cql(measures): apply inline code-filter to all 6 unfiltered measures

backend/src/main/resources/measures/audiogram.cql

@@ -11,14 +11,17 @@ parameter "Measurement Period" Interval<DateTime>
 context Patient
 
 define "In Hearing Conservation Program":
-  exists([Condition])
+  exists([Condition] C
+    where exists(C.code.coding x where x.system = 'urn:workwell:vs:hearing-enrollment' and x.code = 'hearing-enrollment'))
 
 define "Has Active Waiver":
-  Count([Condition]) > 1
+  exists([Condition] C
+    where exists(C.code.coding x where x.system = 'urn:workwell:vs:audiogram-waiver' and x.code = 'audiogram-waiver'))
 
 define "Most Recent Audiogram Date":
   Last(
     [Procedure] P
+      where exists(P.code.coding C where C.system = 'urn:workwell:vs:audiogram-procedures' and C.code = 'audiogram-procedure')
       sort by (performed as FHIR.dateTime)
   ).performed as FHIR.dateTime
 

backend/src/main/resources/measures/cholesterol_ldl.cql

@@ -10,14 +10,17 @@ parameter "Measurement Period" Interval<DateTime>
 context Patient
 
 define "In Cholesterol Program":
-  exists([Condition])
+  exists([Condition] C
+    where exists(C.code.coding x where x.system = 'urn:workwell:vs:cholesterol-program' and x.code = 'cholesterol-enrolled'))
 
 define "Has Medical Exemption":
-  Count([Condition]) > 1
+  exists([Condition] C
+    where exists(C.code.coding x where x.system = 'urn:workwell:vs:cholesterol-exemption' and x.code = 'cholesterol-exempt'))
 
 define "Most Recent LDL Screening Date":
   Last(
     [Procedure] P
+      where exists(P.code.coding C where C.system = 'urn:workwell:vs:ldl-labs' and C.code = 'ldl-lab')
       sort by (performed as FHIR.dateTime)
   ).performed as FHIR.dateTime
 

backend/src/main/resources/measures/diabetes_hba1c.cql

@@ -10,14 +10,17 @@ parameter "Measurement Period" Interval<DateTime>
 context Patient
 
 define "In Diabetes Program":
-  exists([Condition])
+  exists([Condition] C
+    where exists(C.code.coding x where x.system = 'urn:workwell:vs:diabetes-program' and x.code = 'diabetes-enrolled'))
 
 define "Has Medical Exemption":
-  Count([Condition]) > 1
+  exists([Condition] C
+    where exists(C.code.coding x where x.system = 'urn:workwell:vs:diabetes-exemption' and x.code = 'diabetes-exempt'))
 
 define "Most Recent HbA1c Date":
   Last(
     [Procedure] P
+      where exists(P.code.coding C where C.system = 'urn:workwell:vs:hba1c-labs' and C.code = 'hba1c-lab')
       sort by (performed as FHIR.dateTime)
   ).performed as FHIR.dateTime
 

backend/src/main/resources/measures/flu_vaccine.cql

@@ -10,18 +10,22 @@ parameter "Measurement Period" Interval<DateTime>
 context Patient
 
 define "Clinical Facing Employee":
-  exists([Condition])
+  exists([Condition] C
+    where exists(C.code.coding x where x.system = 'urn:workwell:vs:clinical-roles' and x.code = 'clinical-role'))
 
 define "Has Valid Exemption":
-  Count([Condition]) > 1
+  exists([Condition] C
+    where exists(C.code.coding x where x.system = 'urn:workwell:vs:flu-exemption' and x.code = 'flu-exemption'))
 
 define "Flu Vaccine This Season":
   exists([Immunization] I
-    where (I.occurrence as FHIR.dateTime) during "Measurement Period")
+    where exists(I.vaccineCode.coding C where C.system = 'urn:workwell:vs:flu-vaccines' and C.code = 'flu-vaccine')
+      and (I.occurrence as FHIR.dateTime) during "Measurement Period")
 
 define "Most Recent Flu Vaccine Date":
   Last(
     [Immunization] I
+      where exists(I.vaccineCode.coding C where C.system = 'urn:workwell:vs:flu-vaccines' and C.code = 'flu-vaccine')
       sort by (occurrence as FHIR.dateTime)
   ).occurrence as FHIR.dateTime
 

backend/src/main/resources/measures/hypertension.cql

@@ -10,14 +10,17 @@ parameter "Measurement Period" Interval<DateTime>
 context Patient
 
 define "In Wellness Program":
-  exists([Condition])
+  exists([Condition] C
+    where exists(C.code.coding x where x.system = 'urn:workwell:vs:wellness-enrollment' and x.code = 'wellness-enrolled'))
 
 define "Has Medical Exemption":
-  Count([Condition]) > 1
+  exists([Condition] C
+    where exists(C.code.coding x where x.system = 'urn:workwell:vs:wellness-exemption' and x.code = 'wellness-exempt'))
 
 define "Most Recent BP Screening Date":
   Last(
     [Procedure] P
+      where exists(P.code.coding C where C.system = 'urn:workwell:vs:bp-screening' and C.code = 'bp-screen')
       sort by (performed as FHIR.dateTime)
   ).performed as FHIR.dateTime
 

backend/src/main/resources/measures/obesity_bmi.cql

@@ -10,14 +10,17 @@ parameter "Measurement Period" Interval<DateTime>
 context Patient
 
 define "In Wellness Program":
-  exists([Condition])
+  exists([Condition] C
+    where exists(C.code.coding x where x.system = 'urn:workwell:vs:wellness-enrollment' and x.code = 'wellness-enrolled'))
 
 define "Has Medical Exemption":
-  Count([Condition]) > 1
+  exists([Condition] C
+    where exists(C.code.coding x where x.system = 'urn:workwell:vs:wellness-exemption' and x.code = 'wellness-exempt'))
 
 define "Most Recent BMI Screening Date":
   Last(
     [Procedure] P
+      where exists(P.code.coding C where C.system = 'urn:workwell:vs:bmi-screening' and C.code = 'bmi-screen')
       sort by (performed as FHIR.dateTime)
   ).performed as FHIR.dateTime
 

docs/MEASURES.md

@@ -196,6 +196,6 @@ Each outcome evidence payload includes:
 
 ## Implementation Notes
 
-- TB and HAZWOPER recency checks use explicit procedure-code filtering in CQL so the seeded in-memory CQF evaluator can resolve the most recent exam date without relying on unsupported value-set token retrieval.
+- All 8 active CQL measures now use inline code-filter expressions on both the qualifying event (Procedure or Immunization) and the enrollment/exemption Conditions, matching the system/code stamped by `SyntheticFhirBundleBuilder`. This replaces the earlier `exists([Condition])` / `Count([Condition]) > 1` pattern that was semantically correct but not code-scoped. True ValueSet token expansion (resolving `urn:workwell:vs:*` OIDs via the VSAC or a local expansion service) is a known evaluator limitation of the in-memory CQF path; the inline-code pattern is the stable workaround until a resolver is wired.
 - All four HEDIS wellness measures are seeded via `ensureInstanceSeeds()` when `WORKWELL_INSTANCE=ecqm` or `twh`.
 - All 49 CMS eCQM catalog entries (2026 performance period) are seeded via `ensureCmsEcqmCatalogSeed()` for the same instance values. They are Draft-only and do not participate in CQL evaluation runs until CQL is authored and compiled. On re-seed, existing measures are looked up by CMS ID prefix (`LIKE 'CMSNNNv%'`) and updated in-place so version bumps (e.g., v13→v14) do not create duplicate DB rows.