1 library PRS_HEDIS_2020 version '1.4.000'
2 
3 using QDM version '5.5'
4 
5 include NCQA_Common version '5.1.000' called Common
6 
7 codesystem "SNOMEDCT": 'urn:oid:2.16.840.1.113883.6.96' 
8 
9 valueset "37 Weeks Gestation": 'urn:oid:2.16.840.1.113883.3.464.1004.1509' 
10 valueset "38 Weeks Gestation": 'urn:oid:2.16.840.1.113883.3.464.1004.1510' 
11 valueset "39 Weeks Gestation": 'urn:oid:2.16.840.1.113883.3.464.1004.1511' 
12 valueset "40 Weeks Gestation": 'urn:oid:2.16.840.1.113883.3.464.1004.1512' 
13 valueset "41 Weeks Gestation": 'urn:oid:2.16.840.1.113883.3.464.1004.1513' 
14 valueset "42 Weeks Gestation": 'urn:oid:2.16.840.1.113883.3.464.1004.1514' 
15 valueset "43 Weeks Gestation": 'urn:oid:2.16.840.1.113883.3.464.1004.1515' 
16 valueset "Adult Influenza Immunization": 'urn:oid:2.16.840.1.113883.3.464.1004.1913' 
17 valueset "Adult Influenza Vaccine Procedure": 'urn:oid:2.16.840.1.113883.3.464.1004.1914' 
18 valueset "Deliveries": 'urn:oid:2.16.840.1.113883.3.464.1004.1072' 
19 valueset "Ethnicity": 'urn:oid:2.16.840.1.114222.4.11.837' 
20 valueset "Hospice Encounter": 'urn:oid:2.16.840.1.113883.3.464.1004.1761' 
21 valueset "Hospice Intervention": 'urn:oid:2.16.840.1.113883.3.464.1004.1762' 
22 valueset "ONC Administrative Sex": 'urn:oid:2.16.840.1.113762.1.4.1' 
23 valueset "Payer": 'urn:oid:2.16.840.1.114222.4.11.3591' 
24 valueset "Race": 'urn:oid:2.16.840.1.114222.4.11.836' 
25 valueset "Tdap Immunization": 'urn:oid:2.16.840.1.113883.3.464.1004.1791' 
26 valueset "Tdap Vaccine Procedure": 'urn:oid:2.16.840.1.113883.3.464.1004.1792' 
27 valueset "Weeks of Gestation Less than 37": 'urn:oid:2.16.840.1.113883.3.464.1004.1479' 
28 
29 code "Anaphylaxis due to diphtheria and tetanus vaccine (disorder)": '428281000124107' from "SNOMEDCT" display 'Anaphylaxis due to diphtheria and tetanus vaccine (disorder)'
30 code "Anaphylaxis due to tetanus, diphtheria and acellular pertussis vaccine (disorder)": '428291000124105' from "SNOMEDCT" display 'Anaphylaxis due to tetanus, diphtheria and acellular pertussis vaccine (disorder)'
31 code "Influenza virus vaccine adverse reaction (disorder)": '420113004' from "SNOMEDCT" display 'Influenza virus vaccine adverse reaction (disorder)'
32 code "Length of gestation at birth (observable entity)": '412726003' from "SNOMEDCT" display 'Length of gestation at birth (observable entity)'
33 code "Post diphtheria vaccination encephalitis (disorder)": '192711008' from "SNOMEDCT" display 'Post diphtheria vaccination encephalitis (disorder)'
34 code "Post pertussis vaccination encephalitis (disorder)": '192712001' from "SNOMEDCT" display 'Post pertussis vaccination encephalitis (disorder)'
35 code "Post tetanus vaccination encephalitis (disorder)": '192710009' from "SNOMEDCT" display 'Post tetanus vaccination encephalitis (disorder)'
36 
37 parameter "Measurement Period" Interval<DateTime>
38 parameter "Product Line" String
39 
40 context Patient
41 
42 define "SDE Ethnicity":
43   ["Patient Characteristic Ethnicity": "Ethnicity"]
44 
45 define "SDE Payer":
46   ["Patient Characteristic Payer": "Payer"]
47 
48 define "SDE Race":
49   ["Patient Characteristic Race": "Race"]
50 
51 define "SDE Sex":
52   ["Patient Characteristic Sex": "ONC Administrative Sex"]
53 
54 define "LOG":
55   1 + 1 = 2
56   /*
57   Quality Gate 1 LOGIC UPDATE 4.19.2019
58   change definition name "Delivery at Less than 37 Weeks Gestation" to "Delivery in Measurement Period at Less than 37 Weeks Gestation"
59    change definition name "Delivery with Hospice Order or Intervention" to "Delivery in Measurement Period with Hospice Order or Intervention"
60    
61    5/31 updated Common library to 5.0. Added Parameter def. Updated Continuous Enrollment Defs.Updated stratification. Updated Hospice Def to call Common library
62   */
63 
64 define "Delivery in Measurement Period with Hospice Intervention or Encounter":
65   "Delivery" DeliveryProcedure
66     where exists Common."Hospice Intervention or Encounter"
67 
68 define "Denominator Exclusions":
69   "Delivery in Measurement Period at Less than 37 Weeks Gestation"
70     union "Delivery in Measurement Period with Hospice Intervention or Encounter"
71 
72 define "Numerator 1":
73   ( "Delivery" DeliveryProcedure
74       where "Has Influenza Vaccine 18 Months or Less Before End of Measurement Period and Delivery"
75         or "Has Influenza Vaccine Adverse Reaction Before or During Measurement Period"
76   )
77 
78 define "Numerator 3":
79   ( "Delivery" DeliveryProcedure
80       where "Has Influenza Vaccine or Vaccine Reaction and TDAP Vaccine or Vaccine Reaction"
81   )
82 
83 define "Stratification 1":
84   Common."Product Line"("Product Line", "Delivery Event Date", Interval["Delivery Event Date" - 28 days, "Delivery Event Date"])= Common."Commercial Product"
85     and exists "Delivery"
86 
87 define "Stratification 2":
88   Common."Product Line"("Product Line", "Delivery Event Date", Interval["Delivery Event Date" - 28 days, "Delivery Event Date"])= Common."Medicaid Product"
89     and exists "Delivery"
90 
91 define function "Conception Date"(Delivery "Procedure, Performed" ):
92   end of Delivery.relevantPeriod - Last("All Gestational Age Assessment" Assessment
93       where Assessment.authorDatetime within 24 hours of 
94       end of Delivery.relevantPeriod
95       sort by authorDatetime
96   ).result
97 
98 context Population
99 
100 define "All Gestational Age Assessment":
101   ( ( "Gestational Age Assessment"
102       union "Gestational Age Diagnosis"
103       union "Less than 37 Weeks Assessment" ) GestationalAge
104   )
105 
106 define "Delivery":
107   ["Procedure, Performed": "Deliveries"] Procedure
108     where Procedure.relevantPeriod during "Measurement Period"
109 
110 define "Delivery At Greater Than 36 Weeks Gestation":
111   "All Gestational Age Assessment" AgeAssessment
112     with "Delivery" DeliveryProcedure
113       such that AgeAssessment.authorDatetime during DeliveryProcedure.relevantPeriod
114         and AgeAssessment.result > 36 weeks
115 
116 define "Delivery Event Date":
117   First("Delivery" DeliveryProcedure
118       where DeliveryProcedure.relevantPeriod during "Measurement Period"
119       return DeliveryProcedure.authorDatetime
120   )
121 
122 define "Delivery in Measurement Period at Less than 37 Weeks Gestation":
123   "Delivery" DeliveryProcedure
124     with "Less than 37 Weeks Assessment" Assessment
125       such that Assessment.authorDatetime within 24 hours of DeliveryProcedure.relevantPeriod
126 
127 define "Denominator 1":
128   "Initial Population"
129 
130 define "Denominator 2":
131   "Initial Population"
132 
133 define "Denominator 3":
134   "Initial Population"
135 
136 define "Enrolled During Participation Period":
137   Common."Is Enrolled"("Product Line", "Delivery Event Date", Interval["Delivery Event Date" - 28 days, "Delivery Event Date"], 0)
138 
139 define "Gestational Age Assessment":
140   ["Assessment, Performed": "Length of gestation at birth (observable entity)"]
141 
142 define "Gestational Age Diagnosis":
143   ( ["Diagnosis": "37 Weeks Gestation"] D
144       return {
145         id: D.id,
146         code: D.code,
147         authorDatetime: 
148         end of D.prevalencePeriod,
149         result: 37 weeks
150       }
151   )
152     union ( ["Diagnosis": "38 Weeks Gestation"] D
153         return {
154           id: D.id,
155           code: D.code,
156           authorDatetime: 
157           end of D.prevalencePeriod,
158           result: 38 weeks
159         }
160     )
161     union ( ["Diagnosis": "39 Weeks Gestation"] D
162         return {
163           id: D.id,
164           code: D.code,
165           authorDatetime: 
166           end of D.prevalencePeriod,
167           result: 39 weeks
168         }
169     )
170     union ( ["Diagnosis": "40 Weeks Gestation"] D
171         return {
172           id: D.id,
173           code: D.code,
174           authorDatetime: 
175           end of D.prevalencePeriod,
176           result: 40 weeks
177         }
178     )
179     union ( ["Diagnosis": "41 Weeks Gestation"] D
180         return {
181           id: D.id,
182           code: D.code,
183           authorDatetime: 
184           end of D.prevalencePeriod,
185           result: 41 weeks
186         }
187     )
188     union ( ["Diagnosis": "42 Weeks Gestation"] D
189         return {
190           id: D.id,
191           code: D.code,
192           authorDatetime: 
193           end of D.prevalencePeriod,
194           result: 42 weeks
195         }
196     )
197     union ( ["Diagnosis": "43 Weeks Gestation"] D
198         return {
199           id: D.id,
200           code: D.code,
201           authorDatetime: 
202           end of D.prevalencePeriod,
203           result: 43 weeks
204         }
205     )
206 
207 define "Has Influenza Vaccine Adverse Reaction Before or During Measurement Period":
208   exists ( ["Diagnosis": "Influenza virus vaccine adverse reaction (disorder)"] InfluenzaReaction
209       where InfluenzaReaction.prevalencePeriod starts before "Measurement Period"
210         or InfluenzaReaction.prevalencePeriod starts during "Measurement Period"
211   )
212 
213 define "Less than 37 Weeks Assessment":
214   ( ( ["Assessment, Performed": "Length of gestation at birth (observable entity)"] GestationAssessment
215         where GestationAssessment.result < 37 weeks
216           and GestationAssessment.authorDatetime in "Measurement Period"
217     )
218       union "Less Than 37 Weeks Diagnosis" GestationalDiagnosis
219         where GestationalDiagnosis.authorDatetime in "Measurement Period"
220   )
221 
222 define "Less Than 37 Weeks Diagnosis":
223   ["Diagnosis": "Weeks of Gestation Less than 37"]
224 
225 define "Numerator 2":
226   ( "Delivery with Tdap Vaccine between Conception and Delivery"
227       union ( "Delivery" DeliveryProcedure
228           where exists "TD or TDAP Vaccine Contraindications"
229       )
230   )
231 
232 define "Delivery with Tdap Vaccine between Conception and Delivery":
233   "Delivery" DeliveryProcedure
234     with ( ["Immunization, Administered": "Tdap Immunization"]
235       union ["Procedure, Performed": "Tdap Vaccine Procedure"] TdapVaccine
236         return "Immunization, Administered" { authorDatetime: start of TdapVaccine.relevantPeriod } ) TDAP
237       such that TDAP.authorDatetime between "Conception Date"(DeliveryProcedure)and 
238       end of DeliveryProcedure.relevantPeriod
239 
240 define "Initial Population":
241   "Delivery" Procedure
242     with ( "All Gestational Age Assessment" ) AgeAssessment
243       such that Procedure.relevantPeriod starts before AgeAssessment.authorDatetime
244         and AgeAssessment.authorDatetime within 24 hours of 
245         end of Procedure.relevantPeriod
246         and AgeAssessment is not null
247     where "Enrolled During Participation Period"
248 
249 define "Has Influenza Vaccine 18 Months or Less Before End of Measurement Period and Delivery":
250   exists ( ( ["Immunization, Administered": "Adult Influenza Immunization"]
251       union ["Procedure, Performed": "Adult Influenza Vaccine Procedure"] InfluenzaVaccine
252         return "Immunization, Administered" { authorDatetime: start of InfluenzaVaccine.relevantPeriod } ) Influenza
253       with "Delivery" DeliveryProcedure
254         such that Influenza.authorDatetime during Interval[
255         end of "Measurement Period" - 17 months - 31 days, 
256         end of DeliveryProcedure.relevantPeriod]
257   )
258 
259 define "Has Influenza Vaccine or Vaccine Reaction and TDAP Vaccine or Vaccine Reaction":
260   exists ( ( ( ["Immunization, Administered": "Adult Influenza Immunization"]
261         union ["Procedure, Performed": "Adult Influenza Vaccine Procedure"] InfluenzaVaccine
262           return "Immunization, Administered" { authorDatetime: start of InfluenzaVaccine.relevantPeriod } ) Influenza
263         with "Delivery" DeliveryProcedure
264           such that Influenza.authorDatetime during Interval[
265           end of "Measurement Period" - 17 months - 31 days, 
266           end of DeliveryProcedure.relevantPeriod]
267     )
268       union ( ["Diagnosis": "Influenza virus vaccine adverse reaction (disorder)"] InfluenzaReaction
269           where InfluenzaReaction.prevalencePeriod starts before "Measurement Period"
270             or InfluenzaReaction.prevalencePeriod starts during "Measurement Period"
271       )
272   )
273     and exists ( ( ( ["Immunization, Administered": "Tdap Immunization"]
274           union ["Procedure, Performed": "Tdap Vaccine Procedure"] TdapVaccine
275             return "Immunization, Administered" { authorDatetime: start of TdapVaccine.relevantPeriod } ) TDAP
276           with "Delivery" DeliveryProcedure
277             such that TDAP.authorDatetime between "Conception Date"(DeliveryProcedure)and 
278             end of DeliveryProcedure.relevantPeriod
279       )
280         union ( "TD or TDAP Vaccine Contraindications" )
281     )
282 
283 define "TD or TDAP Vaccine Contraindications":
284   ( ( ["Diagnosis": "Anaphylaxis due to diphtheria and tetanus vaccine (disorder)"] )
285       union ( ["Diagnosis": "Anaphylaxis due to tetanus, diphtheria and acellular pertussis vaccine (disorder)"] )
286       union ( ["Diagnosis": "Post diphtheria vaccination encephalitis (disorder)"] )
287       union ( ["Diagnosis": "Post pertussis vaccination encephalitis (disorder)"] )
288       union ( ["Diagnosis": "Post tetanus vaccination encephalitis (disorder)"] ) VaccineContraindications
289         where VaccineContraindications.prevalencePeriod starts before "Measurement Period"
290           or VaccineContraindications.prevalencePeriod starts during "Measurement Period"
291   )

/*******************************************************************************************************************
ERRORS:
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Line 98: Could not resolve context name Population in model QDM.
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