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SQL (for debugging): Insert into SearchEntries Select 8573, Ids.ResourceKey, Versions.ResourceVersionKey, RIGHT ('0000000000000'+CAST(Versions.ResourceVersionKey AS VARCHAR(14)),14) as sort, null, null from Versions, Ids, Sessions where Ids.ResourceTypeKey = 65 and Versions.ResourceKey = Ids.ResourceKey and Versions.SessionKey = Sessions.SessionKey order by ResourceVersionKey DESC

Measure "measure-predecessor-example" Version "1"

Created by SYSTEM () at 11/28/2017 8:31:19 AM(UTC)

Tags: (no tags)  +

This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

Id:
Measure/measure-predecessor-example

Identifier:
value: exclusive-breastfeeding-measure

Title:
Exclusive Breastfeeding Measure

Status:
active

Description:
Exclusive breastfeeding measure of outcomes for exclusive breastmilk feeding of newborns.

Purpose:
Exclusive breast milk feeding for the first 6 months of neonatal life can result in numerous long-term health benefits for both mother and newborn and is recommended by a number of national and international organizations. Evidence suggests that the prenatal and intrapartum period is critical for the success of exclusive (or any) breast feeding. Therefore, it is recommended that newborns are fed breast milk only from birth to discharge.

Topic:
text: Exclusive Breastfeeding

Library:
reference: Library/library-exclusive-breastfeeding-cqm-logic

Type:
outcome

Group:
Identifier:
value: Population Group 1
Population:

type:initial-population

Identifier:
value: initial-population-1-identifier

criteria: InitialPopulation1

Population:

type:denominator

Identifier:
value: denominator-1-identifier

criteria: Denominator1

Population:

type:denominator-exclusion

Identifier:
value: denominator-exclusions-1-identifier

criteria: DenominatorExclusions1

Population:

type:numerator

Identifier:
value: numerator-1-identifier

criteria: Numerator1

Group:
Identifier:
value: Population Group 2
Population:

type:initial-population

Identifier:
value: initial-population-2-identifier

criteria: InitialPopulation2

Population:

type:denominator

Identifier:
value: denominator-2-identifier

criteria: Denominator2

Population:

type:denominator-exclusion

Identifier:
value: denominator-exclusions-2-identifier

criteria: DenominatorExclusions2

Population:

type:numerator

Identifier:
value: numerator-2-identifier

criteria: Numerator2


<?xml version="1.0" encoding="UTF-8"?>
<Measure xmlns="http://hl7.org/fhir">
  <id value="measure-predecessor-example"/>
  <meta>
    <versionId value="1"/>
    <lastUpdated value="2017-11-28T08:31:19Z"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
      <table class="grid dict">
        <tr>
          <td>
            <b>Id: </b>
          </td>
        </tr>
        <tr>
          <td style="padding-left: 25px padding-right: 25px">Measure/measure-predecessor-example</td>
        </tr>
      </table>
      <p/>
      <table class="grid dict">
        <tr>
          <td>
            <b>Identifier: </b>
          </td>
        </tr>
        <tr>
          <td style="padding-left: 25px padding-right: 25px">
            <b>value: </b>
            <span>exclusive-breastfeeding-measure</span>
          </td>
        </tr>
      </table>
      <p/>
      <table class="grid dict">
        <tr>
          <td>
            <b>Title: </b>
          </td>
        </tr>
        <tr>
          <td style="padding-left: 25px padding-right: 25px">Exclusive Breastfeeding Measure</td>
        </tr>
      </table>
      <p/>
      <table class="grid dict">
        <tr>
          <td>
            <b>Status: </b>
          </td>
        </tr>
        <tr>
          <td style="padding-left: 25px padding-right: 25px">active</td>
        </tr>
      </table>
      <p/>
      <table class="grid dict">
        <tr>
          <td>
            <b>Description: </b>
          </td>
        </tr>
        <tr>
          <td style="padding-left: 25px padding-right: 25px">Exclusive breastfeeding measure of outcomes for exclusive breastmilk feeding of newborns.</td>
        </tr>
      </table>
      <p/>
      <table class="grid dict">
        <tr>
          <td>
            <b>Purpose: </b>
          </td>
        </tr>
        <tr>
          <td style="padding-left: 25px padding-right: 25px">Exclusive breast milk feeding for the first 6 months of neonatal life can result in numerous long-term health benefits for both mother and newborn and is recommended by a number of national and international organizations. Evidence suggests that the prenatal and intrapartum period is critical for the success of exclusive (or any) breast feeding. Therefore, it is recommended that newborns are fed breast milk only from birth to discharge.</td>
        </tr>
      </table>
      <p/>
      <table class="grid dict">
        <tr>
          <td>
            <b>Topic: </b>
          </td>
        </tr>
        <tr>
          <td style="padding-right: 25px">
            <span style="padding-left: 25px">
              <b>text: </b>
              <span>Exclusive Breastfeeding</span>
              <br/>
            </span>
          </td>
        </tr>
      </table>
      <p/>
      <table class="grid dict">
        <tr>
          <td>
            <b>Library: </b>
          </td>
        </tr>
        <tr>
          <td style="padding-left: 25px padding-right: 25px">
            <b>reference: </b>
            <span>Library/library-exclusive-breastfeeding-cqm-logic</span>
          </td>
        </tr>
      </table>
      <p/>
      <table class="grid dict">
        <tr>
          <td>
            <b>Type: </b>
          </td>
        </tr>
        <tr>
          <td style="padding-left: 25px padding-right: 25px">outcome</td>
        </tr>
      </table>
      <p/>
      <table class="grid dict">
        <tr>
          <td>
            <b>Group:</b>
          </td>
        </tr>
        <tr>
          <td style="padding-left: 25px padding-right: 25px">
            <b>Identifier:</b>
            <br/>
            <span style="padding-left: 25px">
              <b>value: </b>
              <span>Population Group 1</span>
              <br/>
            </span>
          </td>
        </tr>
        <tr>
          <td style="padding-left: 25px padding-right: 25px">
            <b>Population:</b>
            <br/>
            <p style="margin-bottom: 5px padding-left: 25px">
              <b>type:</b>
              <span>initial-population</span>
            </p>
            <p style="margin-bottom: 5px padding-left: 25px">
              <b>Identifier:</b>
              <br/>
              <span style="padding-left: 25px">
                <b>value: </b>
                <span>initial-population-1-identifier</span>
                <br/>
              </span>
            </p>
            <p style="margin-bottom: 5px padding-left: 25px">
              <b>criteria: </b>
              <span>InitialPopulation1</span>
            </p>
          </td>
        </tr>
        <tr>
          <td style="padding-left: 25px padding-right: 25px">
            <b>Population:</b>
            <br/>
            <p style="margin-bottom: 5px padding-left: 25px">
              <b>type:</b>
              <span>denominator</span>
            </p>
            <p style="margin-bottom: 5px padding-left: 25px">
              <b>Identifier:</b>
              <br/>
              <span style="padding-left: 25px">
                <b>value: </b>
                <span>denominator-1-identifier</span>
                <br/>
              </span>
            </p>
            <p style="margin-bottom: 5px padding-left: 25px">
              <b>criteria: </b>
              <span>Denominator1</span>
            </p>
          </td>
        </tr>
        <tr>
          <td style="padding-left: 25px padding-right: 25px">
            <b>Population:</b>
            <br/>
            <p style="margin-bottom: 5px padding-left: 25px">
              <b>type:</b>
              <span>denominator-exclusion</span>
            </p>
            <p style="margin-bottom: 5px padding-left: 25px">
              <b>Identifier:</b>
              <br/>
              <span style="padding-left: 25px">
                <b>value: </b>
                <span>denominator-exclusions-1-identifier</span>
                <br/>
              </span>
            </p>
            <p style="margin-bottom: 5px padding-left: 25px">
              <b>criteria: </b>
              <span>DenominatorExclusions1</span>
            </p>
          </td>
        </tr>
        <tr>
          <td style="padding-left: 25px padding-right: 25px">
            <b>Population:</b>
            <br/>
            <p style="margin-bottom: 5px padding-left: 25px">
              <b>type:</b>
              <span>numerator</span>
            </p>
            <p style="margin-bottom: 5px padding-left: 25px">
              <b>Identifier:</b>
              <br/>
              <span style="padding-left: 25px">
                <b>value: </b>
                <span>numerator-1-identifier</span>
                <br/>
              </span>
            </p>
            <p style="margin-bottom: 5px padding-left: 25px">
              <b>criteria: </b>
              <span>Numerator1</span>
            </p>
          </td>
        </tr>
      </table>
      <table class="grid dict">
        <tr>
          <td>
            <b>Group:</b>
          </td>
        </tr>
        <tr>
          <td style="padding-left: 25px padding-right: 25px">
            <b>Identifier:</b>
            <br/>
            <span style="padding-left: 25px">
              <b>value: </b>
              <span>Population Group 2</span>
              <br/>
            </span>
          </td>
        </tr>
        <tr>
          <td style="padding-left: 25px padding-right: 25px">
            <b>Population:</b>
            <br/>
            <p style="margin-bottom: 5px padding-left: 25px">
              <b>type:</b>
              <span>initial-population</span>
            </p>
            <p style="margin-bottom: 5px padding-left: 25px">
              <b>Identifier:</b>
              <br/>
              <span style="padding-left: 25px">
                <b>value: </b>
                <span>initial-population-2-identifier</span>
                <br/>
              </span>
            </p>
            <p style="margin-bottom: 5px padding-left: 25px">
              <b>criteria: </b>
              <span>InitialPopulation2</span>
            </p>
          </td>
        </tr>
        <tr>
          <td style="padding-left: 25px padding-right: 25px">
            <b>Population:</b>
            <br/>
            <p style="margin-bottom: 5px padding-left: 25px">
              <b>type:</b>
              <span>denominator</span>
            </p>
            <p style="margin-bottom: 5px padding-left: 25px">
              <b>Identifier:</b>
              <br/>
              <span style="padding-left: 25px">
                <b>value: </b>
                <span>denominator-2-identifier</span>
                <br/>
              </span>
            </p>
            <p style="margin-bottom: 5px padding-left: 25px">
              <b>criteria: </b>
              <span>Denominator2</span>
            </p>
          </td>
        </tr>
        <tr>
          <td style="padding-left: 25px padding-right: 25px">
            <b>Population:</b>
            <br/>
            <p style="margin-bottom: 5px padding-left: 25px">
              <b>type:</b>
              <span>denominator-exclusion</span>
            </p>
            <p style="margin-bottom: 5px padding-left: 25px">
              <b>Identifier:</b>
              <br/>
              <span style="padding-left: 25px">
                <b>value: </b>
                <span>denominator-exclusions-2-identifier</span>
                <br/>
              </span>
            </p>
            <p style="margin-bottom: 5px padding-left: 25px">
              <b>criteria: </b>
              <span>DenominatorExclusions2</span>
            </p>
          </td>
        </tr>
        <tr>
          <td style="padding-left: 25px padding-right: 25px">
            <b>Population:</b>
            <br/>
            <p style="margin-bottom: 5px padding-left: 25px">
              <b>type:</b>
              <span>numerator</span>
            </p>
            <p style="margin-bottom: 5px padding-left: 25px">
              <b>Identifier:</b>
              <br/>
              <span style="padding-left: 25px">
                <b>value: </b>
                <span>numerator-2-identifier</span>
                <br/>
              </span>
            </p>
            <p style="margin-bottom: 5px padding-left: 25px">
              <b>criteria: </b>
              <span>Numerator2</span>
            </p>
          </td>
        </tr>
      </table>
    </div>
  </text>
  <identifier>
    <use value="official"/>
    <value value="exclusive-breastfeeding-measure"/>
  </identifier>
  <version value="3.0.1"/>
  <title value="Exclusive Breastfeeding Measure"/>
  <status value="active"/>
  <date value="2014-03-08"/>
  <description value="Exclusive breastfeeding measure of outcomes for exclusive breastmilk feeding of newborns."/>
  <purpose value="Measure of newborns who were fed breast milk only since birth"/>
  <topic>
    <text value="Exclusive Breastfeeding"/>
  </topic>
  <relatedArtifact>
    <type value="documentation"/>
    <citation value="American Academy of Pediatrics. (2005). Section on Breastfeeding. Policy Statement:Breastfeeding and the Use of Human Milk. Pediatrics.115:496-506."/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="documentation"/>
    <citation value="American College of Obstetricians and Gynecologists. (Feb. 2007). Committee on Obstetric Practice and Committee on Health Care for Underserved Women. Breastfeeding: Maternal and Infant Aspects. ACOG Committee Opinion 361."/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="documentation"/>
    <citation value="California Department of Public Health. (2006). Genetic Disease Branch. California In-Hospital Breastfeeding as Indicated on the Newborn Screening Test Form, Statewide, County and Hospital of Occurrence: Available at: http://www.cdph.ca.gov/data/statistics/Pages/BreastfeedingStatistics.aspx."/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="documentation"/>
    <citation value="Centers for Disease Control and Prevention. (Aug 3, 2007). Breastfeeding trends and updated national health objectives for exclusive breastfeeding--United States birth years 2000-2004. MMWR - Morbidity &amp; Mortality Weekly Report. 56(30):760-3."/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="documentation"/>
    <citation value="Centers for Disease Control and Prevention. (2014). Division of Nutrition, Physical Activity and Obesity. Breastfeeding Report Card. Available at: http://www.cdc.gov/breastfeeding/pdf/2014breastfeedingreportcard.pdf"/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="documentation"/>
    <citation value="Ip, S., Chung, M., Raman, G., et al. (2007). Breastfeeding and maternal and infant health outcomes in developed countries. Rockville, MD: US Department of Health and Human Services. Available at: http://www.ahrq.gov/downloads/pub/evidence/pdf/brfout/brfout.pdf"/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="documentation"/>
    <citation value="Kramer, M.S. &amp; Kakuma, R. (2002).Optimal duration of exclusive breastfeeding. [107 refs] Cochrane Database of Systematic Reviews. (1):CD003517."/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="documentation"/>
    <citation value="Petrova, A., Hegyi, T., &amp; Mehta, R. (2007). Maternal race/ethnicity and one-month exclusive breastfeeding in association with the in-hospital feeding modality. Breastfeeding Medicine. 2(2):92-8."/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="documentation"/>
    <citation value="Shealy, K.R., Li, R., Benton-Davis, S., &amp; Grummer-Strawn, L.M. (2005).The CDC guide to breastfeeding interventions. Atlanta, GA: US Department of Health and Human Services, CDC. Available at: http://www.cdc.gov/breastfeeding/pdf/breastfeeding_interventions.pdf."/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="documentation"/>
    <citation value="Taveras, E.M., Li, R., Grummer-Strawn, L., Richardson, M., Marshall, R., Rego, V.H., Miroshnik, I., &amp; Lieu, T.A. (2004). Opinions and practices of clinicians associated with continuation of exclusive breastfeeding. Pediatrics. 113(4):e283-90."/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="documentation"/>
    <citation value="US Department of Health and Human Services. (2007). Healthy People 2010 Midcourse Review. Washington, DC: US Department of Health and Human Services. Available at: http://www.healthypeople.gov/2010/data/midcourse/?visit=1."/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="documentation"/>
    <citation value="World Health Organization. (1991). Indicators for assessing breastfeeding practices. Geneva, Switzerland: World Health Organization. Available at: http://whqlibdoc.who.int/hq/1991/WHO_CDD_SER_91.14.pdf?ua=1."/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="successor"/>
    <resource>
      <reference value="Measure/measure-exclusive-breastfeeding"/>
    </resource>
  </relatedArtifact>
  <library>
    <reference value="Library/library-exclusive-breastfeeding-cqm-logic"/>
  </library>
  <disclaimer value="These performance measures are not clinical guidelines and do not establish a standard of medical care, and have not been tested for all potential applications. The measures and specifications are provided without warranty."/>
  <scoring>
    <coding>
      <code value="proportion"/>
    </coding>
  </scoring>
  <type>
    <coding>
      <code value="process"/>
    </coding>
  </type>
  <rationale value="Exclusive breast milk feeding for the first 6 months of neonatal life has long been the expressed goal of World Health Organization (WHO), Department of Health and Human Services (DHHS), American Academy of Pediatrics (AAP) and American College of Obstetricians and Gynecologists (ACOG). ACOG has recently reiterated its position (ACOG, 2007). A recent Cochrane review substantiates the benefits (Kramer et al., 2002). Much evidence has now focused on the prenatal and intrapartum period as critical for the success of exclusive (or any) BF (Centers for Disease Control and Prevention [CDC], 2007 Petrova et al., 2007 Shealy et al., 2005 Taveras et al., 2004). Exclusive breast milk feeding rate during birth hospital stay has been calculated by the California Department of Public Health for the last several years using newborn genetic disease testing data. Healthy People 2010 and the CDC have also been active in promoting this goal."/>
  <clinicalRecommendationStatement value="Exclusive breast milk feeding for the first 6 months of neonatal life can result in numerous long-term health benefits for both mother and newborn and is recommended by a number of national and international organizations. Evidence suggests that the prenatal and intrapartum period is critical for the success of exclusive (or any) breast feeding. Therefore, it is recommended that newborns are fed breast milk only from birth to discharge."/>
  <improvementNotation value="Improvement noted as an increase in the rate"/>
  <guidance value="A discharge to a designated cancer center or children's hospital should be captured as a discharge to an acute care facility. It is acceptable to calculate Gestational Age using the American College of Obstetricians and Gynecologists ReVITALize guidelines, which define Gestational Age as calculated using the best obstetrical Estimated Due Date (EDD) based on the formula: Gestational Age= (280-(EDD-Reference Date))/7 where Reference Date is the date on which you are trying to determine gestational age. For PC-05, Reference Date is the Birth Date. Note however that the calculation may yield a non-whole number and gestational age should be rounded off to the nearest completed week. For example, an infant born on the 5th day of the 36th week (35 weeks and 5/7 days) is at a gestational age of 35 weeks, not 36 weeks."/>
  <group>
    <identifier>
      <value value="Population Group 1"/>
    </identifier>
    <population>
      <identifier>
        <value value="initial-population-1-identifier"/>
      </identifier>
      <code>
        <coding>
          <code value="initial-population"/>
        </coding>
      </code>
      <criteria value="InitialPopulation1"/>
    </population>
    <population>
      <identifier>
        <value value="denominator-1-identifier"/>
      </identifier>
      <code>
        <coding>
          <code value="denominator"/>
        </coding>
      </code>
      <criteria value="Denominator1"/>
    </population>
    <population>
      <identifier>
        <value value="denominator-exclusions-1-identifier"/>
      </identifier>
      <code>
        <coding>
          <code value="denominator-exclusions"/>
        </coding>
      </code>
      <criteria value="DenominatorExclusions1"/>
    </population>
    <population>
      <identifier>
        <value value="numerator-1-identifier"/>
      </identifier>
      <code>
        <coding>
          <code value="numerator"/>
        </coding>
      </code>
      <criteria value="Numerator1"/>
    </population>
  </group>
  <group>
    <identifier>
      <value value="Population Group 2"/>
    </identifier>
    <population>
      <identifier>
        <value value="initial-population-2-identifier"/>
      </identifier>
      <code>
        <coding>
          <code value="initial-population"/>
        </coding>
      </code>
      <criteria value="InitialPopulation2"/>
    </population>
    <population>
      <identifier>
        <value value="denominator-2-identifier"/>
      </identifier>
      <code>
        <coding>
          <code value="denominator"/>
        </coding>
      </code>
      <criteria value="Denominator2"/>
    </population>
    <population>
      <identifier>
        <value value="denominator-exclusions-2-identifier"/>
      </identifier>
      <code>
        <coding>
          <code value="denominator-exclusion"/>
        </coding>
      </code>
      <criteria value="DenominatorExclusions2"/>
    </population>
    <population>
      <identifier>
        <value value="numerator-2-identifier"/>
      </identifier>
      <code>
        <coding>
          <code value="numerator"/>
        </coding>
      </code>
      <criteria value="Numerator2"/>
    </population>
  </group>
</Measure>

Measure "measure-exclusive-breastfeeding" Version "1"

Created by SYSTEM () at 11/28/2017 8:31:18 AM(UTC)

Tags: (no tags)  +

This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

Id:
Measure/measure-exclusive-breastfeeding

Identifier:
value: exclusive-breastfeeding-measure

Title:
Exclusive Breastfeeding Measure

Status:
active

Description:
Exclusive breastfeeding measure of outcomes for exclusive breastmilk feeding of newborns.

Purpose:
Exclusive breast milk feeding for the first 6 months of neonatal life can result in numerous long-term health benefits for both mother and newborn and is recommended by a number of national and international organizations. Evidence suggests that the prenatal and intrapartum period is critical for the success of exclusive (or any) breast feeding. Therefore, it is recommended that newborns are fed breast milk only from birth to discharge.

Topic:
text: Exclusive Breastfeeding

Library:
reference: Library/library-exclusive-breastfeeding-cqm-logic

Type:
outcome

Group:
Identifier:
value: Population Group 1
Population:

type:initial-population

Identifier:
value: initial-population-1-identifier

criteria: InitialPopulation1

Population:

type:denominator

Identifier:
value: denominator-1-identifier

criteria: Denominator1

Population:

type:denominator-exclusion

Identifier:
value: denominator-exclusions-1-identifier

criteria: DenominatorExclusions1

Population:

type:numerator

Identifier:
value: numerator-1-identifier

criteria: Numerator1

Group:
Identifier:
value: Population Group 2
Population:

type:initial-population

Identifier:
value: initial-population-2-identifier

criteria: InitialPopulation2

Population:

type:denominator

Identifier:
value: denominator-2-identifier

criteria: Denominator2

Population:

type:denominator-exclusion

Identifier:
value: denominator-exclusions-2-identifier

criteria: DenominatorExclusions2

Population:

type:numerator

Identifier:
value: numerator-2-identifier

criteria: Numerator2


<?xml version="1.0" encoding="UTF-8"?>
<Measure xmlns="http://hl7.org/fhir">
  <id value="measure-exclusive-breastfeeding"/>
  <meta>
    <versionId value="1"/>
    <lastUpdated value="2017-11-28T08:31:18Z"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
      <table class="grid dict">
        <tr>
          <td>
            <b>Id: </b>
          </td>
        </tr>
        <tr>
          <td style="padding-left: 25px padding-right: 25px">Measure/measure-exclusive-breastfeeding</td>
        </tr>
      </table>
      <p/>
      <table class="grid dict">
        <tr>
          <td>
            <b>Identifier: </b>
          </td>
        </tr>
        <tr>
          <td style="padding-left: 25px padding-right: 25px">
            <b>value: </b>
            <span>exclusive-breastfeeding-measure</span>
          </td>
        </tr>
      </table>
      <p/>
      <table class="grid dict">
        <tr>
          <td>
            <b>Title: </b>
          </td>
        </tr>
        <tr>
          <td style="padding-left: 25px padding-right: 25px">Exclusive Breastfeeding Measure</td>
        </tr>
      </table>
      <p/>
      <table class="grid dict">
        <tr>
          <td>
            <b>Status: </b>
          </td>
        </tr>
        <tr>
          <td style="padding-left: 25px padding-right: 25px">active</td>
        </tr>
      </table>
      <p/>
      <table class="grid dict">
        <tr>
          <td>
            <b>Description: </b>
          </td>
        </tr>
        <tr>
          <td style="padding-left: 25px padding-right: 25px">Exclusive breastfeeding measure of outcomes for exclusive breastmilk feeding of newborns.</td>
        </tr>
      </table>
      <p/>
      <table class="grid dict">
        <tr>
          <td>
            <b>Purpose: </b>
          </td>
        </tr>
        <tr>
          <td style="padding-left: 25px padding-right: 25px">Exclusive breast milk feeding for the first 6 months of neonatal life can result in numerous long-term health benefits for both mother and newborn and is recommended by a number of national and international organizations. Evidence suggests that the prenatal and intrapartum period is critical for the success of exclusive (or any) breast feeding. Therefore, it is recommended that newborns are fed breast milk only from birth to discharge.</td>
        </tr>
      </table>
      <p/>
      <table class="grid dict">
        <tr>
          <td>
            <b>Topic: </b>
          </td>
        </tr>
        <tr>
          <td style="padding-right: 25px">
            <span style="padding-left: 25px">
              <b>text: </b>
              <span>Exclusive Breastfeeding</span>
              <br/>
            </span>
          </td>
        </tr>
      </table>
      <p/>
      <table class="grid dict">
        <tr>
          <td>
            <b>Library: </b>
          </td>
        </tr>
        <tr>
          <td style="padding-left: 25px padding-right: 25px">
            <b>reference: </b>
            <span>Library/library-exclusive-breastfeeding-cqm-logic</span>
          </td>
        </tr>
      </table>
      <p/>
      <table class="grid dict">
        <tr>
          <td>
            <b>Type: </b>
          </td>
        </tr>
        <tr>
          <td style="padding-left: 25px padding-right: 25px">outcome</td>
        </tr>
      </table>
      <p/>
      <table class="grid dict">
        <tr>
          <td>
            <b>Group:</b>
          </td>
        </tr>
        <tr>
          <td style="padding-left: 25px padding-right: 25px">
            <b>Identifier:</b>
            <br/>
            <span style="padding-left: 25px">
              <b>value: </b>
              <span>Population Group 1</span>
              <br/>
            </span>
          </td>
        </tr>
        <tr>
          <td style="padding-left: 25px padding-right: 25px">
            <b>Population:</b>
            <br/>
            <p style="margin-bottom: 5px padding-left: 25px">
              <b>type:</b>
              <span>initial-population</span>
            </p>
            <p style="margin-bottom: 5px padding-left: 25px">
              <b>Identifier:</b>
              <br/>
              <span style="padding-left: 25px">
                <b>value: </b>
                <span>initial-population-1-identifier</span>
                <br/>
              </span>
            </p>
            <p style="margin-bottom: 5px padding-left: 25px">
              <b>criteria: </b>
              <span>InitialPopulation1</span>
            </p>
          </td>
        </tr>
        <tr>
          <td style="padding-left: 25px padding-right: 25px">
            <b>Population:</b>
            <br/>
            <p style="margin-bottom: 5px padding-left: 25px">
              <b>type:</b>
              <span>denominator</span>
            </p>
            <p style="margin-bottom: 5px padding-left: 25px">
              <b>Identifier:</b>
              <br/>
              <span style="padding-left: 25px">
                <b>value: </b>
                <span>denominator-1-identifier</span>
                <br/>
              </span>
            </p>
            <p style="margin-bottom: 5px padding-left: 25px">
              <b>criteria: </b>
              <span>Denominator1</span>
            </p>
          </td>
        </tr>
        <tr>
          <td style="padding-left: 25px padding-right: 25px">
            <b>Population:</b>
            <br/>
            <p style="margin-bottom: 5px padding-left: 25px">
              <b>type:</b>
              <span>denominator-exclusion</span>
            </p>
            <p style="margin-bottom: 5px padding-left: 25px">
              <b>Identifier:</b>
              <br/>
              <span style="padding-left: 25px">
                <b>value: </b>
                <span>denominator-exclusions-1-identifier</span>
                <br/>
              </span>
            </p>
            <p style="margin-bottom: 5px padding-left: 25px">
              <b>criteria: </b>
              <span>DenominatorExclusions1</span>
            </p>
          </td>
        </tr>
        <tr>
          <td style="padding-left: 25px padding-right: 25px">
            <b>Population:</b>
            <br/>
            <p style="margin-bottom: 5px padding-left: 25px">
              <b>type:</b>
              <span>numerator</span>
            </p>
            <p style="margin-bottom: 5px padding-left: 25px">
              <b>Identifier:</b>
              <br/>
              <span style="padding-left: 25px">
                <b>value: </b>
                <span>numerator-1-identifier</span>
                <br/>
              </span>
            </p>
            <p style="margin-bottom: 5px padding-left: 25px">
              <b>criteria: </b>
              <span>Numerator1</span>
            </p>
          </td>
        </tr>
      </table>
      <table class="grid dict">
        <tr>
          <td>
            <b>Group:</b>
          </td>
        </tr>
        <tr>
          <td style="padding-left: 25px padding-right: 25px">
            <b>Identifier:</b>
            <br/>
            <span style="padding-left: 25px">
              <b>value: </b>
              <span>Population Group 2</span>
              <br/>
            </span>
          </td>
        </tr>
        <tr>
          <td style="padding-left: 25px padding-right: 25px">
            <b>Population:</b>
            <br/>
            <p style="margin-bottom: 5px padding-left: 25px">
              <b>type:</b>
              <span>initial-population</span>
            </p>
            <p style="margin-bottom: 5px padding-left: 25px">
              <b>Identifier:</b>
              <br/>
              <span style="padding-left: 25px">
                <b>value: </b>
                <span>initial-population-2-identifier</span>
                <br/>
              </span>
            </p>
            <p style="margin-bottom: 5px padding-left: 25px">
              <b>criteria: </b>
              <span>InitialPopulation2</span>
            </p>
          </td>
        </tr>
        <tr>
          <td style="padding-left: 25px padding-right: 25px">
            <b>Population:</b>
            <br/>
            <p style="margin-bottom: 5px padding-left: 25px">
              <b>type:</b>
              <span>denominator</span>
            </p>
            <p style="margin-bottom: 5px padding-left: 25px">
              <b>Identifier:</b>
              <br/>
              <span style="padding-left: 25px">
                <b>value: </b>
                <span>denominator-2-identifier</span>
                <br/>
              </span>
            </p>
            <p style="margin-bottom: 5px padding-left: 25px">
              <b>criteria: </b>
              <span>Denominator2</span>
            </p>
          </td>
        </tr>
        <tr>
          <td style="padding-left: 25px padding-right: 25px">
            <b>Population:</b>
            <br/>
            <p style="margin-bottom: 5px padding-left: 25px">
              <b>type:</b>
              <span>denominator-exclusion</span>
            </p>
            <p style="margin-bottom: 5px padding-left: 25px">
              <b>Identifier:</b>
              <br/>
              <span style="padding-left: 25px">
                <b>value: </b>
                <span>denominator-exclusions-2-identifier</span>
                <br/>
              </span>
            </p>
            <p style="margin-bottom: 5px padding-left: 25px">
              <b>criteria: </b>
              <span>DenominatorExclusions2</span>
            </p>
          </td>
        </tr>
        <tr>
          <td style="padding-left: 25px padding-right: 25px">
            <b>Population:</b>
            <br/>
            <p style="margin-bottom: 5px padding-left: 25px">
              <b>type:</b>
              <span>numerator</span>
            </p>
            <p style="margin-bottom: 5px padding-left: 25px">
              <b>Identifier:</b>
              <br/>
              <span style="padding-left: 25px">
                <b>value: </b>
                <span>numerator-2-identifier</span>
                <br/>
              </span>
            </p>
            <p style="margin-bottom: 5px padding-left: 25px">
              <b>criteria: </b>
              <span>Numerator2</span>
            </p>
          </td>
        </tr>
      </table>
    </div>
  </text>
  <identifier>
    <use value="official"/>
    <value value="exclusive-breastfeeding-measure"/>
  </identifier>
  <version value="4.0.0"/>
  <title value="Exclusive Breastfeeding Measure"/>
  <status value="active"/>
  <date value="2015-03-08"/>
  <description value="Exclusive breastfeeding measure of outcomes for exclusive breastmilk feeding of newborns."/>
  <purpose value="Measure of newborns who were fed breast milk only since birth"/>
  <topic>
    <text value="Exclusive Breastfeeding"/>
  </topic>
  <relatedArtifact>
    <type value="documentation"/>
    <citation value="American Academy of Pediatrics. (2005). Section on Breastfeeding. Policy Statement:Breastfeeding and the Use of Human Milk. Pediatrics.115:496-506."/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="documentation"/>
    <citation value="American College of Obstetricians and Gynecologists. (Feb. 2007). Committee on Obstetric Practice and Committee on Health Care for Underserved Women. Breastfeeding: Maternal and Infant Aspects. ACOG Committee Opinion 361."/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="documentation"/>
    <citation value="California Department of Public Health. (2006). Genetic Disease Branch. California In-Hospital Breastfeeding as Indicated on the Newborn Screening Test Form, Statewide, County and Hospital of Occurrence: Available at: http://www.cdph.ca.gov/data/statistics/Pages/BreastfeedingStatistics.aspx."/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="documentation"/>
    <citation value="Centers for Disease Control and Prevention. (Aug 3, 2007). Breastfeeding trends and updated national health objectives for exclusive breastfeeding--United States birth years 2000-2004. MMWR - Morbidity &amp; Mortality Weekly Report. 56(30):760-3."/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="documentation"/>
    <citation value="Centers for Disease Control and Prevention. (2014). Division of Nutrition, Physical Activity and Obesity. Breastfeeding Report Card. Available at: http://www.cdc.gov/breastfeeding/pdf/2014breastfeedingreportcard.pdf"/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="documentation"/>
    <citation value="Ip, S., Chung, M., Raman, G., et al. (2007). Breastfeeding and maternal and infant health outcomes in developed countries. Rockville, MD: US Department of Health and Human Services. Available at: http://www.ahrq.gov/downloads/pub/evidence/pdf/brfout/brfout.pdf"/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="documentation"/>
    <citation value="Kramer, M.S. &amp; Kakuma, R. (2002).Optimal duration of exclusive breastfeeding. [107 refs] Cochrane Database of Systematic Reviews. (1):CD003517."/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="documentation"/>
    <citation value="Petrova, A., Hegyi, T., &amp; Mehta, R. (2007). Maternal race/ethnicity and one-month exclusive breastfeeding in association with the in-hospital feeding modality. Breastfeeding Medicine. 2(2):92-8."/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="documentation"/>
    <citation value="Shealy, K.R., Li, R., Benton-Davis, S., &amp; Grummer-Strawn, L.M. (2005).The CDC guide to breastfeeding interventions. Atlanta, GA: US Department of Health and Human Services, CDC. Available at: http://www.cdc.gov/breastfeeding/pdf/breastfeeding_interventions.pdf."/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="documentation"/>
    <citation value="Taveras, E.M., Li, R., Grummer-Strawn, L., Richardson, M., Marshall, R., Rego, V.H., Miroshnik, I., &amp; Lieu, T.A. (2004). Opinions and practices of clinicians associated with continuation of exclusive breastfeeding. Pediatrics. 113(4):e283-90."/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="documentation"/>
    <citation value="US Department of Health and Human Services. (2007). Healthy People 2010 Midcourse Review. Washington, DC: US Department of Health and Human Services. Available at: http://www.healthypeople.gov/2010/data/midcourse/?visit=1."/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="documentation"/>
    <citation value="World Health Organization. (1991). Indicators for assessing breastfeeding practices. Geneva, Switzerland: World Health Organization. Available at: http://whqlibdoc.who.int/hq/1991/WHO_CDD_SER_91.14.pdf?ua=1."/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="predecessor"/>
    <resource>
      <reference value="Measure/measure-predecessor-example"/>
    </resource>
  </relatedArtifact>
  <relatedArtifact>
    <type value="derived-from"/>
    <resource>
      <reference value="Measure/measure-predecessor-example"/>
    </resource>
  </relatedArtifact>
  <library>
    <reference value="Library/library-exclusive-breastfeeding-cqm-logic"/>
  </library>
  <disclaimer value="These performance measures are not clinical guidelines and do not establish a standard of medical care, and have not been tested for all potential applications. The measures and specifications are provided without warranty."/>
  <scoring>
    <coding>
      <code value="proportion"/>
    </coding>
  </scoring>
  <type>
    <coding>
      <code value="process"/>
    </coding>
  </type>
  <rationale value="Exclusive breast milk feeding for the first 6 months of neonatal life has long been the expressed goal of World Health Organization (WHO), Department of Health and Human Services (DHHS), American Academy of Pediatrics (AAP) and American College of Obstetricians and Gynecologists (ACOG). ACOG has recently reiterated its position (ACOG, 2007). A recent Cochrane review substantiates the benefits (Kramer et al., 2002). Much evidence has now focused on the prenatal and intrapartum period as critical for the success of exclusive (or any) BF (Centers for Disease Control and Prevention [CDC], 2007 Petrova et al., 2007 Shealy et al., 2005 Taveras et al., 2004). Exclusive breast milk feeding rate during birth hospital stay has been calculated by the California Department of Public Health for the last several years using newborn genetic disease testing data. Healthy People 2010 and the CDC have also been active in promoting this goal."/>
  <clinicalRecommendationStatement value="Exclusive breast milk feeding for the first 6 months of neonatal life can result in numerous long-term health benefits for both mother and newborn and is recommended by a number of national and international organizations. Evidence suggests that the prenatal and intrapartum period is critical for the success of exclusive (or any) breast feeding. Therefore, it is recommended that newborns are fed breast milk only from birth to discharge."/>
  <improvementNotation value="Improvement noted as an increase in the rate"/>
  <definition value="Gestational age is calculated using the ACOG ReVITALize guidelines with Estimated Due Date (EDD) http://www.acog.org/about_acog/acog_departments/patient_safety_and_quality_improvement/~/media/departments/patient%20safety%20and%20quality%20improvement/201213issuesandrationale-gestationalageterm.pdf. The exam used needs to be the most recent exam associated with this pregnancy"/>
  <guidance value="A discharge to a designated cancer center or children's hospital should be captured as a discharge to an acute care facility. It is acceptable to calculate Gestational Age using the American College of Obstetricians and Gynecologists ReVITALize guidelines, which define Gestational Age as calculated using the best obstetrical Estimated Due Date (EDD) based on the formula: Gestational Age= (280-(EDD-Reference Date))/7 where Reference Date is the date on which you are trying to determine gestational age. For PC-05, Reference Date is the Birth Date. Note however that the calculation may yield a non-whole number and gestational age should be rounded off to the nearest completed week. For example, an infant born on the 5th day of the 36th week (35 weeks and 5/7 days) is at a gestational age of 35 weeks, not 36 weeks."/>
  <group>
    <identifier>
      <value value="Population Group 1"/>
    </identifier>
    <population>
      <identifier>
        <value value="initial-population-1-identifier"/>
      </identifier>
      <code>
        <coding>
          <code value="initial-population"/>
        </coding>
      </code>
      <criteria value="InitialPopulation1"/>
    </population>
    <population>
      <identifier>
        <value value="denominator-1-identifier"/>
      </identifier>
      <code>
        <coding>
          <code value="denominator"/>
        </coding>
      </code>
      <criteria value="Denominator1"/>
    </population>
    <population>
      <identifier>
        <value value="denominator-exclusions-1-identifier"/>
      </identifier>
      <code>
        <coding>
          <code value="denominator-exclusions"/>
        </coding>
      </code>
      <criteria value="DenominatorExclusions1"/>
    </population>
    <population>
      <identifier>
        <value value="numerator-1-identifier"/>
      </identifier>
      <code>
        <coding>
          <code value="numerator"/>
        </coding>
      </code>
      <criteria value="Numerator1"/>
    </population>
  </group>
  <group>
    <identifier>
      <value value="Population Group 2"/>
    </identifier>
    <population>
      <identifier>
        <value value="initial-population-2-identifier"/>
      </identifier>
      <code>
        <coding>
          <code value="initial-population"/>
        </coding>
      </code>
      <criteria value="InitialPopulation2"/>
    </population>
    <population>
      <identifier>
        <value value="denominator-2-identifier"/>
      </identifier>
      <code>
        <coding>
          <code value="denominator"/>
        </coding>
      </code>
      <criteria value="Denominator2"/>
    </population>
    <population>
      <identifier>
        <value value="denominator-exclusions-2-identifier"/>
      </identifier>
      <code>
        <coding>
          <code value="denominator-exclusion"/>
        </coding>
      </code>
      <criteria value="DenominatorExclusions2"/>
    </population>
    <population>
      <identifier>
        <value value="numerator-2-identifier"/>
      </identifier>
      <code>
        <coding>
          <code value="numerator"/>
        </coding>
      </code>
      <criteria value="Numerator2"/>
    </population>
  </group>
</Measure>

Measure "composite-example" Version "1"

Created by SYSTEM () at 11/28/2017 8:31:18 AM(UTC)

Tags: (no tags)  +

This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

Behavioral Assessment Composite Measure

This measure example is used to illustrate how a composite measure can be constructured. This measure is a composite measure of the Screening for Alcohol Misuse and Screening for Depression measures.


<?xml version="1.0" encoding="UTF-8"?>
<Measure xmlns="http://hl7.org/fhir">
  <id value="composite-example"/>
  <meta>
    <versionId value="1"/>
    <lastUpdated value="2017-11-28T08:31:18Z"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">Behavioral Assessment Composite Measure
      <p>This measure example is used to illustrate how a composite measure can be constructured. This measure is a composite measure of the Screening for Alcohol Misuse and Screening for Depression measures.</p>
    </div>
  </text>
  <title value="Behavioral Assessment Composite Measure"/>
  <status value="draft"/>
  <relatedArtifact>
    <type value="composed-of"/>
    <resource>
      <reference value="Measure/component-a-example"/>
    </resource>
  </relatedArtifact>
  <relatedArtifact>
    <type value="composed-of"/>
    <resource>
      <reference value="Measure/component-b-example"/>
    </resource>
  </relatedArtifact>
  <scoring>
    <coding>
      <code value="proportion"/>
    </coding>
  </scoring>
  <compositeScoring>
    <coding>
      <code value="opportunity"/>
    </coding>
  </compositeScoring>
</Measure>

Measure "component-b-example" Version "1"

Created by SYSTEM () at 11/28/2017 8:31:18 AM(UTC)

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This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

Screening for Depression

This measure example is used to illustrate how a composite measure can be constructured. This measure is one component of the composite measure.


<?xml version="1.0" encoding="UTF-8"?>
<Measure xmlns="http://hl7.org/fhir">
  <id value="component-b-example"/>
  <meta>
    <versionId value="1"/>
    <lastUpdated value="2017-11-28T08:31:18Z"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">Screening for Depression
      <p>This measure example is used to illustrate how a composite measure can be constructured. This measure is one component of the composite measure.</p>
    </div>
  </text>
  <title value="Screening for Depression"/>
  <status value="draft"/>
  <scoring>
    <coding>
      <code value="proportion"/>
    </coding>
  </scoring>
  <group>
    <identifier>
      <value value="Main"/>
    </identifier>
    <population>
      <code>
        <coding>
          <code value="initial-population"/>
        </coding>
      </code>
      <criteria value="Initial Population"/>
    </population>
    <population>
      <code>
        <coding>
          <code value="denominator"/>
        </coding>
      </code>
      <criteria value="Denominator"/>
    </population>
    <population>
      <code>
        <coding>
          <code value="numerator"/>
        </coding>
      </code>
      <criteria value="Numerator"/>
    </population>
  </group>
</Measure>

Measure "component-a-example" Version "1"

Created by SYSTEM () at 11/28/2017 8:31:18 AM(UTC)

Tags: (no tags)  +

This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

Screening for Alcohol Misuse

This measure example is used to illustrate how a composite measure can be constructured. This measure is one component of the composite measure.


<?xml version="1.0" encoding="UTF-8"?>
<Measure xmlns="http://hl7.org/fhir">
  <id value="component-a-example"/>
  <meta>
    <versionId value="1"/>
    <lastUpdated value="2017-11-28T08:31:18Z"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">Screening for Alcohol Misuse
      <p>This measure example is used to illustrate how a composite measure can be constructured. This measure is one component of the composite measure.</p>
    </div>
  </text>
  <title value="Screening for Alcohol Misuse"/>
  <status value="draft"/>
  <scoring>
    <coding>
      <code value="proportion"/>
    </coding>
  </scoring>
  <group>
    <identifier>
      <value value="Main"/>
    </identifier>
    <population>
      <code>
        <coding>
          <code value="initial-population"/>
        </coding>
      </code>
      <criteria value="Initial Population"/>
    </population>
    <population>
      <code>
        <coding>
          <code value="denominator"/>
        </coding>
      </code>
      <criteria value="Denominator"/>
    </population>
    <population>
      <code>
        <coding>
          <code value="numerator"/>
        </coding>
      </code>
      <criteria value="Numerator"/>
    </population>
  </group>
</Measure>

Measure "measure-cms146-example" Version "1"

Created by SYSTEM () at 11/28/2017 8:31:18 AM(UTC)

Tags: (no tags)  +

This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

Id:
Measure/measure-cms146-example

Identifier:
system: http://hl7.org/fhir/cqi/ecqm/Measure/Identifier/cms
value: 146
Identifier:
system: http://hl7.org/fhir/cqi/ecqm/Measure/Identifier/nqf
value: 0002

Title:
Appropriate Testing for Children with Pharyngitis

Status:
active

Description:
Percentage of children 2-18 years of age who were diagnosed with pharyngitis, ordered an antibiotic and received a group A streptococcus (strep) test for the episode.

Purpose:
The Infectious Diseases Society of America (IDSA) "recommends swabbing the throat and testing for GAS pharyngitis by rapid antigen detection test (RADT) and/or culture because the clinical features alone do not reliably discriminate between GAS and viral pharyngitis except when overt viral features like rhinorrhea, cough, oral ulcers, and/or hoarseness are present"

Topic:
system: http://hl7.org/fhir/c80-doc-typecodes
code: 57024-2

Library:
reference: Library/library-cms146-example

Scoring:
proportion

Type:
process

Group:
Identifier:
value: CMS146-group-1
Population:

type:initial-population

Identifier:
value: initial-population-identifier

criteria: CMS146.InInitialPopulation

Population:

type:numerator

Identifier:
value: numerator-identifier

criteria: CMS146.InNumerator

Population:

type:denominator

Identifier:
value: denominator-identifier

criteria: CMS146.InDenominator

Population:

type:denominator-exclusion

Identifier:
value: denominator-exclusions-identifier

criteria: CMS146.InDenominatorExclusions

Stratifier:

Identifier:
value: stratifier-ages-up-to-9

criteria: CMS146.AgesUpToNine

Stratifier:

Identifier:
value: stratifier-ages-10-plus

criteria: CMS146.AgesTenPlus

Stratifier:

Identifier:
value: stratifier-ages-up-to-9

path: Patient.gender

Supplemental Data:

Identifier:
value: supplemental-data-gender

path: Patient.gender

Supplemental Data:

Identifier:
value: supplemental-data-deceased

path: deceasedBoolean


<?xml version="1.0" encoding="UTF-8"?>
<Measure xmlns="http://hl7.org/fhir">
  <id value="measure-cms146-example"/>
  <meta>
    <versionId value="1"/>
    <lastUpdated value="2017-11-28T08:31:18Z"/>
  </meta>
  <text>
    <status value="additional"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
      <table class="grid dict">
        <tr>
          <td>
            <b>Id: </b>
          </td>
        </tr>
        <tr>
          <td style="padding-left: 25px padding-right: 25px">Measure/measure-cms146-example</td>
        </tr>
      </table>
      <p/>
      <table class="grid dict">
        <tr>
          <td>
            <b>Identifier: </b>
          </td>
        </tr>
        <tr>
          <td style="padding-left: 25px padding-right: 25px">
            <b>system: </b>
            <span>http://hl7.org/fhir/cqi/ecqm/Measure/Identifier/cms</span>
          </td>
        </tr>
        <tr>
          <td style="padding-left: 25px padding-right: 25px">
            <b>value: </b>
            <span>146</span>
          </td>
        </tr>
      </table>
      <table class="grid dict">
        <tr>
          <td>
            <b>Identifier: </b>
          </td>
        </tr>
        <tr>
          <td style="padding-left: 25px padding-right: 25px">
            <b>system: </b>
            <span>http://hl7.org/fhir/cqi/ecqm/Measure/Identifier/nqf</span>
          </td>
        </tr>
        <tr>
          <td style="padding-left: 25px padding-right: 25px">
            <b>value: </b>
            <span>0002</span>
          </td>
        </tr>
      </table>
      <p/>
      <table class="grid dict">
        <tr>
          <td>
            <b>Title: </b>
          </td>
        </tr>
        <tr>
          <td style="padding-left: 25px padding-right: 25px">Appropriate Testing for Children with Pharyngitis</td>
        </tr>
      </table>
      <p/>
      <table class="grid dict">
        <tr>
          <td>
            <b>Status: </b>
          </td>
        </tr>
        <tr>
          <td style="padding-left: 25px padding-right: 25px">active</td>
        </tr>
      </table>
      <p/>
      <table class="grid dict">
        <tr>
          <td>
            <b>Description: </b>
          </td>
        </tr>
        <tr>
          <td style="padding-left: 25px padding-right: 25px">Percentage of children 2-18 years of age who were diagnosed with pharyngitis, ordered an antibiotic and received a group A streptococcus (strep) test for the episode.</td>
        </tr>
      </table>
      <p/>
      <table class="grid dict">
        <tr>
          <td>
            <b>Purpose: </b>
          </td>
        </tr>
        <tr>
          <td style="padding-left: 25px padding-right: 25px">The Infectious Diseases Society of America (IDSA) "recommends swabbing the throat and testing for GAS pharyngitis by rapid antigen detection test (RADT) and/or culture because the clinical features alone do not reliably discriminate between GAS and viral pharyngitis except when overt viral features like rhinorrhea, cough, oral ulcers, and/or hoarseness are present"</td>
        </tr>
      </table>
      <p/>
      <table class="grid dict">
        <tr>
          <td>
            <b>Topic: </b>
          </td>
        </tr>
        <tr>
          <td style="padding-right: 25px">
            <span>
              <span>
                <span style="padding-left: 25px">
                  <b>system: </b>
                  <span>http://hl7.org/fhir/c80-doc-typecodes</span>
                  <br/>
                </span>
                <span style="padding-left: 25px">
                  <b>code: </b>
                  <span>57024-2</span>
                  <br/>
                </span>
              </span>
            </span>
          </td>
        </tr>
      </table>
      <p/>
      <table class="grid dict">
        <tr>
          <td>
            <b>Library: </b>
          </td>
        </tr>
        <tr>
          <td style="padding-left: 25px padding-right: 25px">
            <b>reference: </b>
            <span>Library/library-cms146-example</span>
          </td>
        </tr>
      </table>
      <p/>
      <table class="grid dict">
        <tr>
          <td>
            <b>Scoring: </b>
          </td>
        </tr>
        <tr>
          <td style="padding-left: 25px padding-right: 25px">proportion</td>
        </tr>
      </table>
      <p/>
      <table class="grid dict">
        <tr>
          <td>
            <b>Type: </b>
          </td>
        </tr>
        <tr>
          <td style="padding-left: 25px padding-right: 25px">process</td>
        </tr>
      </table>
      <p/>
      <table class="grid dict">
        <tr>
          <td>
            <b>Group:</b>
          </td>
        </tr>
        <tr>
          <td style="padding-left: 25px padding-right: 25px">
            <b>Identifier:</b>
            <br/>
            <span style="padding-left: 25px">
              <b>value: </b>
              <span>CMS146-group-1</span>
              <br/>
            </span>
          </td>
        </tr>
        <tr>
          <td style="padding-left: 25px padding-right: 25px">
            <b>Population:</b>
            <br/>
            <p style="margin-bottom: 5px padding-left: 25px">
              <b>type:</b>
              <span>initial-population</span>
            </p>
            <p style="margin-bottom: 5px padding-left: 25px">
              <b>Identifier:</b>
              <br/>
              <span style="padding-left: 25px">
                <b>value: </b>
                <span>initial-population-identifier</span>
                <br/>
              </span>
            </p>
            <p style="margin-bottom: 5px padding-left: 25px">
              <b>criteria: </b>
              <span>CMS146.InInitialPopulation</span>
            </p>
          </td>
        </tr>
        <tr>
          <td style="padding-left: 25px padding-right: 25px">
            <b>Population:</b>
            <br/>
            <p style="margin-bottom: 5px padding-left: 25px">
              <b>type:</b>
              <span>numerator</span>
            </p>
            <p style="margin-bottom: 5px padding-left: 25px">
              <b>Identifier:</b>
              <br/>
              <span style="padding-left: 25px">
                <b>value: </b>
                <span>numerator-identifier</span>
                <br/>
              </span>
            </p>
            <p style="margin-bottom: 5px padding-left: 25px">
              <b>criteria: </b>
              <span>CMS146.InNumerator</span>
            </p>
          </td>
        </tr>
        <tr>
          <td style="padding-left: 25px padding-right: 25px">
            <b>Population:</b>
            <br/>
            <p style="margin-bottom: 5px padding-left: 25px">
              <b>type:</b>
              <span>denominator</span>
            </p>
            <p style="margin-bottom: 5px padding-left: 25px">
              <b>Identifier:</b>
              <br/>
              <span style="padding-left: 25px">
                <b>value: </b>
                <span>denominator-identifier</span>
                <br/>
              </span>
            </p>
            <p style="margin-bottom: 5px padding-left: 25px">
              <b>criteria: </b>
              <span>CMS146.InDenominator</span>
            </p>
          </td>
        </tr>
        <tr>
          <td style="padding-left: 25px padding-right: 25px">
            <b>Population:</b>
            <br/>
            <p style="margin-bottom: 5px padding-left: 25px">
              <b>type:</b>
              <span>denominator-exclusion</span>
            </p>
            <p style="margin-bottom: 5px padding-left: 25px">
              <b>Identifier:</b>
              <br/>
              <span style="padding-left: 25px">
                <b>value: </b>
                <span>denominator-exclusions-identifier</span>
                <br/>
              </span>
            </p>
            <p style="margin-bottom: 5px padding-left: 25px">
              <b>criteria: </b>
              <span>CMS146.InDenominatorExclusions</span>
            </p>
          </td>
        </tr>
        <tr>
          <td style="padding-left: 25px padding-right: 25px">
            <b>Stratifier:</b>
            <br/>
            <p style="padding-left: 25px margin-bottom: 5px">
              <b>Identifier:</b>
              <br/>
              <span style="padding-left: 25px">
                <b>value: </b>
                <span>stratifier-ages-up-to-9</span>
                <br/>
              </span>
            </p>
            <p style="margin-bottom: 5px padding-left: 25px">
              <b>criteria: </b>
              <span>CMS146.AgesUpToNine</span>
            </p>
          </td>
        </tr>
        <tr>
          <td style="padding-left: 25px padding-right: 25px">
            <b>Stratifier:</b>
            <br/>
            <p style="padding-left: 25px margin-bottom: 5px">
              <b>Identifier:</b>
              <br/>
              <span style="padding-left: 25px">
                <b>value: </b>
                <span>stratifier-ages-10-plus</span>
                <br/>
              </span>
            </p>
            <p style="margin-bottom: 5px padding-left: 25px">
              <b>criteria: </b>
              <span>CMS146.AgesTenPlus</span>
            </p>
          </td>
        </tr>
        <tr>
          <td style="padding-left: 25px padding-right: 25px">
            <b>Stratifier:</b>
            <br/>
            <p style="padding-left: 25px margin-bottom: 5px">
              <b>Identifier:</b>
              <br/>
              <span style="padding-left: 25px">
                <b>value: </b>
                <span>stratifier-ages-up-to-9</span>
                <br/>
              </span>
            </p>
            <p style="margin-bottom: 5px padding-left: 25px">
              <b>path: </b>
              <span>Patient.gender</span>
            </p>
          </td>
        </tr>
      </table>
      <p/>
      <table class="grid dict">
        <tr>
          <td>
            <b>Supplemental Data:</b>
          </td>
        </tr>
        <tr>
          <td style="padding-left: 25px padding-right: 25px">
            <p style="margin-bottom: 5px">
              <b>Identifier:</b>
              <br/>
              <span style="padding-left: 25px">
                <b>value: </b>
                <span>supplemental-data-gender</span>
                <br/>
              </span>
            </p>
            <p style="margin-bottom: 5px">
              <b>path: </b>
              <span>Patient.gender</span>
            </p>
          </td>
        </tr>
      </table>
      <table class="grid dict">
        <tr>
          <td>
            <b>Supplemental Data:</b>
          </td>
        </tr>
        <tr>
          <td style="padding-left: 25px padding-right: 25px">
            <p style="margin-bottom: 5px">
              <b>Identifier:</b>
              <br/>
              <span style="padding-left: 25px">
                <b>value: </b>
                <span>supplemental-data-deceased</span>
                <br/>
              </span>
            </p>
            <p style="margin-bottom: 5px">
              <b>path: </b>
              <span>deceasedBoolean</span>
            </p>
          </td>
        </tr>
      </table>
    </div>
  </text>
  <url value="http://hl7.org/fhir/Measure/measure-cms146-example"/>
  <identifier>
    <use value="official"/>
    <system value="http://hl7.org/fhir/cqi/ecqm/Measure/Identifier/cms"/>
    <value value="146"/>
  </identifier>
  <identifier>
    <use value="official"/>
    <system value="http://hl7.org/fhir/cqi/ecqm/Measure/Identifier/nqf"/>
    <value value="0002"/>
  </identifier>
  <version value="1.0.0"/>
  <name value="CMS146"/>
  <title value="Appropriate Testing for Children with Pharyngitis"/>
  <status value="active"/>
  <experimental value="true"/>
  <date value="2017-03-10"/>
  <publisher value="National Committee for Quality Assurance"/>
  <description value="Percentage of children 3-18 years of age who were diagnosed with pharyngitis, ordered an antibiotic and received a group A streptococcus (strep) test for the episode."/>
  <purpose value="Measure of children with a group A streptococcus test in the 7-day period from 3 days prior through 3 days after the diagnosis of pharyngitis"/>
  <approvalDate value="2016-01-01"/>
  <lastReviewDate value="2016-09-01"/>
  <effectivePeriod>
    <start value="2017-01-01"/>
    <end value="2017-12-31"/>
  </effectivePeriod>
  <useContext>
    <code>
      <code value="program"/>
    </code>
    <valueCodeableConcept>
      <text value="eligibile-provider"/>
    </valueCodeableConcept>
  </useContext>
  <jurisdiction>
    <coding>
      <system value="urn:iso:std:iso:3166"/>
      <code value="US"/>
    </coding>
  </jurisdiction>
  <topic>
    <coding>
      <system value="http://hl7.org/fhir/c80-doc-typecodes"/>
      <code value="57024-2"/>
    </coding>
  </topic>
  <contributor>
    <type value="author"/>
    <name value="National Committee for Quality Assurance"/>
  </contributor>
  <contact>
    <telecom>
      <system value="url"/>
      <value value="http://www.ncqa.org/"/>
    </telecom>
  </contact>
  <copyright value="Physician Performance Measure (Measures) and related data specifications were developed by the National Committee for Quality Assurance (NCQA). The Measures are copyrighted but can be reproduced and distributed, without modification, for noncommercial purposes (eg, use by healthcare providers in connection with their practices). Commercial use is defined as the sale, licensing, or distribution of the Measures for commercial gain, or incorporation of the Measures into a product or service that is sold, licensed or distributed for commercial gain. Commercial use of the Measures requires a license agreement between the user and NCQA. NCQA is not responsible for any use of the Measures. (c) 2008-2016 National Committee for Quality Assurance. All Rights Reserved. Limited proprietary coding is contained in the Measure specifications for user convenience. Users of proprietary code sets should obtain all necessary licenses from the owners of the code sets. NCQA disclaims all liability for use or accuracy of any CPT or other codes contained in the specifications. CPT(R) contained in the Measure specifications is copyright 2004-2015 American Medical Association. LOINC(R) copyright 2004-2015 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2015 International Health Terminology Standards Development Organisation. ICD-10 copyright 2015 World Health Organization. All Rights Reserved."/>
  <relatedArtifact>
    <type value="documentation"/>
    <citation value="Linder, J.A., D.W. Bates, G.M. Lee, J.A. Finkelstein. 2005. &quot;Antibiotic treatment of children with sore throat.&quot; JAMA 294(18):2315-2322. "/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="documentation"/>
    <citation value="Infectious Diseases Society of America. 2012. &quot;Clinical Practice Guideline for the Diagnosis and Management of Group A Streptococcal Pharyngitis: 2012 Update.&quot; "/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="documentation"/>
    <citation value="Roberts, R.R., B. Hota, I. Ahmad, et al. &quot;Hospital and Societal Costs of Antimicrobial-Resistant Infections in a Chicago Teaching Hospital: Implications for Antibiotic Stewardship.&quot; Clin Infect Dis. Oct 2009 49(8):1175-84."/>
  </relatedArtifact>
  <library>
    <reference value="Library/library-cms146-example"/>
  </library>
  <disclaimer value="These performance Measures are not clinical guidelines and do not establish a standard of medical care, and have not been tested for all potential applications. THE MEASURES AND SPECIFICATIONS ARE PROVIDED &quot;AS IS&quot; WITHOUT WARRANTY OF ANY KIND. Due to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM]."/>
  <scoring>
    <coding>
      <code value="proportion"/>
    </coding>
  </scoring>
  <type>
    <coding>
      <code value="process"/>
    </coding>
  </type>
  <rationale value="Group A streptococcal bacterial infections and other infections that cause pharyngitis (which are most often viral) often produce the same signs and symptoms (IDSA 2002). The American Academy of Pediatrics, the Centers for Disease Control and Prevention, and the Infectious Diseases Society of America all recommend a diagnostic test for Strep A to improve diagnostic accuracy and avoid unnecessary antibiotic treatment (Linder et al. 2005). Estimated economic costs of pediatric streptococcal pharyngitis in the United States range from $224 million to $539 million per year, including indirect costs related to parental work losses. At a higher level, the economic cost of antibiotic resistance vary but have extended as high as $20 billion in excess direct healthcare costs, with additional costs to society for lost productivity as high as $35 billion a year (2008 dollars) (Roberts et al. 2009)."/>
  <clinicalRecommendationStatement value="The Infectious Diseases Society of America (IDSA) &quot;recommends swabbing the throat and testing for GAS pharyngitis by rapid antigen detection test (RADT) and/or culture because the clinical features alone do not reliably discriminate between GAS and viral pharyngitis except when overt viral features like rhinorrhea, cough, oral ulcers, and/or hoarseness are present&quot;"/>
  <improvementNotation value="Higher score indicates better quality"/>
  <guidance value="This is an episode of care measure that examines all eligible episodes for the patient during the measurement period. If the patient has more than one episode, include all episodes in the measure"/>
  <group>
    <identifier>
      <value value="CMS146-group-1"/>
    </identifier>
    <population>
      <identifier>
        <value value="initial-population-identifier"/>
      </identifier>
      <code>
        <coding>
          <code value="initial-population"/>
        </coding>
      </code>
      <criteria value="CMS146.InInitialPopulation"/>
    </population>
    <population>
      <identifier>
        <value value="numerator-identifier"/>
      </identifier>
      <code>
        <coding>
          <code value="numerator"/>
        </coding>
      </code>
      <criteria value="CMS146.InNumerator"/>
    </population>
    <population>
      <identifier>
        <value value="denominator-identifier"/>
      </identifier>
      <code>
        <coding>
          <code value="denominator"/>
        </coding>
      </code>
      <criteria value="CMS146.InDenominator"/>
    </population>
    <population>
      <identifier>
        <value value="denominator-exclusions-identifier"/>
      </identifier>
      <code>
        <coding>
          <code value="denominator-exclusion"/>
        </coding>
      </code>
      <criteria value="CMS146.InDenominatorExclusions"/>
    </population>
    <stratifier>
      <identifier>
        <value value="stratifier-ages-up-to-9"/>
      </identifier>
      <criteria value="CMS146.AgesUpToNine"/>
    </stratifier>
    <stratifier>
      <identifier>
        <value value="stratifier-ages-10-plus"/>
      </identifier>
      <criteria value="CMS146.AgesTenPlus"/>
    </stratifier>
    <stratifier>
      <identifier>
        <value value="stratifier-ages-up-to-9"/>
      </identifier>
      <path value="Patient.gender"/>
    </stratifier>
  </group>
  <supplementalData>
    <identifier>
      <value value="supplemental-data-gender"/>
    </identifier>
    <path value="Patient.gender"/>
  </supplementalData>
  <supplementalData>
    <identifier>
      <value value="supplemental-data-deceased"/>
    </identifier>
    <path value="deceasedBoolean"/>
  </supplementalData>
</Measure>