{
  "resourceType": "Measure",
  "id": "measure-EXM104-FHIR3-8.1.000",
  "meta": {
    "versionId": "4",
    "lastUpdated": "2019-09-13T20:33:19.546+00:00",
    "profile": [
      "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/proportion-measure-cqfm"
    ]
  },
  "text": {
    "status": "generated",
    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table style=\"width: 60%; border-bottom: none;\" class=\"header_table\">    <!-- <tr th:if=\"${resource.hasId()}\" style=\"vertical-align: top;\"><th style=\"background-color:#656565; width:20%\" scope=\"row\"><span class=\"td_label\">Id: </span></th><td style=\"width:80%\" colspan=\"3\"  th:narrative=\"${resource.id}\"></td></tr> --><tr style=\"vertical-align: top;\"><td scope=\"row\" style=\"background-color:#656565; width:20%\"><span class=\"td_label\">Measure Title</span></td><td colspan=\"1\" style=\"width:60%\"><h1 style=\"font-size:10px\">Discharged on Antithrombotic Therapy</h1></td><td scope=\"row\" style=\"background-color:#656565; width:10%\"><span class=\"td_label\">Measure ID</span></td><td colspan=\"1\" style=\"width:10%\"><h1 style=\"font-size:10px\">EXM104</h1></td></tr>    <!-- <th:block th:each=\"ident, iter : ${resource.identifier}\"><tr th:if=\"${ident.type.coding[0].code == 'CMS'}\" style=\"vertical-align: top;\"><td style=\"background-color:#656565; width:20%\" scope=\"row\"><span class=\"td_label\">eCQM Identifier (Measure Authoring Tool)</span></td><td style=\"width:30%\" th:narrative=\"${ident.value}\"></td><td style=\"background-color:#656565; width:20%\" scope=\"row\"><span class=\"td_label\">eCQM Version number</span></td><td style=\"width:30%\" th:narrative=\"${resource.version}\"></td></tr></th:block><th:block th:each=\"ident, iter : ${resource.identifier}\"><tr th:if=\"${ident.type.coding[0].code == 'NQF'}\" style=\"vertical-align: top;\"><td style=\"background-color:#656565; width:20%\" scope=\"row\"><span class=\"td_label\">NQF Number</span></td><td style=\"width:30%\" th:narrative=\"${ident.value}\"></td><td style=\"background-color:#656565; width:20%\" scope=\"row\"><span class=\"td_label\">GUID</span></td><td style=\"width:30%\" th:narrative=\"${resource.url}\"></td></tr></th:block> --><tr style=\"vertical-align: top;\"><td scope=\"row\" style=\"background-color:#656565; width:20%\"><span class=\"td_label\">Description</span></td><td colspan=\"3\" style=\"width:80%\"><div style=\"width:660px;overflow-x:hidden;overflow-y:auto\"><pre><p>Ischemic stroke patients prescribed or continuing to take antithrombotic therapy at hospital discharge</p>\n</pre>\n                </div>\n            </td>\n        </tr>\n        <tr>\n            <td scope=\"row\" style=\"background-color:#656565; width:20%\"><span class=\"td_label\">Measurement Period</span></td>\n            <td colspan=\"3\" style=\"width:80%\">January 1 - December 31</td>\n        </tr>\n            <!-- <tr>\n            <td style=\"background-color:#656565; width:20%\" scope=\"row\"><span class=\"td_label\">Measure Steward</span></td>\n            <td style=\"width:80%\" colspan=\"3\" th:narrative=\"${resource.publisher}\"></td>\n        </tr>\n        <tr>\n            <td style=\"background-color:#656565; width:20%\" scope=\"row\"><span class=\"td_label\">Measure Developer</span></td>\n            <td style=\"width:80%\" colspan=\"3\" th:narrative=\"${resource.publisher}\"></td>\n        </tr> -->\n            <!-- <tr th:if=\"${resource.hasDisclaimer()}\">\n            <td style=\"background-color:#656565; width:20%\" scope=\"row\"><span class=\"td_label\">Disclaimer</span></td>\n            <td style=\"width:80%\" colspan=\"3\">\n                <div style=\"width:660px;overflow-x:hidden;overflow-y:auto\">\n                    <pre th:text=\"${resource.disclaimer}\"></pre>\n                </div>\n            </td>\n        </tr> -->\n        <tr>\n            <td scope=\"row\" style=\"background-color:#656565; width:20%\"><span class=\"td_label\">Copyright and Disclaimer Notice</span></td>\n            <td colspan=\"3\" style=\"width:80%\">\n                <div style=\"width:660px;overflow-x:hidden;overflow-y:auto\">\n                    <pre>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.</pre>\n                    <br/>\n                    <pre>HEDIS%26reg; is a registered trademark of the National Committee for Quality Assurance (NCQA). The HEDIS measures and specifications are owned by NCQA. NCQA holds a copyright in the HEDIS measures and specifications and may rescind or alter these measures and specifications at any time. Users of the HEDIS measures and specifications shall not have the right to alter, enhance or otherwise modify the HEDIS measures and specifications, and shall not disassemble, recompile or reverse engineer the HEDIS measures and specifications. Anyone desiring to use or reproduce the materials, subject to licensed user restrictions, without modification for an internal, non-commercial purpose may do so without obtaining any approval from NCQA. Use of the Rules for Allowable Adjustments of HEDIS to make permitted adjustments of the materials does not constitute a modification. All other uses, including a commercial use, or any external reproduction, distribution and publication must be approved by NCQA and are subject to a license at the discretion of NCQA.\n\nHEDIS measures and specifications are not clinical guidelines, do not establish a standard of medical care and have not been tested for all potential applications. The measures and specifications are provided “as is” without warranty of any kind. NCQA makes no representations, warranties or endorsements about the quality of any product, test or protocol identified as numerator compliant or otherwise identified as meeting the requirements of a HEDIS measure or specification. NCQA also makes no representations, warranties or endorsements about the quality of any organization or clinician who uses or reports performance measures. NCQA has no liability to anyone who relies on HEDIS measures and specifications or data reflective of performance under such measures and specifications.\n\nCalculated measure results, based on unadjusted HEDIS specifications, may not be termed “Health Plan HEDIS rates” until the logic used to produce the measure results has been certified by NCQA and has been audited and designated reportable by an NCQA-Certified Auditor. Such results should be referred to as “Uncertified, Unaudited Health Plan HEDIS Rates.”\n\nCalculated measure results, based on adjusted HEDIS specifications, may not be termed “Adjusted HEDIS rates” until the logic used to produce the measure results has been certified by NCQA and has been audited and designated reportable by an NCQA-Certified Auditor. Such results should be referred to as “Adjusted, Uncertified, Unaudited HEDIS Rates.”\n\nLimited proprietary coding is contained in the measure specifications for convenience. Users of the proprietary code sets should obtain all necessary licenses from the owners of these code sets. NCQA disclaims all liability for use or accuracy of any coding contained in the specifications.\n\nThe American Medical Association holds a copyright to the CPT%26reg; codes contained in the measures specifications.\n\nThe American Hospital Association holds a copyright to the Uniform Bill Codes (UB) contained in the measure specifications. The UB Codes in the HEDIS specifications are included with the permission of the AHA. The UB Codes contained in the HEDIS specifications may be used by health plans and other health care delivery organizations for the purpose of calculating and reporting HEDIS measure results or using HEDIS measure results for their internal quality improvement purposes. All other uses of the UB Codes require a license from the AHA. Anyone desiring to use the UB Codes in a commercial Product(s) to generate HEDIS results, or for any other commercial use, must obtain a commercial use license directly from the AHA. To inquire about licensing, contact ub04@healthforum.com.\n\nSome measure specifications contain coding from LOINC%26reg; (http://loinc.org). The LOINC table, LOINC codes, LOINC panels and form file, LOINC linguistic variants file, LOINC/RSNA Radiology Playbook, and LOINC/IEEE Medical Device Code Mapping Table are copyright %26copy; 1995-2019, Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee and is available at no cost under the license at http://loinc.org/terms-of-use.\n\n\"SNOMED” and “SNOMED CT” are registered trademarks of the International Health Terminology Standards Development Organization (IHTSDO).\n\n“HL7” is the registered trademark of Health Level Seven International.\n\n%26copy; 2019 by the National Committee for Quality Assurance, all rights reserved.</pre>\n                </div>\n            </td>\n        </tr>\n        <tr>\n            <td scope=\"row\" style=\"background-color:#656565; width:20%\"><span class=\"td_label\">Clinical Recommendation Statement</span></td>\n            <td colspan=\"3\" style=\"width:80%\">\n                <div style=\"width:660px;overflow-x:hidden;overflow-y:auto\"><p>Clinical trial results suggest that antithrombotic therapy should be prescribed at discharge following acute ischemic stroke to reduce stroke mortality and morbidity as long as no contraindications exist</p>\n</div>\n            </td>\n        </tr>\n        \n            <tr style=\"vertical-align: top;\">\n                <td rowspan=\"8\" scope=\"row\" style=\"background-color:#656565; width:20%\"><span class=\"td_label\">References</span></td>\n                <td colspan=\"3\" style=\"width:80%\">\n                    <div style=\"width:660px;overflow-x:hidden;overflow-y:auto\">\n                        <pre>Adams HP, del Zoppo G, Alberts MJ, Bhatt DL, Brass L, Furlan A, Grubb RL, Higashida RT, Jauch EC, Kidwell C, Lyden PD, Morgenstern LB, Qureshi AI, Rosenwasser RH, Scott PA, Wijdicks E. Guidelines for the Early Management of Adults with Ischemic Stroke: A Guideline From the American Heart Association/American Stroke Association Stroke Council, Clinical CardiologyCouncil, Cardiovascular Radiology and Intervention Council, and the Atherosclerotic Peripheral Vascular Disease and Quality of Care Outcomes in Research Interdisciplinary Working Groups. Stroke. 2007;38:1655-1711.</pre>\n                    </div>\n                </td>\n            </tr>\n        \n        \n            <tr style=\"vertical-align: top;\">\n                \n                <td colspan=\"3\" style=\"width:80%\">\n                    <div style=\"width:660px;overflow-x:hidden;overflow-y:auto\">\n                        <pre>Adams H, Adams R, Del Zoppo G, Goldstein LB. Guidelines for the Early Management of Patients With Ischemic Stroke: Guidelines Update A Scientific Statement From the Stroke Council of the American Heart Association/American Stroke Association. Stroke Vol. 36, 2005: 916:923.</pre>\n                    </div>\n                </td>\n            </tr>\n        \n        \n            <tr style=\"vertical-align: top;\">\n                \n                <td colspan=\"3\" style=\"width:80%\">\n                    <div style=\"width:660px;overflow-x:hidden;overflow-y:auto\">\n                        <pre>Albers GW, Amarenco P, Easton JD, Sacco RL, Teal P. Antithrombotic and Thrombolytic Therapy for Ischemic Stroke. Chest Vol. 119, 2001: 300-320.</pre>\n                    </div>\n                </td>\n            </tr>\n        \n        \n            <tr style=\"vertical-align: top;\">\n                \n                <td colspan=\"3\" style=\"width:80%\">\n                    <div style=\"width:660px;overflow-x:hidden;overflow-y:auto\">\n                        <pre>Brott TG, Clark WM, Grotta JC, et al. Stroke the first hours. Guidelines for acute treatment. Consensus Statement. National Stroke Association. 2000.</pre>\n                    </div>\n                </td>\n            </tr>\n        \n        \n            <tr style=\"vertical-align: top;\">\n                \n                <td colspan=\"3\" style=\"width:80%\">\n                    <div style=\"width:660px;overflow-x:hidden;overflow-y:auto\">\n                        <pre>Chen ZM, Sandercock P, Pan HC, et al. Indications for early aspirin use in acute ischemic stroke: a combined analysis of 40,000 randomized patients from the Chinese acute stroke trial and the international stroke trial. On behalf of the CAST and IST collaborative groups, Stroke 2000;31:1240-1249.</pre>\n                    </div>\n                </td>\n            </tr>\n        \n        \n            <tr style=\"vertical-align: top;\">\n                \n                <td colspan=\"3\" style=\"width:80%\">\n                    <div style=\"width:660px;overflow-x:hidden;overflow-y:auto\">\n                        <pre>Coull BM, Williams LS, Goldstein LB, et al. Anticoagulants and Antiplatelet Agents in Acute Ischemic Stroke. Report of the Joint Stroke Guideline Development Committee of the American Academy of Neurology and the American Stroke Association (a Division of the American Heart Association) Stroke. 2002;33:1934 - 1942.</pre>\n                    </div>\n                </td>\n            </tr>\n        \n        \n            <tr style=\"vertical-align: top;\">\n                \n                <td colspan=\"3\" style=\"width:80%\">\n                    <div style=\"width:660px;overflow-x:hidden;overflow-y:auto\">\n                        <pre>Guideline on the Use of Aspirin as Secondary Prophylaxis for Vascular Disease in Primary Care, Centre for Health Services Research University of Newcastle upon Tyne, %26amp; Centre for Health Economics of York, 1998.</pre>\n                    </div>\n                </td>\n            </tr>\n        \n        \n            <tr style=\"vertical-align: top;\">\n                \n                <td colspan=\"3\" style=\"width:80%\">\n                    <div style=\"width:660px;overflow-x:hidden;overflow-y:auto\">\n                        <pre>Kernan, W.N., B. Ovbiagele, H. R. Black, D. M. Bravata, M. I. Chimowitz, M. D. Ezekowitz, M. C. Fang, M. Fisher, K. L. Furie, D. V. Heck, S. C. Johnston, S. E. Kasner, S. J. Kittner, P. H. Mitchell, M. W. Rich, D. Richardson, L. H. Schwamm, J. A. Wilson. \"Guidelines for the Prevention of Stroke in Patients with Stroke and Transient Ischemic Attack: A Guideline for Healthcare Professionals from the American Heart Association/American Stroke Association.\" [in eng.]  Stroke 45, no. 7 (May 2014): 2160-223. </pre>\n                    </div>\n                </td>\n            </tr>\n        \n        <tr>\n            <td colspan=\"4\" scope=\"row\" style=\"background-color:#656565; width:100%\"><span class=\"td_label\">Characteristics</span></td>\n        </tr>\n        <tr>\n            <td scope=\"row\" style=\"width:20%\"><span>Scoring</span></td>\n            <td colspan=\"3\" style=\"width:80%\">Proportion</td>\n        </tr>\n            <!-- <tr th:if=\"${resource.hasCompositeScoring()}\">\n            <td style=\"width:20%\" scope=\"row\"><span class=\"td_label\">Composite Scoring</span></td>\n            <td style=\"width:80%\" colspan=\"3\" th:narrative=\"${resource.compositeScoring.getText().substring(0, 1).toUpperCase() + resource.compositeScoring.getText().substring(1)}\"></td>\n        </tr> -->\n        \n            <tr style=\"vertical-align: top;\">\n                <td rowspan=\"1\" scope=\"row\" style=\"width:20%\"><span>Type</span></td>\n                <td colspan=\"3\" style=\"width:80%\">Process</td>\n            </tr>\n        \n            <!-- <tr th:if=\"${resource.hasStatus()}\" style=\"vertical-align: top;\">\n            <td style=\"background-color:#656565; width:20%\" scope=\"row\"><span class=\"td_label\">Status</span></td>\n            <td style=\"width:80%\" colspan=\"3\" th:narrative=\"${resource.status.toString().substring(0, 1).toUpperCase() + resource.status.toString().substring(1).toLowerCase()}\"></td>\n        </tr>\n        <tr th:if=\"${resource.hasPurpose()}\" style=\"vertical-align: top;\">\n            <td style=\"background-color:#656565; width:20%\" scope=\"row\"><span class=\"td_label\">Purpose</span></td>\n            <td style=\"width:80%\" colspan=\"3\" th:narrative=\"${resource.purpose}\"></td>\n        </tr>\n        <tr th:if=\"${resource.hasUsage()}\" style=\"vertical-align: top;\" >\n            <td style=\"background-color:#656565; width:20%\" scope=\"row\"><span class=\"td_label\">Usage</span></td>\n            <td style=\"width:80%\" colspan=\"3\" th:narrative=\"${resource.usage}\"></td>\n        </tr>\n        <th:block th:each=\"context, iter : ${resource.useContext}\" >\n            <tr style=\"vertical-align: top;\">\n                <td th:if=\"${iter.index == 0}\" th:rowspan=\"${iter.size}\" style=\"background-color:#656565; width:20%\" scope=\"row\"><span class=\"td_label\">Use Context</span></td>\n                <td style=\"width:80%\" colspan=\"3\" th:narrative=\"${context}\"></td>\n            </tr>\n        </th:block>\n        <th:block th:each=\"topics, iter : ${resource.topic}\" >\n            <tr style=\"vertical-align: top;\">\n                <td th:if=\"${iter.index == 0}\" th:rowspan=\"${iter.size}\" style=\"background-color:#656565; width:20%\" scope=\"row\"><span class=\"td_label\">Topic</span></td>\n                <td style=\"width:80%\" colspan=\"3\" th:narrative=\"${topics}\"></td>\n            </tr>\n        </th:block>\n        <th:block th:each=\"cont, iter : ${resource.contributor}\" >\n            <tr style=\"vertical-align: top;\">\n                <td th:if=\"${iter.index == 0}\" th:rowspan=\"${iter.size}\" style=\"background-color:#656565; width:20%\" scope=\"row\"><span class=\"td_label\">Contributor</span></td>\n                <td style=\"width:80%\" colspan=\"3\">\n                    <b><span th:narrative=\"${cont.type.toCode()}\"></span>: </b><span th:narrative=\"${cont.name}\"></span>\n                </td>\n            </tr>\n        </th:block> -->\n            <!-- <th:block th:each=\"lib, iter : ${resource.library}\" >\n            <tr style=\"vertical-align: top;\">\n                <td th:if=\"${iter.index == 0}\" th:rowspan=\"${iter.size}\" style=\"background-color:#656565; width:20%\" scope=\"row\"><span class=\"td_label\">Library</span></td>\n                <td style=\"width:80%\" colspan=\"3\">\n                    <p th:if=\"${lib.hasIdentifier()}\"><b>identifier: </b><span th:narrative=\"${lib.identifier}\"></span></p>\n                    <p th:if=\"${lib.hasReference()}\"><b>reference: </b><span th:narrative=\"${lib.reference}\"></span></p>\n                    <p th:if=\"${lib.hasDisplay()}\"><b>display: </b><span th:narrative=\"${lib.display}\"></span></p>\n                </td>\n            </tr>\n        </th:block> -->\n        \n            <!-- <tr th:if=\"${resource.hasRateAggregation()}\" >\n            <td style=\"background-color:#656565; width:20%\" scope=\"row\"><span class=\"td_label\">Rate Aggregation</span></td>\n            <td style=\"width:80%\" colspan=\"3\">\n                <div style=\"width:660px;overflow-x:hidden;overflow-y:auto\">\n                    <pre th:text=\"${resource.rateAggregation}\"></pre>\n                </div>\n            </td>\n        </tr>\n        <tr th:if=\"${resource.hasRationale()}\">\n            <td style=\"background-color:#656565; width:20%\" scope=\"row\"><span class=\"td_label\">Rationale</span></td>\n            <td style=\"width:80%\" colspan=\"3\">\n                <div style=\"width:660px;overflow-x:hidden;overflow-y:auto\">\n                    <pre th:text=\"${resource.rationale}\"></pre>\n                </div>\n            </td>\n        </tr> -->\n        <tr>\n            <td scope=\"row\" style=\"width:20%\"><span>Improvement Notation</span></td>\n            <td colspan=\"3\" style=\"width:80%\">A higher rate indicates better performance.</td>\n            \n        </tr>\n        <tr>\n            <td scope=\"row\" style=\"width:20%\"><span>Guidance</span></td>\n            <td colspan=\"3\" style=\"width:80%\">\n                <div style=\"width:660px;overflow-x:hidden;overflow-y:auto\"><p>The \"Non-elective Inpatient Encounter\" value set intends to capture all non-scheduled hospitalizations. This value set is a subset of the \"Inpatient encounter\" value set, excluding concepts that specifically refer to elective hospital admissions. Non-elective admissions include emergency, urgent and unplanned admissions.</p>\n<p>The \"Medication, Discharge\" datatype refers to the discharge medication list and is intended to express medications ordered for post-discharge use.</p>\n</div>\n            </td>\n        </tr>\n        <tr>\n            <td colspan=\"4\" scope=\"row\" style=\"background-color:#656565; width:100%\"><span class=\"td_label\">Definitions</span></td>\n        </tr>\n        \n        \n            <!-- <th:block th:each=\"groups, iter : ${resource.uniquePopulationGroup}\" >\n            <tr style=\"vertical-align: top;\">\n                <td style=\"background-color:#656565; width:20%\" scope=\"row\"><span class=\"td_label\" th:text=\"${groups.identifier.value}\"></span></td>\n                <td style=\"width:80%\" colspan=\"3\">\n                    <div style=\"width:660px;overflow-x:hidden;overflow-y:auto\">\n                        <pre th:text=\"${pops.description}\"></pre>\n                    </div>\n                </td>\n            </tr>\n        </th:block> -->\n    </table>\n    <table style=\"width: 60%; border-top: none; border-bottom: none\" class=\"header_table\">\n        \n    </table>\n    <table style=\"width: 60%; border-top: none;\" class=\"header_table\">\n            <!-- <th:block th:each=\"supples, iter : ${resource.supplementalData}\">\n            <tr>\n                <th th:if=\"${iter.index == 0}\" th:rowspan=\"${iter.size}\" scope=\"row\"><b>Supplemental Data:</b></th>\n                <td style=\"width:80%\" colspan=\"3\" >\n                    <p style=\"margin-bottom: 5px;\" th:narrative=\"${supples.identifier}\"></p>\n                    <p style=\"margin-bottom: 5px;\" th:each=\"uses : ${supples.usage}\">\n                        <b>usage: </b>\n                        <span th:narrative=\"${uses}\"></span>\n                    </p>\n                    <p style=\"margin-bottom: 5px;\" th:if=\"${supples.hasCriteria()}\">\n                        <b>criteria: </b>\n                        <span th:narrative=\"${supples.criteria}\"></span>\n                    </p>\n                    <p style=\"margin-bottom: 5px;\" th:if=\"${supples.hasPath()}\">\n                        <b>path: </b>\n                        <span th:narrative=\"${supples.path}\"></span>\n                    </p>\n                </td>\n            </tr>\n        </th:block> -->\n            <!-- <th:block th:each=\"param, iter : ${resource.parameter}\">\n            <tr style=\"vertical-align: top;\">\n                <th th:if=\"${iter.index == 0}\" th:rowspan=\"${iter.size}\" scope=\"row\"><b>Parameter: </b></th>\n                <td style=\"width:80%\" colspan=\"3\" >\n                    <span th:if=\"${param.hasName()}\">\n                        <b>name: </b>\n                        <span th:narrative=\"${param.name}\"></span>\n                        <br/>\n                    </span>\n                    <b>use: </b>\n                    <span th:narrative=\"${param.use.toCode()}\"></span>\n                    <br/>\n                    <span th:if=\"${param.hasMin()}\">\n                        <b>minimum cardinality: </b>\n                        <span th:narrative=\"${param.min}\"></span>\n                        <br/>\n                    </span>\n                    <span th:if=\"${param.hasMax()}\">\n                        <b>maximum cardinality: </b>\n                        <span th:narrative=\"${param.max}\"></span>\n                        <br/>\n                    </span>\n                    <b>type: </b>\n                    <span th:narrative=\"${param.type}\"></span>\n                    <br/>\n                    <span th:if=\"${param.hasDocumentation()}\">\n                        <b>documentation: </b>\n                        <span th:narrative=\"${param.documentation}\"></span>\n                        <br/>\n                    </span>\n                    <span th:if=\"${param.hasProfile()}\">\n                        <b>profile: </b>\n                        <span th:narrative=\"${param.profile}\"></span>\n                        <br/>\n                    </span>\n                    <p style=\"margin-bottom: 5px;\"></p>\n                </td>\n            </tr>\n        </th:block> -->\n            <!-- <th:block th:each=\"dataReq, iter : ${resource.dataRequirement}\">\n            <tr style=\"vertical-align: top;\">\n                    <th th:if=\"${iter.index == 0}\" th:rowspan=\"${iter.size}\" scope=\"row\" ><b>Data Requirements: </b></th>\n                    <td style=\"width:80%\" colspan=\"3\" th:narrative=\"${dataReq}\"></td>\n            </tr>\n        </th:block> -->\n    </table>\n  <h2><a name=\"toc\">Table of Contents</a></h2>\n  <ul style=\"padding-left: 50px;\">\n   <li><a href=\"#d1e405\">Population Criteria</a></li>\n   <li><a href=\"#d1e649\">Definitions</a></li>\n   <li><a href=\"#d1e650\">Functions</a></li>\n   <li><a href=\"#d1e555\">Terminology</a></li>\n   <li><a href=\"#d1e647\">Data Criteria (QDM Data Elements)</a></li>\n   <li><a href=\"#d1e767\">Supplemental Data Elements</a></li>\n   <li><a href=\"#d1e879\">Risk Adjustment Variables</a></li>\n  </ul>\n  <div style=\"float:left; background:teal; height:3px; width:80%\"></div>\n  \n  <h3><a name=\"d1e649\" href=\"#toc\">Definitions</a></h3>\n  \n  <h3><a name=\"d1e650\" href=\"#toc\">Functions</a></h3>\n  \n  <h3><a name=\"d1e555\" href=\"#toc\">Terminology</a></h3>\n  <div>\n   <ul style=\"padding-left: 50px;\">\n    \n   </ul>\n  </div>\n  <h3><a name=\"d1e647\" href=\"#toc\">Data Criteria (QDM Data Elements)</a></h3>\n  <div>\n    <ul style=\"padding-left: 50px;\">\n      \n    </ul>\n  </div>\n  <h3><a name=\"d1e767\" href=\"#toc\">Supplemental Data Elements</a></h3>\n  \n  <div>\n    <ul style=\"list-style:none;padding-left: 25px;\">\n        <li>None</li>\n    </ul>\n </div>\n  <h3><a name=\"d1e879\" href=\"#toc\">Risk Adjustment Variables</a></h3>\n  <div>\n   <ul style=\"list-style:none;padding-left: 25px;\">\n    <li>None</li>\n   </ul>\n  </div>\n  <div style=\"float:left; background:teal; height:3px; width:80%\"></div>\n  <table>\n        \n            <!-- <th:block th:each=\"con, iter : ${resource.content}\">\n            <tr th:if=\"${con.contentType == 'text/cql'}\" style=\"vertical-align: top;\">\n                <td style=\"background-color:#656565; width:20%\" scope=\"row\"><span class=\"td_label\">Content</span></td>\n                <td style=\"width:80%\" ><b>type: </b><span th:text=\"${con.contentType}\"></span></td>\n            </tr>\n            <tr th:if=\"${con.contentType == 'text/cql'}\">\n                <td style=\"width:100%\" colspan=\"2\" >\n                    <th:block th:if=\"${con.getData() != null }\" >\n                        <pre><code th:class=\"${con.contentType == 'text/cql' ? 'language-cql' : 'language-xml'}\" th:text=\"${new java.lang.String(con.getData())}\"></code></pre>\n                    </th:block>\n                    <th:block th:if=\"${con.getData() == null }\" >\n                        <span><i>%26lt;content is empty%26gt;</i></span>\n                    </th:block>\n                </td>\n            </tr>\n        </th:block > -->\n    </table>\n</div>"
  },
  "extension": [
    {
      "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis",
      "valueCode": "boolean"
    }
  ],
  "url": "http://hl7.org/fhir/us/cqfmeasures/Measure/measure-exm104-FHIR3",
  "identifier": [
    {
      "use": "official",
      "system": "http://hl7.org/fhir/cqi/ecqm/Measure/Identifier/cms",
      "value": "104"
    }
  ],
  "version": "8.1.000",
  "name": "EXM104",
  "title": "Discharged on Antithrombotic Therapy",
  "status": "draft",
  "experimental": true,
  "publisher": "National Committee for Quality Assurance (NCQA)",
  "description": "Ischemic stroke patients prescribed or continuing to take antithrombotic therapy at hospital discharge",
  "purpose": "Ischemic stroke patients prescribed or continuing to take antithrombotic therapy at hospital discharge",
  "approvalDate": "2016-01-01",
  "lastReviewDate": "2019-08-19",
  "effectivePeriod": {
    "start": "2019-01-01",
    "end": "2019-12-31"
  },
  "useContext": [
    {
      "code": {
        "code": "program"
      },
      "valueCodeableConcept": {
        "text": "eligible-provider"
      }
    }
  ],
  "jurisdiction": [
    {
      "coding": [
        {
          "system": "urn:iso:std:iso:3166",
          "code": "US"
        }
      ]
    }
  ],
  "topic": [
    {
      "coding": [
        {
          "system": "http://loinc.org",
          "code": "57024-2",
          "display": "Health Quality Measure Document"
        }
      ]
    }
  ],
  "contributor": [
    {
      "type": "author",
      "name": "National Committee for Quality Assurance"
    }
  ],
  "contact": [
    {
      "telecom": [
        {
          "system": "url",
          "value": "http://www.ncqa.org/"
        }
      ]
    }
  ],
  "copyright": "Measure specifications are in the Public Domain. LOINC(R) is a registered trademark of the Regenstrief Institute. This material contains SNOMED Clinical Terms(R) (SNOMED CT(C)) copyright 2004-2017 International Health Terminology Standards Development Organization. All rights reserved.",
  "relatedArtifact": [
    {
      "type": "citation",
      "citation": "Adams HP, del Zoppo G, Alberts MJ, Bhatt DL, Brass L, Furlan A, Grubb RL, Higashida RT, Jauch EC, Kidwell C, Lyden PD, Morgenstern LB, Qureshi AI, Rosenwasser RH, Scott PA, Wijdicks E. Guidelines for the Early Management of Adults with Ischemic Stroke: A Guideline From the American Heart Association/American Stroke Association Stroke Council, Clinical CardiologyCouncil, Cardiovascular Radiology and Intervention Council, and the Atherosclerotic Peripheral Vascular Disease and Quality of Care Outcomes in Research Interdisciplinary Working Groups. Stroke. 2007;38:1655-1711."
    },
    {
      "type": "citation",
      "citation": "Adams H, Adams R, Del Zoppo G, Goldstein LB. Guidelines for the Early Management of Patients With Ischemic Stroke: Guidelines Update A Scientific Statement From the Stroke Council of the American Heart Association/American Stroke Association. Stroke Vol. 36, 2005: 916:923."
    },
    {
      "type": "citation",
      "citation": "Albers GW, Amarenco P, Easton JD, Sacco RL, Teal P. Antithrombotic and Thrombolytic Therapy for Ischemic Stroke. Chest Vol. 119, 2001: 300-320."
    },
    {
      "type": "citation",
      "citation": "Brott TG, Clark WM, Grotta JC, et al. Stroke the first hours. Guidelines for acute treatment. Consensus Statement. National Stroke Association. 2000."
    },
    {
      "type": "citation",
      "citation": "Chen ZM, Sandercock P, Pan HC, et al. Indications for early aspirin use in acute ischemic stroke: a combined analysis of 40,000 randomized patients from the Chinese acute stroke trial and the international stroke trial. On behalf of the CAST and IST collaborative groups, Stroke 2000;31:1240-1249."
    },
    {
      "type": "citation",
      "citation": "Coull BM, Williams LS, Goldstein LB, et al. Anticoagulants and Antiplatelet Agents in Acute Ischemic Stroke. Report of the Joint Stroke Guideline Development Committee of the American Academy of Neurology and the American Stroke Association (a Division of the American Heart Association) Stroke. 2002;33:1934 - 1942."
    },
    {
      "type": "citation",
      "citation": "Guideline on the Use of Aspirin as Secondary Prophylaxis for Vascular Disease in Primary Care, Centre for Health Services Research University of Newcastle upon Tyne, & Centre for Health Economics of York, 1998."
    },
    {
      "type": "citation",
      "citation": "Kernan, W.N., B. Ovbiagele, H. R. Black, D. M. Bravata, M. I. Chimowitz, M. D. Ezekowitz, M. C. Fang, M. Fisher, K. L. Furie, D. V. Heck, S. C. Johnston, S. E. Kasner, S. J. Kittner, P. H. Mitchell, M. W. Rich, D. Richardson, L. H. Schwamm, J. A. Wilson. \"Guidelines for the Prevention of Stroke in Patients with Stroke and Transient Ischemic Attack: A Guideline for Healthcare Professionals from the American Heart Association/American Stroke Association.\" [in eng.]  Stroke 45, no. 7 (May 2014): 2160-223. "
    }
  ],
  "library": [
    {
      "reference": "Library/library-EXM104-FHIR3-8.1.000"
    }
  ],
  "disclaimer": "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": [
      {
        "system": "http://hl7.org/fhir/measure-scoring",
        "code": "proportion"
      }
    ]
  },
  "type": [
    {
      "coding": [
        {
          "system": "http://hl7.org/fhir/measure-type",
          "code": "process"
        }
      ]
    }
  ],
  "rateAggregation": "none",
  "rationale": "The effectiveness of antithrombotic agents in reducing stroke mortality, stroke-related morbidity and recurrence rates has been studied in several large clinical trials. While the use of these agents for patients with acute ischemic stroke and transient ischemic attacks continues to be the subject of study, substantial evidence is available from completed studies. Data at this time suggest that antithrombotic therapy should be prescribed at discharge following acute ischemic stroke to reduce stroke mortality and morbidity as long as no contraindications exist.\n\nFor patients with a stroke due to a cardioembolic source (eg atrial fibrillation, mechanical heart valve), warfarin is recommended unless contraindicated. In recent years, novel oral anticoagulant agents (NOACs) have been developed and approved by the U.S. Food and Drug Administration (FDA) for stroke prevention, and may be considered as an alternative to warfarin for select patients. Anticoagulation therapy is not generally recommended for secondary stroke prevention in patients presumed to have a non-cardioembolic stroke.\nAnticoagulants at doses to prevent venous thromboembolism are insufficient antithrombotic therapy to prevent recurrent ischemic stroke or TIA.",
  "clinicalRecommendationStatement": "Clinical trial results suggest that antithrombotic therapy should be prescribed at discharge following acute ischemic stroke to reduce stroke mortality and morbidity as long as no contraindications exist",
  "improvementNotation": "increase",
  "guidance": "The \"Non-elective Inpatient Encounter\" value set intends to capture all non-scheduled hospitalizations. This value set is a subset of the \"Inpatient encounter\" value set, excluding concepts that specifically refer to elective hospital admissions. Non-elective admissions include emergency, urgent and unplanned admissions.\n\nThe \"Medication, Discharge\" datatype refers to the discharge medication list and is intended to express medications ordered for post-discharge use.",
  "group": [
    {
      "identifier": {
        "value": "group-1"
      },
      "population": [
        {
          "identifier": {
            "value": "initial-population-identifier"
          },
          "code": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                "code": "initial-population",
                "display": "Initial Population"
              }
            ]
          },
          "criteria": "Initial Population"
        },
        {
          "identifier": {
            "value": "numerator-identifier"
          },
          "code": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                "code": "numerator",
                "display": "Numerator"
              }
            ]
          },
          "criteria": "Numerator"
        },
        {
          "identifier": {
            "value": "denominator-identifier"
          },
          "code": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                "code": "denominator",
                "display": "Denominator"
              }
            ]
          },
          "criteria": "Denominator"
        },
        {
          "identifier": {
            "value": "denominator-exclusions-identifier"
          },
          "code": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                "code": "denominator-exclusion",
                "display": "Denominator Exclusion"
              }
            ]
          },
          "criteria": "Denominator Exclusion"
        }
      ]
    }
  ],
  "supplementalData": [
    {
      "identifier": {
        "value": "sde-ethnicity"
      },
      "usage": [
        {
          "coding": [
            {
              "system": "http://hl7.org/fhir/measure-data-usage",
              "code": "supplemental-data"
            }
          ]
        }
      ],
      "criteria": "SDE Ethnicity"
    },
    {
      "identifier": {
        "value": "sde-payer"
      },
      "usage": [
        {
          "coding": [
            {
              "system": "http://hl7.org/fhir/measure-data-usage",
              "code": "supplemental-data"
            }
          ]
        }
      ],
      "criteria": "SDE Payer"
    },
    {
      "identifier": {
        "value": "sde-race"
      },
      "usage": [
        {
          "coding": [
            {
              "system": "http://hl7.org/fhir/measure-data-usage",
              "code": "supplemental-data"
            }
          ]
        }
      ],
      "criteria": "SDE Race"
    },
    {
      "identifier": {
        "value": "sde-sex"
      },
      "usage": [
        {
          "coding": [
            {
              "system": "http://hl7.org/fhir/measure-data-usage",
              "code": "supplemental-data"
            }
          ]
        }
      ],
      "criteria": "SDE Sex"
    }
  ]
}
