url" : "name",
"valueString" : "ED Encounter"
},
{
"url" : "statement",
"valueString" : "define \"ED Encounter\":\n [Encounter: \"Emergency Department Evaluation and Management Visit\"] EDEncounter\n where EDEncounter.period ends during day of \"Measurement Period\""
},
{
"url" : "displaySequence",
"valueInteger" : 2
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS1264ECCQREHQRFHIR"
},
{
"url" : "name",
"valueString" : "ED Triage"
},
{
"url" : "statement",
"valueString" : "define \"ED Triage\":\n [Encounter: \"Triage\"] EDTriage\n where EDTriage.period ends during day of \"Measurement Period\""
},
{
"url" : "displaySequence",
"valueInteger" : 3
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS1264ECCQREHQRFHIR"
},
{
"url" : "name",
"valueString" : "Initial Population"
},
{
"url" : "statement",
"valueString" : "define \"Initial Population\":\n \"ED Encounter\"\n union \"ED Triage\""
},
{
"url" : "displaySequence",
"valueInteger" : 4
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS1264ECCQREHQRFHIR"
},
{
"url" : "name",
"valueString" : "Denominator"
},
{
"url" : "statement",
"valueString" : "define \"Denominator\":\n \"Initial Population\""
},
{
"url" : "displaySequence",
"valueInteger" : 5
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS1264ECCQREHQRFHIR"
},
{
"url" : "name",
"valueString" : "Time to Treatment Room Greater Than 60 Minutes"
},
{
"url" : "statement",
"valueString" : "define \"Time to Treatment Room Greater Than 60 Minutes\":\n \"Denominator\" EDEncounter\n where \"EDArrivalTime\"(EDEncounter) 61 minutes or more before \"EDTreatmentRoomTimeArrivalTime\"(EDEncounter)"
},
{
"url" : "displaySequence",
"valueInteger" : 6
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS1264ECCQREHQRFHIR"
},
{
"url" : "name",
"valueString" : "ED Arrival Left Without Being Seen"
},
{
"url" : "statement",
"valueString" : "define \"ED Arrival Left Without Being Seen\":\n \"ED Triage\" EDTriage\n where EDTriage.hospitalization.dischargeDisposition ~ \"Patient left without being seen (finding)\""
},
{
"url" : "displaySequence",
"valueInteger" : 7
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS1264ECCQREHQRFHIR"
},
{
"url" : "name",
"valueString" : "Boarded Time Greater Than 240 Minutes"
},
{
"url" : "statement",
"valueString" : "define \"Boarded Time Greater Than 240 Minutes\":\n \"Denominator\" EDEncounter\n where \"TransferDecisionUsingOrder\"() 241 minutes or more before \"EDDepartureTime\"(EDEncounter)"
},
{
"url" : "displaySequence",
"valueInteger" : 8
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS1264ECCQREHQRFHIR"
},
{
"url" : "name",
"valueString" : "ED Observation Encounter Status"
},
{
"url" : "statement",
"valueString" : "define \"ED Observation Encounter Status\":\n [Encounter: \"Emergency Department Observation\"] EDObsEncounter\n with \"Denominator\" EDEncounter\n such that start of EDObsEncounter.period during EDEncounter.period\n and EDEncounter.status = 'finished'\n and EDObsEncounter.status = 'finished'"
},
{
"url" : "displaySequence",
"valueInteger" : 9
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS1264ECCQREHQRFHIR"
},
{
"url" : "name",
"valueString" : "ED Observation Order Status"
},
{
"url" : "statement",
"valueString" : "define \"ED Observation Order Status\":\n [ServiceRequest: code in \"Emergency Department Observation\"] EDObsOrder\n with \"Denominator\" EDEncounter\n such that EDObsOrder.authoredOn during EDEncounter.period\n and EDEncounter.status = 'finished'\n and EDObsOrder.status = 'active'"
},
{
"url" : "displaySequence",
"valueInteger" : 10
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS1264ECCQREHQRFHIR"
},
{
"url" : "name",
"valueString" : "ED Observation Status"
},
{
"url" : "statement",
"valueString" : "define \"ED Observation Status\":\n ( \"ED Observation Encounter Status\"\n union \"ED Observation Order Status\" ) EDObservation\n with \"Denominator\" EDStay\n such that EDObservation.period during EDStay.period\n or ( EDObservation.authoredOn during EDStay.period )"
},
{
"url" : "displaySequence",
"valueInteger" : 11
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS1264ECCQREHQRFHIR"
},
{
"url" : "name",
"valueString" : "Boarded Time Greater Than 240 Minutes and No Observation Stay"
},
{
"url" : "statement",
"valueString" : "define \"Boarded Time Greater Than 240 Minutes and No Observation Stay\":\n ( \"Boarded Time Greater Than 240 Minutes\" Boarding\n where not exists ( \"ED Observation Status\" EDO\n where ( EDO.period starts during Boarding.period\n or EDO.authoredOn during Boarding.period\n )\n )\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 12
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS1264ECCQREHQRFHIR"
},
{
"url" : "name",
"valueString" : "ED Length of Stay Greater Than 480 Minutes"
},
{
"url" : "statement",
"valueString" : "define \"ED Length of Stay Greater Than 480 Minutes\":\n \"Denominator\" EDEncounter\n where \"EDArrivalTime\"(EDEncounter) 481 minutes or more before \"EDDepartureTime\"(EDEncounter)"
},
{
"url" : "displaySequence",
"valueInteger" : 13
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS1264ECCQREHQRFHIR"
},
{
"url" : "name",
"valueString" : "ED Length of Stay Greater Than 480 Minutes and No Observation Stay"
},
{
"url" : "statement",
"valueString" : "define \"ED Length of Stay Greater Than 480 Minutes and No Observation Stay\":\n ( \"ED Length of Stay Greater Than 480 Minutes\" EDStay\n where not exists ( \"ED Observation Status\" EDO\n where ( EDO.period starts during EDStay.period\n or EDO.authoredOn during EDStay.period\n )\n )\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 14
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS1264ECCQREHQRFHIR"
},
{
"url" : "name",
"valueString" : "Numerator"
},
{
"url" : "statement",
"valueString" : "define \"Numerator\":\n \"Time to Treatment Room Greater Than 60 Minutes\"\n union \"ED Arrival Left Without Being Seen\"\n union \"Boarded Time Greater Than 240 Minutes and No Observation Stay\"\n union \"ED Length of Stay Greater Than 480 Minutes and No Observation Stay\""
},
{
"url" : "displaySequence",
"valueInteger" : 15
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS1264ECCQREHQRFHIR"
},
{
"url" : "name",
"valueString" : "ED Encounter or Triage of Patients Less Than 18 Years"
},
{
"url" : "statement",
"valueString" : "define \"ED Encounter or Triage of Patients Less Than 18 Years\":\n \"Denominator\" EDEncounter\n where AgeInYearsAt(date from start of EDEncounter.period) < 18"
},
{
"url" : "displaySequence",
"valueInteger" : 16
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS1264ECCQREHQRFHIR"
},
{
"url" : "name",
"valueString" : "Stratification 1: Pediatric With No Mental Health Diagnosis"
},
{
"url" : "statement",
"valueString" : "define \"Stratification 1: Pediatric With No Mental Health Diagnosis\":\n ( \"ED Encounter or Triage of Patients Less Than 18 Years\" EDEncounter\n let ConditionCode: EDEncounter.principalDiagnosis ( ).code\n where not ( ConditionCode in \"Mental Health Diagnosis without Substance Use Disorders\" )\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 17
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS1264ECCQREHQRFHIR"
},
{
"url" : "name",
"valueString" : "ED Encounter or Triage of Patients 18 Years and Older"
},
{
"url" : "statement",
"valueString" : "define \"ED Encounter or Triage of Patients 18 Years and Older\":\n \"Denominator\" EDEncounter\n where AgeInYearsAt(date from start of EDEncounter.period) >= 18"
},
{
"url" : "displaySequence",
"valueInteger" : 18
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS1264ECCQREHQRFHIR"
},
{
"url" : "name",
"valueString" : "Stratification 4: Adult With Mental Health Diagnosis"
},
{
"url" : "statement",
"valueString" : "define \"Stratification 4: Adult With Mental Health Diagnosis\":\n ( \"ED Encounter or Triage of Patients 18 Years and Older\" EDEncounter\n let ConditionCode: EDEncounter.principalDiagnosis ( ).code\n where ( ConditionCode in \"Mental Health Diagnosis without Substance Use Disorders\" )\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 19
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS1264ECCQREHQRFHIR"
},
{
"url" : "name",
"valueString" : "Stratification 2: Adult With No Mental Health Diagnosis"
},
{
"url" : "statement",
"valueString" : "define \"Stratification 2: Adult With No Mental Health Diagnosis\":\n ( \"ED Encounter or Triage of Patients 18 Years and Older\" EDEncounter\n let ConditionCode: EDEncounter.principalDiagnosis ( ).code\n where not ( ConditionCode in \"Mental Health Diagnosis without Substance Use Disorders\" )\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 20
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SupplementalDataElements"
},
{
"url" : "name",
"valueString" : "SDE Payer"
},
{
"url" : "statement",
"valueString" : "define \"SDE Payer\":\n [Coverage: type in \"Payer Type\"] Payer\n return {\n code: Payer.type,\n period: Payer.period\n }"
},
{
"url" : "displaySequence",
"valueInteger" : 21
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS1264ECCQREHQRFHIR"
},
{
"url" : "name",
"valueString" : "SDE Payer"
},
{
"url" : "statement",
"valueString" : "define \"SDE Payer\":\n SDE.\"SDE Payer\""
},
{
"url" : "displaySequence",
"valueInteger" : 22
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS1264ECCQREHQRFHIR"
},
{
"url" : "name",
"valueString" : "Stratification 3: Pediatric With Mental Health Diagnosis"
},
{
"url" : "statement",
"valueString" : "define \"Stratification 3: Pediatric With Mental Health Diagnosis\":\n ( \"ED Encounter or Triage of Patients Less Than 18 Years\" EDEncounter\n let ConditionCode: EDEncounter.principalDiagnosis ( ).code\n where ( ConditionCode in \"Mental Health Diagnosis without Substance Use Disorders\" )\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 23
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SupplementalDataElements"
},
{
"url" : "name",
"valueString" : "SDE Ethnicity"
},
{
"url" : "statement",
"valueString" : "define \"SDE Ethnicity\":\n Patient.ethnicity E\n return Tuple {\n codes: { E.ombCategory } union E.detailed,\n display: E.text\n }"
},
{
"url" : "displaySequence",
"valueInteger" : 24
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS1264ECCQREHQRFHIR"
},
{
"url" : "name",
"valueString" : "SDE Ethnicity"
},
{
"url" : "statement",
"valueString" : "define \"SDE Ethnicity\":\n SDE.\"SDE Ethnicity\""
},
{
"url" : "displaySequence",
"valueInteger" : 25
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SupplementalDataElements"
},
{
"url" : "name",
"valueString" : "SDE Race"
},
{
"url" : "statement",
"valueString" : "define \"SDE Race\":\n Patient.race R\n return Tuple {\n codes: R.ombCategory union R.detailed,\n display: R.text\n }"
},
{
"url" : "displaySequence",
"valueInteger" : 26
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS1264ECCQREHQRFHIR"
},
{
"url" : "name",
"valueString" : "SDE Race"
},
{
"url" : "statement",
"valueString" : "define \"SDE Race\":\n SDE.\"SDE Race\""
},
{
"url" : "displaySequence",
"valueInteger" : 27
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS1264ECCQREHQRFHIR"
},
{
"url" : "name",
"valueString" : "EDArrivalTime"
},
{
"url" : "statement",
"valueString" : "define function \"EDArrivalTime\"(EDEncounter Encounter):\n Last(EDEncounter.location Location\n where Location.location.getLocation().type in \"Emergency Department Location\"\n and start of Location.period is not null\n return start of Location.period\n sort ascending\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 28
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CQMCommon"
},
{
"url" : "name",
"valueString" : "getLocation"
},
{
"url" : "statement",
"valueString" : "/*\n@description: Returns the Location resource specified by the given reference.\n*/\ndefine fluent function getLocation(reference Reference ):\n singleton from (\n [Location] L where L.id = reference.reference.getId()\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 29
}
],
"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" : 30
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "FHIRHelpers"
},
{
"url" : "name",
"valueString" : "ToConcept"
},
{
"url" : "statement",
"valueString" : "/*\n@description: Converts the given FHIR [CodeableConcept](https://hl7.org/fhir/datatypes.html#CodeableConcept) value to a CQL Concept.\n*/\ndefine function ToConcept(concept FHIR.CodeableConcept):\n if concept is null then\n null\n else\n System.Concept {\n codes: concept.coding C return ToCode(C),\n display: concept.text.value\n }"
},
{
"url" : "displaySequence",
"valueInteger" : 31
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS1264ECCQREHQRFHIR"
},
{
"url" : "name",
"valueString" : "EDTreatmentRoomTimeArrivalTime"
},
{
"url" : "statement",
"valueString" : "define function \"EDTreatmentRoomTimeArrivalTime\"(EDEncounter Encounter):\n Last(EDEncounter.location Location\n where Location.location.getLocation().type in \"Emergency Department Treatment Location\"\n and start of Location.period is not null\n return start of Location.period\n sort ascending\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 32
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS1264ECCQREHQRFHIR"
},
{
"url" : "name",
"valueString" : "TransferDecisionUsingOrder"
},
{
"url" : "statement",
"valueString" : "define function \"TransferDecisionUsingOrder\"():\n Last([ServiceRequest: code in \"Decision to Transfer\"] TransferOrder\n with [Encounter: \"Emergency Department Evaluation and Management Visit\"] EDVisit\n such that TransferOrder.authoredOn during EDVisit.period\n and TransferOrder.intent = 'order'\n and TransferOrder.status = 'completed'\n and EDVisit.status = 'finished'\n return TransferOrder.authoredOn\n sort ascending\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 33
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CMS1264ECCQREHQRFHIR"
},
{
"url" : "name",
"valueString" : "EDDepartureTime"
},
{
"url" : "statement",
"valueString" : "define function \"EDDepartureTime\"(EDEncounter Encounter):\n Last(EDEncounter.location Location\n where Location.location.getLocation().type in \"Emergency Department Location\"\n and \n end of Location.period is not null\n return \n end of Location.period\n sort ascending\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 34
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CQMCommon"
},
{
"url" : "name",
"valueString" : "principalDiagnosis"
},
{
"url" : "statement",
"valueString" : "/*\n@description: Returns the condition that is specified as the principal diagnosis for the encounter\n*/\ndefine fluent function principalDiagnosis(Encounter Encounter ):\n\tsingleton from ((Encounter.diagnosis D where D.rank = 1 and D.use ~ \"Billing\") PD\n return singleton from ([Condition] C where C.id = PD.condition.reference.getId())\n\t)"
},
{
"url" : "displaySequence",
"valueInteger" : 35
}
],
"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" : 36
}
],
"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" : 37
}
],
"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 SDE",
"resource" : "Library/SupplementalDataElements|3.5.000"
},
{
"type" : "depends-on",
"display" : "Library FHIRHelpers",
"resource" : "Library/FHIRHelpers|4.4.000"
},
{
"type" : "depends-on",
"display" : "Library CQMCommon",
"resource" : "Library/CQMCommon|2.2.000"
},
{
"type" : "depends-on",
"display" : "Library QICoreCommon",
"resource" : "Library/QICoreCommon|2.1.000"
},
{
"type" : "depends-on",
"display" : "Code system AdministrativeGender",
"resource" : "http://hl7.org/fhir/administrative-gender"
},
{
"type" : "depends-on",
"display" : "Code system SNOMEDCT",
"resource" : "http://snomed.info/sct"
},
{
"type" : "depends-on",
"display" : "Code system DiagnosisRole",
"resource" : "http://terminology.hl7.org/CodeSystem/diagnosis-role"
},
{
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},
{
"type" : "depends-on",
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{
"type" : "depends-on",
"display" : "Value set Emergency Department Location",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.284"
},
{
"type" : "depends-on",
"display" : "Value set Emergency Department Treatment Location",
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},
{
"type" : "depends-on",
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"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.286"
},
{
"type" : "depends-on",
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"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1170.22"
},
{
"type" : "depends-on",
"display" : "Value set Mental Health Diagnosis without Substance Use Disorders",
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},
{
"type" : "depends-on",
"display" : "Value set Payer Type",
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}
],
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"min" : 0,
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},
{
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"min" : 0,
"max" : "1",
"type" : "Coding"
},
{
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"min" : 0,
"max" : "*",
"type" : "Resource"
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{
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{
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{
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{
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"min" : 0,
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],
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{
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],
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}
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}
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{
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{
"path" : "hospitalization.dischargeDisposition"
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],
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}
]
}
}
]
},
{
"extension" : [
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"extension" : [
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"url" : "targetId",
"valueString" : "959"
},
{
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"valueString" : "authoredOn.value"
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-relatedRequirement"
}
],
"type" : "Encounter",
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{
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}
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},
{
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],
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},
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"code" : [
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}
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]
},
{
"type" : "Condition",
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],
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},
{
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]
}
],
"extension" : [
{
"id" : "supplementalDataGuidance",
"extension" : [
{
"url" : "guidance",
"valueString" : "For every patient evaluated by this measure also identify payer, race, ethnicity and sex"
},
{
"url" : "usage",
"valueCodeableConcept" : {
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{
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"code" : "supplemental-data",
"display" : "Supplemental Data"
}
],
"text" : "Supplemental Data 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/CMS1264ECCQREHQRFHIR",
"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" : "CMS1264FHIR"
},
{
"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:eb3e269b-97ef-4548-9e87-c89b25789184"
},
{
"use" : "official",
"type" : {
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{
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"code" : "version-specific",
"display" : "Version Specific"
}
]
},
"system" : "urn:ietf:rfc:3986",
"value" : "urn:uuid:2074450c-e3eb-49a0-bc87-0f63344a1962"
},
{
"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" : "1264FHIR",
"assigner" : {
"display" : "CMS"
}
}
],
"version" : "0.3.001",
"name" : "CMS1264ECCQREHQRFHIR",
"title" : "Emergency Care Capacity and Quality (REHQR) FHIR",
"status" : "active",
"experimental" : false,
"date" : "2025-01-14T15:54:08+00:00",
"publisher" : "Centers for Medicare & Medicaid Services (CMS)",
"contact" : [
{
"telecom" : [
{
"system" : "url",
"value" : "https://www.cms.gov/"
}
]
}
],
"description" : "This measure assesses the variation in capacity and quality of emergency care to support rural emergency hospital (REH) quality improvement for patients requiring emergency care in an emergency department (ED). This measure is designed to align with incentives to promote improved care both in EDs and the broader health system to help identify where patients do not receive appropriate or timely access to emergency care.\n\nEmergency care capacity and quality gaps are inclusive of several concepts pertaining to boarding and crowding in an ED, including significantly longer ED wait times, higher left without being seen rates, longer boarding times, and longer total length of stay in the ED.",
"purpose" : "UNKNOWN",
"usage" : "Measure Score Calculation\nThe measure score is calculated at the individual ED level as the proportion of ED visits where any one of the four outcomes occurred, as defined by the numerator. For CMS Certification Numbers (CCNs) with more than one ED, scores are combined as a weighted average for that CCN. \n\nThis eCQM is an episode-based measure. An episode is defined as an ED visit that ends during the measurement period. \n\nThis FHIR-based measure has been derived from the QDM-based measure: CMS1264v1. \n\nPlease refer to the HL7 QI-Core Implementation Guide (https://hl7.org/fhir/us/qicore/STU4.1.1/) for more information on QI-Core and mapping recommendations from QDM to QI-Core 4.1.1 (https://hl7.org/fhir/us/qicore/STU4.1.1/qdm-to-qicore.html).",
"copyright" : "Limited proprietary coding is contained in these specifications for user convenience. Users of proprietary code sets should obtain all necessary licenses from the owners of the code sets.\n\nThis material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2024 International Health Terminology Standards Development Organisation. All rights reserved.\n\nICD-10 copyright 2024 World Health Organization. All Rights Reserved.\n\nCPT(R) contained in the measure specifications is copyright 2004-2024 American Medical Association.",
"effectivePeriod" : {
"start" : "2026-01-01",
"end" : "2026-12-31"
},
"author" : [
{
"name" : "Acumen, LLC",
"telecom" : [
{
"system" : "url",
"value" : "https://www.acumenllc.com/"
}
]
}
],
"library" : [
"https://madie.cms.gov/Library/CMS1264ECCQREHQRFHIR"
],
"disclaimer" : "These performance specifications are not clinical guidelines, do not establish a standard of medical care, and have not been tested for all potential applications.\n\nTHE MEASURES AND SPECIFICATIONS ARE PROVIDED \"AS IS\" WITHOUT WARRANTY OF ANY KIND.\n\nDue to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM].",
"rationale" : "This measure aims to reduce patient harm and improve outcomes for patients requiring emergency care in an ED by addressing the variation in emergency care and measuring the capacity and quality of emergency care. There are long-standing concerns about parameters that impact the quality and timeliness of care in the ED. Currently, there are no national metrics to assess the proportion of patients impacted by the quality of timely ED care.",
"clinicalRecommendationStatement" : "Changes in care provision and workflow are anticipated from implementing this Emergency Care Capacity and Quality (ECCQ) REH eCQM. To improve time to place a patient in a treatment space (as defined by the numerator below), changes in care may include improving patient flow processes, triaging interventions (such as inclusion of predictive models or different clinical deployment), or increased availability and access to outpatient clinical and social services. Other changes in care may include increases in local healthcare capacity including mental health care (mental health liaisons, co-located mental health services, or specialist psychiatry services), and use of ‘hospital home’ care models. Furthermore, changes to the following may also be considered: staffing models, ED observation units, diagnostic testing and imaging processes, or physical changes to ED layout.\n\nSuch changes may result in the following: decreased waiting room time, decreased door to provider times, higher proportion of patients seen within 1 hour, decrease in proportion of patients who leave without being evaluated, better management of mental health diagnoses, reduced length of stay in the ED, decreased turnaround time for diagnostic tests and imaging, improved time to treatment, and decreased ambulance diversion.\n\nChanges in clinician or patient-reported outcomes and costs may include the following: improved patient experience, decrease in morbidity and mortality, increased ED revenue, and improved patient outcomes.",
"guidance" : "Measure Score Calculation\nThe measure score is calculated at the individual ED level as the proportion of ED visits where any one of the four outcomes occurred, as defined by the numerator. For CMS Certification Numbers (CCNs) with more than one ED, scores are combined as a weighted average for that CCN. \n\nThis eCQM is an episode-based measure. An episode is defined as an ED visit that ends during the measurement period. \n\nThis FHIR-based measure has been derived from the QDM-based measure: CMS1264v1. \n\nPlease 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" : "6758b76046b6174510cfef6e",
"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" : "None"
},
{
"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 ED visits at REHs that end during the measurement period for all patients\n",
"population" : [
{
"id" : "6dc9f78d-4414-4061-90ed-1a273b9b3d80",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "initial-population",
"display" : "Initial Population"
}
]
},
"description" : "All ED visits at REHs that end during the measurement period for all patients.",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Initial Population"
}
},
{
"id" : "6ae6be7a-71f6-4fcd-9b1c-7c81d820cdd5",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "denominator",
"display" : "Denominator"
}
]
},
"description" : "Equals Initial Population",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Denominator"
}
},
{
"id" : "f8b1cc23-8916-49a6-bfa3-dba7e8d11dd9",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "numerator",
"display" : "Numerator"
}
]
},
"description" : "The numerator is comprised of any ED visit in the denominator with any quality gap in access; if the patient experiences any of the following during a visit, the visit is included in the numerator:\n1. The patient waited longer than 60 minutes (1 hour) after arrival to ED to be placed in a treatment room or dedicated treatment area that allows for audiovisual privacy during history-taking and physical examination, or\n2. The patient left the ED without being evaluated, or\n3. The patient, if transferred, boarded for longer than 240 minutes (4 hours), or\n4. The patient had an ED length of stay (LOS) (time from ED arrival to ED departure as defined by the ED departure timestamp indicating when the patient physically left the ED) of longer than 480 minutes (8 hours).\n\nED encounters with ED observation stays are excluded from criteria #3 (boarded) and #4 (ED LOS)",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Numerator"
}
}
],
"stratifier" : [
{
"id" : "3f3836fb-fbd2-4550-a00b-c51be90d2ebc",
"extension" : [
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "initial-population",
"display" : "Initial Population"
}
]
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "denominator",
"display" : "Denominator"
}
]
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "numerator",
"display" : "Numerator"
}
]
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "numerator-exclusion",
"display" : "Numerator Exclusion"
}
]
}
}
],
"description" : "All patients aged less than 18 years seen in the ED who do not have an ED encounter principal diagnosis consistent with mental health diagnosis. Patients who have an ED encounter principal diagnosis consistent with substance use disorders will be included in this stratification.",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Stratification 1: Pediatric With No Mental Health Diagnosis"
}
},
{
"id" : "f82a67d5-c742-48ae-8856-30cf58beb32a",
"extension" : [
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "initial-population",
"display" : "Initial Population"
}
]
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "denominator",
"display" : "Denominator"
}
]
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "numerator",
"display" : "Numerator"
}
]
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "numerator-exclusion",
"display" : "Numerator Exclusion"
}
]
}
}
],
"description" : "All patients aged 18 years and older seen in the ED who do not have an ED encounter principal diagnosis consistent with mental health diagnosis. Patients who have an ED encounter principal diagnosis consistent with substance use disorders will be included in this stratification.",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Stratification 2: Adult With No Mental Health Diagnosis"
}
},
{
"id" : "74fdbfd2-6ae1-4616-b9b2-06a7eda78ef3",
"extension" : [
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "initial-population",
"display" : "Initial Population"
}
]
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "denominator",
"display" : "Denominator"
}
]
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "numerator",
"display" : "Numerator"
}
]
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "numerator-exclusion",
"display" : "Numerator Exclusion"
}
]
}
}
],
"description" : "All patients aged less than 18 years seen in the ED who have an ED encounter principal diagnosis consistent with mental health diagnosis.",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Stratification 3: Pediatric With Mental Health Diagnosis"
}
},
{
"id" : "f90fb136-7389-4e52-a40f-569216643f64",
"extension" : [
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "initial-population",
"display" : "Initial Population"
}
]
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "denominator",
"display" : "Denominator"
}
]
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "numerator",
"display" : "Numerator"
}
]
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "numerator-exclusion",
"display" : "Numerator Exclusion"
}
]
}
}
],
"description" : "All patients aged 18 years and older seen in the ED who have an ED encounter principal diagnosis consistent with mental health diagnosis.",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Stratification 4: Adult With Mental Health Diagnosis"
}
}
]
}
],
"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-address",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "supplemental-data"
}
]
}
],
"description" : "SDE Address",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "SDE Address"
}
}
]
}
XIG built as of ??metadata-date??. Found ??metadata-resources?? resources in ??metadata-packages?? packages.