Thank you for your feedback. For continuous variable measures, the initial population (IPOP) identifies those cases that meet the initial population criteria. The measure population (MSRPOPL) identifies the subset of the IPOP that meets the MSRPOPL criteria. The measure population exclusion (MSRPOPLEX) identifies the subset of the MSRPOPL that meet the MSRPOPLEX criteria. For example, the IPOP identifies 200 encounters that meet its criteria (inpatient encounter; ED encounter <= 1 hour; decision to admit that is during the ED encounter and before departure from the ED). The MSRPOPL criteria is the same as the IPOP, so the same 200 encounters are included in the MSRPOPL. From the 200 encounters in the MSRPOPL if we assume 20 encounters were admitted from another hospital setting, representing the MSRPOLEX and are therefore excluded, the measure observation will calculate the median time for 180 encounters.

Refer to original ticket on CQL Issue Tracker ( https://oncprojectracking.healthit.gov/support/browse/CQLIT-118 ) We do have one additional comment for this JIRA. One of the reasons our team was debating MP Exclusions in this way is because we find it confusing how aliases are used in the measure. Again using CMS111 as an example, here is an excerpt of logic from the Measure Population Exclusions: "Inpatient Encounter" Encounter                 with ["Encounter, Performed": "Emergency Department Visit"] EDVisit                                 such that EDVisit.relevantPeriod ends 1 hour or less before or on start of Encounter.relevantPeriod                                                 and EDVisit.admissionSource in "Hospital Settings" To us, the EDVisit alias here is implying any ED visit, but in reality we know that it has to be the ED visit which satisfied the IPP/Measure Population criteria (since it is a subset). Assuming our understanding is correct, it would be great if the Measure Population Exclusion logic looked like this instead: "Inpatient Encounter" Encounter                 with "ED Visit with Admit Order" EDAdmitOrder                                 such that EDAdmitOrder.relevantPeriod ends 1 hour or less before or on start of Encounter.relevantPeriod                                                 and EDAdmitOrder.admissionSource in "Hospital Settings"  Just sharing some feedback. thanks