Metadata
Title | Hospital Harm - Falls with InjuryFHIR
Version | 1.0.000
Short Name | CMS1017FHIR
GUID (Version Independent) | urn:uuid:6425d5e9-a54b-40e0-a07d-e6e17137871c
GUID (Version Specific) | urn:uuid:fd45e28d-9c60-47b3-93df-1a9e96c17795
CMS Identifier | 1017FHIR
CMS Consensus Based Entity Identifier | 4120e
Effective Period | 2026-01-01 through 2026-12-31
Steward (Publisher) | Centers for Medicare & Medicaid Services (CMS)
Developer | Mathematica
Description | This ratio measure assesses the number of inpatient hospitalizations where at least one fall with a major or moderate injury occurs among the total qualifying inpatient hospital days for patients aged 18 years and older
Copyright | Limited proprietary coding is contained in the Measure specifications for user convenience. Users of proprietary code sets should obtain all necessary licenses from the owners of the code sets. Mathematica disclaims all liability for use or accuracy of any third-party codes contained in the specifications. LOINC(R) copyright 2004-2024 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2024 International Health Terminology Standards Development Organisation. ICD-10 copyright 2024 World Health Organization. All Rights Reserved.
Disclaimer | This performance measure is not a clinical guideline, does not establish a standard of medical care, and has not been tested for all potential applications. THE MEASURES AND SPECIFICATIONS ARE PROVIDED "AS IS" WITHOUT WARRANTY OF ANY KIND. Due to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM].
Rationale | Inpatient falls are among the most common incidents reported in hospitals and can increase length of stay and patient costs. Due to the potential for serious harm associated with patient falls, "patient death or serious injury associated with a fall while being cared for in a health care setting" is considered a Serious Reportable Event by the National Quality Forum (NQF, 2019). Falls (including unplanned or unintended descents to the floor) can result in patient injury ranging from minor abrasion or bruising to death as a result of injuries sustained from a fall. While major injuries (e.g., fractures, closed head injuries, internal bleeding) (Mintz et al., 2022) have the biggest impact on patient outcomes, 2008-2021 data findings from the 2022 Network of Patient Safety Databases (NPSD) demonstrated that 41.8 % of falls resulted in moderate injuries such as skin tear, avulsion, hematoma, significant bruising, dislocations and lacerations requiring suturing (AHRQ, 2022). Moderate injury is, as defined by the National Database of Nursing Quality Indicators (NDNQI), that resulted in suturing, application of steri-strips or skin glue, splinting, or muscle/joint strain (NDNQI, 2020). NPSD findings also demonstrated that mild to moderate level of harm represent 24.2.%, 0.4% - severe harm, and 0.1% - death (AHRQ, 2022; WHO, 2009). By focusing on falls with major and moderate injuries, the goal of this hospital harm dQM is to raise awareness of fall rates and, ultimately, to improve patient safety by preventing falls with injury in all hospital patients. The purpose of measuring the rate of falls with major and moderate injury events is to improve hospitals' practices for monitoring patients at high risk for falls with injury and, in so doing, to reduce the frequency of patient falls with injury.
Clinical Recommendation Statement | Certain protocols and prevention measures to reduce patient falls with injury include using fall risk assessment tools to gauge individual patient risk, implementing fall prevention protocols directed at individual patient risk factors, and implementing environmental rounds to assess and correct environmental fall hazards. Recommended clinical guidelines and practices to reduce falls and injuries from falls in hospitals support many prevention activities including implementing multifactorial interventions and tailoring interventions to individual patient's conditions and needs. The intent and desired outcome for this dQM is to work with existing and recommended falls prevention processes to track falls with injury, and aim to reduce rates of inpatient falls resulting in major injury. Recommended falls prevention guidelines are: Optimal Perioperative Management of the Geriatric Patient: Best Practices Guideline (ACS NSQIP/AGS, 2016) Falls in older people: assessing risk and prevention (NICE, 2013) Preventing falls and reducing injury from falls (4th edition) (RNAO, 2017) Fall prevention in hospitals and nursing homes: Clinical practice guideline (Schoberer et al., 2022) World guidelines for falls prevention and management for older adults: a global initiative, (Montero-Odasso et al., 2022)
Citation | Mintz, J., Duprey, M. S., Zullo, A. R., Lee, Y., Kiel, D. P., Daiello, L. A., Rodriguez, K. E., Venkatesh, A. K., & Berry, S. D. (2022). Identification of Fall-Related Injuries in Nursing Home Residents Using Administrative Claims Data. The journals of gerontology. Series A, Biological sciences and medical sciences, 77(7), 1421-1429. https://doi.org/10.1093/gerona/glab274
Citation | Mohanty, S., Rosenthal, R.A., Russell, M.M., Neuman, M.D., Ko, C.Y., & Esnaola, N.F. (2016). Optimal Perioperative Management of the Geriatric Patient: Best Practices Guideline from ACS NSQIP/AGS. Journal of the American College of Surgeons 222(5), 930-947. doi: 10.1016/j.jamcollsurg.2015.12.026
Citation | Montero-Odasso, M., van der Velde, N., Martin, F. C., Petrovic, M., Tan, M. P., Ryg, J., Aguilar-Navarro, S., Alexander, N. B., Becker, C., Blain, H., Bourke, R., Cameron, I. D., Camicioli, R., Clemson, L., Close, J., Delbaere, K., Duan, L., Duque, G., Dyer, S. M., ... Rixt Zijlstra, G. A. (2022). World guidelines for falls prevention and management for older adults: a global initiative. Age and Ageing, 51(9), 1-36. https://doi.org/10.1093/ageing/afac205
Citation | National Quality Forum. Serious Reportable Events. http://www.qualityforum.org/topics/sres/serious_reportable_events.aspx. Accessed July 24, 2019
Citation | Network of Patient Safety Databases Chartbook, 2022. Rockville, MD: Agency for Healthcare Research and Quality; September 2022. AHRQ Pub. No. 22-0051
Citation | NICE. (2013). Falls in older people: assessing risk and prevention. London, UK
Citation | Press Ganey Guidelines for Data Collection and Submission Patient Falls Indicator, January 2020
Citation | RNAO. (2017). Preventing falls and reducing injury from falls (4th edition). Toronto, ON
Citation | Schoberer, D., Breimaier, H. E., Zuschnegg, J., Findling, T., Schaffer, S., & Archan, T. (2022). Fall prevention in hospitals and nursing homes: Clinical practice guideline. Worldviews on Evidence-Based Nursing, Vol. 19. https://doi.org/10.1111/wvn.12571
Citation | WHO. (2009). Conceptual Framework for the International Classification for Patient Safety, Version 1.1. https://apps.who.int/iris/bitstream/handle/10665/70882/WHO_IER_PSP_2010.2_eng.pdf
Guidance (Usage) | Hospital days are measured in 24-hour periods starting from the time of arrival at the hospital (including time in the Emergency Department and or Observation). The number of days will be counted as whole numbers; any fractional periods are dropped. For example, an eligible encounter with a length of stay of 75 hours will be measured as 3 days (72 hours). This measure includes two measure observations used to calculate the ratio of the number of encounters with a fall over the total number of eligible hospital days. The ratio is reported as the rate of inpatient hospitalizations with falls with moderate or major injury per 1000 patient days. To express the rate of inpatient hospitalizations with falls with moderate or major injury per 1,000 patient days, the following calculation is applied post-production during implementation: (Total number of encounters with falls with moderate or major injury / Total number of eligible hospital days) x 1000 = rate. Example: 1 eligible encounter with a patient fall with moderate or major injury over 120 eligible days (1/120) x 1000 = 8.33. In ratio measures, both the Denominator and Numerator populations flow separately from the same Initial Population. Therefore, the same exclusion criteria must be applied to both the Denominator and Numerator to prevent excluded cases from being considered. This dQM is an episode-based measure. An episode is defined as each inpatient hospitalization or encounter that ends during the measurement period. This FHIR-based measure has been derived from the QDM-based measure: CMS1017v2. Please refer to the HL7 QI-Core Implementation Guide (https://hl7.org/fhir/us/qicore/STU6/) for more information on QI-Core and mapping recommendations from QDM to QI-Core STU 6 (https://hl7.org/fhir/us/qicore/STU6/qdm-to-qicore.html).
Measure Group (Rate) (ID: Group_1)
Basis | Encounter
Scoring | [http://terminology.hl7.org/CodeSystem/measure-scoring#ratio: 'Ratio']
Type | [http://terminology.hl7.org/CodeSystem/measure-type#outcome: 'Outcome']
Rate Aggregation | None
Improvement Notation | [http://terminology.hl7.org/CodeSystem/measure-improvement-notation#decrease: 'Decreased score indicates improvement']
Initial Population | ID: InitialPopulation_1 Description: Inpatient hospitalizations for patients aged 18 years and older with a length of stay less than or equal to 120 days that ends during the measurement period Logic Definition: Initial Population
Denominator | ID: Denominator_1 Description: Equals Initial Population Logic Definition: Denominator
Denominator Exclusion | ID: DenominatorExclusion_1 Description: Inpatient hospitalizations where the patient has a fall diagnosis present on admission. Logic Definition: Denominator Exclusions
Numerator | ID: Numerator_1 Description: Inpatient hospitalizations where the patient has a fall that results in a major or moderate injury during the encounter. The diagnosis of a major or moderate injury must not be present on admission. Logic Definition: Numerator
Numerator Exclusion | ID: NumeratorExclusion_1 Description: Inpatient hospitalizations where the patient has a fall diagnosis present on admission Logic Definition: Numerator Exclusions
Measure Observation | ID: MeasureObservation_1_1 Description: Denominator Observation, associated with the Denominator: The total number of eligible days across all encounters which match the initial population/denominator criteria. Logic Definition: Denominator Observation
Measure Observation | ID: MeasureObservation_1_2 Description: Numerator Observation, associated with the Numerator: The total number of inpatient hospitalizations where a fall with major or moderate injury occurred, across all eligible encounters. Logic Definition: Numerator Observation
Supplemental Data Guidance | For every patient evaluated by this measure also identify payer, race, ethnicity and sex
Supplemental Data Guidance | Variables being collected for the development of baseline risk adjustment model include encounters with: Medications active on admission such as: anticoagulants antidepressants antihypertensives central nervous system depressant medications diuretics opioids Medications administered during the hospitalization, such as anticoagulants Diagnoses present on admission which may increase the risk for a fall with injury, such as: abnormal weight loss or malnutrition coagulation disorders delirium, dementia, or other psychosis depression epilepsy leukemia or lymphoma liver disease (moderate to severe) malignant bone disease neurologic movement and related disorders obesity osteoporosis peripheral neuropathy stroke suicide attempt Physical traits, such as body mass index (BMI) All encounter diagnoses along with their rank (e.g., 1 = principal, 2 = secondary) and present on admission (POA) indicators are being collected for the development of baseline risk adjustment model.
Supplemental Data Elements
Supplemental Data Element | ID: sde-ethnicity Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#supplemental-data] Description: SDE Ethnicity Logic Definition: SDE Ethnicity
Supplemental Data Element | ID: sde-payer Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#supplemental-data] Description: SDE Payer Logic Definition: SDE Payer
Supplemental Data Element | ID: sde-race Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#supplemental-data] Description: SDE Race Logic Definition: SDE Race
Supplemental Data Element | ID: sde-sex Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#supplemental-data] Description: SDE Sex Logic Definition: SDE Sex
Supplemental Data Element | ID: risk-variable-body-mass-index-(bmi) Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#risk-adjustment-factor] Description: Risk Variable Body Mass Index (BMI) Logic Definition: Risk Variable Body Mass Index (BMI)
Supplemental Data Element | ID: risk-variable-all-encounter-diagnoses-with-rank-and-poa-indication Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#risk-adjustment-factor] Description: Risk Variable All Encounter Diagnoses with Rank and POA Indication Logic Definition: Risk Variable All Encounter Diagnoses with Rank and POA Indication
Supplemental Data Element | ID: risk-variable-encounter-with-abnormal-weight-loss-or-malnutrition-present-on-admission Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#risk-adjustment-factor] Description: Risk Variable Encounter with Abnormal Weight Loss or Malnutrition Present on Admission Logic Definition: Risk Variable Encounter with Abnormal Weight Loss or Malnutrition Present on Admission
Supplemental Data Element | ID: risk-variable-encounter-with-anticoagulant-active-at-admission Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#risk-adjustment-factor] Description: Risk Variable Encounter with Anticoagulant Active at Admission Logic Definition: Risk Variable Encounter with Anticoagulant Active at Admission
Supplemental Data Element | ID: risk-variable-encounter-with-anticoagulant-administration-during-encounter Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#risk-adjustment-factor] Description: Risk Variable Encounter with Anticoagulant Administration During Encounter Logic Definition: Risk Variable Encounter with Anticoagulant Administration During Encounter
Supplemental Data Element | ID: risk-variable-encounter-with-antidepressant-active-at-admission Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#risk-adjustment-factor] Description: Risk Variable Encounter with Antidepressant Active at Admission Logic Definition: Risk Variable Encounter with Antidepressant Active at Admission
Supplemental Data Element | ID: risk-variable-encounter-with-antihypertensive-active-at-admission Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#risk-adjustment-factor] Description: Risk Variable Encounter with Antihypertensive Active at Admission Logic Definition: Risk Variable Encounter with Antihypertensive Active at Admission
Supplemental Data Element | ID: risk-variable-encounter-with-cns-depressant-active-at-admission Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#risk-adjustment-factor] Description: Risk Variable Encounter with CNS Depressant Active at Admission Logic Definition: Risk Variable Encounter with CNS Depressant Active at Admission
Supplemental Data Element | ID: risk-variable-encounter-with-diuretic-active-at-admission Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#risk-adjustment-factor] Description: Risk Variable Encounter with Diuretic Active at Admission Logic Definition: Risk Variable Encounter with Diuretic Active at Admission
Supplemental Data Element | ID: risk-variable-encounter-with-opioid-medication-active-at-admission Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#risk-adjustment-factor] Description: Risk Variable Encounter with Opioid Medication Active at Admission Logic Definition: Risk Variable Encounter with Opioid Medication Active at Admission
Supplemental Data Element | ID: risk-variable-encounter-with-coagulation-disorder-present-on-admission Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#risk-adjustment-factor] Description: Risk Variable Encounter with Coagulation Disorder Present on Admission Logic Definition: Risk Variable Encounter with Coagulation Disorder Present on Admission
Supplemental Data Element | ID: risk-variable-encounter-with-depression-present-on-admission Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#risk-adjustment-factor] Description: Risk Variable Encounter with Depression Present on Admission Logic Definition: Risk Variable Encounter with Depression Present on Admission
Supplemental Data Element | ID: risk-variable-encounter-with-delirium-or-dementia-or-other-psychosis-present-on-admission Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#risk-adjustment-factor] Description: Risk Variable Encounter with Delirium or Dementia or Other Psychosis Present on Admission Logic Definition: Risk Variable Encounter with Delirium or Dementia or Other Psychosis Present on Admission
Supplemental Data Element | ID: risk-variable-encounter-with-epilepsy-present-on-admission Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#risk-adjustment-factor] Description: Risk Variable Encounter with Epilepsy Present on Admission Logic Definition: Risk Variable Encounter with Epilepsy Present on Admission
Supplemental Data Element | ID: risk-variable-encounter-with-leukemia-or-lymphoma-present-on-admission Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#risk-adjustment-factor] Description: Risk Variable Encounter with Leukemia or Lymphoma Present on Admission Logic Definition: Risk Variable Encounter with Leukemia or Lymphoma Present on Admission
Supplemental Data Element | ID: risk-variable-encounter-with-liver-disease-moderate-to-severe-present-on-admission Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#risk-adjustment-factor] Description: Risk Variable Encounter with Liver Disease Moderate to Severe Present on Admission Logic Definition: Risk Variable Encounter with Liver Disease Moderate to Severe Present on Admission
Supplemental Data Element | ID: risk-variable-encounter-with-malignant-bone-disease-present-on-admission Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#risk-adjustment-factor] Description: Risk Variable Encounter with Malignant Bone Disease Present on Admission Logic Definition: Risk Variable Encounter with Malignant Bone Disease Present on Admission
Supplemental Data Element | ID: risk-variable-encounter-with-neurologic-disorder-present-on-admission Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#risk-adjustment-factor] Description: Risk Variable Encounter with Neurologic Disorder Present on Admission Logic Definition: Risk Variable Encounter with Neurologic Disorder Present on Admission
Supplemental Data Element | ID: risk-variable-encounter-with-obesity-present-on-admission Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#risk-adjustment-factor] Description: Risk Variable Encounter with Obesity Present on Admission Logic Definition: Risk Variable Encounter with Obesity Present on Admission
Supplemental Data Element | ID: risk-variable-encounter-with-osteoporosis-present-on-admission Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#risk-adjustment-factor] Description: Risk Variable Encounter with Osteoporosis Present on Admission Logic Definition: Risk Variable Encounter with Osteoporosis Present on Admission
Supplemental Data Element | ID: risk-variable-encounter-with-peripheral-neuropathy-present-on-admission Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#risk-adjustment-factor] Description: Risk Variable Encounter with Peripheral Neuropathy Present on Admission Logic Definition: Risk Variable Encounter with Peripheral Neuropathy Present on Admission
Supplemental Data Element | ID: risk-variable-encounter-with-stroke-present-on-admission Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#risk-adjustment-factor] Description: Risk Variable Encounter with Stroke Present on Admission Logic Definition: Risk Variable Encounter with Stroke Present on Admission
Supplemental Data Element | ID: risk-variable-encounter-with-suicide-attempt Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#risk-adjustment-factor] Description: Risk Variable Encounter with Suicide Attempt Logic Definition: Risk Variable Encounter with Suicide Attempt
Measure Logic
Primary Library | https://madie.cms.gov/Library/CMS1017FHIRHHFI
Contents | Population Criteria Logic Definitions Terminology Dependencies Data Requirements
Population Criteria
Measure Group (Rate) (ID: Group_1)
Initial Population
    define "Initial Population":
      "Qualifying Encounter"
Denominator
    define "Denominator":
      "Initial Population"
Denominator Exclusion
    define "Denominator Exclusions":
      "Encounter With A Fall Present On Admission"
Numerator
    define "Numerator":
      "Encounter Where A Fall And Major Injury Occurred Not POA"
        union "Encounter Where A Fall And Moderate Injury Occurred Not POA"
Numerator Exclusion
    define "Numerator Exclusions":
      "Encounter With A Fall Present On Admission"
Measure Observation
    define function "Denominator Observation"(QualifyingEncounter Encounter):
      duration in days of QualifyingEncounter.hospitalizationWithObservation ( )
Measure Observation
    define function "Numerator Observation"(QualifyingEncounter Encounter):
      Count("Numerator" FallsEncounter
          where FallsEncounter.period ends during QualifyingEncounter.hospitalizationWithObservation()
      )
Logic Definitions
Logic Definition | Library Name: SupplementalDataElements
    define "SDE Payer":
      [Coverage: type in "Payer Type"] Payer
        return {
          code: Payer.type,
          period: Payer.period
        }
Logic Definition | Library Name: SupplementalDataElements
    define "SDE Race":
      Patient.race R
        return Tuple {
          codes: R.ombCategory union R.detailed,
          display: R.text
        }
Logic Definition | Library Name: SupplementalDataElements
    define "SDE Sex":
      case
        when Patient.sex = '248153007' then "Male (finding)"
        when Patient.sex = '248152002' then "Female (finding)"
        else null
      end
Logic Definition | Library Name: SupplementalDataElements
    define "SDE Ethnicity":
      Patient.ethnicity E
        return Tuple {
          codes: { E.ombCategory } union E.detailed,
          display: E.text
        }
Logic Definition | Library Name: CQMCommon
    define "Inpatient Encounter":
      [Encounter: "Encounter Inpatient"] EncounterInpatient
        where EncounterInpatient.status = 'finished'
          and EncounterInpatient.period ends during day of "Measurement Period"
Logic Definition | Library Name: CQMCommon
    /*
    @description: Calculates the difference in calendar days between the start and end of the given interval.
    */
    define fluent function lengthInDays(Value Interval<DateTime> ):
      difference in days between start of Value and end of Value
Logic Definition | Library Name: CQMCommon
    /*
    @description: Hospitalization with Observation returns the total interval from the start of any immediately prior emergency department visit through the observation visit to the discharge of the given encounter
    */
    define fluent function hospitalizationWithObservation(TheEncounter Encounter ):
      TheEncounter Visit
      		let ObsVisit: Last([Encounter: "Observation Services"] LastObs
      				where LastObs.status = 'finished'
                and LastObs.period ends 1 hour or less on or before start of Visit.period
      				sort by end of period
      			),
      			VisitStart: Coalesce(start of ObsVisit.period, start of Visit.period),
      			EDVisit: Last([Encounter: "Emergency Department Visit"] LastED
      				where LastED.status = 'finished'
                and LastED.period ends 1 hour or less on or before VisitStart
      				sort by end of period
      			)
      		return Interval[Coalesce(start of EDVisit.period, VisitStart), end of Visit.period]
Logic Definition | Library Name: CQMCommon
    /*
     @description: Returns true if the given diagnosis is present on admission, based on the given poaValueSet
     @comment: See the QICore 6 Authoring Patterns discussion on [Principal Diagnosis and Present on Admission](https://github.com/cqframework/CQL-Formatting-and-Usage-Wiki/wiki/Authoring-Patterns-QICore-v6.0.0#conditions-present-on-admission-and-principal-diagnoses) for more information
     */
     define fluent function isDiagnosisPresentOnAdmission(encounter Encounter, diagnosisValueSet ValueSet, poaValueSet ValueSet):
       exists (
         (encounter.claimDiagnosis()) CD
           where CD.onAdmission in poaValueSet
             and (
               CD.diagnosis in diagnosisValueSet
                 or CD.diagnosis.getCondition().code in diagnosisValueSet
             )
       )
Logic Definition | Library Name: CQMCommon
    /*
    @description: Returns the claim diagnosis elements for the given encounter
    @comment: See the QICore 6 Authoring Patterns discussion on [Principal Diagnosis and Present on Admission](https://github.com/cqframework/CQL-Formatting-and-Usage-Wiki/wiki/Authoring-Patterns-QICore-v6.0.0#conditions-present-on-admission-and-principal-diagnoses) for more information
    */
    define fluent function claimDiagnosis(encounter Encounter):
      encounter E
        let
          claim: ([Claim] C where C.status = 'active' and C.use = 'claim' and exists (C.item I where I.encounter.references(E))),
          claimItem: (claim.item I where I.encounter.references(E))
        return claim.diagnosis D where D.sequence in claimItem.diagnosisSequence
Logic Definition | Library Name: CQMCommon
    /*
    @description: Returns the Condition resource for the given reference
    */
    define fluent function getCondition(reference Reference):
      singleton from (([ConditionEncounterDiagnosis] union [ConditionProblemsHealthConcerns]) C where reference.references(C.id))
Logic Definition | Library Name: QICoreCommon
    /*
    @description: Returns true if any of the given references are to the given resource
    @comment: Returns true if the `id` element of the given resource exactly equals the tail of any of the given references.
    NOTE: This function assumes resources from the same source server.
    */
    define fluent function references(references List<Reference>, resource Resource):
      exists (references R where R.references(resource))
Logic Definition | Library Name: QICoreCommon
    /*
    @description: Returns true if the given reference is to the given resource
    @comment: Returns true if the `id` element of the given resource exactly equals the tail of the given reference.
    NOTE: This function assumes resources from the same source server.
    */
    define fluent function references(reference Reference, resource Resource):
      resource.id = Last(Split(reference.reference, '/'))
Logic Definition | Library Name: QICoreCommon
    /*
    @description: Returns true if the given reference is to the given resourceId
    @comment: Returns true if the `resourceId` parameter exactly equals the tail of the given reference.
    NOTE: This function assumes resources from the same source server.
    */
    define fluent function references(reference Reference, resourceId String):
      resourceId = Last(Split(reference.reference, '/'))
Logic Definition | Library Name: QICoreCommon
    /*
    @description: Returns the tail of the given uri (i.e. everything after the last slash in the URI).
    @comment: This function can be used to determine the logical id of a given resource. It can be used in
    a single-server environment to trace references. However, this function does not attempt to resolve
    or distinguish the base of the given url, and so cannot be used safely in multi-server environments.
    */
    define fluent function getId(uri String):
      Last(Split(uri, '/'))
Logic Definition | Library Name: QICoreCommon
    /*
    @description: Returns true if the given MedicationRequest has a category of Community
    */
    define fluent function isCommunity(medicationRequest Choice<MedicationRequest, MedicationNotRequested>):
      exists (medicationRequest.category C
        where C ~ Community
      )
Logic Definition | Library Name: CumulativeMedicationDuration
    define fluent function medicationRequestPeriod(Request "MedicationRequest"):
      Request R
        let
          dosage: singleton from R.dosageInstruction,
          doseAndRate: singleton from dosage.doseAndRate,
          timing: dosage.timing,
          frequency: Coalesce(timing.repeat.frequencyMax, timing.repeat.frequency),
          period: Quantity(timing.repeat.period, timing.repeat.periodUnit),
          doseRange: doseAndRate.dose,
          doseQuantity: doseAndRate.dose,
          dose: Coalesce(end of doseRange, doseQuantity),
          dosesPerDay: Coalesce(ToDaily(frequency, period), Count(timing.repeat.timeOfDay), 1.0),
          boundsPeriod: timing.repeat.bounds as Interval<DateTime>,
          daysSupply: (convert R.dispenseRequest.expectedSupplyDuration to days).value,
          quantity: R.dispenseRequest.quantity,
          refills: Coalesce(R.dispenseRequest.numberOfRepeatsAllowed, 0),
          startDate:
            Coalesce(
              date from start of boundsPeriod,
              date from R.authoredOn,
              date from start of R.dispenseRequest.validityPeriod
            ),
          totalDaysSupplied: Coalesce(daysSupply, quantity.value / (dose.value * dosesPerDay)) * (1 + refills)
        return
          if startDate is not null and totalDaysSupplied is not null then
            Interval[startDate, startDate + Quantity(totalDaysSupplied - 1, 'day') ]
          else if startDate is not null and boundsPeriod."high" is not null then
            Interval[startDate, date from end of boundsPeriod]
          else
            null
Logic Definition | Library Name: CumulativeMedicationDuration
    /**********************************************************************/
    /* Functions in this region are copied from opioid-mme-r4             */
    /**********************************************************************/

    define function Quantity(value Decimal, unit String):
      if value is not null then
        System.Quantity { value: value, unit: unit }
      else
        null
Logic Definition | Library Name: CumulativeMedicationDuration
    /*
     Goal is to get to number of days
     Two broad approaches to the calculation:
      1) Based on supply and frequency, calculate the number of expected days the medication will cover/has covered
      2) Based on relevant period, determine a covered interval and calculate the length of that interval in days
    This topic covers several use cases and illustrates how to calculate Cumulative
    Medication Duration for each type of medication resource using the supply and
    frequency approach.
    */

    /*
      For the first approach, we need to get from frequency to a frequency/day
      So we define ToDaily
    */

    /*
      Calculates daily frequency given frequency within a period
    */
    define function ToDaily(frequency System.Integer, period System.Quantity):
      case period.unit
        when 'h' then frequency * (24.0 / period.value)
        when 'min' then frequency * (24.0 / period.value) * 60
        when 's' then frequency * (24.0 / period.value) * 60 * 60
        when 'd' then frequency * (24.0 / period.value) / 24
        when 'wk' then frequency * (24.0 / period.value) / (24 * 7)
        when 'mo' then frequency * (24.0 / period.value) / (24 * 30) /* assuming 30 days in month */
        when 'a' then frequency * (24.0 / period.value) / (24 * 365) /* assuming 365 days in year */
        when 'hour' then frequency * (24.0 / period.value)
        when 'minute' then frequency * (24.0 / period.value) * 60
        when 'second' then frequency * (24.0 / period.value) * 60 * 60
        when 'day' then frequency * (24.0 / period.value) / 24
        when 'week' then frequency * (24.0 / period.value) / (24 * 7)
        when 'month' then frequency * (24.0 / period.value) / (24 * 30) /* assuming 30 days in month */
        when 'year' then frequency * (24.0 / period.value) / (24 * 365) /* assuming 365 days in year */
        when 'hours' then frequency * (24.0 / period.value)
        when 'minutes' then frequency * (24.0 / period.value) * 60
        when 'seconds' then frequency * (24.0 / period.value) * 60 * 60
        when 'days' then frequency * (24.0 / period.value) / 24
        when 'weeks' then frequency * (24.0 / period.value) / (24 * 7)
        when 'months' then frequency * (24.0 / period.value) / (24 * 30) /* assuming 30 days in month */
        when 'years' then frequency * (24.0 / period.value) / (24 * 365) /* assuming 365 days in year */
        else Message(null, true, 'CMDLogic.ToDaily.UnknownUnit', ErrorLevel, 'Unknown unit ' & period.unit)
      end
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
    /*
    @description: Converts the given FHIR [CodeableConcept](https://hl7.org/fhir/datatypes.html#CodeableConcept) value to a CQL Concept.
    */
    define function ToConcept(concept FHIR.CodeableConcept):
        if concept is null then
            null
        else
            System.Concept {
                codes: concept.coding C return ToCode(C),
                display: concept.text.value
            }
Logic Definition | Library Name: FHIRHelpers
    /*
    @description: Converts the given FHIR [Coding](https://hl7.org/fhir/datatypes.html#Coding) value to a CQL Code.
    */
    define function ToCode(coding FHIR.Coding):
        if coding is null then
            null
        else
            System.Code {
              code: coding.code.value,
              system: coding.system.value,
              version: coding.version.value,
              display: coding.display.value
            }
Logic Definition | Library Name: FHIRHelpers
    define function ToString(value uri): value.value
Logic Definition | Library Name: CMS1017FHIRHHFI
    define "Qualifying Encounter":
      CQMCommon."Inpatient Encounter" InpatientEncounter
        where InpatientEncounter.hospitalizationWithObservation ( ).lengthInDays ( ) <= 120
          and AgeInYearsAt(date from start of InpatientEncounter.period) >= 18
Logic Definition | Library Name: CMS1017FHIRHHFI
    define "Risk Variable Encounter with Osteoporosis Present on Admission":
      "Qualifying Encounter" InpatientEncounter
        where InpatientEncounter.isDiagnosisPresentOnAdmission ( "Osteoporosis", "Present on Admission or Clinically Undetermined" )
Logic Definition | Library Name: CMS1017FHIRHHFI
    define "Risk Variable Encounter with Coagulation Disorder Present on Admission":
      "Qualifying Encounter" InpatientEncounter
        where InpatientEncounter.isDiagnosisPresentOnAdmission ( "Coagulation Disorders", "Present on Admission or Clinically Undetermined" )
Logic Definition | Library Name: CMS1017FHIRHHFI
    define "Risk Variable Encounter with Antidepressant Active at Admission":
      "Qualifying Encounter" InpatientEncounter
        with ["MedicationRequest": "Antidepressants"] AntidepressantMed
          such that AntidepressantMed.status in { 'active', 'completed' }
            and ( AntidepressantMed.intent = 'order'
                or ( AntidepressantMed.intent = 'plan'
                    and AntidepressantMed.subject.reference.getId ( ) = Patient.id
                )
            )
            and AntidepressantMed.isCommunity ( )
            and AntidepressantMed.medicationRequestPeriod ( ) overlaps before day of InpatientEncounter.period
Logic Definition | Library Name: CMS1017FHIRHHFI
    define "Risk Variable All Encounter Diagnoses with Rank and POA Indication":
      from
        "Qualifying Encounter" InpatientEncounter
        let claim: ( [Claim] C
            where C.status = 'active'
              and C.use = 'claim'
              and exists ( C.item ClaimItem
                  where ClaimItem.encounter.references ( InpatientEncounter )
              )
        ),
        claimItem: ( claim.item ClaimItem
            where ClaimItem.encounter.references ( InpatientEncounter )
        )
        return Tuple {
          encounterId: InpatientEncounter.id,
          diagnosis: claim.diagnosis,
          rank: claim.diagnosis.sequence,
          POA: claim.diagnosis Diag
            where Diag.onAdmission in "Present on Admission or Clinically Undetermined"
              or Diag.onAdmission in "Not Present On Admission or Documentation Insufficient to Determine"
        }
Logic Definition | Library Name: CMS1017FHIRHHFI
    define "Risk Variable Encounter with Leukemia or Lymphoma Present on Admission":
      "Qualifying Encounter" InpatientEncounter
        where InpatientEncounter.isDiagnosisPresentOnAdmission ( "Leukemia or Lymphoma", "Present on Admission or Clinically Undetermined" )
Logic Definition | Library Name: CMS1017FHIRHHFI
    define "Risk Variable Encounter with Obesity Present on Admission":
      "Qualifying Encounter" InpatientEncounter
        where InpatientEncounter.isDiagnosisPresentOnAdmission ( "Obesity", "Present on Admission or Clinically Undetermined" )
Logic Definition | Library Name: CMS1017FHIRHHFI
    define "Risk Variable Encounter with Peripheral Neuropathy Present on Admission":
      "Qualifying Encounter" InpatientEncounter
        where InpatientEncounter.isDiagnosisPresentOnAdmission ( "Peripheral Neuropathy", "Present on Admission or Clinically Undetermined" )
Logic Definition | Library Name: CMS1017FHIRHHFI
    define "Risk Variable Encounter with Delirium or Dementia or Other Psychosis Present on Admission":
      "Qualifying Encounter" InpatientEncounter
        where InpatientEncounter.isDiagnosisPresentOnAdmission ( "Delirium, Dementia, and Other Psychoses", "Present on Admission or Clinically Undetermined" )
Logic Definition | Library Name: CMS1017FHIRHHFI
    define "Risk Variable Encounter with Suicide Attempt":
      "Qualifying Encounter" InpatientEncounter
        where InpatientEncounter.encountersDiagnosis ( ).code in "Suicide Attempt"
Logic Definition | Library Name: CMS1017FHIRHHFI
    define "SDE Payer":
      SDE."SDE Payer"
Logic Definition | Library Name: CMS1017FHIRHHFI
    define "Risk Variable Encounter with Liver Disease Moderate to Severe Present on Admission":
      "Qualifying Encounter" InpatientEncounter
        where InpatientEncounter.isDiagnosisPresentOnAdmission ( "Liver Disease Moderate to Severe", "Present on Admission or Clinically Undetermined" )
Logic Definition | Library Name: CMS1017FHIRHHFI
    define "Initial Population":
      "Qualifying Encounter"
Logic Definition | Library Name: CMS1017FHIRHHFI
    define "Risk Variable Encounter with Anticoagulant Administration During Encounter":
      "Qualifying Encounter" InpatientEncounter
        with ["MedicationAdministration": "Anticoagulants for All Indications"] Anticoagulants
          such that Anticoagulants.effective.toInterval ( ) starts during InpatientEncounter.hospitalizationWithObservation ( )
            and Anticoagulants.status in { 'in-progress', 'completed' }
Logic Definition | Library Name: CMS1017FHIRHHFI
    define "Risk Variable Encounter with Neurologic Disorder Present on Admission":
      "Qualifying Encounter" InpatientEncounter
        where InpatientEncounter.isDiagnosisPresentOnAdmission ( "Neurologic Movement and Related Disorders", "Present on Admission or Clinically Undetermined" )
Logic Definition | Library Name: CMS1017FHIRHHFI
    define "Risk Variable Encounter with Abnormal Weight Loss or Malnutrition Present on Admission":
      "Qualifying Encounter" InpatientEncounter
        where InpatientEncounter.isDiagnosisPresentOnAdmission ( "Abnormal Weight Loss", "Present on Admission or Clinically Undetermined" )
          or InpatientEncounter.isDiagnosisPresentOnAdmission ( "Malnutrition", "Present on Admission or Clinically Undetermined" )
Logic Definition | Library Name: CMS1017FHIRHHFI
    define "Risk Variable Encounter with Anticoagulant Active at Admission":
      "Qualifying Encounter" InpatientEncounter
        with ["MedicationRequest": "Anticoagulants for All Indications"] Anticoagulants
          such that Anticoagulants.status in { 'active', 'completed' }
            and ( Anticoagulants.intent = 'order'
                or ( Anticoagulants.intent = 'plan'
                    and Anticoagulants.subject.reference.getId ( ) = Patient.id
                )
            )
            and Anticoagulants.isCommunity ( )
            and Anticoagulants.medicationRequestPeriod ( ) overlaps before day of InpatientEncounter.period
Logic Definition | Library Name: CMS1017FHIRHHFI
    define "Risk Variable Body Mass Index (BMI)":
      from
        ["USCoreBMIProfile"] BMI
        with "Qualifying Encounter" InpatientEncounter
          such that BMI.effective.toInterval ( ) starts during InpatientEncounter.hospitalizationWithObservation ( )
            and BMI.value is not null
            and BMI.status in { 'final', 'amended', 'corrected' }
        return BMI.value as Quantity
Logic Definition | Library Name: CMS1017FHIRHHFI
    define "Risk Variable Encounter with Depression Present on Admission":
      "Qualifying Encounter" InpatientEncounter
        where InpatientEncounter.isDiagnosisPresentOnAdmission ( "Depression", "Present on Admission or Clinically Undetermined" )
Logic Definition | Library Name: CMS1017FHIRHHFI
    define "Risk Variable Encounter with Epilepsy Present on Admission":
      "Qualifying Encounter" InpatientEncounter
        where InpatientEncounter.isDiagnosisPresentOnAdmission ( "Epilepsy", "Present on Admission or Clinically Undetermined" )
Logic Definition | Library Name: CMS1017FHIRHHFI
    define "Risk Variable Encounter with Diuretic Active at Admission":
      "Qualifying Encounter" InpatientEncounter
        with ["MedicationRequest": "Diuretics"] DiureticMed
          such that DiureticMed.status in { 'active', 'completed' }
            and ( DiureticMed.intent = 'order'
                or ( DiureticMed.intent = 'plan'
                    and DiureticMed.subject.reference.getId ( ) = Patient.id
                )
            )
            and DiureticMed.isCommunity ( )
            and DiureticMed.medicationRequestPeriod ( ) overlaps before day of InpatientEncounter.period
Logic Definition | Library Name: CMS1017FHIRHHFI
    define "Risk Variable Encounter with CNS Depressant Active at Admission":
      "Qualifying Encounter" InpatientEncounter
        with ["MedicationRequest": "Central Nervous System Depressants"] CNSMed
          such that CNSMed.status in { 'active', 'completed' }
            and ( CNSMed.intent = 'order'
                or ( CNSMed.intent = 'plan'
                    and CNSMed.subject.reference.getId ( ) = Patient.id
                )
            )
            and CNSMed.isCommunity ( )
            and CNSMed.medicationRequestPeriod ( ) overlaps before day of InpatientEncounter.period
Logic Definition | Library Name: CMS1017FHIRHHFI
    define "SDE Race":
      SDE."SDE Race"
Logic Definition | Library Name: CMS1017FHIRHHFI
    define "Risk Variable Encounter with Malignant Bone Disease Present on Admission":
      "Qualifying Encounter" InpatientEncounter
        where InpatientEncounter.isDiagnosisPresentOnAdmission ( "Malignant Bone Disease", "Present on Admission or Clinically Undetermined" )
Logic Definition | Library Name: CMS1017FHIRHHFI
    define "SDE Sex":
      SDE."SDE Sex"
Logic Definition | Library Name: CMS1017FHIRHHFI
    define "Risk Variable Encounter with Antihypertensive Active at Admission":
      "Qualifying Encounter" InpatientEncounter
        with ["MedicationRequest": "Antihypertensives"] BPMed
          such that BPMed.status in { 'active', 'completed' }
            and ( BPMed.intent = 'order'
                or ( BPMed.intent = 'plan'
                    and BPMed.subject.reference.getId ( ) = Patient.id
                )
            )
            and BPMed.isCommunity ( )
            and BPMed.medicationRequestPeriod ( ) overlaps before day of InpatientEncounter.period
Logic Definition | Library Name: CMS1017FHIRHHFI
    define "Risk Variable Encounter with Opioid Medication Active at Admission":
      "Qualifying Encounter" InpatientEncounter
        with ["MedicationRequest": "Opioids"] OpioidMed
          such that OpioidMed.status in { 'active', 'completed' }
            and ( OpioidMed.intent = 'order'
                or ( OpioidMed.intent = 'plan'
                    and OpioidMed.subject.reference.getId ( ) = Patient.id
                )
            )
            and OpioidMed.isCommunity ( )
            and OpioidMed.medicationRequestPeriod ( ) overlaps before day of InpatientEncounter.period
Logic Definition | Library Name: CMS1017FHIRHHFI
    define "Encounter With A Fall Diagnosis":
      "Qualifying Encounter" QualifyingFall
        where QualifyingFall.reasonCode in "Inpatient Falls"
          or QualifyingFall.encountersDiagnosis ( ).code in "Inpatient Falls"
Logic Definition | Library Name: CMS1017FHIRHHFI
    define "Encounter With A Fall Event":
      "Qualifying Encounter" InpatientEncounter
        with [AdverseEvent: "Inpatient Falls"] FallsDocumentation
          such that Coalesce(FallsDocumentation.date, FallsDocumentation.recordedDate) during InpatientEncounter.hospitalizationWithObservation ( )
Logic Definition | Library Name: CMS1017FHIRHHFI
    define "Encounter Where A Fall Occurred":
      "Encounter With A Fall Diagnosis" EncounterFallDiagnosis
        union "Encounter With A Fall Event" EncounterFallEvent
Logic Definition | Library Name: CMS1017FHIRHHFI
    define "Encounter With A Fall Not Present On Admission":
      "Encounter Where A Fall Occurred" EncounterFallDiagnosis
        where EncounterFallDiagnosis.hasDiagnosisNotPresentOnAdmissionOrNull ( "Inpatient Falls" )
Logic Definition | Library Name: CMS1017FHIRHHFI
    define "Encounter Where A Fall And Major Injury Occurred Not POA":
      "Encounter With A Fall Not Present On Admission" FallOccurred
        where exists ( ( FallOccurred.claimDiagnosis ( ) ) MajorFallOccurred
            where ( MajorFallOccurred.onAdmission is null
                or MajorFallOccurred.onAdmission in "Not Present On Admission or Documentation Insufficient to Determine"
            )
              and ( MajorFallOccurred.diagnosis in "Major Injuries"
                  or MajorFallOccurred.diagnosis.getCondition ( ).code in "Major Injuries"
              )
        )
Logic Definition | Library Name: CMS1017FHIRHHFI
    define "Encounter Where A Fall And Moderate Injury Occurred Not POA":
      "Encounter With A Fall Not Present On Admission" FallOccurred
        where exists ( ( FallOccurred.claimDiagnosis ( ) ) ModerateFallOccurred
            where ( ModerateFallOccurred.onAdmission is null
                or ModerateFallOccurred.onAdmission in "Not Present On Admission or Documentation Insufficient to Determine"
            )
              and ( ModerateFallOccurred.diagnosis in "Moderate Injuries"
                  or ModerateFallOccurred.diagnosis.getCondition ( ).code in "Moderate Injuries"
              )
        )
Logic Definition | Library Name: CMS1017FHIRHHFI
    define "Numerator":
      "Encounter Where A Fall And Major Injury Occurred Not POA"
        union "Encounter Where A Fall And Moderate Injury Occurred Not POA"
Logic Definition | Library Name: CMS1017FHIRHHFI
    define "Denominator":
      "Initial Population"
Logic Definition | Library Name: CMS1017FHIRHHFI
    define "Encounter With A Fall Present On Admission":
      "Qualifying Encounter" InpatientEncounter
        where InpatientEncounter.isDiagnosisPresentOnAdmission ( "Inpatient Falls", "Present on Admission or Clinically Undetermined" )
Logic Definition | Library Name: CMS1017FHIRHHFI
    define "Numerator Exclusions":
      "Encounter With A Fall Present On Admission"
Logic Definition | Library Name: CMS1017FHIRHHFI
    define "SDE Ethnicity":
      SDE."SDE Ethnicity"
Logic Definition | Library Name: CMS1017FHIRHHFI
    define "Denominator Exclusions":
      "Encounter With A Fall Present On Admission"
Logic Definition | Library Name: CMS1017FHIRHHFI
    define "Risk Variable Encounter with Stroke Present on Admission":
      "Qualifying Encounter" InpatientEncounter
        where InpatientEncounter.isDiagnosisPresentOnAdmission ( "Stroke", "Present on Admission or Clinically Undetermined" )
Logic Definition | Library Name: CMS1017FHIRHHFI
    define fluent function encountersDiagnosis(Encounter Encounter):
      Encounter.reasonReference EncDiag
        return singleton from ( ( [ConditionEncounterDiagnosis] ConditionED
            union [ConditionProblemsHealthConcerns] ConditionPHC ) Cond
            where EncDiag.references ( Cond.id )
        )
Logic Definition | Library Name: CMS1017FHIRHHFI
    define function "Denominator Observation"(QualifyingEncounter Encounter):
      duration in days of QualifyingEncounter.hospitalizationWithObservation ( )
Logic Definition | Library Name: CMS1017FHIRHHFI
    define fluent function hasDiagnosisNotPresentOnAdmissionOrNull(encounter Encounter, diagnosisValueSet ValueSet):
      exists ( [Claim] C
          where C.status = 'active'
            and C.use = 'claim'
            and exists ( C.item I
                where I.encounter.references ( encounter )
            )
          return C.diagnosis D
            where exists ( C.item I
                where I.encounter.references ( encounter )
                  and D.sequence in I.diagnosisSequence
            )
              and ( D.onAdmission is null
                  or D.onAdmission in "Not Present On Admission or Documentation Insufficient to Determine"
              )
              and D.diagnosis in diagnosisValueSet
      )
Logic Definition | Library Name: CMS1017FHIRHHFI
    define function "Numerator Observation"(QualifyingEncounter Encounter):
      Count("Numerator" FallsEncounter
          where FallsEncounter.period ends during QualifyingEncounter.hospitalizationWithObservation()
      )
Terminology
Code System | Description: Code system MedicationRequestCategory Resource: http://terminology.hl7.org/CodeSystem/medicationrequest-category Canonical URL: `http://terminology.hl7.org/CodeSystem/medicationrequest-category`
Code System | Description: Code system SNOMEDCT Resource: http://snomed.info/sct Canonical URL: `http://snomed.info/sct`
Value Set | Description: Value set Encounter Inpatient Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307`
Value Set | Description: Value set Observation Services Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.143 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.143`
Value Set | Description: Value set Emergency Department Visit Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292`
Value Set | Description: Value set Osteoporosis Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1200.147 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1200.147`
Value Set | Description: Value set Present on Admission or Clinically Undetermined Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1147.197 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1147.197`
Value Set | Description: Value set Coagulation Disorders Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.23 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.23`
Value Set | Description: Value set Antidepressants Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.163 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.163`
Value Set | Description: Value set Not Present On Admission or Documentation Insufficient to Determine Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1147.198 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1147.198`
Value Set | Description: Value set Leukemia or Lymphoma Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.136 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.136`
Value Set | Description: Value set Obesity Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.162 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.162`
Value Set | Description: Value set Peripheral Neuropathy Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.175 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.175`
Value Set | Description: Value set Delirium, Dementia, and Other Psychoses Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.168 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.168`
Value Set | Description: Value set Suicide Attempt Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.130 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.130`
Value Set | Description: Value set Payer Type 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 Liver Disease Moderate to Severe Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.137 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.137`
Value Set | Description: Value set Anticoagulants for All Indications Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.22 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.22`
Value Set | Description: Value set Neurologic Movement and Related Disorders Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.174 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.174`
Value Set | Description: Value set Abnormal Weight Loss Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1258.2 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1258.2`
Value Set | Description: Value set Malnutrition Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1272.1 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1272.1`
Value Set | Description: Value set Depression Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.169 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.169`
Value Set | Description: Value set Epilepsy Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.171 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.171`
Value Set | Description: Value set Diuretics Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.170 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.170`
Value Set | Description: Value set Central Nervous System Depressants Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.134 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.134`
Value Set | Description: Value set Malignant Bone Disease Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.24 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.24`
Value Set | Description: Value set Antihypertensives Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.164 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.164`
Value Set | Description: Value set Opioids Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.120 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.120`
Value Set | Description: Value set Inpatient Falls Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1147.171 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1147.171`
Value Set | Description: Value set Major Injuries Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1147.120 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1147.120`
Value Set | Description: Value set Moderate Injuries Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.205 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.205`
Value Set | Description: Value set Stroke Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.176 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.176`
Direct Reference Code | Display: Community Code: community System: `http://terminology.hl7.org/CodeSystem/medicationrequest-category`
Direct Reference Code | Display: Male (finding) Code: 248153007 System: `http://snomed.info/sct`
Direct Reference Code | Display: Female (finding) Code: 248152002 System: `http://snomed.info/sct`
Dependencies
Dependency | Description: QICore model information Resource: http://hl7.org/fhir/Library/QICore-ModelInfo Canonical URL: `http://hl7.org/fhir/Library/QICore-ModelInfo`
Dependency | Description: Library CQMCommon Resource: https://madie.cms.gov/Library/CQMCommon|4.1.000 Canonical URL: `https://madie.cms.gov/Library/CQMCommon|4.1.000`
Dependency | Description: Library FHIRHelpers Resource: https://madie.cms.gov/Library/FHIRHelpers|4.4.000 Canonical URL: `https://madie.cms.gov/Library/FHIRHelpers|4.4.000`
Dependency | Description: Library QICoreCommon Resource: https://madie.cms.gov/Library/QICoreCommon|4.0.000 Canonical URL: `https://madie.cms.gov/Library/QICoreCommon|4.0.000`
Dependency | Description: Library CMD Resource: https://madie.cms.gov/Library/CumulativeMedicationDuration|6.0.000 Canonical URL: `https://madie.cms.gov/Library/CumulativeMedicationDuration|6.0.000`
Dependency | Description: Library SDE Resource: https://madie.cms.gov/Library/SupplementalDataElements|5.1.000 Canonical URL: `https://madie.cms.gov/Library/SupplementalDataElements|5.1.000`
Data Requirements
Data Requirement | Type: Encounter Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter Must Support Elements: type, status, status.value, period, onAdmission, diagnosis, diagnosis.code Code Filter(s): Path: type ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.143
Data Requirement | Type: Encounter Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter Must Support Elements: type, status, status.value, period, onAdmission, diagnosis, diagnosis.code Code Filter(s): Path: type ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292
Data Requirement | Type: Encounter Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter Must Support Elements: type, status, status.value, period, onAdmission, diagnosis, diagnosis.code, id, id.value, reasonCode Code Filter(s): Path: type ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307
Data Requirement | Type: Patient Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient Must Support Elements: id, id.value, url, extension
Data Requirement | Type: Resource Profile(s): http://hl7.org/fhir/StructureDefinition/Resource Must Support Elements: id, id.value
Data Requirement | Type: Claim Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-claim Must Support Elements: status, status.value, use, use.value, item, diagnosis
Data Requirement | Type: Condition Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis
Data Requirement | Type: Condition Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns
Data Requirement | Type: MedicationRequest Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest Must Support Elements: medication, dosageInstruction, dispenseRequest, dispenseRequest.expectedSupplyDuration, dispenseRequest.quantity, dispenseRequest.numberOfRepeatsAllowed, dispenseRequest.numberOfRepeatsAllowed.value, authoredOn, authoredOn.value, dispenseRequest.validityPeriod, status, status.value, intent, intent.value, subject, subject.reference, subject.reference.value Code Filter(s): Path: medication ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.163
Data Requirement | Type: MedicationRequest Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest Must Support Elements: medication, dosageInstruction, dispenseRequest, dispenseRequest.expectedSupplyDuration, dispenseRequest.quantity, dispenseRequest.numberOfRepeatsAllowed, dispenseRequest.numberOfRepeatsAllowed.value, authoredOn, authoredOn.value, dispenseRequest.validityPeriod, status, status.value, intent, intent.value, subject, subject.reference, subject.reference.value Code Filter(s): Path: medication ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.22
Data Requirement | Type: MedicationRequest Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest Must Support Elements: medication, dosageInstruction, dispenseRequest, dispenseRequest.expectedSupplyDuration, dispenseRequest.quantity, dispenseRequest.numberOfRepeatsAllowed, dispenseRequest.numberOfRepeatsAllowed.value, authoredOn, authoredOn.value, dispenseRequest.validityPeriod, status, status.value, intent, intent.value, subject, subject.reference, subject.reference.value Code Filter(s): Path: medication ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.170
Data Requirement | Type: MedicationRequest Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest Must Support Elements: medication, dosageInstruction, dispenseRequest, dispenseRequest.expectedSupplyDuration, dispenseRequest.quantity, dispenseRequest.numberOfRepeatsAllowed, dispenseRequest.numberOfRepeatsAllowed.value, authoredOn, authoredOn.value, dispenseRequest.validityPeriod, status, status.value, intent, intent.value, subject, subject.reference, subject.reference.value Code Filter(s): Path: medication ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.134
Data Requirement | Type: MedicationRequest Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest Must Support Elements: medication, dosageInstruction, dispenseRequest, dispenseRequest.expectedSupplyDuration, dispenseRequest.quantity, dispenseRequest.numberOfRepeatsAllowed, dispenseRequest.numberOfRepeatsAllowed.value, authoredOn, authoredOn.value, dispenseRequest.validityPeriod, status, status.value, intent, intent.value, subject, subject.reference, subject.reference.value Code Filter(s): Path: medication ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.164
Data Requirement | Type: MedicationRequest Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest Must Support Elements: medication, dosageInstruction, dispenseRequest, dispenseRequest.expectedSupplyDuration, dispenseRequest.quantity, dispenseRequest.numberOfRepeatsAllowed, dispenseRequest.numberOfRepeatsAllowed.value, authoredOn, authoredOn.value, dispenseRequest.validityPeriod, status, status.value, intent, intent.value, subject, subject.reference, subject.reference.value Code Filter(s): Path: medication ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.120
Data Requirement | Type: MedicationRequest Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest Must Support Elements: medication.reference.value, dosageInstruction, dispenseRequest, dispenseRequest.expectedSupplyDuration, dispenseRequest.quantity, dispenseRequest.numberOfRepeatsAllowed, dispenseRequest.numberOfRepeatsAllowed.value, authoredOn, authoredOn.value, dispenseRequest.validityPeriod, status, status.value, intent, intent.value, subject, subject.reference, subject.reference.value
Data Requirement | Type: Medication Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medication Must Support Elements: id.value, code
Data Requirement | Type: Coverage Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-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
Data Requirement | Type: MedicationAdministration Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationadministration Must Support Elements: medication, effective, status, status.value Code Filter(s): Path: medication ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.22
Data Requirement | Type: MedicationAdministration Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationadministration Must Support Elements: medication.reference.value, effective, status, status.value
Data Requirement | Type: Observation Profile(s): http://hl7.org/fhir/us/core/StructureDefinition/us-core-bmi Must Support Elements: effective, value, status, status.value
Data Requirement | Type: AdverseEvent Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-adverseevent Must Support Elements: event, date, date.value, recordedDate, recordedDate.value Code Filter(s): Path: event ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1147.171
Generated using version 0.4.8 of the sample-content-ig Liquid templates