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EXM111-9.1.000.cql
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EXM111-9.1.000.cql
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library EXM111 version '9.1.000'
using FHIR version '4.0.1'
include MATGlobalCommonFunctions version '5.0.000' called Global
include FHIRHelpers version '4.0.1' called FHIRHelpers
include SupplementalDataElements version '2.0.0' called SDE
valueset "Admit Inpatient": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.164'
valueset "Decision to Admit to Hospital Inpatient": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.295'
valueset "Emergency Department Evaluation": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.163'
valueset "Emergency Department Visit": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292'
valueset "Encounter Inpatient": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307'
valueset "Ethnicity": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.837'
valueset "Hospital Settings": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.126'
valueset "ONC Administrative Sex": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1'
valueset "Payer": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591'
valueset "Psychiatric/Mental Health Diagnosis": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.299'
valueset "Race": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.836'
parameter "Measurement Period" Interval<DateTime>
default Interval[@2019-01-01T00:00:00.0, @2020-01-01T00:00:00.0)
context Patient
define "SDE Ethnicity":
SDE."SDE Ethnicity"
define "SDE Payer":
SDE."SDE Payer"
define "SDE Race":
SDE."SDE Race"
define "SDE Sex":
SDE."SDE Sex"
define "Initial Population":
"ED Encounter with Decision to Admit"
define "Measure Population":
"Initial Population"
define "Measure Population Exclusions":
/* Exclude the most recent ED encounter (LastEDVisit) that occurred within an hour of the inpatient admission with ED admission source in "Hospital Setting" (any different facility- by location or CCN ) */
Global."Inpatient Encounter" EncounterInpatient
where "LastEDEncounter"(EncounterInpatient).hospitalization.admitSource in "Hospital Settings"
define "Stratification 1":
/* Patient encounters without a principal diagnosis of "Psychiatric/Mental Health Diagnosis */
Global."Inpatient Encounter" EncounterInpatient
let Diag: Global."PrincipalDiagnosis"(EncounterInpatient)
where IsNull(Diag) or not (Diag.code in "Psychiatric/Mental Health Diagnosis")
define "Stratification 2":
/* Patient encounters with a principal diagnosis of "Psychiatric/Mental Health Diagnosis */
Global."Inpatient Encounter" EncounterInpatient
where Global."PrincipalDiagnosis"(EncounterInpatient).code in "Psychiatric/Mental Health Diagnosis"
define "ED Encounter with Decision to Admit":
/* Constrains the inpatient encounter to having an ED visit with a decision to admit (assessment or order) to inpatient and ED facility location period is not null */
from
Global."Inpatient Encounter" EncounterInpatient
let LastEDVisit: LastEDEncounter(EncounterInpatient)
where Global."Normalize Interval"("AdmitDecisionUsingAssessmentDuringLastEDBeforeDeparture"(EncounterInpatient).effective) during LastEDVisit.period
or "AdmitDecisionUsingEncounterOrderDuringLastEDandBeforeDeparture"(EncounterInpatient).authoredOn during LastEDVisit.period
and exists ( LastEDVisit.location Location
where Global.GetLocation(Location.location).type in "Emergency Department Visit"
and end of Location.period != maximum DateTime)
define function "AdmitDecisionUsingAssessmentDuringLastEDBeforeDeparture"(EncounterInpatient Encounter):
/* Captures the decision to admit assessment, time, and result that was performed during the last ED visit */
Last(
["Observation": "Emergency Department Evaluation"] EDEvaluation
let LastEDVisit: "LastEDEncounter"(EncounterInpatient)
where Global."Normalize Interval"(EDEvaluation.effective) during LastEDVisit.period
and EDEvaluation.value in "Admit Inpatient"
and EDEvaluation.status in {'final', 'amended', 'corrected'}
and Global."Normalize Interval"(EDEvaluation.effective) ends before or on "EDDepartureTime"(LastEDVisit)
sort by effective)
define function "LastEDEncounter"(EncounterInpatient Encounter):
/* The most recent (last) ED encounter that is within an hour of an inpatient encounter */
Last(["Encounter":"Emergency Department Visit"] EDVisit
where EDVisit.period ends 1 hour or less before or on start of EncounterInpatient.period
and EDVisit.status='finished'
sort by
end of period ascending)
define function "MeasureObservation"(EncounterInpatient Encounter):
/* The duration from the Decision to Admit (order or assessment) to the departure from the Emergency Department */
duration in minutes of Interval[ Coalesce( start of Global."Normalize Interval" ("AdmitDecisionUsingAssessmentDuringLastEDBeforeDeparture"(EncounterInpatient).effective),
"AdmitDecisionUsingEncounterOrderDuringLastEDandBeforeDeparture"(EncounterInpatient).authoredOn),
"EDDepartureTime"("LastEDEncounter"(EncounterInpatient))]
define function "AdmitDecisionUsingEncounterOrderDuringLastEDandBeforeDeparture"(EncounterInpatient Encounter):
/* Captures the decision to admit order and time that occured during the last ED visit */
Last(["ServiceRequest": "Decision to Admit to Hospital Inpatient"] AdmitOrder
let LastEDVisit: "LastEDEncounter"(EncounterInpatient)
where AdmitOrder.authoredOn during LastEDVisit.period
and AdmitOrder.authoredOn before or on "EDDepartureTime"(LastEDVisit)
and AdmitOrder.intent in {'plan', 'order'}
sort by authoredOn)
define function "EDDepartureTime"(Encounter Encounter):
/* The time the patient physically departed the Emergency Department */
Last(Encounter.location Location
where Global.GetLocation(Location.location).type in "Emergency Department Visit"
and end of Location.period != maximum DateTime
return
end of Location.period
sort ascending)