FHIR IG Statistics: Measure/PatientsByRiskFactorWithSupplementalData

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{
  "resourceType": "Measure",
  "id": "PatientsByRiskFactorWithSupplementalData",
  "meta": {
    "profile": [
      "http://hl7.org/fhir/uv/saner/StructureDefinition/PublicHealthMeasure"
    ]
  },
  "text": {
    "status": "extensions",
    "div": "<!-- snip (see above) -->"
  },
  "extension": [
    {
      "url": "http://hl7.org/fhir/uv/saner/StructureDefinition/ReportingPeriod",
      "valueTiming": {
        "repeat": {
          "frequency": 1,
          "period": 1,
          "periodUnit": "d"
        }
      }
    }
  ],
  "url": "http://hl7.org/fhir/uv/saner/Measure/PatientsByRiskFactorWithSupplementalData",
  "identifier": [
    {
      "system": "urn:ietf:rfc:3986",
      "value": "urn:oid:2.16.840.1.113883.4.642.40.42.29.6"
    }
  ],
  "version": "1.0.1",
  "name": "PatientsByRiskFactor",
  "title": "COVID-19 Patients By Risk Factor",
  "status": "draft",
  "experimental": true,
  "date": "2024-05-18T21:25:01+00:00",
  "publisher": "HL7 International / Public Health",
  "contact": [
    {
      "telecom": [
        {
          "system": "url",
          "value": "http://www.hl7.org/Special/committees/pher"
        }
      ]
    },
    {
      "telecom": [
        {
          "system": "email",
          "value": "pher@lists.hl7.org"
        }
      ]
    },
    {
      "name": "Keith W. Boone",
      "telecom": [
        {
          "system": "email",
          "value": "mailto:kboone@ainq.com"
        }
      ]
    }
  ],
  "description": "This measure demonstrates automated reporting of patients with COVID-19 stratified by condition, and reporting supplemental data",
  "useContext": [
    {
      "code": {
        "system": "http://terminology.hl7.org/CodeSystem/usage-context-type",
        "code": "focus"
      },
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "http://snomed.info/sct",
            "code": "840539006",
            "display": "COVID-19"
          }
        ]
      }
    }
  ],
  "jurisdiction": [
    {
      "coding": [
        {
          "system": "http://unstats.un.org/unsd/methods/m49/m49.htm",
          "code": "001",
          "display": "World"
        }
      ]
    }
  ],
  "author": [
    {
      "name": "Centers for Disease Control/National Healthcare Safety Network (CDC/NHSN)",
      "telecom": [
        {
          "system": "email",
          "value": "mailto:nhsn@cdc.gov"
        }
      ]
    }
  ],
  "relatedArtifact": [
    {
      "type": "documentation",
      "label": "NHSN COVID-19 Reporting",
      "display": "CDC/NHSN COVID-19 Patient Impact & Hospital Capacity Module Home Page",
      "url": "https://web.archive.org/web/20200501215043/https://www.cdc.gov/nhsn/acute-care-hospital/covid19/",
      "document": {
        "url": "https://web.archive.org/web/20200501215043/https://www.cdc.gov/nhsn/acute-care-hospital/covid19/"
      }
    },
    {
      "type": "documentation",
      "label": "How to import COVID-19 Summary Data",
      "display": "Importing COVID-19 Patient Module Denominator data for Patient Safety Component",
      "url": "https://web.archive.org/web/20200501215043/https://www.cdc.gov/nhsn/pdfs/covid19/import-covid19-data-508.pdf",
      "document": {
        "url": "https://web.archive.org/web/20200501215043/https://www.cdc.gov/nhsn/pdfs/covid19/import-covid19-data-508.pdf"
      }
    },
    {
      "type": "documentation",
      "label": "Table of Instructions",
      "display": "Instructions for Completion of the COVID-19 Patient Impact and Hospital Capacity Module Form (CDC 57.130)",
      "url": "https://web.archive.org/web/20200501215043/https://www.cdc.gov/nhsn/pdfs/covid19/57.130-toi-508.pdf",
      "document": {
        "url": "https://web.archive.org/web/20200501215043/https://www.cdc.gov/nhsn/pdfs/covid19/57.130-toi-508.pdf"
      }
    },
    {
      "type": "documentation",
      "label": "CSV File Template",
      "display": "CDC/NHSN COVID-19 Reporting CSV File Template",
      "url": "https://web.archive.org/web/20200501215043/https://www.cdc.gov/nhsn/pdfs/covid19/covid19-test-csv-import.csv",
      "document": {
        "url": "https://web.archive.org/web/20200501215043/https://www.cdc.gov/nhsn/pdfs/covid19/covid19-test-csv-import.csv"
      }
    }
  ],
  "library": [
    "http://hl7.org/fhir/uv/saner/Library/ComputableNHSNMeasureLibrary"
  ],
  "group": [
    {
      "extension": [
        {
          "extension": [
            {
              "url": "subject",
              "valueCodeableConcept": {
                "coding": [
                  {
                    "system": "http://hl7.org/fhir/resource-types",
                    "code": "Encounter"
                  },
                  {
                    "system": "http://snomed.info/sct",
                    "code": "398284004",
                    "display": "Patient in room"
                  }
                ],
                "text": "Patient in room"
              }
            },
            {
              "url": "scoring",
              "valueCodeableConcept": {
                "coding": [
                  {
                    "system": "http://hl7.org/fhir/uv/saner/CodeSystem/PublicHealthMeasureScoring",
                    "code": "queue-length"
                  }
                ]
              }
            },
            {
              "url": "type",
              "valueCodeableConcept": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/measure-type",
                    "code": "structure"
                  }
                ]
              }
            },
            {
              "url": "improvementNotation",
              "valueCodeableConcept": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/measure-improvement-notation",
                    "code": "decrease"
                  }
                ]
              }
            },
            {
              "url": "rateAggregation",
              "valueString": "point-in-time"
            }
          ],
          "url": "http://hl7.org/fhir/uv/saner/StructureDefinition/MeasureGroupAttributes"
        }
      ],
      "code": {
        "coding": [
          {
            "system": "http://hl7.org/fhir/uv/saner/CodeSystem/MeasureGroupSystem",
            "code": "Encounters",
            "display": "Encounters"
          }
        ],
        "text": "Hospital COVID-19 Patient Encounters Reporting"
      },
      "population": [
        {
          "code": {
            "coding": [
              {
                "system": "http://hl7.org/fhir/uv/saner/CodeSystem/MeasuredValues",
                "code": "confirmedC19Pats",
                "display": "All Confirmed COVID-19 Patients"
              },
              {
                "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                "code": "initial-population"
              }
            ],
            "text": "Patients with confirmed COVID-19 in any location."
          },
          "description": "Active encounters where the encounter diagnosis is suspected or confirmed COVID-19,\nor a Condition of confirmed COVID-19 was created during that encounter.  This includes the patients with laboratory-confirmed\nor clinically diagnosed COVID-19.",
          "criteria": {
            "description": "This expression finds encounters that were active or finished in the reporting period, and their referenced Patient, Condition\nand Observation resources. It filters these based on cases where Encounter reports a reason or condition in the\nConfirmedCOVID19Diagnoses value set, or where a positive lab test from the Covid19Labs valueset, or where the patient\nhas any such associated Condition or Observation resources in the prior two weeks.",
            "name": "ConfirmedC19Pats",
            "language": "text/fhirpath",
            "expression": "findAll('Encounter',\n    including('subject','condition','reasonReference'),\n    with('status').equalTo('in-progress,finished'),\n    with('date').within(%ReportingPeriod)\n ).onServers(%Base).\n where(\n   iif(\n     (Encounter.reasonCode | Condition.code).member0f(%ConfirmedCOVID19Diagnoses.url) |\n     Observation.where(code.member0f(%Covid19Labs.url) and value.member0f(%PositiveResults.url)),\n     true,\n     iif(\n       Patient.distinct()\n          .whereExists('Observation',\n            for('patient', $this.id),\n            with('status').equalTo(\n                'registered,preliminary,final,amended,corrected'),\n            with('date').greaterThan(%ReportingPeriod.start - 1 'year'),\n            with('code').in(%Covid19Labs),\n            with('value-concept').in(%PositiveResults)\n       ).onServers(%Base),\n       true,\n       Patient.distinct()\n          .whereExists('Condition',\n            for('patient', $this.id),\n            with('verification-status').notEqualTo('refuted,entered-in-error').\n            with('date').greaterThan(%ReportingPeriod.start - 1 'year'),\n            with('code').in(%ConfirmedCOVID19Diagnoses.url)\n       ).onServers(%Base)\n     )\n  )\n)\n.ofType(Encounter)\n.distinct()\n.aggregate(\n  iif($total.subject contains $this.subject, $total, $total | $this )\n)"
          }
        }
      ],
      "stratifier": [
        {
          "code": {
            "text": "By Risk Factor"
          },
          "description": "Stratifies the population by Condition/RiskFactor",
          "criteria": {
            "description": "Final all conditions for each patient in the AllCOVID19RiskFactors ValueSet\nand stratify by membership in subsets of that value set.  NOTE: A patient\ncan belong to multiple strata in this example.",
            "language": "text/fhirpath",
            "expression": "findAll('Condition',\n\tfor('patient', $this.subject),\n\twith('code').in(%AllCOVID19RiskFactors.url),\n       with('onset-date').greaterThan(%ReportingPeriod.start - 1 'year')\n   ).onServers(%Base).select(\n   \tiif(code.member0f(%NeoplasticCOVID19RiskFactors.url), 'Neoplastic Disease', {}) |\n   \tiif(code.member0f(%COPDCOVID19RiskFactors.url), 'COPD', {}) |\n   \tiif(code.member0f(%TobaccoCOVID19RiskFactors.url), 'Tobacco User', {}) |\n   \tiif(code.member0f(%HypertensionCOVID19RiskFactors.url), 'Hypertension', {}) |\t// Calling out Hypertension separately for reasons\n   \tiif(code.member0f(%CardiovascularCOVID19RiskFactors.url), 'Cardiovascular Disease', {}) |\t// Even though it isa Cardiovascular disease\n   \tiif(code.member0f(%ObesityCOVID19RiskFactors.url), 'Obesity', {}) |\n   \tiif(code.member0f(%SickleCellCOVID19RiskFactors.url), 'Sickle cell Disease', {}) |\n   \tiif(code.member0f(%KidneyDiseaseCOVID19RiskFactors.url), 'Chronic Kidney Disease', {}) |\n   \tiif(code.member0f(%PregnancyCOVID19RiskFactors.url), 'Pregnant', {}) |\n   \tiif(code.member0f(%DiabetesCOVID19RiskFactors.url), 'Diabetes', {})\n   )"
          }
        }
      ]
    }
  ],
  "supplementalData": [
    {
      "code": {
        "coding": [
          {
            "system": "http://hl7.org/fhir/resource-types",
            "code": "Encounter"
          }
        ]
      },
      "usage": [
        {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/measure-data-usage",
              "code": "supplemental-data"
            }
          ]
        }
      ],
      "description": "The patient encounter",
      "criteria": {
        "description": "Encounter dates, reason (e.g., Chief Complaint), discharge disposition",
        "name": "Encounter",
        "language": "text/fhirpath",
        "expression": "Encounter"
      }
    },
    {
      "code": {
        "coding": [
          {
            "system": "http://hl7.org/fhir/resource-types",
            "code": "Patient"
          }
        ]
      },
      "usage": [
        {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/measure-data-usage",
              "code": "supplemental-data"
            }
          ]
        }
      ],
      "description": "The patient",
      "criteria": {
        "description": "The Patient, including sex, dob, race and ethnicity",
        "name": "Patient",
        "language": "text/fhirpath",
        "expression": "Encounter.subject.resolve()"
      }
    },
    {
      "code": {
        "coding": [
          {
            "system": "http://hl7.org/fhir/resource-types",
            "code": "Location"
          }
        ]
      },
      "usage": [
        {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/measure-data-usage",
              "code": "supplemental-data"
            }
          ]
        }
      ],
      "description": "The patient location",
      "criteria": {
        "description": "The Patient Location",
        "name": "PatientLocation",
        "language": "text/fhirpath",
        "expression": "Encounter.location.location.resolve()"
      }
    },
    {
      "code": {
        "coding": [
          {
            "system": "http://hl7.org/fhir/resource-types",
            "code": "Condition"
          }
        ]
      },
      "usage": [
        {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/measure-data-usage",
              "code": "supplemental-data"
            }
          ]
        }
      ],
      "description": "The encounter and other diagnosis",
      "criteria": {
        "description": "Retrieves all conditions associated with the encounter",
        "name": "EncounterDiagnosis",
        "language": "text/fhirpath",
        "expression": "(Encounter.reasonReference|Encounter.diagnosis.condition).resolve() |\nfindAll('Condition',\n\tfor('patient', $this.subject),\n\twith('encounter').equalTo($this.id)\n).onServers(%Base)"
      }
    },
    {
      "code": {
        "coding": [
          {
            "system": "http://hl7.org/fhir/resource-types",
            "code": "MedicationRequest"
          },
          {
            "system": "http://hl7.org/fhir/resource-types",
            "code": "MedicationAdministration"
          },
          {
            "system": "http://hl7.org/fhir/resource-types",
            "code": "Immunization"
          }
        ]
      },
      "usage": [
        {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/measure-data-usage",
              "code": "supplemental-data"
            }
          ]
        }
      ],
      "description": "Medications/Immunizations given during the encounter",
      "criteria": {
        "description": "Retrieves all medications/immunizations associated with the encounter",
        "name": "EncounterMeds",
        "language": "text/fhirpath",
        "expression": "findAll('MedicationRequest',\n\tfor('patient', $this.subject),\n\twith('encounter').equalTo($this.id)  // alternately, this could be within encounter dates\n).onServers(%Base) |\nfindAll('MedicationAdministration',\n\tfor('patient', $this.subject),\n\twith('effective-time').within(%ReportingPeriod)\n).onServers(%Base) |\nfindAll('Immunization',\n\tfor('patient', $this.subject),\n\twith('date').within(%ReportingPeriod)\n).onServers(%Base)"
      }
    },
    {
      "code": {
        "coding": [
          {
            "system": "http://hl7.org/fhir/resource-types",
            "code": "Observation"
          }
        ]
      },
      "usage": [
        {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/measure-data-usage",
              "code": "supplemental-data"
            }
          ]
        }
      ],
      "description": "COVID-19 Lab Results",
      "criteria": {
        "description": "Retrieves all Observations associated with COVID-19 Labs",
        "name": "COVID19Labs",
        "language": "text/fhirpath",
        "expression": "findAll('Observation',\n\tfor('patient', $this.subject),\n\twith('code').in(%Covid19Labs.url),\n\twith('date').greaterThan(%ReportingPeriod.start - 1 'year')\n).onServers(%Base)"
      }
    },
    {
      "code": {
        "coding": [
          {
            "system": "http://hl7.org/fhir/resource-types",
            "code": "DiagnosticReport"
          },
          {
            "system": "http://hl7.org/fhir/resource-types",
            "code": "DocumentReference"
          },
          {
            "system": "http://hl7.org/fhir/resource-types",
            "code": "Observation"
          },
          {
            "system": "http://hl7.org/fhir/resource-types",
            "code": "ServiceRequest"
          }
        ]
      },
      "usage": [
        {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/measure-data-usage",
              "code": "supplemental-data"
            }
          ]
        }
      ],
      "description": "VTE Diagnostic Results",
      "criteria": {
        "description": "Retrieves diagnostics associated with VTE",
        "name": "VTEDiagnostics",
        "language": "text/fhirpath",
        "expression": "findAll('DiagnosticReport',\n\tfor('patient', $this.subject),\n\tincluding('result', 'media'), // what else?\n\twith('date').greaterThan(%ReportingPeriod.start - 1 'year'),\n\twith('code').in(%VTEReports.url)\n).onServers(%Base) |\nfindAll('DocumentReference',\n\tfor('patient', $this.subject),\n\tincluding('related'), // what else?\n\twith('date').greaterThan(%ReportingPeriod.start - 1 'year'),\n\twith('type').in(%VTEReports.url)\n).onServers(%Base) |\nfindAll('Observation',\n\tfor('patient', $this.subject),\n\tincluding('based-on'), // what else?\n\twith('date').greaterThan(%ReportingPeriod.start - 1 'year'),\n\twith('code').in(%VTEReports.url)\n).onServers(%Base) |\nfindAll('ServiceRequest',\n\tfor('patient', $this.subject),\n\tincluding('based-on'), // what else?\n\twith('date').greaterThan(%ReportingPeriod.start - 1 'year'),\n\twith('code').in(%VTEReports.url)\n).onServers(%Base)"
      }
    },
    {
      "code": {
        "coding": [
          {
            "system": "http://hl7.org/fhir/resource-types",
            "code": "Procedure"
          },
          {
            "system": "http://hl7.org/fhir/resource-types",
            "code": "ServiceRequest"
          }
        ]
      },
      "usage": [
        {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/measure-data-usage",
              "code": "supplemental-data"
            }
          ]
        }
      ],
      "description": "Isolation Precautions",
      "criteria": {
        "description": "Retrieves orders or procedures associated with Isolation Precautions",
        "name": "IsolationOrders",
        "language": "text/fhirpath",
        "expression": "findAll('ServiceRequest',\n\tfor('patient', $this.subject),\n\tfor('encounter', $this.id),\n\twith('code').in(%IsolationPrecautions.url)\n).onServers(%Base) |\nfindAll('Procedure',\n\tfor('patient', $this.subject),\n\tfor('encounter', $this.id),\n\twith('code').in(%IsolationPrecautions.url)\n).onServers(%Base)"
      }
    }
  ]
}