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FHIR IG Statistics: Measure/EXM55-FHIR

Packagehl7.fhir.uv.cqm
Resource TypeMeasure
IdEXM55-FHIR
FHIR VersionR4
Sourcehttp://hl7.org/fhir/uv/cqm/https://build.fhir.org/ig/HL7/fhir-cqm/Measure-EXM55-FHIR.html
URLhttp://hl7.org/fhir/uv/cqm/Measure/EXM55-FHIR
Version5.0.0
Statusactive
Date2025-08-07
NameEXM55
TitleEXM55 - Median Emergency Department Visit Duration
Realmuv
Authorityhl7
DescriptionThis example illustrates a continuous variable measure represented as a FHIR eCQM

Resources that use this resource

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Resources that this resource uses

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Narrative

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

Knowledge Artifact Metadata
Name (machine-readable) EXM55
Title (human-readable) EXM55 - Median Emergency Department Visit Duration
Status Active
Experimental true
Description

This example illustrates a continuous variable measure represented as a FHIR eCQM
Approval Date 2019-03-08
Effective Period 2018-01-01..2018-12-31
Use Context Clinical Venue = EH
Topic Health Quality Measure Document
Measure Steward HL7 International / Clinical Quality Information
Steward Contact Details http://www.hl7.org/Special/committees/cqi
Measure Metadata
Version Number 5.0.0
Measure Scoring Continuous Variable
Measure Type Process
Improvement Notation Decreased score indicates improvement
Measure Population Criteria (ID: group-1)
Initial Population Description: No description provided Logic Definition: Initial Population
Measure Population Description: No description provided Logic Definition: Measure Population
Measure Population Exclusion Description: No description provided Logic Definition: Measure Population Exclusion
Measure Observation Description: No description provided Logic Definition: Measure Observation
Stratifier Code: Stratification 1
Stratifier Code: Stratification 2
Stratifier Code: Stratification 3
Measure Logic
Primary Library EXM55 - Median Emergency Department Visit Duration Library (Example Continuous Variable Measure Library)
Dependency Description: Library FHIRHelpers
Resource: http://hl7.org/fhir/uv/cql/Library/FHIRHelpers|4.0.1
Canonical URL: http://hl7.org/fhir/uv/cql/Library/FHIRHelpers|4.0.1
Dependency Description: Code system Diagnosis Role
Resource: Diagnosis Role
Canonical URL: http://terminology.hl7.org/CodeSystem/diagnosis-role
Dependency Description: Value set Psychiatric/Mental Health Patient
Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.299
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.299
Dependency Description: Value set Emergency Department Visit
Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292
Dependency Description: Value set Hospital Settings
Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.126
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.126
Direct Reference Code Display: Billing
Code: billing
System: http://terminology.hl7.org/CodeSystem/diagnosis-role
Parameter Name: Measurement Period
Use: In
Min Cardinality: 0
Max Cardinality: 1
Type: Period
Parameter Name: Stratification 3
Use: Out
Min Cardinality: 0
Max Cardinality: *
Type: Encounter
Parameter Name: Stratification 2
Use: Out
Min Cardinality: 0
Max Cardinality: *
Type: Encounter
Parameter Name: Measure Population Exclusion
Use: Out
Min Cardinality: 0
Max Cardinality: *
Type: Encounter
Parameter Name: Stratification 1
Use: Out
Min Cardinality: 0
Max Cardinality: *
Type: Encounter
Parameter Name: Initial Population
Use: Out
Min Cardinality: 0
Max Cardinality: *
Type: Encounter
Parameter Name: Measure Population
Use: Out
Min Cardinality: 0
Max Cardinality: *
Type: Encounter
Measure Logic Data Requirements
Data Requirement Type: Encounter
Profile(s): Encounter
Must Support Elements: period, use, rank, rank.value, condition, condition.reference
Data Requirement Type: Encounter
Profile(s): Encounter
Must Support Elements: type, period, status, hospitalization, hospitalization.admitSource, use, rank, rank.value, condition, condition.reference
Code Filter(s):
Path: type
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292
Data Requirement Type: Condition
Profile(s): Condition
Must Support Elements: id
Code Filter(s):
Path: id
Measure Logic Definitions
Logic Definition Library Name: EXM55 
define "Inpatient Encounter" :
  ["Encounter"] Encounter
    where LengthInDays(Encounter.period) <= 120
      and Encounter.period ends during "Measurement Period"
Logic Definition Library Name: EXM55 
define "Stratification 3" :
  "Inpatient Encounter" Encounter
    where PrincipalDiagnosis(Encounter) is null
Logic Definition Library Name: EXM55 
define "Stratification 2" :
  "Inpatient Encounter" Encounter
    where PrincipalDiagnosis(Encounter).code in "Psychiatric/Mental Health Patient"
Logic Definition Library Name: EXM55 
define "Measure Population Exclusion" :
  "Inpatient Encounter" Encounter
    with ["Encounter" : "Emergency Department Visit"] ED
      such that ED.period ends 1 hour or less before start of Encounter.period
        and ED.status = 'finished'
        and ED.hospitalization.admitSource in "Hospital Settings"
Logic Definition Library Name: EXM55 
define "Stratification 1" :
  "Inpatient Encounter" Encounter
    where not (PrincipalDiagnosis(Encounter).code in "Psychiatric/Mental Health Patient")
Logic Definition Library Name: EXM55 
define "Initial Population" :
  "Inpatient Encounter" Encounter
    with ["Encounter" : "Emergency Department Visit"] ED
     such that ED.status = 'finished'
       and ED.period ends 1 hour or less before start of Encounter.period
Logic Definition Library Name: EXM55 
define "Measure Population" :
  "Initial Population"
Logic Definition Library Name: EXM55 
define function "LengthInDays"(Value Interval<DateTime>):
	difference in days between start of Value and end of Value
Logic Definition Library Name: FHIRHelpers 
/*
@description: Converts the given [Period](https://hl7.org/fhir/datatypes.html#Period)
value to a CQL DateTime Interval
@comment: If the start value of the given period is unspecified, the starting
boundary of the resulting interval will be open (meaning the start of the interval
is unknown, as opposed to interpreted as the beginning of time).
*/
define function ToInterval(period FHIR.Period):
    if period is null then
        null
    else
        if period."start" is null then
            Interval(period."start".value, period."end".value]
        else
            Interval[period."start".value, period."end".value]
Logic Definition Library Name: EXM55 
define function "PrincipalDiagnosis"(Encounter Encounter):
	(singleton from (Encounter.diagnosis D where D.use ~ ToConcept("Billing") and D.rank.value = 1)) PD
		return singleton from ([Condition: id in "GetId"(PD.condition.reference)])
Logic Definition Library Name: FHIRHelpers 
/*
@description: Converts the given FHIR [CodeableConcept](https://hl7.org/fhir/datatypes.html#CodeableConcept) value to a CQL Concept.
*/
define function ToConcept(concept FHIR.CodeableConcept):
    if concept is null then
        null
    else
        System.Concept {
            codes: concept.coding C return ToCode(C),
            display: concept.text.value
        }
Logic Definition Library Name: FHIRHelpers 
/*
@description: Converts the given FHIR [Coding](https://hl7.org/fhir/datatypes.html#Coding) value to a CQL Code.
*/
define function ToCode(coding FHIR.Coding):
    if coding is null then
        null
    else
        System.Code {
          code: coding.code.value,
          system: coding.system.value,
          version: coding.version.value,
          display: coding.display.value
        }
Logic Definition Library Name: EXM55 
define function "GetId"(uri String):
	Last(Split(uri, '/'))
Logic Definition Library Name: FHIRHelpers 
define function ToString(value string): value.value
Logic Definition Library Name: FHIRHelpers 
define function ToString(value EncounterStatus): value.value
Logic Definition Library Name: EXM55 
define function "Measure Observation" (Encounter "Encounter" ) :
  duration in minutes of "Related ED Visit"(Encounter).period
Logic Definition Library Name: EXM55 
//Measure Observation
define function "Related ED Visit" (Encounter "Encounter" ) :
  Last(["Encounter" : "Emergency Department Visit"] ED
    where ED.status = 'finished'
      and ED.period ends 1 hour or less before start of Encounter.period
    sort by start of period )
Generated using version 0.4.6 of the sample-content-ig Liquid templates

Source

{
  "resourceType": "Measure",
  "id": "EXM55-FHIR",
  "meta": {
    "profile": [
      "http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-cvmeasure",
      "http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-computablemeasure",
      "http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-shareablemeasure",
      "http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-cqlmeasure",
      "http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-computablemeasure"
    ]
  },
  "text": {
    "status": "extensions",
    "div": "<!-- snip (see above) -->"
  },
  "contained": [
    {
      "resourceType": "Library",
      "id": "effective-data-requirements-exm55",
      "extension": [
        {
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
          "valueCoding": {
            "system": "http://terminology.hl7.org/CodeSystem/diagnosis-role",
            "code": "billing",
            "display": "Billing"
          }
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "EXM55"
            },
            {
              "url": "name",
              "valueString": "Inpatient Encounter"
            },
            {
              "url": "statement",
              "valueString": "define \"Inpatient Encounter\" :\n  [\"Encounter\"] Encounter\n    where LengthInDays(Encounter.period) <= 120\n      and Encounter.period ends during \"Measurement Period\""
            },
            {
              "url": "displaySequence",
              "valueInteger": 0
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "EXM55"
            },
            {
              "url": "name",
              "valueString": "Stratification 3"
            },
            {
              "url": "statement",
              "valueString": "define \"Stratification 3\" :\n  \"Inpatient Encounter\" Encounter\n    where PrincipalDiagnosis(Encounter) is null"
            },
            {
              "url": "displaySequence",
              "valueInteger": 1
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "EXM55"
            },
            {
              "url": "name",
              "valueString": "Stratification 2"
            },
            {
              "url": "statement",
              "valueString": "define \"Stratification 2\" :\n  \"Inpatient Encounter\" Encounter\n    where PrincipalDiagnosis(Encounter).code in \"Psychiatric/Mental Health Patient\""
            },
            {
              "url": "displaySequence",
              "valueInteger": 2
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "EXM55"
            },
            {
              "url": "name",
              "valueString": "Measure Population Exclusion"
            },
            {
              "url": "statement",
              "valueString": "define \"Measure Population Exclusion\" :\n  \"Inpatient Encounter\" Encounter\n    with [\"Encounter\" : \"Emergency Department Visit\"] ED\n      such that ED.period ends 1 hour or less before start of Encounter.period\n        and ED.status = 'finished'\n        and ED.hospitalization.admitSource in \"Hospital Settings\""
            },
            {
              "url": "displaySequence",
              "valueInteger": 3
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "EXM55"
            },
            {
              "url": "name",
              "valueString": "Stratification 1"
            },
            {
              "url": "statement",
              "valueString": "define \"Stratification 1\" :\n  \"Inpatient Encounter\" Encounter\n    where not (PrincipalDiagnosis(Encounter).code in \"Psychiatric/Mental Health Patient\")"
            },
            {
              "url": "displaySequence",
              "valueInteger": 4
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "EXM55"
            },
            {
              "url": "name",
              "valueString": "Initial Population"
            },
            {
              "url": "statement",
              "valueString": "define \"Initial Population\" :\n  \"Inpatient Encounter\" Encounter\n    with [\"Encounter\" : \"Emergency Department Visit\"] ED\n     such that ED.status = 'finished'\n       and ED.period ends 1 hour or less before start of Encounter.period"
            },
            {
              "url": "displaySequence",
              "valueInteger": 5
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "EXM55"
            },
            {
              "url": "name",
              "valueString": "Measure Population"
            },
            {
              "url": "statement",
              "valueString": "define \"Measure Population\" :\n  \"Initial Population\""
            },
            {
              "url": "displaySequence",
              "valueInteger": 6
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "EXM55"
            },
            {
              "url": "name",
              "valueString": "LengthInDays"
            },
            {
              "url": "statement",
              "valueString": "define function \"LengthInDays\"(Value Interval<DateTime>):\n\tdifference in days between start of Value and end of Value"
            },
            {
              "url": "displaySequence",
              "valueInteger": 7
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "FHIRHelpers"
            },
            {
              "url": "name",
              "valueString": "ToInterval"
            },
            {
              "url": "statement",
              "valueString": "/*\n@description: Converts the given [Period](https://hl7.org/fhir/datatypes.html#Period)\nvalue to a CQL DateTime Interval\n@comment: If the start value of the given period is unspecified, the starting\nboundary of the resulting interval will be open (meaning the start of the interval\nis unknown, as opposed to interpreted as the beginning of time).\n*/\ndefine function ToInterval(period FHIR.Period):\n    if period is null then\n        null\n    else\n        if period.\"start\" is null then\n            Interval(period.\"start\".value, period.\"end\".value]\n        else\n            Interval[period.\"start\".value, period.\"end\".value]"
            },
            {
              "url": "displaySequence",
              "valueInteger": 8
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "EXM55"
            },
            {
              "url": "name",
              "valueString": "PrincipalDiagnosis"
            },
            {
              "url": "statement",
              "valueString": "define function \"PrincipalDiagnosis\"(Encounter Encounter):\n\t(singleton from (Encounter.diagnosis D where D.use ~ ToConcept(\"Billing\") and D.rank.value = 1)) PD\n\t\treturn singleton from ([Condition: id in \"GetId\"(PD.condition.reference)])"
            },
            {
              "url": "displaySequence",
              "valueInteger": 9
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-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": 10
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-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": 11
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "EXM55"
            },
            {
              "url": "name",
              "valueString": "GetId"
            },
            {
              "url": "statement",
              "valueString": "define function \"GetId\"(uri String):\n\tLast(Split(uri, '/'))"
            },
            {
              "url": "displaySequence",
              "valueInteger": 12
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "FHIRHelpers"
            },
            {
              "url": "name",
              "valueString": "ToString"
            },
            {
              "url": "statement",
              "valueString": "define function ToString(value string): value.value"
            },
            {
              "url": "displaySequence",
              "valueInteger": 13
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "FHIRHelpers"
            },
            {
              "url": "name",
              "valueString": "ToString"
            },
            {
              "url": "statement",
              "valueString": "define function ToString(value EncounterStatus): value.value"
            },
            {
              "url": "displaySequence",
              "valueInteger": 14
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "EXM55"
            },
            {
              "url": "name",
              "valueString": "Measure Observation"
            },
            {
              "url": "statement",
              "valueString": "define function \"Measure Observation\" (Encounter \"Encounter\" ) :\n  duration in minutes of \"Related ED Visit\"(Encounter).period"
            },
            {
              "url": "displaySequence",
              "valueInteger": 15
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "EXM55"
            },
            {
              "url": "name",
              "valueString": "Related ED Visit"
            },
            {
              "url": "statement",
              "valueString": "//Measure Observation\ndefine function \"Related ED Visit\" (Encounter \"Encounter\" ) :\n  Last([\"Encounter\" : \"Emergency Department Visit\"] ED\n    where ED.status = 'finished'\n      and ED.period ends 1 hour or less before start of Encounter.period\n    sort by start of period )"
            },
            {
              "url": "displaySequence",
              "valueInteger": 16
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        }
      ],
      "name": "EffectiveDataRequirements",
      "status": "active",
      "type": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/library-type",
            "code": "module-definition"
          }
        ]
      },
      "relatedArtifact": [
        {
          "type": "depends-on",
          "display": "Library FHIRHelpers",
          "resource": "http://hl7.org/fhir/uv/cql/Library/FHIRHelpers|4.0.1"
        },
        {
          "type": "depends-on",
          "display": "Code system Diagnosis Role",
          "resource": "http://terminology.hl7.org/CodeSystem/diagnosis-role"
        },
        {
          "type": "depends-on",
          "display": "Value set Psychiatric/Mental Health Patient",
          "resource": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.299"
        },
        {
          "type": "depends-on",
          "display": "Value set Emergency Department Visit",
          "resource": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292"
        },
        {
          "type": "depends-on",
          "display": "Value set Hospital Settings",
          "resource": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.126"
        }
      ],
      "parameter": [
        {
          "name": "Measurement Period",
          "use": "in",
          "min": 0,
          "max": "1",
          "type": "Period"
        },
        {
          "name": "Stratification 3",
          "use": "out",
          "min": 0,
          "max": "*",
          "type": "Encounter"
        },
        {
          "name": "Stratification 2",
          "use": "out",
          "min": 0,
          "max": "*",
          "type": "Encounter"
        },
        {
          "name": "Measure Population Exclusion",
          "use": "out",
          "min": 0,
          "max": "*",
          "type": "Encounter"
        },
        {
          "name": "Stratification 1",
          "use": "out",
          "min": 0,
          "max": "*",
          "type": "Encounter"
        },
        {
          "name": "Initial Population",
          "use": "out",
          "min": 0,
          "max": "*",
          "type": "Encounter"
        },
        {
          "name": "Measure Population",
          "use": "out",
          "min": 0,
          "max": "*",
          "type": "Encounter"
        }
      ],
      "dataRequirement": [
        {
          "type": "Encounter",
          "profile": [
            "http://hl7.org/fhir/StructureDefinition/Encounter"
          ],
          "mustSupport": [
            "period",
            "use",
            "rank",
            "rank.value",
            "condition",
            "condition.reference"
          ]
        },
        {
          "type": "Encounter",
          "profile": [
            "http://hl7.org/fhir/StructureDefinition/Encounter"
          ],
          "mustSupport": [
            "type",
            "period",
            "status",
            "hospitalization",
            "hospitalization.admitSource",
            "use",
            "rank",
            "rank.value",
            "condition",
            "condition.reference"
          ],
          "codeFilter": [
            {
              "path": "type",
              "valueSet": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292"
            }
          ]
        },
        {
          "type": "Condition",
          "profile": [
            "http://hl7.org/fhir/StructureDefinition/Condition"
          ],
          "mustSupport": [
            "id"
          ],
          "codeFilter": [
            {
              "path": "id"
            }
          ]
        }
      ]
    }
  ],
  "extension": [
    {
      "url": "http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis",
      "valueCode": "Encounter"
    },
    {
      "url": "http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-softwaresystem",
      "valueReference": {
        "reference": "Device/software-system-example"
      }
    },
    {
      "url": "http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements",
      "valueCanonical": "#effective-data-requirements-exm55"
    }
  ],
  "url": "http://hl7.org/fhir/uv/cqm/Measure/EXM55-FHIR",
  "identifier": [
    {
      "use": "official",
      "system": "http://example.org/fhir/cqi/ecqm/Measure/Identifier/exm",
      "value": "55"
    },
    {
      "system": "urn:ietf:rfc:3986",
      "value": "urn:oid:2.16.840.1.113883.4.642.40.61.29.8"
    }
  ],
  "version": "5.0.0",
  "name": "EXM55",
  "title": "EXM55 - Median Emergency Department Visit Duration",
  "status": "active",
  "experimental": true,
  "date": "2025-08-07",
  "publisher": "HL7 International / Clinical Quality Information",
  "contact": [
    {
      "telecom": [
        {
          "system": "url",
          "value": "http://www.hl7.org/Special/committees/cqi"
        }
      ]
    }
  ],
  "description": "This example illustrates a continuous variable measure represented as a FHIR eCQM",
  "useContext": [
    {
      "code": {
        "system": "http://terminology.hl7.org/CodeSystem/usage-context-type",
        "code": "venue",
        "display": "Clinical Venue"
      },
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "http://hl7.org/fhir/uv/cqm/CodeSystem/intended-venue-codes",
            "code": "eh",
            "display": "EH"
          }
        ]
      }
    }
  ],
  "jurisdiction": [
    {
      "coding": [
        {
          "system": "http://unstats.un.org/unsd/methods/m49/m49.htm",
          "code": "001"
        }
      ]
    }
  ],
  "approvalDate": "2019-03-08",
  "lastReviewDate": "2019-03-08",
  "effectivePeriod": {
    "start": "2018-01-01",
    "end": "2018-12-31"
  },
  "topic": [
    {
      "coding": [
        {
          "system": "http://loinc.org",
          "code": "57024-2",
          "display": "Health Quality Measure Document"
        }
      ]
    }
  ],
  "library": [
    "http://hl7.org/fhir/uv/cqm/Library/EXM55"
  ],
  "scoring": {
    "coding": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/measure-scoring",
        "code": "continuous-variable",
        "display": "Continuous Variable"
      }
    ]
  },
  "type": [
    {
      "coding": [
        {
          "system": "http://terminology.hl7.org/CodeSystem/measure-type",
          "code": "process"
        }
      ]
    }
  ],
  "improvementNotation": {
    "coding": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/measure-improvement-notation",
        "code": "decrease",
        "display": "Decreased score indicates improvement"
      }
    ]
  },
  "group": [
    {
      "id": "group-1",
      "extension": [
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.linkId",
          "valueString": "primary"
        }
      ],
      "population": [
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.population.linkId",
              "valueString": "primary-exm55-initial-population"
            }
          ],
          "code": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                "code": "initial-population",
                "display": "Initial Population"
              }
            ]
          },
          "criteria": {
            "language": "text/cql-identifier",
            "expression": "Initial Population"
          }
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.population.linkId",
              "valueString": "primary-exm55-measure-population"
            }
          ],
          "code": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                "code": "measure-population",
                "display": "Measure Population"
              }
            ]
          },
          "criteria": {
            "language": "text/cql-identifier",
            "expression": "Measure Population"
          }
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.population.linkId",
              "valueString": "primary-exm55-measure-population-exclusion"
            }
          ],
          "code": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                "code": "measure-population-exclusion",
                "display": "Measure Population Exclusion"
              }
            ]
          },
          "criteria": {
            "language": "text/cql-identifier",
            "expression": "Measure Population Exclusion"
          }
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.population.linkId",
              "valueString": "primary-exm55-measure-population-identifier"
            },
            {
              "url": "http://hl7.org/fhir/StructureDefinition/cqf-criteriaReference",
              "valueString": "measure-population-identifier"
            },
            {
              "url": "http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-aggregateMethod",
              "valueCode": "median"
            }
          ],
          "code": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                "code": "measure-observation",
                "display": "Measure Observation"
              }
            ]
          },
          "criteria": {
            "language": "text/cql-identifier",
            "expression": "Measure Observation"
          }
        }
      ],
      "stratifier": [
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.stratifier.linkId",
              "valueString": "primary-exm55-stratification-1"
            },
            {
              "url": "http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-appliesTo",
              "valueCodeableConcept": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                    "code": "initial-population",
                    "display": "Initial Population"
                  }
                ]
              }
            }
          ],
          "code": {
            "coding": [
              {
                "system": "http://example.org/stratification",
                "code": "Stratification 1",
                "display": "Stratification 1"
              }
            ]
          },
          "criteria": {
            "language": "text/cql-identifier",
            "expression": "Stratification 1"
          }
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.stratifier.linkId",
              "valueString": "primary-exm55-stratificatio-2"
            },
            {
              "url": "http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-appliesTo",
              "valueCodeableConcept": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                    "code": "initial-population",
                    "display": "Initial Population"
                  }
                ]
              }
            }
          ],
          "code": {
            "coding": [
              {
                "system": "http://example.org/stratification",
                "code": "Stratification 2",
                "display": "Stratification 2"
              }
            ]
          },
          "criteria": {
            "language": "text/cql-identifier",
            "expression": "Stratification 2"
          }
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.stratifier.linkId",
              "valueString": "primary-exm55-stratification-3"
            },
            {
              "url": "http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-appliesTo",
              "valueCodeableConcept": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                    "code": "initial-population",
                    "display": "Initial Population"
                  }
                ]
              }
            }
          ],
          "code": {
            "coding": [
              {
                "system": "http://example.org/stratification",
                "code": "Stratification 3",
                "display": "Stratification 3"
              }
            ]
          },
          "criteria": {
            "language": "text/cql-identifier",
            "expression": "Stratification 3"
          }
        }
      ]
    }
  ]
}