WHO SMART Guidelines - HIV
0.4.4 - ci-build

WHO SMART Guidelines - HIV, published by WHO. This guide is not an authorized publication; it is the continuous build for version 0.4.4 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/WorldHealthOrganization/smart-hiv/tree/main and changes regularly. See the Directory of published versions

Measure: HIV.IND.39 Infant ARV prophylaxis coverage (Experimental)

Official URL: http://smart.who.int/hiv/Measure/HIVIND39 Version: 0.4.4
Draft as of 2024-08-18 Computable Name: HIVIND39

% of HIV-exposed infants who initiated ARV prophylaxis

Knowledge Artifact Metadata
Name (machine-readable) HIVIND39
Title (human-readable) HIV.IND.39 Infant ARV prophylaxis coverage
Status Draft
Experimental true
Description

% of HIV-exposed infants who initiated ARV prophylaxis

Measure Steward WHO
Steward Contact Details WHO: http://who.int
Measure Metadata
Version Number 0.4.4
Measure Scoring Proportion
Improvement Notation Increased score indicates improvement
Population Basis boolean
Measure Population Criteria
Initial Population ID: HIV.IND.39.IP
Description:

Initial Population

Logic Definition: Initial Population
Denominator ID: HIV.IND.39.DEN
Description:

a) Programme-based/service delivery denominator: Number of HIV-positive women who delivered in a facility within the past 12 months. | | B) Population-based denominator: Number of HIV-positive women who delivered within the past 12 months.

Logic Definition: Denominator
Numerator ID: HIV.IND.39.NUM
Description:

Number of HIV-exposed infants born within the past 12 months who were started on ARV prophylaxis at birth

Logic Definition: Numerator
Measure Logic
Primary Library HIV.IND.39 Logic
Dependency Description: FHIR model information
Resource: http://fhir.org/guides/cqf/common/Library/FHIR-ModelInfo|4.0.1
Canonical URL: http://fhir.org/guides/cqf/common/Library/FHIR-ModelInfo|4.0.1
Dependency Description: Library HIE
Resource: HIVIndicatorElements
Canonical URL: http://smart.who.int/hiv/Library/HIVIndicatorElements
Dependency Description: Library FHIRHelpers
Resource: http://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1
Canonical URL: http://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1
Dependency Description: Library Elements
Resource: HIVElements
Canonical URL: http://smart.who.int/hiv/Library/HIVElements
Dependency Description: Library Concepts
Resource: http://smart.who.int/hiv/Library/HIVConcepts|0.0.2
Canonical URL: http://smart.who.int/hiv/Library/HIVConcepts|0.0.2
Dependency Description: Library WC
Resource: WHOCommon
Canonical URL: http://smart.who.int/hiv/Library/WHOCommon
Dependency Description: Library ConceptsCustom
Resource: http://smart.who.int/hiv/Library/HIVConceptsCustom|0.0.1
Canonical URL: http://smart.who.int/hiv/Library/HIVConceptsCustom|0.0.1
Dependency Description: Code system HIVConcepts
Resource: WHO SMART HIV Concepts CodeSystem
Canonical URL: http://smart.who.int/hiv/CodeSystem/HIVConcepts
Dependency Description: Code system ConditionClinicalStatusCodes
Resource: Condition Clinical Status Codes
Canonical URL: http://terminology.hl7.org/CodeSystem/condition-clinical
Dependency Description: Code system ConditionCategoryCodes
Resource: Condition Category Codes
Canonical URL: http://terminology.hl7.org/CodeSystem/condition-category
Dependency Description: Value set ART regimen Choices
Resource: ART regimen ValueSet
Canonical URL: http://smart.who.int/hiv/ValueSet/HIV.D.DE90
Direct Reference Code Display: HIV-exposed infant or child
Code: HIV.E.DE112
System: http://smart.who.int/hiv/CodeSystem/HIVConcepts
Direct Reference Code Display: HIV-positive
Code: HIV.B.DE116
System: http://smart.who.int/hiv/CodeSystem/HIVConcepts
Direct Reference Code Code: active
System: http://terminology.hl7.org/CodeSystem/condition-clinical
Direct Reference Code Display: Encounter Diagnosis
Code: encounter-diagnosis
System: http://terminology.hl7.org/CodeSystem/condition-category
Direct Reference Code Display: HIV status
Code: HIV.B.DE115
System: http://smart.who.int/hiv/CodeSystem/HIVConcepts
Direct Reference Code Display: Live birth
Code: HIV.E.DE48
System: http://smart.who.int/hiv/CodeSystem/HIVConcepts
Direct Reference Code Display: Health facility
Code: HIV.E.DE68
System: http://smart.who.int/hiv/CodeSystem/HIVConcepts
Parameter Name: Measurement Period
Use: In
Min Cardinality: 0
Max Cardinality: 1
Type: Period
Parameter Name: Numerator
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: boolean
Parameter Name: Denominator
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: boolean
Parameter Name: Initial Population
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: boolean
Measure Logic Data Requirements
Data Requirement Type: Patient
Profile(s): Patient
Data Requirement Type: Observation
Profile(s): Observation
Must Support Elements: code, status, effective
Code Filter(s):
Path: code
Code:
Data Requirement Type: Observation
Profile(s): Observation
Must Support Elements: code, status, value, issued, effective
Code Filter(s):
Path: code
Code:
Data Requirement Type: Observation
Profile(s): Observation
Must Support Elements: code, status, effective, value
Code Filter(s):
Path: code
Code:
Data Requirement Type: MedicationStatement
Profile(s): MedicationStatement
Must Support Elements: medication, effective
Code Filter(s):
Path: medication
ValueSet: ART regimen ValueSet
Data Requirement Type: MedicationStatement
Profile(s): MedicationStatement
Must Support Elements: medication.reference, effective
Data Requirement Type: Medication
Profile(s): Medication
Must Support Elements: id, code
Data Requirement Type: Condition
Profile(s): Condition
Must Support Elements: code, clinicalStatus, category, onset
Code Filter(s):
Path: code
Code:
Measure Logic Definitions
Logic Definition Library Name: HIVIndicatorElements
define "Is Infant Patient":
  Patient.birthDate is not null
  and difference in years between Patient.birthDate and start of "Measurement Period" < 1
Logic Definition Library Name: HIVElements
/* End of Age of infant */

/*
@dataElement: HIV.E.DE112 - HIV-exposed infant or child
@activity: HIV.F6 Check whether infant/child had HIV exposure
@description: Whether the infant or child was determined to have had HIV exposure
*/
define "HIV-exposed infant or child E.DE112":

  [Observation: Concepts."HIV-exposed infant or child - HIV.E.DE112"] O
    where O.status in { 'final', 'amended', 'corrected' }
Logic Definition Library Name: HIVIndicatorElements
/* End of Age of infant */

/*
@dataElement: HIV.E.DE112 - HIV-exposed infant or child
@activity: HIV.F6 Check whether infant/child had HIV exposure
@description: Whether the infant or child was determined to have had HIV exposure
*/
define "is HIV-exposed infant or child E.DE112":
  "Is Infant Patient" and 
  exists(Elements."HIV-exposed infant or child E.DE112" O
    where O.effective.toInterval() during "Measurement Period")
Logic Definition Library Name: HIVElements
/* On ART - includes "On ART - HIV.B.DE47" and "On ART - HIV.B.DE48" */
define "ART Medication Statement":
  [MedicationStatement: Concepts."ART regimen Choices"] MS
  sort by start of effective.toInterval()
Logic Definition Library Name: HIVElements
define "ART start date":
  "ART Medication Statement" MS
  return start of MS.effective.toInterval()
Logic Definition Library Name: HIVIND39Logic
/**
 * Numerator
 * 
 * Definition: Number of HIV-exposed infants born within the past 12 months who were started on ARV prophylaxis at birth
 * Calculation: COUNT of infants who are an "HIV-exposed infant or child" AND "Infant date of birth" within reporting period AND "Infant ART start date" is on"Infant date of birth"
 */

define "Numerator":
  HIE."is HIV-exposed infant or child E.DE112" and 
    exists(HE."ART start date" d where date from d same day as Patient.birthDate)
Logic Definition Library Name: HIVElements
define "HIV Status Positive Condition":
  [Condition: Concepts."HIV-positive - HIV.B.DE116"] C
    where C.clinicalStatus ~ ConceptsCustom."active"
      and exists(C.category CC where CC ~ ConceptsCustom."encounter-diagnosis")
    sort by start of onset.toInterval()
Logic Definition Library Name: HIVIndicatorElements
define "HIV Status Positive Condition":
  Elements."HIV Status Positive Condition" C
  where C.onset before end of "Measurement Period"
Logic Definition Library Name: HIVElements
/* End of HIV-inconclusive */

/*
@dataElement: HIV.B.DE115 - HIV status
@activity: HIV.B7 Test for HIV using testing algorithm
@description: HIV status reported after applying the national HIV testing algorithm. No single HIV test can provide an HIV-positive diagnosis.
*/
define "HIV Status Observation":
  [Observation: Concepts."HIV status"] O
    where O.status in { 'final', 'amended', 'corrected' }
Logic Definition Library Name: HIVElements
define "HIV Status Positive Observation":
"HIV Status Observation" O
    where O.value ~ Concepts."HIV-positive - HIV.B.DE116"
      sort by start of effective.toInterval()
Logic Definition Library Name: HIVIndicatorElements
define "HIV Status Positive Observation":
  Elements."HIV Status Positive Observation" O
  where O.issued before end of "Measurement Period"
  or O.effective.toInterval() starts before end of "Measurement Period"
Logic Definition Library Name: HIVIndicatorElements
define "Has HIV-positive Status":
  exists "HIV Status Positive Condition"
  or exists "HIV Status Positive Observation"
Logic Definition Library Name: HIVElements
/* End of Newly on ART during labour and delivery */

/*
@dataElement: HIV.E.DE46 - Delivery date
@activity: HIV.E1 Capture or update mother's history
@description: Date on which the woman delivered
*/
define "Live Birth Delivery":
  [Observation: Concepts."Live birth"] O
    where O.status in { 'final', 'amended', 'corrected' }
Logic Definition Library Name: HIVIndicatorElements
/* End of Newly on ART during labour and delivery */

/*
@dataElement: HIV.E.DE46 - Delivery date
@activity: HIV.E1 Capture or update mother's history
@description: Date on which the woman delivered
*/
define "Live Birth Delivery":
  Elements."Live Birth Delivery" O
    where O.effective.toInterval() during "Measurement Period"
Logic Definition Library Name: HIVIndicatorElements
define "Has Delivery in Health Facility":
  exists (
    "Live Birth Delivery" O
      where O.value is CodeableConcept
        and O.value as CodeableConcept = Concepts."Health facility"
  )
Logic Definition Library Name: HIVIND39Logic
/**
 * Denominator
 *
 * Definition: a) Programme-based/service delivery denominator: Number of HIV-positive women who delivered in a facility within the past 12 months. |  | B) Population-based denominator: Number of HIV-positive women who delivered within the past 12 months.
 * Calculation: Programme-based/service delivery denominator: | COUNT of women with "HIV status"='HIV-positive' AND "Place of delivery" is a 'Health facility' AND "Delivery date" within reporting period |  | Population-based denominator: | *Estimated number of HIV-positive women who delivered during the past 12 months
 */

define "Denominator":
  HIE."Has HIV-positive Status" and
    HIE."Has Delivery in Health Facility"
Logic Definition Library Name: HIVIND39Logic
/* Populations */

/*
 *Initial Population
 */

define "Initial Population":
  true
Logic Definition Library Name: FHIRHelpers
define function ToDate(value date): value.value
Logic Definition Library Name: FHIRHelpers
define function ToString(value ObservationStatus): value.value
Logic Definition Library Name: FHIRHelpers
define function ToString(value string): value.value
Logic Definition Library Name: FHIRHelpers
define function ToConcept(concept FHIR.CodeableConcept):
    if concept is null then
        null
    else
        System.Concept {
            codes: concept.coding C return ToCode(C),
            display: concept.text.value
        }
Logic Definition Library Name: FHIRHelpers
define function ToCode(coding FHIR.Coding):
    if coding is null then
        null
    else
        System.Code {
          code: coding.code.value,
          system: coding.system.value,
          version: coding.version.value,
          display: coding.display.value
        }
Logic Definition Library Name: FHIRHelpers
define function ToDateTime(value dateTime): value.value
Logic Definition Library Name: FHIRHelpers
define function ToDateTime(value instant): value.value
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