Cooking with CQL Q&A Index Value Sets and CQL Category

Each Q&A has the Cooking with CQL session number and date. For the most current and accurate information, please check the CQL Qs&As for a more recent answer to your question.

ImmunizationNotDoneExample - define “Influenza Vaccine Not Administered”: In the library ImmunizationNotDoneExample, using Fast Healthcare Interoperability Resources® (FHIR®) version 4.0.1, does the measure developer need to specify the define “Influenza Vaccine Not Administered” in the measure since the code is happening in the background?

Following the negation rationale pattern

define "Medical Patient or System Reason for Not Administering Influenza Vaccine":
	  [Immunization: "Influenza Vaccine"] FluVaccine
	    where FluVaccine.recorded during "Influenza Season Including August and September of the Prior Year"
	      and FluVaccine.status = 'not-done'
	      and (
	        FluVaccine.statusReason in "Medical Reason"
	          or FluVaccine.statusReason in "Patient Reason"
	          or FluVaccine.statusReason in "System Reason"
	          or FluVaccine.statusReason in "Influenza Vaccination Declined"
	      )

Logic happening underneath within the Expression Logical Model (ELM)

define "Influenza Vaccine Not Administered":
	  [Immunization] I
	    where I.vaccineCode in "Influenza Vaccine"
	      or ToValueSet(Global.GetBaseExtension(I.vaccineCode, 'valueset-reference').value as FHIR.uri) = "Influenza Vaccine"

define function ToValueSet(uri FHIR.uri):
	  System.ValueSet { id: uri.value }

(Session 55 - 6/24/21)

• Correct, the define "Influenza Vaccine Not Administered" and define function ToValueSet(uri FHIR.uri) illustrate what is happening in the ELM and do not need to be written into the logic expression. Measure developers should always utilize the negation rationale pattern and the logic expressions to derive the appropriate values.

Negation Rationale Pattern:

define "Medical Patient or System Reason for Not Administering Influenza Vaccine":
	  [Immunization: "Influenza Vaccine"] FluVaccine
	    where FluVaccine.recorded during "Influenza Season Including August and September of the Prior Year"
	      and FluVaccine.status = 'not-done'
	      and (
	        FluVaccine.statusReason in "Medical Reason"
	          or FluVaccine.statusReason in "Patient Reason"
	          or FluVaccine.statusReason in "System Reason"
	          or FluVaccine.statusReason in "Influenza Vaccination Declined"
	      )

Importance of being able to query using QI-Core: What is the importance of being able to query for a negation when using Quality Improvement-Core? (Session 67 - 9/29/22)

• There is importance in understanding what was not done among a value set. Instead of searching for all the codes individually in a value set, this process allows a search indicating none of the items in a value set were performed. For example, if there are 10 members in a value set, there is less clinical burden to state none of the 10 were performed rather than having to do so 10 times, once for each member.

Mother Relationship Value Set: What is the definition of "mother"? Is this a new value set to represent the mother relationship? I expect the new value set to represent the mother relationship (Session 33 - 3/28/19)

• The concept “mother” is managed by the relationship attribute of Related Person and could be represented as a value set. If appropriate, it could also be a direct reference code. Consistency in defining relationships across all eCQMs is ideal.