Data Exchange For Quality Measures Implementation Guide
5.0.0 - STU5
Data Exchange For Quality Measures Implementation Guide
5.0.0 - STU5
Data Exchange For Quality Measures Implementation Guide, published by HL7 International / Clinical Quality Information. This guide is not an authorized publication; it is the continuous build for version 5.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-deqm/ and changes regularly. See the Directory of published versions
{
"resourceType" : "Bundle",
"id" : "single-gaps-closed-indv-report02",
"meta" : {
"profile" : [
🔗 "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/gaps-bundle-deqm"
]
},
"identifier" : {
"system" : "urn:ietf:rfc:3986",
"value" : "urn:uuid:e2eaf470-f7ca-453f-8fd7-232a07f1b63c"
},
"type" : "document",
"timestamp" : "2020-07-07T13:08:53+00:00",
"entry" : [
{
"fullUrl" : "http://example.org/fhir/gaps/Composition/gaps-composition03",
"resource" : {
"resourceType" : "Composition",
"id" : "gaps-composition03",
"meta" : {
"profile" : [
🔗 "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/gaps-composition-deqm"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Composition_gaps-composition03\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Composition gaps-composition03</b></p><a name=\"gaps-composition03\"> </a><a name=\"hcgaps-composition03\"> </a><a name=\"gaps-composition03-en-US\"> </a><p><b>status</b>: Final</p><p><b>type</b>: <span title=\"Codes:{http://loinc.org 96315-7}\">Gaps in care report</span></p><p><b>date</b>: 2020-07-07 13:08:53+0000</p><p><b>author</b>: <a href=\"Organization-gaps-organization-reportingvendor.html\">Organization GapsReportingVendor01</a></p><p><b>title</b>: Care Gap Report for patient gaps-patient01</p></div>"
},
"status" : "final",
"type" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "96315-7",
"display" : "Gaps in care report"
}
]
},
"subject" : {
🔗 "reference" : "Patient/gaps-patient01"
},
"date" : "2020-07-07T13:08:53+00:00",
"author" : [
{
🔗 "reference" : "Organization/gaps-organization-reportingvendor"
}
],
"title" : "Care Gap Report for patient gaps-patient01",
"section" : [
{
"title" : "Colorectal Cancer Screening",
"focus" : {
🔗 "reference" : "MeasureReport/gaps-indv-measurereport04"
},
"entry" : [
{
🔗 "reference" : "DetectedIssue/gaps-detectedissue04"
}
]
}
]
}
},
{
"fullUrl" : "http://example.org/fhir/gaps/DetectedIssue/gaps-detectedissue04",
"resource" : {
"resourceType" : "DetectedIssue",
"id" : "gaps-detectedissue04",
"meta" : {
"profile" : [
🔗 "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/gaps-detectedissue-deqm"
]
},
"text" : {
"status" : "extensions",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"DetectedIssue_gaps-detectedissue04\"> </a><p class=\"res-header-id\"><b>Generated Narrative: DetectedIssue gaps-detectedissue04</b></p><a name=\"gaps-detectedissue04\"> </a><a name=\"hcgaps-detectedissue04\"> </a><a name=\"gaps-detectedissue04-en-US\"> </a><p><b>DEQM Gap Status Modifier Extension</b>: <span title=\"Codes:{http://hl7.org/fhir/us/davinci-deqm/CodeSystem/gaps-status open-gap}\">Open Gap</span></p><p><b>status</b>: Final</p><p><b>code</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/v3-ActCode CAREGAP}\">Caregap</span></p><p><b>patient</b>: <a href=\"Patient-gaps-patient01.html\">Parker Susan Female, DoB: 1965-01-01 ( Medical Record Number: 999995992\u00a0(use:\u00a0usual,\u00a0))</a></p><h3>Evidences</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Detail</b></td></tr><tr><td style=\"display: none\">*</td><td><a href=\"MeasureReport-gaps-indv-measurereport04.html\">MeasureReport: extension = Proportion,urn:oid:2.16.840.1.113883.3.2074.1#0015HQN9BD3304E,->Organization GapsReportingVendor01; status = complete; type = individual; measure = http://hl7.org/fhir/us/davinci-deqm/Measure/measure-exm130-example; date = 2020-07-07 13:08:52+0000; period = 2020-01-01 --> 2020-12-31; improvementNotation = Increased score indicates improvement</a></td></tr></table></div>"
},
"modifierExtension" : [
{
"url" : "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-gapStatus",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/us/davinci-deqm/CodeSystem/gaps-status",
"code" : "open-gap"
}
]
}
}
],
"status" : "final",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"code" : "CAREGAP",
"display" : "Caregap"
}
]
},
"patient" : {
🔗 "reference" : "Patient/gaps-patient01"
},
"evidence" : [
{
"detail" : [
{
🔗 "reference" : "MeasureReport/gaps-indv-measurereport04"
}
]
}
]
}
},
{
"fullUrl" : "http://example.org/fhir/gaps/MeasureReport/gaps-indv-measurereport04",
"resource" : {
"resourceType" : "MeasureReport",
"id" : "gaps-indv-measurereport04",
"meta" : {
"profile" : [
🔗 "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/indv-measurereport-deqm"
]
},
"text" : {
"status" : "extensions",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"MeasureReport_gaps-indv-measurereport04\"> </a><p class=\"res-header-id\"><b>Generated Narrative: MeasureReport gaps-indv-measurereport04</b></p><a name=\"gaps-indv-measurereport04\"> </a><a name=\"hcgaps-indv-measurereport04\"> </a><a name=\"gaps-indv-measurereport04-en-US\"> </a><p><b>DEQM Measure Scoring Extension</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/measure-scoring proportion}\">Proportion</span></p><p><b>DEQM Certification Identifier Extension</b>: <code>urn:oid:2.16.840.1.113883.3.2074.1</code>/0015HQN9BD3304E</p><p><b>DEQM Reporting Vendor Extension</b>: <a href=\"Organization-gaps-organization-reportingvendor.html\">Organization GapsReportingVendor01</a></p><p><b>status</b>: Complete</p><p><b>type</b>: Individual</p><p><b>measure</b>: <a href=\"Measure-measure-exm130-example.html\">Colorectal Cancer Screening Measure</a></p><p><b>subject</b>: <a href=\"Patient-gaps-patient01.html\">Parker Susan Female, DoB: 1965-01-01 ( Medical Record Number: 999995992\u00a0(use:\u00a0usual,\u00a0))</a></p><p><b>date</b>: 2020-07-07 13:08:52+0000</p><p><b>reporter</b>: <a href=\"Organization-gaps-organization-reportingvendor.html\">Organization GapsReportingVendor01</a></p><p><b>period</b>: 2020-01-01 --> 2020-12-31</p><p><b>improvementNotation</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/measure-improvement-notation increase}\">Increased score indicates improvement</span></p><blockquote><p><b>group</b></p><blockquote><p><b>id</b></p>group-exm130</blockquote><blockquote><p><b>population</b></p><p><b>code</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/measure-population initial-population}\">Initial Population</span></p><p><b>count</b>: 1</p></blockquote><blockquote><p><b>population</b></p><p><b>code</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/measure-population numerator}\">Numerator</span></p><p><b>count</b>: 1</p></blockquote><blockquote><p><b>population</b></p><p><b>code</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/measure-population denominator}\">Denominator</span></p><p><b>count</b>: 1</p></blockquote><blockquote><p><b>population</b></p><p><b>code</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/measure-population denominator-exclusion}\">Denominator Exclusion</span></p><p><b>count</b>: 0</p></blockquote><p><b>measureScore</b>: 1.0</p></blockquote><p><b>evaluatedResource</b>: </p><ul><li><a href=\"Encounter-gaps-encounter03.html\">Encounter: status = finished; class = ambulatory (ActCode#AMB); type = Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using time for code selection, 15-29 minutes of total time is spent on the date of the encounter.; period = 2020-07-06 07:07:00+0000 --> 2020-07-06 10:11:00+0000</a></li><li><a href=\"Patient-gaps-patient01.html\">Parker Susan Female, DoB: 1965-01-01 ( Medical Record Number: 999995992\u00a0(use:\u00a0usual,\u00a0))</a></li><li><a href=\"Procedure-gaps-procedure02.html\">Procedure Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps</a></li></ul></div>"
},
"extension" : [
{
"url" : "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-scoring",
"code" : "proportion"
}
]
}
},
{
"url" : "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-certificationIdentifier",
"valueIdentifier" : {
"system" : "urn:oid:2.16.840.1.113883.3.2074.1",
"value" : "0015HQN9BD3304E"
}
},
{
"url" : "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-reportingVendor",
"valueReference" : {
🔗 "reference" : "Organization/gaps-organization-reportingvendor"
}
}
],
"status" : "complete",
"type" : "individual",
"measure" : "http://hl7.org/fhir/us/davinci-deqm/Measure/measure-exm130-example",
"subject" : {
🔗 "reference" : "Patient/gaps-patient01"
},
"date" : "2020-07-07T13:08:52+00:00",
"reporter" : {
🔗 "reference" : "Organization/gaps-organization-reportingvendor"
},
"period" : {
"start" : "2020-01-01",
"end" : "2020-12-31"
},
"improvementNotation" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-improvement-notation",
"code" : "increase"
}
]
},
"group" : [
{
"id" : "group-exm130",
"population" : [
{
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "initial-population",
"display" : "Initial Population"
}
]
},
"count" : 1
},
{
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "numerator",
"display" : "Numerator"
}
]
},
"count" : 1
},
{
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "denominator",
"display" : "Denominator"
}
]
},
"count" : 1
},
{
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "denominator-exclusion",
"display" : "Denominator Exclusion"
}
]
},
"count" : 0
}
],
"measureScore" : {
"value" : 1.0
}
}
],
"evaluatedResource" : [
{
🔗 "extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-criteriaReference",
"valueString" : "initial-population"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-criteriaReference",
"valueString" : "denominator"
}
],
"reference" : "Encounter/gaps-encounter03"
},
{
🔗 "extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-criteriaReference",
"valueString" : "initial-population"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-criteriaReference",
"valueString" : "denominator"
}
],
"reference" : "Patient/gaps-patient01"
},
{
🔗 "extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-criteriaReference",
"valueString" : "numerator"
}
],
"reference" : "Procedure/gaps-procedure02"
}
]
}
},
{
"fullUrl" : "http://example.org/fhir/gaps/Encounter/gaps-encounter03",
"resource" : {
"resourceType" : "Encounter",
"id" : "gaps-encounter03",
"meta" : {
"profile" : [
🔗 "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Encounter_gaps-encounter03\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Encounter gaps-encounter03</b></p><a name=\"gaps-encounter03\"> </a><a name=\"hcgaps-encounter03\"> </a><a name=\"gaps-encounter03-en-US\"> </a><p><b>status</b>: Finished</p><p><b>class</b>: <a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-v3-ActCode.html#v3-ActCode-AMB\">ActCode</a> AMB: ambulatory</p><p><b>type</b>: <span title=\"Codes:{http://www.ama-assn.org/go/cpt 99202}\">Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using time for code selection, 15-29 minutes of total time is spent on the date of the encounter.</span></p><p><b>subject</b>: <a href=\"Patient-gaps-patient01.html\">Parker Susan Female, DoB: 1965-01-01 ( Medical Record Number: 999995992\u00a0(use:\u00a0usual,\u00a0))</a></p><p><b>period</b>: 2020-07-06 07:07:00+0000 --> 2020-07-06 10:11:00+0000</p></div>"
},
"status" : "finished",
"class" : {
"system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"code" : "AMB",
"display" : "ambulatory"
},
"type" : [
{
"coding" : [
{
"system" : "http://www.ama-assn.org/go/cpt",
"code" : "99202",
"display" : "Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using time for code selection, 15-29 minutes of total time is spent on the date of the encounter."
}
]
}
],
"subject" : {
🔗 "reference" : "Patient/gaps-patient01"
},
"period" : {
"start" : "2020-07-06T07:07:00-00:00",
"end" : "2020-07-06T10:11:00-00:00"
}
}
},
{
"fullUrl" : "http://example.org/fhir/gaps/Procedure/gaps-procedure02",
"resource" : {
"resourceType" : "Procedure",
"id" : "gaps-procedure02",
"meta" : {
"profile" : [
🔗 "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure"
]
},
"text" : {
"status" : "extensions",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Procedure_gaps-procedure02\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Procedure gaps-procedure02</b></p><a name=\"gaps-procedure02\"> </a><a name=\"hcgaps-procedure02\"> </a><a name=\"gaps-procedure02-en-US\"> </a><p><b>QICore Not Done Recorded</b>: 2020-07-06 09:00:00+0000</p><p><b>status</b>: Completed</p><p><b>code</b>: <span title=\"Codes:{http://www.ama-assn.org/go/cpt 45384}\">Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps</span></p><p><b>subject</b>: <a href=\"Patient-gaps-patient01.html\">Parker Susan Female, DoB: 1965-01-01 ( Medical Record Number: 999995992\u00a0(use:\u00a0usual,\u00a0))</a></p><p><b>performed</b>: 2020-07-06 08:00:00+0000 --> 2020-07-06 09:00:00+0000</p></div>"
},
"extension" : [
{
"url" : "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-recorded",
"valueDateTime" : "2020-07-06T09:00:00-00:00"
}
],
"status" : "completed",
"code" : {
"coding" : [
{
"system" : "http://www.ama-assn.org/go/cpt",
"code" : "45384",
"display" : "Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps"
}
]
},
"subject" : {
🔗 "reference" : "Patient/gaps-patient01"
},
"performedPeriod" : {
"start" : "2020-07-06T08:00:00-00:00",
"end" : "2020-07-06T09:00:00-00:00"
}
}
},
{
"fullUrl" : "http://example.org/fhir/gaps/Patient/gaps-patient01",
"resource" : {
"resourceType" : "Patient",
"id" : "gaps-patient01",
"meta" : {
"profile" : [
🔗 "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Patient_gaps-patient01\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Patient gaps-patient01</b></p><a name=\"gaps-patient01\"> </a><a name=\"hcgaps-patient01\"> </a><a name=\"gaps-patient01-en-US\"> </a><p style=\"border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;\">Parker Susan Female, DoB: 1965-01-01 ( Medical Record Number: 999995992\u00a0(use:\u00a0usual,\u00a0))</p><hr/><table class=\"grid\"><tr><td style=\"background-color: #f3f5da\" title=\"Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality. The ethnicity codes used to represent these concepts are based upon the [CDC ethnicity and Ethnicity Code Set Version 1.0](http://www.cdc.gov/phin/resources/vocabulary/index.html) which includes over 900 concepts for representing race and ethnicity of which 43 reference ethnicity. The ethnicity concepts are grouped by and pre-mapped to the 2 OMB ethnicity categories: - Hispanic or Latino - Not Hispanic or Latino.\">US Core Ethnicity Extension:</td><td colspan=\"3\"><ul><li>ombCategory: <a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-CDCREC.html#CDCREC-2135-2\">CDC Race and Ethnicity</a> 2135-2: Hispanic or Latino</li><li>text: Hispanic or Latino</li></ul></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality. The race codes used to represent these concepts are based upon the [CDC Race and Ethnicity Code Set Version 1.0](http://www.cdc.gov/phin/resources/vocabulary/index.html#3) which includes over 900 concepts for representing race and ethnicity of which 921 reference race. The race concepts are grouped by and pre-mapped to the 5 OMB race categories:\n\n - American Indian or Alaska Native\n - Asian\n - Black or African American\n - Native Hawaiian or Other Pacific Islander\n - White.\">US Core Race Extension:</td><td colspan=\"3\"><ul><li>ombCategory: <a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-CDCREC.html#CDCREC-2028-9\">CDC Race and Ethnicity</a> 2028-9: Asian</li><li>text: Asian</li></ul></td></tr></table></div>"
},
"extension" : [
{
"extension" : [
{
"url" : "ombCategory",
"valueCoding" : {
"system" : "urn:oid:2.16.840.1.113883.6.238",
"code" : "2028-9",
"display" : "Asian"
}
},
{
"url" : "text",
"valueString" : "Asian"
}
],
"url" : "http://hl7.org/fhir/us/core/StructureDefinition/us-core-race"
},
{
"extension" : [
{
"url" : "ombCategory",
"valueCoding" : {
"system" : "urn:oid:2.16.840.1.113883.6.238",
"code" : "2135-2",
"display" : "Hispanic or Latino"
}
},
{
"url" : "text",
"valueString" : "Hispanic or Latino"
}
],
"url" : "http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity"
}
],
"identifier" : [
{
"use" : "usual",
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
"code" : "MR",
"display" : "Medical Record Number"
}
]
},
"system" : "http://hospital.smarthealthit.org",
"value" : "999995992"
}
],
"name" : [
{
"family" : "Susan",
"given" : [
"Parker"
]
}
],
"gender" : "female",
"birthDate" : "1965-01-01"
}
},
{
"fullUrl" : "http://example.org/fhir/gaps/Organization/gaps-organization-reportingvendor",
"resource" : {
"resourceType" : "Organization",
"id" : "gaps-organization-reportingvendor",
"meta" : {
"profile" : [
🔗 "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-organization"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Organization_gaps-organization-reportingvendor\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Organization gaps-organization-reportingvendor</b></p><a name=\"gaps-organization-reportingvendor\"> </a><a name=\"hcgaps-organization-reportingvendor\"> </a><a name=\"gaps-organization-reportingvendor-en-US\"> </a><p><b>identifier</b>: Tax ID number/123446789\u00a0(use:\u00a0official,\u00a0)</p><p><b>active</b>: true</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/organization-type pay}\">Payer</span></p><p><b>name</b>: GapsReportingVendor01</p><p><b>telecom</b>: ph: (+1) 401-545-1212</p><p><b>address</b>: 13 Drive Street Cityplace MA 01101 USA </p></div>"
},
"identifier" : [
{
"use" : "official",
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
"code" : "TAX",
"display" : "Tax ID number"
}
]
},
"system" : "urn:oid:2.16.840.1.113883.4.4",
"value" : "123446789",
"assigner" : {
"display" : "www.irs.gov"
}
}
],
"active" : true,
"type" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/organization-type",
"code" : "pay",
"display" : "Payer"
}
]
}
],
"name" : "GapsReportingVendor01",
"telecom" : [
{
"system" : "phone",
"value" : "(+1) 401-545-1212"
}
],
"address" : [
{
"line" : [
"13 Drive Street"
],
"city" : "Cityplace",
"state" : "MA",
"postalCode" : "01101",
"country" : "USA"
}
]
}
}
]
}
IG © 2020+ HL7 International / Clinical Quality Information. Package hl7.fhir.us.davinci-deqm#5.0.0 based on FHIR 4.0.1. Generated 2024-10-21
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