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FHIR IG Statistics: Measure/EXM55-FHIR

Packagehl7.fhir.us.cqfmeasures
Resource TypeMeasure
IdEXM55-FHIR
FHIR VersionR4
Sourcehttp://hl7.org/fhir/us/cqfmeasures/http://hl7.org/fhir/us/cqfmeasures/STU5/Measure-EXM55-FHIR.html
URLhttp://hl7.org/fhir/us/cqfmeasures/Measure/EXM55-FHIR
Version5.0.0
Statusactive
Date2022-02-22
NameEXM55
TitleEXM55 - Median Emergency Department Visit Duration
Realmus
Authorityhl7
DescriptionThis example illustrates a continuous variable measure represented as a FHIR eCQM

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

Title: EXM55 - Median Emergency Department Visit Duration
Id: EXM55-FHIR
Version: 5.0.0
Url: EXM55 - Median Emergency Department Visit Duration
Official

55

Effective Period: 2018-01-01..2018-12-31
Experimental: true
Publisher: HL7 International / Clinical Quality Information
Description:

This example illustrates a continuous variable measure represented as a FHIR eCQM
Use Context:
code value
venue
Jurisdiction: US
Topic: 57024-2
Basis: Encounter
Scoring:

Continuous Variable

Type:

process

Improvement Notation:

Decreased score indicates improvement

Libraries:
EXM55 - Median Emergency Department Visit Duration Library (Example Continuous Variable Measure Library)
Terminology and Other Dependencies:
  • http://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1
  • Diagnosis Role
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.299
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.126
    		•
    Parameters:
    name use min max type
    Measurement Period In 0 1 Period
    Stratification 3 Out 0 * Encounter
    Stratification 2 Out 0 * Encounter
    Measure Population Exclusion Out 0 * Encounter
    Stratification 1 Out 0 * Encounter
    Initial Population Out 0 * Encounter
    Measure Population Out 0 * Encounter
    DataRequirements:
    Resource Type Resource Elements Valueset Name Valueset
    Encounter(Encounter) period hospitalization hospitalization.admitSource type status Emergency Department Visit http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292
    Encounter(Encounter) period
    Condition(Condition) id
    Direct Reference Codes:
    display code system
    Billing billing http://terminology.hl7.org/CodeSystem/diagnosis-role
    Logic Definitions:
    Group Scoring Population Criteria Expression
    Measure scoring:

    Continuous Variable

    Initial Population 
    define "Initial Population" :
  "Inpatient Encounter" Encounter
    with ["Encounter" : "Emergency Department Visit"] ED
     such that ED.status = 'finished'
       and ED.period ends 1 hour or less before start of Encounter.period
    Measure Population 
    define "Measure Population" :
  "Initial Population"
    Measure Population Exclusion 
    define "Measure Population Exclusion" :
  "Inpatient Encounter" Encounter
    with ["Encounter" : "Emergency Department Visit"] ED
      such that ED.period ends 1 hour or less before start of Encounter.period
        and ED.status = 'finished'
        and ED.hospitalization.admitSource in "Hospital Settings"
    Measure Observation
    Stratification 1 
    define "Stratification 1" :
  "Inpatient Encounter" Encounter
    where not (PrincipalDiagnosis(Encounter).code in "Psychiatric/Mental Health Patient")
    Stratification 2 
    define "Stratification 2" :
  "Inpatient Encounter" Encounter
    where PrincipalDiagnosis(Encounter).code in "Psychiatric/Mental Health Patient"
    Stratification 3 
    define "Stratification 3" :
  "Inpatient Encounter" Encounter
    where PrincipalDiagnosis(Encounter) is null
    Library Name Name
    EXM55-FHIR Inpatient Encounter 
    define "Inpatient Encounter" :
  ["Encounter"] Encounter
    where LengthInDays(Encounter.period) <= 120
      and Encounter.period ends during "Measurement Period"
    Library Name Name
    EXM55-FHIR Stratification 3 
    define "Stratification 3" :
  "Inpatient Encounter" Encounter
    where PrincipalDiagnosis(Encounter) is null
    Library Name Name
    EXM55-FHIR Stratification 2 
    define "Stratification 2" :
  "Inpatient Encounter" Encounter
    where PrincipalDiagnosis(Encounter).code in "Psychiatric/Mental Health Patient"
    Library Name Name
    EXM55-FHIR Measure Population Exclusion 
    define "Measure Population Exclusion" :
  "Inpatient Encounter" Encounter
    with ["Encounter" : "Emergency Department Visit"] ED
      such that ED.period ends 1 hour or less before start of Encounter.period
        and ED.status = 'finished'
        and ED.hospitalization.admitSource in "Hospital Settings"
    Library Name Name
    EXM55-FHIR Stratification 1 
    define "Stratification 1" :
  "Inpatient Encounter" Encounter
    where not (PrincipalDiagnosis(Encounter).code in "Psychiatric/Mental Health Patient")
    Library Name Name
    EXM55-FHIR Initial Population 
    define "Initial Population" :
  "Inpatient Encounter" Encounter
    with ["Encounter" : "Emergency Department Visit"] ED
     such that ED.status = 'finished'
       and ED.period ends 1 hour or less before start of Encounter.period
    Library Name Name
    EXM55-FHIR Measure Population 
    define "Measure Population" :
  "Initial Population"

    Source

    {
  "resourceType": "Measure",
  "id": "EXM55-FHIR",
  "meta": {
    "profile": [
      "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cv-measure-cqfm",
      "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-measure-cqfm",
      "http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-shareablemeasure",
      "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cql-measure-cqfm"
    ]
  },
  "text": {
    "status": "extensions",
    "div": "<!-- snip (see above) -->"
  },
  "contained": [
    {
      "resourceType": "Library",
      "id": "effective-data-requirements-exm55",
      "meta": {
        "profile": [
          "http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-moduledefinitionlibrary"
        ]
      },
      "extension": [
        {
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
          "valueCoding": {
            "system": "http://terminology.hl7.org/CodeSystem/diagnosis-role",
            "code": "billing",
            "display": "Billing"
          }
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "EXM55-FHIR"
            },
            {
              "url": "name",
              "valueString": "Inpatient Encounter"
            },
            {
              "url": "statement",
              "valueString": "define \"Inpatient Encounter\" :\n  [\"Encounter\"] Encounter\n    where LengthInDays(Encounter.period) <= 120\n      and Encounter.period ends during \"Measurement Period\""
            },
            {
              "url": "displaySequence",
              "valueInteger": 0
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "EXM55-FHIR"
            },
            {
              "url": "name",
              "valueString": "Stratification 3"
            },
            {
              "url": "statement",
              "valueString": "define \"Stratification 3\" :\n  \"Inpatient Encounter\" Encounter\n    where PrincipalDiagnosis(Encounter) is null"
            },
            {
              "url": "displaySequence",
              "valueInteger": 1
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "EXM55-FHIR"
            },
            {
              "url": "name",
              "valueString": "Stratification 2"
            },
            {
              "url": "statement",
              "valueString": "define \"Stratification 2\" :\n  \"Inpatient Encounter\" Encounter\n    where PrincipalDiagnosis(Encounter).code in \"Psychiatric/Mental Health Patient\""
            },
            {
              "url": "displaySequence",
              "valueInteger": 2
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "EXM55-FHIR"
            },
            {
              "url": "name",
              "valueString": "Measure Population Exclusion"
            },
            {
              "url": "statement",
              "valueString": "define \"Measure Population Exclusion\" :\n  \"Inpatient Encounter\" Encounter\n    with [\"Encounter\" : \"Emergency Department Visit\"] ED\n      such that ED.period ends 1 hour or less before start of Encounter.period\n        and ED.status = 'finished'\n        and ED.hospitalization.admitSource in \"Hospital Settings\""
            },
            {
              "url": "displaySequence",
              "valueInteger": 3
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "EXM55-FHIR"
            },
            {
              "url": "name",
              "valueString": "Stratification 1"
            },
            {
              "url": "statement",
              "valueString": "define \"Stratification 1\" :\n  \"Inpatient Encounter\" Encounter\n    where not (PrincipalDiagnosis(Encounter).code in \"Psychiatric/Mental Health Patient\")"
            },
            {
              "url": "displaySequence",
              "valueInteger": 4
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "EXM55-FHIR"
            },
            {
              "url": "name",
              "valueString": "Initial Population"
            },
            {
              "url": "statement",
              "valueString": "define \"Initial Population\" :\n  \"Inpatient Encounter\" Encounter\n    with [\"Encounter\" : \"Emergency Department Visit\"] ED\n     such that ED.status = 'finished'\n       and ED.period ends 1 hour or less before start of Encounter.period"
            },
            {
              "url": "displaySequence",
              "valueInteger": 5
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "EXM55-FHIR"
            },
            {
              "url": "name",
              "valueString": "Measure Population"
            },
            {
              "url": "statement",
              "valueString": "define \"Measure Population\" :\n  \"Initial Population\""
            },
            {
              "url": "displaySequence",
              "valueInteger": 6
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        }
      ],
      "url": "http://hl7.org/fhir/us/cqfmeasures/Library/effective-data-requirements-exm55",
      "version": "1.0.0",
      "name": "ModuleDefinitionLibraryEXM55",
      "title": "Module Definition Library - EXM55",
      "status": "active",
      "experimental": true,
      "type": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/library-type",
            "code": "module-definition"
          }
        ]
      },
      "date": "2022-02-22T10:37:03-07:00",
      "description": "This library is used as an example module definition in the FHIR Quality Measure Implementation Guide",
      "relatedArtifact": [
        {
          "type": "depends-on",
          "display": "Library FHIRHelpers",
          "resource": "http://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1"
        },
        {
          "type": "depends-on",
          "display": "Code system Diagnosis Role",
          "resource": "http://terminology.hl7.org/CodeSystem/diagnosis-role"
        },
        {
          "type": "depends-on",
          "display": "Value set Psychiatric/Mental Health Patient",
          "resource": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.299"
        },
        {
          "type": "depends-on",
          "display": "Value set Emergency Department Visit",
          "resource": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292"
        },
        {
          "type": "depends-on",
          "display": "Value set Hospital Settings",
          "resource": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.126"
        }
      ],
      "parameter": [
        {
          "name": "Measurement Period",
          "use": "in",
          "min": 0,
          "max": "1",
          "type": "Period"
        },
        {
          "name": "Stratification 3",
          "use": "out",
          "min": 0,
          "max": "*",
          "type": "Encounter"
        },
        {
          "name": "Stratification 2",
          "use": "out",
          "min": 0,
          "max": "*",
          "type": "Encounter"
        },
        {
          "name": "Measure Population Exclusion",
          "use": "out",
          "min": 0,
          "max": "*",
          "type": "Encounter"
        },
        {
          "name": "Stratification 1",
          "use": "out",
          "min": 0,
          "max": "*",
          "type": "Encounter"
        },
        {
          "name": "Initial Population",
          "use": "out",
          "min": 0,
          "max": "*",
          "type": "Encounter"
        },
        {
          "name": "Measure Population",
          "use": "out",
          "min": 0,
          "max": "*",
          "type": "Encounter"
        }
      ],
      "dataRequirement": [
        {
          "type": "Encounter",
          "profile": [
            "http://hl7.org/fhir/StructureDefinition/Encounter"
          ],
          "mustSupport": [
            "period",
            "hospitalization",
            "hospitalization.admitSource",
            "type",
            "status"
          ],
          "codeFilter": [
            {
              "path": "type",
              "valueSet": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292"
            }
          ]
        },
        {
          "type": "Encounter",
          "profile": [
            "http://hl7.org/fhir/StructureDefinition/Encounter"
          ],
          "mustSupport": [
            "period"
          ]
        },
        {
          "type": "Condition",
          "profile": [
            "http://hl7.org/fhir/StructureDefinition/Condition"
          ],
          "mustSupport": [
            "id"
          ],
          "codeFilter": [
            {
              "path": "id"
            }
          ]
        }
      ]
    }
  ],
  "extension": [
    {
      "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis",
      "valueCode": "Encounter"
    },
    {
      "url": "http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-softwaresystem",
      "valueReference": {
        "reference": "Device/software-system-example"
      }
    },
    {
      "url": "http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements",
      "valueCanonical": "#effective-data-requirements-exm55"
    }
  ],
  "url": "http://hl7.org/fhir/us/cqfmeasures/Measure/EXM55-FHIR",
  "identifier": [
    {
      "use": "official",
      "system": "http://example.org/fhir/cqi/ecqm/Measure/Identifier/exm",
      "value": "55"
    }
  ],
  "version": "5.0.0",
  "name": "EXM55",
  "title": "EXM55 - Median Emergency Department Visit Duration",
  "status": "active",
  "experimental": true,
  "date": "2022-02-22",
  "publisher": "HL7 International / Clinical Quality Information",
  "contact": [
    {
      "telecom": [
        {
          "system": "url",
          "value": "http://www.hl7.org/Special/committees/cqi"
        }
      ]
    }
  ],
  "description": "This example illustrates a continuous variable measure represented as a FHIR eCQM",
  "useContext": [
    {
      "code": {
        "system": "http://terminology.hl7.org/CodeSystem/usage-context-type",
        "code": "venue",
        "display": "Venue"
      },
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "http://hl7.org/fhir/us/cqfmeasures/CodeSystem/intended-venue-codes",
            "code": "eh",
            "display": "EH"
          }
        ]
      }
    }
  ],
  "jurisdiction": [
    {
      "coding": [
        {
          "system": "urn:iso:std:iso:3166",
          "code": "US"
        }
      ]
    }
  ],
  "approvalDate": "2019-03-08",
  "lastReviewDate": "2019-03-08",
  "effectivePeriod": {
    "start": "2018-01-01",
    "end": "2018-12-31"
  },
  "topic": [
    {
      "coding": [
        {
          "system": "http://loinc.org",
          "code": "57024-2",
          "display": "Health Quality Measure Document"
        }
      ]
    }
  ],
  "library": [
    "http://hl7.org/fhir/us/cqfmeasures/Library/EXM55-FHIR"
  ],
  "scoring": {
    "coding": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/measure-scoring",
        "code": "continuous-variable",
        "display": "Continuous Variable"
      }
    ]
  },
  "type": [
    {
      "coding": [
        {
          "system": "http://terminology.hl7.org/CodeSystem/measure-type",
          "code": "process"
        }
      ]
    }
  ],
  "improvementNotation": {
    "coding": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/measure-improvement-notation",
        "code": "decrease",
        "display": "Decreased score indicates improvement"
      }
    ]
  },
  "group": [
    {
      "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"
          }
        },
        {
          "code": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                "code": "measure-population",
                "display": "Measure Population"
              }
            ]
          },
          "criteria": {
            "language": "text/cql-identifier",
            "expression": "Measure Population"
          }
        },
        {
          "code": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                "code": "measure-population-exclusion",
                "display": "Measure Population Exclusion"
              }
            ]
          },
          "criteria": {
            "language": "text/cql-identifier",
            "expression": "Measure Population Exclusion"
          }
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-criteriaReference",
              "valueString": "measure-population-identifier"
            },
            {
              "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-aggregateMethod",
              "valueCode": "median"
            }
          ],
          "code": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                "code": "measure-observation",
                "display": "Measure Observation"
              }
            ]
          },
          "criteria": {
            "language": "text/cql-identifier",
            "expression": "Measure Observation"
          }
        }
      ],
      "stratifier": [
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo",
              "valueCodeableConcept": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                    "code": "initial-population",
                    "display": "Initial Population"
                  }
                ]
              }
            }
          ],
          "code": {
            "coding": [
              {
                "system": "http://example.org/stratification",
                "code": "Stratification 1",
                "display": "Stratification 1"
              }
            ]
          },
          "criteria": {
            "language": "text/cql-identifier",
            "expression": "Stratification 1"
          }
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo",
              "valueCodeableConcept": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                    "code": "initial-population",
                    "display": "Initial Population"
                  }
                ]
              }
            }
          ],
          "code": {
            "coding": [
              {
                "system": "http://example.org/stratification",
                "code": "Stratification 2",
                "display": "Stratification 2"
              }
            ]
          },
          "criteria": {
            "language": "text/cql-identifier",
            "expression": "Stratification 2"
          }
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo",
              "valueCodeableConcept": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                    "code": "initial-population",
                    "display": "Initial Population"
                  }
                ]
              }
            }
          ],
          "code": {
            "coding": [
              {
                "system": "http://example.org/stratification",
                "code": "Stratification 3",
                "display": "Stratification 3"
              }
            ]
          },
          "criteria": {
            "language": "text/cql-identifier",
            "expression": "Stratification 3"
          }
        }
      ]
    }
  ]
}