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FHIR IG Statistics: Measure/measure-publishable-exm

Packagehl7.fhir.uv.cqm
Resource TypeMeasure
Idmeasure-publishable-exm
FHIR VersionR4
Sourcehttp://hl7.org/fhir/uv/cqm/https://build.fhir.org/ig/HL7/fhir-cqm/Measure-measure-publishable-exm.html
URLhttp://hl7.org/fhir/uv/cqm/Measure/measure-publishable-exm
Version2.0.0
Statusactive
Date2025-08-07
NamePublishableMeasureEXM
TitleEXM Publishable Measure
Realmuv
Authorityhl7
DescriptionAn example FHIR-based publishable 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) PublishableMeasureEXM
Title (human-readable) EXM Publishable Measure
Status Active
Experimental true
Description

An example FHIR-based publishable measure
Purpose

This measure has been developed to support improvement in clinical care.
Clinical Usage Users of this measure should be aware of...
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
Citation Citation:

Linder, J.A., D.W. Bates, G.M. Lee, J.A. Finkelstein. 2005. 'Antibiotic treatment of children with sore throat.' JAMA 294(18):2315-2322.

Content URL: https://pubmed.ncbi.nlm.nih.gov/16278359/
Document: null @ https://pubmed.ncbi.nlm.nih.gov/16278359/
Citation Citation:

Infectious Diseases Society of America. 2012. 'Clinical Practice Guideline for the Diagnosis and Management of Group A Streptococcal Pharyngitis: 2012 Update.'

Content URL: https://pubmed.ncbi.nlm.nih.gov/23091044/
Document: null @ https://pubmed.ncbi.nlm.nih.gov/23091044/
Citation Citation:

Roberts, R.R., B. Hota, I. Ahmad, et al. 'Hospital and Societal Costs of Antimicrobial-Resistant Infections in a Chicago Teaching Hospital: Implications for Antibiotic Stewardship.' Clin Infect Dis. Oct 2009; 49(8):1175-84.

Content URL: https://pubmed.ncbi.nlm.nih.gov/19739972/
Document: null @ https://pubmed.ncbi.nlm.nih.gov/19739972/
Citation Citation:

Example citation to draft publication

Content URL: http://example.org/publications/1234
Document: null @ http://example.org/publications/1234
Measure Metadata
Short Name Identifier EXM-123
Version Independent Identifier urn:uuid:11873bc9-ca0a-4cf3-b8f2-605a950aac74
Version Specific Identifier urn:uuid:b366f29b-347f-464e-8064-c83842d825c7
Publisher (CMS) Identifier CMS-123
Identifier Endorser/NQF-123 (use: official, )
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 rationale of this measure is to...
Clinical Recommendation Statement

The clinical recommendation statement for this measure is...
Improvement Notation Increased score indicates improvement
Measure Population Criteria (ID: group-1)
Initial Population ID: initial-population
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
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 Publishable 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: 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
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: 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
Measure Logic Data Requirements
Data Requirement Type: Patient
Profile(s): Patient
Must Support Elements: url, extension, value
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
Data Requirement Type: Encounter
Profile(s): Encounter
Must Support Elements: period
Measure Logic Definitions
Logic Definition Library Name: EXMPublishableLibrary 
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: EXMPublishableLibrary 
define "SDE Payer":     [Coverage: type in "Payer"] Payer       return {         code: Payer.type,         period: Payer.period       }
Logic Definition Library Name: EXMPublishableLibrary 
define "Inpatient Encounter" :   ["Encounter"] Encounter     where LengthInDays(Encounter.period) <= 120       and Encounter.period ends during "Measurement Period"
Logic Definition Library Name: EXMPublishableLibrary 
define "Initial Population" :   "Inpatient Encounter" Encounter
Logic Definition Library Name: EXMPublishableLibrary 
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: EXMPublishableLibrary 
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: FHIRHelpers 
define function ToString(value AdministrativeGender): value.value
Logic Definition Library Name: EXMPublishableLibrary 
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: 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": "measure-publishable-exm",
  "meta": {
    "profile": [
      "http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-publishablemeasure",
      "http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-computablemeasure",
      "http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-computablemeasure"
    ]
  },
  "text": {
    "status": "extensions",
    "div": "<!-- snip (see above) -->"
  },
  "contained": [
    {
      "resourceType": "Library",
      "id": "effective-data-requirements",
      "extension": [
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "EXMPublishableLibrary"
            },
            {
              "url": "name",
              "valueString": "SDE Sex"
            },
            {
              "url": "statement",
              "valueString": "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"
            },
            {
              "url": "displaySequence",
              "valueInteger": 0
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "EXMPublishableLibrary"
            },
            {
              "url": "name",
              "valueString": "SDE Payer"
            },
            {
              "url": "statement",
              "valueString": "define \"SDE Payer\":     [Coverage: type in \"Payer\"] Payer       return {         code: Payer.type,         period: Payer.period       }"
            },
            {
              "url": "displaySequence",
              "valueInteger": 1
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "EXMPublishableLibrary"
            },
            {
              "url": "name",
              "valueString": "Inpatient Encounter"
            },
            {
              "url": "statement",
              "valueString": "define \"Inpatient Encounter\" :   [\"Encounter\"] Encounter     where LengthInDays(Encounter.period) <= 120       and Encounter.period ends during \"Measurement Period\""
            },
            {
              "url": "displaySequence",
              "valueInteger": 2
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "EXMPublishableLibrary"
            },
            {
              "url": "name",
              "valueString": "Initial Population"
            },
            {
              "url": "statement",
              "valueString": "define \"Initial Population\" :   \"Inpatient Encounter\" Encounter"
            },
            {
              "url": "displaySequence",
              "valueInteger": 3
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "EXMPublishableLibrary"
            },
            {
              "url": "name",
              "valueString": "SDE Ethnicity"
            },
            {
              "url": "statement",
              "valueString": "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"
            },
            {
              "url": "displaySequence",
              "valueInteger": 4
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "EXMPublishableLibrary"
            },
            {
              "url": "name",
              "valueString": "SDE Race"
            },
            {
              "url": "statement",
              "valueString": "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"
            },
            {
              "url": "displaySequence",
              "valueInteger": 5
            }
          ],
          "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": 6
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "EXMPublishableLibrary"
            },
            {
              "url": "name",
              "valueString": "LengthInDays"
            },
            {
              "url": "statement",
              "valueString": "define function \"LengthInDays\"(Value Interval<DateTime>):  difference 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": "/* @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]"
            },
            {
              "url": "displaySequence",
              "valueInteger": 8
            }
          ],
          "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": 9
            }
          ],
          "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": "Value set Payer",
          "resource": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"
        }
      ],
      "parameter": [
        {
          "name": "Measurement Period",
          "use": "in",
          "min": 0,
          "max": "1",
          "type": "Period"
        },
        {
          "name": "SDE Sex",
          "use": "out",
          "min": 0,
          "max": "1",
          "type": "Coding"
        },
        {
          "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"
        }
      ],
      "dataRequirement": [
        {
          "type": "Patient",
          "profile": [
            "http://hl7.org/fhir/StructureDefinition/Patient"
          ],
          "mustSupport": [
            "url",
            "extension",
            "value"
          ]
        },
        {
          "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"
            }
          ]
        },
        {
          "type": "Encounter",
          "profile": [
            "http://hl7.org/fhir/StructureDefinition/Encounter"
          ],
          "mustSupport": [
            "period"
          ]
        }
      ]
    }
  ],
  "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"
    },
    {
      "extension": [
        {
          "url": "code",
          "valueCodeableConcept": {
            "coding": [
              {
                "system": "http://example.org/fhir/CodeSystem/measure-terms",
                "code": "example-term-code",
                "display": "Example Term Display"
              }
            ]
          }
        },
        {
          "url": "definition",
          "valueMarkdown": "A term used in the measure that bears clearly definition to communicate the measure intent"
        }
      ],
      "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.term"
    },
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
      "valueCode": "cqi"
    }
  ],
  "url": "http://hl7.org/fhir/uv/cqm/Measure/measure-publishable-exm",
  "identifier": [
    {
      "use": "usual",
      "type": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/artifact-identifier-type",
            "code": "short-name"
          }
        ]
      },
      "system": "http://example.org/fhir/cqi/ecqm/Measure/Identifier/exm",
      "value": "EXM-123"
    },
    {
      "use": "official",
      "type": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/artifact-identifier-type",
            "code": "version-independent"
          }
        ]
      },
      "system": "urn:ietf:rfc:3986",
      "value": "urn:uuid:11873bc9-ca0a-4cf3-b8f2-605a950aac74"
    },
    {
      "use": "official",
      "type": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/artifact-identifier-type",
            "code": "version-specific"
          }
        ]
      },
      "system": "urn:ietf:rfc:3986",
      "value": "urn:uuid:b366f29b-347f-464e-8064-c83842d825c7"
    },
    {
      "use": "official",
      "type": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/artifact-identifier-type",
            "code": "endorser"
          }
        ]
      },
      "system": "http://example.org/fhir/cqi/ecqm/Measure/Identifier/nqf",
      "value": "NQF-123",
      "assigner": {
        "display": "NQF"
      }
    },
    {
      "use": "official",
      "type": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/artifact-identifier-type",
            "code": "publisher"
          }
        ]
      },
      "system": "http://example.org/fhir/cqi/ecqm/Measure/Identifier/cms",
      "value": "CMS-123",
      "assigner": {
        "display": "CMS"
      }
    },
    {
      "system": "urn:ietf:rfc:3986",
      "value": "urn:oid:2.16.840.1.113883.4.642.40.61.29.23"
    }
  ],
  "version": "2.0.0",
  "name": "PublishableMeasureEXM",
  "title": "EXM Publishable 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 publishable 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 of...",
  "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"
    }
  ],
  "relatedArtifact": [
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-isPrimaryCitation",
          "valueBoolean": true
        }
      ],
      "type": "citation",
      "citation": "Linder, J.A., D.W. Bates, G.M. Lee, J.A. Finkelstein. 2005. 'Antibiotic treatment       of children with sore throat.' JAMA 294(18):2315-2322.",
      "url": "https://pubmed.ncbi.nlm.nih.gov/16278359/",
      "document": {
        "url": "https://pubmed.ncbi.nlm.nih.gov/16278359/"
      }
    },
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-isPrimaryCitation",
          "valueBoolean": true
        }
      ],
      "type": "citation",
      "citation": "Infectious Diseases Society of America. 2012. 'Clinical Practice Guideline for the Diagnosis and Management of Group A Streptococcal Pharyngitis: 2012 Update.'",
      "url": "https://pubmed.ncbi.nlm.nih.gov/23091044/",
      "document": {
        "url": "https://pubmed.ncbi.nlm.nih.gov/23091044/"
      }
    },
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-isPrimaryCitation",
          "valueBoolean": true
        }
      ],
      "type": "citation",
      "citation": "Roberts, R.R., B. Hota, I. Ahmad, et al. 'Hospital and Societal Costs of Antimicrobial-Resistant Infections in a Chicago Teaching Hospital: Implications for Antibiotic Stewardship.' Clin Infect Dis. Oct 2009; 49(8):1175-84.",
      "url": "https://pubmed.ncbi.nlm.nih.gov/19739972/",
      "document": {
        "url": "https://pubmed.ncbi.nlm.nih.gov/19739972/"
      }
    },
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-publicationStatus",
          "valueCode": "draft"
        },
        {
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-publicationDate",
          "valueDate": "2019-01-01"
        }
      ],
      "type": "citation",
      "citation": "Example citation to draft publication",
      "url": "http://example.org/publications/1234",
      "document": {
        "url": "http://example.org/publications/1234"
      }
    }
  ],
  "library": [
    "http://hl7.org/fhir/uv/cqm/Library/EXMPublishableLibrary"
  ],
  "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 rationale of this measure is to...",
  "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"
      }
    ]
  },
  "group": [
    {
      "id": "group-1",
      "extension": [
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.linkId",
          "valueString": "primary"
        }
      ],
      "population": [
        {
          "id": "initial-population",
          "extension": [
            {
              "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.population.linkId",
              "valueString": "primary-publishablexm-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-publishablexm-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-publishablexm-denominator"
            }
          ],
          "code": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                "code": "denominator",
                "display": "Denominator"
              }
            ]
          },
          "criteria": {
            "language": "text/cql-identifier",
            "expression": "Denominator"
          }
        }
      ]
    }
  ],
  "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"
      }
    }
  ]
}