| Package | example.fhir.uv.mycontentig |
| Resource Type | Measure |
| Id | DischargedonAntithromboticTherapyFHIRExample |
| FHIR Version | R4 |
| Source | http://somewhere.org/fhir/uv/mycontentig/https://build.fhir.org/ig/cqframework/sample-content-ig/Measure-DischargedonAntithromboticTherapyFHIRExample.html |
| URL | http://somewhere.org/fhir/uv/mycontentig/Measure/DischargedonAntithromboticTherapyFHIRExample |
| Version | 0.4.9-cibuild |
| Status | draft |
| Date | 2025-04-24T12:02:57+00:00 |
| Name | DischargedonAntithromboticTherapyFHIRExample |
| Title | Discharged on Antithrombotic Therapy FHIR Example |
| Realm | uv |
| Authority | hl7 |
| Description | Ischemic stroke patients prescribed or continuing to take antithrombotic therapy at hospital discharge |
| Purpose | UNKNOWN |
| Copyright | Measure specifications are in the Public Domain LOINC(R) copyright 2004-2022 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2022 International Health Terminology Standards Development Organisation. ICD-10 copyright 2021 World Health Organization. All Rights Reserved. |
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FHIR{
"resourceType": "Measure",
"id": "DischargedonAntithromboticTherapyFHIRExample",
"meta": {
"profile": [
"http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-measure-cqfm"
]
},
"text": {
"status": "extensions",
"div": "<!-- snip (see above) -->"
},
"contained": [
{
"resourceType": "Library",
"id": "effective-data-requirements",
"extension": [
{
"url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
"valueCoding": {
"system": "http://terminology.hl7.org/CodeSystem/medicationrequest-category",
"code": "community",
"display": "Community"
}
},
{
"url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
"valueCoding": {
"system": "http://terminology.hl7.org/CodeSystem/medicationrequest-category",
"code": "discharge",
"display": "Discharge"
}
},
{
"extension": [
{
"url": "libraryName",
"valueString": "SupplementalDataElementsExample"
},
{
"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/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension": [
{
"url": "libraryName",
"valueString": "DischargedonAntithromboticTherapyFHIRExample"
},
{
"url": "name",
"valueString": "SDE Sex"
},
{
"url": "statement",
"valueString": "define \"SDE Sex\":\n SDE.\"SDE Sex\""
},
{
"url": "displaySequence",
"valueInteger": 1
}
],
"url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension": [
{
"url": "libraryName",
"valueString": "TJCOverallExample"
},
{
"url": "name",
"valueString": "Non Elective Inpatient Encounter"
},
{
"url": "statement",
"valueString": "define \"Non Elective Inpatient Encounter\":\n [\"Encounter\": \"Nonelective Inpatient Encounter\"] NonElectiveEncounter\n where NonElectiveEncounter.period ends during day of \"Measurement Period\""
},
{
"url": "displaySequence",
"valueInteger": 2
}
],
"url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension": [
{
"url": "libraryName",
"valueString": "TJCOverallExample"
},
{
"url": "name",
"valueString": "All Stroke Encounter"
},
{
"url": "statement",
"valueString": "define \"All Stroke Encounter\":\n \"Non Elective Inpatient Encounter\" NonElectiveEncounter\n let ConditionCode: NonElectiveEncounter.principalDiagnosis().code\n where ( ConditionCode in \"Hemorrhagic Stroke\"\n or ConditionCode in \"Ischemic Stroke\" )"
},
{
"url": "displaySequence",
"valueInteger": 3
}
],
"url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension": [
{
"url": "libraryName",
"valueString": "TJCOverallExample"
},
{
"url": "name",
"valueString": "Encounter with Principal Diagnosis and Age"
},
{
"url": "statement",
"valueString": "define \"Encounter with Principal Diagnosis and Age\":\n \"All Stroke Encounter\" AllStrokeEncounter\n where AgeInYearsAt(date from start of AllStrokeEncounter.period ) >= 18"
},
{
"url": "displaySequence",
"valueInteger": 4
}
],
"url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension": [
{
"url": "libraryName",
"valueString": "TJCOverallExample"
},
{
"url": "name",
"valueString": "Ischemic Stroke Encounter"
},
{
"url": "statement",
"valueString": "define \"Ischemic Stroke Encounter\":\n \"Encounter with Principal Diagnosis and Age\" EncounterWithAge\n where EncounterWithAge.principalDiagnosis().code in \"Ischemic Stroke\""
},
{
"url": "displaySequence",
"valueInteger": 5
}
],
"url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension": [
{
"url": "libraryName",
"valueString": "DischargedonAntithromboticTherapyFHIRExample"
},
{
"url": "name",
"valueString": "Numerator"
},
{
"url": "statement",
"valueString": "define \"Numerator\":\n TJC.\"Ischemic Stroke Encounter\" IschemicStrokeEncounter\n with [\"MedicationRequest\": \"Antithrombotic Therapy for Ischemic Stroke\"] DischargeAntithrombotic\n such that DischargeAntithrombotic.authoredOn during IschemicStrokeEncounter.period"
},
{
"url": "displaySequence",
"valueInteger": 6
}
],
"url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension": [
{
"url": "libraryName",
"valueString": "DischargedonAntithromboticTherapyFHIRExample"
},
{
"url": "name",
"valueString": "Denominator"
},
{
"url": "statement",
"valueString": "define \"Denominator\":\n TJC.\"Ischemic Stroke Encounter\""
},
{
"url": "displaySequence",
"valueInteger": 7
}
],
"url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension": [
{
"url": "libraryName",
"valueString": "SupplementalDataElementsExample"
},
{
"url": "name",
"valueString": "SDE Payer"
},
{
"url": "statement",
"valueString": "define \"SDE Payer\":\n [Coverage: type in \"Payer Type\"] Payer\n return {\n code: Payer.type,\n period: Payer.period\n }"
},
{
"url": "displaySequence",
"valueInteger": 8
}
],
"url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension": [
{
"url": "libraryName",
"valueString": "DischargedonAntithromboticTherapyFHIRExample"
},
{
"url": "name",
"valueString": "SDE Payer"
},
{
"url": "statement",
"valueString": "define \"SDE Payer\":\n SDE.\"SDE Payer\""
},
{
"url": "displaySequence",
"valueInteger": 9
}
],
"url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension": [
{
"url": "libraryName",
"valueString": "DischargedonAntithromboticTherapyFHIRExample"
},
{
"url": "name",
"valueString": "Initial Population"
},
{
"url": "statement",
"valueString": "define \"Initial Population\":\n TJC.\"Encounter with Principal Diagnosis and Age\""
},
{
"url": "displaySequence",
"valueInteger": 10
}
],
"url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension": [
{
"url": "libraryName",
"valueString": "SupplementalDataElementsExample"
},
{
"url": "name",
"valueString": "SDE Ethnicity"
},
{
"url": "statement",
"valueString": "define \"SDE Ethnicity\":\n Patient.ethnicity E\n return Tuple {\n codes: { E.ombCategory } union E.detailed,\n display: E.text\n }"
},
{
"url": "displaySequence",
"valueInteger": 11
}
],
"url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension": [
{
"url": "libraryName",
"valueString": "DischargedonAntithromboticTherapyFHIRExample"
},
{
"url": "name",
"valueString": "SDE Ethnicity"
},
{
"url": "statement",
"valueString": "define \"SDE Ethnicity\":\n SDE.\"SDE Ethnicity\""
},
{
"url": "displaySequence",
"valueInteger": 12
}
],
"url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension": [
{
"url": "libraryName",
"valueString": "TJCOverallExample"
},
{
"url": "name",
"valueString": "Ischemic Stroke Encounters with Discharge Disposition"
},
{
"url": "statement",
"valueString": "define \"Ischemic Stroke Encounters with Discharge Disposition\":\n \"Ischemic Stroke Encounter\" IschemicStrokeEncounter\n let DischDisp: IschemicStrokeEncounter.hospitalization.dischargeDisposition\n \twhere DischDisp in \"Discharge To Acute Care Facility\"\n\t\tor DischDisp in \"Left Against Medical Advice\"\n\t\tor DischDisp in \"Patient Expired\"\n\t\tor DischDisp in \"Discharged to Home for Hospice Care\"\n\t\tor DischDisp in \"Discharged to Health Care Facility for Hospice Care\""
},
{
"url": "displaySequence",
"valueInteger": 13
}
],
"url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension": [
{
"url": "libraryName",
"valueString": "TJCOverallExample"
},
{
"url": "name",
"valueString": "Intervention Comfort Measures"
},
{
"url": "statement",
"valueString": "define \"Intervention Comfort Measures\":\n ( [\"ServiceRequest\": code in \"Comfort Measures\"] SR\n where SR.status in { 'active', 'completed', 'on-hold' }\n and SR.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }\n and SR.doNotPerform is not true\n ) \n union ( [\"Procedure\": \"Comfort Measures\"] InterventionPerformed\n where InterventionPerformed.status in { 'completed', 'in-progress' }\n )"
},
{
"url": "displaySequence",
"valueInteger": 14
}
],
"url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension": [
{
"url": "libraryName",
"valueString": "DischargedonAntithromboticTherapyFHIRExample"
},
{
"url": "name",
"valueString": "Encounter with Comfort Measures during Hospitalization for Patients with Documented Ischemic Stroke"
},
{
"url": "statement",
"valueString": "define \"Encounter with Comfort Measures during Hospitalization for Patients with Documented Ischemic Stroke\":\n \"Denominator\" Encounter\n with TJC.\"Intervention Comfort Measures\" ComfortMeasure\n such that Coalesce(start of ComfortMeasure.performed.toInterval(), ComfortMeasure.authoredOn) during Encounter.hospitalizationWithObservation ( )"
},
{
"url": "displaySequence",
"valueInteger": 15
}
],
"url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension": [
{
"url": "libraryName",
"valueString": "DischargedonAntithromboticTherapyFHIRExample"
},
{
"url": "name",
"valueString": "Denominator Exclusions"
},
{
"url": "statement",
"valueString": "define \"Denominator Exclusions\":\n TJC.\"Ischemic Stroke Encounters with Discharge Disposition\"\n union \"Encounter with Comfort Measures during Hospitalization for Patients with Documented Ischemic Stroke\""
},
{
"url": "displaySequence",
"valueInteger": 16
}
],
"url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension": [
{
"url": "libraryName",
"valueString": "SupplementalDataElementsExample"
},
{
"url": "name",
"valueString": "SDE Race"
},
{
"url": "statement",
"valueString": "define \"SDE Race\":\n Patient.race R\n return Tuple {\n codes: R.ombCategory union R.detailed,\n display: R.text\n }"
},
{
"url": "displaySequence",
"valueInteger": 17
}
],
"url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension": [
{
"url": "libraryName",
"valueString": "DischargedonAntithromboticTherapyFHIRExample"
},
{
"url": "name",
"valueString": "SDE Race"
},
{
"url": "statement",
"valueString": "define \"SDE Race\":\n SDE.\"SDE Race\""
},
{
"url": "displaySequence",
"valueInteger": 18
}
],
"url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension": [
{
"url": "libraryName",
"valueString": "DischargedonAntithromboticTherapyFHIRExample"
},
{
"url": "name",
"valueString": "Reason for Not Giving Antithrombotic at Discharge"
},
{
"url": "statement",
"valueString": "define \"Reason for Not Giving Antithrombotic at Discharge\":\n [\"MedicationNotRequested\": \"Antithrombotic Therapy for Ischemic Stroke\"] NoAntithromboticDischarge\n where ( NoAntithromboticDischarge.reasonCode in \"Medical Reason For Not Providing Treatment\"\n or NoAntithromboticDischarge.reasonCode in \"Patient Refusal\"\n )\n and ( NoAntithromboticDischarge.isCommunity ( )\n or NoAntithromboticDischarge.isDischarge ( )\n )\n and NoAntithromboticDischarge.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }"
},
{
"url": "displaySequence",
"valueInteger": 19
}
],
"url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension": [
{
"url": "libraryName",
"valueString": "DischargedonAntithromboticTherapyFHIRExample"
},
{
"url": "name",
"valueString": "Encounter with Documented Reason for No Antithrombotic At Discharge"
},
{
"url": "statement",
"valueString": "define \"Encounter with Documented Reason for No Antithrombotic At Discharge\":\n TJC.\"Ischemic Stroke Encounter\" IschemicStrokeEncounter\n with \"Reason for Not Giving Antithrombotic at Discharge\" NoDischargeAntithrombotic\n such that NoDischargeAntithrombotic.authoredOn during IschemicStrokeEncounter.period"
},
{
"url": "displaySequence",
"valueInteger": 20
}
],
"url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension": [
{
"url": "libraryName",
"valueString": "DischargedonAntithromboticTherapyFHIRExample"
},
{
"url": "name",
"valueString": "Pharmacological Contraindications for Antithrombotic Therapy at Discharge"
},
{
"url": "statement",
"valueString": "define \"Pharmacological Contraindications for Antithrombotic Therapy at Discharge\":\n [\"MedicationRequest\": \"Pharmacological Contraindications For Antithrombotic Therapy\"] Pharmacological\n where ( Pharmacological.isCommunity ( )\n or Pharmacological.isDischarge ( )\n )\n and Pharmacological.status in { 'active', 'completed' }\n and Pharmacological.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }\n and Pharmacological.doNotPerform is not true"
},
{
"url": "displaySequence",
"valueInteger": 21
}
],
"url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension": [
{
"url": "libraryName",
"valueString": "DischargedonAntithromboticTherapyFHIRExample"
},
{
"url": "name",
"valueString": "Encounter with Pharmacological Contraindications for Antithrombotic Therapy at Discharge"
},
{
"url": "statement",
"valueString": "define \"Encounter with Pharmacological Contraindications for Antithrombotic Therapy at Discharge\":\n TJC.\"Ischemic Stroke Encounter\" IschemicStrokeEncounter\n with \"Pharmacological Contraindications for Antithrombotic Therapy at Discharge\" DischargePharmacological\n such that DischargePharmacological.authoredOn during IschemicStrokeEncounter.period"
},
{
"url": "displaySequence",
"valueInteger": 22
}
],
"url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension": [
{
"url": "libraryName",
"valueString": "DischargedonAntithromboticTherapyFHIRExample"
},
{
"url": "name",
"valueString": "Denominator Exceptions"
},
{
"url": "statement",
"valueString": "define \"Denominator Exceptions\":\n \"Encounter with Documented Reason for No Antithrombotic At Discharge\"\n union \"Encounter with Pharmacological Contraindications for Antithrombotic Therapy at Discharge\""
},
{
"url": "displaySequence",
"valueInteger": 23
}
],
"url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension": [
{
"url": "libraryName",
"valueString": "CQMCommonExample"
},
{
"url": "name",
"valueString": "principalDiagnosis"
},
{
"url": "statement",
"valueString": "/*\n@description: Returns the condition that is specified as the principal diagnosis for the encounter\n*/\ndefine fluent function principalDiagnosis(Encounter Encounter ):\n\tsingleton from ((Encounter.diagnosis D where D.rank = 1) PD\n return singleton from ([Condition] C where C.id = PD.condition.reference.getId())\n\t)"
},
{
"url": "displaySequence",
"valueInteger": 24
}
],
"url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension": [
{
"url": "libraryName",
"valueString": "QICoreCommonExample"
},
{
"url": "name",
"valueString": "getId"
},
{
"url": "statement",
"valueString": "/*\n@description: Returns the tail of the given uri (i.e. everything after the last slash in the URI).\n@comment: This function can be used to determine the logical id of a given resource. It can be used in\na single-server environment to trace references. However, this function does not attempt to resolve\nor distinguish the base of the given url, and so cannot be used safely in multi-server environments.\n*/\ndefine fluent function getId(uri String):\n Last(Split(uri, '/'))"
},
{
"url": "displaySequence",
"valueInteger": 25
}
],
"url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension": [
{
"url": "libraryName",
"valueString": "FHIRHelpers"
},
{
"url": "name",
"valueString": "ToString"
},
{
"url": "statement",
"valueString": "define function ToString(value uri): value.value"
},
{
"url": "displaySequence",
"valueInteger": 26
}
],
"url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension": [
{
"url": "libraryName",
"valueString": "FHIRHelpers"
},
{
"url": "name",
"valueString": "ToCode"
},
{
"url": "statement",
"valueString": "define 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": 27
}
],
"url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension": [
{
"url": "libraryName",
"valueString": "CQMCommonExample"
},
{
"url": "name",
"valueString": "hospitalizationWithObservation"
},
{
"url": "statement",
"valueString": "/*\n@description: Hospitalization with Observation returns the total interval from the start of any immediately prior emergency department visit through the observation visit to the discharge of the given encounter\n*/\ndefine fluent function hospitalizationWithObservation(TheEncounter Encounter ):\n TheEncounter Visit\n \t\tlet ObsVisit: Last([Encounter: \"Observation Services\"] LastObs\n \t\t\t\twhere LastObs.status = 'finished'\n and LastObs.period ends 1 hour or less on or before start of Visit.period\n \t\t\t\tsort by end of period\n \t\t\t),\n \t\t\tVisitStart: Coalesce(start of ObsVisit.period, start of Visit.period),\n \t\t\tEDVisit: Last([Encounter: \"Emergency Department Visit\"] LastED\n \t\t\t\twhere LastED.status = 'finished'\n and LastED.period ends 1 hour or less on or before VisitStart\n \t\t\t\tsort by end of period\n \t\t\t)\n \t\treturn Interval[Coalesce(start of EDVisit.period, VisitStart), end of Visit.period]"
},
{
"url": "displaySequence",
"valueInteger": 28
}
],
"url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension": [
{
"url": "libraryName",
"valueString": "FHIRHelpers"
},
{
"url": "name",
"valueString": "ToConcept"
},
{
"url": "statement",
"valueString": "define 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": 29
}
],
"url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension": [
{
"url": "libraryName",
"valueString": "QICoreCommonExample"
},
{
"url": "name",
"valueString": "isCommunity"
},
{
"url": "statement",
"valueString": "/*\n@description: Returns true if the given MedicationRequest has a category of Community\n*/\ndefine fluent function isCommunity(medicationRequest MedicationNotRequested):\n exists (medicationRequest.category C\n where C ~ Community\n )"
},
{
"url": "displaySequence",
"valueInteger": 30
}
],
"url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension": [
{
"url": "libraryName",
"valueString": "QICoreCommonExample"
},
{
"url": "name",
"valueString": "isDischarge"
},
{
"url": "statement",
"valueString": "/*\n@description: Returns true if the given MedicationRequest has a category of Discharge\n*/\ndefine fluent function isDischarge(medicationRequest MedicationNotRequested):\n exists (medicationRequest.category C\n where C ~ Discharge\n )"
},
{
"url": "displaySequence",
"valueInteger": 31
}
],
"url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
}
],
"name": "EffectiveDataRequirements",
"status": "active",
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/library-type",
"code": "module-definition"
}
]
},
"relatedArtifact": [
{
"type": "depends-on",
"display": "Library SDE",
"resource": "http://somewhere.org/fhir/uv/mycontentig/Library/SupplementalDataElementsExample"
},
{
"type": "depends-on",
"display": "Library TJC",
"resource": "http://somewhere.org/fhir/uv/mycontentig/Library/TJCOverallExample"
},
{
"type": "depends-on",
"display": "Library FHIRHelpers",
"resource": "http://somewhere.org/fhir/uv/mycontentig/Library/FHIRHelpers|4.0.1"
},
{
"type": "depends-on",
"display": "Library CQMCommon",
"resource": "http://somewhere.org/fhir/uv/mycontentig/Library/CQMCommonExample"
},
{
"type": "depends-on",
"display": "Library QICoreCommon",
"resource": "http://somewhere.org/fhir/uv/mycontentig/Library/QICoreCommonExample"
},
{
"type": "depends-on",
"display": "Code system MedicationRequestCategory",
"resource": "http://terminology.hl7.org/CodeSystem/medicationrequest-category"
},
{
"type": "depends-on",
"display": "Value set Nonelective Inpatient Encounter",
"resource": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.424"
},
{
"type": "depends-on",
"display": "Value set Hemorrhagic Stroke",
"resource": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.212"
},
{
"type": "depends-on",
"display": "Value set Ischemic Stroke",
"resource": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.247"
},
{
"type": "depends-on",
"display": "Value set Antithrombotic Therapy for Ischemic Stroke",
"resource": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.62"
},
{
"type": "depends-on",
"display": "Value set Payer Type",
"resource": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"
},
{
"type": "depends-on",
"display": "Value set Discharge To Acute Care Facility",
"resource": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.87"
},
{
"type": "depends-on",
"display": "Value set Left Against Medical Advice",
"resource": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.308"
},
{
"type": "depends-on",
"display": "Value set Patient Expired",
"resource": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.309"
},
{
"type": "depends-on",
"display": "Value set Discharged to Home for Hospice Care",
"resource": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.209"
},
{
"type": "depends-on",
"display": "Value set Discharged to Health Care Facility for Hospice Care",
"resource": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.207"
},
{
"type": "depends-on",
"display": "Value set Comfort Measures",
"resource": "http://cts.nlm.nih.gov/fhir/ValueSet/1.3.6.1.4.1.33895.1.3.0.45"
},
{
"type": "depends-on",
"display": "Value set Observation Services",
"resource": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.143"
},
{
"type": "depends-on",
"display": "Value set 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 Medical Reason For Not Providing Treatment",
"resource": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.473"
},
{
"type": "depends-on",
"display": "Value set Patient Refusal",
"resource": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.93"
},
{
"type": "depends-on",
"display": "Value set Pharmacological Contraindications For Antithrombotic Therapy",
"resource": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.52"
}
],
"parameter": [
{
"name": "Measurement Period",
"use": "in",
"min": 0,
"max": "1",
"type": "Period"
},
{
"name": "SDE Sex",
"use": "out",
"min": 0,
"max": "1",
"type": "Coding"
},
{
"name": "Numerator",
"use": "out",
"min": 0,
"max": "*",
"type": "Resource"
},
{
"name": "Denominator",
"use": "out",
"min": 0,
"max": "*",
"type": "Resource"
},
{
"name": "SDE Payer",
"use": "out",
"min": 0,
"max": "*",
"type": "Resource"
},
{
"name": "Initial Population",
"use": "out",
"min": 0,
"max": "*",
"type": "Resource"
},
{
"name": "SDE Ethnicity",
"use": "out",
"min": 0,
"max": "1",
"type": "Resource"
},
{
"name": "Denominator Exclusions",
"use": "out",
"min": 0,
"max": "*",
"type": "Resource"
},
{
"name": "SDE Race",
"use": "out",
"min": 0,
"max": "1",
"type": "Resource"
},
{
"name": "Denominator Exceptions",
"use": "out",
"min": 0,
"max": "*",
"type": "Resource"
}
],
"dataRequirement": [
{
"type": "Patient",
"profile": [
"http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"
],
"mustSupport": [
"url",
"extension"
]
},
{
"type": "Encounter",
"profile": [
"http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"
],
"mustSupport": [
"type",
"period",
"rank",
"rank.value",
"condition",
"condition.reference",
"condition.reference.value",
"hospitalization",
"hospitalization.dischargeDisposition"
],
"codeFilter": [
{
"path": "type",
"valueSet": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.424"
}
]
},
{
"type": "Encounter",
"profile": [
"http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"
],
"mustSupport": [
"type",
"status",
"status.value",
"period",
"rank",
"rank.value",
"condition",
"condition.reference",
"condition.reference.value",
"hospitalization",
"hospitalization.dischargeDisposition"
],
"codeFilter": [
{
"path": "type",
"valueSet": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.143"
}
]
},
{
"type": "Encounter",
"profile": [
"http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"
],
"mustSupport": [
"type",
"status",
"status.value",
"period",
"rank",
"rank.value",
"condition",
"condition.reference",
"condition.reference.value",
"hospitalization",
"hospitalization.dischargeDisposition"
],
"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/us/qicore/StructureDefinition/qicore-condition"
],
"mustSupport": [
"id",
"id.value"
]
},
{
"type": "MedicationRequest",
"profile": [
"http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest"
],
"mustSupport": [
"medication",
"authoredOn",
"authoredOn.value",
"status",
"status.value",
"intent",
"intent.value",
"doNotPerform",
"doNotPerform.value"
],
"codeFilter": [
{
"path": "medication",
"valueSet": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.62"
}
]
},
{
"type": "MedicationRequest",
"profile": [
"http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest"
],
"mustSupport": [
"medication",
"authoredOn",
"authoredOn.value",
"status",
"status.value",
"intent",
"intent.value",
"doNotPerform",
"doNotPerform.value"
],
"codeFilter": [
{
"path": "medication",
"valueSet": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.52"
}
]
},
{
"type": "MedicationRequest",
"profile": [
"http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest"
],
"mustSupport": [
"medication.reference",
"authoredOn",
"authoredOn.value",
"status",
"status.value",
"intent",
"intent.value",
"doNotPerform",
"doNotPerform.value"
]
},
{
"type": "Medication",
"profile": [
"http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medication"
],
"mustSupport": [
"id"
]
},
{
"type": "Coverage",
"profile": [
"http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-coverage"
],
"mustSupport": [
"type",
"period"
],
"codeFilter": [
{
"path": "type",
"valueSet": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"
}
]
},
{
"type": "ServiceRequest",
"profile": [
"http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest"
],
"mustSupport": [
"code",
"status",
"status.value",
"intent",
"intent.value",
"doNotPerform",
"doNotPerform.value"
],
"codeFilter": [
{
"path": "code",
"valueSet": "http://cts.nlm.nih.gov/fhir/ValueSet/1.3.6.1.4.1.33895.1.3.0.45"
}
]
},
{
"type": "Procedure",
"profile": [
"http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure"
],
"mustSupport": [
"code",
"status",
"status.value"
],
"codeFilter": [
{
"path": "code",
"valueSet": "http://cts.nlm.nih.gov/fhir/ValueSet/1.3.6.1.4.1.33895.1.3.0.45"
}
]
},
{
"type": "MedicationRequest",
"profile": [
"http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-mednotrequested"
],
"mustSupport": [
"medication",
"reasonCode",
"intent",
"intent.value",
"authoredOn",
"authoredOn.value"
],
"codeFilter": [
{
"path": "medication",
"valueSet": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.62"
}
]
},
{
"type": "MedicationRequest",
"profile": [
"http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-mednotrequested"
],
"mustSupport": [
"medication",
"reasonCode",
"intent",
"intent.value",
"authoredOn",
"authoredOn.value"
],
"codeFilter": [
{
"path": "medication",
"valueSet": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.62"
}
]
}
]
}
],
"extension": [
{
"id": "supplementalDataGuidance",
"extension": [
{
"url": "guidance",
"valueString": "Patient's Ethnicity:\nHispanic or Latino\nNot Hispanic or Latino\n Patient's Payer:\nCategories of types of health care payer entities as defined by the US Public Health Data Consortium SOP code system\n Patient's Race:\nNative Hawaiian or Other Pacific Islander\nAsian\nAmerican Indian or Alaska Native\nOther Race\nWhite\nBlack or African American\n Patient's Sex:\nGender identity restricted to only Male and Female used in administrative situations requiring a restriction to these two categories.\n"
},
{
"url": "usage",
"valueCodeableConcept": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code": "supplemental-data",
"display": "Supplemental Data"
}
],
"text": "Supplemental Data Guidance"
}
}
],
"url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-supplementalDataGuidance"
},
{
"url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-softwaresystem",
"valueReference": {
"reference": "Device/cqf-tooling"
}
},
{
"id": "effective-data-requirements",
"url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-effectiveDataRequirements",
"valueReference": {
"reference": "#effective-data-requirements"
}
}
],
"url": "http://somewhere.org/fhir/uv/mycontentig/Measure/DischargedonAntithromboticTherapyFHIRExample",
"identifier": [
{
"use": "usual",
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type",
"code": "short-name"
}
]
},
"system": "https://madie.cms.gov/measure/shortName",
"value": "CMS104FHIR"
},
{
"use": "official",
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type",
"code": "version-independent"
}
]
},
"system": "urn:ietf:rfc:3986",
"value": "urn:uuid:4f57e4a2-097b-45f8-9c85-91b35ea92dc1"
},
{
"use": "official",
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type",
"code": "version-specific"
}
]
},
"system": "urn:ietf:rfc:3986",
"value": "urn:uuid:e0b5379f-4b9c-4177-a530-d744fa95d080"
},
{
"use": "official",
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type",
"code": "publisher"
}
]
},
"system": "https://madie.cms.gov/measure/cmsId",
"value": "104FHIR",
"assigner": {
"display": "CMS"
}
}
],
"version": "0.4.9-cibuild",
"name": "DischargedonAntithromboticTherapyFHIRExample",
"title": "Discharged on Antithrombotic Therapy FHIR Example",
"status": "draft",
"experimental": false,
"date": "2025-04-24T12:02:57+00:00",
"publisher": "HL7 International - [Some] Work Group",
"contact": [
{
"telecom": [
{
"system": "url",
"value": "http://hl7.org/Special/committees/[something]"
}
]
}
],
"description": "Ischemic stroke patients prescribed or continuing to take antithrombotic therapy at hospital discharge",
"useContext": [
{
"code": {
"system": "http://terminology.hl7.org/CodeSystem/usage-context-type",
"code": "venue"
},
"valueCodeableConcept": {
"coding": [
{
"system": "http://hl7.org/fhir/uv/cqm/ValueSet/intended-venue",
"code": "eh",
"display": "EH"
}
]
}
}
],
"jurisdiction": [
{
"coding": [
{
"system": "http://unstats.un.org/unsd/methods/m49/m49.htm",
"code": "001"
}
]
}
],
"purpose": "UNKNOWN",
"usage": "The \"Nonelective Inpatient Encounter\" value set intends to capture all non-scheduled hospitalizations. This value set is a subset of the \"Inpatient encounter\" value set, excluding concepts that specifically refer to elective hospital admissions. Non-elective admissions include emergency, urgent and unplanned admissions.\n\nThe \"MedicationRequest\" datatype refers to the discharge medication list and is intended to express medications ordered for post-discharge use.\n\nThe denominator population includes patients with inpatient hospitalizations and patients from Acute Hospital Care at Home programs, who are treated and billed as inpatients but receive care in their home.\n\nThis eCQM is an episode-based measure. An episode is defined as each inpatient hospitalization or encounter that ends during the measurement period.\n\nThis FHIR-based measure has been derived from the QDM-based measure: CMS104v12.\n \nPlease refer to the HL7 QI-Core Implementation Guide (http://hl7.org/fhir/us/qicore/index.html) for more information on QI-Core and mapping recommendations from QDM to QI-Core 4.1.1 (http://hl7.org/fhir/us/qicore/qdm-to-qicore.html).",
"copyright": "Measure specifications are in the Public Domain\n\nLOINC(R) copyright 2004-2022 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2022 International Health Terminology Standards Development Organisation. ICD-10 copyright 2021 World Health Organization. All Rights Reserved.",
"approvalDate": "2023-08-01",
"lastReviewDate": "2023-08-01",
"effectivePeriod": {
"start": "2024-01-01",
"end": "2024-12-31"
},
"author": [
{
"name": "The Joint Commission",
"telecom": [
{
"system": "url",
"value": "https://www.jointcommission.org/"
}
]
}
],
"library": [
"http://somewhere.org/fhir/uv/mycontentig/Library/DischargedonAntithromboticTherapyFHIRExample"
],
"disclaimer": "These performance measures are not clinical guidelines and do not establish a standard of medical care, and have not been tested for all potential applications. The measures and specifications are provided without warranty.",
"rationale": "The effectiveness of antithrombotic agents in reducing stroke mortality, stroke-related morbidity and recurrence rates has been studied in several large clinical trials. While the use of these agents for patients with acute ischemic stroke and transient ischemic attacks continues to be the subject of study, substantial evidence is available from completed studies. Data at this time suggest that antithrombotic therapy should be prescribed at discharge following acute ischemic stroke to reduce stroke mortality and morbidity as long as no contraindications exist.\n\nor patients with a stroke due to a cardioembolic source (e.g. atrial fibrillation, mechanical heart valve), warfarin is recommended unless contraindicated. In recent years, novel oral anticoagulant agents (NOACs) have been developed and approved by the U.S. Food and Drug Administration (FDA) for stroke prevention, and may be considered as an alternative to warfarin for select patients. Anticoagulation therapy is not generally recommended for secondary stroke prevention in patients presumed to have a non-cardioembolic stroke.\nAnticoagulants at doses to prevent venous thromboembolism are insufficient antithrombotic therapy to prevent recurrent ischemic stroke or transient ischemic attack (TIA).",
"clinicalRecommendationStatement": "Clinical trial results suggest that antithrombotic therapy should be prescribed at discharge following acute ischemic stroke to reduce stroke mortality and morbidity as long as no contraindications exist",
"group": [
{
"id": "64403d17d4d7050edabb0562",
"extension": [
{
"url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring",
"valueCodeableConcept": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/measure-scoring",
"code": "proportion",
"display": "Proportion"
}
]
}
},
{
"url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis",
"valueCode": "Encounter"
},
{
"url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-type",
"valueCodeableConcept": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/measure-type",
"code": "process",
"display": "Process"
}
]
}
}
],
"population": [
{
"id": "937BAF2A-D36A-4EE5-B2B2-762A0FE04502",
"code": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/measure-population",
"code": "initial-population",
"display": "Initial Population"
}
]
},
"description": "Inpatient hospitalizations for patients age 18 and older, discharged from inpatient care (non-elective admissions) with a principal diagnosis of ischemic or hemorrhagic stroke and a length of stay less than or equal to 120 days that ends during the measurement period",
"criteria": {
"language": "text/cql-identifier",
"expression": "Initial Population"
}
},
{
"id": "302C1DCC-7FE6-41EF-A94E-FDAE24B7BB1B",
"code": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/measure-population",
"code": "denominator",
"display": "Denominator"
}
]
},
"description": "Inpatient hospitalizations for patients with a principal diagnosis of Ischemic stroke",
"criteria": {
"language": "text/cql-identifier",
"expression": "Denominator"
}
},
{
"id": "4B649804-9C55-4949-8CE0-01B462CAA74C",
"code": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/measure-population",
"code": "denominator-exclusion",
"display": "Denominator Exclusion"
}
]
},
"description": "- Inpatient hospitalizations for patients admitted for elective carotid intervention. This exclusion is implicitly modeled by only including non-elective hospitalizations.\n- Inpatient hospitalizations for patients discharged to another hospital\n- Inpatient hospitalizations for patients who left against medical advice\n- Inpatient hospitalizations for patients who expired\n- Inpatient hospitalizations for patients discharged to home for hospice care\n- Inpatient hospitalizations for patients discharged to a health care facility for hospice care\n- Inpatient hospitalizations for patients with comfort measures documented",
"criteria": {
"language": "text/cql-identifier",
"expression": "Denominator Exclusions"
}
},
{
"id": "516A3DD0-69B0-49EF-BBD3-12809CDC843E",
"code": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/measure-population",
"code": "denominator-exception",
"display": "Denominator Exception"
}
]
},
"description": "- Inpatient hospitalizations for patients with a documented reason for not prescribing antithrombotic therapy at discharge.\n- Inpatient hospitalizations for patients who receive Prasugrel as an antithrombotic therapy at discharge.",
"criteria": {
"language": "text/cql-identifier",
"expression": "Denominator Exceptions"
}
},
{
"id": "99961E3A-EFC4-4858-A3EE-F7F1D5B222FB",
"code": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/measure-population",
"code": "numerator",
"display": "Numerator"
}
]
},
"description": "Inpatient hospitalizations for patients prescribed or continuing to take antithrombotic therapy at hospital discharge",
"criteria": {
"language": "text/cql-identifier",
"expression": "Numerator"
}
},
{
"id": "5f33f3ea-6ffb-4897-85dd-872dd7ac55b8",
"code": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/measure-population",
"code": "numerator-exclusion",
"display": "Numerator Exclusion"
}
]
},
"criteria": {
"language": "text/cql-identifier"
}
}
]
}
],
"supplementalData": [
{
"id": "sde-ethnicity",
"usage": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code": "supplemental-data"
}
]
}
],
"description": "SDE Ethnicity",
"criteria": {
"language": "text/cql-identifier",
"expression": "SDE Ethnicity"
}
},
{
"id": "sde-payer",
"usage": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code": "supplemental-data"
}
]
}
],
"description": "SDE Payer",
"criteria": {
"language": "text/cql-identifier",
"expression": "SDE Payer"
}
},
{
"id": "sde-race",
"usage": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code": "supplemental-data"
}
]
}
],
"description": "SDE Race",
"criteria": {
"language": "text/cql-identifier",
"expression": "SDE Race"
}
},
{
"id": "sde-sex",
"usage": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code": "supplemental-data"
}
]
}
],
"description": "SDE Sex",
"criteria": {
"language": "text/cql-identifier",
"expression": "SDE Sex"
}
}
]
}