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FHIR IG Statistics: Measure/EXMLogic-FHIR

Packagehl7.fhir.us.cqfmeasures
Resource TypeMeasure
IdEXMLogic-FHIR
FHIR VersionR4
Sourcehttp://hl7.org/fhir/us/cqfmeasures/http://hl7.org/fhir/us/cqfmeasures/STU5/Measure-EXMLogic-FHIR.html
URLhttp://hl7.org/fhir/us/cqfmeasures/Measure/EXMLogic-FHIR
Version2.0.0
Statusactive
Date2022-02-22
NameMeasureEXM
TitleEXM Measure
Realmus
Authorityhl7
DescriptionAn example FHIR-based measure
PurposeThis measure has been developed to support improvement in clinical care.
CopyrightExample Copyright Statement

Resources that use this resource

No resources found

Resources that this resource uses

No resources found

Narrative

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

Title: EXM Measure
Id: EXMLogic-FHIR
Version: 2.0.0
Url: EXM Measure

EXM

Effective Period: 2018-01-01..2018-12-31
Experimental: true
Publisher: HL7 International / Clinical Quality Information
Author: Example Measure Content Developer
Description:

An example FHIR-based measure
Use Context:
code value
venue
Jurisdiction: US
Topic: 57024-2
Purpose:

This measure has been developed to support improvement in clinical care.
Copyright:

Example Copyright Statement
Disclaimer:

Example disclaimer
Basis: Encounter
Scoring:

Proportion

Type:

process

Risk Adjustment: Risk adjustment for this measure is performed by...
Rate Aggregation: Rate aggregation for this measure is performed by...
Rationale:

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

The clinical recommendation statement for this measure is...
Improvement Notation:

Increased score indicates improvement

Guidance (Usage): Users of this measure should be aware that this is intentionally simplified to show specific aspects of a measure.
Supplemental Data Elements:

SDE Ethnicity

SDE Race

SDE Payer

SDE Sex
Libraries:
Example Logic 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/2.16.840.1.114222.4.11.3591
  • http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.299
    		•
    Parameters:
    name use min max type
    Measurement Period In 0 1 Period
    SDE Sex Out 0 1 Coding
    Stratifier 3 Out 0 * Encounter
    Stratifier 4 Out 0 * Encounter
    SDE Payer Out 0 * Resource
    Initial Population Out 0 * Encounter
    SDE Ethnicity Out 0 * Coding
    SDE Race Out 0 * Coding
    Stratifier 1 Out 0 * Encounter
    Stratifier 2 Out 0 * Encounter
    DataRequirements:
    Resource Type Resource Elements Valueset Name Valueset
    Patient(http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient)
    Patient(http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient) url extension value
    Patient(http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient) url extension value
    Encounter(Encounter) period
    Coverage(Coverage) type period Payer http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591
    Direct Reference Codes:
    display code system
    Billing billing http://terminology.hl7.org/CodeSystem/diagnosis-role
    Logic Definitions:
    Group Scoring Population Criteria Expression
    group-1 Measure scoring:

    Proportion

    Initial Population 
    define "Initial Population" :
  "Inpatient Encounter" Encounter
    Numerator
    Denominator 
    define "Stratifier 1" :
  "Inpatient Encounter" Encounter
    where not (PrincipalDiagnosis(Encounter).code in "Psychiatric/Mental Health Patient")
    		 
    define "Stratifier 2" :
  "Inpatient Encounter" Encounter
    where PrincipalDiagnosis(Encounter).code in "Psychiatric/Mental Health Patient"
    		 
    define "Stratifier 3" :
  "Inpatient Encounter" Encounter
    where PrincipalDiagnosis(Encounter) is null
    		 
    define "Stratifier 4" :
  "Inpatient Encounter" Encounter
    where PrincipalDiagnosis(Encounter) is null
    Library Name Name
    EXMLogic-FHIR SDE Sex 
    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
    Library Name Name
    EXMLogic-FHIR Inpatient Encounter 
    define "Inpatient Encounter" :
  ["Encounter"] Encounter
    where LengthInDays(Encounter.period) <= 120
      and Encounter.period ends during "Measurement Period"
    Library Name Name
    EXMLogic-FHIR Stratifier 3 
    define "Stratifier 3" :
  "Inpatient Encounter" Encounter
    where PrincipalDiagnosis(Encounter) is null
    Library Name Name
    EXMLogic Stratifier 4 
    define "Stratifier 4" :
  "Inpatient Encounter" Encounter
    where PrincipalDiagnosis(Encounter) is null
    Library Name Name
    EXMLogic-FHIR SDE Payer 
    define "SDE Payer":
    [Coverage: type in "Payer"] Payer
      return {
        code: Payer.type,
        period: Payer.period
      }
    Library Name Name
    EXMLogic Initial Population 
    define "Initial Population" :
  "Inpatient Encounter" Encounter
    Library Name Name
    EXMLogic-FHIR SDE Ethnicity 
    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
    Library Name Name
    EXMLogic SDE Race 
    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
    Library Name Name
    EXMLogic-FHIR Stratifier 1 
    define "Stratifier 1" :
  "Inpatient Encounter" Encounter
    where not (PrincipalDiagnosis(Encounter).code in "Psychiatric/Mental Health Patient")
    Library Name Name
    EXMLogic-FHIR Stratifier 2 
    define "Stratifier 2" :
  "Inpatient Encounter" Encounter
    where PrincipalDiagnosis(Encounter).code in "Psychiatric/Mental Health Patient"

    Source

    {
  "resourceType": "Measure",
  "id": "EXMLogic-FHIR",
  "meta": {
    "profile": [
      "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/proportion-measure-cqfm",
      "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-measure-cqfm",
      "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/executable-measure-cqfm",
      "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cql-measure-cqfm",
      "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/elm-measure-cqfm"
    ]
  },
  "text": {
    "status": "extensions",
    "div": "<!-- snip (see above) -->"
  },
  "contained": [
    {
      "resourceType": "Library",
      "id": "effective-data-requirements-exmlogic",
      "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": "EXMLogic-FHIR"
            },
            {
              "url": "name",
              "valueString": "SDE Sex"
            },
            {
              "url": "statement",
              "valueString": "define \"SDE Sex\":\n  case\n    when Patient.gender = 'male' then Code { code: 'M', system: 'http://hl7.org/fhir/v3/AdministrativeGender', display: 'Male' }\n    when Patient.gender = 'female' then Code { code: 'F', system: 'http://hl7.org/fhir/v3/AdministrativeGender', display: 'Female' }\n    else null\n  end"
            },
            {
              "url": "displaySequence",
              "valueInteger": 0
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "EXMLogic-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": 1
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "EXMLogic-FHIR"
            },
            {
              "url": "name",
              "valueString": "Stratifier 3"
            },
            {
              "url": "statement",
              "valueString": "define \"Stratifier 3\" :\n  \"Inpatient Encounter\" Encounter\n    where PrincipalDiagnosis(Encounter) is null"
            },
            {
              "url": "displaySequence",
              "valueInteger": 2
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "EXMLogic"
            },
            {
              "url": "name",
              "valueString": "Stratifier 4"
            },
            {
              "url": "statement",
              "valueString": "define \"Stratifier 4\" :\n  \"Inpatient Encounter\" Encounter\n    where PrincipalDiagnosis(Encounter) is null"
            },
            {
              "url": "displaySequence",
              "valueInteger": 3
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "EXMLogic-FHIR"
            },
            {
              "url": "name",
              "valueString": "SDE Payer"
            },
            {
              "url": "statement",
              "valueString": "define \"SDE Payer\":\n    [Coverage: type in \"Payer\"] Payer\n      return {\n        code: Payer.type,\n        period: Payer.period\n      }"
            },
            {
              "url": "displaySequence",
              "valueInteger": 4
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "EXMLogic"
            },
            {
              "url": "name",
              "valueString": "Initial Population"
            },
            {
              "url": "statement",
              "valueString": "define \"Initial Population\" :\n  \"Inpatient Encounter\" Encounter"
            },
            {
              "url": "displaySequence",
              "valueInteger": 5
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "EXMLogic-FHIR"
            },
            {
              "url": "name",
              "valueString": "SDE Ethnicity"
            },
            {
              "url": "statement",
              "valueString": "define \"SDE Ethnicity\":\n  (flatten (\n    Patient.extension Extension\n      where Extension.url = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity'\n        return Extension.extension\n  )) E\n    where E.url = 'ombCategory'\n      or E.url = 'detailed'\n    return E.value as Coding"
            },
            {
              "url": "displaySequence",
              "valueInteger": 6
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "EXMLogic"
            },
            {
              "url": "name",
              "valueString": "SDE Race"
            },
            {
              "url": "statement",
              "valueString": "define \"SDE Race\":\n  (flatten (\n    Patient.extension Extension\n      where Extension.url = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-race'\n        return Extension.extension\n  )) E\n    where E.url = 'ombCategory'\n      or E.url = 'detailed'\n    return E.value as Coding"
            },
            {
              "url": "displaySequence",
              "valueInteger": 7
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "EXMLogic-FHIR"
            },
            {
              "url": "name",
              "valueString": "Stratifier 1"
            },
            {
              "url": "statement",
              "valueString": "define \"Stratifier 1\" :\n  \"Inpatient Encounter\" Encounter\n    where not (PrincipalDiagnosis(Encounter).code in \"Psychiatric/Mental Health Patient\")"
            },
            {
              "url": "displaySequence",
              "valueInteger": 8
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "EXMLogic-FHIR"
            },
            {
              "url": "name",
              "valueString": "Stratifier 2"
            },
            {
              "url": "statement",
              "valueString": "define \"Stratifier 2\" :\n  \"Inpatient Encounter\" Encounter\n    where PrincipalDiagnosis(Encounter).code in \"Psychiatric/Mental Health Patient\""
            },
            {
              "url": "displaySequence",
              "valueInteger": 9
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        }
      ],
      "url": "http://hl7.org/fhir/us/cqfmeasures/Library/effective-data-requirements-exmlogic",
      "version": "1.0.0",
      "name": "EffectiveDataRequirements",
      "title": "Module Definition Library - EXM Logic",
      "status": "active",
      "type": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/library-type",
            "code": "module-definition"
          }
        ]
      },
      "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 Payer",
          "resource": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"
        },
        {
          "type": "depends-on",
          "display": "Value set Psychiatric/Mental Health Patient",
          "resource": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.299"
        }
      ],
      "parameter": [
        {
          "name": "Measurement Period",
          "use": "in",
          "min": 0,
          "max": "1",
          "type": "Period"
        },
        {
          "name": "SDE Sex",
          "use": "out",
          "min": 0,
          "max": "1",
          "type": "Coding"
        },
        {
          "name": "Stratifier 3",
          "use": "out",
          "min": 0,
          "max": "*",
          "type": "Encounter"
        },
        {
          "name": "Stratifier 4",
          "use": "out",
          "min": 0,
          "max": "*",
          "type": "Encounter"
        },
        {
          "name": "SDE Payer",
          "use": "out",
          "min": 0,
          "max": "*",
          "type": "Resource"
        },
        {
          "name": "Initial Population",
          "use": "out",
          "min": 0,
          "max": "*",
          "type": "Encounter"
        },
        {
          "name": "SDE Ethnicity",
          "use": "out",
          "min": 0,
          "max": "*",
          "type": "Coding"
        },
        {
          "name": "SDE Race",
          "use": "out",
          "min": 0,
          "max": "*",
          "type": "Coding"
        },
        {
          "name": "Stratifier 1",
          "use": "out",
          "min": 0,
          "max": "*",
          "type": "Encounter"
        },
        {
          "name": "Stratifier 2",
          "use": "out",
          "min": 0,
          "max": "*",
          "type": "Encounter"
        }
      ],
      "dataRequirement": [
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/cqf-fhirQueryPattern",
              "valueString": "Patient?_id={{context.patientId}}"
            }
          ],
          "type": "Patient",
          "profile": [
            "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"
          ]
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/cqf-fhirQueryPattern",
              "valueString": "Patient?_id={{context.patientId}}"
            },
            {
              "extension": [
                {
                  "url": "path",
                  "valueString": "url"
                },
                {
                  "url": "comparator",
                  "valueCode": "eq"
                },
                {
                  "url": "value",
                  "valueString": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity"
                }
              ],
              "url": "http://hl7.org/fhir/StructureDefinition/cqf-valueFilter"
            }
          ],
          "type": "Patient",
          "profile": [
            "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"
          ],
          "mustSupport": [
            "url",
            "extension",
            "value"
          ]
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/cqf-fhirQueryPattern",
              "valueString": "Patient?_id={{context.patientId}}"
            }
          ],
          "type": "Patient",
          "profile": [
            "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"
          ],
          "mustSupport": [
            "url",
            "extension",
            "value"
          ],
          "codeFilter": [
            {
              "path": "url",
              "code": [
                {
                  "system": "urn:ietf:rfc:3986",
                  "code": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-race"
                }
              ]
            }
          ]
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/cqf-fhirQueryPattern",
              "valueString": "Encounter?subject=Patient/{{context.patientId}}"
            },
            {
              "url": "http://hl7.org/fhir/StructureDefinition/cqf-isSelective",
              "valueBoolean": true
            }
          ],
          "type": "Encounter",
          "profile": [
            "http://hl7.org/fhir/StructureDefinition/Encounter"
          ],
          "mustSupport": [
            "period"
          ],
          "dateFilter": [
            {
              "path": "period",
              "valuePeriod": {
                "extension": [
                  {
                    "url": "http://hl7.org/fhir/StructureDefinition/cqf-expression",
                    "valueExpression": {
                      "language": "text/cql-identifier",
                      "expression": "Measurement Period"
                    }
                  }
                ]
              }
            }
          ]
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/cqf-fhirQueryPattern",
              "valueString": "Coverage?policy-holder=Patient/{{context.patientId}}&type:in=http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"
            }
          ],
          "type": "Coverage",
          "profile": [
            "http://hl7.org/fhir/StructureDefinition/Coverage"
          ],
          "mustSupport": [
            "type",
            "period"
          ],
          "codeFilter": [
            {
              "path": "type",
              "valueSet": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"
            }
          ]
        }
      ]
    }
  ],
  "extension": [
    {
      "extension": [
        {
          "url": "type",
          "valueCode": "documentation"
        },
        {
          "url": "text",
          "valueMarkdown": "This illustrates an example comment"
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-artifactComment"
    },
    {
      "url": "http://hl7.org/fhir/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-exmlogic"
    },
    {
      "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoringPrecision",
      "valuePositiveInt": 2
    }
  ],
  "url": "http://hl7.org/fhir/us/cqfmeasures/Measure/EXMLogic-FHIR",
  "identifier": [
    {
      "system": "http://example.org/fhir/cqi/ecqm/Measure/Identifier/exm",
      "value": "EXM"
    }
  ],
  "version": "2.0.0",
  "name": "MeasureEXM",
  "title": "EXM Measure",
  "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": "An example FHIR-based measure",
  "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": "ec",
            "display": "EC"
          }
        ]
      }
    }
  ],
  "jurisdiction": [
    {
      "coding": [
        {
          "system": "urn:iso:std:iso:3166",
          "code": "US"
        }
      ]
    }
  ],
  "purpose": "This measure has been developed to support improvement in clinical care.",
  "usage": "Users of this measure should be aware that this is intentionally simplified to show specific aspects of a measure.",
  "copyright": "Example Copyright Statement",
  "approvalDate": "2019-02-17",
  "lastReviewDate": "2019-02-17",
  "effectivePeriod": {
    "extension": [
      {
        "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-effectivePeriodAnchor",
        "valueDateTime": "2018-01-01"
      },
      {
        "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-effectivePeriodDuration",
        "valueDuration": {
          "value": 1,
          "system": "http://unitsofmeasure.org",
          "code": "a"
        }
      }
    ],
    "start": "2018-01-01",
    "end": "2018-12-31"
  },
  "topic": [
    {
      "coding": [
        {
          "system": "http://loinc.org",
          "code": "57024-2"
        }
      ],
      "text": "Health Quality Measure Document"
    }
  ],
  "author": [
    {
      "name": "Example Measure Content Developer"
    }
  ],
  "library": [
    "http://hl7.org/fhir/us/cqfmeasures/Library/EXMLogic-FHIR"
  ],
  "disclaimer": "Example disclaimer",
  "scoring": {
    "coding": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/measure-scoring",
        "code": "proportion",
        "display": "Proportion"
      }
    ]
  },
  "type": [
    {
      "coding": [
        {
          "system": "http://terminology.hl7.org/CodeSystem/measure-type",
          "code": "process"
        }
      ]
    }
  ],
  "riskAdjustment": "Risk adjustment for this measure is performed by...",
  "rateAggregation": "Rate aggregation for this measure is performed by...",
  "rationale": "The purpose of this measure is to show how all the elements of a FHIR-based quality measure are represented.",
  "clinicalRecommendationStatement": "The clinical recommendation statement for this measure is...",
  "improvementNotation": {
    "coding": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/measure-improvement-notation",
        "code": "increase",
        "display": "Increased score indicates improvement"
      }
    ]
  },
  "guidance": "Additional guidance provided to help communicate the intent of the measure",
  "group": [
    {
      "id": "group-1",
      "code": {
        "coding": [
          {
            "system": "http://example.org/group",
            "code": "group",
            "display": "group-1"
          }
        ]
      },
      "population": [
        {
          "id": "initial-population-1",
          "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",
          "code": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                "code": "numerator",
                "display": "Numerator"
              }
            ]
          },
          "criteria": {
            "language": "text/cql-identifier",
            "expression": "Numerator"
          }
        },
        {
          "id": "denominator",
          "code": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                "code": "denominator",
                "display": "Denominator"
              }
            ]
          },
          "criteria": {
            "language": "text/cql-identifier",
            "expression": "Denominator"
          }
        }
      ],
      "stratifier": [
        {
          "id": "stratifier-1",
          "extension": [
            {
              "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo",
              "valueCodeableConcept": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                    "code": "initial-population",
                    "display": "Initial Population"
                  }
                ],
                "text": "initial-population"
              }
            }
          ],
          "code": {
            "text": "Stratifier 1"
          },
          "criteria": {
            "language": "text/cql-identifier",
            "expression": "Stratifier 1"
          }
        },
        {
          "id": "stratifier-2",
          "extension": [
            {
              "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo",
              "valueCodeableConcept": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                    "code": "initial-population",
                    "display": "Initial Population"
                  }
                ],
                "text": "initial-population"
              }
            }
          ],
          "code": {
            "text": "Stratifier 2"
          },
          "criteria": {
            "language": "text/cql-identifier",
            "expression": "Stratifier 2"
          }
        },
        {
          "id": "stratifier-3",
          "extension": [
            {
              "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo",
              "valueCodeableConcept": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                    "code": "initial-population",
                    "display": "Initial Population"
                  }
                ],
                "text": "initial-population"
              }
            }
          ],
          "code": {
            "text": "Stratifier 3"
          },
          "criteria": {
            "language": "text/cql-identifier",
            "expression": "Stratifier 3"
          }
        },
        {
          "id": "stratifier-4",
          "extension": [
            {
              "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo",
              "valueCodeableConcept": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                    "code": "initial-population",
                    "display": "Initial Population"
                  }
                ],
                "text": "initial-population"
              }
            }
          ],
          "code": {
            "text": "Stratifier 4"
          },
          "criteria": {
            "language": "text/cql-identifier",
            "expression": "Stratifier 4"
          }
        }
      ]
    }
  ],
  "supplementalData": [
    {
      "id": "sde-ethnicity",
      "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",
      "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",
      "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",
      "usage": [
        {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/measure-data-usage",
              "code": "supplemental-data"
            }
          ]
        }
      ],
      "criteria": {
        "language": "text/cql-identifier",
        "expression": "SDE Sex"
      }
    }
  ]
}