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FHIR IG Statistics: Measure/EXMLogic-FHIR

Packagehl7.fhir.uv.cqm
Resource TypeMeasure
IdEXMLogic-FHIR
FHIR VersionR4
Sourcehttp://hl7.org/fhir/uv/cqm/https://build.fhir.org/ig/HL7/fhir-cqm/Measure-EXMLogic-FHIR.html
URLhttp://hl7.org/fhir/uv/cqm/Measure/EXMLogic-FHIR
Version2.0.0
Statusactive
Date2025-08-07
NameMeasureEXM
TitleEXM Measure
Realmuv
Authorityhl7
DescriptionAn example FHIR-based measure
PurposeThis measure has been developed to support improvement in clinical care.
CopyrightExample Copyright Statement

Resources that use this resource

No resources found

Resources that this resource uses

No resources found

Narrative

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

Knowledge Artifact Metadata
Name (machine-readable) MeasureEXM
Title (human-readable) EXM Measure
Status Active
Experimental true
Description

An example FHIR-based measure
Purpose

This measure has been developed to support improvement in clinical care.
Clinical Usage Users of this measure should be aware that this is intentionally simplified to show specific aspects of a measure.
Approval Date 2019-02-17
Effective Period 2018-01-01..2018-12-31
Use Context Clinical Venue = EC
Topic Health Quality Measure Document
Measure Developer Example Measure Content Developer:
Measure Steward HL7 International / Clinical Quality Information
Steward Contact Details http://www.hl7.org/Special/committees/cqi
Copyright

Example Copyright Statement
Comment

This illustrates an example comment
Measure Metadata
Version Number 2.0.0
Measure Scoring Proportion
Measure Type Process
Risk Adjustment Risk adjustment for this measure is performed by...
Rate Aggregation Rate aggregation for this measure is performed by...
Rationale

The purpose of this measure is to show how all the elements of a FHIR-based quality measure are represented.
Clinical Recommendation Statement

The clinical recommendation statement for this measure is...
Improvement Notation Increased score indicates improvement
Guidance

Additional guidance provided to help communicate the intent of the measure
Measure Population Criteria (ID: group-1)
Initial Population ID: initial-population-1
Description: No description provided Logic Definition: Initial Population
Numerator ID: numerator
Description: No description provided Logic Definition: Numerator
Denominator ID: denominator
Description: No description provided Logic Definition: Denominator
Stratifier ID: stratifier-1
Code: Stratifier 1
Stratifier ID: stratifier-2
Code: Stratifier 2
Stratifier ID: stratifier-3
Code: Stratifier 3
Stratifier ID: stratifier-4
Code: Stratifier 4
Supplemental Data Elements
Supplemental Data Element ID: sde-ethnicity
Usage Code: Supplemental Data
Description: No description provided
Logic Definition: SDE Ethnicity
Supplemental Data Element ID: sde-race
Usage Code: Supplemental Data
Description: No description provided
Logic Definition: SDE Race
Supplemental Data Element ID: sde-payer
Usage Code: Supplemental Data
Description: No description provided
Logic Definition: SDE Payer
Supplemental Data Element ID: sde-sex
Usage Code: Supplemental Data
Description: No description provided
Logic Definition: SDE Sex
Measure Logic
Primary Library Example Logic 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 Payer
Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591
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
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: SDE Sex
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: Coding
Parameter Name: Stratifier 3
Use: Out
Min Cardinality: 0
Max Cardinality: *
Type: Encounter
Parameter Name: Stratifier 4
Use: Out
Min Cardinality: 0
Max Cardinality: *
Type: Encounter
Parameter Name: SDE Payer
Use: Out
Min Cardinality: 0
Max Cardinality: *
Type: Resource
Parameter Name: Initial Population
Use: Out
Min Cardinality: 0
Max Cardinality: *
Type: Encounter
Parameter Name: SDE Ethnicity
Use: Out
Min Cardinality: 0
Max Cardinality: *
Type: Coding
Parameter Name: SDE Race
Use: Out
Min Cardinality: 0
Max Cardinality: *
Type: Coding
Parameter Name: Stratifier 1
Use: Out
Min Cardinality: 0
Max Cardinality: *
Type: Encounter
Parameter Name: Stratifier 2
Use: Out
Min Cardinality: 0
Max Cardinality: *
Type: Encounter
Measure Logic Data Requirements
Data Requirement Type: Patient
Profile(s): Patient
Must Support Elements: url, extension, value
Data Requirement Type: Encounter
Profile(s): Encounter
Must Support Elements: period, use, rank, rank.value, condition, condition.reference
Data Requirement Type: Condition
Profile(s): Condition
Must Support Elements: id
Code Filter(s):
Path: id
Data Requirement Type: Coverage
Profile(s): Coverage
Must Support Elements: type, period
Code Filter(s):
Path: type
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591
Measure Logic Definitions
Logic Definition Library Name: EXMLogic 
define "SDE Sex":
  case
    when Patient.gender = 'male' then Code { code: 'M', system: 'http://hl7.org/fhir/v3/AdministrativeGender', display: 'Male' }
    when Patient.gender = 'female' then Code { code: 'F', system: 'http://hl7.org/fhir/v3/AdministrativeGender', display: 'Female' }
    else null
  end
Logic Definition Library Name: EXMLogic 
define "Inpatient Encounter" :
  ["Encounter"] Encounter
    where LengthInDays(Encounter.period) <= 120
      and Encounter.period ends during "Measurement Period"
Logic Definition Library Name: EXMLogic 
define "Stratifier 3" :
  "Inpatient Encounter" Encounter
    where PrincipalDiagnosis(Encounter) is null
Logic Definition Library Name: EXMLogic 
define "Stratifier 4" :
  "Inpatient Encounter" Encounter
    where PrincipalDiagnosis(Encounter) is null
Logic Definition Library Name: EXMLogic 
define "SDE Payer":
    [Coverage: type in "Payer"] Payer
      return {
        code: Payer.type,
        period: Payer.period
      }
Logic Definition Library Name: EXMLogic 
define "Initial Population" :
  "Inpatient Encounter" Encounter
Logic Definition Library Name: EXMLogic 
define "SDE Ethnicity":
  (flatten (
    Patient.extension Extension
      where Extension.url = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity'
        return Extension.extension
  )) E
    where E.url = 'ombCategory'
      or E.url = 'detailed'
    return E.value as Coding
Logic Definition Library Name: EXMLogic 
define "SDE Race":
  (flatten (
    Patient.extension Extension
      where Extension.url = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-race'
        return Extension.extension
  )) E
    where E.url = 'ombCategory'
      or E.url = 'detailed'
    return E.value as Coding
Logic Definition Library Name: EXMLogic 
define "Stratifier 1" :
  "Inpatient Encounter" Encounter
    where not (PrincipalDiagnosis(Encounter).code in "Psychiatric/Mental Health Patient")
Logic Definition Library Name: EXMLogic 
define "Stratifier 2" :
  "Inpatient Encounter" Encounter
    where PrincipalDiagnosis(Encounter).code in "Psychiatric/Mental Health Patient"
Logic Definition Library Name: FHIRHelpers 
define function ToString(value AdministrativeGender): value.value
Logic Definition Library Name: EXMLogic 
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: EXMLogic 
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: EXMLogic 
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 uri): value.value
Generated using version 0.4.6 of the sample-content-ig Liquid templates

Source

{
  "resourceType": "Measure",
  "id": "EXMLogic-FHIR",
  "meta": {
    "profile": [
      "http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-proportionmeasure",
      "http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-computablemeasure",
      "http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-executablemeasure",
      "http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-cqlmeasure",
      "http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-elmmeasure",
      "http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-computablemeasure"
    ]
  },
  "text": {
    "status": "extensions",
    "div": "<!-- snip (see above) -->"
  },
  "contained": [
    {
      "resourceType": "Library",
      "id": "effective-data-requirements-exmlogic",
      "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": "EXMLogic"
            },
            {
              "url": "name",
              "valueString": "SDE Sex"
            },
            {
              "url": "statement",
              "valueString": "define \"SDE Sex\":\n  case\n    when Patient.gender = 'male' then Code { code: 'M', system: 'http://hl7.org/fhir/v3/AdministrativeGender', display: 'Male' }\n    when Patient.gender = 'female' then Code { code: 'F', system: 'http://hl7.org/fhir/v3/AdministrativeGender', display: 'Female' }\n    else null\n  end"
            },
            {
              "url": "displaySequence",
              "valueInteger": 0
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "EXMLogic"
            },
            {
              "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": 1
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "EXMLogic"
            },
            {
              "url": "name",
              "valueString": "Stratifier 3"
            },
            {
              "url": "statement",
              "valueString": "define \"Stratifier 3\" :\n  \"Inpatient Encounter\" Encounter\n    where PrincipalDiagnosis(Encounter) is null"
            },
            {
              "url": "displaySequence",
              "valueInteger": 2
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "EXMLogic"
            },
            {
              "url": "name",
              "valueString": "Stratifier 4"
            },
            {
              "url": "statement",
              "valueString": "define \"Stratifier 4\" :\n  \"Inpatient Encounter\" Encounter\n    where PrincipalDiagnosis(Encounter) is null"
            },
            {
              "url": "displaySequence",
              "valueInteger": 3
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "EXMLogic"
            },
            {
              "url": "name",
              "valueString": "SDE Payer"
            },
            {
              "url": "statement",
              "valueString": "define \"SDE Payer\":\n    [Coverage: type in \"Payer\"] Payer\n      return {\n        code: Payer.type,\n        period: Payer.period\n      }"
            },
            {
              "url": "displaySequence",
              "valueInteger": 4
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "EXMLogic"
            },
            {
              "url": "name",
              "valueString": "Initial Population"
            },
            {
              "url": "statement",
              "valueString": "define \"Initial Population\" :\n  \"Inpatient Encounter\" Encounter"
            },
            {
              "url": "displaySequence",
              "valueInteger": 5
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "EXMLogic"
            },
            {
              "url": "name",
              "valueString": "SDE Ethnicity"
            },
            {
              "url": "statement",
              "valueString": "define \"SDE Ethnicity\":\n  (flatten (\n    Patient.extension Extension\n      where Extension.url = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity'\n        return Extension.extension\n  )) E\n    where E.url = 'ombCategory'\n      or E.url = 'detailed'\n    return E.value as Coding"
            },
            {
              "url": "displaySequence",
              "valueInteger": 6
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "EXMLogic"
            },
            {
              "url": "name",
              "valueString": "SDE Race"
            },
            {
              "url": "statement",
              "valueString": "define \"SDE Race\":\n  (flatten (\n    Patient.extension Extension\n      where Extension.url = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-race'\n        return Extension.extension\n  )) E\n    where E.url = 'ombCategory'\n      or E.url = 'detailed'\n    return E.value as Coding"
            },
            {
              "url": "displaySequence",
              "valueInteger": 7
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "EXMLogic"
            },
            {
              "url": "name",
              "valueString": "Stratifier 1"
            },
            {
              "url": "statement",
              "valueString": "define \"Stratifier 1\" :\n  \"Inpatient Encounter\" Encounter\n    where not (PrincipalDiagnosis(Encounter).code in \"Psychiatric/Mental Health Patient\")"
            },
            {
              "url": "displaySequence",
              "valueInteger": 8
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "EXMLogic"
            },
            {
              "url": "name",
              "valueString": "Stratifier 2"
            },
            {
              "url": "statement",
              "valueString": "define \"Stratifier 2\" :\n  \"Inpatient Encounter\" Encounter\n    where PrincipalDiagnosis(Encounter).code in \"Psychiatric/Mental Health Patient\""
            },
            {
              "url": "displaySequence",
              "valueInteger": 9
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "FHIRHelpers"
            },
            {
              "url": "name",
              "valueString": "ToString"
            },
            {
              "url": "statement",
              "valueString": "define function ToString(value AdministrativeGender): value.value"
            },
            {
              "url": "displaySequence",
              "valueInteger": 10
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "EXMLogic"
            },
            {
              "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": 11
            }
          ],
          "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": 12
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "EXMLogic"
            },
            {
              "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": 13
            }
          ],
          "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": 14
            }
          ],
          "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": 15
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "EXMLogic"
            },
            {
              "url": "name",
              "valueString": "GetId"
            },
            {
              "url": "statement",
              "valueString": "define function \"GetId\"(uri String):\n\tLast(Split(uri, '/'))"
            },
            {
              "url": "displaySequence",
              "valueInteger": 16
            }
          ],
          "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": 17
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "FHIRHelpers"
            },
            {
              "url": "name",
              "valueString": "ToString"
            },
            {
              "url": "statement",
              "valueString": "define function ToString(value uri): value.value"
            },
            {
              "url": "displaySequence",
              "valueInteger": 18
            }
          ],
          "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 Payer",
          "resource": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"
        },
        {
          "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"
        }
      ],
      "parameter": [
        {
          "name": "Measurement Period",
          "use": "in",
          "min": 0,
          "max": "1",
          "type": "Period"
        },
        {
          "name": "SDE Sex",
          "use": "out",
          "min": 0,
          "max": "1",
          "type": "Coding"
        },
        {
          "name": "Stratifier 3",
          "use": "out",
          "min": 0,
          "max": "*",
          "type": "Encounter"
        },
        {
          "name": "Stratifier 4",
          "use": "out",
          "min": 0,
          "max": "*",
          "type": "Encounter"
        },
        {
          "name": "SDE Payer",
          "use": "out",
          "min": 0,
          "max": "*",
          "type": "Resource"
        },
        {
          "name": "Initial Population",
          "use": "out",
          "min": 0,
          "max": "*",
          "type": "Encounter"
        },
        {
          "name": "SDE Ethnicity",
          "use": "out",
          "min": 0,
          "max": "*",
          "type": "Coding"
        },
        {
          "name": "SDE Race",
          "use": "out",
          "min": 0,
          "max": "*",
          "type": "Coding"
        },
        {
          "name": "Stratifier 1",
          "use": "out",
          "min": 0,
          "max": "*",
          "type": "Encounter"
        },
        {
          "name": "Stratifier 2",
          "use": "out",
          "min": 0,
          "max": "*",
          "type": "Encounter"
        }
      ],
      "dataRequirement": [
        {
          "type": "Patient",
          "profile": [
            "http://hl7.org/fhir/StructureDefinition/Patient"
          ],
          "mustSupport": [
            "url",
            "extension",
            "value"
          ]
        },
        {
          "type": "Encounter",
          "profile": [
            "http://hl7.org/fhir/StructureDefinition/Encounter"
          ],
          "mustSupport": [
            "period",
            "use",
            "rank",
            "rank.value",
            "condition",
            "condition.reference"
          ]
        },
        {
          "type": "Condition",
          "profile": [
            "http://hl7.org/fhir/StructureDefinition/Condition"
          ],
          "mustSupport": [
            "id"
          ],
          "codeFilter": [
            {
              "path": "id"
            }
          ]
        },
        {
          "type": "Coverage",
          "profile": [
            "http://hl7.org/fhir/StructureDefinition/Coverage"
          ],
          "mustSupport": [
            "type",
            "period"
          ],
          "codeFilter": [
            {
              "path": "type",
              "valueSet": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"
            }
          ]
        }
      ]
    }
  ],
  "extension": [
    {
      "extension": [
        {
          "url": "type",
          "valueCode": "documentation"
        },
        {
          "url": "text",
          "valueMarkdown": "This illustrates an example comment"
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-artifactComment"
    },
    {
      "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-exmlogic"
    },
    {
      "url": "http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringPrecision",
      "valuePositiveInt": 2
    }
  ],
  "url": "http://hl7.org/fhir/uv/cqm/Measure/EXMLogic-FHIR",
  "identifier": [
    {
      "system": "http://example.org/fhir/cqi/ecqm/Measure/Identifier/exm",
      "value": "EXM"
    },
    {
      "system": "urn:ietf:rfc:3986",
      "value": "urn:oid:2.16.840.1.113883.4.642.40.61.29.9"
    }
  ],
  "version": "2.0.0",
  "name": "MeasureEXM",
  "title": "EXM Measure",
  "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": "An example FHIR-based measure",
  "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": "ec",
            "display": "EC"
          }
        ]
      }
    }
  ],
  "jurisdiction": [
    {
      "coding": [
        {
          "system": "http://unstats.un.org/unsd/methods/m49/m49.htm",
          "code": "001"
        }
      ]
    }
  ],
  "purpose": "This measure has been developed to support improvement in clinical care.",
  "usage": "Users of this measure should be aware that this is intentionally simplified to show specific aspects of a measure.",
  "copyright": "Example Copyright Statement",
  "approvalDate": "2019-02-17",
  "lastReviewDate": "2019-02-17",
  "effectivePeriod": {
    "extension": [
      {
        "url": "http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-effectivePeriodAnchor",
        "valueDateTime": "2018-01-01"
      },
      {
        "url": "http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-effectivePeriodDuration",
        "valueDuration": {
          "value": 1,
          "system": "http://unitsofmeasure.org",
          "code": "a"
        }
      }
    ],
    "start": "2018-01-01",
    "end": "2018-12-31"
  },
  "topic": [
    {
      "coding": [
        {
          "system": "http://loinc.org",
          "code": "57024-2"
        }
      ],
      "text": "Health Quality Measure Document"
    }
  ],
  "author": [
    {
      "name": "Example Measure Content Developer"
    }
  ],
  "library": [
    "http://hl7.org/fhir/uv/cqm/Library/EXMLogic"
  ],
  "disclaimer": "Example disclaimer",
  "scoring": {
    "coding": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/measure-scoring",
        "code": "proportion",
        "display": "Proportion"
      }
    ]
  },
  "type": [
    {
      "coding": [
        {
          "system": "http://terminology.hl7.org/CodeSystem/measure-type",
          "code": "process"
        }
      ]
    }
  ],
  "riskAdjustment": "Risk adjustment for this measure is performed by...",
  "rateAggregation": "Rate aggregation for this measure is performed by...",
  "rationale": "The purpose of this measure is to show how all the elements of a FHIR-based quality measure are represented.",
  "clinicalRecommendationStatement": "The clinical recommendation statement for this measure is...",
  "improvementNotation": {
    "coding": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/measure-improvement-notation",
        "code": "increase",
        "display": "Increased score indicates improvement"
      }
    ]
  },
  "guidance": "Additional guidance provided to help communicate the intent of the measure",
  "group": [
    {
      "id": "group-1",
      "extension": [
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.linkId",
          "valueString": "primary"
        }
      ],
      "code": {
        "coding": [
          {
            "system": "http://example.org/group",
            "code": "group",
            "display": "group-1"
          }
        ]
      },
      "population": [
        {
          "id": "initial-population-1",
          "extension": [
            {
              "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.population.linkId",
              "valueString": "primary-exmlogic-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"
          }
        },
        {
          "id": "numerator",
          "extension": [
            {
              "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.population.linkId",
              "valueString": "primary-exmlogic-numerator"
            }
          ],
          "code": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                "code": "numerator",
                "display": "Numerator"
              }
            ]
          },
          "criteria": {
            "language": "text/cql-identifier",
            "expression": "Numerator"
          }
        },
        {
          "id": "denominator",
          "extension": [
            {
              "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.population.linkId",
              "valueString": "primary-exmlogic-denominator"
            }
          ],
          "code": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                "code": "denominator",
                "display": "Denominator"
              }
            ]
          },
          "criteria": {
            "language": "text/cql-identifier",
            "expression": "Denominator"
          }
        }
      ],
      "stratifier": [
        {
          "id": "stratifier-1",
          "extension": [
            {
              "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.stratifier.linkId",
              "valueString": "primary-exmlogic-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"
                  }
                ],
                "text": "initial-population"
              }
            }
          ],
          "code": {
            "text": "Stratifier 1"
          },
          "criteria": {
            "language": "text/cql-identifier",
            "expression": "Stratifier 1"
          }
        },
        {
          "id": "stratifier-2",
          "extension": [
            {
              "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.stratifier.linkId",
              "valueString": "primary-exmlogic-stratification-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"
                  }
                ],
                "text": "initial-population"
              }
            }
          ],
          "code": {
            "text": "Stratifier 2"
          },
          "criteria": {
            "language": "text/cql-identifier",
            "expression": "Stratifier 2"
          }
        },
        {
          "id": "stratifier-3",
          "extension": [
            {
              "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.stratifier.linkId",
              "valueString": "primary-exmlogic-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"
                  }
                ],
                "text": "initial-population"
              }
            }
          ],
          "code": {
            "text": "Stratifier 3"
          },
          "criteria": {
            "language": "text/cql-identifier",
            "expression": "Stratifier 3"
          }
        },
        {
          "id": "stratifier-4",
          "extension": [
            {
              "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.stratifier.linkId",
              "valueString": "primary-exmlogic-stratification-4"
            },
            {
              "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"
                  }
                ],
                "text": "initial-population"
              }
            }
          ],
          "code": {
            "text": "Stratifier 4"
          },
          "criteria": {
            "language": "text/cql-identifier",
            "expression": "Stratifier 4"
          }
        }
      ]
    }
  ],
  "supplementalData": [
    {
      "id": "sde-ethnicity",
      "extension": [
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.supplementalData.linkId",
          "valueString": "primary-sde-ethnicity"
        }
      ],
      "usage": [
        {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/measure-data-usage",
              "code": "supplemental-data"
            }
          ]
        }
      ],
      "criteria": {
        "language": "text/cql-identifier",
        "expression": "SDE Ethnicity"
      }
    },
    {
      "id": "sde-race",
      "extension": [
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.supplementalData.linkId",
          "valueString": "primary-sde-race"
        }
      ],
      "usage": [
        {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/measure-data-usage",
              "code": "supplemental-data"
            }
          ]
        }
      ],
      "criteria": {
        "language": "text/cql-identifier",
        "expression": "SDE Race"
      }
    },
    {
      "id": "sde-payer",
      "extension": [
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.supplementalData.linkId",
          "valueString": "primary-sde-payer"
        }
      ],
      "usage": [
        {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/measure-data-usage",
              "code": "supplemental-data"
            }
          ]
        }
      ],
      "criteria": {
        "language": "text/cql-identifier",
        "expression": "SDE Payer"
      }
    },
    {
      "id": "sde-sex",
      "extension": [
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.supplementalData.linkId",
          "valueString": "primary-sde-sex"
        }
      ],
      "usage": [
        {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/measure-data-usage",
              "code": "supplemental-data"
            }
          ]
        }
      ],
      "criteria": {
        "language": "text/cql-identifier",
        "expression": "SDE Sex"
      }
    }
  ]
}