MedicationNotRequested Throwing Error When Evaluated

The following CQL throws an error when executed...

`library HFBetaBlockerTherapyforLVSDQICore4 version '1.0.000'

using QICore version '4.1.1'

//refer to FHIRHelpers at https://github.com/cqframework/ecqm-content-qicore-2022/tree/master/input/cql include FHIRHelpers version '4.0.012' called FHIRHelpers

valueset "Beta Blocker Therapy for LVSD": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1184' valueset "Medical Reason": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1007' valueset "Patient Reason": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1008'

parameter "Measurement Period" default Interval[@2022-01-01, @2022-12-31]

exists ( ["MedicationNotRequested": "Beta Blocker Therapy for LVSD"] NoBetaBlockerOrdered //for AHA."Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD" refer to https://github.com/JSRankins/ecqm-content-qicore-2022/blob/master/input/cql/AHAOverallQICore4.cql with AHA."Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD" ModerateOrSevereLVSDHFOutpatientEncounter such that NoBetaBlockerOrdered.authoredOn during ModerateOrSevereLVSDHFOutpatientEncounter.period where ( NoBetaBlockerOrdered.reasonCode in "Medical Reason" or NoBetaBlockerOrdered.reasonCode in "Patient Reason") )`

This is the error stack: The following errors were encountered during evaluation: org.opencds.cqf.cql.engine.exception.CqlException: Could not resolve call to operator 'ToConcept(java.util.List)' in library 'FHIRHelpers'. at org.opencds.cqf.cql.engine.execution.Context.resolveFunctionRef(Context.java:606) at org.opencds.cqf.cql.engine.elm.execution.FunctionRefEvaluator.internalEvaluate(FunctionRefEvaluator.java:23) at org.opencds.cqf.cql.engine.elm.execution.Executable.evaluate(Executable.java:18) at org.opencds.cqf.cql.engine.elm.execution.InValueSetEvaluator.internalEvaluate(InValueSetEvaluator.java:65) at org.opencds.cqf.cql.engine.elm.execution.Executable.evaluate(Executable.java:18) at org.opencds.cqf.cql.engine.elm.execution.OrEvaluator.internalEvaluate(OrEvaluator.java:43) at org.opencds.cqf.cql.engine.elm.execution.Executable.evaluate(Executable.java:18) at org.opencds.cqf.cql.engine.elm.execution.QueryEvaluator.evaluateWhere(QueryEvaluator.java:75) at org.opencds.cqf.cql.engine.elm.execution.QueryEvaluator.internalEvaluate(QueryEvaluator.java:198) at org.opencds.cqf.cql.engine.elm.execution.Executable.evaluate(Executable.java:18) at org.opencds.cqf.cql.engine.elm.execution.ExistsEvaluator.internalEvaluate(ExistsEvaluator.java:28) at org.opencds.cqf.cql.engine.elm.execution.Executable.evaluate(Executable.java:18) at org.opencds.cqf.cql.engine.elm.execution.ExpressionDefEvaluator.internalEvaluate(ExpressionDefEvaluator.java:19) at org.opencds.cqf.cql.engine.elm.execution.Executable.evaluate(Executable.java:18) at org.opencds.cqf.cql.engine.execution.CqlEngine.evaluateExpressions(CqlEngine.java:186) at org.opencds.cqf.cql.engine.execution.CqlEngine.evaluate(CqlEngine.java:164) at org.opencds.cqf.cql.evaluator.CqlEvaluator.evaluate(CqlEvaluator.java:89) at org.opencds.cqf.cql.evaluator.CqlEvaluator.evaluate(CqlEvaluator.java:76) at org.opencds.cqf.cql.evaluator.cli.command.CqlCommand.call(CqlCommand.java:163) at org.opencds.cqf.cql.evaluator.cli.command.CqlCommand.call(CqlCommand.java:34) at picocli.CommandLine.executeUserObject(CommandLine.java:1953) at picocli.CommandLine.access$1300(CommandLine.java:145) at picocli.CommandLine$RunLast.executeUserObjectOfLastSubcommandWithSameParent(CommandLine.java:2352) at picocli.CommandLine$RunLast.handle(CommandLine.java:2346) at picocli.CommandLine$RunLast.handle(CommandLine.java:2311) at picocli.CommandLine$AbstractParseResultHandler.execute(CommandLine.java:2179) at picocli.CommandLine.execute(CommandLine.java:2078) at org.opencds.cqf.cql.evaluator.cli.Main.run(Main.java:19) at org.opencds.cqf.cql.ls.DebugCqlCommandContribution.executeCql(DebugCqlCommandContribution.java:37) at org.opencds.cqf.cql.ls.DebugCqlCommandContribution.executeCommand(DebugCqlCommandContribution.java:65) at org.opencds.cqf.cql.ls.service.CqlWorkspaceService.executeCommandFromContributions(CqlWorkspaceService.java:173) at org.opencds.cqf.cql.ls.service.CqlWorkspaceService.executeCommand(CqlWorkspaceService.java:121) at java.base/jdk.internal.reflect.NativeMethodAccessorImpl.invoke0(Native Method) at java.base/jdk.internal.reflect.NativeMethodAccessorImpl.invoke(NativeMethodAccessorImpl.java:62) at java.base/jdk.internal.reflect.DelegatingMethodAccessorImpl.invoke(DelegatingMethodAccessorImpl.java:43) at java.base/java.lang.reflect.Method.invoke(Method.java:566) at org.eclipse.lsp4j.jsonrpc.services.GenericEndpoint.lambda$null$0(GenericEndpoint.java:65) at org.eclipse.lsp4j.jsonrpc.services.GenericEndpoint.request(GenericEndpoint.java:120) at org.eclipse.lsp4j.jsonrpc.RemoteEndpoint.handleRequest(RemoteEndpoint.java:261) at org.eclipse.lsp4j.jsonrpc.RemoteEndpoint.consume(RemoteEndpoint.java:190) at org.eclipse.lsp4j.jsonrpc.json.StreamMessageProducer.handleMessage(StreamMessageProducer.java:194) at org.eclipse.lsp4j.jsonrpc.json.StreamMessageProducer.listen(StreamMessageProducer.java:94) at org.eclipse.lsp4j.jsonrpc.json.ConcurrentMessageProcessor.run(ConcurrentMessageProcessor.java:113) at java.base/java.util.concurrent.Executors$RunnableAdapter.call(Executors.java:515) at java.base/java.util.concurrent.FutureTask.run(FutureTask.java:264) at java.base/java.util.concurrent.ThreadPoolExecutor.runWorker(ThreadPoolExecutor.java:1128) at java.base/java.util.concurrent.ThreadPoolExecutor$Worker.run(ThreadPoolExecutor.java:628) at java.base/java.lang.Thread.run(Thread.java:829)

This is the test case bundle: { "resourceType": "Bundle", "id": "tests-denexcep-pos-HFBetaBlockerTherapyforLVSDQICore4-bundle", "type": "transaction", "entry": [ { "resource": { "resourceType": "Encounter", "id": "denexcep-pos-HFBetaBlockerTherapyforLVSDQICore4-6", "meta": { "profile": [ "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter" ] }, "status": "finished", "class": { "code": "AMB", "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode", "display": "ambulatory" }, "type": [ { "coding": [ { "code": "99201", "system": "http://www.ama-assn.org/go/cpt", "display": "Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A problem focused history; A problem focused examination; Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self limited or minor. Typically, 10 minutes are spent face-to-face with the patient and/or family." } ] } ], "subject": { "reference": "Patient/denexcep-pos-HFBetaBlockerTherapyforLVSDQICore4" }, "period": { "start": "2021-03-02T10:00:00.000Z", "end": "2021-03-02T10:30:00.000Z" } }, "request": { "method": "PUT", "url": "Encounter/denexcep-pos-HFBetaBlockerTherapyforLVSDQICore4-6" } }, { "resource": { "resourceType": "Encounter", "id": "denexcep-pos-HFBetaBlockerTherapyforLVSDQICore4-1", "status": "finished", "class": { "code": "AMB", "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode", "display": "ambulatory" }, "type": [ { "coding": [ { "code": "99201", "system": "http://www.ama-assn.org/go/cpt", "display": "Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A problem focused history; A problem focused examination; Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self limited or minor. Typically, 10 minutes are spent face-to-face with the patient and/or family." } ] } ], "subject": { "reference": "Patient/denexcep-pos-HFBetaBlockerTherapyforLVSDQICore4" }, "period": { "start": "2022-01-02T10:00:00.000Z", "end": "2022-01-02T10:30:00.000Z" } }, "request": { "method": "PUT", "url": "Encounter/denexcep-pos-HFBetaBlockerTherapyforLVSDQICore4-1" } }, { "resource": { "resourceType": "Encounter", "id": "denexcep-pos-HFBetaBlockerTherapyforLVSDQICore4-2", "meta": { "profile": [ "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter" ] }, "status": "finished", "class": { "code": "AMB", "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode", "display": "ambulatory" }, "type": [ { "coding": [ { "code": "99201", "system": "http://www.ama-assn.org/go/cpt", "display": "Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A problem focused history; A problem focused examination; Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self limited or minor. Typically, 10 minutes are spent face-to-face with the patient and/or family." } ] } ], "subject": { "reference": "Patient/denexcep-pos-HFBetaBlockerTherapyforLVSDQICore4" }, "period": { "start": "2022-03-02T10:00:00.000Z", "end": "2022-03-02T10:30:00.000Z" } }, "request": { "method": "PUT", "url": "Encounter/denexcep-pos-HFBetaBlockerTherapyforLVSDQICore4-2" } }, { "resource": { "resourceType": "Condition", "id": "denexcep-pos-HFBetaBlockerTherapyforLVSDQICore4-3", "meta": { "profile": [ "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition" ] }, "clinicalStatus" : { "coding" : [ { "system" : "http://terminology.hl7.org/CodeSystem/condition-clinical", "code" : "active" } ] }, "verificationStatus" : { "coding" : [ { "system" : "http://terminology.hl7.org/CodeSystem/condition-ver-status", "code" : "confirmed" } ] }, "category" : [ { "coding" : [ { "system" : "http://terminology.hl7.org/CodeSystem/condition-category", "code" : "encounter-diagnosis", "display" : "Encounter Diagnosis" } ] } ], "severity" : { "coding" : [ { "system" : "http://snomed.info/sct", "code" : "24484000", "display" : "Severe (severity modifier)" } ] }, "code": { "coding": [ { "code": "I11.0", "system": "http://hl7.org/fhir/sid/icd-10-cm", "display": "Hypertensive heart disease with heart failure" } ] }, "subject": { "reference": "Patient/denexcep-pos-HFBetaBlockerTherapyforLVSDQICore4" }, "onsetDateTime": "2020-11-01" }, "request": { "method": "PUT", "url": "Condition/denexcep-pos-HFBetaBlockerTherapyforLVSDQICore4-3" } }, { "resource": { "resourceType": "Observation", "id": "denexcep-pos-HFBetaBlockerTherapyforLVSDQICore4-4", "meta": { "profile": [ "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation" ] }, "status": "final", "category": [ { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/observation-category", "code": "imaging", "display": "Imaging" } ] } ], "code": { "coding": [ { "system": "http://loinc.org", "code": "10230-1", "display": "Left ventricular Ejection fraction" } ] }, "subject": { "reference": "Patient/denexcep-pos-HFBetaBlockerTherapyforLVSDQICore4" }, "effectiveDateTime": "2020-11-01T10:30:00.000Z", "issued": "2020-11-01T10:30:00.000Z", "valueQuantity": { "value": 55.0, "unit": "%", "system": "http://unitsofmeasure.org", "code": "%" }, "interpretation": [ { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation", "code": "N", "display": "Normal" } ], "text": "Normal" } ] }, "request": { "method": "PUT", "url": "Observation/denexcep-pos-HFBetaBlockerTherapyforLVSDQICore4-4" } }, { "resource": { "resourceType": "MedicationRequest", "id": "denexcep-pos-HFBetaBlockerTherapyforLVSDQICore4-5", "meta": { "profile": [ "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest" ] }, "status": "active", "intent": "order", "medicationCodeableConcept": { "coding": [ { "system": "http://www.nlm.nih.gov/research/umls/rxnorm", "code": "860516", "display": "24 HR carvedilol phosphate 20 MG Extended Release Oral Capsule" } ] }, "subject": { "reference": "Patient/denexcep-pos-HFBetaBlockerTherapyforLVSDQICore4", "display": "Betty Dunn" }, "encounter": { "reference": "Encounter/denexcep-pos-HFBetaBlockerTherapyforLVSDQICore4-6", "display": "encounter who leads to this prescription" }, "authoredOn": "2021-03-02T10:15:00.000Z", "note": [ { "text": "Patient told to take with food" } ], "dosageInstruction": [ { "sequence": 1, "text": "One tablet daily for 10 days starting on March 3, 2022", "additionalInstruction": [ { "coding": [ { "system": "http://snomed.info/sct", "code": "769557005", "display": "With meals" } ] } ], "timing": { "repeat": { "boundsPeriod": { "start": "2021-03-03", "end": "2021-03-12" }, "frequency": 1, "period": 1, "periodUnit": "d" } }, "route": { "coding": [ { "system": "http://snomed.info/sct", "code": "26643006", "display": "Oral Route" } ] }, "method": { "coding": [ { "system": "http://snomed.info/sct", "code": "421521009", "display": "Swallow - dosing instruction imperative (qualifier value)" } ] }, "doseAndRate": [ { "type": { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/dose-rate-type", "code": "ordered", "display": "Ordered" } ] }, "doseQuantity": { "value": 1, "unit": "TAB", "system": "http://terminology.hl7.org/CodeSystem/v3-orderableDrugForm", "code": "TAB" } } ] }, { "sequence": 2, "text": "If tolerated, take 2 pills once a day starting March 13, 2022 for 10 days", "additionalInstruction": [ { "coding": [ { "system": "http://snomed.info/sct", "code": "769557005", "display": "With meals" } ] } ], "timing": { "repeat": { "boundsPeriod": { "start": "2021-03-13", "end": "2021-03-22" }, "frequency": 1, "period": 1, "periodUnit": "d" } }, "route": { "coding": [ { "system": "http://snomed.info/sct", "code": "26643006", "display": "Oral Route" } ] }, "doseAndRate": [ { "type": { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/dose-rate-type", "code": "ordered", "display": "Ordered" } ] }, "doseQuantity": { "value": 2, "unit": "TAB", "system": "http://terminology.hl7.org/CodeSystem/v3-orderableDrugForm", "code": "TAB" } } ] }, { "sequence": 3, "text": "If tolerated, take 4 pills once a day from thereon starting March 23, 2022. At end, re-evaluate.", "additionalInstruction": [ { "coding": [ { "system": "http://snomed.info/sct", "code": "769557005", "display": "With meals" } ] } ], "timing": { "repeat": { "boundsPeriod": { "start": "2021-03-23", "end": "2021-04-02" }, "frequency": 1, "period": 1, "periodUnit": "d" } }, "route": { "coding": [ { "system": "http://snomed.info/sct", "code": "26643006", "display": "Oral Route" } ] }, "doseAndRate": [ { "type": { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/dose-rate-type", "code": "ordered", "display": "Ordered" } ] }, "doseQuantity": { "value": 4, "unit": "TAB", "system": "http://terminology.hl7.org/CodeSystem/v3-orderableDrugForm", "code": "TAB" } } ] } ], "dispenseRequest": { "validityPeriod": { "start": "2021-03-02", "end": "2022-03-02" }, "numberOfRepeatsAllowed": 0, "quantity": { "value": 70, "unit": "TAB", "system": "http://terminology.hl7.org/CodeSystem/v3-orderableDrugForm", "code": "TAB" }, "expectedSupplyDuration": { "value": 30, "unit": "days", "system": "http://unitsofmeasure.org", "code": "d" } }, "substitution": { "allowedBoolean": true, "reason": { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/v3-ActReason", "code": "FP", "display": "formulary policy" } ] } } }, "request": { "method": "PUT", "url": "MedicationRequest/denexcep-pos-HFBetaBlockerTherapyforLVSDQICore4-5" } }, { "resource": { "resourceType": "MedicationRequest", "id": "denexcep-pos-HFBetaBlockerTherapyforLVSDQICore4-7", "meta": { "profile": [ "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest" ] }, "status": "completed", "intent": "order", "category" : [ { "coding" : [ { "system" : "http://terminology.hl7.org/CodeSystem/medicationrequest-category", "code" : "community" } ] } ], "doNotPerform" : true, "medicationCodeableConcept": { "extension" : [ { "url" : "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet", "valueCanonical" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1184" } ], "text" : "Not Done Value Set: Beta Blocker Therapy for LVSD" }, "subject": { "reference": "Patient/denexcep-pos-HFBetaBlockerTherapyforLVSDQICore4", "display": "Betty Dunn" }, "encounter": { "reference": "Encounter/denexcep-pos-HFBetaBlockerTherapyforLVSDQICore4-2", "display": "encounter that leads to this medical reason documentation for not continuing beta blocker" }, "authoredOn": "2022-01-02T10:00:00.000Z", "note": [ { "text": "Patient has medical reason for not taking beta blocker - treatment not tolerated" } ], "reasonCode" : [ { "coding" : [ { "system": "http://snomed.info/sct", "code": "407563006", "display": "Treatment not tolerated (situation)" } ] } ] }, "request": { "method": "PUT", "url": "MedicationRequest/denexcep-pos-HFBetaBlockerTherapyforLVSDQICore4-7" } }, { "resource": { "resourceType": "Patient", "id": "denexcep-pos-HFBetaBlockerTherapyforLVSDQICore4", "meta": { "profile": [ "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient" ] }, "extension": [ { "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-race", "extension": [ { "url": "ombCategory", "valueCoding": { "code": "2028-9", "system": "urn:oid:2.16.840.1.113883.6.238", "display": "Asian" } }, { "url": "text", "valueString": "Asian" } ] }, { "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity", "extension": [ { "url": "ombCategory", "valueCoding": { "code": "2135-2", "system": "urn:oid:2.16.840.1.113883.6.238", "display": "Hispanic or Latino" } }, { "url": "text", "valueString": "Hispanic or Latino" } ] } ], "identifier": [ { "use": "usual", "type": { "coding": [ { "code": "MR", "system": "http://terminology.hl7.org/CodeSystem/v2-0203", "display": "Medical Record Number" } ] }, "system": "http://hospital.smarthealthit.org", "value": "685945948" } ], "name": [ { "family": "Dunn", "given": [ "Betty" ] } ], "gender": "female", "birthDate": "1978-01-01" }, "request": { "method": "PUT", "url": "Patient/denexcep-pos-HFBetaBlockerTherapyforLVSDQICore4" } } ] }

cqframework / vscode-cql

MedicationNotRequested Throwing Error When Evaluated #14