Canonical Resource Management Infrastructure Implementation Guide
1.0.0 - STU1

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## : ANC.IND.01 Percentage of pregnant women with first ANC contact in the first trimester (Publishable Example) - XML Representation

Draft as of 2023-03-13

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    <Measure xmlns="http://hl7.org/fhir">
      <id value="publishable-example"/>
      <meta>
        <profile
                 value="http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-publishablemeasure"/>
      </meta>
      <text>
        <status value="extensions"/>
        <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: Measure </b><a name="publishable-example"> </a><a name="hcpublishable-example"> </a></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">ResourceMeasure &quot;publishable-example&quot; </p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-crmi-publishablemeasure.html">CRMI Publishable Measure</a></p></div><p><b>CRMI Software System</b>: <a href="Device-cqf-tooling.html">Device/cqf-tooling</a></p><p><b>CRMI Effective Data Requirements</b>: <code>#effective-data-requirements</code></p><p><b>url</b>: <code>http://hl7.org/fhir/uv/crmi/Measure/publishable-example</code></p><p><b>identifier</b>: <a href="http://terminology.hl7.org/5.5.0/NamingSystem-uri.html" title="As defined by RFC 3986 (http://www.ietf.org/rfc/rfc3986.txt)(with many schemes defined in many RFCs). For OIDs and UUIDs, use the URN form (urn:oid:(note: lowercase) and urn:uuid:). See http://www.ietf.org/rfc/rfc3001.txt and http://www.ietf.org/rfc/rfc4122.txt

    This oid is used as an identifier II.root to indicate the the extension is an absolute URI (technically, an IRI). Typically, this is used for OIDs and GUIDs. Note that when this OID is used with OIDs and GUIDs, the II.extension should start with urn:oid or urn:uuid:

    Note that this OID is created to aid with interconversion between CDA and FHIR - FHIR uses urn:ietf:rfc:3986 as equivalent to this OID. URIs as identifiers appear more commonly in FHIR.

    This OID may also be used in CD.codeSystem.">Uniform Resource Identifier (URI)</a>/urn:oid:2.16.840.1.113883.4.642.40.38.29.1</p><p><b>version</b>: 1.0.0</p><p><b>name</b>: ANCIND01Publishable</p><p><b>title</b>: ANC.IND.01 Percentage of pregnant women with first ANC contact in the first trimester (Publishable Example)</p><p><b>status</b>: draft</p><p><b>experimental</b>: true</p><p><b>date</b>: 2023-03-13 22:32:10-0600</p><p><b>publisher</b>: HL7 International / Clinical Decision Support</p><p><b>contact</b>: <a href="http://www.hl7.org/Special/committees/dss">http://www.hl7.org/Special/committees/dss</a></p><p><b>description</b>: Percentage of pregnant women with first ANC contact in the first trimester (before 12 weeks of gestation)</p><p><b>jurisdiction</b>: World <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (m49.htm#001)</span></p><blockquote><p><b>relatedArtifact</b></p><p><b>Is Primary Citation</b>: true</p><p><b>type</b>: citation</p><p><b>citation</b>: WHO, UN Women, UNFPA. Health care for women subjected to intimate partner violence or sexual violence – a clinical handbook. Geneva: World Health Organization; 2014</p><p><b>url</b>: <a href="https://apps.who.int/iris/bitstream/handle/10665/136101/WHO_RHR_14.26_eng.pdf">https://apps.who.int/iris/bitstream/handle/10665/136101/WHO_RHR_14.26_eng.pdf</a></p><blockquote><p><b>document</b></p></blockquote></blockquote><p><b>library</b>: <a href="Library-ANCCohort.html">ANC Cohort</a></p><p><b>scoring</b>: Proportion <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.5.0/CodeSystem-measure-scoring.html">MeasureScoring</a>#proportion)</span></p><p><b>type</b>: Process <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.5.0/CodeSystem-measure-type.html">MeasureType</a>#process)</span></p><p><b>improvementNotation</b>: Increased score indicates improvement <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.5.0/CodeSystem-measure-improvement-notation.html">MeasureImprovementNotation</a>#increase)</span></p><blockquote><p><b>group</b></p><blockquote><p><b>id</b></p>group-1</blockquote><blockquote><p><b>population</b></p><blockquote><p><b>id</b></p>initial-population</blockquote><p><b>code</b>: Initial Population <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.5.0/CodeSystem-measure-population.html">MeasurePopulationType</a>#initial-population)</span></p><h3>Criteria</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Language</b></td><td><b>Expression</b></td></tr><tr><td style="display: none">*</td><td>text/cql-identifier</td><td>Initial Population</td></tr></table></blockquote><blockquote><p><b>population</b></p><blockquote><p><b>id</b></p>denominator</blockquote><p><b>code</b>: Denominator <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.5.0/CodeSystem-measure-population.html">MeasurePopulationType</a>#denominator)</span></p><h3>Criteria</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Language</b></td><td><b>Expression</b></td></tr><tr><td style="display: none">*</td><td>text/cql-identifier</td><td>Denominator</td></tr></table></blockquote><blockquote><p><b>population</b></p><blockquote><p><b>id</b></p>numerator</blockquote><p><b>code</b>: Numerator <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.5.0/CodeSystem-measure-population.html">MeasurePopulationType</a>#numerator)</span></p><h3>Criteria</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Language</b></td><td><b>Expression</b></td></tr><tr><td style="display: none">*</td><td>text/cql-identifier</td><td>Numerator</td></tr></table></blockquote><blockquote><p><b>stratifier</b></p><blockquote><p><b>id</b></p>by-age</blockquote><p><b>code</b>: Age <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p><h3>Criteria</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Language</b></td><td><b>Expression</b></td></tr><tr><td style="display: none">*</td><td>text/cql-identifier</td><td>Age Stratifier</td></tr></table></blockquote><blockquote><p><b>stratifier</b></p><blockquote><p><b>id</b></p>by-education-level</blockquote><p><b>code</b>: Education Level <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p><h3>Criteria</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Language</b></td><td><b>Expression</b></td></tr><tr><td style="display: none">*</td><td>text/cql-identifier</td><td>Education Level Stratifier</td></tr></table></blockquote></blockquote></div>
      </text>
      <contained>
        <Library>
          <id value="effective-data-requirements"/>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
            <valueCoding>
              <system
                      value="http://example.org/CodeSystem/iso-8601-derived-periods"/>
              <code value="P10Y--P14Y"/>
              <display value="10-14 years"/>
            </valueCoding>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
            <valueCoding>
              <system
                      value="http://example.org/CodeSystem/iso-8601-derived-periods"/>
              <code value="P15Y--P19Y"/>
              <display value="15-19 years"/>
            </valueCoding>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
            <valueCoding>
              <system
                      value="http://example.org/CodeSystem/iso-8601-derived-periods"/>
              <code value="P20Y--P9999Y"/>
              <display value="20+ years"/>
            </valueCoding>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="ANCBaseDataElements"/>
            </extension>
            <extension url="name">
              <valueString value="Antenatal care contact"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="define &quot;Antenatal care contact&quot;:
      [&quot;Encounter&quot;: type in BCx.&quot;Antenatal care contact&quot;]"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="0"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="ANCIND01"/>
            </extension>
            <extension url="name">
              <valueString value="First antenatal care contact"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="define &quot;First antenatal care contact&quot;:
      BaseData.&quot;Antenatal care contact&quot; C
        where C.reasonCode in Cx.&quot;First Antenatal Care Contact Choices&quot;"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="1"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="ANCContactDataElements"/>
            </extension>
            <extension url="name">
              <valueString value="Gestational age"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="/*
      @dataElement: ANC.B6.DE17 Gestational age
      @activity: ANC.B6 Profile
      @description: Gestational age in weeks and/or days depending on the source of gestational age
    */
    define &quot;Gestational age&quot;:
      WC.MostRecent(
      [Observation: Cx.&quot;Gestational age&quot;] O
        where O.status in { 'final', 'amended', 'corrected' }
          and Coalesce(WC.ModifierExtension(O, 'who-notDone').value, false) is false
          and Last(Split(O.encounter.reference, '/')) = Last(Split(encounter, '/'))
      ).value as FHIR.Quantity"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="2"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="ANCIND01"/>
            </extension>
            <extension url="name">
              <valueString value="Numerator"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="/*
    Numerator: Number of pregnant women who had their first ANC contact before 12 weeks (facility level)
    Numerator Computation: Count of women whose gestational age &lt;= 12 weeks at the time of first contact
    */
    define Numerator:
      exists (
        &quot;First antenatal care contact&quot; C
          where C.period starts during &quot;Measurement Period&quot;
            and ContactData.&quot;Gestational age&quot; &lt;= 12 weeks
      )"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="3"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="ANCStratifiers"/>
            </extension>
            <extension url="name">
              <valueString value="By Age"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="/*
    By Patient Age as of the start of the Measurement Period
    Age (10-14, 15-19, 20+)
    */
    define &quot;By Age&quot;:
      case
        when AgeInYearsAt(start of &quot;Measurement Period&quot;) in Interval[10, 14] then &quot;P10Y--P14Y&quot;
        when AgeInYearsAt(start of &quot;Measurement Period&quot;) in Interval[15, 19] then &quot;P15Y--P19Y&quot;
        when AgeInYearsAt(start of &quot;Measurement Period&quot;) &gt;= 20 then &quot;P20Y--P9999Y&quot;
        else null
      end"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="4"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="ANCIND01"/>
            </extension>
            <extension url="name">
              <valueString value="Age Stratifier"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="/*
    Disaggregation: Age (10-14, 15-19, 20+)
    */
    define &quot;Age Stratifier&quot;:
      Stratifiers.&quot;By Age&quot;"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="5"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="ANCIND01"/>
            </extension>
            <extension url="name">
              <valueString value="Denominator"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="/*
    Denominator: Total number of antenatal clients with a first contact
    Denominator Computation: Count of all women who had first contact within the last reporting period
    */
    define Denominator:
      exists (
        &quot;First antenatal care contact&quot; C
          where C.period starts during &quot;Measurement Period&quot;
      )"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="6"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="ANCStratifiers"/>
            </extension>
            <extension url="name">
              <valueString value="By Education Level"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="/*
    By Patient Education Level (none, don't know, primary, secondary, higher)
    */
    define &quot;By Education Level&quot;:
      Patient.extension E
        where E.url = 'http://fhir.org/guides/who/anc-cds/StructureDefinition/educationlevel'
        return E.value as CodeableConcept"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="7"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="ANCIND01"/>
            </extension>
            <extension url="name">
              <valueString value="Education Level Stratifier"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="/*
    Disaggregation: Education Level (none, don't know, primary, secondary, higher)
    */
    define &quot;Education Level Stratifier&quot;:
      Stratifiers.&quot;By Education Level&quot;"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="8"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="ANCBaseDataElements"/>
            </extension>
            <extension url="name">
              <valueString value="Antenatal care case"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="/*
    define &quot;Pregnant&quot;:
      &quot;Pregnancy&quot; is not null
        or &quot;Pregnancy status&quot; in BCx.&quot;Pregnancy status - pregnant&quot;

    define &quot;Pregnancy status&quot;:
      FHIRHelpers.ToConcept(
        Last(
          [Observation: BCx.&quot;Pregnancy status&quot;] O
            where O.status = 'final'
            sort by FHIRHelpers.ToDateTime(effective as FHIR.dateTime)
        ).value
      )
    */
    define &quot;Antenatal care case&quot;:
      [&quot;EpisodeOfCare&quot;: type in BCx.&quot;Antenatal care case&quot;]"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="9"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="ANCIND01"/>
            </extension>
            <extension url="name">
              <valueString value="Initial Population"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="/*
    Initial population: Antenatal clients
    */
    define &quot;Initial Population&quot;:
      exists (BaseData.&quot;Antenatal care case&quot;)"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="10"/>
            </extension>
          </extension>
          <status value="active"/>
          <type>
            <coding>
              <system value="http://terminology.hl7.org/CodeSystem/library-type"/>
              <code value="module-definition"/>
            </coding>
          </type>
          <relatedArtifact>
            <type value="depends-on"/>
            <display value="Library ANCCohort"/>
            <resource value="http://hl7.org/fhir/uv/crmi/Library/ANCCohort"/>
          </relatedArtifact>
          <relatedArtifact>
            <type value="depends-on"/>
            <display value="Library FHIRHelpers"/>
            <resource
                      value="http://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1"/>
          </relatedArtifact>
          <relatedArtifact>
            <type value="depends-on"/>
            <display value="Example Code system ISO-8601-Derived Periods"/>
            <resource
                      value="http://example.org/CodeSystem/iso-8601-derived-periods"/>
          </relatedArtifact>
          <relatedArtifact>
            <type value="depends-on"/>
            <display value="Value set Antenatal care contact"/>
            <resource
                      value="http://fhir.org/guides/who/anc-cds/ValueSet/antenatal-care-contact"/>
          </relatedArtifact>
          <relatedArtifact>
            <type value="depends-on"/>
            <display value="Value set First Antenatal Care Contact Choices"/>
            <resource
                      value="http://fhir.org/guides/who/anc-cds/ValueSet/anc-b5-de2"/>
          </relatedArtifact>
          <relatedArtifact>
            <type value="depends-on"/>
            <display value="Value set Gestational age"/>
            <resource
                      value="http://fhir.org/guides/who/anc-cds/ValueSet/anc-b6-de17"/>
          </relatedArtifact>
          <relatedArtifact>
            <type value="depends-on"/>
            <display value="Value set Antenatal care case"/>
            <resource
                      value="http://fhir.org/guides/who/anc-cds/ValueSet/antenatal-care-case"/>
          </relatedArtifact>
          <parameter>
            <name value="Measurement Period"/>
            <use value="in"/>
            <min value="0"/>
            <max value="1"/>
            <type value="Period"/>
          </parameter>
          <parameter>
            <name value="encounter"/>
            <use value="in"/>
            <min value="0"/>
            <max value="1"/>
            <type value="string"/>
          </parameter>
          <parameter>
            <name value="Numerator"/>
            <use value="out"/>
            <min value="0"/>
            <max value="1"/>
            <type value="boolean"/>
          </parameter>
          <parameter>
            <name value="Age Stratifier"/>
            <use value="out"/>
            <min value="0"/>
            <max value="1"/>
            <type value="Coding"/>
          </parameter>
          <parameter>
            <name value="Denominator"/>
            <use value="out"/>
            <min value="0"/>
            <max value="1"/>
            <type value="boolean"/>
          </parameter>
          <parameter>
            <name value="Education Level Stratifier"/>
            <use value="out"/>
            <min value="0"/>
            <max value="*"/>
            <type value="CodeableConcept"/>
          </parameter>
          <parameter>
            <name value="Initial Population"/>
            <use value="out"/>
            <min value="0"/>
            <max value="1"/>
            <type value="boolean"/>
          </parameter>
          <dataRequirement>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/cqf-isSelective">
              <valueBoolean value="true"/>
            </extension>
            <type value="Encounter"/>
            <profile value="http://hl7.org/fhir/StructureDefinition/Encounter"/>
            <mustSupport value="type"/>
            <mustSupport value="reasonCode"/>
            <mustSupport value="period"/>
            <codeFilter>
              <path value="type"/>
              <valueSet
                        value="http://fhir.org/guides/who/anc-cds/ValueSet/antenatal-care-contact"/>
            </codeFilter>
          </dataRequirement>
          <dataRequirement>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/cqf-isSelective">
              <valueBoolean value="true"/>
            </extension>
            <type value="Observation"/>
            <profile value="http://hl7.org/fhir/StructureDefinition/Observation"/>
            <mustSupport value="code"/>
            <mustSupport value="status"/>
            <mustSupport value="encounter"/>
            <mustSupport value="encounter.reference"/>
            <codeFilter>
              <path value="code"/>
              <valueSet
                        value="http://fhir.org/guides/who/anc-cds/ValueSet/anc-b6-de17"/>
            </codeFilter>
          </dataRequirement>
          <dataRequirement>
            <type value="Patient"/>
            <profile value="http://hl7.org/fhir/StructureDefinition/Patient"/>
            <mustSupport value="url"/>
            <mustSupport value="value"/>
          </dataRequirement>
          <dataRequirement>
            <type value="EpisodeOfCare"/>
            <profile
                     value="http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"/>
            <mustSupport value="type"/>
            <codeFilter>
              <path value="type"/>
              <valueSet
                        value="http://fhir.org/guides/who/anc-cds/ValueSet/antenatal-care-case"/>
            </codeFilter>
          </dataRequirement>
        </Library>
      </contained>
      <extension
                 url="http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-softwaresystem">
        <valueReference>🔗
          <reference value="Device/cqf-tooling"/>
        </valueReference>
      </extension>
      <extension
                 url="http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements" id="effective-data-requirements">
        <valueCanonical value="#effective-data-requirements"/>
      </extension>
      <url value="http://hl7.org/fhir/uv/crmi/Measure/publishable-example"/>
      <identifier>
        <system value="urn:ietf:rfc:3986"/>
        <value value="urn:oid:2.16.840.1.113883.4.642.40.38.29.1"/>
      </identifier>
      <version value="1.0.0"/>
      <name value="ANCIND01Publishable"/>
      <title
             value="ANC.IND.01 Percentage of pregnant women with first ANC contact in the first trimester (Publishable Example)"/>
      <status value="draft"/>
      <experimental value="true"/>
      <date value="2023-03-13T22:32:10-06:00"/>
      <publisher value="HL7 International / Clinical Decision Support"/>
      <contact>
        <telecom>
          <system value="url"/>
          <value value="http://www.hl7.org/Special/committees/dss"/>
        </telecom>
      </contact>
      <description
                   value="Percentage of pregnant women with first ANC contact in the first trimester (before 12 weeks of gestation)"/>
      <jurisdiction>
        <coding>
          <system value="http://unstats.un.org/unsd/methods/m49/m49.htm"/>
          <code value="001"/>
          <display value="World"/>
        </coding>
      </jurisdiction>
      <relatedArtifact>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/cqf-isPrimaryCitation">
          <valueBoolean value="true"/>
        </extension>
        <type value="citation"/>
        <citation
                  value="WHO, UN Women, UNFPA. Health care for women subjected to intimate partner violence or sexual violence – a clinical handbook. Geneva: World Health Organization; 2014"/>
        <url
             value="https://apps.who.int/iris/bitstream/handle/10665/136101/WHO_RHR_14.26_eng.pdf"/>
        <document>
          <url
               value="https://apps.who.int/iris/bitstream/handle/10665/136101/WHO_RHR_14.26_eng.pdf"/>
        </document>
      </relatedArtifact>
      <library value="http://hl7.org/fhir/uv/crmi/Library/ANCCohort"/>
      <scoring>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/measure-scoring"/>
          <code value="proportion"/>
        </coding>
      </scoring>
      <type>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/measure-type"/>
          <code value="process"/>
        </coding>
      </type>
      <improvementNotation>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/measure-improvement-notation"/>
          <code value="increase"/>
        </coding>
      </improvementNotation>
      <group id="group-1">
        <population id="initial-population">
          <code>
            <coding>
              <system
                      value="http://terminology.hl7.org/CodeSystem/measure-population"/>
              <code value="initial-population"/>
            </coding>
          </code>
          <criteria>
            <language value="text/cql-identifier"/>
            <expression value="Initial Population"/>
          </criteria>
        </population>
        <population id="denominator">
          <code>
            <coding>
              <system
                      value="http://terminology.hl7.org/CodeSystem/measure-population"/>
              <code value="denominator"/>
            </coding>
          </code>
          <criteria>
            <language value="text/cql-identifier"/>
            <expression value="Denominator"/>
          </criteria>
        </population>
        <population id="numerator">
          <code>
            <coding>
              <system
                      value="http://terminology.hl7.org/CodeSystem/measure-population"/>
              <code value="numerator"/>
            </coding>
          </code>
          <criteria>
            <language value="text/cql-identifier"/>
            <expression value="Numerator"/>
          </criteria>
        </population>
        <stratifier id="by-age">
          <code>
            <text value="Age"/>
          </code>
          <criteria>
            <language value="text/cql-identifier"/>
            <expression value="Age Stratifier"/>
          </criteria>
        </stratifier>
        <stratifier id="by-education-level">
          <code>
            <text value="Education Level"/>
          </code>
          <criteria>
            <language value="text/cql-identifier"/>
            <expression value="Education Level Stratifier"/>
          </criteria>
        </stratifier>
      </group>
    </Measure>