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FHIR IG analytics

Packagehl7.fhir.uv.cqm
Resource TypeMeasure
IdMeasure-measure-publishable-exm.json
FHIR VersionR4
Sourcehttps://build.fhir.org/ig/HL7/fhir-cqm/Measure-measure-publishable-exm.html
URLhttp://hl7.org/fhir/uv/cqm/Measure/measure-publishable-exm
Version2.0.0
Statusactive
Date2025-08-13
NamePublishableMeasureEXM
TitleEXM Publishable Measure
Realmuv
Authorityhl7
DescriptionAn example FHIR-based publishable measure
PurposeThis measure has been developed to support improvement in clinical care.
CopyrightExample Copyright Statement

Resources that use this resource

No resources found

Resources that this resource uses

No resources found

Narrative

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

Metadata
Title EXM Publishable Measure
Version 2.0.0
Short Name EXM-123
GUID (Version Independent) urn:uuid:11873bc9-ca0a-4cf3-b8f2-605a950aac74
GUID (Version Specific) urn:uuid:b366f29b-347f-464e-8064-c83842d825c7
CMS Identifier CMS-123
NQF Identifier NQF-123
Identifier urn:oid:2.16.840.1.113883.4.642.40.61.29.23
Effective Period 2018-01-01 + 1 year(s)
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 publishable measure
Purpose

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

Example Copyright Statement
Disclaimer

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

The rationale of this measure is to...
Clinical Recommendation Statement

The clinical recommendation statement for this measure is...
Improvement Notation Increased score indicates improvement
Citation

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

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

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

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

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

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

Example citation to draft publication

Content URL: http://example.org/publications/1234
Document: null @ http://example.org/publications/1234
Guidance (Usage) Users of this measure should be aware of...
Measure Group (Rate) (ID: primary)
Initial Population ID: primary-publishablexm-initial-population
Description: No description provided Criteria: Initial Population
Measure Population ID: primary-publishablexm-measure-population
Description: No description provided Criteria: Measure Population
Measure Observation ID: primary-publishablexm-measure-observation
Description: No description provided Criteria: Measure Observation
Supplemental Data Elements
Supplemental Data Element ID: sde-ethnicity
Usage Code: Supplemental Data
Description: No description provided
Logic Definition: SDE Ethnicity
Supplemental Data Element ID: sde-race
Usage Code: Supplemental Data
Description: No description provided
Logic Definition: SDE Race
Supplemental Data Element ID: sde-payer
Usage Code: Supplemental Data
Description: No description provided
Logic Definition: SDE Payer
Supplemental Data Element ID: sde-sex
Usage Code: Supplemental Data
Description: No description provided
Logic Definition: SDE Sex
Measure Logic
Primary Library Example Publishable Library
Contents Population Criteria
Logic Definitions
Terminology
Dependencies
Data Requirements
Population Criteria
Measure Group (Rate) (ID: primary)
Initial Population 
define "Initial Population" :   "Inpatient Encounter" Encounter
Definition
Measure Population 
define "Measure Population" :   "Initial Population"
Definition
Measure Observation 
define function "Measure Observation" (Encounter "Encounter" ) :   duration in minutes of "Related ED Visit"(Encounter).period
Definition
Logic Definitions
Logic Definition Library Name: EXMPublishableLibrary 
define "SDE Sex":   case     when Patient.gender = 'male' then Code { code: 'M', system: 'http://hl7.org/fhir/v3/AdministrativeGender', display: 'Male' }     when Patient.gender = 'female' then Code { code: 'F', system: 'http://hl7.org/fhir/v3/AdministrativeGender', display: 'Female' }     else null   end
Logic Definition Library Name: EXMPublishableLibrary 
define "SDE Payer":     [Coverage: type in "Payer"] Payer       return {         code: Payer.type,         period: Payer.period       }
Logic Definition Library Name: EXMPublishableLibrary 
define "Inpatient Encounter" :   ["Encounter"] Encounter     where LengthInDays(Encounter.period) <= 120       and Encounter.period ends during "Measurement Period"
Logic Definition Library Name: EXMPublishableLibrary 
define "Initial Population" :   "Inpatient Encounter" Encounter
Logic Definition Library Name: EXMPublishableLibrary 
define "SDE Ethnicity":   (flatten (     Patient.extension Extension       where Extension.url = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity'         return Extension.extension   )) E     where E.url = 'ombCategory'       or E.url = 'detailed'     return E.value as Coding
Logic Definition Library Name: EXMPublishableLibrary 
define "SDE Race":   (flatten (     Patient.extension Extension       where Extension.url = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-race'         return Extension.extension   )) E     where E.url = 'ombCategory'       or E.url = 'detailed'     return E.value as Coding
Logic Definition Library Name: EXMPublishableLibrary 
define "Measure Population" :   "Initial Population"
Logic Definition Library Name: EXMPublishableLibrary 
define function "LengthInDays"(Value Interval<DateTime>):  difference in days between start of Value and end of Value
Logic Definition Library Name: EXMPublishableLibrary 
define function "Measure Observation" (Encounter "Encounter" ) :   duration in minutes of "Related ED Visit"(Encounter).period
Logic Definition Library Name: EXMPublishableLibrary 
//Measure Observation define function "Related ED Visit" (Encounter "Encounter" ) :   Last(["Encounter" : "Emergency Department Visit"] ED     where ED.status = 'finished'       and ED.period ends 1 hour or less before start of Encounter.period     sort by start of period )
Logic Definition Library Name: FHIRHelpers 
define function ToString(value AdministrativeGender): value.value
Logic Definition Library Name: FHIRHelpers 
/* @description: Converts the given [Period](https://hl7.org/fhir/datatypes.html#Period) value to a CQL DateTime Interval @comment: If the start value of the given period is unspecified, the starting boundary of the resulting interval will be open (meaning the start of the interval is unknown, as opposed to interpreted as the beginning of time). */ define function ToInterval(period FHIR.Period):     if period is null then         null     else         if period."start" is null then             Interval(period."start".value, period."end".value]         else             Interval[period."start".value, period."end".value]
Logic Definition Library Name: FHIRHelpers 
define function ToString(value uri): value.value
Logic Definition Library Name: FHIRHelpers 
define function ToString(value EncounterStatus): value.value
Terminology
Value Set Description: Value set Payer
Resource: Payer Type
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591
Value Set Description: Value set Emergency Department Visit
Resource: Emergency Department Visit
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292
Dependencies
Dependency Description: Library FHIRHelpers
Resource: http://hl7.org/fhir/uv/cql/Library/FHIRHelpers|4.0.1
Canonical URL: http://hl7.org/fhir/uv/cql/Library/FHIRHelpers|4.0.1
Data Requirements
Data Requirement Type: Patient
Profile(s): Patient
Must Support Elements: url, extension, value
Data Requirement Type: Coverage
Profile(s): Coverage
Must Support Elements: type, period
Code Filter(s):
Path: type
ValueSet: Payer Type
Data Requirement Type: Encounter
Profile(s): Encounter
Must Support Elements: type, status, period
Code Filter(s):
Path: type
ValueSet: Emergency Department Visit
Data Requirement Type: Encounter
Profile(s): Encounter
Must Support Elements: period
Generated using version 0.4.9 of the sample-content-ig Liquid templates

Source1

{
  "resourceType": "Measure",
  "id": "measure-publishable-exm",
  "meta": {
    "profile": [
      "http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-publishablemeasure",
      "http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-computablemeasure"
    ]
  },
  "text": {
    "status": "extensions",
    "div": "<!-- snip (see above) -->"
  },
  "contained": [
    {
      "resourceType": "Library",
      "id": "effective-data-requirements",
      "extension": [
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "EXMPublishableLibrary"
            },
            {
              "url": "name",
              "valueString": "SDE Sex"
            },
            {
              "url": "statement",
              "valueString": "define \"SDE Sex\":   case     when Patient.gender = 'male' then Code { code: 'M', system: 'http://hl7.org/fhir/v3/AdministrativeGender', display: 'Male' }     when Patient.gender = 'female' then Code { code: 'F', system: 'http://hl7.org/fhir/v3/AdministrativeGender', display: 'Female' }     else null   end"
            },
            {
              "url": "displaySequence",
              "valueInteger": 0
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "EXMPublishableLibrary"
            },
            {
              "url": "name",
              "valueString": "SDE Payer"
            },
            {
              "url": "statement",
              "valueString": "define \"SDE Payer\":     [Coverage: type in \"Payer\"] Payer       return {         code: Payer.type,         period: Payer.period       }"
            },
            {
              "url": "displaySequence",
              "valueInteger": 1
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "EXMPublishableLibrary"
            },
            {
              "url": "name",
              "valueString": "Inpatient Encounter"
            },
            {
              "url": "statement",
              "valueString": "define \"Inpatient Encounter\" :   [\"Encounter\"] Encounter     where LengthInDays(Encounter.period) <= 120       and Encounter.period ends during \"Measurement Period\""
            },
            {
              "url": "displaySequence",
              "valueInteger": 2
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "EXMPublishableLibrary"
            },
            {
              "url": "name",
              "valueString": "Initial Population"
            },
            {
              "url": "statement",
              "valueString": "define \"Initial Population\" :   \"Inpatient Encounter\" Encounter"
            },
            {
              "url": "displaySequence",
              "valueInteger": 3
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "EXMPublishableLibrary"
            },
            {
              "url": "name",
              "valueString": "SDE Ethnicity"
            },
            {
              "url": "statement",
              "valueString": "define \"SDE Ethnicity\":   (flatten (     Patient.extension Extension       where Extension.url = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity'         return Extension.extension   )) E     where E.url = 'ombCategory'       or E.url = 'detailed'     return E.value as Coding"
            },
            {
              "url": "displaySequence",
              "valueInteger": 4
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "EXMPublishableLibrary"
            },
            {
              "url": "name",
              "valueString": "SDE Race"
            },
            {
              "url": "statement",
              "valueString": "define \"SDE Race\":   (flatten (     Patient.extension Extension       where Extension.url = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-race'         return Extension.extension   )) E     where E.url = 'ombCategory'       or E.url = 'detailed'     return E.value as Coding"
            },
            {
              "url": "displaySequence",
              "valueInteger": 5
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "EXMPublishableLibrary"
            },
            {
              "url": "name",
              "valueString": "Measure Population"
            },
            {
              "url": "statement",
              "valueString": "define \"Measure Population\" :   \"Initial Population\""
            },
            {
              "url": "displaySequence",
              "valueInteger": 6
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "FHIRHelpers"
            },
            {
              "url": "name",
              "valueString": "ToString"
            },
            {
              "url": "statement",
              "valueString": "define function ToString(value AdministrativeGender): value.value"
            },
            {
              "url": "displaySequence",
              "valueInteger": 7
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "EXMPublishableLibrary"
            },
            {
              "url": "name",
              "valueString": "LengthInDays"
            },
            {
              "url": "statement",
              "valueString": "define function \"LengthInDays\"(Value Interval<DateTime>):  difference in days between start of Value and end of Value"
            },
            {
              "url": "displaySequence",
              "valueInteger": 8
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "FHIRHelpers"
            },
            {
              "url": "name",
              "valueString": "ToInterval"
            },
            {
              "url": "statement",
              "valueString": "/* @description: Converts the given [Period](https://hl7.org/fhir/datatypes.html#Period) value to a CQL DateTime Interval @comment: If the start value of the given period is unspecified, the starting boundary of the resulting interval will be open (meaning the start of the interval is unknown, as opposed to interpreted as the beginning of time). */ define function ToInterval(period FHIR.Period):     if period is null then         null     else         if period.\"start\" is null then             Interval(period.\"start\".value, period.\"end\".value]         else             Interval[period.\"start\".value, period.\"end\".value]"
            },
            {
              "url": "displaySequence",
              "valueInteger": 9
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "FHIRHelpers"
            },
            {
              "url": "name",
              "valueString": "ToString"
            },
            {
              "url": "statement",
              "valueString": "define function ToString(value uri): value.value"
            },
            {
              "url": "displaySequence",
              "valueInteger": 10
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "EXMPublishableLibrary"
            },
            {
              "url": "name",
              "valueString": "Measure Observation"
            },
            {
              "url": "statement",
              "valueString": "define function \"Measure Observation\" (Encounter \"Encounter\" ) :   duration in minutes of \"Related ED Visit\"(Encounter).period"
            },
            {
              "url": "displaySequence",
              "valueInteger": 11
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "EXMPublishableLibrary"
            },
            {
              "url": "name",
              "valueString": "Related ED Visit"
            },
            {
              "url": "statement",
              "valueString": "//Measure Observation define function \"Related ED Visit\" (Encounter \"Encounter\" ) :   Last([\"Encounter\" : \"Emergency Department Visit\"] ED     where ED.status = 'finished'       and ED.period ends 1 hour or less before start of Encounter.period     sort by start of period )"
            },
            {
              "url": "displaySequence",
              "valueInteger": 12
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "FHIRHelpers"
            },
            {
              "url": "name",
              "valueString": "ToString"
            },
            {
              "url": "statement",
              "valueString": "define function ToString(value EncounterStatus): value.value"
            },
            {
              "url": "displaySequence",
              "valueInteger": 13
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        }
      ],
      "name": "EffectiveDataRequirements",
      "status": "active",
      "type": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/library-type",
            "code": "module-definition"
          }
        ]
      },
      "relatedArtifact": [
        {
          "type": "depends-on",
          "display": "Library FHIRHelpers",
          "resource": "http://hl7.org/fhir/uv/cql/Library/FHIRHelpers|4.0.1"
        },
        {
          "type": "depends-on",
          "display": "Value set Payer",
          "resource": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"
        },
        {
          "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"
        }
      ],
      "parameter": [
        {
          "name": "Measurement Period",
          "use": "in",
          "min": 0,
          "max": "1",
          "type": "Period"
        },
        {
          "name": "SDE Sex",
          "use": "out",
          "min": 0,
          "max": "1",
          "type": "Coding"
        },
        {
          "name": "SDE Payer",
          "use": "out",
          "min": 0,
          "max": "*",
          "type": "Resource"
        },
        {
          "name": "Initial Population",
          "use": "out",
          "min": 0,
          "max": "*",
          "type": "Encounter"
        },
        {
          "name": "SDE Ethnicity",
          "use": "out",
          "min": 0,
          "max": "*",
          "type": "Coding"
        },
        {
          "name": "SDE Race",
          "use": "out",
          "min": 0,
          "max": "*",
          "type": "Coding"
        },
        {
          "name": "Measure Population",
          "use": "out",
          "min": 0,
          "max": "*",
          "type": "Encounter"
        }
      ],
      "dataRequirement": [
        {
          "type": "Patient",
          "profile": [
            "http://hl7.org/fhir/StructureDefinition/Patient"
          ],
          "mustSupport": [
            "url",
            "extension",
            "value"
          ]
        },
        {
          "type": "Coverage",
          "profile": [
            "http://hl7.org/fhir/StructureDefinition/Coverage"
          ],
          "mustSupport": [
            "type",
            "period"
          ],
          "codeFilter": [
            {
              "path": "type",
              "valueSet": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"
            }
          ]
        },
        {
          "type": "Encounter",
          "profile": [
            "http://hl7.org/fhir/StructureDefinition/Encounter"
          ],
          "mustSupport": [
            "type",
            "status",
            "period"
          ],
          "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"
          ]
        }
      ]
    }
  ],
  "extension": [
    {
      "url": "http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis",
      "valueCode": "Encounter"
    },
    {
      "url": "http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-softwaresystem",
      "valueReference": {
        "reference": "Device/software-system-example"
      }
    },
    {
      "extension": [
        {
          "url": "code",
          "valueCodeableConcept": {
            "coding": [
              {
                "system": "http://example.org/fhir/CodeSystem/measure-terms",
                "code": "example-term-code",
                "display": "Example Term Display"
              }
            ]
          }
        },
        {
          "url": "definition",
          "valueMarkdown": "A term used in the measure that bears clearly definition to communicate the measure intent"
        }
      ],
      "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.term"
    },
    {
      "id": "effective-data-requirements",
      "url": "http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements",
      "valueCanonical": "#effective-data-requirements"
    },
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
      "valueCode": "cqi"
    }
  ],
  "url": "http://hl7.org/fhir/uv/cqm/Measure/measure-publishable-exm",
  "identifier": [
    {
      "use": "usual",
      "type": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/artifact-identifier-type",
            "code": "short-name"
          }
        ]
      },
      "system": "http://example.org/fhir/cqi/ecqm/Measure/Identifier/exm",
      "value": "EXM-123"
    },
    {
      "use": "official",
      "type": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/artifact-identifier-type",
            "code": "version-independent"
          }
        ]
      },
      "system": "urn:ietf:rfc:3986",
      "value": "urn:uuid:11873bc9-ca0a-4cf3-b8f2-605a950aac74"
    },
    {
      "use": "official",
      "type": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/artifact-identifier-type",
            "code": "version-specific"
          }
        ]
      },
      "system": "urn:ietf:rfc:3986",
      "value": "urn:uuid:b366f29b-347f-464e-8064-c83842d825c7"
    },
    {
      "use": "official",
      "type": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/artifact-identifier-type",
            "code": "endorser"
          }
        ]
      },
      "system": "http://example.org/fhir/cqi/ecqm/Measure/Identifier/nqf",
      "value": "NQF-123",
      "assigner": {
        "display": "NQF"
      }
    },
    {
      "use": "official",
      "type": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/artifact-identifier-type",
            "code": "publisher"
          }
        ]
      },
      "system": "http://example.org/fhir/cqi/ecqm/Measure/Identifier/cms",
      "value": "CMS-123",
      "assigner": {
        "display": "CMS"
      }
    },
    {
      "system": "urn:ietf:rfc:3986",
      "value": "urn:oid:2.16.840.1.113883.4.642.40.61.29.23"
    }
  ],
  "version": "2.0.0",
  "name": "PublishableMeasureEXM",
  "title": "EXM Publishable Measure",
  "status": "active",
  "experimental": true,
  "date": "2025-08-13",
  "publisher": "HL7 International / Clinical Quality Information",
  "contact": [
    {
      "telecom": [
        {
          "system": "url",
          "value": "http://www.hl7.org/Special/committees/cqi"
        }
      ]
    }
  ],
  "description": "An example FHIR-based publishable measure",
  "useContext": [
    {
      "code": {
        "system": "http://terminology.hl7.org/CodeSystem/usage-context-type",
        "code": "venue",
        "display": "Clinical Venue"
      },
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "http://hl7.org/fhir/uv/cqm/CodeSystem/intended-venue-codes",
            "code": "ec",
            "display": "EC"
          }
        ]
      }
    }
  ],
  "jurisdiction": [
    {
      "coding": [
        {
          "system": "http://unstats.un.org/unsd/methods/m49/m49.htm",
          "code": "001"
        }
      ]
    }
  ],
  "purpose": "This measure has been developed to support improvement in clinical care.",
  "usage": "Users of this measure should be aware of...",
  "copyright": "Example Copyright Statement",
  "approvalDate": "2019-02-17",
  "lastReviewDate": "2019-02-17",
  "effectivePeriod": {
    "extension": [
      {
        "url": "http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-effectivePeriodAnchor",
        "valueDateTime": "2018-01-01"
      },
      {
        "url": "http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-effectivePeriodDuration",
        "valueDuration": {
          "value": 1,
          "system": "http://unitsofmeasure.org",
          "code": "a"
        }
      }
    ],
    "start": "2018-01-01",
    "end": "2018-12-31"
  },
  "topic": [
    {
      "coding": [
        {
          "system": "http://loinc.org",
          "code": "57024-2"
        }
      ],
      "text": "Health Quality Measure Document"
    }
  ],
  "author": [
    {
      "name": "Example Measure Content Developer"
    }
  ],
  "relatedArtifact": [
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-isPrimaryCitation",
          "valueBoolean": true
        }
      ],
      "type": "citation",
      "citation": "Linder, J.A., D.W. Bates, G.M. Lee, J.A. Finkelstein. 2005. 'Antibiotic treatment       of children with sore throat.' JAMA 294(18):2315-2322.",
      "url": "https://pubmed.ncbi.nlm.nih.gov/16278359/",
      "document": {
        "url": "https://pubmed.ncbi.nlm.nih.gov/16278359/"
      }
    },
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-isPrimaryCitation",
          "valueBoolean": true
        }
      ],
      "type": "citation",
      "citation": "Infectious Diseases Society of America. 2012. 'Clinical Practice Guideline for the Diagnosis and Management of Group A Streptococcal Pharyngitis: 2012 Update.'",
      "url": "https://pubmed.ncbi.nlm.nih.gov/23091044/",
      "document": {
        "url": "https://pubmed.ncbi.nlm.nih.gov/23091044/"
      }
    },
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-isPrimaryCitation",
          "valueBoolean": true
        }
      ],
      "type": "citation",
      "citation": "Roberts, R.R., B. Hota, I. Ahmad, et al. 'Hospital and Societal Costs of Antimicrobial-Resistant Infections in a Chicago Teaching Hospital: Implications for Antibiotic Stewardship.' Clin Infect Dis. Oct 2009; 49(8):1175-84.",
      "url": "https://pubmed.ncbi.nlm.nih.gov/19739972/",
      "document": {
        "url": "https://pubmed.ncbi.nlm.nih.gov/19739972/"
      }
    },
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-publicationStatus",
          "valueCode": "draft"
        },
        {
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-publicationDate",
          "valueDate": "2019-01-01"
        }
      ],
      "type": "citation",
      "citation": "Example citation to draft publication",
      "url": "http://example.org/publications/1234",
      "document": {
        "url": "http://example.org/publications/1234"
      }
    }
  ],
  "library": [
    "http://hl7.org/fhir/uv/cqm/Library/EXMPublishableLibrary"
  ],
  "disclaimer": "Example disclaimer",
  "scoring": {
    "coding": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/measure-scoring",
        "code": "continuous-variable",
        "display": "Continuous Variable"
      }
    ]
  },
  "type": [
    {
      "coding": [
        {
          "system": "http://terminology.hl7.org/CodeSystem/measure-type",
          "code": "process"
        }
      ]
    }
  ],
  "riskAdjustment": "Risk adjustment for this measure is performed by...",
  "rateAggregation": "Rate aggregation for this measure is performed by...",
  "rationale": "The rationale of this measure is to...",
  "clinicalRecommendationStatement": "The clinical recommendation statement for this measure is...",
  "improvementNotation": {
    "coding": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/measure-improvement-notation",
        "code": "increase",
        "display": "Increased score indicates improvement"
      }
    ]
  },
  "group": [
    {
      "id": "group-1",
      "extension": [
        {
          "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.linkId",
          "valueString": "primary"
        }
      ],
      "population": [
        {
          "id": "initial-population",
          "extension": [
            {
              "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.population.linkId",
              "valueString": "primary-publishablexm-initial-population"
            }
          ],
          "code": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                "code": "initial-population",
                "display": "Initial Population"
              }
            ]
          },
          "criteria": {
            "language": "text/cql-identifier",
            "expression": "Initial Population"
          }
        },
        {
          "id": "measure-population",
          "extension": [
            {
              "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.population.linkId",
              "valueString": "primary-publishablexm-measure-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"
          }
        },
        {
          "id": "measure-observation",
          "extension": [
            {
              "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.population.linkId",
              "valueString": "primary-publishablexm-measure-observation"
            }
          ],
          "code": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                "code": "measure-observation",
                "display": "Measure Observation"
              }
            ]
          },
          "criteria": {
            "language": "text/cql-identifier",
            "expression": "Measure Observation"
          }
        }
      ]
    }
  ],
  "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"
      }
    }
  ]
}