<?xml version="1.0" encoding="UTF-8"?>

<Measure xmlns="http://hl7.org/fhir">
  <id value="IMMZIND24"/>
  <meta>
    <profile value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-measure-cqfm"/>
  </meta>
  <text>
    <status value="generated"/><div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: Measure</b><a name="IMMZIND24"> </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">Resource Measure &quot;IMMZIND24&quot; </p><p style="margin-bottom: 0px">Profile: <code>http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-measure-cqfm</code></p></div><p><b>url</b>: <code>http://fhir.org/guides/who/smart-immunization/Measure/IMMZIND24</code></p><p><b>version</b>: 0.1.0</p><p><b>name</b>: IMMZIND24</p><p><b>title</b>: IMMZ.IND.24 Dropout Rate of BCG to MCV1 (Target / Reported Cohort)</p><p><b>status</b>: draft</p><p><b>date</b>: 2022-05-12 15:36:35-0400</p><p><b>publisher</b>: World Health Organization (WHO)</p><p><b>description</b>: Indicates the aggregate dropout rate of children which have begun vaccination (at birth, BCG if given) with aggregate administration of measles containing vaccines. 

The indicator compares the number of administration of BCG minus the number of administration of MCV1 divided by the number of BCG vaccinations (BCG - MCV1 / BCG)</p><p><b>jurisdiction</b>: Global (Whole world) <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (m49.htm#001)</span></p><p><b>library</b>: <a href="Library-IMMZIND24.html">IMMZIND24</a></p><p><b>scoring</b>: Proportion <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.0.0/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/5.0.0/CodeSystem-measure-type.html">MeasureType</a>#process)</span></p><p><b>improvementNotation</b>: Decreased score indicates improvement <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.0.0/CodeSystem-measure-improvement-notation.html">MeasureImprovementNotation</a>#decrease)</span></p><blockquote><p><b>group</b></p><blockquote><p><b>id</b></p>IMMZIND24</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/5.0.0/CodeSystem-measure-population.html">MeasurePopulationType</a>#numerator)</span></p><p><b>description</b>: The number of doses of MCV1 administered during reporting period minus the number of BCG doses administered during reporting period</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</td><td>numerator</td></tr></table></blockquote><blockquote><p><b>population</b></p><blockquote><p><b>id</b></p>numerator-exclusion</blockquote><p><b>code</b>: Numerator Exclusion <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.0.0/CodeSystem-measure-population.html">MeasurePopulationType</a>#numerator-exclusion)</span></p><p><b>description</b>: The number of doses of MCV1 administered during reporting period minus the number of BCG doses administered during reporting period</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</td><td>numerator-exclusion</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/5.0.0/CodeSystem-measure-population.html">MeasurePopulationType</a>#denominator)</span></p><p><b>description</b>: Number of doses of BCG administered during reporting period.</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</td><td>denominator</td></tr></table></blockquote><blockquote><p><b>stratifier</b></p><blockquote><p><b>id</b></p>geographic-region-stratifier</blockquote><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</td><td>Geographic Region Stratifier</td></tr></table></blockquote></blockquote></div>
  </text>
  <contained>
    <Library>
      <id value="effective-data-requirements"/>
      <extension url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
        <extension url="libraryName">
          <valueString value="IMMZCommon"/>
        </extension>
        <extension url="name">
          <valueString value="Doses Administered to Patient"/>
        </extension>
        <extension url="statement">
          <valueString value="/**&#xA; * @dataElement All Doses Administered to Patient to patient ordered newest to oldest&#xA; */&#xA;define &quot;Doses Administered to Patient&quot;:&#xA;  [Immunization] I&#xA;    where I.status = 'completed'&#xA;    sort by date from (occurrence as FHIR.dateTime) desc"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="0"/>
        </extension>
      </extension>
      <extension url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
        <extension url="libraryName">
          <valueString value="IMMZCommon"/>
        </extension>
        <extension url="name">
          <valueString value="MCV Doses Administered to Patient"/>
        </extension>
        <extension url="statement">
          <valueString value="/**&#xA; * @dataElement MCV containing Doses Administered to Patient&#xA; */&#xA;define &quot;MCV Doses Administered to Patient&quot;:&#xA;  &quot;Doses Administered to Patient&quot; I&#xA;  where&#xA;    I.vaccineCode in IMMZc.&quot;MCV Vaccine&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="1"/>
        </extension>
      </extension>
      <extension url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
        <extension url="libraryName">
          <valueString value="IMMZIndicatorCommon"/>
        </extension>
        <extension url="name">
          <valueString value="MCV Doses Administered to Patient During Measurement Period"/>
        </extension>
        <extension url="statement">
          <valueString value="/**&#xA; * MCV Doses Administered to Patient&#xA; */&#xA;define &quot;MCV Doses Administered to Patient During Measurement Period&quot;:&#xA;    IMMZCom.&quot;MCV Doses Administered to Patient&quot; I &#xA;    where IMMZCom.ToDate(I.occurrence) during &quot;Measurement Period&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="2"/>
        </extension>
      </extension>
      <extension url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
        <extension url="libraryName">
          <valueString value="IMMZIND24"/>
        </extension>
        <extension url="name">
          <valueString value="numerator-exclusion"/>
        </extension>
        <extension url="statement">
          <valueString value="/** &#xA; * Exclusion for numerator&#xA; */&#xA;define &quot;numerator-exclusion&quot;:&#xA;&#x9;exists(IMMZIndCom.&quot;MCV Doses Administered to Patient During Measurement Period&quot; I where (singleton from I.protocolApplied).doseNumber = 1)"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="3"/>
        </extension>
      </extension>
      <extension url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
        <extension url="libraryName">
          <valueString value="IMMZIndicatorCommon"/>
        </extension>
        <extension url="name">
          <valueString value="By Geographic Region Stratifier"/>
        </extension>
        <extension url="statement">
          <valueString value="/**&#xA; * By Administrative Gender of Patient Stratifier&#xA; */&#xA;define &quot;By Geographic Region Stratifier&quot;:&#xA;    First(Patient.address A where A.use in { 'home' }).state"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="4"/>
        </extension>
      </extension>
      <extension url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
        <extension url="libraryName">
          <valueString value="IMMZIND24"/>
        </extension>
        <extension url="name">
          <valueString value="Geographic Region Stratifier"/>
        </extension>
        <extension url="statement">
          <valueString value="/*&#xA; * Disaggregator: Geographic Region&#xA; */&#xA;define &quot;Geographic Region Stratifier&quot;:&#xA;&#x9;IMMZIndCom.&quot;By Geographic Region Stratifier&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="5"/>
        </extension>
      </extension>
      <extension url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
        <extension url="libraryName">
          <valueString value="IMMZCommon"/>
        </extension>
        <extension url="name">
          <valueString value="BCG Doses Administered to Patient"/>
        </extension>
        <extension url="statement">
          <valueString value="/**&#xA; * @dataElement BCG Doses Administered to Patient&#xA; */&#xA;define &quot;BCG Doses Administered to Patient&quot;:&#xA;  &quot;Doses Administered to Patient&quot; I &#xA;  where &#xA;    I.vaccineCode in IMMZc.&quot;BCG Vaccine&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="6"/>
        </extension>
      </extension>
      <extension url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
        <extension url="libraryName">
          <valueString value="IMMZIndicatorCommon"/>
        </extension>
        <extension url="name">
          <valueString value="BCG Doses Administered to Patient During Measurement Period"/>
        </extension>
        <extension url="statement">
          <valueString value="/*&#xA; * BCG Doses administered to the patient during the measurement period&#xA; */&#xA;define &quot;BCG Doses Administered to Patient During Measurement Period&quot;:&#xA;    IMMZCom.&quot;BCG Doses Administered to Patient&quot; I&#xA;&#x9;&#x9;where IMMZCom.ToDate(I.occurrence) during &quot;Measurement Period&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="7"/>
        </extension>
      </extension>
      <extension url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
        <extension url="libraryName">
          <valueString value="IMMZIND24"/>
        </extension>
        <extension url="name">
          <valueString value="numerator"/>
        </extension>
        <extension url="statement">
          <valueString value="/*&#xA; * Numerator: The number of doses of MCV1 administered during reporting period minus the number of BCG doses administered during reporting period&#xA; * Numerator Computation: COUNT immunization events WHERE administered product is BCG (IMMZ.A1.DE1)  during reporting period&#xA;SUBTRACT &#xA;COUNT immunization events WHERE administered product is measles containing vaccine (IMMZ.A1.DE9) AND dose sequence is 1 during reporting period&#xA; */&#xA;define &quot;numerator&quot;:&#xA;&#x9;exists(IMMZIndCom.&quot;BCG Doses Administered to Patient During Measurement Period&quot;)"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="8"/>
        </extension>
      </extension>
      <extension url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
        <extension url="libraryName">
          <valueString value="IMMZIND24"/>
        </extension>
        <extension url="name">
          <valueString value="denominator"/>
        </extension>
        <extension url="statement">
          <valueString value="/*&#xA; * Denominator: Number of doses of BCG administered during reporting period.&#xA; * Denominator Computation: COUNT immunization events WHERE administered product is BCG (IMMZ.A1.DE1)  during reporting period&#xA; */&#xA;define &quot;denominator&quot;:&#xA;&#x9;exists(IMMZIndCom.&quot;BCG Doses Administered to Patient During Measurement Period&quot;)"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="9"/>
        </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 IMMZIndCom"/>
        <resource value="http://fhir.org/guides/who/smart-immunization/Library/IMMZIndicatorCommon"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Library IMMZCom"/>
        <resource value="http://fhir.org/guides/who/smart-immunization/Library/IMMZCommon"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Library FHIRHelpers"/>
        <resource value="http://fhir.org/guides/who/smart-immunization/Library/FHIRHelpers|4.0.1"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Library IMMZc"/>
        <resource value="http://fhir.org/guides/who/smart-immunization/Library/IMMZConcepts"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set MCV Vaccine"/>
        <resource value="http://fhir.org/guides/who/smart-immunization/ValueSet/IMMZ.A1.DE9"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set BCG Vaccine"/>
        <resource value="http://fhir.org/guides/who/smart-immunization/ValueSet/IMMZ.A1.DE1"/>
      </relatedArtifact>
      <parameter>
        <name value="Measurement Period"/>
        <use value="in"/>
        <min value="0"/>
        <max value="1"/>
        <type value="Period"/>
      </parameter>
      <parameter>
        <name value="numerator-exclusion"/>
        <use value="out"/>
        <min value="0"/>
        <max value="1"/>
        <type value="boolean"/>
      </parameter>
      <parameter>
        <name value="Geographic Region Stratifier"/>
        <use value="out"/>
        <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="denominator"/>
        <use value="out"/>
        <min value="0"/>
        <max value="1"/>
        <type value="boolean"/>
      </parameter>
      <dataRequirement>
        <type value="Immunization"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Immunization"/>
        <mustSupport value="status"/>
        <mustSupport value="vaccineCode"/>
        <mustSupport value="occurrence"/>
        <mustSupport value="protocolApplied"/>
        <mustSupport value="protocolApplied.doseNumber"/>
      </dataRequirement>
      <dataRequirement>
        <type value="Patient"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Patient"/>
        <mustSupport value="use"/>
      </dataRequirement>
    </Library>
  </contained>
  <extension url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-softwaresystem">
    <valueReference>
      <reference value="Device/cqf-tooling"/>
    </valueReference>
  </extension>
  <extension id="effective-data-requirements" url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-effectiveDataRequirements">
    <valueReference>
      <reference value="#effective-data-requirements"/>
    </valueReference>
  </extension>
  <url value="http://fhir.org/guides/who/smart-immunization/Measure/IMMZIND24"/>
  <version value="0.1.0"/>
  <name value="IMMZIND24"/>
  <title value="IMMZ.IND.24 Dropout Rate of BCG to MCV1 (Target / Reported Cohort)"/>
  <status value="draft"/>
  <date value="2022-05-12T15:36:35.002-04:00"/>
  <publisher value="World Health Organization (WHO)"/>
  <description value="Indicates the aggregate dropout rate of children which have begun vaccination (at birth, BCG if given) with aggregate administration of measles containing vaccines. &#xA;&#xA;The indicator compares the number of administration of BCG minus the number of administration of MCV1 divided by the number of BCG vaccinations (BCG - MCV1 / BCG)"/>
  <jurisdiction>
    <coding>
      <system value="http://unstats.un.org/unsd/methods/m49/m49.htm"/>
      <code value="001"/>
    </coding>
  </jurisdiction>
  <library value="http://fhir.org/guides/who/smart-immunization/Library/IMMZIND24"/>
  <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="decrease"/>
    </coding>
  </improvementNotation>
  <group id="IMMZIND24">
    <population id="numerator">
      <code>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/measure-population"/>
          <code value="numerator"/>
        </coding>
      </code>
      <description value="The number of doses of MCV1 administered during reporting period minus the number of BCG doses administered during reporting period"/>
      <criteria>
        <language value="text/cql"/>
        <expression value="numerator"/>
      </criteria>
    </population>
    <population id="numerator-exclusion">
      <code>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/measure-population"/>
          <code value="numerator-exclusion"/>
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      </code>
      <description value="The number of doses of MCV1 administered during reporting period minus the number of BCG doses administered during reporting period"/>
      <criteria>
        <language value="text/cql"/>
        <expression value="numerator-exclusion"/>
      </criteria>
    </population>
    <population id="denominator">
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        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/measure-population"/>
          <code value="denominator"/>
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      </code>
      <description value="Number of doses of BCG administered during reporting period."/>
      <criteria>
        <language value="text/cql"/>
        <expression value="denominator"/>
      </criteria>
    </population>
    <stratifier id="geographic-region-stratifier">
      <criteria>
        <language value="text/cql"/>
        <expression value="Geographic Region Stratifier"/>
      </criteria>
    </stratifier>
  </group>
</Measure>