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

<Measure xmlns="http://hl7.org/fhir">
  <id value="IMMZIND25"/>
  <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="IMMZIND25"> </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;IMMZIND25&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/IMMZIND25</code></p><p><b>version</b>: 0.1.0</p><p><b>name</b>: IMMZIND25</p><p><b>title</b>: IMMZ.IND.25 Dropout Rate of MCV1 to MCV2 (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 began vaccination of measles containing vaccines (MCV1) with the aggregate administration of the second dose (MCV2).

The indicator compares the number of administrations of MCV dose 1 minus the number of administration of MCV2 divided by the number of MCV1 vaccinations (MCV1 - MCV2 / MCV1)</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-IMMZIND25.html">IMMZIND25</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>IMMZIND25</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 first doses of measles containing vaccine administered during reporting period minus the number of last doses of measles containing vaccine during the report 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 first doses of measles containing vaccine administered during reporting period minus the number of last doses of measles containing vaccine during the report 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 first doses of measles containing vaccine administered during the 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>
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    <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="IMMZIND25"/>
        </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 = 2)"/>
        </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="IMMZIND25"/>
        </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="IMMZIND25"/>
        </extension>
        <extension url="name">
          <valueString value="numerator"/>
        </extension>
        <extension url="statement">
          <valueString value="/*&#xA; * Numerator: The number of first doses of measles containing vaccine administered during reporting period minus the number of last doses of measles containing vaccine during the report period&#xA; * Numerator Computation: COUNT immunization events WHERE administered product is measles containing vaccine (IMMZ.A1.DE9) AND dose sequence is 1  during reporting period&#xA;SUBTRACT &#xA;COUNT immunization events WHERE administered product is measles containing vaccine (IMMZ.A1.DE9) AND dose sequence is 3 during reporting period&#xA; */&#xA;define &quot;numerator&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="6"/>
        </extension>
      </extension>
      <extension url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
        <extension url="libraryName">
          <valueString value="IMMZIND25"/>
        </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;MCV Doses Administered to Patient During Measurement Period&quot; I where (singleton from I.protocolApplied).doseNumber = 1)"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="7"/>
        </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>
      <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/IMMZIND25"/>
  <version value="0.1.0"/>
  <name value="IMMZIND25"/>
  <title value="IMMZ.IND.25 Dropout Rate of MCV1 to MCV2 (Target / Reported Cohort)"/>
  <status value="draft"/>
  <date value="2022-05-12T15:36:35.004-04:00"/>
  <publisher value="World Health Organization (WHO)"/>
  <description value="Indicates the aggregate dropout rate of children which began vaccination of measles containing vaccines (MCV1) with the aggregate administration of the second dose (MCV2).&#xA;&#xA;The indicator compares the number of administrations of MCV dose 1 minus the number of administration of MCV2 divided by the number of MCV1 vaccinations (MCV1 - MCV2 / MCV1)"/>
  <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/IMMZIND25"/>
  <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="IMMZIND25">
    <population id="numerator">
      <code>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/measure-population"/>
          <code value="numerator"/>
        </coding>
      </code>
      <description value="The number of first doses of measles containing vaccine administered during reporting period minus the number of last doses of measles containing vaccine during the report period"/>
      <criteria>
        <language value="text/cql"/>
        <expression value="numerator"/>
      </criteria>
    </population>
    <population id="numerator-exclusion">
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        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/measure-population"/>
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        </coding>
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      <description value="The number of first doses of measles containing vaccine administered during reporting period minus the number of last doses of measles containing vaccine during the report period"/>
      <criteria>
        <language value="text/cql"/>
        <expression value="numerator-exclusion"/>
      </criteria>
    </population>
    <population id="denominator">
      <code>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/measure-population"/>
          <code value="denominator"/>
        </coding>
      </code>
      <description value="Number of first doses of measles containing vaccine administered during the 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>