define fluent function isDeviceOrder(DeviceRequest List<DeviceRequest>):
  DeviceRequest D
    where D.status in { 'active', 'completed' }
      and D.intent = 'order 

define "Has Criteria Indicating Frailty":
  exists ( (([DeviceRequest: "Frailty Device"]).isDeviceOrder()) FrailtyDeviceOrder
      where FrailtyDeviceOrder.doNotPerform() is not true
      and FrailtyDeviceOrder.authoredOn.toInterval() during day of "Measurement Period"
  )
    or exists ( (([Observation: "Medical equipment used"]).isAssessmentPerformed()) EquipmentUsed
        where EquipmentUsed.value as Concept in "Frailty Device" 
        and EquipmentUsed.effective.toInterval() ends during day of "Measurement Period"
    )
    or exists ( ([Condition: "Frailty Diagnosis"]) FrailtyDiagnosis
        where FrailtyDiagnosis.prevalenceInterval() overlaps "Measurement Period"
    )
    or exists ( (([Encounter: "Frailty Encounter"]).isEncounterPerformed()) FrailtyEncounter
        where FrailtyEncounter.period.toInterval() overlaps "Measurement Period"
    )
    or exists ( (([Observation: "Frailty Symptom"]).isSymptom()) FrailtySymptom
        where FrailtySymptom.effective.toInterval() overlaps "Measurement Period"
    ) 

define "Is Age 66 to 80 with Advanced Illness and Frailty or Is Age 81 or Older with Frailty":
  ( AgeInYearsAt(date from end of "Measurement Period")in Interval[66, 80]
      and "Has Criteria Indicating Frailty"
      and ( "Has Two Outpatient Encounters with Advanced Illness on Different Dates of Service"
          or "Has Inpatient Encounter with Advanced Illness"
          or "Has Dementia Medications in Year Before or During Measurement Period"
      )
  )
    or ( AgeInYearsAt(date from end of "Measurement Period")>= 81
        and "Has Criteria Indicating Frailty"
    ) 

define "Denominator Exclusions":
  Hospice."Has Hospice Services"
    or exists ( "Pregnancy or Renal Diagnosis" )
    or exists ( "End Stage Renal Disease Procedures" )
    or exists ( "End Stage Renal Disease Encounter" )
    or AIFrailLTCF."Is Age 66 to 80 with Advanced Illness and Frailty or Is Age 81 or Older with Frailty"
    or AIFrailLTCF."Is Age 66 or Older Living Long Term in a Nursing Home"
    or PalliativeCare."Has Palliative Care in the Measurement Period"