{ "calculate_sdes": false, "calculate_ravs": true, "calculation_method": "EPISODE_OF_CARE", "cms_id": "CMS530v0", "component": false, "component_hqmf_set_ids": [ ], "composite": false, "composite_hqmf_set_id": null, "cql_libraries": [ { "cql": "library CoreClinicalDataElementsfortheHybridHospitalWideReadmissionHWRMeasurewithClaimsandElectronicHealthRecordData version '0.1.016'\r\n\r\nusing QDM version '5.3'\r\n\r\ninclude MATGlobalCommonFunctions version '2.0.000' called Global\r\n\r\ncodesystem \"LOINC:2.58\": 'urn:oid:2.16.840.1.113883.6.1' version 'urn:hl7:version:2.58'\r\ncodesystem \"LOINC:2.63\": 'urn:oid:2.16.840.1.113883.6.1' version 'urn:hl7:version:2.63'\r\n\r\nvalueset \"Payer\": 'urn:oid:2.16.840.1.114222.4.11.3591'\r\nvalueset \"Bicarbonate Lab Test\": 'urn:oid:2.16.840.1.113762.1.4.1045.138'\r\nvalueset \"Body Temperature LOINC\": 'urn:oid:2.16.840.1.113762.1.4.1045.152'\r\nvalueset \"Body Weight\": 'urn:oid:2.16.840.1.113762.1.4.1045.159'\r\nvalueset \"Creatinine Lab Test\": 'urn:oid:2.16.840.1.113883.3.666.5.2363'\r\nvalueset \"Glucose Lab Test\": 'urn:oid:2.16.840.1.113762.1.4.1045.134'\r\nvalueset \"Hematocrit lab test\": 'urn:oid:2.16.840.1.113762.1.4.1045.114'\r\nvalueset \"Medicare payer\": 'urn:oid:2.16.840.1.113762.1.4.1104.10'\r\nvalueset \"Potassium Lab Test\": 'urn:oid:2.16.840.1.113762.1.4.1045.117'\r\nvalueset \"Sodium Lab Test V\": 'urn:oid:2.16.840.1.113762.1.4.1045.119'\r\nvalueset \"White Blood Cells Count Lab Test\": 'urn:oid:2.16.840.1.113762.1.4.1045.129'\r\nvalueset \"Acute care hospital Inpatient Encounter\": 'urn:oid:2.16.840.1.113883.3.666.5.2289'\r\n\r\ncode \"Heart rate\": '8867-4' from \"LOINC:2.58\" display 'Heart rate'\r\ncode \"Oxygen saturation in Arterial blood by Pulse oximetry\": '59408-5' from \"LOINC:2.63\" display 'Oxygen saturation in Arterial blood by Pulse oximetry'\r\ncode \"Respiratory rate\": '9279-1' from \"LOINC:2.63\" display 'Respiratory rate'\r\ncode \"Systolic blood pressure\": '8480-6' from \"LOINC:2.58\" display 'Systolic blood pressure'\r\n\r\nparameter \"Measurement Period\" Interval\r\n\r\ncontext Patient\r\n\r\ndefine \"Denominator\":\r\n\t\"Initial Population\"\r\n\r\ndefine \"Initial Population\":\r\n\t\"IP Encounters\"\r\n\r\ndefine \"Numerator\":\r\n\t\"Initial Population\"\r\n\r\ndefine \"Results\":\r\n\t{\n\t // First physical exams\r\n\t\tfirstHR: \"FirstPhysicalExam\"([\"Physical Exam, Performed\": \"Heart rate\"]),\r\n\t\tfirstSBP: \"FirstPhysicalExam\"([\"Physical Exam, Performed\": \"Systolic blood pressure\"]),\r\n\t\tfirstRR: \"FirstPhysicalExam\"([\"Physical Exam, Performed\": \"Respiratory rate\"]),\r\n\t\tfirstTemp: \"FirstPhysicalExam\"([\"Physical Exam, Performed\": \"Body Temperature LOINC\"]),\r\n\t\tfirstO2S: \"FirstPhysicalExam\"([\"Physical Exam, Performed\": \"Oxygen saturation in Arterial blood by Pulse oximetry\"]),\n\t // Weight uses lab test timing\r\n\t\tfirstWeight: \"FirstPhysicalExamWithLabTiming\"([\"Physical Exam, Performed\": \"Body Weight\"]),\n\t\n\t // First lab tests\r\n\t\tfirstHemat: \"FirstLabTest\"([\"Laboratory Test, Performed\": \"Hematocrit lab test\"]),\r\n\t\tfirstWBC: \"FirstLabTest\"([\"Laboratory Test, Performed\": \"White Blood Cells Count Lab Test\"]),\r\n\t\tfirstPotass: \"FirstLabTest\"([\"Laboratory Test, Performed\": \"Potassium Lab Test\"]),\r\n\t\tfirstSodium: \"FirstLabTest\"([\"Laboratory Test, Performed\": \"Sodium Lab Test V\"]),\r\n\t\tfirstBicarb: \"FirstLabTest\"([\"Laboratory Test, Performed\": \"Bicarbonate Lab Test\"]),\r\n\t\tfirstCreat: \"FirstLabTest\"([\"Laboratory Test, Performed\": \"Creatinine Lab Test\"]),\r\n\t\tfirstGlucose: \"FirstLabTest\"([\"Laboratory Test, Performed\": \"Glucose Lab Test\"])\r\n\t}\r\n\r\ndefine \"IP Encounters\":\r\n\tfrom\r\n\t\t[\"Encounter, Performed\": \"Acute care hospital Inpatient Encounter\"] Encounter,\r\n\t\t[\"Patient Characteristic\": \"Payer\"] Payer,\r\n\t\t[\"Patient Characteristic Birthdate\"] Birthdate\r\n\t\twhere Payer.code in \"Medicare payer\"\r\n\t\t\tand Global.\"Hospitalization Length of Stay\"(Encounter)< 365\r\n\t\t\tand Encounter.relevantPeriod ends during \"Measurement Period\"\r\n\t\t\tand Global.\"CalendarAgeInYearsAt\"(Birthdate.birthDatetime, start of Encounter.relevantPeriod)>= 65\r\n\t\treturn Encounter\r\n\r\ndefine function \"FirstPhysicalExamWithLabTiming\"(exam List):\r\n\t\"IP Encounters\" Encounter\r\n\t\treturn First(exam e\r\n\t\t\t\twhere e.relevantPeriod starts during Interval[start of Encounter.relevantPeriod - 1440 minutes, start of Encounter.relevantPeriod + 1440 minutes]\r\n\t\t\t\tsort by start of relevantPeriod\r\n\t\t).result\r\n\r\ndefine function \"FirstLabTest\"(lab List):\r\n\t\"IP Encounters\" Encounter\r\n\t\treturn First(lab l\r\n\t\t\t\twhere l.resultDatetime during Interval[start of Encounter.relevantPeriod - 1440 minutes, start of Encounter.relevantPeriod + 1440 minutes]\r\n\t\t\t\tsort by start of relevantPeriod\r\n\t\t).result\r\n\r\ndefine function \"FirstPhysicalExam\"(exam List):\r\n\t\"IP Encounters\" Encounter\r\n\t\treturn First(exam e\r\n\t\t\t\twhere e.relevantPeriod starts during Interval[start of Encounter.relevantPeriod - 1440 minutes, start of Encounter.relevantPeriod + 120 minutes]\r\n\t\t\t\tsort by start of relevantPeriod\r\n\t\t).result\r\n", "elm": { "library": { "identifier": { "id": "CoreClinicalDataElementsfortheHybridHospitalWideReadmissionHWRMeasurewithClaimsandElectronicHealthRecordData", "version": "0.1.016" }, "schemaIdentifier": { "id": "urn:hl7-org:elm", "version": "r1" }, "usings": { "def": [ { "localIdentifier": "System", "uri": "urn:hl7-org:elm-types:r1" }, { "localId": "1", "locator": "3:1-3:23", "localIdentifier": "QDM", "uri": "urn:healthit-gov:qdm:v5_3", "version": "5.3" } ] }, "includes": { "def": [ { "localId": "2", "locator": "5:1-5:64", "localIdentifier": "Global", "path": "MATGlobalCommonFunctions", "version": "2.0.000" } ] }, "parameters": { "def": [ { "localId": "27", "locator": "28:1-28:49", "name": "Measurement Period", "accessLevel": "Public", "parameterTypeSpecifier": { "localId": "26", "locator": "28:32-28:49", "type": "IntervalTypeSpecifier", "pointType": { "localId": "25", "locator": "28:41-28:48", "name": "{urn:hl7-org:elm-types:r1}DateTime", "type": "NamedTypeSpecifier" } } } ] }, "codeSystems": { "def": [ { "localId": "3", "locator": "7:1-7:87", "name": "LOINC:2.58", "id": "2.16.840.1.113883.6.1", "version": "urn:hl7:version:2.58", "accessLevel": "Public" }, { "localId": "4", "locator": "8:1-8:87", "name": "LOINC:2.63", "id": "2.16.840.1.113883.6.1", "version": "urn:hl7:version:2.63", "accessLevel": "Public" } ] }, "valueSets": { "def": [ { "localId": "5", "locator": "10:1-10:55", "name": "Payer", "id": "2.16.840.1.114222.4.11.3591", "accessLevel": "Public" }, { "localId": "6", "locator": "11:1-11:73", "name": "Bicarbonate Lab Test", "id": "2.16.840.1.113762.1.4.1045.138", "accessLevel": "Public" }, { "localId": "7", "locator": "12:1-12:75", "name": "Body Temperature LOINC", "id": "2.16.840.1.113762.1.4.1045.152", "accessLevel": "Public" }, { "localId": "8", "locator": "13:1-13:64", "name": "Body Weight", "id": "2.16.840.1.113762.1.4.1045.159", "accessLevel": "Public" }, { "localId": "9", "locator": "14:1-14:72", "name": "Creatinine Lab Test", "id": "2.16.840.1.113883.3.666.5.2363", "accessLevel": "Public" }, { "localId": "10", "locator": "15:1-15:69", "name": "Glucose Lab Test", "id": "2.16.840.1.113762.1.4.1045.134", "accessLevel": "Public" }, { "localId": "11", "locator": "16:1-16:72", "name": "Hematocrit lab test", "id": "2.16.840.1.113762.1.4.1045.114", "accessLevel": "Public" }, { "localId": "12", "locator": "17:1-17:66", "name": "Medicare payer", "id": "2.16.840.1.113762.1.4.1104.10", "accessLevel": "Public" }, { "localId": "13", "locator": "18:1-18:71", "name": "Potassium Lab Test", "id": "2.16.840.1.113762.1.4.1045.117", "accessLevel": "Public" }, { "localId": "14", "locator": "19:1-19:70", "name": "Sodium Lab Test V", "id": "2.16.840.1.113762.1.4.1045.119", "accessLevel": "Public" }, { "localId": "15", "locator": "20:1-20:85", "name": "White Blood Cells Count Lab Test", "id": "2.16.840.1.113762.1.4.1045.129", "accessLevel": "Public" }, { "localId": "16", "locator": "21:1-21:92", "name": "Acute care hospital Inpatient Encounter", "id": "2.16.840.1.113883.3.666.5.2289", "accessLevel": "Public" } ] }, "codes": { "def": [ { "localId": "18", "locator": "23:1-23:66", "name": "Heart rate", "id": "8867-4", "display": "Heart rate", "accessLevel": "Public", "codeSystem": { "localId": "17", "locator": "23:34-23:45", "name": "LOINC:2.58" } }, { "localId": "20", "locator": "24:1-24:153", "name": "Oxygen saturation in Arterial blood by Pulse oximetry", "id": "59408-5", "display": "Oxygen saturation in Arterial blood by Pulse oximetry", "accessLevel": "Public", "codeSystem": { "localId": "19", "locator": "24:78-24:89", "name": "LOINC:2.63" } }, { "localId": "22", "locator": "25:1-25:78", "name": "Respiratory rate", "id": "9279-1", "display": "Respiratory rate", "accessLevel": "Public", "codeSystem": { "localId": "21", "locator": "25:40-25:51", "name": "LOINC:2.63" } }, { "localId": "24", "locator": "26:1-26:92", "name": "Systolic blood pressure", "id": "8480-6", "display": "Systolic blood pressure", "accessLevel": "Public", "codeSystem": { "localId": "23", "locator": "26:47-26:58", "name": "LOINC:2.58" } } ] }, "statements": { "def": [ { "locator": "30:1-30:15", "name": "Patient", "context": "Patient", "expression": { "type": "SingletonFrom", "operand": { "locator": "30:1-30:15", "dataType": "{urn:healthit-gov:qdm:v5_3}Patient", "templateId": "Patient", "type": "Retrieve" } } }, { "localId": "62", "locator": "62:1-71:18", "name": "IP Encounters", "context": "Patient", "accessLevel": "Public", "annotation": [ { "type": "Annotation", "s": { "r": "62", "s": [ { "value": [ "define ", "\"IP Encounters\"", ":\n\t" ] }, { "r": "61", "s": [ { "s": [ { "value": [ "from\n\t\t" ] }, { "r": "29", "s": [ { "r": "28", "s": [ { "r": "28", "s": [ { "value": [ "[", "\"Encounter, Performed\"", ": " ] }, { "s": [ { "value": [ "\"Acute care hospital Inpatient Encounter\"" ] } ] }, { "value": [ "]" ] } ] } ] }, { "value": [ " ", "Encounter" ] } ] }, { "value": [ ",\n\t\t" ] }, { "r": "31", "s": [ { "r": "30", "s": [ { "r": "30", "s": [ { "value": [ "[", "\"Patient Characteristic\"", ": " ] }, { "s": [ { "value": [ "\"Payer\"" ] } ] }, { "value": [ "]" ] } ] } ] }, { "value": [ " ", "Payer" ] } ] }, { "value": [ ",\n\t\t" ] }, { "r": "33", "s": [ { "r": "32", "s": [ { "r": "32", "s": [ { "value": [ "[", "\"Patient Characteristic Birthdate\"", "]" ] } ] } ] }, { "value": [ " ", "Birthdate" ] } ] } ] }, { "value": [ "\n\t\t" ] }, { "r": "58", "s": [ { "value": [ "where " ] }, { "r": "58", "s": [ { "r": "48", "s": [ { "r": "43", "s": [ { "r": "37", "s": [ { "r": "35", "s": [ { "r": "34", "s": [ { "value": [ "Payer" ] } ] }, { "value": [ "." ] }, { "r": "35", "s": [ { "value": [ "code" ] } ] } ] }, { "value": [ " in " ] }, { "r": "36", "s": [ { "value": [ "\"Medicare payer\"" ] } ] } ] }, { "value": [ "\n\t\t\tand " ] }, { "r": "42", "s": [ { "r": "40", "s": [ { "r": "38", "s": [ { "value": [ "Global" ] } ] }, { "value": [ "." ] }, { "r": "40", "s": [ { "value": [ "\"Hospitalization Length of Stay\"", "(" ] }, { "r": "39", "s": [ { "value": [ "Encounter" ] } ] }, { "value": [ ")" ] } ] } ] }, { "value": [ "<", " ", "365" ] } ] } ] }, { "value": [ "\n\t\t\tand " ] }, { "r": "47", "s": [ { "r": "45", "s": [ { "r": "44", "s": [ { "value": [ "Encounter" ] } ] }, { "value": [ "." ] }, { "r": "45", "s": [ { "value": [ "relevantPeriod" ] } ] } ] }, { "value": [ " ", "ends during", " " ] }, { "r": "46", "s": [ { "value": [ "\"Measurement Period\"" ] } ] } ] } ] }, { "value": [ "\n\t\t\tand " ] }, { "r": "57", "s": [ { "r": "55", "s": [ { "r": "49", "s": [ { "value": [ "Global" ] } ] }, { "value": [ "." ] }, { "r": "55", "s": [ { "value": [ "\"CalendarAgeInYearsAt\"", "(" ] }, { "r": "51", "s": [ { "r": "50", "s": [ { "value": [ "Birthdate" ] } ] }, { "value": [ "." ] }, { "r": "51", "s": [ { "value": [ "birthDatetime" ] } ] } ] }, { "value": [ ", " ] }, { "r": "54", "s": [ { "value": [ "start of " ] }, { "r": "53", "s": [ { "r": "52", "s": [ { "value": [ "Encounter" ] } ] }, { "value": [ "." ] }, { "r": "53", "s": [ { "value": [ "relevantPeriod" ] } ] } ] } ] }, { "value": [ ")" ] } ] } ] }, { "value": [ ">=", " ", "65" ] } ] } ] } ] }, { "value": [ "\n\t\t" ] }, { "r": "60", "s": [ { "value": [ "return " ] }, { "r": "59", "s": [ { "value": [ "Encounter" ] } ] } ] } ] } ] } } ], "expression": { "localId": "61", "locator": "63:2-71:18", "type": "Query", "source": [ { "localId": "29", "locator": "64:3-64:79", "alias": "Encounter", "expression": { "localId": "28", "locator": "64:3-64:69", "dataType": "{urn:healthit-gov:qdm:v5_3}PositiveEncounterPerformed", "templateId": "PositiveEncounterPerformed", "codeProperty": "code", "type": "Retrieve", "codes": { "name": "Acute care hospital Inpatient Encounter", "type": "ValueSetRef" } } }, { "localId": "31", "locator": "65:3-65:43", "alias": "Payer", "expression": { "localId": "30", "locator": "65:3-65:37", "dataType": "{urn:healthit-gov:qdm:v5_3}PatientCharacteristic", "codeProperty": "code", "type": "Retrieve", "codes": { "name": "Payer", "type": "ValueSetRef" } } }, { "localId": "33", "locator": "66:3-66:48", "alias": "Birthdate", "expression": { "localId": "32", "locator": "66:3-66:38", "dataType": "{urn:healthit-gov:qdm:v5_3}PatientCharacteristicBirthdate", "type": "Retrieve" } } ], "relationship": [ ], "where": { "localId": "58", "locator": "67:3-70:101", "type": "And", "operand": [ { "localId": "48", "locator": "67:9-69:64", "type": "And", "operand": [ { "localId": "43", "locator": "67:9-68:62", "type": "And", "operand": [ { "localId": "37", "locator": "67:9-67:38", "type": "InValueSet", "code": { "localId": "35", "locator": "67:9-67:18", "path": "code", "scope": "Payer", "type": "Property" }, "valueset": { "localId": "36", "locator": "67:23-67:38", "name": "Medicare payer" } }, { "localId": "42", "locator": "68:8-68:62", "type": "Less", "operand": [ { "localId": "40", "locator": "68:8-68:57", "name": "Hospitalization Length of Stay", "libraryName": "Global", "type": "FunctionRef", "operand": [ { "localId": "39", "locator": "68:48-68:56", "name": "Encounter", "type": "AliasRef" } ] }, { "localId": "41", "locator": "68:60-68:62", "valueType": "{urn:hl7-org:elm-types:r1}Integer", "value": "365", "type": "Literal" } ] } ] }, { "localId": "47", "locator": "69:8-69:64", "type": "In", "operand": [ { "locator": "69:33-69:36", "type": "End", "operand": { "localId": "45", "locator": "69:8-69:31", "path": "relevantPeriod", "scope": "Encounter", "type": "Property" } }, { "localId": "46", "locator": "69:45-69:64", "name": "Measurement Period", "type": "ParameterRef" } ] } ] }, { "localId": "57", "locator": "70:8-70:101", "type": "GreaterOrEqual", "operand": [ { "localId": "55", "locator": "70:8-70:96", "name": "CalendarAgeInYearsAt", "libraryName": "Global", "type": "FunctionRef", "operand": [ { "localId": "51", "locator": "70:38-70:60", "path": "birthDatetime", "scope": "Birthdate", "type": "Property" }, { "localId": "54", "locator": "70:63-70:95", "type": "Start", "operand": { "localId": "53", "locator": "70:72-70:95", "path": "relevantPeriod", "scope": "Encounter", "type": "Property" } } ] }, { "localId": "56", "locator": "70:100-70:101", "valueType": "{urn:hl7-org:elm-types:r1}Integer", "value": "65", "type": "Literal" } ] } ] }, "return": { "localId": "60", "locator": "71:3-71:18", "expression": { "localId": "59", "locator": "71:10-71:18", "name": "Encounter", "type": "AliasRef" } } } }, { "localId": "64", "locator": "35:1-36:16", "name": "Initial Population", "context": "Patient", "accessLevel": "Public", "annotation": [ { "type": "Annotation", "s": { "r": "64", "s": [ { "value": [ "define ", "\"Initial Population\"", ":\n\t" ] }, { "r": "63", "s": [ { "value": [ "\"IP Encounters\"" ] } ] } ] } } ], "expression": { "localId": "63", "locator": "36:2-36:16", "name": "IP Encounters", "type": "ExpressionRef" } }, { "localId": "66", "locator": "32:1-33:21", "name": "Denominator", "context": "Patient", "accessLevel": "Public", "annotation": [ { "type": "Annotation", "s": { "r": "66", "s": [ { "value": [ "define ", "\"Denominator\"", ":\n\t" ] }, { "r": "65", "s": [ { "value": [ "\"Initial Population\"" ] } ] } ] } } ], "expression": { "localId": "65", "locator": "33:2-33:21", "name": "Initial Population", "type": "ExpressionRef" } }, { "localId": "68", "locator": "38:1-39:21", "name": "Numerator", "context": "Patient", "accessLevel": "Public", "annotation": [ { "type": "Annotation", "s": { "r": "68", "s": [ { "value": [ "define ", "\"Numerator\"", ":\n\t" ] }, { "r": "67", "s": [ { "value": [ "\"Initial Population\"" ] } ] } ] } } ], "expression": { "localId": "67", "locator": "39:2-39:21", "name": "Initial Population", "type": 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"text": "\n )" } ] } ], "ref_id": "135" }, { "children": [ { "text": "." } ] }, { "children": [ { "children": [ { "text": "result" } ] } ], "node_type": "Property", "ref_id": "136" } ], "node_type": "Property", "ref_id": "136" } ], "ref_id": "137" } ], "node_type": "Query", "ref_id": "138" } ], "node_type": "Query", "ref_id": "138" } ], "ref_id": "139" } ], "define_name": "FirstPhysicalExamWithLabTiming" }, { "children": [ { "children": [ { "children": [ { "text": "define function \"FirstLabTest\"(lab " } ] }, { "children": [ { "children": [ { "text": "List<" } ] }, { "children": [ { "children": [ { "text": "QDM.PositiveLaboratoryTestPerformed" } ] } ], "ref_id": "142" }, { "children": [ { "text": ">" } ] } ], "ref_id": "143" }, { "children": [ { "text": " ):\n " } ] }, { "children": [ { "children": [ { "children": [ { "children": [ { "children": [ { "children": [ { "children": [ { "text": "\"IP Encounters\"" } ] } ] } ], "node_type": "ExpressionRef", "ref_id": "144" }, { "children": [ { "text": " Encounter" } ] } ], "ref_id": "145" } ] }, { "children": [ { "text": "\n " } ] }, { "children": [ { "children": [ { "text": "return " } ] }, { "children": [ { "children": [ { "children": [ { "text": "First(" } ] }, { "children": [ { "children": [ { "children": [ { "children": [ { "children": [ { "children": [ { "text": "lab" } ] } ] } ], "node_type": "OperandRef", "ref_id": "146" }, { "children": [ { "text": " l" } ] } ], "ref_id": "147" } ] }, { "children": [ { "text": "\n " } ] }, { "children": [ { "children": [ { "text": "where " } ] }, { "children": [ { "children": [ { "children": [ { "children": [ { "text": "l" } ] } ], "ref_id": "148" }, { "children": [ { "text": "." } ] }, { "children": [ { "children": [ { "text": "resultDatetime" } ] } ], "node_type": "Property", "ref_id": "149" } ], "node_type": "Property", "ref_id": "149" }, { "children": [ { "text": " during " } ] }, { "children": [ { "children": [ { "text": "Interval[" } ] }, { "children": [ { "children": [ { "children": [ { "text": "start of " } ] }, { "children": [ { "children": [ { "children": [ { "text": "Encounter" } ] } ], "ref_id": "150" }, { "children": [ { "text": "." } ] }, { "children": [ { "children": [ { "text": "relevantPeriod" } ] } ], "node_type": "Property", "ref_id": "151" } ], "node_type": "Property", "ref_id": "151" } ], "node_type": "Start", "ref_id": "152" }, { "children": [ { "text": " - " } ] }, { "children": [ { "children": [ { "text": "1440 minutes" } ] } ], "node_type": "Quantity", "ref_id": "153" } ], "ref_id": "154" }, { "children": [ { "text": ", " } ] }, { "children": [ { "children": [ { "children": [ { "text": "start of " } ] }, { "children": [ { "children": [ { "children": [ { "text": "Encounter" } ] } ], "ref_id": "155" }, { "children": [ { "text": "." } ] }, { "children": [ { "children": [ { "text": "relevantPeriod" } ] } ], "node_type": "Property", "ref_id": "156" } ], "node_type": "Property", "ref_id": "156" } ], "node_type": "Start", "ref_id": "157" }, { "children": [ { "text": " + " } ] }, { "children": [ { "children": [ { "text": "1440 minutes" } ] } ], "node_type": "Quantity", "ref_id": "158" } ], "ref_id": "159" }, { "children": [ { "text": "]" } ] } ], "node_type": "Interval", "ref_id": "160" } ], "ref_id": "161" } ], "ref_id": "161" }, { "children": [ { "text": "\n " } ] }, { "children": [ { "children": [ { "text": "sort by " } ] }, { "children": [ { "children": [ { "children": [ { "text": "start of " } ] }, { "children": [ { "children": [ { "text": "relevantPeriod" } ] } ], "node_type": "IdentifierRef", "ref_id": "162" } ], "node_type": "Start", "ref_id": "163" } ], "ref_id": "164" } ], "ref_id": "165" } ], "ref_id": "166" }, { "children": [ { "text": "\n )" } ] } ], "ref_id": "167" }, { "children": [ { "text": "." } ] }, { "children": [ { "children": [ { "text": "result" } ] } ], "node_type": "Property", "ref_id": "168" } ], "node_type": "Property", "ref_id": "168" } ], "ref_id": "169" } ], "node_type": "Query", "ref_id": "170" } ], "node_type": "Query", "ref_id": "170" } ], "ref_id": "171" } ], "define_name": "FirstLabTest" }, { "children": [ { "children": [ { "children": [ { "text": "define \"Results\":\n " } ] }, { "children": [ { "children": [ { "text": "{\n // First physical exams\n " } ] }, { "children": [ { "children": [ { "text": "firstHR: " } ] }, { "children": [ { "children": [ { "text": "\"FirstPhysicalExam\"(" } ] }, { "children": [ { "children": [ { "text": "[\"Physical Exam, Performed\": " } ] }, { "children": [ { "children": [ { "text": "\"Heart rate\"" } ] } ] }, { "children": [ { "text": "]" } ] } ], "node_type": "Retrieve", "ref_id": "69" }, { "children": [ { "text": ")" } ] } ], "ref_id": "100" } ] }, { "children": [ { "text": ",\n " } ] }, { "children": [ { "children": [ { "text": "firstSBP: " } ] }, { "children": [ { "children": [ { "text": "\"FirstPhysicalExam\"(" } ] }, { "children": [ { "children": [ { "text": "[\"Physical Exam, Performed\": " } ] }, { "children": [ { "children": [ { "text": "\"Systolic blood pressure\"" } ] } ] }, { "children": [ { "text": "]" } ] } ], "node_type": "Retrieve", "ref_id": "101" }, { "children": [ { "text": ")" } ] } ], "ref_id": "102" } ] }, { "children": [ { "text": ",\n " } ] }, { "children": [ { "children": [ { "text": "firstRR: " } ] }, { "children": [ { "children": [ { "text": "\"FirstPhysicalExam\"(" } ] }, { "children": [ { "children": [ { "text": "[\"Physical Exam, Performed\": " } ] }, { "children": [ { "children": [ { "text": "\"Respiratory rate\"" } ] } ] }, { "children": [ { "text": "]" } ] } ], "node_type": "Retrieve", "ref_id": "103" }, { "children": [ { "text": ")" } ] } ], "ref_id": "104" } ] }, { "children": [ { "text": ",\n " } ] }, { "children": [ { "children": [ { "text": "firstTemp: " } ] }, { "children": [ { "children": [ { "text": "\"FirstPhysicalExam\"(" } ] }, { "children": [ { "children": [ { "text": "[\"Physical Exam, Performed\": " } ] }, { "children": [ { "children": [ { "text": "\"Body Temperature LOINC\"" } ] } ] }, { "children": [ { "text": "]" } ] } ], "node_type": "Retrieve", "ref_id": "105" }, { "children": [ { "text": ")" } ] } ], "ref_id": "106" } ] }, { "children": [ { "text": ",\n " } ] }, { "children": [ { "children": [ { "text": "firstO2S: " } ] }, { "children": [ { "children": [ { "text": "\"FirstPhysicalExam\"(" } ] }, { "children": [ { "children": [ { "text": "[\"Physical Exam, Performed\": " } ] }, { "children": [ { "children": [ { "text": "\"Oxygen saturation in Arterial blood by Pulse oximetry\"" } ] } ] }, { "children": [ { "text": "]" } ] } ], "node_type": "Retrieve", "ref_id": "107" }, { "children": [ { "text": ")" } ] } ], "ref_id": "108" } ] }, { "children": [ { "text": ",\n // Weight uses lab test timing\n " } ] }, { "children": [ { "children": [ { "text": "firstWeight: " } ] }, { "children": [ { "children": [ { "text": "\"FirstPhysicalExamWithLabTiming\"(" } ] }, { "children": [ { "children": [ { "text": "[\"Physical Exam, Performed\": " } ] }, { "children": [ { "children": [ { "text": "\"Body Weight\"" } ] } ] }, { "children": [ { "text": "]" } ] } ], "node_type": "Retrieve", "ref_id": "109" }, { "children": [ { "text": ")" } ] } ], "ref_id": "140" } ] }, { "children": [ { "text": ",\n \n // First lab tests\n " } ] }, { "children": [ { "children": [ { "text": "firstHemat: " } ] }, { "children": [ { "children": [ { "text": "\"FirstLabTest\"(" } ] }, { "children": [ { "children": [ { "text": "[\"Laboratory Test, Performed\": " } ] }, { "children": [ { "children": [ { "text": "\"Hematocrit lab test\"" } ] } ] }, { "children": [ { "text": "]" } ] } ], "node_type": "Retrieve", "ref_id": "141" }, { "children": [ { "text": ")" } ] } ], "ref_id": "172" } ] }, { "children": [ { "text": ",\n " } ] }, { "children": [ { "children": [ { "text": "firstWBC: " } ] }, { "children": [ { "children": [ { "text": "\"FirstLabTest\"(" } ] }, { "children": [ { "children": [ { "text": "[\"Laboratory Test, Performed\": " } ] }, { "children": [ { "children": [ { "text": "\"White Blood Cells Count Lab Test\"" } ] } ] }, { "children": [ { "text": "]" } ] } ], "node_type": "Retrieve", "ref_id": "173" }, { "children": [ { "text": ")" } ] } ], "ref_id": "174" } ] }, { "children": [ { "text": ",\n " } ] }, { "children": [ { "children": [ { "text": "firstPotass: " } ] }, { "children": [ { "children": [ { "text": "\"FirstLabTest\"(" } ] }, { "children": [ { "children": [ { "text": "[\"Laboratory Test, Performed\": " } ] }, { "children": [ { "children": [ { "text": "\"Potassium Lab Test\"" } ] } ] }, { "children": [ { "text": "]" } ] } ], "node_type": "Retrieve", "ref_id": "175" }, { "children": [ { "text": ")" } ] } ], "ref_id": "176" } ] }, { "children": [ { "text": ",\n " } ] }, { "children": [ { "children": [ { "text": "firstSodium: " } ] }, { "children": [ { "children": [ { "text": "\"FirstLabTest\"(" } ] }, { "children": [ { "children": [ { "text": "[\"Laboratory Test, Performed\": " } ] }, { "children": [ { "children": [ { "text": "\"Sodium Lab Test V\"" } ] } ] }, { "children": [ { "text": "]" } ] } ], "node_type": "Retrieve", "ref_id": "177" }, { "children": [ { "text": ")" } ] } ], "ref_id": "178" } ] }, { "children": [ { "text": ",\n " } ] }, { "children": [ { "children": [ { "text": "firstBicarb: " } ] }, { "children": [ { "children": [ { "text": "\"FirstLabTest\"(" } ] }, { "children": [ { "children": [ { "text": "[\"Laboratory Test, Performed\": " } ] }, { "children": [ { "children": [ { "text": "\"Bicarbonate Lab Test\"" } ] } ] }, { "children": [ { "text": "]" } ] } ], "node_type": "Retrieve", "ref_id": "179" }, { "children": [ { "text": ")" } ] } ], "ref_id": "180" } ] }, { "children": [ { "text": ",\n " } ] }, { "children": [ { "children": [ { "text": "firstCreat: " } ] }, { "children": [ { "children": [ { "text": "\"FirstLabTest\"(" } ] }, { "children": [ { "children": [ { "text": "[\"Laboratory Test, Performed\": " } ] }, { "children": [ { "children": [ { "text": "\"Creatinine Lab Test\"" } ] } ] }, { "children": [ { "text": "]" } ] } ], "node_type": "Retrieve", "ref_id": "181" }, { "children": [ { "text": ")" } ] } ], "ref_id": "182" } ] }, { "children": [ { "text": ",\n " } ] }, { "children": [ { "children": [ { "text": "firstGlucose: " } ] }, { "children": [ { "children": [ { "text": "\"FirstLabTest\"(" } ] }, { "children": [ { "children": [ { "text": "[\"Laboratory Test, Performed\": " } ] }, { "children": [ { "children": [ { "text": "\"Glucose Lab Test\"" } ] } ] }, { "children": [ { "text": "]" } ] } ], "node_type": "Retrieve", "ref_id": "183" }, { "children": [ { "text": ")" } ] } ], "ref_id": "184" } ] }, { "children": [ { "text": "\n }" } ] } ], "node_type": "Tuple", "ref_id": "185" } ], "ref_id": "186" } ], "define_name": "Results" } ], "identifier": { "id": "CoreClinicalDataElementsfortheHybridHospitalWideReadmissionHWRMeasurewithClaimsandElectronicHealthRecordData", "version": "0.1.016" } }, "is_main_library": true, "is_top_level": true, "library_name": "CoreClinicalDataElementsfortheHybridHospitalWideReadmissionHWRMeasurewithClaimsandElectronicHealthRecordData", "library_version": "0.1.016", "statement_dependencies": [ { "statement_name": "Patient" }, { "statement_name": "IP Encounters", "statement_references": [ { "hqmf_id": null, "library_name": "MATGlobalCommonFunctions", "statement_name": "Hospitalization Length of Stay" }, { "hqmf_id": null, "library_name": "MATGlobalCommonFunctions", "statement_name": "CalendarAgeInYearsAt" } ] }, { "statement_name": "Initial Population", "statement_references": [ { "hqmf_id": null, "library_name": "CoreClinicalDataElementsfortheHybridHospitalWideReadmissionHWRMeasurewithClaimsandElectronicHealthRecordData", "statement_name": "IP Encounters" } ] }, { "statement_name": "Denominator", "statement_references": [ { "hqmf_id": null, "library_name": "CoreClinicalDataElementsfortheHybridHospitalWideReadmissionHWRMeasurewithClaimsandElectronicHealthRecordData", "statement_name": "Initial Population" } ] }, { "statement_name": "Numerator", "statement_references": [ { "hqmf_id": null, "library_name": "CoreClinicalDataElementsfortheHybridHospitalWideReadmissionHWRMeasurewithClaimsandElectronicHealthRecordData", "statement_name": "Initial Population" } ] }, { "statement_name": "FirstPhysicalExam", "statement_references": [ { "hqmf_id": null, "library_name": "CoreClinicalDataElementsfortheHybridHospitalWideReadmissionHWRMeasurewithClaimsandElectronicHealthRecordData", "statement_name": "IP Encounters" } ] }, { "statement_name": "FirstPhysicalExamWithLabTiming", "statement_references": [ { "hqmf_id": null, "library_name": "CoreClinicalDataElementsfortheHybridHospitalWideReadmissionHWRMeasurewithClaimsandElectronicHealthRecordData", "statement_name": "IP Encounters" } ] }, { "statement_name": "FirstLabTest", "statement_references": [ { "hqmf_id": null, "library_name": "CoreClinicalDataElementsfortheHybridHospitalWideReadmissionHWRMeasurewithClaimsandElectronicHealthRecordData", "statement_name": "IP Encounters" } ] }, { "statement_name": "Results", "statement_references": [ { "hqmf_id": null, "library_name": "CoreClinicalDataElementsfortheHybridHospitalWideReadmissionHWRMeasurewithClaimsandElectronicHealthRecordData", "statement_name": "FirstPhysicalExam" }, { "hqmf_id": null, "library_name": "CoreClinicalDataElementsfortheHybridHospitalWideReadmissionHWRMeasurewithClaimsandElectronicHealthRecordData", "statement_name": "FirstPhysicalExam" }, { "hqmf_id": null, "library_name": "CoreClinicalDataElementsfortheHybridHospitalWideReadmissionHWRMeasurewithClaimsandElectronicHealthRecordData", "statement_name": "FirstPhysicalExam" }, { "hqmf_id": null, "library_name": "CoreClinicalDataElementsfortheHybridHospitalWideReadmissionHWRMeasurewithClaimsandElectronicHealthRecordData", "statement_name": "FirstPhysicalExam" }, { "hqmf_id": null, "library_name": "CoreClinicalDataElementsfortheHybridHospitalWideReadmissionHWRMeasurewithClaimsandElectronicHealthRecordData", "statement_name": "FirstPhysicalExam" }, { "hqmf_id": null, "library_name": "CoreClinicalDataElementsfortheHybridHospitalWideReadmissionHWRMeasurewithClaimsandElectronicHealthRecordData", "statement_name": "FirstPhysicalExamWithLabTiming" }, { "hqmf_id": null, "library_name": "CoreClinicalDataElementsfortheHybridHospitalWideReadmissionHWRMeasurewithClaimsandElectronicHealthRecordData", "statement_name": "FirstLabTest" }, { "hqmf_id": null, "library_name": "CoreClinicalDataElementsfortheHybridHospitalWideReadmissionHWRMeasurewithClaimsandElectronicHealthRecordData", "statement_name": "FirstLabTest" }, { "hqmf_id": null, "library_name": "CoreClinicalDataElementsfortheHybridHospitalWideReadmissionHWRMeasurewithClaimsandElectronicHealthRecordData", "statement_name": "FirstLabTest" }, { "hqmf_id": null, "library_name": "CoreClinicalDataElementsfortheHybridHospitalWideReadmissionHWRMeasurewithClaimsandElectronicHealthRecordData", "statement_name": "FirstLabTest" }, { "hqmf_id": null, "library_name": "CoreClinicalDataElementsfortheHybridHospitalWideReadmissionHWRMeasurewithClaimsandElectronicHealthRecordData", "statement_name": "FirstLabTest" }, { "hqmf_id": null, "library_name": "CoreClinicalDataElementsfortheHybridHospitalWideReadmissionHWRMeasurewithClaimsandElectronicHealthRecordData", "statement_name": "FirstLabTest" }, { "hqmf_id": null, "library_name": "CoreClinicalDataElementsfortheHybridHospitalWideReadmissionHWRMeasurewithClaimsandElectronicHealthRecordData", "statement_name": "FirstLabTest" } ] } ] }, { "cql": "library MATGlobalCommonFunctions version '2.0.000'\r\n\r\nusing QDM version '5.3'\r\n\r\ncodesystem \"LOINC:2.46\": 'urn:oid:2.16.840.1.113883.6.1' version 'urn:hl7:version:2.46'\r\ncodesystem \"SNOMEDCT:2016-03\": 'urn:oid:2.16.840.1.113883.6.96' version 'urn:hl7:version:2016-03'\r\n\r\nvalueset \"Emergency Department Visit\": 'urn:oid:2.16.840.1.113883.3.117.1.7.1.292'\r\nvalueset \"Encounter Inpatient\": 'urn:oid:2.16.840.1.113883.3.666.5.307'\r\nvalueset \"Intensive Care Unit\": 'urn:oid:2.16.840.1.113762.1.4.1110.23'\r\n\r\ncode \"Birthdate\": '21112-8' from \"LOINC:2.46\" display 'Birth date'\r\ncode \"Dead\": '419099009' from \"SNOMEDCT:2016-03\" display 'Dead'\r\n\r\nparameter \"Measurement Period\" Interval\r\n\r\ncontext Patient\r\n\r\ndefine \"Encounter\":\r\n\t[\"Encounter, Performed\": \"Emergency Department Visit\"]\r\n\r\ndefine \"Inpatient Encounter\":\r\n\t[\"Encounter, Performed\": \"Encounter Inpatient\"] EncounterInpatient\r\n\t\twhere \"LengthInDays\"(EncounterInpatient.relevantPeriod)<= 120\r\n\t\t\tand EncounterInpatient.relevantPeriod ends during \"Measurement Period\"\n\n/*ToDate takes a given DateTime value and returns a DateTime with the time components \"zeroed\", and the timezone of the input value, for example, given the DateTime @2012-01-01T06:30:00.0Z, this function will return @2012-01-01T00:00:00.0Z.*/\r\n\r\ndefine function \"ToDate\"(Value DateTime):\r\n\tDateTime(year from Value, month from Value, day from Value, 0, 0, 0, 0, timezone from Value)\n\n/*CalendarAgeInDaysAt calculates the calendar age (meaning the age without considering time components) in days.*/\r\n\r\ndefine function \"CalendarAgeInDaysAt\"(BirthDateTime DateTime, AsOf DateTime):\r\n\tdays between ToDate(BirthDateTime)and ToDate(AsOf)\n\n/*CalendarAgeInDays calculates the calendar age (meaning the age without considering time components) in days as of today*/\r\n\r\ndefine function \"CalendarAgeInDays\"(BirthDateTime DateTime):\r\n\tCalendarAgeInDaysAt(BirthDateTime, Today())\n\n/*CalendarAgeInMonthsAt calculates the calendar age (meaning the age without considering time components) in months.*/\r\n\r\ndefine function \"CalendarAgeInMonthsAt\"(BirthDateTime DateTime, AsOf DateTime):\r\n\tmonths between ToDate(BirthDateTime)and ToDate(AsOf)\n\n/*CalendarAgeInMonths calculates the calendar age (meaning the age without considering time components) in months as of today.*/\r\n\r\ndefine function \"CalendarAgeInMonths\"(BirthDateTime DateTime):\r\n\tCalendarAgeInMonthsAt(BirthDateTime, Today())\n\n/*CalendarAgeInYearsAt calculates the calendar age (meaning the age without considering time components) in years.*/\r\n\r\ndefine function \"CalendarAgeInYearsAt\"(BirthDateTime DateTime, AsOf DateTime):\r\n\tyears between ToDate(BirthDateTime)and ToDate(AsOf)\n\n/*CalendarAgeInYears calculates the calendar age (meaning the age without considering time components) in years as of today.*/\r\n\r\ndefine function \"CalendarAgeInYears\"(BirthDateTime DateTime):\r\n\tCalendarAgeInYearsAt(BirthDateTime, Today())\n\n/*Hospitalization returns the total interval for admission to discharge for the given encounter, or for the admission of any immediately prior emergency department visit to the discharge of the given encounter.*/\r\n\r\ndefine function \"Hospitalization\"(Encounter \"Encounter, Performed\"):\r\n\t( singleton from ( [\"Encounter, Performed\": \"Emergency Department Visit\"] EDVisit\r\n\t\t\twhere EDVisit.relevantPeriod ends 1 hour or less on or before start of Encounter.relevantPeriod\r\n\t) ) X\r\n\t\treturn if X is null then Encounter.relevantPeriod else Interval[start of X.relevantPeriod, end of Encounter.relevantPeriod]\n\n/*calculates the difference in calendar days between the start and end of the given interval.*/\r\n\r\ndefine function \"LengthInDays\"(Value Interval):\r\n\tdifference in days between start of Value and end of Value\n\n/* returns list of all locations within an encounter, including locations for immediately prior ED visit. If data contains many encounters within 1 hour before the start of encounter error will occur indicating the hospitalization cannot be determined*/\r\n\r\ndefine function \"Hospitalization Locations\"(Encounter \"Encounter, Performed\"):\r\n\t( singleton from ( [\"Encounter, Performed\": \"Emergency Department Visit\"] EDVisit\r\n\t\t\twhere EDVisit.relevantPeriod ends 1 hour or less on or before start of Encounter.relevantPeriod\r\n\t) ) EDEncounter\r\n\t\treturn if EDEncounter is null then Encounter.facilityLocations else flatten { EDEncounter.facilityLocations, Encounter.facilityLocations }\n\n/*Returns the length of stay in days (i.e. the number of days between admission and discharge) for the given encounter, or from the admission of any immediately prior emergency department visit to the discharge of the encounter*/\r\n\r\ndefine function \"Hospitalization Length of Stay\"(Encounter \"Encounter, Performed\"):\r\n\tLengthInDays(\"Hospitalization\"(Encounter))\n\n/*Returns admission time for an encounter or for immediately prior emergency department visit. If the data contain many encounters within 1 hour before the start of the encounter an error indicating hospitalization cannot be determined\n*/\r\n\r\ndefine function \"Hospital Admission Time\"(Encounter \"Encounter, Performed\"):\r\n\tstart of \"Hospitalization\"(Encounter)\n\n/*Hospital Discharge Time returns the discharge time for an encounter*/\r\n\r\ndefine function \"Hospital Discharge Time\"(Encounter \"Encounter, Performed\"):\r\n\tend of Encounter.relevantPeriod\n\n/*Returns earliest arrival time for an encounter including any prior ED visit. If the data contain multiple encounters within 1 hour before the start of the encounter, an error will occur indicating it cannot be unambiguously determined\n*/\r\n\r\ndefine function \"Hospital Arrival Time\"(Encounter \"Encounter, Performed\"):\r\n\tstart of First((\"Hospitalization Locations\"(Encounter))HospitalLocation\r\n\t\t\tsort by start of locationPeriod\r\n\t).locationPeriod\n\n/*Returns the latest departure time for encounter including any prior ED visit. If the data contain multiple encounters within 1 hour before the start of the encounter, an error will occur indicating it cannot be unambiguously determined*/\r\n\r\ndefine function \"Hospital Departure Time\"(Encounter \"Encounter, Performed\"):\r\n\tend of Last((\"Hospitalization Locations\"(Encounter))HospitalLocation\r\n\t\t\tsort by start of locationPeriod\r\n\t).locationPeriod\n\n/*Returns the arrival time in the ED for the encounter. If the data contain multiple encounters within 1 hour before the start of the encounter or multiple ED locations an error will occur indicating it cannot be determined\n*/\r\n\r\ndefine function \"Emergency Department Arrival Time\"(Encounter \"Encounter, Performed\"):\r\n\tstart of ( singleton from ( ( \"Hospitalization Locations\"(Encounter)) HospitalLocation\r\n\t\t\t\twhere HospitalLocation.code in \"Emergency Department Visit\"\r\n\t\t)\r\n\t).locationPeriod\n\n/*First Inpatient Intensive Care Unit returns the first intensive care unit for\nthe given encounter, without considering any immediately prior emergency\ndepartment visit.*/\r\n\r\ndefine function \"First Inpatient Intensive Care Unit\"(Encounter \"Encounter, Performed\"):\r\n\tFirst((Encounter.facilityLocations)HospitalLocation\r\n\t\t\twhere HospitalLocation.code in \"Intensive Care Unit\"\r\n\t\t\t\tand HospitalLocation.locationPeriod during Encounter.relevantPeriod\r\n\t\t\tsort by start of locationPeriod\r\n\t)\r\n", 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"children": [ { "text": "\n " } ] }, { "children": [ { "children": [ { "text": "where " } ] }, { "children": [ { "children": [ { "children": [ { "children": [ { "children": [ { "text": "HospitalLocation" } ] } ], "ref_id": "208" }, { "children": [ { "text": "." } ] }, { "children": [ { "children": [ { "text": "code" } ] } ], "ref_id": "209" } ], "ref_id": "209" }, { "children": [ { "text": " in " } ] }, { "children": [ { "children": [ { "text": "\"Intensive Care Unit\"" } ] } ], "ref_id": "210" } ], "node_type": "InValueSet", "ref_id": "211" }, { "children": [ { "text": "\n and " } ] }, { "children": [ { "children": [ { "children": [ { "children": [ { "text": "HospitalLocation" } ] } ], "ref_id": "212" }, { "children": [ { "text": "." } ] }, { "children": [ { "children": [ { "text": "locationPeriod" } ] } ], "node_type": "Property", "ref_id": "213" } ], "node_type": "Property", "ref_id": "213" }, { "children": [ { "text": " during " } ] }, { "children": [ { "children": [ { "children": [ { "text": "Encounter" } ] } ], "ref_id": "214" }, { "children": [ { "text": "." } ] }, { "children": [ { "children": [ { "text": "relevantPeriod" } ] } ], "node_type": "Property", "ref_id": "215" } ], "node_type": "Property", "ref_id": "215" } ], "node_type": "IncludedIn", "ref_id": "216" } ], "ref_id": "217" } ], "ref_id": "217" }, { "children": [ { "text": "\n " } ] }, { "children": [ { "children": [ { "text": "sort by " } ] }, { "children": [ { "children": [ { "children": [ { "text": "start of " } ] }, { "children": [ { "children": [ { "text": "locationPeriod" } ] } ], "node_type": "IdentifierRef", "ref_id": "218" } ], "node_type": "Start", "ref_id": "219" } ], "ref_id": "220" } ], "ref_id": "221" } ], "ref_id": "222" }, { "children": [ { "text": "\n )" } ] } ], "node_type": "First", "ref_id": "223" } ], "node_type": "First", "ref_id": "223" } ], "ref_id": "224" } ], "define_name": "First Inpatient Intensive Care Unit" } ], "identifier": { "id": "MATGlobalCommonFunctions", "version": "2.0.000" } }, "is_main_library": false, "is_top_level": true, "library_name": "MATGlobalCommonFunctions", "library_version": "2.0.000", "statement_dependencies": [ { "statement_name": "Hospitalization Length of Stay", "statement_references": [ { "hqmf_id": null, "library_name": "MATGlobalCommonFunctions", "statement_name": "LengthInDays" }, { "hqmf_id": null, "library_name": "MATGlobalCommonFunctions", "statement_name": "Hospitalization" } ] }, { "statement_name": "LengthInDays" }, { "statement_name": "Hospitalization" }, { "statement_name": "CalendarAgeInYearsAt", "statement_references": [ { "hqmf_id": null, "library_name": "MATGlobalCommonFunctions", "statement_name": "ToDate" } ] }, { "statement_name": "ToDate" } ] } ], "created_at": null, "description": "This logic is intended to extract electronic clinical data. This is not an electronic clinical quality measure and this logic will not produce measure results. Instead, it will produce a file containing the data that CMS will link with administrative claims to risk adjust the hybrid HWR outcome measure. It is designed to extract the first captured set of vital signs and basic laboratory results obtained on adult Medicare fee-for-service patients admitted to acute care short stay hospitals.", "hqmf_id": "40280382-5FA6-FE85-0160-128121CF2479", "hqmf_set_id": "FA75DE85-A934-45D7-A2F7-C700A756078B", "hqmf_version_number": "0", "main_cql_library": "CoreClinicalDataElementsfortheHybridHospitalWideReadmissionHWRMeasurewithClaimsandElectronicHealthRecordData", "measure_attributes": [ { "code": "OTH", "value": "529", "name": "eCQM Identifier (Measure Authoring Tool)", "code_obj": { "type": "CD", "null_flavor": "OTH", "original_text": "eCQM Identifier (Measure Authoring Tool)" }, "value_obj": { "type": "ED", "value": "529", "media_type": "text/plain" } }, { "code": "OTH", "value": "2879", "name": "NQF Number", "code_obj": { "type": "CD", "null_flavor": "OTH", "original_text": "NQF Number" }, "value_obj": { "type": "ED", "value": "2879", "media_type": "text/plain" } }, { "code": "COPY", "value": "Limited proprietary coding is contained in these specifications for user convenience. Users of proprietary code sets should obtain all necessary licenses from the owners of the code sets. \n\nThis material contains SNOMED Clinical Terms (R) (SNOMED CT(C)) copyright 2004-2016 International Health Terminology Standards Development Organization. All rights reserved.\n\nLOINC (R) is a registered trademark of the Regenstrief Institute.", "name": "Copyright", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "COPY", "title": "Copyright" }, "value_obj": { "type": "ED", "value": "Limited proprietary coding is contained in these specifications for user convenience. Users of proprietary code sets should obtain all necessary licenses from the owners of the code sets. \n\nThis material contains SNOMED Clinical Terms (R) (SNOMED CT(C)) copyright 2004-2016 International Health Terminology Standards Development Organization. All rights reserved.\n\nLOINC (R) is a registered trademark of the Regenstrief Institute.", "media_type": "text/plain" } }, { "code": "DISC", "value": "These performance specifications are not clinical guidelines and do not establish a standard of medical care, and have not been tested for all potential applications.\n\nTHE MEASURES AND SPECIFICATIONS ARE PROVIDED AS IS WITHOUT WARRANTY OF ANY KIND.\n\nDue to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM].", "name": "Disclaimer", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "DISC", "title": "Disclaimer" }, "value_obj": { "type": "ED", "value": "These performance specifications are not clinical guidelines and do not establish a standard of medical care, and have not been tested for all potential applications.\n\nTHE MEASURES AND SPECIFICATIONS ARE PROVIDED AS IS WITHOUT WARRANTY OF ANY KIND.\n\nDue to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM].", "media_type": "text/plain" } }, { "code": "MSRSCORE", "name": "Measure Scoring", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "MSRSCORE", "title": "Measure Scoring" }, "value_obj": { "type": "CD", "system": "2.16.840.1.113883.1.11.20367", "code": "PROPOR", "title": "Proportion" } }, { "code": "STRAT", "value": "None", "name": "Stratification", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "STRAT", "title": "Stratification" }, "value_obj": { "type": "ED", "value": "None", "media_type": "text/plain" } }, { "code": "MSRADJ", "value": "For a detailed description of how the core clinical data elements are used in the hybrid HWR measure risk adjustment model, see the Hybrid HWR Measure with Electronic Health Record Extracted Risk Factors Specifications Report on QualityNet.org here:\nhttps://www.qualitynet.org/dcs/ContentServer?c=Page&pagename=QnetPublic%2FPage%2FQnetTier3&cid=1228776337297", "name": "Risk Adjustment", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "MSRADJ", "title": "Risk Adjustment" }, "value_obj": { "type": "ED", "value": "For a detailed description of how the core clinical data elements are used in the hybrid HWR measure risk adjustment model, see the Hybrid HWR Measure with Electronic Health Record Extracted Risk Factors Specifications Report on QualityNet.org here:\nhttps://www.qualitynet.org/dcs/ContentServer?c=Page&pagename=QnetPublic%2FPage%2FQnetTier3&cid=1228776337297", "media_type": "text/plain" } }, { "code": "MSRAGG", "value": "None", "name": "Rate Aggregation", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "MSRAGG", "title": "Rate Aggregation" }, "value_obj": { "type": "ED", "value": "None", "media_type": "text/plain" } }, { "code": "RAT", "value": "Although we are using the \"proportion\" function in the MAT, hospitals will not report a proportion, ratio, or rate. Instead hospitals will report actual data values for all the elements included. \n\nThe intent of this logic is to extract the FIRST set of clinical data elements on patients, from hospital EHRs. The data will be linked with administrative claims to risk adjust the hybrid HWR outcome measure. This work addresses stakeholder concerns that clinical data garnered from patients, and used by clinicians to guide diagnostic decisions and treatment, are preferable to administrative claims data when profiling hospitals' case mix. We are calling the list of data elements for extraction the \"HWR-specific core clinical data elements\". The core clinical data elements are the first set of vital signs and basic laboratory test results captured on adult Medicare fee-for-service patients, age 65 or older (Initial Population), after they arrive at the hospital to which they are subsequently admitted. For example, this first set of data values is often captured in the emergency department or in the pre-operative area sometimes hours before a patient is admitted to that same facility. \n\nThese data elements were selected because they: 1. reflect patients' clinical status when they first present to the hospital; 2. are clinically and statistically relevant to patient outcomes; 3. are consistently obtained on adult inpatients based on current clinical practice; 4. are captured with a standard definition and recorded in a standard format across providers; and 5. are entered in structured fields that are feasibly retrieved from current EHR systems. Additional data called Linking Variables are used to link EHR data files with administrative claims data for CMS to calculate results for the hybrid HWR measure, which are: CMS Certification Number; Health Insurance Claim Number or Medicare Beneficiary Identifier; date of birth; sex; admission date; and discharge date.", "name": "Rationale", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "RAT", "title": "Rationale" }, "value_obj": { "type": "ED", "value": "Although we are using the \"proportion\" function in the MAT, hospitals will not report a proportion, ratio, or rate. Instead hospitals will report actual data values for all the elements included. \n\nThe intent of this logic is to extract the FIRST set of clinical data elements on patients, from hospital EHRs. The data will be linked with administrative claims to risk adjust the hybrid HWR outcome measure. This work addresses stakeholder concerns that clinical data garnered from patients, and used by clinicians to guide diagnostic decisions and treatment, are preferable to administrative claims data when profiling hospitals' case mix. We are calling the list of data elements for extraction the \"HWR-specific core clinical data elements\". The core clinical data elements are the first set of vital signs and basic laboratory test results captured on adult Medicare fee-for-service patients, age 65 or older (Initial Population), after they arrive at the hospital to which they are subsequently admitted. For example, this first set of data values is often captured in the emergency department or in the pre-operative area sometimes hours before a patient is admitted to that same facility. \n\nThese data elements were selected because they: 1. reflect patients' clinical status when they first present to the hospital; 2. are clinically and statistically relevant to patient outcomes; 3. are consistently obtained on adult inpatients based on current clinical practice; 4. are captured with a standard definition and recorded in a standard format across providers; and 5. are entered in structured fields that are feasibly retrieved from current EHR systems. Additional data called Linking Variables are used to link EHR data files with administrative claims data for CMS to calculate results for the hybrid HWR measure, which are: CMS Certification Number; Health Insurance Claim Number or Medicare Beneficiary Identifier; date of birth; sex; admission date; and discharge date.", "media_type": "text/plain" } }, { "code": "CRS", "value": "The logic is not meant to guide or alter the care patients receive. The purpose of this core clinical data elements logic is to extract clinical data that are already routinely captured in EHRs among hospitalized adult patients. It is not intended to require that clinical staff perform additional measurements or tests that are not needed for diagnostic assessment or treatment of patients.", "name": "Clinical Recommendation Statement", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "CRS", "title": "Clinical Recommendation Statement" }, "value_obj": { "type": "ED", "value": "The logic is not meant to guide or alter the care patients receive. The purpose of this core clinical data elements logic is to extract clinical data that are already routinely captured in EHRs among hospitalized adult patients. It is not intended to require that clinical staff perform additional measurements or tests that are not needed for diagnostic assessment or treatment of patients.", "media_type": "text/plain" } }, { "code": "IDUR", "value": "No actual measure score will be generated by hospitals. Instead hospitals will report the data values for each of the core clinical data elements for all patients in the Initial Population. These core clinical data elements will be linked to administrative claims data and used by CMS to calculate results for the hybrid HWR measure. Hospitals that submit this data will receive reports detailing the success of their data submission.", "name": "Improvement Notation", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "IDUR", "title": "Improvement Notation" }, "value_obj": { "type": "ED", "value": "No actual measure score will be generated by hospitals. Instead hospitals will report the data values for each of the core clinical data elements for all patients in the Initial Population. These core clinical data elements will be linked to administrative claims data and used by CMS to calculate results for the hybrid HWR measure. Hospitals that submit this data will receive reports detailing the success of their data submission.", "media_type": "text/plain" } }, { "code": "REF", "name": "Reference", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "REF", "title": "Reference" }, "value_obj": { "type": "ED", "media_type": "text/plain" } }, { "code": "DEF", "value": "HWR-Specific Core Clinical Data Elements", "name": "Definition", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "DEF", "title": "Definition" }, "value_obj": { "type": "ED", "value": "HWR-Specific Core Clinical Data Elements", "media_type": "text/plain" } }, { "code": "GUIDE", "value": "This logic guides the user to extract the FIRST captured HWR-specific core clinical data elements for all Medicare fee-for-service patients age 65 or older (Initial Population) directly admitted to the hospital or admitted to the same facility after an emergency department stay or surgical procedure. \n\nThe logic supports extraction of the FIRST set of HWR-specific core clinical data elements in two different ways depending on if the patient was a direct admission, meaning that the patient was admitted directly to an inpatient unit without first receiving care in the Emergency Department or other outpatient location within the same admitting facility: \n\n1. If the patient was a direct admission, the logic supports extraction of the FIRST captured vital signs within 2 hours after the start of the inpatient admission, and the FIRST captured laboratory test results within 24 hours after the start of the inpatient admission. \n2. If the patient has values captured prior to admission, for example from the emergency department or pre-operative or other outpatient area within the hospital, the logic supports extraction of the FIRST captured vital signs and laboratory test results within 24 hours PRIOR to the start of the inpatient admission. All clinical systems used in inpatient and outpatient locations within the hospital facility should be queried when looking for core clinical data element values related to a patient who is subsequently admitted.\n\nValue sets for the laboratory tests represent the LOINC codes currently available for these tests. If the institution is using local codes to capture and store relevant laboratory test data, those sites should map that information to the LOINC code for CCDE reporting.\n\nNOTE: Do not report ALL values on a patient during their entire admission. Only report the FIRST recorded value for EACH core clinical data element collected in the appropriate timeframe, if available.\n\nFor each patient please also submit the following Linking Variables: \nCMS Certification Number; \nHealth Insurance Claim Number or Medicare Beneficiary Identifier;\nDate of Birth;\nSex;\nAdmission Date; and,\nDischarge Date.", "name": "Guidance", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "GUIDE", "title": "Guidance" }, "value_obj": { "type": "ED", "value": "This logic guides the user to extract the FIRST captured HWR-specific core clinical data elements for all Medicare fee-for-service patients age 65 or older (Initial Population) directly admitted to the hospital or admitted to the same facility after an emergency department stay or surgical procedure. \n\nThe logic supports extraction of the FIRST set of HWR-specific core clinical data elements in two different ways depending on if the patient was a direct admission, meaning that the patient was admitted directly to an inpatient unit without first receiving care in the Emergency Department or other outpatient location within the same admitting facility: \n\n1. If the patient was a direct admission, the logic supports extraction of the FIRST captured vital signs within 2 hours after the start of the inpatient admission, and the FIRST captured laboratory test results within 24 hours after the start of the inpatient admission. \n2. If the patient has values captured prior to admission, for example from the emergency department or pre-operative or other outpatient area within the hospital, the logic supports extraction of the FIRST captured vital signs and laboratory test results within 24 hours PRIOR to the start of the inpatient admission. All clinical systems used in inpatient and outpatient locations within the hospital facility should be queried when looking for core clinical data element values related to a patient who is subsequently admitted.\n\nValue sets for the laboratory tests represent the LOINC codes currently available for these tests. If the institution is using local codes to capture and store relevant laboratory test data, those sites should map that information to the LOINC code for CCDE reporting.\n\nNOTE: Do not report ALL values on a patient during their entire admission. Only report the FIRST recorded value for EACH core clinical data element collected in the appropriate timeframe, if available.\n\nFor each patient please also submit the following Linking Variables: \nCMS Certification Number; \nHealth Insurance Claim Number or Medicare Beneficiary Identifier;\nDate of Birth;\nSex;\nAdmission Date; and,\nDischarge Date.", "media_type": "text/plain" } }, { "code": "TRANF", "value": "To be determined.", "name": "Transmission Format", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "TRANF", "title": "Transmission Format" }, "value_obj": { "type": "ED", "value": "To be determined.", "media_type": "text/plain" } }, { "code": "IPOP", "value": "All Medicare fee-for-service patients age 65 and older with an inpatient admission (length of stay <365 days) during the measurement period.", "name": "Initial Population", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "IPOP", "title": "Initial Population" }, "value_obj": { "type": "ED", "value": "All Medicare fee-for-service patients age 65 and older with an inpatient admission (length of stay <365 days) during the measurement period.", "media_type": "text/plain" } }, { "code": "DENOM", "value": "Same as initial population", "name": "Denominator", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "DENOM", "title": "Denominator" }, "value_obj": { "type": "ED", "value": "Same as initial population", "media_type": "text/plain" } }, { "code": "DENEX", "value": "None", "name": "Denominator Exclusions", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "DENEX", "title": "Denominator Exclusions" }, "value_obj": { "type": "ED", "value": "None", "media_type": "text/plain" } }, { "code": "NUMER", "value": "Same as initial population", "name": "Numerator", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "NUMER", "title": "Numerator" }, "value_obj": { "type": "ED", "value": "Same as initial population", "media_type": "text/plain" } }, { "code": "NUMEX", "value": "None", "name": "Numerator Exclusions", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "NUMEX", "title": "Numerator Exclusions" }, "value_obj": { "type": "ED", "value": "None", "media_type": "text/plain" } }, { "code": "DENEXCEP", "value": "None", "name": "Denominator Exceptions", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "DENEXCEP", "title": "Denominator Exceptions" }, "value_obj": { "type": "ED", "value": "None", "media_type": "text/plain" } }, { "code": "SDE", "value": "For patients in the denominator, report the FIRST value for vital signs captured within the 24 hours prior to the inpatient admission. If no values were captured in the 24 hours prior to the admission (for example, for patients directly admitted to the hospital) report the first value captured within 2 hours after the start of the inpatient admission. For laboratory test results, report the first value captured in the 24 hours prior to admission. If there are no values in the 24 hours prior to admission, report the first value captured within 24 hours after the start of the inpatient admission. First values for the following data elements may be captured in the emergency department or other outpatient area within the hospital before a patient is subsequently admitted to the same hospital. First values for these data elements may also be captured on an inpatient unit for directly admitted patients who do not receive care in the emergency department or other hospital outpatient location before admission. \n\nThe core clinical data elements are as follows:\nHeart rate\nSystolic blood pressure\nRespiratory rate\nTemperature\nOxygen saturation\nWeight\nHematocrit\nWhite blood cell count\nPotassium\nSodium\nBicarbonate\nCreatinine\nGlucose\n\nNOTE: Do not report ALL values on a patient during their entire admission. Only report the FIRST recorded value for EACH core clinical data element collected in the appropriate timeframe, if available.", "name": "Supplemental Data Elements", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "SDE", "title": "Supplemental Data Elements" }, "value_obj": { "type": "ED", "value": "For patients in the denominator, report the FIRST value for vital signs captured within the 24 hours prior to the inpatient admission. If no values were captured in the 24 hours prior to the admission (for example, for patients directly admitted to the hospital) report the first value captured within 2 hours after the start of the inpatient admission. For laboratory test results, report the first value captured in the 24 hours prior to admission. If there are no values in the 24 hours prior to admission, report the first value captured within 24 hours after the start of the inpatient admission. First values for the following data elements may be captured in the emergency department or other outpatient area within the hospital before a patient is subsequently admitted to the same hospital. First values for these data elements may also be captured on an inpatient unit for directly admitted patients who do not receive care in the emergency department or other hospital outpatient location before admission. \n\nThe core clinical data elements are as follows:\nHeart rate\nSystolic blood pressure\nRespiratory rate\nTemperature\nOxygen saturation\nWeight\nHematocrit\nWhite blood cell count\nPotassium\nSodium\nBicarbonate\nCreatinine\nGlucose\n\nNOTE: Do not report ALL values on a patient during their entire admission. Only report the FIRST recorded value for EACH core clinical data element collected in the appropriate timeframe, if available.", "media_type": "text/plain" } } ], "measure_period": { "type": "IVL_TS", "low": { "type": "TS", "value": "201201010000", "inclusive?": true, "derived?": false }, "high": { "type": "TS", "value": "201212312359", "inclusive?": true, "derived?": false }, "width": { "type": "PQ", "unit": "a", "value": "1", "inclusive?": true, "derived?": false } }, "measure_scoring": "PROPORTION", "population_criteria": { "IPP": { "conjunction?": true, "type": "IPP", "hqmf_id": "33719872-9241-4DF9-BF73-D7BDE6D44929", "preconditions": [ { "id": 2, "preconditions": [ { "id": 1, "reference": "CoreClinicalDataElementsfortheHybridHospitalWideReadmissionHWRMeasurewithClaimsandElectronicHealthRecordData__IP_Encounters__61CCDF82_CA04_4F66_965D_2778481058B5" } ], "conjunction_code": "allTrue" } ] }, "DENOM": { "conjunction?": true, "type": "DENOM", "hqmf_id": "B4C75BE6-6F53-42E3-9C63-13AB374685DE", "preconditions": [ { "id": 4, "preconditions": [ { "id": 3, "reference": "CoreClinicalDataElementsfortheHybridHospitalWideReadmissionHWRMeasurewithClaimsandElectronicHealthRecordData__Denominator__61CCDF82_CA04_4F66_965D_2778481058B5" } ], "conjunction_code": "allTrue" } ] }, "NUMER": { "conjunction?": true, "type": "NUMER", "hqmf_id": "ADE8C6B6-A77C-49E1-BB2A-728A5AA7BB06", "preconditions": [ { "id": 6, "preconditions": [ { "id": 5, "reference": "CoreClinicalDataElementsfortheHybridHospitalWideReadmissionHWRMeasurewithClaimsandElectronicHealthRecordData__Numerator__61CCDF82_CA04_4F66_965D_2778481058B5" } ], "conjunction_code": "allTrue" } ] } }, "population_sets": [ { "population_set_id": "PopulationCriteria1", "populations": { "DENOM": { "hqmf_id": "B4C75BE6-6F53-42E3-9C63-13AB374685DE", "library_name": "CoreClinicalDataElementsfortheHybridHospitalWideReadmissionHWRMeasurewithClaimsandElectronicHealthRecordData", "statement_name": "Denominator" }, "IPP": { "hqmf_id": "33719872-9241-4DF9-BF73-D7BDE6D44929", "library_name": "CoreClinicalDataElementsfortheHybridHospitalWideReadmissionHWRMeasurewithClaimsandElectronicHealthRecordData", "statement_name": "IP Encounters" }, "NUMER": { "hqmf_id": "ADE8C6B6-A77C-49E1-BB2A-728A5AA7BB06", "library_name": "CoreClinicalDataElementsfortheHybridHospitalWideReadmissionHWRMeasurewithClaimsandElectronicHealthRecordData", "statement_name": "Numerator" }, "_type": "CQM::ProportionPopulationMap" }, "supplemental_data_elements": [ { "hqmf_id": null, "library_name": "CoreClinicalDataElementsfortheHybridHospitalWideReadmissionHWRMeasurewithClaimsandElectronicHealthRecordData", "statement_name": "Patient" } ], "risk_adjustment_variables": [ { "hqmf_id": null, "library_name": "CoreClinicalDataElementsfortheHybridHospitalWideReadmissionHWRMeasurewithClaimsandElectronicHealthRecordData", "statement_name": "IP Encounters" } ], "title": "Population Criteria Section" } ], "source_data_criteria": [ { 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