{ "resourceType" : "Measure", "id" : "IMMZIND30", "meta" : { "profile" : ["http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-measure-cqfm"] }, "text" : { "status" : "generated", "div" : "

Generated Narrative: Measure

Resource Measure "IMMZIND30"

Profile: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-measure-cqfm

url: http://fhir.org/guides/who/smart-immunization/Measure/IMMZIND30

version: 0.1.0

name: IMMZIND30

title: IMMZ.IND.30 Adverse Event Following Immunization (AEFI) case rate.

status: draft

date: 2022-05-12 15:36:35-0400

publisher: World Health Organization (WHO)

description: Clinics should report adverse events (reported and confirmed) to the central authority. \n\nThis should be tracked as an aggregate tally (which should indicate the severity, and optionally the manifestation such as rash, vomiting, etc.), with severe cases being reported using case reporting forms, and should include an analysis of whether the AEFI was a direct result (confirmed) of vaccination or not (suspected). Serious cases are those which involved hospitalization, disability, or death.\n\nInvestigation of AEFI events can lead to withdrawal of the vaccine from the market, or inform further guidance on administration of a particular antigen/product.

jurisdiction: Global (Whole world) (m49.htm#001)

library: IMMZIND30

scoring: Proportion (MeasureScoring#proportion)

type: Process (MeasureType#process)

improvementNotation: Increased score indicates improvement (MeasureImprovementNotation#increase)

group

id

IMMZIND30

population

id

numerator

code: Numerator (MeasurePopulationType#numerator)

description: Number of persons which have received a vaccine dose, and have reported an adverse event

Criteria

-LanguageExpression
*text/cqlnumerator

population

id

denominator

code: Denominator (MeasurePopulationType#denominator)

description: The total number of doses administered to patients of the product.

Criteria

-LanguageExpression
*text/cqldenominator

stratifier

id

vaccine-stratifier

Criteria

-LanguageExpression
*text/cqlVaccine Stratifier

stratifier

id

product/manufacturer-stratifier

Criteria

-LanguageExpression
*text/cqlProduct/Manufacturer Stratifier

stratifier

id

severity-stratifier

Criteria

-LanguageExpression
*text/cqlSeverity Stratifier

stratifier

id

geographic-region-stratifier

Criteria

-LanguageExpression
*text/cqlGeographic Region Stratifier

stratifier

id

manifestation-/-event-stratifier

Criteria

-LanguageExpression
*text/cqlManifestation / Event Stratifier

stratifier

id

-stratifier

Criteria

-LanguageExpression
*text/cqlStratifier
" }, "contained" : [{ "resourceType" : "Library", "id" : "effective-data-requirements", "extension" : [{ "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode", "valueCoding" : { "system" : "http://snomed.info/sct", "code" : "246112005", "display" : "Severity (attribute)" } }, { "extension" : [{ "url" : "libraryName", "valueString" : "IMMZCommon" }, { "url" : "name", "valueString" : "Doses Administered to Patient" }, { "url" : "statement", "valueString" : "/**\n * @dataElement All Doses Administered to Patient to patient ordered newest to oldest\n */\ndefine \"Doses Administered to Patient\":\n [Immunization] I\n where I.status = 'completed'\n sort by date from (occurrence as FHIR.dateTime) desc" }, { "url" : "displaySequence", "valueInteger" : 0 }], "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "IMMZIndicatorCommon" }, { "url" : "name", "valueString" : "Immunizations with Adverse Events During Measurement Period" }, { "url" : "statement", "valueString" : "/** \n * @define Adverse events for immunizations which occurred during (or observed) during measurement period\n */\ndefine \"Immunizations with Adverse Events During Measurement Period\":\n IMMZCom.\"Doses Administered to Patient\" I\n with [Observation: code in WC.\"Adverse Events\"] O\n such that exists(I.reaction R where O.id = Last(Split(R.detail.reference, '/')))\n and FC.ToInterval(O.effective) during \"Measurement Period\"" }, { "url" : "displaySequence", "valueInteger" : 1 }], "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "IMMZIND30" }, { "url" : "name", "valueString" : "Vaccine Stratifier" }, { "url" : "statement", "valueString" : "/*\n * Disaggregator: Vaccine (BCG, OPV, etc.)\n */\ndefine \"Vaccine Stratifier\":\n\tIMMZIndCom.\"Immunizations with Adverse Events During Measurement Period\" A\n\treturn A.vaccineCode" }, { "url" : "displaySequence", "valueInteger" : 2 }], "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "IMMZIndicatorCommon" }, { "url" : "name", "valueString" : "Adverse Event Reactions During Measurement Period" }, { "url" : "statement", "valueString" : "/** \n * @define Adverse events for immunizations which occurred during (or observed) during measurement period\n */\ndefine \"Adverse Event Reactions During Measurement Period\":\n [Observation: code in WC.\"Adverse Events\"] O\n with IMMZCom.\"Doses Administered to Patient\" I\n such that exists(I.reaction R where O.id = Last(Split(R.detail.reference, '/')))\n where FC.ToInterval(O.effective) during \"Measurement Period\"" }, { "url" : "displaySequence", "valueInteger" : 3 }], "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "IMMZIND30" }, { "url" : "name", "valueString" : "Severity Stratifier" }, { "url" : "statement", "valueString" : "/*\n * Disaggregator: Severity (Severe, Non-Severe)\n */\ndefine \"Severity Stratifier\":\n\tIMMZIndCom.\"Adverse Event Reactions During Measurement Period\" A\n\treturn First(A.component C where C.code = IMMZc.\"Adverse Event Severity\").value as FHIR.CodeableConcept" }, { "url" : "displaySequence", "valueInteger" : 4 }], "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "IMMZIND30" }, { "url" : "name", "valueString" : "Manifestation / Event Stratifier" }, { "url" : "statement", "valueString" : "/*\n * Disaggregator: Manifestation / Event (optional - Rash, Vomiting, etc.)\n */\ndefine \"Manifestation / Event Stratifier\":\n\tIMMZIndCom.\"Adverse Event Reactions During Measurement Period\" A\n\treturn A.value as FHIR.CodeableConcept" }, { "url" : "displaySequence", "valueInteger" : 5 }], "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "IMMZIndicatorCommon" }, { "url" : "name", "valueString" : "By Geographic Region Stratifier" }, { "url" : "statement", "valueString" : "/**\n * By Administrative Gender of Patient Stratifier\n */\ndefine \"By Geographic Region Stratifier\":\n First(Patient.address A where A.use in { 'home' }).state" }, { "url" : "displaySequence", "valueInteger" : 6 }], "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "IMMZIND30" }, { "url" : "name", "valueString" : "Geographic Region Stratifier" }, { "url" : "statement", "valueString" : "/*\n * Disaggregator: Geographic Region\n */\ndefine \"Geographic Region Stratifier\":\n\tIMMZIndCom.\"By Geographic Region Stratifier\"" }, { "url" : "displaySequence", "valueInteger" : 7 }], "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "IMMZIND30" }, { "url" : "name", "valueString" : "Product/Manufacturer Stratifier" }, { "url" : "statement", "valueString" : "/*\n * Disaggregator: Product/Manufacturer\n */\ndefine \"Product/Manufacturer Stratifier\":\n\tIMMZIndCom.\"Immunizations with Adverse Events During Measurement Period\" A\n\t// TODO: Find a better way to do this\n\treturn Tuple { Manufacturer : First([Organization] O where O.id = Last(Split(A.manufacturer.reference, '/'))), LotNumber : A.lotNumber, VaccineType: A.vaccineCode }" }, { "url" : "displaySequence", "valueInteger" : 8 }], "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "IMMZIND30" }, { "url" : "name", "valueString" : "numerator" }, { "url" : "statement", "valueString" : "/*\n * Numerator: Number of persons which have received a vaccine dose, and have reported an adverse event\n * Numerator Computation: COUNT immunization HAVING reaction reported during reporting period\n */\ndefine \"numerator\":\n\texists(IMMZIndCom.\"Immunizations with Adverse Events During Measurement Period\")" }, { "url" : "displaySequence", "valueInteger" : 9 }], "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "IMMZIndicatorCommon" }, { "url" : "name", "valueString" : "Doses Administered to Patient During Measurement Period" }, { "url" : "statement", "valueString" : "/** \n * @define Doses which were \n */\ndefine \"Doses Administered to Patient During Measurement Period\":\n IMMZCom.\"Doses Administered to Patient\" I\n where IMMZCom.ToDate(I.occurrence) during \"Measurement Period\"" }, { "url" : "displaySequence", "valueInteger" : 10 }], "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "IMMZIND30" }, { "url" : "name", "valueString" : "denominator" }, { "url" : "statement", "valueString" : "/*\n * Denominator: The total number of doses administered to patients of the product.\n * Denominator Computation: COUNT number of doses administered during reporting period\n */\ndefine \"denominator\":\n\texists(IMMZIndCom.\"Doses Administered to Patient During Measurement Period\")" }, { "url" : "displaySequence", "valueInteger" : 11 }], "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition" }], "status" : "active", "type" : { "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/library-type", "code" : "module-definition" }] }, "relatedArtifact" : [{ "type" : "depends-on", "display" : "Library IMMZIndCom", "resource" : "http://fhir.org/guides/who/smart-immunization/Library/IMMZIndicatorCommon" }, { "type" : "depends-on", "display" : "Library IMMZCom", "resource" : "http://fhir.org/guides/who/smart-immunization/Library/IMMZCommon" }, { "type" : "depends-on", "display" : "Library FHIRHelpers", "resource" : "http://fhir.org/guides/who/smart-immunization/Library/FHIRHelpers|4.0.1" }, { "type" : "depends-on", "display" : "Library WC", "resource" : "http://fhir.org/guides/who/smart-immunization/Library/WHOConcepts" }, { "type" : "depends-on", "display" : "Library FC", "resource" : "http://fhir.org/guides/who/smart-immunization/Library/FHIRCommon" }, { "type" : "depends-on", "display" : "Library IMMZc", "resource" : "http://fhir.org/guides/who/smart-immunization/Library/IMMZConcepts" }, { "type" : "depends-on", "display" : "Code system SNOMED-CT", "resource" : "http://snomed.info/sct" }, { "type" : "depends-on", "display" : "Value set Adverse Events", "resource" : "http://hl7.org/fhir/ValueSet/adverse-event-type" }], "parameter" : [{ "name" : "Measurement Period", "use" : "in", "min" : 0, "max" : "1", "type" : "Period" }, { "name" : "Vaccine Stratifier", "use" : "out", "min" : 0, "max" : "*", "type" : "CodeableConcept" }, { "name" : "Severity Stratifier", "use" : "out", "min" : 0, "max" : "*", "type" : "CodeableConcept" }, { "name" : "Manifestation / Event Stratifier", "use" : "out", "min" : 0, "max" : "*", "type" : "CodeableConcept" }, { "name" : "Geographic Region Stratifier", "use" : "out", "min" : 0, "max" : "1", "type" : "string" }, { "name" : "Product/Manufacturer Stratifier", "use" : "out", "min" : 0, "max" : "*", "type" : "Resource" }, { "name" : "numerator", "use" : "out", "min" : 0, "max" : "1", "type" : "boolean" }, { "name" : "denominator", "use" : "out", "min" : 0, "max" : "1", "type" : "boolean" }], "dataRequirement" : [{ "type" : "Immunization", "profile" : ["http://hl7.org/fhir/StructureDefinition/Immunization"], "mustSupport" : ["status", "reaction", "occurrence"] }, { "type" : "Observation", "profile" : ["http://hl7.org/fhir/StructureDefinition/Observation"], "mustSupport" : ["code", "id", "effective"], "codeFilter" : [{ "path" : "code", "valueSet" : "http://hl7.org/fhir/ValueSet/adverse-event-type" }] }, { "type" : "Patient", "profile" : ["http://hl7.org/fhir/StructureDefinition/Patient"], "mustSupport" : ["use"] }, { "type" : "Organization", "profile" : ["http://hl7.org/fhir/StructureDefinition/Organization"], "mustSupport" : ["id"] }] }], "extension" : [{ "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-softwaresystem", "valueReference" : { "reference" : "Device/cqf-tooling" } }, { "id" : "effective-data-requirements", "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-effectiveDataRequirements", "valueReference" : { "reference" : "#effective-data-requirements" } }], "url" : "http://fhir.org/guides/who/smart-immunization/Measure/IMMZIND30", "version" : "0.1.0", "name" : "IMMZIND30", "title" : "IMMZ.IND.30 Adverse Event Following Immunization (AEFI) case rate.", "status" : "draft", "date" : "2022-05-12T15:36:35.009-04:00", "publisher" : "World Health Organization (WHO)", "description" : "Clinics should report adverse events (reported and confirmed) to the central authority. \n\nThis should be tracked as an aggregate tally (which should indicate the severity, and optionally the manifestation such as rash, vomiting, etc.), with severe cases being reported using case reporting forms, and should include an analysis of whether the AEFI was a direct result (confirmed) of vaccination or not (suspected). Serious cases are those which involved hospitalization, disability, or death.\n\nInvestigation of AEFI events can lead to withdrawal of the vaccine from the market, or inform further guidance on administration of a particular antigen/product.", "jurisdiction" : [{ "coding" : [{ "system" : "http://unstats.un.org/unsd/methods/m49/m49.htm", "code" : "001" }] }], "library" : ["http://fhir.org/guides/who/smart-immunization/Library/IMMZIND30"], "scoring" : { "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/measure-scoring", "code" : "proportion" }] }, "type" : [{ "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/measure-type", "code" : "process" }] }], "improvementNotation" : { "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/measure-improvement-notation", "code" : "increase" }] }, "group" : [{ "id" : "IMMZIND30", "population" : [{ "id" : "numerator", "code" : { "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/measure-population", "code" : "numerator" }] }, "description" : "Number of persons which have received a vaccine dose, and have reported an adverse event", "criteria" : { "language" : "text/cql", "expression" : "numerator" } }, { "id" : "denominator", "code" : { "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/measure-population", "code" : "denominator" }] }, "description" : "The total number of doses administered to patients of the product.", "criteria" : { "language" : "text/cql", "expression" : "denominator" } }], "stratifier" : [{ "id" : "vaccine-stratifier", "criteria" : { "language" : "text/cql", "expression" : "Vaccine Stratifier" } }, { "id" : "product/manufacturer-stratifier", "criteria" : { "language" : "text/cql", "expression" : "Product/Manufacturer Stratifier" } }, { "id" : "severity-stratifier", "criteria" : { "language" : "text/cql", "expression" : "Severity Stratifier" } }, { "id" : "geographic-region-stratifier", "criteria" : { "language" : "text/cql", "expression" : "Geographic Region Stratifier" } }, { "id" : "manifestation-/-event-stratifier", "criteria" : { "language" : "text/cql", "expression" : "Manifestation / Event Stratifier" } }, { "id" : "-stratifier", "criteria" : { "language" : "text/cql", "expression" : "Stratifier" } }] }] }