{
  "resourceType": "Measure",
  "id": "measure-ratio-exm",
  "meta": {
    "profile": [
      "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/ratio-measure-cqfm",
      "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-measure-cqfm"
    ]
  },
  "text": {
    "status": "extensions",
    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n    <table class=\"grid dict\">\n        \n        <tr>\n            <th scope=\"row\"><b>Id: </b></th>\n            <td style=\"padding-left: 4px;\">measure-ratio-exm</td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Url: </b></th>\n            <td style=\"padding-left: 4px;\">http://example.org/fhir/measures/measure-ratio-exm</td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Version: </b></th>\n            <td style=\"padding-left: 4px;\">2.0.0</td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Identifier: </b></th>\n            <td style=\"padding-left: 4px;\">\n                \n                \n                <p style=\"margin-bottom: 5px;\">\n                    <b>value: </b> <span>EXMRatio</span>\n                </p>\n                \n            </td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Name: </b></th>\n            <td style=\"padding-left: 4px;\">EXMRatioMeasure</td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Title: </b></th>\n            <td style=\"padding-left: 4px;\">EXM Ratio Measure</td>\n        </tr>\n        \n        \n        \n        <tr>\n            <th scope=\"row\"><b>Status: </b></th>\n            <td style=\"padding-left: 4px;\">active</td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Experimental: </b></th>\n            <td style=\"padding-left: 4px;\">true</td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Scoring: </b></th>\n            <td style=\"padding-left: 4px;\">\n                \n                    \n                        \n                        <p style=\"margin-bottom: 5px;\">\n                            <b>system: </b> <span>http://terminology.hl7.org/CodeSystem/measure-scoring</span>\n                        </p>\n                        \n                        \n                        <p style=\"margin-bottom: 5px;\">\n                            <b>code: </b> <span>ratio</span>\n                        </p>\n                        \n                        \n                        <p style=\"margin-bottom: 5px;\">\n                            <b>display: </b> <span>Ratio</span>\n                        </p>\n                        \n                    \n                \n                \n            </td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Improvement Notation: </b></th>\n            <td style=\"padding-left: 4px;\">\n                \n                    \n                        \n                        <p style=\"margin-bottom: 5px;\">\n                            <b>system: </b> <span>http://terminology.hl7.org/CodeSystem/measure-improvement-notation</span>\n                        </p>\n                        \n                        \n                        <p style=\"margin-bottom: 5px;\">\n                            <b>code: </b> <span>decrease</span>\n                        </p>\n                        \n                        \n                        <p style=\"margin-bottom: 5px;\">\n                            <b>display: </b> <span>Decreased score indicates improvement</span>\n                        </p>\n                        \n                    \n                \n                \n            </td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Type: </b></th>\n            <td style=\"padding-left: 4px;\">\n                \n                    \n                        \n                        <p style=\"margin-bottom: 5px;\">\n                            <b>system: </b> <span>http://terminology.hl7.org/CodeSystem/measure-type</span>\n                        </p>\n                        \n                        \n                        <p style=\"margin-bottom: 5px;\">\n                            <b>code: </b> <span>process</span>\n                        </p>\n                        \n                        \n                    \n                \n                \n            </td>\n        </tr>\n        \n        \n        \n        <tr>\n            <th scope=\"row\"><b>Date: </b></th>\n            <td style=\"padding-left: 4px;\">2021-04-03</td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Publisher: </b></th>\n            <td style=\"padding-left: 4px;\">Clinical Quality Information WG</td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Description: </b></th>\n            <td style=\"padding-left: 4px;\">An example FHIR-based publishable measure</td>\n        </tr>\n        \n        \n        \n        \n        <tr>\n            <th scope=\"row\"><b>Parameters: </b></th>\n            <td style=\"padding-left: 4px;\">\n                <table class=\"grid-dict\">\n                    <tr><th><b>name</b></th><th><b>use</b></th><th><b>min</b></th><th><b>max</b></th><th><b>type</b></th></tr>\n                    \n                    <tr>\n                        <td>Numerator</td>\n                        <td>out</td>\n                        <td>0</td>\n                        <td>*</td>\n                        <td>Encounter</td>\n                    </tr>\n                    \n                    <tr>\n                        <td>Initial Population</td>\n                        <td>out</td>\n                        <td>0</td>\n                        <td>*</td>\n                        <td>Encounter</td>\n                    </tr>\n                    \n                    <tr>\n                        <td>Qualifying Encounters</td>\n                        <td>out</td>\n                        <td>0</td>\n                        <td>*</td>\n                        <td>Encounter</td>\n                    </tr>\n                    \n                    <tr>\n                        <td>Denominator</td>\n                        <td>out</td>\n                        <td>0</td>\n                        <td>*</td>\n                        <td>Encounter</td>\n                    </tr>\n                    \n                </table>\n            </td>\n        </tr>\n        \n        \n        <tr>\n          <th scope=\"row\"><b>Data Requirements: </b></th>\n          <td style=\"padding-left: 4px;\">\n                <table class=\"grid-dict\">\n                    <tr><th><b>type</b></th><th><b>path</b></th><th><b>valueSet or system</b></th><th><b>code</b></th></tr>\n                    \n                        <tr>\n                            <td>Encounter</td>\n                            <td>type</td>\n                            \n                                <td>http://example.org/fhir/ValueSet/TBD</td>\n                                <td></td>\n                            \n                            \n                        </tr>\n                    \n                </table>\n          </td>\n        </tr>\n        \n        \n        \n        \n        <tr>\n            <th scope=\"row\"><b>Use Context: </b></th>\n            <td style=\"padding-left: 4px;\">\n                <table class=\"grid-dict\">\n                    <tr><th><b>code</b></th><th><b>value</b></th></tr>\n                    \n                      <tr>\n                        <td>program</td>\n                        <td>eligible-provider</td>\n                      </tr>\n                    \n                </table>\n            </td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Jurisdiction: </b></th>\n            <td style=\"padding-left: 25px;\">US</td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Topic: </b></th>\n            <td style=\"padding-left: 25px;\">57024-2</td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Purpose: </b></th>\n            <td style=\"padding-left: 4px;\">The purpose of this measure is to...</td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Usage: </b></th>\n            <td style=\"padding-left: 4px;\">Users of this measure should be aware of...</td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Copyright: </b></th>\n            <td style=\"padding-left: 25px;\">Example Copyright Statement</td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Disclaimer: </b></th>\n            <td style=\"padding-left: 25px;\">Example disclaimer</td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Approval Date: </b></th>\n            <td style=\"padding-left: 4px;\">2019-02-17</td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Last Review Date: </b></th>\n            <td style=\"padding-left: 4px;\">2019-02-17</td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Effective Period: </b></th>\n            <td style=\"padding-left: 4px;\">2018-01-01..2018-12-31</td>\n        </tr>\n        \n        \n        <tr>\n          <th scope=\"row\"><b>Related Artifacts: </b></th>\n          <td style=\"padding-left: 4px;\">\n            \n            \n            \n            <p><b>Dependencies</b></p>\n            <ul>\n              \n                <li>http://example.org/fhir/ValueSet/TBD</li>\n              \n            </ul>\n            \n            \n            \n            \n            \n          </td>\n        </tr>\n        \n        \n        \n        \n        \n        <tr>\n          <th scope=\"row\"><b>Logic Definitions: </b></th>\n          <td style=\"padding-left: 4px;\">\n            \n                <table class=\"grid-dict\">\n                    <tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>\n                    <tr>\n                        \n                            <td>EXMRatio</td>\n                        \n                        \n                            <td>Numerator</td>\n                        \n                        \n                    </tr>\n                </table>\n                \n                    <pre><code class=\"language-cql\">define \"Numerator\":\n  \"Initial Population\"</code></pre>\n                \n                <br/><br/>\n            \n                <table class=\"grid-dict\">\n                    <tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>\n                    <tr>\n                        \n                            <td>EXMRatio</td>\n                        \n                        \n                            <td>Initial Population</td>\n                        \n                        \n                    </tr>\n                </table>\n                \n                    <pre><code class=\"language-cql\">define \"Initial Population\":\n  \"Qualifying Encounters\"</code></pre>\n                \n                <br/><br/>\n            \n                <table class=\"grid-dict\">\n                    <tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>\n                    <tr>\n                        \n                            <td>EXMRatio</td>\n                        \n                        \n                            <td>Qualifying Encounters</td>\n                        \n                        \n                    </tr>\n                </table>\n                \n                    <pre><code class=\"language-cql\">define \"Qualifying Encounters\":\n  [\"Encounter\": \"Inpatient\"]</code></pre>\n                \n                <br/><br/>\n            \n                <table class=\"grid-dict\">\n                    <tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>\n                    <tr>\n                        \n                            <td>EXMRatio</td>\n                        \n                        \n                            <td>Denominator</td>\n                        \n                        \n                    </tr>\n                </table>\n                \n                    <pre><code class=\"language-cql\">define \"Denominator\":\n  \"Initial Population\"</code></pre>\n                \n                <br/><br/>\n            \n                <table class=\"grid-dict\">\n                    <tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>\n                    <tr>\n                        \n                            <td>EXMRatio</td>\n                        \n                        \n                            <td>Initial Population</td>\n                        \n                        \n                    </tr>\n                </table>\n                \n                    <pre><code class=\"language-cql\">define \"Initial Population\":\n  \"Qualifying Encounters\"</code></pre>\n                \n                <br/><br/>\n            \n          </td>\n        </tr>\n        \n    </table>\n</div>"
  },
  "extension": [
    {
      "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis",
      "valueCode": "Encounter"
    },
    {
      "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoringUnit",
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "http://unitsofmeasure.org",
            "code": "/1000.d"
          }
        ]
      }
    },
    {
      "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-parameter",
      "valueParameterDefinition": {
        "name": "Numerator",
        "use": "out",
        "min": 0,
        "max": "*",
        "type": "Encounter"
      }
    },
    {
      "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-parameter",
      "valueParameterDefinition": {
        "name": "Initial Population",
        "use": "out",
        "min": 0,
        "max": "*",
        "type": "Encounter"
      }
    },
    {
      "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-parameter",
      "valueParameterDefinition": {
        "name": "Qualifying Encounters",
        "use": "out",
        "min": 0,
        "max": "*",
        "type": "Encounter"
      }
    },
    {
      "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-parameter",
      "valueParameterDefinition": {
        "name": "Denominator",
        "use": "out",
        "min": 0,
        "max": "*",
        "type": "Encounter"
      }
    },
    {
      "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-dataRequirement",
      "valueDataRequirement": {
        "type": "Encounter",
        "profile": [
          "http://hl7.org/fhir/StructureDefinition/Encounter"
        ],
        "codeFilter": [
          {
            "path": "type",
            "valueSet": "http://example.org/fhir/ValueSet/TBD"
          }
        ]
      }
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "EXMRatio"
        },
        {
          "url": "name",
          "valueString": "Numerator"
        },
        {
          "url": "statement",
          "valueString": "define \"Numerator\":\n  \"Initial Population\""
        },
        {
          "url": "displaySequence",
          "valueInteger": 0
        }
      ],
      "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "EXMRatio"
        },
        {
          "url": "name",
          "valueString": "Initial Population"
        },
        {
          "url": "statement",
          "valueString": "define \"Initial Population\":\n  \"Qualifying Encounters\""
        },
        {
          "url": "displaySequence",
          "valueInteger": 1
        }
      ],
      "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "EXMRatio"
        },
        {
          "url": "name",
          "valueString": "Qualifying Encounters"
        },
        {
          "url": "statement",
          "valueString": "define \"Qualifying Encounters\":\n  [\"Encounter\": \"Inpatient\"]"
        },
        {
          "url": "displaySequence",
          "valueInteger": 2
        }
      ],
      "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "EXMRatio"
        },
        {
          "url": "name",
          "valueString": "Denominator"
        },
        {
          "url": "statement",
          "valueString": "define \"Denominator\":\n  \"Initial Population\""
        },
        {
          "url": "displaySequence",
          "valueInteger": 3
        }
      ],
      "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "EXMRatio"
        },
        {
          "url": "name",
          "valueString": "Initial Population"
        },
        {
          "url": "statement",
          "valueString": "define \"Initial Population\":\n  \"Qualifying Encounters\""
        },
        {
          "url": "displaySequence",
          "valueInteger": 4
        }
      ],
      "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
    }
  ],
  "url": "http://example.org/fhir/measures/measure-ratio-exm",
  "identifier": [
    {
      "system": "http://example.org/fhir/cqi/ecqm/Measure/Identifier/exm",
      "value": "EXMRatio"
    }
  ],
  "version": "2.0.0",
  "name": "EXMRatioMeasure",
  "title": "EXM Ratio Measure",
  "status": "active",
  "experimental": true,
  "date": "2021-04-03",
  "publisher": "Clinical Quality Information WG",
  "contact": [
    {
      "telecom": [
        {
          "system": "url",
          "value": "http://www.hl7.org/Special/committees/cqi/index.cfm"
        }
      ]
    }
  ],
  "description": "An example FHIR-based publishable measure",
  "useContext": [
    {
      "code": {
        "system": "http://terminology.hl7.org/CodeSystem/usage-context-type",
        "code": "program"
      },
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "http://hl7.org/fhir/us/cqfmeasures/CodeSystem/quality-programs",
            "code": "ep-ec"
          }
        ],
        "text": "eligible-provider"
      }
    }
  ],
  "jurisdiction": [
    {
      "coding": [
        {
          "system": "urn:iso:std:iso:3166",
          "code": "US"
        }
      ]
    }
  ],
  "purpose": "The purpose of this measure is to...",
  "usage": "Users of this measure should be aware of...",
  "copyright": "Example Copyright Statement",
  "approvalDate": "2019-02-17",
  "lastReviewDate": "2019-02-17",
  "effectivePeriod": {
    "extension": [
      {
        "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-effectivePeriodAnchor",
        "valueDateTime": "2018-01-01"
      },
      {
        "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-effectivePeriodDuration",
        "valueDuration": {
          "value": 1,
          "system": "http://unitsofmeasure.org",
          "code": "a"
        }
      }
    ],
    "start": "2018-01-01",
    "end": "2018-12-31"
  },
  "topic": [
    {
      "coding": [
        {
          "system": "http://loinc.org",
          "code": "57024-2"
        }
      ],
      "text": "Health Quality Measure Document"
    }
  ],
  "author": [
    {
      "name": "Example Measure Content Developer"
    }
  ],
  "relatedArtifact": [
    {
      "type": "depends-on",
      "display": "Value set Inpatient",
      "resource": "http://example.org/fhir/ValueSet/TBD"
    }
  ],
  "library": [
    "http://hl7.org/fhir/us/cqfmeasures/Library/EXMRatio"
  ],
  "disclaimer": "Example disclaimer",
  "scoring": {
    "coding": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/measure-scoring",
        "code": "ratio",
        "display": "Ratio"
      }
    ]
  },
  "type": [
    {
      "coding": [
        {
          "system": "http://terminology.hl7.org/CodeSystem/measure-type",
          "code": "process"
        }
      ]
    }
  ],
  "improvementNotation": {
    "coding": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/measure-improvement-notation",
        "code": "decrease",
        "display": "Decreased score indicates improvement"
      }
    ]
  },
  "group": [
    {
      "id": "group-1",
      "population": [
        {
          "id": "initial-population",
          "code": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                "code": "initial-population",
                "display": "Initial Population"
              }
            ]
          },
          "criteria": {
            "language": "text/cql.identifier",
            "expression": "Initial Population"
          }
        },
        {
          "id": "numerator",
          "code": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                "code": "numerator",
                "display": "Numerator"
              }
            ]
          },
          "criteria": {
            "language": "text/cql.identifier",
            "expression": "Numerator"
          }
        },
        {
          "id": "denominator",
          "code": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                "code": "denominator",
                "display": "Denominator"
              }
            ]
          },
          "criteria": {
            "language": "text/cql.identifier",
            "expression": "Denominator"
          }
        },
        {
          "id": "denominator-observation",
          "extension": [
            {
              "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-criteriaReference",
              "valueString": "denominator"
            },
            {
              "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-aggregateMethod",
              "valueCode": "sum"
            }
          ],
          "code": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                "code": "measure-observation",
                "display": "Measure Observation"
              }
            ]
          },
          "criteria": {
            "language": "text/cql.identifier",
            "expression": "Measure Denominator Observation"
          }
        },
        {
          "id": "numerator-observation",
          "extension": [
            {
              "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-criteriaReference",
              "valueString": "numerator"
            },
            {
              "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-aggregateMethod",
              "valueCode": "sum"
            }
          ],
          "code": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                "code": "measure-observation",
                "display": "Measure Observation"
              }
            ]
          },
          "criteria": {
            "language": "text/cql.identifier",
            "expression": "Measure Numerator Observation"
          }
        }
      ]
    }
  ]
}