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FHIR IG Statistics: Measure/EXMLogic-FHIR

Packagehl7.fhir.uv.cqm
Resource TypeMeasure
IdEXMLogic-FHIR
FHIR VersionR4
Sourcehttp://hl7.org/fhir/uv/cqm/https://build.fhir.org/ig/HL7/fhir-cqm/Measure-EXMLogic-FHIR.html
URLhttp://hl7.org/fhir/uv/cqm/Measure/EXMLogic-FHIR
Version2.0.0
Statusactive
Date2022-02-22
NameMeasureEXM
TitleEXM Measure
Realmuv
Authorityhl7
DescriptionAn example FHIR-based measure
PurposeThis measure has been developed to support improvement in clinical care.
CopyrightExample Copyright Statement

Resources that use this resource

No resources found

Resources that this resource uses

No resources found

Narrative

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

Metadata
Title EXM Measure
Version 2.0.0
Identifier EXM
Effective Period 2018-01-01 through 2018-12-31
Approval Date 2019-02-17
Last Review Date 2019-02-17
Experimental true
Use Context Clinical Venue = EC
Jurisdiction Global (Whole world)
Topic Health Quality Measure Document
Steward (Publisher) HL7 International / Clinical Quality Information
Developer Example Measure Content Developer
Description

An example FHIR-based measure
Purpose

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

Example Copyright Statement
Disclaimer

Example disclaimer
Measure Scoring Proportion
Measure Type Process
Risk Adjustment Risk adjustment for this measure is performed by...
Rate Aggregation Rate aggregation for this measure is performed by...
Rationale

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

The clinical recommendation statement for this measure is...
Improvement Notation Increased score indicates improvement
Guidance (Usage) Users of this measure should be aware that this is intentionally simplified to show specific aspects of a measure.
Measure Group (Rate) (ID: group-1)
Initial Population ID: initial-population-1
Description: No description provided Logic Definition: Initial Population
Numerator ID: numerator
Description: No description provided Logic Definition: Numerator
Denominator ID: denominator
Description: No description provided Logic Definition: Denominator
Stratifier ID: stratifier-1
Code: Stratifier 1
Stratifier ID: stratifier-2
Code: Stratifier 2
Stratifier ID: stratifier-3
Code: Stratifier 3
Stratifier ID: stratifier-4
Code: Stratifier 4
Supplemental Data Elements
Supplemental Data Element ID: sde-ethnicity
Usage Code: Supplemental Data
Description: No description provided
Logic Definition: SDE Ethnicity
Supplemental Data Element ID: sde-race
Usage Code: Supplemental Data
Description: No description provided
Logic Definition: SDE Race
Supplemental Data Element ID: sde-payer
Usage Code: Supplemental Data
Description: No description provided
Logic Definition: SDE Payer
Supplemental Data Element ID: sde-sex
Usage Code: Supplemental Data
Description: No description provided
Logic Definition: SDE Sex
Measure Logic
Primary Library Example Logic Library
Contents Population Criteria
Logic Definitions
Terminology
Dependencies
Data Requirements
Population Criteria
Measure Group (Rate) (ID: group-1)
Initial Population 
define "Initial Population" :
  "Inpatient Encounter" Encounter
Stratifier 
define "Stratifier 1" :
  "Inpatient Encounter" Encounter
    where not (PrincipalDiagnosis(Encounter).code in "Psychiatric/Mental Health Patient")
Stratifier 
define "Stratifier 2" :
  "Inpatient Encounter" Encounter
    where PrincipalDiagnosis(Encounter).code in "Psychiatric/Mental Health Patient"
Stratifier 
define "Stratifier 3" :
  "Inpatient Encounter" Encounter
    where PrincipalDiagnosis(Encounter) is null
Stratifier 
define "Stratifier 4" :
  "Inpatient Encounter" Encounter
    where PrincipalDiagnosis(Encounter) is null
Logic Definitions
Logic Definition Library Name: EXMLogic 
define "Stratifier 4" :
  "Inpatient Encounter" Encounter
    where PrincipalDiagnosis(Encounter) is null
Logic Definition Library Name: EXMLogic 
define "Initial Population" :
  "Inpatient Encounter" Encounter
Logic Definition Library Name: EXMLogic 
define "SDE Race":
  (flatten (
    Patient.extension Extension
      where Extension.url = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-race'
        return Extension.extension
  )) E
    where E.url = 'ombCategory'
      or E.url = 'detailed'
    return E.value as Coding
Logic Definition Library Name: EXMLogic-FHIR 
define "SDE Sex":
  case
    when Patient.gender = 'male' then Code { code: 'M', system: 'http://hl7.org/fhir/v3/AdministrativeGender', display: 'Male' }
    when Patient.gender = 'female' then Code { code: 'F', system: 'http://hl7.org/fhir/v3/AdministrativeGender', display: 'Female' }
    else null
  end
Logic Definition Library Name: EXMLogic-FHIR 
define "Inpatient Encounter" :
  ["Encounter"] Encounter
    where LengthInDays(Encounter.period) <= 120
      and Encounter.period ends during "Measurement Period"
Logic Definition Library Name: EXMLogic-FHIR 
define "Stratifier 3" :
  "Inpatient Encounter" Encounter
    where PrincipalDiagnosis(Encounter) is null
Logic Definition Library Name: EXMLogic-FHIR 
define "SDE Payer":
    [Coverage: type in "Payer"] Payer
      return {
        code: Payer.type,
        period: Payer.period
      }
Logic Definition Library Name: EXMLogic-FHIR 
define "SDE Ethnicity":
  (flatten (
    Patient.extension Extension
      where Extension.url = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity'
        return Extension.extension
  )) E
    where E.url = 'ombCategory'
      or E.url = 'detailed'
    return E.value as Coding
Logic Definition Library Name: EXMLogic-FHIR 
define "Stratifier 1" :
  "Inpatient Encounter" Encounter
    where not (PrincipalDiagnosis(Encounter).code in "Psychiatric/Mental Health Patient")
Logic Definition Library Name: EXMLogic-FHIR 
define "Stratifier 2" :
  "Inpatient Encounter" Encounter
    where PrincipalDiagnosis(Encounter).code in "Psychiatric/Mental Health Patient"
Terminology
Code System Description: Code system Diagnosis Role
Resource: Diagnosis Roleversion: null1.1.0)
Canonical URL: http://terminology.hl7.org/CodeSystem/diagnosis-role|1.1.0
Value Set Description: Value set Payer
Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591
Value Set Description: Value set Psychiatric/Mental Health Patient
Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.299
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.299
Direct Reference Code Display: Billing
Code: billing
System: http://terminology.hl7.org/CodeSystem/diagnosis-role
Dependencies
Dependency Description: Library FHIRHelpers
Resource: http://ecqi.healthit.gov/ecqms/Library/FHIRHelpers|4.0.1
Canonical URL: http://ecqi.healthit.gov/ecqms/Library/FHIRHelpers|4.0.1
Data Requirements
Data Requirement Type: Patient
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient
Data Requirement Type: Patient
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient
Must Support Elements: url, extension, value
Data Requirement Type: Patient
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient
Must Support Elements: url, extension, value
Code Filter(s):
Path: url
Code(s): unknown http://hl7.org/fhir/us/core/StructureDefinition/us-core-race: http://hl7.org/fhir/us/core/StructureDefinition/us-core-race
Data Requirement Type: Encounter
Profile(s): Encounter
Must Support Elements: period
Data Requirement Type: Coverage
Profile(s): Coverage
Must Support Elements: type, period
Code Filter(s):
Path: type
ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591
Generated using version 0.4.8 of the sample-content-ig Liquid templates

Source

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  "resourceType": "Measure",
  "id": "EXMLogic-FHIR",
  "meta": {
    "profile": [
      "http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-proportionmeasure",
      "http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-computablemeasure",
      "http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-executablemeasure",
      "http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-cqlmeasure",
      "http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-elmmeasure"
    ]
  },
  "text": {
    "status": "extensions",
    "div": "<!-- snip (see above) -->"
  },
  "contained": [
    {
      "resourceType": "Library",
      "id": "effective-data-requirements-exmlogic",
      "meta": {
        "profile": [
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        ]
      },
      "extension": [
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          "valueCoding": {
            "system": "http://terminology.hl7.org/CodeSystem/diagnosis-role",
            "code": "billing",
            "display": "Billing"
          }
        },
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              "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"
            },
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              "url": "displaySequence",
              "valueInteger": 0
            }
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        },
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              "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\""
            },
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              "valueString": "EXMLogic-FHIR"
            },
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              "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/uv/cqm/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://ecqi.healthit.gov/ecqms/Library/FHIRHelpers|4.0.1"
        },
        {
          "type": "depends-on",
          "display": "Code system Diagnosis Role",
          "resource": "http://terminology.hl7.org/CodeSystem/diagnosis-role|1.1.0"
        },
        {
          "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/uv/cqm/StructureDefinition/cqm-populationBasis",
      "valueCode": "Encounter"
    },
    {
      "url": "http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-softwaresystem",
      "valueReference": {
        "reference": "Device/software-system-example"
      }
    },
    {
      "url": "http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements",
      "valueCanonical": "#effective-data-requirements-exmlogic"
    },
    {
      "url": "http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringPrecision",
      "valuePositiveInt": 2
    }
  ],
  "url": "http://hl7.org/fhir/uv/cqm/Measure/EXMLogic-FHIR",
  "identifier": [
    {
      "system": "http://example.org/fhir/cqi/ecqm/Measure/Identifier/exm",
      "value": "EXM"
    }
  ],
  "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": "Clinical Venue"
      },
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "http://hl7.org/fhir/uv/cqm/CodeSystem/intended-venue-codes",
            "code": "ec",
            "display": "EC"
          }
        ]
      }
    }
  ],
  "jurisdiction": [
    {
      "coding": [
        {
          "system": "http://unstats.un.org/unsd/methods/m49/m49.htm",
          "code": "001"
        }
      ]
    }
  ],
  "purpose": "This measure has been developed to support improvement in clinical care.",
  "usage": "Users of this measure should be aware that this is intentionally simplified to show specific aspects of a measure.",
  "copyright": "Example Copyright Statement",
  "approvalDate": "2019-02-17",
  "lastReviewDate": "2019-02-17",
  "effectivePeriod": {
    "extension": [
      {
        "url": "http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-effectivePeriodAnchor",
        "valueDateTime": "2018-01-01"
      },
      {
        "url": "http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-effectivePeriodDuration",
        "valueDuration": {
          "value": 1,
          "system": "http://unitsofmeasure.org",
          "code": "a"
        }
      }
    ],
    "start": "2018-01-01",
    "end": "2018-12-31"
  },
  "topic": [
    {
      "coding": [
        {
          "system": "http://loinc.org",
          "code": "57024-2"
        }
      ],
      "text": "Health Quality Measure Document"
    }
  ],
  "author": [
    {
      "name": "Example Measure Content Developer"
    }
  ],
  "library": [
    "http://hl7.org/fhir/uv/cqm/Library/EXMLogic-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",
      "extension": [
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.linkId",
          "valueString": "primary"
        }
      ],
      "code": {
        "coding": [
          {
            "system": "http://example.org/group",
            "code": "group",
            "display": "group-1"
          }
        ]
      },
      "population": [
        {
          "id": "initial-population-1",
          "extension": [
            {
              "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.population.linkId",
              "valueString": "primary-exmlogic-initial-population"
            }
          ],
          "code": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                "code": "initial-population",
                "display": "Initial Population"
              }
            ]
          },
          "criteria": {
            "language": "text/cql-identifier",
            "expression": "Initial Population"
          }
        },
        {
          "id": "numerator",
          "extension": [
            {
              "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.population.linkId",
              "valueString": "primary-exmlogic-numerator"
            }
          ],
          "code": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                "code": "numerator",
                "display": "Numerator"
              }
            ]
          },
          "criteria": {
            "language": "text/cql-identifier",
            "expression": "Numerator"
          }
        },
        {
          "id": "denominator",
          "extension": [
            {
              "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.population.linkId",
              "valueString": "primary-exmlogic-denominator"
            }
          ],
          "code": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                "code": "denominator",
                "display": "Denominator"
              }
            ]
          },
          "criteria": {
            "language": "text/cql-identifier",
            "expression": "Denominator"
          }
        }
      ],
      "stratifier": [
        {
          "id": "stratifier-1",
          "extension": [
            {
              "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.stratifier.linkId",
              "valueString": "primary-exmlogic-stratification-1"
            },
            {
              "url": "http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-appliesTo",
              "valueCodeableConcept": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                    "code": "initial-population",
                    "display": "Initial Population"
                  }
                ],
                "text": "initial-population"
              }
            }
          ],
          "code": {
            "text": "Stratifier 1"
          },
          "criteria": {
            "language": "text/cql-identifier",
            "expression": "Stratifier 1"
          }
        },
        {
          "id": "stratifier-2",
          "extension": [
            {
              "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.stratifier.linkId",
              "valueString": "primary-exmlogic-stratification-2"
            },
            {
              "url": "http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-appliesTo",
              "valueCodeableConcept": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                    "code": "initial-population",
                    "display": "Initial Population"
                  }
                ],
                "text": "initial-population"
              }
            }
          ],
          "code": {
            "text": "Stratifier 2"
          },
          "criteria": {
            "language": "text/cql-identifier",
            "expression": "Stratifier 2"
          }
        },
        {
          "id": "stratifier-3",
          "extension": [
            {
              "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.stratifier.linkId",
              "valueString": "primary-exmlogic-stratification-3"
            },
            {
              "url": "http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-appliesTo",
              "valueCodeableConcept": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                    "code": "initial-population",
                    "display": "Initial Population"
                  }
                ],
                "text": "initial-population"
              }
            }
          ],
          "code": {
            "text": "Stratifier 3"
          },
          "criteria": {
            "language": "text/cql-identifier",
            "expression": "Stratifier 3"
          }
        },
        {
          "id": "stratifier-4",
          "extension": [
            {
              "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.stratifier.linkId",
              "valueString": "primary-exmlogic-stratification-4"
            },
            {
              "url": "http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-appliesTo",
              "valueCodeableConcept": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                    "code": "initial-population",
                    "display": "Initial Population"
                  }
                ],
                "text": "initial-population"
              }
            }
          ],
          "code": {
            "text": "Stratifier 4"
          },
          "criteria": {
            "language": "text/cql-identifier",
            "expression": "Stratifier 4"
          }
        }
      ]
    }
  ],
  "supplementalData": [
    {
      "id": "sde-ethnicity",
      "extension": [
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.supplementalData.linkId",
          "valueString": "primary-sde-ethnicity"
        }
      ],
      "usage": [
        {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/measure-data-usage",
              "code": "supplemental-data"
            }
          ]
        }
      ],
      "criteria": {
        "language": "text/cql-identifier",
        "expression": "SDE Ethnicity"
      }
    },
    {
      "id": "sde-race",
      "extension": [
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.supplementalData.linkId",
          "valueString": "primary-sde-race"
        }
      ],
      "usage": [
        {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/measure-data-usage",
              "code": "supplemental-data"
            }
          ]
        }
      ],
      "criteria": {
        "language": "text/cql-identifier",
        "expression": "SDE Race"
      }
    },
    {
      "id": "sde-payer",
      "extension": [
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.supplementalData.linkId",
          "valueString": "primary-sde-payer"
        }
      ],
      "usage": [
        {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/measure-data-usage",
              "code": "supplemental-data"
            }
          ]
        }
      ],
      "criteria": {
        "language": "text/cql-identifier",
        "expression": "SDE Payer"
      }
    },
    {
      "id": "sde-sex",
      "extension": [
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.supplementalData.linkId",
          "valueString": "primary-sde-sex"
        }
      ],
      "usage": [
        {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/measure-data-usage",
              "code": "supplemental-data"
            }
          ]
        }
      ],
      "criteria": {
        "language": "text/cql-identifier",
        "expression": "SDE Sex"
      }
    }
  ]
}