Metadata
Title | Intensive Care Unit Venous Thromboembolism ProphylaxisFHIR
Version | 1.0.000
Short Name | CMS190FHIR
GUID (Version Independent) | urn:uuid:693f0836-228e-43cc-ac71-53388e5dc010
GUID (Version Specific) | urn:uuid:b7f93612-84e8-4641-b092-3986da8bb608
CMS Identifier | 190FHIR
Effective Period | 2026-01-01 through 2026-12-31
Steward (Publisher) | The Joint Commission
Developer | The Joint Commission
Description | This measure assesses the number of patients who received Venous Thromboembolism (VTE) prophylaxis on the day of or the day after the initial admission (or transfer) to the Intensive Care Unit (ICU) or on the day of or the day after surgery end date for surgeries that end the day after ICU admission (or transfer) or have documentation why no VTE prophylaxis was given between the day of arrival and the day after ICU admission (for patients directly admitted as inpatients to the ICU) or on the day of or the day after surgery end date for surgeries that end the day after ICU admission (or transfer)
Copyright | Measure specifications are in the Public Domain. 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 | These performance measures are not clinical guidelines, do not establish a standard of medical care, and have not been tested for all potential applications. The measures and specifications are provided without warranty.
Rationale | Venous Thromboembolism (VTE) is a known complication of hospitalization, frequently extending the length of stay and increasing hospital mortality (Maynard, 2016). Approximately 20% of VTE are associated with a surgical procedure (Henke et al., 2020). Almost all hospitalized patients have at least one risk factor for VTE, and approximately 40% have three or more risk factors. Without thromboprophylaxis, the incidence of objectively confirmed, hospital-acquired deep-vein thrombosis (DVT) is approximately 10% to 40% among medical or general surgical patients and 40% to 60% following major orthopedic surgery (Geerts et al., 2008). Commonly, criteria for admission to the Intensive Care Unit (ICU) itself puts patients at an increased risk for developing VTE and subsequent increased risk of morbidity from pulmonary embolism (PE). Some risk factors are related to the acute illness present that allowed for the admission to the ICU unit, and some risk factors may be acquired during the ICU admission due to subsequent medical treatments, for example limitations of mobility, presence of central venous lines or mechanical ventilation and subsequent pharmacological paralysis. Reports of DVT in the population of ICU patients vary in relation to the acuity of the illness in this population. DVT in ICU patients diagnosed with routine venography or Doppler ultrasound found ranges between 10% to 100%. Five studies prospectively screened patients who were not receiving thromboprophylaxis during their ICU stays. The rates of DVT using Fibrinogen Uptake Test, Doppler Ultrasound or venography ranged from 13 to 31% (Geerts et al., 2008). It is essential for all ICUs to assess each patient upon admission to the ICU unit, a change in level of status, for the need for VTE prophylaxis due to the above increased development of risk factors (Geerts et al., 2004). American Society of Hematology (ASH) 2018 VTE prophylaxis guidelines strongly recommend pharmacological prophylaxis using unfractionated heparin (UFH), low molecular weight heparin (LMWH) or fondaparinux for acutely and critically ill hospitalized medical patients, unless contraindicated. The use of mechanical prophylaxis is an acceptable alternative for patients with increased risk of bleeding and preferred over no prophylaxis. ASH 2019 guidelines for surgical patients similarly recommend pharmacological or mechanical prophylaxis over no VTE prophylaxis. (NOTE: Some select surgeries have previously been monitored in the Surgical Care Improvement Project; since performance on these surgeries has achieved very high levels, they are not included in this measure.)
Clinical Recommendation Statement | Failure to recognize and protect patients at risk for venous thromboembolism (VTE) increases the chances for critically ill hospitalized patients for developing a deep vein thrombosis or dying from a pulmonary embolism. Screening all patients is the only evidence based practice in reducing incidence of disease. All intensive care unit (ICU) patients should be evaluated for primary VTE prophylaxis, and given appropriate prophylaxis when indicated.
Citation | Anderson, D. R., Morgano, G. P., Bennett, C., Dentali, F., Francis, C. W., Garcia, D. A., . . . Dahm, P. (2019). American Society of Hematology 2019 guidelines for management of venous thromboembolism: Prevention of venous thromboembolism in surgical hospitalized patients. Blood Advances, 3(23), 3898-3944. doi: 10.1182/bloodadvances.2019000975.
Citation | Geerts, W. H., Bergqvist, D., Pineo, G. F., et al. (2008). Prevention of venous thromboembolism: The Eighth ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest, 133, 381S-453S.
Citation | Geerts, W. H., Pineo, G. F., Heit, J. A., et al. (2004). Prevention of venous thromboembolism: The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest, 126(3 Suppl.), 338S-400S.
Citation | Guyatt, G. H., Akl, E. A., Crowther, M., et al. (2012). Antithrombotic therapy and prevention of thrombosis, 9th edition: American College of Chest Physicians evidence-based clinical practice guidelines. Chest, 141(2 Suppl.), 7S-47S.
Citation | Kearon, C., Akl, E. A., Comerota, A. J., et al. (2012, February). Antithrombotic therapy for VTE disease: Antithrombotic therapy and prevention of thrombosis, 9th edition: American College of Chest Physicians evidence-based clinical practice guidelines. Chest, 141(2 Suppl.), e419S-e494S.
Citation | Shojania, K. G., Duncan, B. W., McDonald, D. M., et al. (eds.). (2001). Making health care safer: A critical analysis of patient safety practices. Evidence Report/Technology Assessment No. 43. Rockville, MD: Agency for Healthcare Research and Quality.
Guidance (Usage) | The definition of an ICU for the purpose of the measures noted above is that used by the CDC in the NHSN Patient Safety Project (CDC, 2022). An intensive care unit can be defined as a nursing care area that provides intensive observation, diagnosis, and therapeutic procedures for adults and/or children who are critically ill. An ICU excludes nursing areas that provide step-down, intermediate care or telemetry only and specialty care areas. Reasons for no pharmacological and no mechanical VTE prophylaxis must be explicitly documented by the medical doctor, advanced practice registered nurse, physician assistant, or pharmacist and linked with VTE prophylaxis. The only exception is patient refusal may be documented by a nurse. Ambulation alone is not a sufficient reason for not administering VTE prophylaxis. In order for ambulation/patient ambulating to be considered as an acceptable reason, there needs to be explicit documentation, e.g., "patient out of bed and ambulating in halls - no VTE prophylaxis needed." This measure does not require the use of a specific risk assessment model or tool (e.g., Caprini, Padua, and IMPROVE) to determine VTE risk. The denominator population includes patients with inpatient hospitalizations and patients from Acute Hospital Care at Home programs, who are treated and billed as inpatients but receive care in their home. Inpatient hospitalizations for patients with a principal procedure of selected surgeries are excluded from the measure's denominator. Selected surgeries include general surgery, gynecological surgery, hip fracture surgery, hip/knee replacement surgery, intracranial neurosurgery, and urological surgery. Inpatient hospitalizations for patients administered apixaban or edoxaban, medications included in the "Oral Factor Xa Inhibitor for VTE Prophylaxis or VTE Treatment" value set, would be counted in the numerator population only when the patients also have either a prior or present diagnosis of atrial fibrillation, a prior diagnosis of VTE, or a prior or present procedure of hip/knee replacement surgery. 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: CMS190v14. 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#proportion: 'Proportion']
Type | [http://terminology.hl7.org/CodeSystem/measure-type#process: 'Process']
Rate Aggregation | None
Improvement Notation | [http://terminology.hl7.org/CodeSystem/measure-improvement-notation#increase: 'Increased score indicates improvement']
Initial Population | ID: InitialPopulation_1 Description: Inpatient hospitalizations for patients age 18 and older, discharged from hospital inpatient acute care without a diagnosis of venous thromboembolism (VTE) or obstetrics that ends during the measurement period Logic Definition: Initial Population
Denominator | ID: Denominator_1 Description: Inpatient hospitalizations for patients directly admitted or transferred to ICU during the hospitalization Logic Definition: Denominator
Denominator Exclusion | ID: DenominatorExclusion_1 Description: - Inpatient hospitalizations for patients who have a hospital length of stay (LOS) less than 2 days - Inpatient hospitalizations for patients with a principal procedure of selected surgeries that end the day of or the day after ICU admission or transfer - Inpatient hospitalizations for patients with comfort measures documented anytime between the day of arrival and the day after ICU admission or transfer - Inpatient hospitalizations for patients with comfort measures documented by the day after surgery end date for surgeries that end the day after ICU admission or transfer Logic Definition: Denominator Exclusions
Numerator | ID: Numerator_1 Description: Inpatient hospitalizations for patients who received VTE prophylaxis: - the day of or the day after ICU admission (or transfer) - the day of or the day after surgery end date (for surgeries that end the day after ICU admission or transfer) Inpatient hospitalizations for patients who have documentation of a reason why no VTE prophylaxis was given: - between the day of arrival and the day after ICU admission (for patients directly admitted as inpatients to the ICU) - the day of or the day after surgery end date (for surgeries that end the day after ICU admission or transfer) Logic Definition: Numerator
Denominator Exception | ID: DenominatorException_1 Description: Inpatient hospitalizations for patients with ICU LOS less than one day Logic Definition: Denominator Exceptions
Supplemental Data Guidance | For every patient evaluated by this measure also identify payer, race, ethnicity and sex
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
Measure Logic
Primary Library | https://madie.cms.gov/Library/CMS190FHIRVTEProphylaxisICU
Contents | Population Criteria Logic Definitions Terminology Dependencies Data Requirements
Population Criteria
Measure Group (Rate) (ID: Group_1)
Initial Population
    define "Initial Population":
      VTE."Encounter With Age Range And Without VTE Diagnosis Or Obstetrical Conditions"
Denominator
    define "Denominator":
      "Encounter With ICU Location"
Denominator Exclusion
    define "Denominator Exclusions":
      "Encounter With ICU Location And Encounter Less Than 2 Days"
        union "Encounter With First ICU Stay With Principal Procedure Of Selected Surgery"
        union "Encounter With Intervention Comfort Measures From Day Of Start Of Hospitalization To Day After First ICU Stay"
        union "Encounter With Intervention Comfort Measures On Day Of Or Day After Procedure"
Numerator
    define "Numerator":
      "Encounter With VTE Prophylaxis Received On Day Of Or Day After First ICU Stay Or Procedure"
        union ( "Encounter With Medication Oral Factor Xa Inhibitor Administered On Day Of Or Day After First ICU Stay Or Procedure"
            intersect ( "Encounter With Prior Or Present Diagnosis Of Atrial Fibrillation Or Prior Diagnosis Of VTE"
                union "Encounter With Prior Or Present Procedure Of Hip Or Knee Replacement Surgery"
            )
        )
        union "Encounter With Low Risk For VTE Or Anticoagulant Administered"
        union "Encounter With No VTE Prophylaxis Due To Medical Reason"
        union "Encounter With No VTE Prophylaxis Due To Patient Refusal"
Denominator Exception
    define "Denominator Exceptions":
      "Encounter With First ICU Location Stay Less Than 1 Day"
Logic Definitions
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 Payer":
      [Coverage: type in "Payer Type"] Payer
        return {
          code: Payer.type,
          period: Payer.period
        }
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: SupplementalDataElements
    define "SDE Race":
      Patient.race R
        return Tuple {
          codes: R.ombCategory union R.detailed,
          display: R.text
        }
Logic Definition | Library Name: FHIRHelpers
    define function ToString(value uri): 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
    /*
    @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: TJCOverall
    define fluent function calendarDayOfOrDayAfter(StartValue DateTime):
      Interval [date from (StartValue), date from (StartValue) + 1 day]
Logic Definition | Library Name: CMS190FHIRVTEProphylaxisICU
    define "SDE Sex":
      SDE."SDE Sex"
Logic Definition | Library Name: CMS190FHIRVTEProphylaxisICU
    define "Encounter With ICU Location":
      VTE."Encounter With Age Range And Without VTE Diagnosis Or Obstetrical Conditions" QualifyingEncounter
        where exists ( QualifyingEncounter.location Location
            where Location.location.getLocation ( ).type in "Intensive Care Unit"
              and Location.period during QualifyingEncounter.period
        )
Logic Definition | Library Name: CMS190FHIRVTEProphylaxisICU
    define "Pharmacological Or Mechanical VTE Prophylaxis Received":
      ( ["MedicationAdministration": "Low Dose Unfractionated Heparin for VTE Prophylaxis"] VTEMedication
          where VTEMedication.status = 'completed'
            and VTEMedication.dosage.route in "Subcutaneous route"
      )
        union ( ["MedicationAdministration": "Low Molecular Weight Heparin for VTE Prophylaxis"] LMWH
            where LMWH.status = 'completed'
        )
        union ( ["MedicationAdministration": "Injectable Factor Xa Inhibitor for VTE Prophylaxis"] FactorXa
            where FactorXa.status = 'completed'
        )
        union ( ["MedicationAdministration": "Warfarin"] WarfarinAdm
            where WarfarinAdm.status = 'completed'
        )
        union ( ["MedicationAdministration": "Rivaroxaban for VTE Prophylaxis"] Rivaroxaban
            where Rivaroxaban.status = 'completed'
        )
        union ( ( ["Procedure": "Application of Intermittent Pneumatic Compression Devices"]
            union ["Procedure": "Application of Venous Foot Pumps"]
            union ["Procedure": "Application of Graduated Compression Stockings"] ) DeviceApplied
            where DeviceApplied.status = 'completed'
        )
Logic Definition | Library Name: CMS190FHIRVTEProphylaxisICU
    define "Encounter With VTE Prophylaxis Received On Day Of Or Day After First ICU Stay Or Procedure":
      ( "Encounter With ICU Location" QualifyingEncounterICU
          with "Pharmacological Or Mechanical VTE Prophylaxis Received" VTEProphylaxis
            such that start of Coalesce(VTEProphylaxis.effective.toInterval(), VTEProphylaxis.performed.toInterval()) during day of QualifyingEncounterICU.startOfFirstICU ( ).calendarDayOfOrDayAfter ( )
      )
        union ( from
            "Encounter With ICU Location" QualifyingEncounterICU,
            ["Procedure": "General or Neuraxial Anesthesia"] AnesthesiaProcedure,
            "Pharmacological Or Mechanical VTE Prophylaxis Received" VTEProphylaxis
            where AnesthesiaProcedure.status = 'completed'
              and AnesthesiaProcedure.performed.toInterval ( ) ends 1 day after day of QualifyingEncounterICU.startOfFirstICU ( )
              and start of Coalesce(VTEProphylaxis.effective.toInterval(), VTEProphylaxis.performed.toInterval()) during day of ( end of AnesthesiaProcedure.performed.toInterval ( ) ).calendarDayOfOrDayAfter ( )
            return QualifyingEncounterICU
        )
Logic Definition | Library Name: CMS190FHIRVTEProphylaxisICU
    define "Encounter With Medication Oral Factor Xa Inhibitor Administered On Day Of Or Day After First ICU Stay Or Procedure":
      ( "Encounter With ICU Location" QualifyingEncounterICU
          with ["MedicationAdministration": "Oral Factor Xa Inhibitor for VTE Prophylaxis or VTE Treatment"] FactorXaMedication
            such that FactorXaMedication.status = 'completed'
              and FactorXaMedication.effective.toInterval ( ) starts during day of QualifyingEncounterICU.startOfFirstICU ( ).calendarDayOfOrDayAfter ( )
      )
        union ( from
            "Encounter With ICU Location" QualifyingEncounterICU,
            ["Procedure": "General or Neuraxial Anesthesia"] AnesthesiaProcedure,
            ["MedicationAdministration": "Oral Factor Xa Inhibitor for VTE Prophylaxis or VTE Treatment"] FactorXaMedication
            where FactorXaMedication.status = 'completed'
              and AnesthesiaProcedure.status = 'completed'
              and AnesthesiaProcedure.performed.toInterval ( ) ends 1 day after day of QualifyingEncounterICU.startOfFirstICU ( )
              and FactorXaMedication.effective.toInterval ( ) starts during day of ( end of AnesthesiaProcedure.performed.toInterval ( ) ).calendarDayOfOrDayAfter ( )
            return QualifyingEncounterICU
        )
Logic Definition | Library Name: CMS190FHIRVTEProphylaxisICU
    define "Encounter With Prior Or Present Diagnosis Of Atrial Fibrillation Or Prior Diagnosis Of VTE":
      ( "Encounter With ICU Location" QualifyingEncounterICU
          with ["ConditionProblemsHealthConcerns": "Atrial Fibrillation or Flutter"] AtrialFibrillation
            such that AtrialFibrillation.verificationStatus is not null implies ( AtrialFibrillation.verificationStatus !~ QICoreCommon."refuted"
                and AtrialFibrillation.verificationStatus !~ QICoreCommon."entered-in-error"
            )
              and AtrialFibrillation.onset.toInterval ( ) starts on or before end of QualifyingEncounterICU.period
      )
        union ( "Encounter With ICU Location" QualifyingEncounterICU
            where QualifyingEncounterICU.hasEncDiagnosisOf ( "Atrial Fibrillation or Flutter" )
        )
        union ( "Encounter With ICU Location" QualifyingEncounterICU
            with ["ConditionProblemsHealthConcerns": "Venous Thromboembolism"] VTEDiagnosis
              such that ( VTEDiagnosis.clinicalStatus ~ QICoreCommon."inactive"
                  or VTEDiagnosis.clinicalStatus ~ QICoreCommon."remission"
                  or VTEDiagnosis.clinicalStatus ~ QICoreCommon."resolved"
              )
                and VTEDiagnosis.verificationStatus is not null implies ( VTEDiagnosis.verificationStatus !~ QICoreCommon."refuted"
                  and VTEDiagnosis.verificationStatus !~ QICoreCommon."entered-in-error"
              )
                and VTEDiagnosis.onset.toInterval ( ) before start of QualifyingEncounterICU.period
        )
Logic Definition | Library Name: CMS190FHIRVTEProphylaxisICU
    define "Encounter With Prior Or Present Procedure Of Hip Or Knee Replacement Surgery":
      "Encounter With ICU Location" QualifyingEncounterICU
        with ( ["Procedure": "Hip Replacement Surgery"]
          union ["Procedure": "Knee Replacement Surgery"] ) HipKneeProcedure
          such that HipKneeProcedure.status = 'completed'
            and HipKneeProcedure.performed.toInterval ( ) starts on or before end of QualifyingEncounterICU.period
Logic Definition | Library Name: CMS190FHIRVTEProphylaxisICU
    define "Low Risk Indicator For VTE":
      ( ["SimpleObservation": "Risk for venous thromboembolism"] VTERiskAssessment
          where VTERiskAssessment.value as Concept in "Low Risk"
            and VTERiskAssessment.status in { 'final', 'amended', 'corrected' }
          return {
            id: VTERiskAssessment.id,
            LowRiskDatetime: VTERiskAssessment.effective.earliest ( )
          }
      )
        union ( ["LaboratoryResultObservation": "INR"] INRLabTest
            where INRLabTest.value as Quantity > 3.0
              and INRLabTest.status in { 'final', 'amended', 'corrected' }
            return {
              id: INRLabTest.id,
              LowRiskDatetime: INRLabTest.issued
            }
        )
        union ( ( ( ["MedicationAdministration": "Unfractionated Heparin"] UnfractionatedHeparin
              where UnfractionatedHeparin.dosage.route in "Intravenous route"
          )
            union ["MedicationAdministration": "Direct Thrombin Inhibitor"]
            union ["MedicationAdministration": "Glycoprotein IIb IIIa Inhibitors"] ) AnticoagulantMedication
            where AnticoagulantMedication.status = 'completed'
            return {
              id: AnticoagulantMedication.id,
              LowRiskDatetime: start of AnticoagulantMedication.effective.toInterval ( )
            }
        )
Logic Definition | Library Name: CMS190FHIRVTEProphylaxisICU
    define "Low Risk For VTE Or Anticoagulant Administered From Day Of Start Of Hospitalization To Day After First ICU Stay":
      "Encounter With ICU Location" QualifyingEncounterICU
        with "Low Risk Indicator For VTE" LowRiskForVTE
          such that LowRiskForVTE.LowRiskDatetime during day of QualifyingEncounterICU.fromDayOfStartOfHospitalizationToDayAfterFirstICU ( )
Logic Definition | Library Name: CMS190FHIRVTEProphylaxisICU
    define "Low Risk For VTE Or Anticoagulant Administered On Day Of Or Day After Procedure":
      from
        "Encounter With ICU Location" QualifyingEncounterICU,
        ["Procedure": "General or Neuraxial Anesthesia"] AnesthesiaProcedure,
        "Low Risk Indicator For VTE" LowRiskForVTE
        where AnesthesiaProcedure.status = 'completed'
          and AnesthesiaProcedure.performed.toInterval ( ) ends 1 day after day of QualifyingEncounterICU.startOfFirstICU ( )
          and LowRiskForVTE.LowRiskDatetime during day of ( end of AnesthesiaProcedure.performed.toInterval ( ) ).calendarDayOfOrDayAfter ( )
        return QualifyingEncounterICU
Logic Definition | Library Name: CMS190FHIRVTEProphylaxisICU
    define "Encounter With Low Risk For VTE Or Anticoagulant Administered":
      "Low Risk For VTE Or Anticoagulant Administered From Day Of Start Of Hospitalization To Day After First ICU Stay"
        union "Low Risk For VTE Or Anticoagulant Administered On Day Of Or Day After Procedure"
Logic Definition | Library Name: CMS190FHIRVTEProphylaxisICU
    define "No VTE Prophylaxis Medication Administered Or Ordered":
      ( ( [MedicationAdministrationNotDone: "Low Dose Unfractionated Heparin for VTE Prophylaxis"]
          union [MedicationAdministrationNotDone: "Low Molecular Weight Heparin for VTE Prophylaxis"]
          union [MedicationAdministrationNotDone: "Injectable Factor Xa Inhibitor for VTE Prophylaxis"]
          union [MedicationAdministrationNotDone: "Warfarin"]
          union [MedicationAdministrationNotDone: "Rivaroxaban for VTE Prophylaxis"] ) NoMedicationAdm
          return {
            id: NoMedicationAdm.id,
            medicationStatusReason: NoMedicationAdm.statusReason,
            authoredOn: NoMedicationAdm.recorded
          }
      )
        union ( ( ["MedicationNotRequested": "Low Dose Unfractionated Heparin for VTE Prophylaxis"]
            union ["MedicationNotRequested": "Low Molecular Weight Heparin for VTE Prophylaxis"]
            union ["MedicationNotRequested": "Injectable Factor Xa Inhibitor for VTE Prophylaxis"]
            union ["MedicationNotRequested": "Warfarin"]
            union ["MedicationNotRequested": "Rivaroxaban for VTE Prophylaxis"] ) NoMedicationOrder
            where NoMedicationOrder.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }
              and NoMedicationOrder.status in { 'active', 'completed' }
            return {
              id: NoMedicationOrder.id,
              medicationStatusReason: NoMedicationOrder.reasonCode,
              authoredOn: NoMedicationOrder.authoredOn
            }
        )
        union ( from
            ( ["MedicationRequest": "Low Dose Unfractionated Heparin for VTE Prophylaxis"]
              union ["MedicationRequest": "Low Molecular Weight Heparin for VTE Prophylaxis"]
              union ["MedicationRequest": "Injectable Factor Xa Inhibitor for VTE Prophylaxis"]
              union ["MedicationRequest": "Warfarin"]
              union ["MedicationRequest": "Rivaroxaban for VTE Prophylaxis"] ) MedicationOrderReject,
            [TaskRejected] T
            where T.focus.references ( MedicationOrderReject )
              and T.code ~ QICoreCommon."Fulfill"
              and MedicationOrderReject.status = 'active'
            return {
              id: MedicationOrderReject.id,
              medicationStatusReason: { T.statusReason },
              authoredOn: MedicationOrderReject.authoredOn
            }
        )
Logic Definition | Library Name: CMS190FHIRVTEProphylaxisICU
    define "No VTE Prophylaxis Medication Due To Medical Reason From Day Of Start Of Hospitalization To Day After First ICU Stay":
      "Encounter With ICU Location" QualifyingEncounterICU
        with "No VTE Prophylaxis Medication Administered Or Ordered" NoVTEMedication
          such that NoVTEMedication.medicationStatusReason in "Medical Reason For Not Providing Treatment"
            and NoVTEMedication.authoredOn during day of QualifyingEncounterICU.fromDayOfStartOfHospitalizationToDayAfterFirstICU ( )
Logic Definition | Library Name: CMS190FHIRVTEProphylaxisICU
    define "No Mechanical VTE Prophylaxis Performed Or Ordered":
      ( ( [ServiceNotRequested: "Venous foot pumps"]
          union [ServiceNotRequested: "Intermittent pneumatic compression devices"]
          union [ServiceNotRequested: "Graduated compression stockings"] ) DeviceNotOrder
          where DeviceNotOrder.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }
          return {
            id: DeviceNotOrder.id,
            requestStatusReason: DeviceNotOrder.reasonRefused,
            authoredOn: DeviceNotOrder.authoredOn
          }
      )
        union ( from
            ( [ServiceRequest: "Venous foot pumps"]
              union [ServiceRequest: "Intermittent pneumatic compression devices"]
              union [ServiceRequest: "Graduated compression stockings"] ) DeviceOrderReject,
            [TaskRejected] T
            where DeviceOrderReject.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }
              and DeviceOrderReject.status = 'active'
              and T.focus.references ( DeviceOrderReject )
              and T.code ~ QICoreCommon."Fulfill"
            return {
              id: DeviceOrderReject.id,
              requestStatusReason: T.statusReason,
              authoredOn: DeviceOrderReject.authoredOn
            }
        )
        union ( ( [ProcedureNotDone: "Application of Intermittent Pneumatic Compression Devices"]
            union [ProcedureNotDone: "Application of Venous Foot Pumps"]
            union [ProcedureNotDone: "Application of Graduated Compression Stockings"] ) DeviceNotApplied
            let DeviceNotDoneTiming: DeviceNotApplied.recorded
            return {
              id: DeviceNotApplied.id,
              requestStatusReason: DeviceNotApplied.statusReason,
              authoredOn: DeviceNotDoneTiming
            }
        )
Logic Definition | Library Name: CMS190FHIRVTEProphylaxisICU
    define "No Mechanical VTE Prophylaxis Due To Medical Reason From Day Of Start Of Hospitalization To Day After First ICU Stay":
      "Encounter With ICU Location" QualifyingEncounterICU
        with "No Mechanical VTE Prophylaxis Performed Or Ordered" NoVTEDevice
          such that NoVTEDevice.requestStatusReason in "Medical Reason For Not Providing Treatment"
            and NoVTEDevice.authoredOn during day of QualifyingEncounterICU.fromDayOfStartOfHospitalizationToDayAfterFirstICU ( )
Logic Definition | Library Name: CMS190FHIRVTEProphylaxisICU
    define "No VTE Prophylaxis Medication Due To Medical Reason On Day Of Or Day After Procedure":
      from
        "Encounter With ICU Location" QualifyingEncounterICU,
        ["Procedure": "General or Neuraxial Anesthesia"] AnesthesiaProcedure,
        "No VTE Prophylaxis Medication Administered Or Ordered" NoVTEMedication
        where NoVTEMedication.medicationStatusReason in "Medical Reason For Not Providing Treatment"
          and AnesthesiaProcedure.status = 'completed'
          and AnesthesiaProcedure.performed.toInterval ( ) ends 1 day after day of QualifyingEncounterICU.startOfFirstICU ( )
          and NoVTEMedication.authoredOn during day of ( end of AnesthesiaProcedure.performed.toInterval ( ) ).calendarDayOfOrDayAfter ( )
        return QualifyingEncounterICU
Logic Definition | Library Name: CMS190FHIRVTEProphylaxisICU
    define "No Mechanical VTE Prophylaxis Due To Medical Reason On Day Of Or Day After Procedure":
      from
        "Encounter With ICU Location" QualifyingEncounterICU,
        ["Procedure": "General or Neuraxial Anesthesia"] AnesthesiaProcedure,
        "No Mechanical VTE Prophylaxis Performed Or Ordered" NoVTEDevice
        where NoVTEDevice.requestStatusReason in "Medical Reason For Not Providing Treatment"
          and AnesthesiaProcedure.status = 'completed'
          and AnesthesiaProcedure.performed.toInterval ( ) ends 1 day after day of QualifyingEncounterICU.startOfFirstICU ( )
          and NoVTEDevice.authoredOn during day of ( end of AnesthesiaProcedure.performed.toInterval ( ) ).calendarDayOfOrDayAfter ( )
        return QualifyingEncounterICU
Logic Definition | Library Name: CMS190FHIRVTEProphylaxisICU
    define "Encounter With No VTE Prophylaxis Due To Medical Reason":
      ( "No VTE Prophylaxis Medication Due To Medical Reason From Day Of Start Of Hospitalization To Day After First ICU Stay"
          intersect "No Mechanical VTE Prophylaxis Due To Medical Reason From Day Of Start Of Hospitalization To Day After First ICU Stay"
      )
        union ( "No VTE Prophylaxis Medication Due To Medical Reason On Day Of Or Day After Procedure"
            intersect "No Mechanical VTE Prophylaxis Due To Medical Reason On Day Of Or Day After Procedure"
        )
Logic Definition | Library Name: CMS190FHIRVTEProphylaxisICU
    define "No Mechanical or Pharmacological VTE Prophylaxis Due To Patient Refusal":
      ( "No VTE Prophylaxis Medication Administered Or Ordered" NoVTEMedication
          where NoVTEMedication.medicationStatusReason in "Patient Refusal"
      )
        union ( "No Mechanical VTE Prophylaxis Performed Or Ordered" NoVTEDevice
            where NoVTEDevice.requestStatusReason in "Patient Refusal"
        )
Logic Definition | Library Name: CMS190FHIRVTEProphylaxisICU
    define "No VTE Prophylaxis Due To Patient Refusal From Day Of Start Of Hospitalization To Day After First ICU Stay":
      "Encounter With ICU Location" QualifyingEncounterICU
        with "No Mechanical or Pharmacological VTE Prophylaxis Due To Patient Refusal" PatientRefusal
          such that PatientRefusal.authoredOn during day of QualifyingEncounterICU.fromDayOfStartOfHospitalizationToDayAfterFirstICU ( )
Logic Definition | Library Name: CMS190FHIRVTEProphylaxisICU
    define "No VTE Prophylaxis Due To Patient Refusal On Day Of Or Day After Procedure":
      from
        "Encounter With ICU Location" QualifyingEncounterICU,
        ["Procedure": "General or Neuraxial Anesthesia"] AnesthesiaProcedure,
        "No Mechanical or Pharmacological VTE Prophylaxis Due To Patient Refusal" PatientRefusal
        where AnesthesiaProcedure.status = 'completed'
          and AnesthesiaProcedure.performed.toInterval ( ) ends 1 day after day of QualifyingEncounterICU.startOfFirstICU ( )
          and PatientRefusal.authoredOn during day of ( end of AnesthesiaProcedure.performed.toInterval ( ) ).calendarDayOfOrDayAfter ( )
        return QualifyingEncounterICU
Logic Definition | Library Name: CMS190FHIRVTEProphylaxisICU
    define "Encounter With No VTE Prophylaxis Due To Patient Refusal":
      "No VTE Prophylaxis Due To Patient Refusal From Day Of Start Of Hospitalization To Day After First ICU Stay"
        union "No VTE Prophylaxis Due To Patient Refusal On Day Of Or Day After Procedure"
Logic Definition | Library Name: CMS190FHIRVTEProphylaxisICU
    define "Numerator":
      "Encounter With VTE Prophylaxis Received On Day Of Or Day After First ICU Stay Or Procedure"
        union ( "Encounter With Medication Oral Factor Xa Inhibitor Administered On Day Of Or Day After First ICU Stay Or Procedure"
            intersect ( "Encounter With Prior Or Present Diagnosis Of Atrial Fibrillation Or Prior Diagnosis Of VTE"
                union "Encounter With Prior Or Present Procedure Of Hip Or Knee Replacement Surgery"
            )
        )
        union "Encounter With Low Risk For VTE Or Anticoagulant Administered"
        union "Encounter With No VTE Prophylaxis Due To Medical Reason"
        union "Encounter With No VTE Prophylaxis Due To Patient Refusal"
Logic Definition | Library Name: CMS190FHIRVTEProphylaxisICU
    define "Denominator":
      "Encounter With ICU Location"
Logic Definition | Library Name: CMS190FHIRVTEProphylaxisICU
    define "SDE Payer":
      SDE."SDE Payer"
Logic Definition | Library Name: CMS190FHIRVTEProphylaxisICU
    define "Initial Population":
      VTE."Encounter With Age Range And Without VTE Diagnosis Or Obstetrical Conditions"
Logic Definition | Library Name: CMS190FHIRVTEProphylaxisICU
    define "SDE Ethnicity":
      SDE."SDE Ethnicity"
Logic Definition | Library Name: CMS190FHIRVTEProphylaxisICU
    define "Encounter With ICU Location And Encounter Less Than 2 Days":
      "Encounter With ICU Location" QualifyingEncounterICU
        where QualifyingEncounterICU.period.lengthInDays ( ) < 2
Logic Definition | Library Name: CMS190FHIRVTEProphylaxisICU
    define "Encounter With First ICU Stay With Principal Procedure Of Selected Surgery":
      "Encounter With ICU Location" QualifyingEncounterICU
        where QualifyingEncounterICU.hasPrincipalProcedureOf ( "General Surgery" )
          or QualifyingEncounterICU.hasPrincipalProcedureOf ( "Gynecological Surgery" )
          or QualifyingEncounterICU.hasPrincipalProcedureOf ( "Hip Fracture Surgery" )
          or QualifyingEncounterICU.hasPrincipalProcedureOf ( "Hip Replacement Surgery" )
          or QualifyingEncounterICU.hasPrincipalProcedureOf ( "Intracranial Neurosurgery" )
          or QualifyingEncounterICU.hasPrincipalProcedureOf ( "Knee Replacement Surgery" )
          or QualifyingEncounterICU.hasPrincipalProcedureOf ( "Urological Surgery" )
Logic Definition | Library Name: CMS190FHIRVTEProphylaxisICU
    define "Intervention Comfort Measures":
      ( ["ServiceRequest": "Comfort Measures"] InterventionRequest
          where InterventionRequest.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }
            and InterventionRequest.status in { 'active', 'completed' }
      )
        union ( ["Procedure": "Comfort Measures"] InterventionPerformed
            where InterventionPerformed.status in { 'completed', 'in-progress' }
        )
Logic Definition | Library Name: CMS190FHIRVTEProphylaxisICU
    define "Encounter With Intervention Comfort Measures From Day Of Start Of Hospitalization To Day After First ICU Stay":
      "Encounter With ICU Location" QualifyingEncounterICU
        with "Intervention Comfort Measures" ComfortMeasure
          such that Coalesce(start of ComfortMeasure.performed.toInterval(), ComfortMeasure.authoredOn) during day of QualifyingEncounterICU.fromDayOfStartOfHospitalizationToDayAfterFirstICU ( )
Logic Definition | Library Name: CMS190FHIRVTEProphylaxisICU
    define "Encounter With Intervention Comfort Measures On Day Of Or Day After Procedure":
      from
        "Encounter With ICU Location" QualifyingEncounterICU,
        ["Procedure": "General or Neuraxial Anesthesia"] AnesthesiaProcedure,
        "Intervention Comfort Measures" ComfortMeasure
        where AnesthesiaProcedure.status = 'completed'
          and AnesthesiaProcedure.performed.toInterval ( ) ends 1 day after day of QualifyingEncounterICU.startOfFirstICU ( )
          and Coalesce(start of ComfortMeasure.performed.toInterval(), ComfortMeasure.authoredOn) during day of ( end of AnesthesiaProcedure.performed.toInterval ( ) ).calendarDayOfOrDayAfter ( )
        return QualifyingEncounterICU
Logic Definition | Library Name: CMS190FHIRVTEProphylaxisICU
    define "Denominator Exclusions":
      "Encounter With ICU Location And Encounter Less Than 2 Days"
        union "Encounter With First ICU Stay With Principal Procedure Of Selected Surgery"
        union "Encounter With Intervention Comfort Measures From Day Of Start Of Hospitalization To Day After First ICU Stay"
        union "Encounter With Intervention Comfort Measures On Day Of Or Day After Procedure"
Logic Definition | Library Name: CMS190FHIRVTEProphylaxisICU
    define "SDE Race":
      SDE."SDE Race"
Logic Definition | Library Name: CMS190FHIRVTEProphylaxisICU
    define "Encounter With First ICU Location Stay Less Than 1 Day":
      "Encounter With ICU Location" QualifyingEncounterICU
        where QualifyingEncounterICU.firstInpatientIntensiveCareUnit ( ).period.lengthInDays ( ) < 1
Logic Definition | Library Name: CMS190FHIRVTEProphylaxisICU
    define "Denominator Exceptions":
      "Encounter With First ICU Location Stay Less Than 1 Day"
Logic Definition | Library Name: CMS190FHIRVTEProphylaxisICU
    define fluent function "startOfFirstICU"(Encounter Encounter):
      start of Encounter.firstInpatientIntensiveCareUnit ( ).period
Logic Definition | Library Name: CMS190FHIRVTEProphylaxisICU
    define fluent function "fromDayOfStartOfHospitalizationToDayAfterFirstICU"(Encounter Encounter):
      Interval[date from ( start of Encounter.hospitalizationWithObservation ( ) ), date from ( Encounter.startOfFirstICU ( ) ) + 1 day]
Logic Definition | Library Name: VTE
    define "Admission Without VTE Or Obstetrical Conditions":
      CQMCommon."Inpatient Encounter" InpatientEncounter
      where not (InpatientEncounter.hasEncDiagnosisOf("Obstetrical or Pregnancy Related Conditions")
                 or InpatientEncounter.hasEncDiagnosisOf("Venous Thromboembolism")
                 or InpatientEncounter.hasEncDiagnosisOf("Obstetrics VTE")
                )
Logic Definition | Library Name: VTE
    define "Encounter With Age Range And Without VTE Diagnosis Or Obstetrical Conditions":
     "Admission Without VTE Or Obstetrical Conditions" EncounterWithoutConditions
         where AgeInYearsAt(date from start of EncounterWithoutConditions.period) >= 18
Logic Definition | Library Name: VTE
    define fluent function hasEncDiagnosisOf(TheEncounter Encounter, DiagnosisValueSet ValueSet):
       TheEncounter E
         return (E.encounterDiagnosis()).code in DiagnosisValueSet
           or E.reasonCode in DiagnosisValueSet
Logic Definition | Library Name: VTE
    define fluent function hasPrincipalProcedureOf(TheEncounter Encounter, DiagnosisValueSet ValueSet):
       TheEncounter E
       let
            PPx: E.principalProcedure(),
            CPx: singleton from ([Procedure] P where PPx.procedure.references(P.id))
         return PPx.procedure in DiagnosisValueSet
           or CPx.code in DiagnosisValueSet
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: Returns the Condition resources referenced by the diagnosis element of the Encounter
    */
    define fluent function encounterDiagnosis(Encounter Encounter ):
      Encounter.reasonReference D
        return singleton from (([ConditionEncounterDiagnosis] union [ConditionProblemsHealthConcerns]) C where D.references(C.id))
Logic Definition | Library Name: CQMCommon
    /*
    @description: Returns the Location resource specified by the given reference.
    */
    define fluent function getLocation(reference Reference):
      singleton from (
        [Location] L where reference.references(L)
      )
Logic Definition | Library Name: CQMCommon
    /*
    @description: First Inpatient Intensive Care Unit returns the first intensive care unit for the given encounter, without considering any immediately prior emergency department visit.
    */
    define fluent function firstInpatientIntensiveCareUnit(Encounter Encounter ):
      First((Encounter.location)HospitalLocation
      			where GetLocation(HospitalLocation.location).type in "Intensive Care Unit"
      				and HospitalLocation.period during Encounter.period
      			sort by start of period
      	)
Logic Definition | Library Name: CQMCommon
    /*
    @description: Returns the Location resource specified by the given reference
    @deprecated: This function is deprecated. Use the fluent function `getLocation()` instead.
    */
    define function "GetLocation"(reference Reference):
      singleton from (
        [Location] L where reference.references(L)
      )
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: 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: Returns the claim procedure elements for the given encounter
    */
    define fluent function principalProcedure(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),
            princProcedure: singleton from (claim.procedure P where P.sequence in claimItem.procedureSequence and P.type.includesCode("Primary procedure"))
        return princProcedure
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 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: Normalizes a value that is a choice of timing-valued types to an equivalent interval
    @comment: Normalizes a choice type of DateTime, Quanitty, Interval<DateTime>, or Interval<Quantity> types
    to an equivalent interval. This selection of choice types is a superset of the majority of choice types that are used as possible
    representations for timing-valued elements in QICore, allowing this function to be used across any resource.
    The input can be provided as a DateTime, Quantity, Interval<DateTime> or Interval<Quantity>.
    The intent of this function is to provide a clear and concise mechanism to treat single
    elements that have multiple possible representations as intervals so that logic doesn't have to account
    for the variability. More complex calculations (such as medication request period or dispense period
    calculation) need specific guidance and consideration. That guidance may make use of this function, but
    the focus of this function is on single element calculations where the semantics are unambiguous.
    If the input is a DateTime, the result a DateTime Interval beginning and ending on that DateTime.
    If the input is a Quantity, the quantity is expected to be a calendar-duration interpreted as an Age,
    and the result is a DateTime Interval beginning on the Date the patient turned that age and ending immediately before one year later.
    If the input is a DateTime Interval, the result is the input.
    If the input is a Quantity Interval, the quantities are expected to be calendar-durations interpreted as an Age, and the result
    is a DateTime Interval beginning on the date the patient turned the age given as the start of the quantity interval, and ending
    immediately before one year later than the date the patient turned the age given as the end of the quantity interval.
    If the input is a Timing, an error will be thrown indicating that Timing calculations are not implemented. Any other input will reslt in a null DateTime Interval
    */
    define fluent function toInterval(choice Choice<DateTime, Quantity, Interval<DateTime>, Interval<Quantity>, Timing>):
      case
    	  when choice is DateTime then
        	Interval[choice as DateTime, choice as DateTime]
    		when choice is Interval<DateTime> then
      		choice as Interval<DateTime>
    		when choice is Quantity then
    		  Interval[Patient.birthDate + (choice as Quantity),
    			  Patient.birthDate + (choice as Quantity) + 1 year)
    		when choice is Interval<Quantity> then
    		  Interval[Patient.birthDate + (choice.low as Quantity),
    			  Patient.birthDate + (choice.high as Quantity) + 1 year)
    		when choice is Timing then
          Message(null, true, 'NOT_IMPLEMENTED', 'Error', 'Calculation of an interval from a Timing value is not supported') as Interval<DateTime>
    		else
    			null as Interval<DateTime>
    	end
Logic Definition | Library Name: QICoreCommon
    /*
    @description: Given an interval, return the starting point if the interval has a starting boundary specified,
    otherwise, return the ending point
    */
    define fluent function earliest(choice Choice<DateTime, Quantity, Interval<DateTime>, Interval<Quantity>> ):
      (choice.toInterval()) period
        return
          if (period."hasStart"()) then start of period
          else end of period
Logic Definition | Library Name: QICoreCommon
    /*
    @description: Given an interval, return true if the interval has a starting boundary specified
    (i.e. the start of the interval is not null and not the minimum DateTime value)
    */
    define fluent function hasStart(period Interval<DateTime> ):
      not ( start of period is null
          or start of period = minimum DateTime
      )
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 code is in the given codeList
    @comment: Returns true if the `code` is equivalent to any of the codes in the given `codeList`, false otherwise.
    */
    define fluent function includesCode(codeList List<Concept>, code Code):
      exists (codeList C where C ~ code)
Terminology
Code System | Description: Code system SNOMEDCT Resource: http://snomed.info/sct Canonical URL: `http://snomed.info/sct`
Code System | Description: Code system ConditionVerificationStatusCodes Resource: http://terminology.hl7.org/CodeSystem/condition-ver-status Canonical URL: `http://terminology.hl7.org/CodeSystem/condition-ver-status`
Code System | Description: Code system ConditionClinicalStatusCodes Resource: http://terminology.hl7.org/CodeSystem/condition-clinical Canonical URL: `http://terminology.hl7.org/CodeSystem/condition-clinical`
Code System | Description: Code system LOINC Resource: http://loinc.org Canonical URL: `http://loinc.org`
Code System | Description: Code system TaskCodeSystem Resource: http://hl7.org/fhir/CodeSystem/task-code Canonical URL: `http://hl7.org/fhir/CodeSystem/task-code`
Code System | Description: Code system Procedure Type Resource: http://terminology.hl7.org/CodeSystem/ex-procedure-type Canonical URL: `http://terminology.hl7.org/CodeSystem/ex-procedure-type`
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 Obstetrical or Pregnancy Related Conditions Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.263 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.263`
Value Set | Description: Value set Venous Thromboembolism Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.279 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.279`
Value Set | Description: Value set Obstetrics VTE Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.264 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.264`
Value Set | Description: Value set Intensive Care Unit Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.206 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1029.206`
Value Set | Description: Value set Low Dose Unfractionated Heparin for VTE Prophylaxis Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.39 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.39`
Value Set | Description: Value set Subcutaneous route Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.223 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.223`
Value Set | Description: Value set Low Molecular Weight Heparin for VTE Prophylaxis Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.219 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.219`
Value Set | Description: Value set Injectable Factor Xa Inhibitor for VTE Prophylaxis Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.211 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.211`
Value Set | Description: Value set Warfarin Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.232 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.232`
Value Set | Description: Value set Rivaroxaban for VTE Prophylaxis Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.50 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.50`
Value Set | Description: Value set Application of Intermittent Pneumatic Compression Devices Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.65 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.65`
Value Set | Description: Value set Application of Venous Foot Pumps Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.64 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.64`
Value Set | Description: Value set Application of Graduated Compression Stockings Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.66 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.66`
Value Set | Description: Value set General or Neuraxial Anesthesia Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.1743 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.1743`
Value Set | Description: Value set Oral Factor Xa Inhibitor for VTE Prophylaxis or VTE Treatment Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.134 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.134`
Value Set | Description: Value set Atrial Fibrillation or Flutter Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.202 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.202`
Value Set | Description: Value set Hip Replacement Surgery Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.259 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.259`
Value Set | Description: Value set Knee Replacement Surgery Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.261 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.261`
Value Set | Description: Value set Low Risk Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.400 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.400`
Value Set | Description: Value set INR Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.213 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.213`
Value Set | Description: Value set Unfractionated Heparin Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.218 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.218`
Value Set | Description: Value set Intravenous route Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.222 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.222`
Value Set | Description: Value set Direct Thrombin Inhibitor Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.205 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.205`
Value Set | Description: Value set Glycoprotein IIb IIIa Inhibitors Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.41 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.41`
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 Medical Reason For Not Providing Treatment Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.473 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.473`
Value Set | Description: Value set Venous foot pumps Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.230 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.230`
Value Set | Description: Value set Intermittent pneumatic compression devices Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.214 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.214`
Value Set | Description: Value set Graduated compression stockings Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.256 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.256`
Value Set | Description: Value set Patient Refusal Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.93 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.93`
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 General Surgery Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.255 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.255`
Value Set | Description: Value set Gynecological Surgery Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.257 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.257`
Value Set | Description: Value set Hip Fracture Surgery Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.258 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.258`
Value Set | Description: Value set Intracranial Neurosurgery Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.260 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.260`
Value Set | Description: Value set Urological Surgery Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.272 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.272`
Value Set | Description: Value set Comfort Measures Resource: http://cts.nlm.nih.gov/fhir/ValueSet/1.3.6.1.4.1.33895.1.3.0.45 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/1.3.6.1.4.1.33895.1.3.0.45`
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`
Direct Reference Code | Display: Refuted Code: refuted System: `http://terminology.hl7.org/CodeSystem/condition-ver-status`
Direct Reference Code | Display: Entered in Error Code: entered-in-error System: `http://terminology.hl7.org/CodeSystem/condition-ver-status`
Direct Reference Code | Display: Inactive Code: inactive System: `http://terminology.hl7.org/CodeSystem/condition-clinical`
Direct Reference Code | Display: Remission Code: remission System: `http://terminology.hl7.org/CodeSystem/condition-clinical`
Direct Reference Code | Display: Resolved Code: resolved System: `http://terminology.hl7.org/CodeSystem/condition-clinical`
Direct Reference Code | Display: Risk for venous thromboembolism Code: 72136-5 System: `http://loinc.org`
Direct Reference Code | Display: Fulfill Code: fulfill System: `http://hl7.org/fhir/CodeSystem/task-code`
Direct Reference Code | Display: Primary procedure Code: primary System: `http://terminology.hl7.org/CodeSystem/ex-procedure-type`
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 SDE Resource: https://madie.cms.gov/Library/SupplementalDataElements|5.1.000 Canonical URL: `https://madie.cms.gov/Library/SupplementalDataElements|5.1.000`
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 VTE Resource: https://madie.cms.gov/Library/VTE|8.18.000 Canonical URL: `https://madie.cms.gov/Library/VTE|8.18.000`
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 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 TJC Resource: https://madie.cms.gov/Library/TJCOverall|8.25.000 Canonical URL: `https://madie.cms.gov/Library/TJCOverall|8.25.000`
Data Requirements
Data Requirement | Type: Patient Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient Must Support Elements: extension, birthDate, birthDate.value, url
Data Requirement | Type: Encounter Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter Must Support Elements: location, reasonCode, period
Data Requirement | Type: Encounter Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter Must Support Elements: type, status, status.value, period, reasonCode 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, reasonCode 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, reasonCode, location 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: 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: Condition Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns Must Support Elements: code, verificationStatus, onset Code Filter(s): Path: code ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.202
Data Requirement | Type: Condition Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns Must Support Elements: code, clinicalStatus, verificationStatus, onset Code Filter(s): Path: code ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.279
Data Requirement | Type: Resource Profile(s): http://hl7.org/fhir/StructureDefinition/Resource Must Support Elements: id, id.value
Data Requirement | Type: Location Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-location
Data Requirement | Type: MedicationAdministration Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationadministration Must Support Elements: medication, status, status.value, dosage, dosage.route, effective, id, id.value Code Filter(s): Path: medication ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.39
Data Requirement | Type: MedicationAdministration Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationadministration Must Support Elements: medication, status, status.value, dosage, dosage.route, effective, id, id.value Code Filter(s): Path: medication ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.219
Data Requirement | Type: MedicationAdministration Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationadministration Must Support Elements: medication, status, status.value, dosage, dosage.route, effective, id, id.value Code Filter(s): Path: medication ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.211
Data Requirement | Type: MedicationAdministration Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationadministration Must Support Elements: medication, status, status.value, dosage, dosage.route, effective, id, id.value Code Filter(s): Path: medication ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.232
Data Requirement | Type: MedicationAdministration Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationadministration Must Support Elements: medication, status, status.value, dosage, dosage.route, effective, id, id.value Code Filter(s): Path: medication ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.50
Data Requirement | Type: MedicationAdministration Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationadministration Must Support Elements: medication, status, status.value, dosage, dosage.route, effective, id, id.value Code Filter(s): Path: medication ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.134
Data Requirement | Type: MedicationAdministration Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationadministration Must Support Elements: medication, status, status.value, dosage, dosage.route, effective, id, id.value Code Filter(s): Path: medication ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.218
Data Requirement | Type: MedicationAdministration Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationadministration Must Support Elements: medication, status, status.value, dosage, dosage.route, effective, id, id.value Code Filter(s): Path: medication ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.205
Data Requirement | Type: MedicationAdministration Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationadministration Must Support Elements: medication, status, status.value, dosage, dosage.route, effective, id, id.value Code Filter(s): Path: medication ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.41
Data Requirement | Type: MedicationAdministration Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationadministration Must Support Elements: medication.reference.value, status, status.value, dosage, dosage.route, effective, id, id.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: Procedure Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure Must Support Elements: code, status, status.value, performed Code Filter(s): Path: code ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.65
Data Requirement | Type: Procedure Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure Must Support Elements: code, status, status.value, performed Code Filter(s): Path: code ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.64
Data Requirement | Type: Procedure Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure Must Support Elements: code, status, status.value, performed Code Filter(s): Path: code ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.66
Data Requirement | Type: Procedure Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure Must Support Elements: code, status, status.value, performed Code Filter(s): Path: code ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.259
Data Requirement | Type: Procedure Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure Must Support Elements: code, status, status.value, performed Code Filter(s): Path: code ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.261
Data Requirement | Type: Procedure Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure Must Support Elements: id, id.value, status, status.value, performed, code
Data Requirement | Type: Procedure Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure Must Support Elements: code, status, status.value, performed Code Filter(s): Path: code ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/1.3.6.1.4.1.33895.1.3.0.45
Data Requirement | Type: Procedure Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure Must Support Elements: code, status, status.value, performed Code Filter(s): Path: code ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.1743
Data Requirement | Type: Observation Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-simple-observation Must Support Elements: code, value, status, status.value, id, id.value, effective Code Filter(s): Path: code Code(s): http://loinc.org#72136-5: 'Risk for venous thromboembolism'
Data Requirement | Type: Observation Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation-lab Must Support Elements: code, value, status, status.value, id, id.value, issued, issued.value Code Filter(s): Path: code ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.213
Data Requirement | Type: MedicationAdministration Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationadministrationnotdone Must Support Elements: medication, id, id.value, statusReason, extension Code Filter(s): Path: medication ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.39
Data Requirement | Type: MedicationAdministration Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationadministrationnotdone Must Support Elements: medication, id, id.value, statusReason, extension Code Filter(s): Path: medication ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.219
Data Requirement | Type: MedicationAdministration Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationadministrationnotdone Must Support Elements: medication, id, id.value, statusReason, extension Code Filter(s): Path: medication ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.211
Data Requirement | Type: MedicationAdministration Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationadministrationnotdone Must Support Elements: medication, id, id.value, statusReason, extension Code Filter(s): Path: medication ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.232
Data Requirement | Type: MedicationAdministration Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationadministrationnotdone Must Support Elements: medication, id, id.value, statusReason, extension Code Filter(s): Path: medication ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.50
Data Requirement | Type: MedicationRequest Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationnotrequested Must Support Elements: medication, intent, intent.value, status, status.value, id, id.value, reasonCode, authoredOn, authoredOn.value Code Filter(s): Path: medication ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.39
Data Requirement | Type: MedicationRequest Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationnotrequested Must Support Elements: medication, intent, intent.value, status, status.value, id, id.value, reasonCode, authoredOn, authoredOn.value Code Filter(s): Path: medication ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.219
Data Requirement | Type: MedicationRequest Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationnotrequested Must Support Elements: medication, intent, intent.value, status, status.value, id, id.value, reasonCode, authoredOn, authoredOn.value Code Filter(s): Path: medication ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.211
Data Requirement | Type: MedicationRequest Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationnotrequested Must Support Elements: medication, intent, intent.value, status, status.value, id, id.value, reasonCode, authoredOn, authoredOn.value Code Filter(s): Path: medication ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.232
Data Requirement | Type: MedicationRequest Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationnotrequested Must Support Elements: medication, intent, intent.value, status, status.value, id, id.value, reasonCode, authoredOn, authoredOn.value Code Filter(s): Path: medication ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.50
Data Requirement | Type: MedicationRequest Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest Must Support Elements: medication, status, status.value, id, id.value, authoredOn, authoredOn.value Code Filter(s): Path: medication ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.39
Data Requirement | Type: MedicationRequest Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest Must Support Elements: medication, status, status.value, id, id.value, authoredOn, authoredOn.value Code Filter(s): Path: medication ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.219
Data Requirement | Type: MedicationRequest Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest Must Support Elements: medication, status, status.value, id, id.value, authoredOn, authoredOn.value Code Filter(s): Path: medication ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.211
Data Requirement | Type: MedicationRequest Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest Must Support Elements: medication, status, status.value, id, id.value, authoredOn, authoredOn.value Code Filter(s): Path: medication ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.232
Data Requirement | Type: MedicationRequest Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest Must Support Elements: medication, status, status.value, id, id.value, authoredOn, authoredOn.value Code Filter(s): Path: medication ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.50
Data Requirement | Type: MedicationRequest Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest Must Support Elements: medication.reference.value, status, status.value, id, id.value, authoredOn, authoredOn.value
Data Requirement | Type: Task Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-taskrejected Must Support Elements: focus, code, statusReason
Data Requirement | Type: ServiceRequest Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicenotrequested Must Support Elements: code, intent, intent.value, id, id.value, extension, authoredOn, authoredOn.value Code Filter(s): Path: code ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.230
Data Requirement | Type: ServiceRequest Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicenotrequested Must Support Elements: code, intent, intent.value, id, id.value, extension, authoredOn, authoredOn.value Code Filter(s): Path: code ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.214
Data Requirement | Type: ServiceRequest Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicenotrequested Must Support Elements: code, intent, intent.value, id, id.value, extension, authoredOn, authoredOn.value Code Filter(s): Path: code ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.256
Data Requirement | Type: ServiceRequest Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest Must Support Elements: code, intent, intent.value, status, status.value, id, id.value, authoredOn, authoredOn.value Code Filter(s): Path: code ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.230
Data Requirement | Type: ServiceRequest Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest Must Support Elements: code, intent, intent.value, status, status.value, id, id.value, authoredOn, authoredOn.value Code Filter(s): Path: code ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.214
Data Requirement | Type: ServiceRequest Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest Must Support Elements: code, intent, intent.value, status, status.value, id, id.value, authoredOn, authoredOn.value Code Filter(s): Path: code ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.256
Data Requirement | Type: ServiceRequest Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest Must Support Elements: code, intent, intent.value, status, status.value, id, id.value, authoredOn, authoredOn.value Code Filter(s): Path: code ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/1.3.6.1.4.1.33895.1.3.0.45
Data Requirement | Type: Procedure Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedurenotdone Must Support Elements: code, extension, id, id.value, statusReason Code Filter(s): Path: code ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.65
Data Requirement | Type: Procedure Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedurenotdone Must Support Elements: code, extension, id, id.value, statusReason Code Filter(s): Path: code ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.64
Data Requirement | Type: Procedure Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedurenotdone Must Support Elements: code, extension, id, id.value, statusReason Code Filter(s): Path: code ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.66
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: Claim Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-claim Must Support Elements: status, status.value, use, use.value, item
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