Data Exchange For Quality Measures STU3 for FHIR R4
3.0.0 - CI Build

Data Exchange For Quality Measures STU3 for FHIR R4, published by HL7 International - Clinical Quality Information Work Group. This is not an authorized publication; it is the continuous build for version 3.0.0). This version is based on the current content of https://github.com/HL7/davinci-deqm/ and changes regularly. See the Directory of published versions

Medication Reconciliation Post-Discharge (MRP)

Introduction

The Medication Reconciliation Use Case defines the process by which the MRP Measure data can be exchanged between a provider acting in the role of the Producer to a Payer which is acting in the role of the Consumer. MRP Measure is an attestation that a medication reconciliation post-discharge was performed on a covered member. This use case covers both the request to send attestation information and the unsolicited submission of that data.

MRP Use Case Background

In the case of medication reconciliation after discharge from the hospital, the patient’s discharge medication(s) is compared with the medication(s) the patient was taking prior to hospitalization. This can avoid medication errors such as omissions, duplications, dosing errors or drug interactions, and should be done at every transition of care in which new medications are ordered or existing orders are rewritten. This attestation message is intended to be performed by the next provider where the patient returns for follow-up and can then be used by the payer to show compliance for the HEDIS measure Medication Reconciliation Post-Discharge. (Any necessary documentation will also be put in the record)

In the past, attestation to the reconciliation had been done by posting a CPT Category II code on a claim typically for a small monetary amount that was then denied by the payer and had to be written off by the provider. This is a cumbersome process and most providers are no longer doing this.

Proof of 30 day medication reconciliations is increasingly required for value based care incentives.  Providers and care coordinators face the challenge of collecting accurate and complete patient medication records across care settings. Today’s manual and ad hoc processes are costly and will not scale. Payers and providers need common standards to share the data required to complete medication reconciliation at all transitions of care, for care management plans, and during medication changes. Vendors are actively leveraging FHIR resources to improve partner’s access to patient medication history by unlocking existing silos of this critical data from vendor systems, healthcare operations systems and provider EHRs.

Note that the exchange of the reconciled medication list, indication of conversations with the patient, and notification of discharge from inpatient systems are out of scope for this version of the use case.

FHIR Resource Overview

Resources supported for this Use Case

Resource Type Profile Name Link to Profile
Coverage QI Core Coverage Profile QI Core Coverage
Encounter QI Core Encounter Profile QI Core Encounter
Location QI Core Location Profile QI Core Location
Library CQFM Library Profile CQFM Library
Measure CQFM Measure Profile CQFM Measure
MeasureReport DEQM Data Exchange MeasureReport Profile DEQM Data Exchange MeasureReport Profile
MeasureReport DEQM Individual MeasureReport Profile DEQM Individual MeasureReport Profile
MeasureReport DEQM Summary MeasureReport Profile DEQM Summary MeasureReport Profile
Observation QI Core Observation Profile QI Core Observation
Organization DEQM Organization Profile1 DEQM Organization
Patient QI Core Patient Profile QI Core Patient
Practitioner DEQM Practitioner Profile1 DEQM Practitioner
Task QI Core Task Profile QI Core Task

Graph of MRP Resources

For MRP either a Task resource or an Observation resource can be used as the primary resource for evaluating the measure. The Task resource is more appropriate to represent an administrative activity that can be performed and the state of completion of that activity tracked. In the case where systems do not support Task, Observation can be used to track the status of the process. The table below compares how the activity is represented

Data element Task Observation
The activity Task.code Observation.code
The state of completion Task.status Observation.valueBoolean(= “true” for complete) + Observation.status
Figure 3-1 MRP Using Task
mrp-task.png

Figure 3-2 MRP Using Observation
mrp-observation.png

MRP Data Exchange Interactions

In the following interactions, the Provider is acting in the role of the Producer and the Payer (“Aggregator”) is acting in the role of the Consumer.

Gather Data Requirements from Payer

In this optional step, the Provider queries the Payer (“Aggregator”) for which resources are needed for MRP measure reporting. Note that instead of using this API, the measure definition can be reviewed manually to determine what data needs to be submitted.

Example

Scenario

Provider X acting in the role of the Producer requests data requirements for the MRP measure from Payer Z which is acting in the role of Consumer. A Library resource containing the required resources for MRP attestation returned on successful evaluation.

Request using GET

GET [base]/Measure/measure-mrp/$data-requirements?periodStart=2018&periodEnd=2018

Request using POST

POST [base]/Measure/measure-mrp/$data-requirements

Request body

{
   "resourceType":"Parameters",
   "parameter":[
      {
         "name":"periodStart",
         "valueDate":"2018"
      },
      {
         "name":"periodEnd",
         "valueDate":"2018"
      }
    ]
 }

Response

HTTP/1.1 200 OK
[other headers]

Response body

{
  "resourceType": "Library",
  "id": "library-mrp-example",
  "meta": {
    "source": "http://example.org/fhir/server"
  },
  "text": {
    "status": "generated",
    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h2>Data Requirements</h2><table class=\"grid\"><tr><td colspan=\"2\"><b>Type</b>: <a href=\"http://hl7.org/fhir/R4/measurereport.html\">MeasureReport</a> (<a href=\"StructureDefinition-datax-measurereport-deqm.html\">DEQM Data Exchange MeasureReport Profile</a>)</td></tr></table><table class=\"grid\"><tr><td colspan=\"2\"><b>Type</b>: <a href=\"http://hl7.org/fhir/R4/patient.html\">Patient</a> (<a href=\"http://hl7.org/fhir/us/qicore/STU4/StructureDefinition-qicore-patient.html\">QICorePatient</a>)</td></tr></table><table class=\"grid\"><tr><td colspan=\"2\"><b>Type</b>: <a href=\"http://hl7.org/fhir/R4/encounter.html\">Encounter</a> (<a href=\"http://hl7.org/fhir/us/qicore/STU4/StructureDefinition-qicore-encounter.html\">QICoreEncounter</a>)</td></tr></table><table class=\"grid\"><tr><td colspan=\"2\"><b>Type</b>: <a href=\"http://hl7.org/fhir/R4/location.html\">Location</a> (<a href=\"http://hl7.org/fhir/us/qicore/STU4/StructureDefinition-qicore-location.html\">QICoreLocation</a>)</td></tr></table><table class=\"grid\"><tr><td colspan=\"2\"><b>Type</b>: <a href=\"http://hl7.org/fhir/R4/task.html\">Task</a> (<a href=\"http://hl7.org/fhir/us/qicore/STU4/StructureDefinition-qicore-task.html\">QICoreTask</a>)</td></tr></table><table class=\"grid\"><tr><td colspan=\"2\"><b>Type</b>: <a href=\"http://hl7.org/fhir/R4/organization.html\">Organization</a> (<a href=\"StructureDefinition-organization-deqm.html\">DEQM Organization Profile</a>)</td></tr></table><table class=\"grid\"><tr><td colspan=\"2\"><b>Type</b>: <a href=\"http://hl7.org/fhir/R4/practitioner.html\">Practitioner</a> (<a href=\"StructureDefinition-practitioner-deqm.html\">DEQM Practitioner Profile</a>)</td></tr></table><h2>Contents</h2></div>"
  },
  "url": "http://hl7.org/fhir/us/davinci-deqm/Library/library-mrp-example",
  "version": "3.0.0",
  "name": "DEQMLibraryMRPExample",
  "title": "DEQM Library MRP Example",
  "status": "active",
  "type": {
    "coding": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/library-type",
        "code": "module-definition"
      }
    ]
  },
  "date": "2021-10-12T21:43:31+00:00",
  "publisher": "HL7 International - Clinical Quality Information Work Group",
  "contact": [
    {
      "telecom": [
        {
          "system": "url",
          "value": "http://www.hl7.org/Special/committees/cqi/index.cfm"
        }
      ]
    }
  ],
  "description": "Example Library resource to demonstrate the framework for MRP",
  "jurisdiction": [
    {
      "coding": [
        {
          "system": "urn:iso:std:iso:3166",
          "code": "US"
        }
      ]
    }
  ],
  "dataRequirement": [
    {
      "type": "MeasureReport",
      "profile": [
        "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/datax-measurereport-deqm"
      ]
    },
    {
      "type": "Patient",
      "profile": [
        "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"
      ]
    },
    {
      "type": "Encounter",
      "profile": [
        "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"
      ]
    },
    {
      "type": "Location",
      "profile": [
        "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-location"
      ]
    },
    {
      "type": "Task",
      "profile": [
        "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-task"
      ]
    },
    {
      "type": "Organization",
      "profile": [
        "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/organization-deqm"
      ]
    },
    {
      "type": "Practitioner",
      "profile": [
        "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/practitioner-deqm"
      ]
    }
  ]
}

Data Exchange Using the Submit Data Operation

The Provider will use the Submit Data operation to submit a MeasureReport and the referenced resources required by the payers as supporting evidence to provide the MRP attestation to the Payer. Note that the Collect Data and Subscription Operations are not supported for this use case.

The technical Workflow is outlined in the following figure. The parts outlined in orange are the actual FHIR transactions that are the focus of this Guide and are described in detail in the following sections:

Figure 3-3 Submit Data Technical Workflow
MRP_Technical_Workflow.jpg

Examples

Scenario:

Provider X acting in the role of Producer submits MRP data for Patient Y to Payer Z who is acting in the role of Consumer. The body of the request is a Parameters resource containing the required profiles for MRP attestation using Task as the resource used to evaluate the measure. An HTTP Status success code is returned on successful submission.

Request using POST

POST [base]/Measure/measure-mrp/$submit-data

Request body

{
  "resourceType": "Parameters",
  "id": "mrp-submit-task",
  "meta": {
    "source": "http://example.org/fhir/server"
  },
  "parameter": [
    {
      "name": "measureReport",
      "resource": {
        "resourceType": "MeasureReport",
        "id": "datax-measurereport01",
        "meta": {
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/datax-measurereport-deqm"
          ]
        },
        "extension": [
          {
            "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-softwaresystem",
            "valueReference": {
              "reference": "Device/deqm-software-system-example"
            }
          },
          {
            "url": "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-submitDataUpdateType",
            "valueCode": "incremental"
          }
        ],
        "status": "complete",
        "type": "data-collection",
        "measure": "http://hl7.org/fhir/us/davinci-deqm/Measure/measure-mrp-example",
        "subject": {
          "reference": "Patient/patient01"
        },
        "date": "2018-09-05T16:59:52.404Z",
        "reporter": {
          "reference": "Organization/organization01"
        },
        "period": {
          "start": "2018-08-01",
          "end": "2018-09-01"
        },
        "evaluatedResource": [
          {
            "reference": "Task/task01"
          }
        ]
      }
    },
    {
      "name": "resource",
      "resource": {
        "resourceType": "Patient",
        "id": "patient01",
        "meta": {
          "versionId": "5",
          "lastUpdated": "2019-02-11T14:19:25.000+00:00",
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"
          ]
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><div class=\"hapiHeaderText\">Jairo <b>WEBSTER </b></div><table class=\"hapiPropertyTable\"><tbody><tr><td>Identifier</td><td>12345</td></tr><tr><td>Address</td><td><span>7496 Beaver Ridge Ave </span><br/><span>Thornton </span><span>NJ </span><span>USA </span></td></tr><tr><td>Date of birth</td><td><span>16 December 1946</span></td></tr></tbody></table></div>"
        },
        "extension": [
          {
            "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex",
            "valueCode": "M"
          },
          {
            "extension": [
              {
                "url": "ombCategory",
                "valueCoding": {
                  "system": "urn:oid:2.16.840.1.113883.6.238",
                  "code": "2106-3",
                  "display": "White"
                }
              },
              {
                "url": "text",
                "valueString": "White"
              }
            ],
            "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": "2186-5",
                  "display": "Not Hispanic or Latino"
                }
              },
              {
                "url": "text",
                "valueString": "Not 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.davinci.org",
            "value": "12345"
          }
        ],
        "active": true,
        "name": [
          {
            "use": "official",
            "family": "Webster",
            "given": [
              "Jairo"
            ]
          }
        ],
        "gender": "male",
        "birthDate": "1946-12-16",
        "deceasedBoolean": false,
        "address": [
          {
            "use": "home",
            "line": [
              "7496 Beaver Ridge Ave"
            ],
            "city": "Thornton",
            "state": "NJ",
            "postalCode": "07003",
            "country": "USA"
          }
        ],
        "maritalStatus": {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus",
              "code": "M",
              "display": "Married"
            }
          ]
        },
        "communication": [
          {
            "language": {
              "coding": [
                {
                  "system": "urn:ietf:bcp:47",
                  "code": "en-US",
                  "display": "English (Region=United States)"
                }
              ]
            },
            "preferred": true
          }
        ],
        "managingOrganization": {
          "reference": "Organization/organization01"
        }
      }
    },
    {
      "name": "resource",
      "resource": {
        "resourceType": "Task",
        "id": "Task01",
        "meta": {
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-task"
          ]
        },
        "identifier": [
          {
            "system": "http://example.org/tasks",
            "value": "19009"
          }
        ],
        "status": "completed",
        "intent": "plan",
        "priority": "routine",
        "code": {
          "coding": [
            {
              "system": "http://www.ama-assn.org/go/cpt",
              "code": "1111F",
              "display": "Medication Reconciliation"
            }
          ]
        },
        "for": {
          "reference": "Patient/patient01"
        },
        "encounter": {
          "reference": "Encounter/encounter01"
        },
        "executionPeriod": {
          "start": "2017-06-11",
          "end": "2017-06-11"
        },
        "authoredOn": "2018-09-25T14:24:23.584Z",
        "owner": {
          "reference": "Practitioner/practitioner01"
        }
      }
    },
    {
      "name": "resource",
      "resource": {
        "resourceType": "Practitioner",
        "id": "practitioner01",
        "meta": {
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/practitioner-deqm"
          ]
        },
        "identifier": [
          {
            "use": "official",
            "type": {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                  "code": "PRN",
                  "display": "Provider number"
                }
              ]
            },
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "456789123"
          }
        ],
        "active": true,
        "name": [
          {
            "family": "Hale",
            "given": [
              "Cody"
            ],
            "suffix": [
              "MD"
            ]
          }
        ],
        "gender": "male"
      }
    },
    {
      "name": "resource",
      "resource": {
        "resourceType": "Encounter",
        "id": "encounter01",
        "meta": {
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"
          ]
        },
        "status": "finished",
        "class": {
          "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
          "code": "IMP",
          "display": "inpatient encounter"
        },
        "type": [
          {
            "coding": [
              {
                "system": "http://snomed.info/sct",
                "code": "56876005",
                "display": "Drug rehabilitation and detoxification"
              }
            ]
          }
        ],
        "subject": {
          "reference": "Patient/patient01",
          "display": "Jairo Webster"
        },
        "period": {
          "start": "2018-05-29T11:00:00-04:00",
          "end": "2018-05-29T11:00:00-04:00"
        },
        "hospitalization": {
          "dischargeDisposition": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/discharge-disposition",
                "code": "home",
                "display": "Home"
              }
            ]
          }
        }
      }
    },
    {
      "name": "resource",
      "resource": {
        "resourceType": "Coverage",
        "id": "coverage01",
        "meta": {
          "versionId": "2",
          "lastUpdated": "2019-02-11T14:19:25.000+00:00",
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/coverage-deqm"
          ]
        },
        "status": "active",
        "policyHolder": {
          "reference": "Patient/patient01"
        },
        "subscriber": {
          "reference": "Patient/patient01"
        },
        "subscriberId": "A123456789",
        "beneficiary": {
          "reference": "Patient/patient01"
        },
        "relationship": {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
              "code": "self"
            }
          ]
        },
        "payor": [
          {
            "reference": "Organization/organization04"
          }
        ]
      }
    },
    {
      "name": "resource",
      "resource": {
        "resourceType": "Location",
        "id": "location01",
        "meta": {
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-location"
          ]
        },
        "name": "DaVinciClinic01",
        "address": {
          "line": [
            "102 Heritage Dr."
          ],
          "city": "Somerset",
          "state": "NJ",
          "postalCode": "08873",
          "country": "USA"
        }
      }
    },
    {
      "name": "resource",
      "resource": {
        "resourceType": "Organization",
        "id": "organization01",
        "meta": {
          "versionId": "4",
          "lastUpdated": "2019-02-21T01:47:54.000+00:00",
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/organization-deqm"
          ]
        },
        "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": "123456789",
            "assigner": {
              "display": "www.irs.gov"
            }
          }
        ],
        "active": true,
        "type": [
          {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/organization-type",
                "code": "prov",
                "display": "Healthcare Provider"
              }
            ]
          }
        ],
        "name": "DaVinciHospital01",
        "telecom": [
          {
            "system": "phone",
            "value": "(+1) 401-555-1212"
          }
        ],
        "address": [
          {
            "line": [
              "73 Lakewood Street"
            ],
            "city": "Warwick",
            "state": "RI",
            "postalCode": "02886",
            "country": "USA"
          }
        ]
      }
    },
    {
      "name": "resource",
      "resource": {
        "resourceType": "Organization",
        "id": "organization02",
        "meta": {
          "versionId": "3",
          "lastUpdated": "2019-03-06T19:03:03.000+00:00",
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/organization-deqm"
          ]
        },
        "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": "234567891",
            "assigner": {
              "display": "www.irs.gov"
            }
          }
        ],
        "active": true,
        "type": [
          {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/organization-type",
                "code": "prov",
                "display": "Healthcare Provider"
              }
            ]
          }
        ],
        "name": "DaVinciHospital02",
        "telecom": [
          {
            "system": "phone",
            "value": "(+1) 551-555-1212"
          }
        ],
        "address": [
          {
            "line": [
              "3 Sherwood St."
            ],
            "city": "Englewood",
            "state": "NJ",
            "postalCode": "07631",
            "country": "USA"
          }
        ]
      }
    },
    {
      "name": "resource",
      "resource": {
        "resourceType": "Organization",
        "id": "organization04",
        "meta": {
          "versionId": "4",
          "lastUpdated": "2019-03-06T19:03:03.000+00:00",
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/organization-deqm"
          ]
        },
        "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": "456789123",
            "assigner": {
              "display": "www.irs.gov"
            }
          }
        ],
        "active": true,
        "type": [
          {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/organization-type",
                "code": "ins",
                "display": "Insurance Company"
              }
            ]
          }
        ],
        "name": "DVPayer04",
        "telecom": [
          {
            "system": "phone",
            "value": "(+1) 616-555-1212"
          }
        ],
        "address": [
          {
            "line": [
              "160 Glen Eagles Road"
            ],
            "city": "Grand Rapids",
            "state": "MI",
            "postalCode": "49503",
            "country": "USA"
          }
        ]
      }
    }
  ]
}

Response

HTTP/1.1 200 OK
[other headers]

Examples

Scenario:

Provider X acting in the role of Producer submits MRP data for Patient Y to Payer Z who is acting in the role of Consumer. The body of the request is a Parameters resource containing the required profiles for MRP attestation using Observation as the resource used to evaluate the measure. An HTTP Status success code is returned on successful submission.

Request using POST

POST [base]/Measure/measure-mrp/$submit-data

Request body

{
  "resourceType": "Parameters",
  "id": "mrp-submit-obs",
  "meta": {
    "source": "http://example.org/fhir/server"
  },
  "parameter": [
    {
      "name": "measureReport",
      "resource": {
        "resourceType": "MeasureReport",
        "id": "datax-measurereport02",
        "meta": {
          "versionId": "1",
          "lastUpdated": "2018-09-05T16:59:53.000+00:00",
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/datax-measurereport-deqm"
          ]
        },
        "extension": [
          {
            "url": "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-submitDataUpdateType",
            "valueCode": "incremental"
          }
        ],
        "status": "complete",
        "type": "data-collection",
        "measure": "http://hl7.org/fhir/us/davinci-deqm/Measure/measure-mrp-example",
        "subject": {
          "reference": "Patient/patient02"
        },
        "date": "2018-09-05T16:59:52.404Z",
        "reporter": {
          "reference": "Organization/organization01"
        },
        "period": {
          "start": "2018-08-01",
          "end": "2018-09-01"
        },
        "evaluatedResource": [
          {
            "reference": "Observation/observation01"
          }
        ]
      }
    },
    {
      "name": "resource",
      "resource": {
        "resourceType": "Patient",
        "id": "patient01",
        "meta": {
          "versionId": "5",
          "lastUpdated": "2019-02-11T14:19:25.000+00:00",
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"
          ]
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><div class=\"hapiHeaderText\">Jairo <b>WEBSTER </b></div><table class=\"hapiPropertyTable\"><tbody><tr><td>Identifier</td><td>12345</td></tr><tr><td>Address</td><td><span>7496 Beaver Ridge Ave </span><br/><span>Thornton </span><span>NJ </span><span>USA </span></td></tr><tr><td>Date of birth</td><td><span>16 December 1946</span></td></tr></tbody></table></div>"
        },
        "extension": [
          {
            "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex",
            "valueCode": "M"
          },
          {
            "extension": [
              {
                "url": "ombCategory",
                "valueCoding": {
                  "system": "urn:oid:2.16.840.1.113883.6.238",
                  "code": "2106-3",
                  "display": "White"
                }
              },
              {
                "url": "text",
                "valueString": "White"
              }
            ],
            "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": "2186-5",
                  "display": "Not Hispanic or Latino"
                }
              },
              {
                "url": "text",
                "valueString": "Not 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.davinci.org",
            "value": "12345"
          }
        ],
        "active": true,
        "name": [
          {
            "use": "official",
            "family": "Webster",
            "given": [
              "Jairo"
            ]
          }
        ],
        "gender": "male",
        "birthDate": "1946-12-16",
        "deceasedBoolean": false,
        "address": [
          {
            "use": "home",
            "line": [
              "7496 Beaver Ridge Ave"
            ],
            "city": "Thornton",
            "state": "NJ",
            "postalCode": "07003",
            "country": "USA"
          }
        ],
        "maritalStatus": {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus",
              "code": "M",
              "display": "Married"
            }
          ]
        },
        "communication": [
          {
            "language": {
              "coding": [
                {
                  "system": "urn:ietf:bcp:47",
                  "code": "en-US",
                  "display": "English (Region=United States)"
                }
              ]
            },
            "preferred": true
          }
        ],
        "managingOrganization": {
          "reference": "Organization/organization01"
        }
      }
    },
    {
      "name": "resource",
      "resource": {
        "resourceType": "Observation",
        "id": "observation01",
        "meta": {
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation"
          ]
        },
        "status": "final",
        "category": [
          {
            "coding": [
              {
                "system": "http://example.org/CodeSystem/observation-category",
                "code": "measure",
                "display": "Measure"
              }
            ]
          }
        ],
        "code": {
          "coding": [
            {
              "system": "http://www.ama-assn.org/go/cpt",
              "code": "1111F",
              "display": "Medication Reconciliation"
            }
          ]
        },
        "subject": {
          "reference": "Patient/patient01"
        },
        "encounter": {
          "reference": "Encounter/encounter01"
        },
        "effectiveDateTime": "2018-09-29T14:15:04.424Z",
        "issued": "2018-09-29T14:15:04.424Z",
        "performer": [
          {
            "reference": "Practitioner/practitioner01"
          }
        ],
        "valueBoolean": true
      }
    },
    {
      "name": "resource",
      "resource": {
        "resourceType": "Practitioner",
        "id": "practitioner01",
        "meta": {
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/practitioner-deqm"
          ]
        },
        "identifier": [
          {
            "use": "official",
            "type": {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                  "code": "PRN",
                  "display": "Provider number"
                }
              ]
            },
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "456789123"
          }
        ],
        "active": true,
        "name": [
          {
            "family": "Hale",
            "given": [
              "Cody"
            ],
            "suffix": [
              "MD"
            ]
          }
        ],
        "gender": "male"
      }
    },
    {
      "name": "resource",
      "resource": {
        "resourceType": "Encounter",
        "id": "encounter01",
        "meta": {
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"
          ]
        },
        "status": "finished",
        "class": {
          "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
          "code": "IMP",
          "display": "inpatient encounter"
        },
        "type": [
          {
            "coding": [
              {
                "system": "http://snomed.info/sct",
                "code": "56876005",
                "display": "Drug rehabilitation and detoxification"
              }
            ]
          }
        ],
        "subject": {
          "reference": "Patient/patient01",
          "display": "Jairo Webster"
        },
        "period": {
          "start": "2018-05-29T11:00:00-04:00",
          "end": "2018-05-29T11:00:00-04:00"
        },
        "hospitalization": {
          "dischargeDisposition": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/discharge-disposition",
                "code": "home",
                "display": "Home"
              }
            ]
          }
        }
      }
    },
    {
      "name": "resource",
      "resource": {
        "resourceType": "Coverage",
        "id": "coverage01",
        "meta": {
          "versionId": "2",
          "lastUpdated": "2019-02-11T14:19:25.000+00:00",
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/coverage-deqm"
          ]
        },
        "status": "active",
        "policyHolder": {
          "reference": "Patient/patient01"
        },
        "subscriber": {
          "reference": "Patient/patient01"
        },
        "subscriberId": "A123456789",
        "beneficiary": {
          "reference": "Patient/patient01"
        },
        "relationship": {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
              "code": "self"
            }
          ]
        },
        "payor": [
          {
            "reference": "Organization/organization04"
          }
        ]
      }
    },
    {
      "name": "resource",
      "resource": {
        "resourceType": "Location",
        "id": "location01",
        "meta": {
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-location"
          ]
        },
        "name": "DaVinciClinic01",
        "address": {
          "line": [
            "102 Heritage Dr."
          ],
          "city": "Somerset",
          "state": "NJ",
          "postalCode": "08873",
          "country": "USA"
        }
      }
    },
    {
      "name": "resource",
      "resource": {
        "resourceType": "Organization",
        "id": "organization01",
        "meta": {
          "versionId": "4",
          "lastUpdated": "2019-02-21T01:47:54.000+00:00",
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/organization-deqm"
          ]
        },
        "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": "123456789",
            "assigner": {
              "display": "www.irs.gov"
            }
          }
        ],
        "active": true,
        "type": [
          {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/organization-type",
                "code": "prov",
                "display": "Healthcare Provider"
              }
            ]
          }
        ],
        "name": "DaVinciHospital01",
        "telecom": [
          {
            "system": "phone",
            "value": "(+1) 401-555-1212"
          }
        ],
        "address": [
          {
            "line": [
              "73 Lakewood Street"
            ],
            "city": "Warwick",
            "state": "RI",
            "postalCode": "02886",
            "country": "USA"
          }
        ]
      }
    },
    {
      "name": "resource",
      "resource": {
        "resourceType": "Organization",
        "id": "organization02",
        "meta": {
          "versionId": "3",
          "lastUpdated": "2019-03-06T19:03:03.000+00:00",
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/organization-deqm"
          ]
        },
        "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": "234567891",
            "assigner": {
              "display": "www.irs.gov"
            }
          }
        ],
        "active": true,
        "type": [
          {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/organization-type",
                "code": "prov",
                "display": "Healthcare Provider"
              }
            ]
          }
        ],
        "name": "DaVinciHospital02",
        "telecom": [
          {
            "system": "phone",
            "value": "(+1) 551-555-1212"
          }
        ],
        "address": [
          {
            "line": [
              "3 Sherwood St."
            ],
            "city": "Englewood",
            "state": "NJ",
            "postalCode": "07631",
            "country": "USA"
          }
        ]
      }
    },
    {
      "name": "resource",
      "resource": {
        "resourceType": "Organization",
        "id": "organization04",
        "meta": {
          "versionId": "4",
          "lastUpdated": "2019-03-06T19:03:03.000+00:00",
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/organization-deqm"
          ]
        },
        "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": "456789123",
            "assigner": {
              "display": "www.irs.gov"
            }
          }
        ],
        "active": true,
        "type": [
          {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/organization-type",
                "code": "ins",
                "display": "Insurance Company"
              }
            ]
          }
        ],
        "name": "DVPayer04",
        "telecom": [
          {
            "system": "phone",
            "value": "(+1) 616-555-1212"
          }
        ],
        "address": [
          {
            "line": [
              "160 Glen Eagles Road"
            ],
            "city": "Grand Rapids",
            "state": "MI",
            "postalCode": "49503",
            "country": "USA"
          }
        ]
      }
    }
  ]
}

Response

HTTP/1.1 200 OK
[other headers]

MRP Measure Reporting Interactions

In the following interactions, The Payer (“Aggregator”) is acting in the role of the Reporter.

Individual MeasureReport

The Payer (“Aggregator”) pushes the Bundle of supporting resources with the MRP Individual MeasureReport Bundle to the Receiver.

Figure 3-4 Individual Reporting Technical Workflow
mrp_indv_report.jpg

Examples

Scenario:

Payer X who is acting in the role of a Reporter submits a MRP Individual Report for Patient P to Receiver Z. The body of the request is a transaction bundle including the Individual MeasureReport and Task resources all the related resources containing the relevant data used to compute the CQM criteria. An HTTP Status success code and a transaction-response Bundle is returned on successful submission.

POST Summary Report

POST [base]

Request body

{
  "resourceType": "Bundle",
  "id": "single-indv-mrp-task-report",
  "meta": {
    "source": "http://example.org/fhir/server"
  },
  "type": "transaction",
  "timestamp": "2019-12-06T06:28:16.152480Z",
  "entry": [
    {
      "fullUrl": "urn:uuid:97e6dbd2-17f1-11ea-82fa-4ccc6a181ed3",
      "resource": {
        "resourceType": "MeasureReport",
        "id": "urn:uuid:97e6dbd2-17f1-11ea-82fa-4ccc6a181ed3",
        "meta": {
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/indv-measurereport-deqm"
          ]
        },
        "text": {
          "status": "extensions",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><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>: id: 0015HQN9BD3304E</p><p><b>DEQM Reporting Vendor Extension</b>: <a href=\"Organization-organization02.html\">Generated Summary: Tax ID number: 234567891 (OFFICIAL); active: true; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/organization-type prov}\">Healthcare Provider</span>; name: DaVinciHospital02; Phone: (+1) 551-555-1212</a></p><p><b>status</b>: complete</p><p><b>type</b>: individual</p><p><b>measure</b>: <a href=\"http://hl7.org/fhir/us/davinci-deqm/Measure/measure-mrp-example\">http://hl7.org/fhir/us/davinci-deqm/Measure/measure-mrp-example</a></p><p><b>subject</b>: <a href=\"#urnuuid6f0cef31-2235-4d66-82e2-fa861fc909a8\">See above (Patient/null)</a></p><p><b>date</b>: Sep 5, 2018, 4:59:52 PM</p><p><b>reporter</b>: <a href=\"#urnuuidebc3f5c4-6700-34af-8323-85621c313726\">See above (Organization/null)</a></p><p><b>period</b>: 2018-08-01 --&gt; 2018-09-01</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><p><b>code</b>: <span title=\"Codes: {http://example.org/fhir/ mrp-group}\">MRP Group</span></p><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><p><b>measureScore</b>: 1</p></blockquote><p><b>evaluatedResource</b>: <a href=\"#urnuuid97e702cc-17f1-11ea-8b65-4ccc6a181ed3\">See above (Task/null)</a></p></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/organization02"
            }
          }
        ],
        "status": "complete",
        "type": "individual",
        "measure": "http://hl7.org/fhir/us/davinci-deqm/Measure/measure-mrp-example",
        "subject": {
          "reference": "urn:uuid:6f0cef31-2235-4d66-82e2-fa861fc909a8"
        },
        "date": "2018-09-05T16:59:52.404Z",
        "reporter": {
          "reference": "urn:uuid:ebc3f5c4-6700-34af-8323-85621c313726"
        },
        "period": {
          "start": "2018-08-01",
          "end": "2018-09-01"
        },
        "improvementNotation": {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/measure-improvement-notation",
              "code": "increase",
              "display": "Increased score indicates improvement"
            }
          ]
        },
        "group": [
          {
            "code": {
              "coding": [
                {
                  "system": "http://example.org/fhir/",
                  "code": "mrp-group",
                  "display": "MRP Group"
                }
              ],
              "text": "MRP Group"
            },
            "population": [
              {
                "id": "initial-population",
                "code": {
                  "coding": [
                    {
                      "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                      "code": "initial-population",
                      "display": "Initial Population"
                    }
                  ]
                },
                "count": 1
              },
              {
                "id": "numerator",
                "code": {
                  "coding": [
                    {
                      "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                      "code": "numerator",
                      "display": "Numerator"
                    }
                  ]
                },
                "count": 1
              },
              {
                "id": "denominator",
                "code": {
                  "coding": [
                    {
                      "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                      "code": "denominator",
                      "display": "Denominator"
                    }
                  ]
                },
                "count": 1
              }
            ],
            "measureScore": {
              "value": 1
            }
          }
        ],
        "evaluatedResource": [
          {
            "reference": "urn:uuid:97e702cc-17f1-11ea-8b65-4ccc6a181ed3"
          }
        ]
      },
      "request": {
        "method": "POST",
        "url": "MeasureReport"
      }
    },
    {
      "fullUrl": "urn:uuid:97e702cc-17f1-11ea-8b65-4ccc6a181ed3",
      "resource": {
        "resourceType": "Task",
        "meta": {
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-task"
          ]
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>identifier</b>: id: 19009</p><p><b>status</b>: completed</p><p><b>intent</b>: plan</p><p><b>priority</b>: routine</p><p><b>code</b>: <span title=\"Codes: {http://www.ama-assn.org/go/cpt 1111F}\">Medication Reconciliation</span></p><p><b>for</b>: <a href=\"#urnuuid6f0cef31-2235-4d66-82e2-fa861fc909a8\">See above (Patient/null)</a></p><p><b>encounter</b>: <a href=\"#urnuuid1f33ae07-0891-4c2a-a376-fcd18800cb71\">See above (Encounter/null)</a></p><p><b>executionPeriod</b>: 2017-06-11 --&gt; 2017-06-11</p><p><b>authoredOn</b>: Sep 25, 2018, 2:24:23 PM</p><p><b>owner</b>: <a href=\"#urnuuid0000016d-235f-39b3-0000-0000000000fa\">See above (Practitioner/null)</a></p></div>"
        },
        "identifier": [
          {
            "system": "http://example.org/fhir/",
            "value": "19009"
          }
        ],
        "status": "completed",
        "intent": "plan",
        "priority": "routine",
        "code": {
          "coding": [
            {
              "system": "http://www.ama-assn.org/go/cpt",
              "code": "1111F",
              "display": "Medication Reconciliation"
            }
          ]
        },
        "for": {
          "reference": "urn:uuid:6f0cef31-2235-4d66-82e2-fa861fc909a8"
        },
        "encounter": {
          "reference": "urn:uuid:1f33ae07-0891-4c2a-a376-fcd18800cb71"
        },
        "executionPeriod": {
          "start": "2017-06-11",
          "end": "2017-06-11"
        },
        "authoredOn": "2018-09-25T14:24:23.584Z",
        "owner": {
          "reference": "urn:uuid:0000016d-235f-39b3-0000-0000000000fa"
        }
      },
      "request": {
        "method": "POST",
        "url": "Task"
      }
    },
    {
      "fullUrl": "urn:uuid:97e729ba-17f1-11ea-ae32-4ccc6a181ed3",
      "resource": {
        "resourceType": "Coverage",
        "meta": {
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/coverage-deqm"
          ]
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>status</b>: active</p><p><b>policyHolder</b>: <a href=\"#urnuuid6f0cef31-2235-4d66-82e2-fa861fc909a8\">See above (Patient/null)</a></p><p><b>subscriber</b>: <a href=\"#urnuuid6f0cef31-2235-4d66-82e2-fa861fc909a8\">See above (Patient/null)</a></p><p><b>subscriberId</b>: A123456789</p><p><b>beneficiary</b>: <a href=\"#urnuuid6f0cef31-2235-4d66-82e2-fa861fc909a8\">See above (Patient/null)</a></p><p><b>relationship</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/subscriber-relationship self}\">Self</span></p><p><b>payor</b>: <a href=\"#urnuuid97e750b7-17f1-11ea-b4af-4ccc6a181ed3\">See above (Organization/null)</a></p></div>"
        },
        "status": "active",
        "policyHolder": {
          "reference": "urn:uuid:6f0cef31-2235-4d66-82e2-fa861fc909a8"
        },
        "subscriber": {
          "reference": "urn:uuid:6f0cef31-2235-4d66-82e2-fa861fc909a8"
        },
        "subscriberId": "A123456789",
        "beneficiary": {
          "reference": "urn:uuid:6f0cef31-2235-4d66-82e2-fa861fc909a8"
        },
        "relationship": {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
              "code": "self"
            }
          ]
        },
        "payor": [
          {
            "reference": "urn:uuid:97e750b7-17f1-11ea-b4af-4ccc6a181ed3"
          }
        ]
      },
      "request": {
        "method": "POST",
        "url": "Coverage"
      }
    },
    {
      "fullUrl": "urn:uuid:97e750b6-17f1-11ea-89ea-4ccc6a181ed3",
      "resource": {
        "resourceType": "Organization",
        "meta": {
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/organization-deqm"
          ]
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>identifier</b>: Tax ID number: 456789124 (OFFICIAL)</p><p><b>active</b>: true</p><p><b>type</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/organization-type other}\">Other</span></p><p><b>name</b>: DV Quality Measure Data Reporter</p><p><b>telecom</b>: ph: (+1) 616-555-1212</p><p><b>address</b>: 160 Glen Eagles Road Grand Rapids MI 49503 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": "456789124",
            "assigner": {
              "display": "www.irs.gov"
            }
          }
        ],
        "active": true,
        "type": [
          {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/organization-type",
                "code": "other",
                "display": "Other"
              }
            ]
          }
        ],
        "name": "DV Quality Measure Data Reporter",
        "telecom": [
          {
            "system": "phone",
            "value": "(+1) 616-555-1212"
          }
        ],
        "address": [
          {
            "line": [
              "160 Glen Eagles Road"
            ],
            "city": "Grand Rapids",
            "state": "MI",
            "postalCode": "49503",
            "country": "USA"
          }
        ]
      },
      "request": {
        "method": "POST",
        "url": "Organization"
      }
    },
    {
      "fullUrl": "urn:uuid:97e750b7-17f1-11ea-b4af-4ccc6a181ed3",
      "resource": {
        "resourceType": "Organization",
        "meta": {
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/organization-deqm"
          ]
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>identifier</b>: Tax ID number: 456789125 (OFFICIAL)</p><p><b>active</b>: true</p><p><b>type</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/organization-type ins}\">Insurance Company</span></p><p><b>name</b>: DVPayer04</p><p><b>telecom</b>: ph: (+1) 616-555-1212</p><p><b>address</b>: 160 Glen Eagles Road Grand Rapids MI 49503 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": "456789125",
            "assigner": {
              "display": "www.irs.gov"
            }
          }
        ],
        "active": true,
        "type": [
          {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/organization-type",
                "code": "ins",
                "display": "Insurance Company"
              }
            ]
          }
        ],
        "name": "DVPayer04",
        "telecom": [
          {
            "system": "phone",
            "value": "(+1) 616-555-1212"
          }
        ],
        "address": [
          {
            "line": [
              "160 Glen Eagles Road"
            ],
            "city": "Grand Rapids",
            "state": "MI",
            "postalCode": "49503",
            "country": "USA"
          }
        ]
      },
      "request": {
        "method": "POST",
        "url": "Organization"
      }
    },
    {
      "fullUrl": "urn:uuid:6f0cef31-2235-4d66-82e2-fa861fc909a8",
      "resource": {
        "resourceType": "Patient",
        "meta": {
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient"
          ]
        },
        "text": {
          "status": "extensions",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><blockquote><p><b>US Core Race Extension</b></p><p><b>value</b>: <span title=\"{urn:oid:2.16.840.1.113883.6.238 2106-3}\">White</span></p><p><b>value</b>: White</p></blockquote><blockquote><p><b>US Core Ethnicity Extension</b></p><p><b>value</b>: <span title=\"{urn:oid:2.16.840.1.113883.6.238 2186-5}\">Not Hispanic or Latino</span></p><p><b>value</b>: Not Hispanic or Latino</p></blockquote><p><b>Mother's Maiden Name</b>: Freda902 Tillman293</p><p><b>US Core Birth Sex Extension</b>: F</p><p><b>Birth Place</b>: Faro Algarve PT </p><p><b>identifier</b>: id: 0156e3a9-c4e1-4c0a-a53e-03ce3984ac65, Medical Record Number: 0156e3a9-c4e1-4c0a-a53e-03ce3984ac65, Social Security Number: 999-61-8566, Driver's license Number: S99966861, Passport Number: X52208740X</p><p><b>name</b>: Debbie941 McDermott739 (OFFICIAL), Debbie941 Funk324 (MAIDEN)</p><p><b>telecom</b>: ph: 555-755-4280(HOME)</p><p><b>gender</b>: female</p><p><b>birthDate</b>: 1961-02-26</p><p><b>address</b>: 903 Wolff Ville Westfield MA 01085 US </p><p><b>maritalStatus</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/v3-MaritalStatus M}\">M</span></p><p><b>multipleBirth</b>: false</p><h3>Communications</h3><table class=\"grid\"><tr><td>-</td><td><b>Language</b></td></tr><tr><td>*</td><td><span title=\"Codes: {urn:ietf:bcp:47 pt}\">Portuguese</span></td></tr></table></div>"
        },
        "extension": [
          {
            "extension": [
              {
                "url": "ombCategory",
                "valueCoding": {
                  "system": "urn:oid:2.16.840.1.113883.6.238",
                  "code": "2106-3",
                  "display": "White"
                }
              },
              {
                "url": "text",
                "valueString": "White"
              }
            ],
            "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": "2186-5",
                  "display": "Not Hispanic or Latino"
                }
              },
              {
                "url": "text",
                "valueString": "Not Hispanic or Latino"
              }
            ],
            "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity"
          },
          {
            "url": "http://hl7.org/fhir/StructureDefinition/patient-mothersMaidenName",
            "valueString": "Freda902 Tillman293"
          },
          {
            "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex",
            "valueCode": "F"
          },
          {
            "url": "http://hl7.org/fhir/StructureDefinition/patient-birthPlace",
            "valueAddress": {
              "city": "Faro",
              "state": "Algarve",
              "country": "PT"
            }
          }
        ],
        "identifier": [
          {
            "system": "https://github.com/synthetichealth/synthea",
            "value": "0156e3a9-c4e1-4c0a-a53e-03ce3984ac65"
          },
          {
            "type": {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                  "code": "MR",
                  "display": "Medical Record Number"
                }
              ],
              "text": "Medical Record Number"
            },
            "system": "http://hospital.smarthealthit.org",
            "value": "0156e3a9-c4e1-4c0a-a53e-03ce3984ac65"
          },
          {
            "type": {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                  "code": "SS",
                  "display": "Social Security Number"
                }
              ],
              "text": "Social Security Number"
            },
            "system": "http://hl7.org/fhir/sid/us-ssn",
            "value": "999-61-8566"
          },
          {
            "type": {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                  "code": "DL",
                  "display": "Driver's license Number"
                }
              ],
              "text": "Driver's license Number"
            },
            "system": "urn:oid:2.16.840.1.113883.4.3.25",
            "value": "S99966861"
          },
          {
            "type": {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                  "code": "PPN",
                  "display": "Passport Number"
                }
              ],
              "text": "Passport Number"
            },
            "system": "http://standardhealthrecord.org/fhir/StructureDefinition/passportNumber",
            "value": "X52208740X"
          }
        ],
        "name": [
          {
            "use": "official",
            "family": "McDermott739",
            "given": [
              "Debbie941"
            ],
            "prefix": [
              "Mrs."
            ]
          },
          {
            "use": "maiden",
            "family": "Funk324",
            "given": [
              "Debbie941"
            ],
            "prefix": [
              "Mrs."
            ]
          }
        ],
        "telecom": [
          {
            "system": "phone",
            "value": "555-755-4280",
            "use": "home"
          }
        ],
        "gender": "female",
        "birthDate": "1961-02-26",
        "address": [
          {
            "extension": [
              {
                "extension": [
                  {
                    "url": "latitude",
                    "valueDecimal": 42.21379047108309
                  },
                  {
                    "url": "longitude",
                    "valueDecimal": -72.73951315911818
                  }
                ],
                "url": "http://hl7.org/fhir/StructureDefinition/geolocation"
              }
            ],
            "line": [
              "903 Wolff Ville"
            ],
            "city": "Westfield",
            "state": "MA",
            "postalCode": "01085",
            "country": "US"
          }
        ],
        "maritalStatus": {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus",
              "code": "M",
              "display": "Married"
            }
          ],
          "text": "M"
        },
        "multipleBirthBoolean": false,
        "communication": [
          {
            "language": {
              "coding": [
                {
                  "system": "urn:ietf:bcp:47",
                  "code": "pt",
                  "display": "Portuguese"
                }
              ],
              "text": "Portuguese"
            }
          }
        ]
      },
      "request": {
        "method": "POST",
        "url": "Patient"
      }
    },
    {
      "fullUrl": "urn:uuid:1f33ae07-0891-4c2a-a376-fcd18800cb71",
      "resource": {
        "resourceType": "Encounter",
        "meta": {
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter"
          ]
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>status</b>: finished</p><p><b>class</b>: <span title=\"{http://terminology.hl7.org/CodeSystem/v3-ActCode AMB}\">ambulatory</span></p><p><b>type</b>: <span title=\"Codes: {http://www.ama-assn.org/go/cpt 99221}\">Initial hospital care</span></p><p><b>subject</b>: <a href=\"#urnuuid6f0cef31-2235-4d66-82e2-fa861fc909a8\">Mrs. Debbie941 McDermott739. Generated Summary: id: 0156e3a9-c4e1-4c0a-a53e-03ce3984ac65, Medical Record Number: 0156e3a9-c4e1-4c0a-a53e-03ce3984ac65, Social Security Number: 999-61-8566, Driver's license Number: S99966861, Passport Number: X52208740X; Debbie941 McDermott739 (OFFICIAL), Debbie941 Funk324 (MAIDEN); Phone: 555-755-4280; gender: female; birthDate: 1961-02-26; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/v3-MaritalStatus M}\">M</span>; multipleBirth: false</a></p><h3>Participants</h3><table class=\"grid\"><tr><td>-</td><td><b>Individual</b></td></tr><tr><td>*</td><td><a href=\"#urnuuid0000016d-235f-39b3-0000-0000000000fa\">Dr. Manuel446 Granados71. Generated Summary: id: 250; active: true; Manuel446 Granados71 ; Manuel446.Granados71@example.com; gender: male</a></td></tr></table><p><b>period</b>: Jun 20, 1976, 5:41:49 PM --&gt; Apr 29, 2018, 5:41:49 PM</p><h3>Locations</h3><table class=\"grid\"><tr><td>-</td><td><b>Location</b></td></tr><tr><td>*</td><td><a href=\"#urnuuid8938e769-59f7-40ff-a541-50b0bfcd6742\">NOBLE HOSPITAL. Generated Summary: status: active; name: NOBLE HOSPITAL; Phone: 4135682811</a></td></tr></table><p><b>serviceProvider</b>: <a href=\"#urnuuidebc3f5c4-6700-34af-8323-85621c313726\">NOBLE HOSPITAL. Generated Summary: Provider number: 9999999999 (OFFICIAL); active: true; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/organization-type prov}\">Healthcare Provider</span>; name: NOBLE HOSPITAL; Phone: 4135682811</a></p></div>"
        },
        "status": "finished",
        "class": {
          "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
          "code": "AMB"
        },
        "type": [
          {
            "coding": [
              {
                "system": "http://www.ama-assn.org/go/cpt",
                "code": "99221",
                "display": "Initial hospital care"
              }
            ],
            "text": "Initial hospital care"
          }
        ],
        "subject": {
          "reference": "urn:uuid:6f0cef31-2235-4d66-82e2-fa861fc909a8",
          "display": "Mrs. Debbie941 McDermott739"
        },
        "participant": [
          {
            "individual": {
              "reference": "urn:uuid:0000016d-235f-39b3-0000-0000000000fa",
              "display": "Dr. Manuel446 Granados71"
            }
          }
        ],
        "period": {
          "start": "1976-06-20T10:41:49-07:00",
          "end": "2018-04-29T10:41:49-07:00"
        },
        "location": [
          {
            "location": {
              "reference": "urn:uuid:8938e769-59f7-40ff-a541-50b0bfcd6742",
              "display": "NOBLE HOSPITAL"
            }
          }
        ],
        "serviceProvider": {
          "reference": "urn:uuid:ebc3f5c4-6700-34af-8323-85621c313726",
          "display": "NOBLE HOSPITAL"
        }
      },
      "request": {
        "method": "POST",
        "url": "Encounter"
      }
    },
    {
      "fullUrl": "urn:uuid:0000016d-235f-39b3-0000-0000000000fa",
      "resource": {
        "resourceType": "Practitioner",
        "meta": {
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner"
          ]
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>identifier</b>: id: 250</p><p><b>active</b>: true</p><p><b>name</b>: Manuel446 Granados71 </p><p><b>telecom</b>: <a href=\"mailto:Manuel446.Granados71@example.com\">Manuel446.Granados71@example.com</a></p><p><b>address</b>: 115 WEST SILVER STREET WESTFIELD MA 01085 US </p><p><b>gender</b>: male</p></div>"
        },
        "identifier": [
          {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "250"
          }
        ],
        "active": true,
        "name": [
          {
            "family": "Granados71",
            "given": [
              "Manuel446"
            ],
            "prefix": [
              "Dr."
            ]
          }
        ],
        "telecom": [
          {
            "extension": [
              {
                "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-direct",
                "valueBoolean": true
              }
            ],
            "system": "email",
            "value": "Manuel446.Granados71@example.com",
            "use": "work"
          }
        ],
        "address": [
          {
            "line": [
              "115 WEST SILVER STREET"
            ],
            "city": "WESTFIELD",
            "state": "MA",
            "postalCode": "01085",
            "country": "US"
          }
        ],
        "gender": "male"
      },
      "request": {
        "method": "POST",
        "url": "Practitioner"
      }
    },
    {
      "fullUrl": "urn:uuid:ebc3f5c4-6700-34af-8323-85621c313726",
      "resource": {
        "resourceType": "Organization",
        "meta": {
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization"
          ]
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>identifier</b>: Provider number: 9999999999 (OFFICIAL)</p><p><b>active</b>: true</p><p><b>type</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/organization-type prov}\">Healthcare Provider</span></p><p><b>name</b>: NOBLE HOSPITAL</p><p><b>telecom</b>: ph: 4135682811</p><p><b>address</b>: 115 WEST SILVER STREET WESTFIELD MA 01085 US </p></div>"
        },
        "identifier": [
          {
            "use": "official",
            "type": {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                  "code": "PRN"
                }
              ]
            },
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999999999"
          }
        ],
        "active": true,
        "type": [
          {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/organization-type",
                "code": "prov",
                "display": "Healthcare Provider"
              }
            ],
            "text": "Healthcare Provider"
          }
        ],
        "name": "NOBLE HOSPITAL",
        "telecom": [
          {
            "system": "phone",
            "value": "4135682811"
          }
        ],
        "address": [
          {
            "line": [
              "115 WEST SILVER STREET"
            ],
            "city": "WESTFIELD",
            "state": "MA",
            "postalCode": "01085",
            "country": "US"
          }
        ]
      },
      "request": {
        "method": "POST",
        "url": "Organization"
      }
    },
    {
      "fullUrl": "urn:uuid:8938e769-59f7-40ff-a541-50b0bfcd6742",
      "resource": {
        "resourceType": "Location",
        "meta": {
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/core/StructureDefinition/us-core-location"
          ]
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>status</b>: active</p><p><b>name</b>: NOBLE HOSPITAL</p><p><b>telecom</b>: ph: 4135682811</p><p><b>address</b>: 115 WEST SILVER STREET WESTFIELD MA 01085 US </p><h3>Positions</h3><table class=\"grid\"><tr><td>-</td><td><b>Longitude</b></td><td><b>Latitude</b></td></tr><tr><td>*</td><td>-72.755911</td><td>42.138838</td></tr></table><p><b>managingOrganization</b>: <a href=\"#urnuuidebc3f5c4-6700-34af-8323-85621c313726\">NOBLE HOSPITAL. Generated Summary: Provider number: 9999999999 (OFFICIAL); active: true; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/organization-type prov}\">Healthcare Provider</span>; name: NOBLE HOSPITAL; Phone: 4135682811</a></p></div>"
        },
        "status": "active",
        "name": "NOBLE HOSPITAL",
        "telecom": [
          {
            "system": "phone",
            "value": "4135682811"
          }
        ],
        "address": {
          "line": [
            "115 WEST SILVER STREET"
          ],
          "city": "WESTFIELD",
          "state": "MA",
          "postalCode": "01085",
          "country": "US"
        },
        "position": {
          "longitude": -72.755911,
          "latitude": 42.138838
        },
        "managingOrganization": {
          "reference": "urn:uuid:ebc3f5c4-6700-34af-8323-85621c313726",
          "display": "NOBLE HOSPITAL"
        }
      },
      "request": {
        "method": "POST",
        "url": "Location"
      }
    }
  ]
}

Response

HTTP/1.1 200 OK
[other headers]

{
"resourceType": "Bundle",
"id": "5d9f7be3-f755-4a3e-8a05-782a1aa4943c",
"type": "transaction-response",
"link": [
{
"relation": "self",
"url": "http://hapi.fhir.org/baseR4"
}
],
"entry": [
{
"response": {
"status": "201 Created",
"location": "MeasureReport/223276/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:21:19.522+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Task/223277/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:21:19.522+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Coverage/223278/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:21:19.522+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Organization/223279/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:21:19.522+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Organization/223280/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:21:19.522+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Patient/223281/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:21:19.522+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Encounter/223282/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:21:19.522+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Practitioner/223283/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:21:19.522+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Organization/223284/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:21:19.522+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Location/223285/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:21:19.522+00:00"
}
}
]
}

Examples

Scenario:

Payer X who is acting in the role of a Reporter submits a MRP Individual Reports for Patients P, Q and R to Receiver Z. The body of the request is a transaction bundle including the Individual MeasureReport and Task resources all the related resources containing the relevant data used to compute the CQM criteria. An HTTP Status success code and a transaction-response Bundle is returned on successful submission.

POST Summary Report

POST [base]

Request body

{
  "resourceType": "Bundle",
  "id": "multiple-indv-mrp-task-report",
  "type": "transaction",
  "timestamp": "2020-07-08T22:16:38.284687Z",
  "entry": [
    {
      "fullUrl": "http://example.org/fhir/receiver/Patient/patient03",
      "resource": {
        "resourceType": "Patient",
        "id": "patient03",
        "meta": {
          "versionId": "4",
          "lastUpdated": "2019-02-07T18:47:34.000+00:00",
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"
          ]
        },
        "text": {
          "status": "extensions",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>US Core Birth Sex Extension</b>: F</p><blockquote><p><b>US Core Race Extension</b></p><p><b>value</b>: <span title=\"{urn:oid:2.16.840.1.113883.6.238 2054-5}\">Black or African American</span></p><p><b>value</b>: Black or African American</p></blockquote><blockquote><p><b>US Core Ethnicity Extension</b></p><p><b>value</b>: <span title=\"{urn:oid:2.16.840.1.113883.6.238 2186-5}\">Not Hispanic or Latino</span></p><p><b>value</b>: Not Hispanic or Latino</p></blockquote><p><b>identifier</b>: Medical record number: 34567 (USUAL)</p><p><b>active</b>: true</p><p><b>name</b>: Virginia Hartman (OFFICIAL)</p><p><b>gender</b>: female</p><p><b>birthDate</b>: 1983-09-12</p><p><b>deceased</b>: false</p><p><b>address</b>: 213 Lilac Ave. Freehold MI 48099 USA (HOME)</p><p><b>maritalStatus</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/v3-MaritalStatus U}\">unmarried</span></p><h3>Communications</h3><table class=\"grid\"><tr><td>-</td><td><b>Language</b></td><td><b>Preferred</b></td></tr><tr><td>*</td><td><span title=\"Codes: {urn:ietf:bcp:47 en-US}\">English (Region=United States)</span></td><td>true</td></tr></table><p><b>managingOrganization</b>: <a href=\"#Organization_organization03\">See above (Organization/organization03)</a></p></div>"
        },
        "extension": [
          {
            "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex",
            "valueCode": "F"
          },
          {
            "extension": [
              {
                "url": "ombCategory",
                "valueCoding": {
                  "system": "urn:oid:2.16.840.1.113883.6.238",
                  "code": "2054-5",
                  "display": "Black or African American"
                }
              },
              {
                "url": "text",
                "valueString": "Black or African American"
              }
            ],
            "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": "2186-5",
                  "display": "Not Hispanic or Latino"
                }
              },
              {
                "url": "text",
                "valueString": "Not 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.davinci.org",
            "value": "34567"
          }
        ],
        "active": true,
        "name": [
          {
            "use": "official",
            "family": "Hartman",
            "given": [
              "Virginia"
            ]
          }
        ],
        "gender": "female",
        "birthDate": "1983-09-12",
        "deceasedBoolean": false,
        "address": [
          {
            "use": "home",
            "line": [
              "213 Lilac Ave."
            ],
            "city": "Freehold",
            "state": "MI",
            "postalCode": "48099",
            "country": "USA"
          }
        ],
        "maritalStatus": {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus",
              "code": "U",
              "display": "unmarried"
            }
          ]
        },
        "communication": [
          {
            "language": {
              "coding": [
                {
                  "system": "urn:ietf:bcp:47",
                  "code": "en-US",
                  "display": "English (Region=United States)"
                }
              ]
            },
            "preferred": true
          }
        ],
        "managingOrganization": {
          "reference": "Organization/organization03"
        }
      },
      "request": {
        "method": "POST",
        "url": "Patient"
      }
    },
    {
      "fullUrl": "http://example.org/fhir/receiver/Patient/patient02",
      "resource": {
        "resourceType": "Patient",
        "id": "patient02",
        "meta": {
          "versionId": "4",
          "lastUpdated": "2019-03-06T19:03:03.000+00:00",
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"
          ]
        },
        "text": {
          "status": "extensions",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>US Core Birth Sex Extension</b>: M</p><blockquote><p><b>US Core Race Extension</b></p><p><b>value</b>: <span title=\"{urn:oid:2.16.840.1.113883.6.238 2028-9}\">Asian</span></p><p><b>value</b>: Asian</p></blockquote><blockquote><p><b>US Core Ethnicity Extension</b></p><p><b>value</b>: <span title=\"{urn:oid:2.16.840.1.113883.6.238 2186-5}\">Not Hispanic or Latino</span></p><p><b>value</b>: Not Hispanic or Latino</p></blockquote><p><b>identifier</b>: Medical record number: 23456 (USUAL)</p><p><b>active</b>: true</p><p><b>name</b>: Darien Bernard (OFFICIAL)</p><p><b>gender</b>: male</p><p><b>birthDate</b>: 1967-06-13</p><p><b>deceased</b>: false</p><p><b>address</b>: 6 Rockwell Street Lynnwood NJ 07420 USA (HOME)</p><p><b>maritalStatus</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/v3-MaritalStatus M}\">Married</span></p><h3>Communications</h3><table class=\"grid\"><tr><td>-</td><td><b>Language</b></td><td><b>Preferred</b></td></tr><tr><td>*</td><td><span title=\"Codes: {urn:ietf:bcp:47 en-US}\">English (Region=United States)</span></td><td>true</td></tr></table><p><b>managingOrganization</b>: <a href=\"#Organization_organization02\">See above (Organization/organization02)</a></p></div>"
        },
        "extension": [
          {
            "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex",
            "valueCode": "M"
          },
          {
            "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": "2186-5",
                  "display": "Not Hispanic or Latino"
                }
              },
              {
                "url": "text",
                "valueString": "Not 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.davinci.org",
            "value": "23456"
          }
        ],
        "active": true,
        "name": [
          {
            "use": "official",
            "family": "Bernard",
            "given": [
              "Darien"
            ]
          }
        ],
        "gender": "male",
        "birthDate": "1967-06-13",
        "deceasedBoolean": false,
        "address": [
          {
            "use": "home",
            "line": [
              "6 Rockwell Street"
            ],
            "city": "Lynnwood",
            "state": "NJ",
            "postalCode": "07420",
            "country": "USA"
          }
        ],
        "maritalStatus": {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus",
              "code": "M",
              "display": "Married"
            }
          ]
        },
        "communication": [
          {
            "language": {
              "coding": [
                {
                  "system": "urn:ietf:bcp:47",
                  "code": "en-US",
                  "display": "English (Region=United States)"
                }
              ]
            },
            "preferred": true
          }
        ],
        "managingOrganization": {
          "reference": "Organization/organization02"
        }
      },
      "request": {
        "method": "POST",
        "url": "Patient"
      }
    },
    {
      "fullUrl": "http://example.org/fhir/receiver/MeasureReport/indv-measurereport02",
      "resource": {
        "resourceType": "MeasureReport",
        "id": "indv-measurereport02",
        "meta": {
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/indv-measurereport-deqm"
          ]
        },
        "text": {
          "status": "extensions",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><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>: id: 0015HQN9BD3304E</p><p><b>DEQM Reporting Vendor Extension</b>: <a href=\"#Organization_organization02\">See above (Organization/organization02)</a></p><p><b>status</b>: complete</p><p><b>type</b>: individual</p><p><b>measure</b>: <a href=\"http://hl7.org/fhir/us/davinci-deqm/Measure/measure-mrp-example\">http://hl7.org/fhir/us/davinci-deqm/Measure/measure-mrp-example</a></p><p><b>subject</b>: <a href=\"#Patient_patient01\">See above (Patient/patient01)</a></p><p><b>date</b>: Sep 5, 2018, 4:59:52 PM</p><p><b>reporter</b>: <a href=\"#Organization_organization01\">See above (Organization/organization01)</a></p><p><b>period</b>: 2018-08-01 --&gt; 2018-09-01</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><p><b>code</b>: <span title=\"Codes: {http://example.org/fhir/ mrp-group}\">MRP Group</span></p><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><p><b>measureScore</b>: 1</p></blockquote><p><b>evaluatedResource</b>: <a href=\"#Task_task01\">See above (Task/task01)</a></p></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/organization02"
            }
          }
        ],
        "status": "complete",
        "type": "individual",
        "measure": "http://hl7.org/fhir/us/davinci-deqm/Measure/measure-mrp-example",
        "subject": {
          "reference": "Patient/patient01"
        },
        "date": "2018-09-05T16:59:52.404Z",
        "reporter": {
          "reference": "Organization/organization01"
        },
        "period": {
          "start": "2018-08-01",
          "end": "2018-09-01"
        },
        "improvementNotation": {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/measure-improvement-notation",
              "code": "increase",
              "display": "Increased score indicates improvement"
            }
          ]
        },
        "group": [
          {
            "code": {
              "coding": [
                {
                  "system": "http://example.org/fhir/",
                  "code": "mrp-group",
                  "display": "MRP Group"
                }
              ],
              "text": "MRP Group"
            },
            "population": [
              {
                "id": "initial-population",
                "code": {
                  "coding": [
                    {
                      "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                      "code": "initial-population",
                      "display": "Initial Population"
                    }
                  ]
                },
                "count": 1
              },
              {
                "id": "numerator",
                "code": {
                  "coding": [
                    {
                      "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                      "code": "numerator",
                      "display": "Numerator"
                    }
                  ]
                },
                "count": 1
              },
              {
                "id": "denominator",
                "code": {
                  "coding": [
                    {
                      "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                      "code": "denominator",
                      "display": "Denominator"
                    }
                  ]
                },
                "count": 1
              }
            ],
            "measureScore": {
              "value": 1
            }
          }
        ],
        "evaluatedResource": [
          {
            "reference": "Task/task01"
          }
        ]
      },
      "request": {
        "method": "POST",
        "url": "MeasureReport"
      }
    },
    {
      "fullUrl": "http://example.org/fhir/receiver/Task/task01",
      "resource": {
        "resourceType": "Task",
        "id": "task01",
        "meta": {
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-task"
          ]
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>identifier</b>: id: 19009</p><p><b>status</b>: completed</p><p><b>intent</b>: plan</p><p><b>priority</b>: routine</p><p><b>code</b>: <span title=\"Codes: {http://www.ama-assn.org/go/cpt 1111F}\">Medication Reconciliation</span></p><p><b>for</b>: <a href=\"#Patient_patient01\">See above (Patient/patient01)</a></p><p><b>encounter</b>: <a href=\"#Encounter_encounter01\">See above (Encounter/encounter01)</a></p><p><b>executionPeriod</b>: 2017-06-11 --&gt; 2017-06-11</p><p><b>authoredOn</b>: Sep 25, 2018, 2:24:23 PM</p><p><b>owner</b>: <a href=\"#Practitioner_practitioner01\">See above (Practitioner/practitioner01)</a></p></div>"
        },
        "identifier": [
          {
            "system": "http://example.org/tasks",
            "value": "19009"
          }
        ],
        "status": "completed",
        "intent": "plan",
        "priority": "routine",
        "code": {
          "coding": [
            {
              "system": "http://www.ama-assn.org/go/cpt",
              "code": "1111F",
              "display": "Medication Reconciliation"
            }
          ]
        },
        "for": {
          "reference": "Patient/patient01"
        },
        "encounter": {
          "reference": "Encounter/encounter01"
        },
        "executionPeriod": {
          "start": "2017-06-11",
          "end": "2017-06-11"
        },
        "authoredOn": "2018-09-25T14:24:23.584Z",
        "owner": {
          "reference": "Practitioner/practitioner01"
        }
      },
      "request": {
        "method": "POST",
        "url": "Task"
      }
    },
    {
      "fullUrl": "http://example.org/fhir/receiver/Encounter/encounter03",
      "resource": {
        "resourceType": "Encounter",
        "id": "encounter03",
        "meta": {
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"
          ]
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>status</b>: finished</p><p><b>class</b>: <span title=\"{http://terminology.hl7.org/CodeSystem/v3-ActCode IMP}\">inpatient encounter</span></p><p><b>type</b>: <span title=\"Codes: {http://snomed.info/sct 53950000}\">Respiratory therapy</span></p><p><b>subject</b>: <a href=\"#Patient_patient03\">See above (Patient/patient03)</a></p><p><b>period</b>: May 29, 2018, 3:00:00 PM --&gt; May 29, 2018, 3:00:00 PM</p><h3>Hospitalizations</h3><table class=\"grid\"><tr><td>-</td><td><b>DischargeDisposition</b></td></tr><tr><td>*</td><td><span title=\"Codes: {http://terminology.hl7.org/CodeSystem/discharge-disposition home}\">Home</span></td></tr></table></div>"
        },
        "status": "finished",
        "class": {
          "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
          "code": "IMP",
          "display": "inpatient encounter"
        },
        "type": [
          {
            "coding": [
              {
                "system": "http://snomed.info/sct",
                "code": "53950000",
                "display": "Respiratory therapy"
              }
            ]
          }
        ],
        "subject": {
          "reference": "Patient/patient03"
        },
        "period": {
          "start": "2018-05-29T11:00:00-04:00",
          "end": "2018-05-29T11:00:00-04:00"
        },
        "hospitalization": {
          "dischargeDisposition": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/discharge-disposition",
                "code": "home",
                "display": "Home"
              }
            ]
          }
        }
      },
      "request": {
        "method": "POST",
        "url": "Encounter"
      }
    },
    {
      "fullUrl": "http://example.org/fhir/receiver/Patient/patient01",
      "resource": {
        "resourceType": "Patient",
        "id": "patient01",
        "meta": {
          "versionId": "5",
          "lastUpdated": "2019-02-11T14:19:25.000+00:00",
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"
          ]
        },
        "text": {
          "status": "extensions",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>US Core Birth Sex Extension</b>: M</p><blockquote><p><b>US Core Race Extension</b></p><p><b>value</b>: <span title=\"{urn:oid:2.16.840.1.113883.6.238 2106-3}\">White</span></p><p><b>value</b>: White</p></blockquote><blockquote><p><b>US Core Ethnicity Extension</b></p><p><b>value</b>: <span title=\"{urn:oid:2.16.840.1.113883.6.238 2186-5}\">Not Hispanic or Latino</span></p><p><b>value</b>: Not Hispanic or Latino</p></blockquote><p><b>identifier</b>: Medical record number: 12345 (USUAL)</p><p><b>active</b>: true</p><p><b>name</b>: Jairo Webster (OFFICIAL)</p><p><b>gender</b>: male</p><p><b>birthDate</b>: 1946-12-16</p><p><b>deceased</b>: false</p><p><b>address</b>: 7496 Beaver Ridge Ave Thornton NJ 07003 USA (HOME)</p><p><b>maritalStatus</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/v3-MaritalStatus M}\">Married</span></p><h3>Communications</h3><table class=\"grid\"><tr><td>-</td><td><b>Language</b></td><td><b>Preferred</b></td></tr><tr><td>*</td><td><span title=\"Codes: {urn:ietf:bcp:47 en-US}\">English (Region=United States)</span></td><td>true</td></tr></table><p><b>managingOrganization</b>: <a href=\"#Organization_organization01\">See above (Organization/organization01)</a></p></div>"
        },
        "extension": [
          {
            "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex",
            "valueCode": "M"
          },
          {
            "extension": [
              {
                "url": "ombCategory",
                "valueCoding": {
                  "system": "urn:oid:2.16.840.1.113883.6.238",
                  "code": "2106-3",
                  "display": "White"
                }
              },
              {
                "url": "text",
                "valueString": "White"
              }
            ],
            "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": "2186-5",
                  "display": "Not Hispanic or Latino"
                }
              },
              {
                "url": "text",
                "valueString": "Not 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.davinci.org",
            "value": "12345"
          }
        ],
        "active": true,
        "name": [
          {
            "use": "official",
            "family": "Webster",
            "given": [
              "Jairo"
            ]
          }
        ],
        "gender": "male",
        "birthDate": "1946-12-16",
        "deceasedBoolean": false,
        "address": [
          {
            "use": "home",
            "line": [
              "7496 Beaver Ridge Ave"
            ],
            "city": "Thornton",
            "state": "NJ",
            "postalCode": "07003",
            "country": "USA"
          }
        ],
        "maritalStatus": {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus",
              "code": "M",
              "display": "Married"
            }
          ]
        },
        "communication": [
          {
            "language": {
              "coding": [
                {
                  "system": "urn:ietf:bcp:47",
                  "code": "en-US",
                  "display": "English (Region=United States)"
                }
              ]
            },
            "preferred": true
          }
        ],
        "managingOrganization": {
          "reference": "Organization/organization01"
        }
      },
      "request": {
        "method": "POST",
        "url": "Patient"
      }
    },
    {
      "fullUrl": "http://example.org/fhir/receiver/Practitioner/practitioner01",
      "resource": {
        "resourceType": "Practitioner",
        "id": "practitioner01",
        "meta": {
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/practitioner-deqm"
          ]
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>identifier</b>: Provider number: 345678912 (OFFICIAL), Provider number: 082583 (SECONDARY)</p><p><b>name</b>: Ronald Bone </p><p><b>address</b>: 1003 Healthcare Drive Amherst MA 01002 (HOME)</p></div>"
        },
        "identifier": [
          {
            "use": "official",
            "type": {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                  "code": "PRN",
                  "display": "Provider number"
                }
              ]
            },
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "345678912",
            "assigner": {
              "display": "www.cms.gov"
            }
          },
          {
            "use": "secondary",
            "type": {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                  "code": "PRN",
                  "display": "Provider number"
                }
              ]
            },
            "system": "urn:oid:2.16.840.1.113883.4.336",
            "value": "082583",
            "assigner": {
              "display": "www.cms.gov"
            }
          }
        ],
        "name": [
          {
            "family": "Bone",
            "given": [
              "Ronald"
            ],
            "prefix": [
              "Dr"
            ]
          }
        ],
        "address": [
          {
            "use": "home",
            "line": [
              "1003 Healthcare Drive"
            ],
            "city": "Amherst",
            "state": "MA",
            "postalCode": "01002"
          }
        ]
      },
      "request": {
        "method": "POST",
        "url": "Practitioner"
      }
    },
    {
      "fullUrl": "http://example.org/fhir/receiver/Task/task03",
      "resource": {
        "resourceType": "Task",
        "id": "task03",
        "meta": {
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-task"
          ]
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>identifier</b>: id: 19011</p><p><b>status</b>: completed</p><p><b>intent</b>: plan</p><p><b>priority</b>: routine</p><p><b>code</b>: <span title=\"Codes: {http://www.ama-assn.org/go/cpt 1111F}\">Medication Reconciliation</span></p><p><b>for</b>: <a href=\"#Patient_patient03\">See above (Patient/patient03)</a></p><p><b>encounter</b>: <a href=\"#Encounter_encounter03\">See above (Encounter/encounter03)</a></p><p><b>executionPeriod</b>: 2017-08-11 --&gt; 2017-08-11</p><p><b>authoredOn</b>: Sep 25, 2018, 2:24:23 PM</p><p><b>owner</b>: <a href=\"Practitioner-practitioner03.html\">Generated Summary: NPI: 9991994957 (OFFICIAL); active: true; Roland Aufderhar(OFFICIAL); Phone: 5555555555, Phone: 5555555555; gender: male; birthDate: 1964-06-19; <span title=\"Codes: {urn:ietf:bcp:47 es}\">English and Spanish</span></a></p></div>"
        },
        "identifier": [
          {
            "system": "http://example.org/tasks",
            "value": "19011"
          }
        ],
        "status": "completed",
        "intent": "plan",
        "priority": "routine",
        "code": {
          "coding": [
            {
              "system": "http://www.ama-assn.org/go/cpt",
              "code": "1111F",
              "display": "Medication Reconciliation"
            }
          ]
        },
        "for": {
          "reference": "Patient/patient03"
        },
        "encounter": {
          "reference": "Encounter/encounter03"
        },
        "executionPeriod": {
          "start": "2017-08-11",
          "end": "2017-08-11"
        },
        "authoredOn": "2018-09-25T14:24:23.584Z",
        "owner": {
          "reference": "Practitioner/practitioner03"
        }
      },
      "request": {
        "method": "POST",
        "url": "Task"
      }
    },
    {
      "fullUrl": "http://example.org/fhir/receiver/Practitioner/practitioner02",
      "resource": {
        "resourceType": "Practitioner",
        "id": "practitioner02",
        "meta": {
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/practitioner-deqm"
          ]
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>identifier</b>: Provider number: 9998266512 (OFFICIAL)</p><p><b>active</b>: true</p><p><b>name</b>: Emile Zieme(OFFICIAL)</p><p><b>telecom</b>: ph: 8605555555(WORK), ph: 8605555555(WORK)</p><p><b>address</b>: UCONN MEDICAL GROUP, FARMINGTON, CT 060300001(HOME)</p><p><b>gender</b>: male</p><p><b>birthDate</b>: 1964-06-19</p><p><b>communication</b>: <span title=\"Codes: {urn:ietf:bcp:47 es}\">English and Spanish</span></p></div>"
        },
        "identifier": [
          {
            "use": "official",
            "type": {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                  "code": "PRN",
                  "display": "Provider number"
                }
              ]
            },
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9998266512",
            "period": {
              "start": "2005-07-16T09:00:00-05:00"
            },
            "assigner": {
              "display": "www.cms.gov"
            }
          }
        ],
        "active": true,
        "name": [
          {
            "use": "official",
            "text": "Emile Zieme",
            "family": "Zieme",
            "given": [
              "Emile"
            ],
            "suffix": [
              "M.D."
            ]
          }
        ],
        "telecom": [
          {
            "system": "phone",
            "value": "8605555555",
            "use": "work",
            "rank": 1
          },
          {
            "system": "phone",
            "value": "8605555555",
            "use": "work",
            "rank": 2
          }
        ],
        "address": [
          {
            "extension": [
              {
                "extension": [
                  {
                    "url": "latitude",
                    "valueDecimal": 41.791776
                  },
                  {
                    "url": "longitude",
                    "valueDecimal": -72.718832
                  }
                ],
                "url": "http://hl7.org/fhir/StructureDefinition/geolocation"
              }
            ],
            "use": "home",
            "type": "both",
            "text": "UCONN MEDICAL GROUP, FARMINGTON, CT 060300001",
            "line": [
              "UCONN MEDICAL GROUP"
            ],
            "city": "FARMINGTON",
            "state": "CT",
            "postalCode": "060300001",
            "country": "USA"
          }
        ],
        "gender": "male",
        "birthDate": "1964-06-19",
        "communication": [
          {
            "coding": [
              {
                "system": "urn:ietf:bcp:47",
                "code": "es",
                "display": "Spanish",
                "userSelected": true
              }
            ],
            "text": "English and Spanish"
          }
        ]
      },
      "request": {
        "method": "POST",
        "url": "Practitioner"
      }
    },
    {
      "fullUrl": "http://example.org/fhir/receiver/Task/task02",
      "resource": {
        "resourceType": "Task",
        "id": "task02",
        "meta": {
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-task"
          ]
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>identifier</b>: id: 19010</p><p><b>status</b>: completed</p><p><b>intent</b>: plan</p><p><b>priority</b>: routine</p><p><b>code</b>: <span title=\"Codes: {http://www.ama-assn.org/go/cpt 1111F}\">Medication Reconciliation</span></p><p><b>for</b>: <a href=\"#Patient_patient02\">See above (Patient/patient02)</a></p><p><b>encounter</b>: <a href=\"#Encounter_encounter02\">See above (Encounter/encounter02)</a></p><p><b>executionPeriod</b>: 2017-06-15 --&gt; 2017-06-17</p><p><b>authoredOn</b>: Sep 25, 2018, 2:24:23 PM</p><p><b>owner</b>: <a href=\"#Practitioner_practitioner02\">See above (Practitioner/practitioner02)</a></p></div>"
        },
        "identifier": [
          {
            "system": "http://example.org/tasks",
            "value": "19010"
          }
        ],
        "status": "completed",
        "intent": "plan",
        "priority": "routine",
        "code": {
          "coding": [
            {
              "system": "http://www.ama-assn.org/go/cpt",
              "code": "1111F",
              "display": "Medication Reconciliation"
            }
          ]
        },
        "for": {
          "reference": "Patient/patient02"
        },
        "encounter": {
          "reference": "Encounter/encounter02"
        },
        "executionPeriod": {
          "start": "2017-06-15",
          "end": "2017-06-17"
        },
        "authoredOn": "2018-09-25T14:24:23.584Z",
        "owner": {
          "reference": "Practitioner/practitioner02"
        }
      },
      "request": {
        "method": "POST",
        "url": "Task"
      }
    },
    {
      "fullUrl": "http://example.org/fhir/receiver/MeasureReport/indv-measurereport02b",
      "resource": {
        "resourceType": "MeasureReport",
        "id": "indv-measurereport02b",
        "meta": {
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/indv-measurereport-deqm"
          ]
        },
        "text": {
          "status": "extensions",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><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>: id: 0015HQN9BD3304E</p><p><b>DEQM Reporting Vendor Extension</b>: <a href=\"#Organization_organization02\">See above (Organization/organization02)</a></p><p><b>status</b>: complete</p><p><b>type</b>: individual</p><p><b>measure</b>: <a href=\"http://hl7.org/fhir/us/davinci-deqm/Measure/measure-mrp-example\">http://hl7.org/fhir/us/davinci-deqm/Measure/measure-mrp-example</a></p><p><b>subject</b>: <a href=\"#Patient_patient03\">See above (Patient/patient03)</a></p><p><b>date</b>: Sep 5, 2018, 4:59:52 PM</p><p><b>reporter</b>: <a href=\"#Organization_organization01\">See above (Organization/organization01)</a></p><p><b>period</b>: 2018-08-01 --&gt; 2018-09-01</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><p><b>code</b>: <span title=\"Codes: {http://example.org/fhir/ mrp-group}\">MRP Group</span></p><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><p><b>measureScore</b>: 1</p></blockquote><p><b>evaluatedResource</b>: <a href=\"#Task_task03\">See above (Task/task03)</a></p></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/organization02"
            }
          }
        ],
        "status": "complete",
        "type": "individual",
        "measure": "http://hl7.org/fhir/us/davinci-deqm/Measure/measure-mrp-example",
        "subject": {
          "reference": "Patient/patient03"
        },
        "date": "2018-09-05T16:59:52.404Z",
        "reporter": {
          "reference": "Organization/organization01"
        },
        "period": {
          "start": "2018-08-01",
          "end": "2018-09-01"
        },
        "improvementNotation": {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/measure-improvement-notation",
              "code": "increase",
              "display": "Increased score indicates improvement"
            }
          ]
        },
        "group": [
          {
            "code": {
              "coding": [
                {
                  "system": "http://example.org/fhir/",
                  "code": "mrp-group",
                  "display": "MRP Group"
                }
              ],
              "text": "MRP Group"
            },
            "population": [
              {
                "id": "initial-population",
                "code": {
                  "coding": [
                    {
                      "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                      "code": "initial-population",
                      "display": "Initial Population"
                    }
                  ]
                },
                "count": 1
              },
              {
                "id": "numerator",
                "code": {
                  "coding": [
                    {
                      "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                      "code": "numerator",
                      "display": "Numerator"
                    }
                  ]
                },
                "count": 1
              },
              {
                "id": "denominator",
                "code": {
                  "coding": [
                    {
                      "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                      "code": "denominator",
                      "display": "Denominator"
                    }
                  ]
                },
                "count": 1
              }
            ],
            "measureScore": {
              "value": 1
            }
          }
        ],
        "evaluatedResource": [
          {
            "reference": "Task/task03"
          }
        ]
      },
      "request": {
        "method": "POST",
        "url": "MeasureReport"
      }
    },
    {
      "fullUrl": "http://example.org/fhir/receiver/Organization/organization01",
      "resource": {
        "resourceType": "Organization",
        "id": "organization01",
        "meta": {
          "versionId": "4",
          "lastUpdated": "2019-02-21T01:47:54.000+00:00",
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/organization-deqm"
          ]
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>identifier</b>: Tax ID number: 123456789 (OFFICIAL)</p><p><b>active</b>: true</p><p><b>type</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/organization-type prov}\">Healthcare Provider</span></p><p><b>name</b>: DaVinciHospital01</p><p><b>telecom</b>: ph: (+1) 401-555-1212</p><p><b>address</b>: 73 Lakewood Street Warwick RI 02886 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": "123456789",
            "assigner": {
              "display": "www.irs.gov"
            }
          }
        ],
        "active": true,
        "type": [
          {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/organization-type",
                "code": "prov",
                "display": "Healthcare Provider"
              }
            ]
          }
        ],
        "name": "DaVinciHospital01",
        "telecom": [
          {
            "system": "phone",
            "value": "(+1) 401-555-1212"
          }
        ],
        "address": [
          {
            "line": [
              "73 Lakewood Street"
            ],
            "city": "Warwick",
            "state": "RI",
            "postalCode": "02886",
            "country": "USA"
          }
        ]
      },
      "request": {
        "method": "POST",
        "url": "Organization"
      }
    },
    {
      "fullUrl": "http://example.org/fhir/receiver/Encounter/encounter01",
      "resource": {
        "resourceType": "Encounter",
        "id": "encounter01",
        "meta": {
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"
          ]
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>status</b>: finished</p><p><b>class</b>: <span title=\"{http://terminology.hl7.org/CodeSystem/v3-ActCode IMP}\">inpatient encounter</span></p><p><b>type</b>: <span title=\"Codes: {http://snomed.info/sct 56876005}\">Drug rehabilitation and detoxification</span></p><p><b>subject</b>: <a href=\"#Patient_patient01\">Jairo Webster. Generated Summary: Medical record number: 12345 (USUAL); active: true; Jairo Webster (OFFICIAL); gender: male; birthDate: 1946-12-16; deceased: false; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/v3-MaritalStatus M}\">Married</span></a></p><p><b>period</b>: May 29, 2018, 3:00:00 PM --&gt; May 29, 2018, 3:00:00 PM</p><h3>Hospitalizations</h3><table class=\"grid\"><tr><td>-</td><td><b>DischargeDisposition</b></td></tr><tr><td>*</td><td><span title=\"Codes: {http://terminology.hl7.org/CodeSystem/discharge-disposition home}\">Home</span></td></tr></table></div>"
        },
        "status": "finished",
        "class": {
          "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
          "code": "IMP",
          "display": "inpatient encounter"
        },
        "type": [
          {
            "coding": [
              {
                "system": "http://snomed.info/sct",
                "code": "56876005",
                "display": "Drug rehabilitation and detoxification"
              }
            ]
          }
        ],
        "subject": {
          "reference": "Patient/patient01",
          "display": "Jairo Webster"
        },
        "period": {
          "start": "2018-05-29T11:00:00-04:00",
          "end": "2018-05-29T11:00:00-04:00"
        },
        "hospitalization": {
          "dischargeDisposition": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/discharge-disposition",
                "code": "home",
                "display": "Home"
              }
            ]
          }
        }
      },
      "request": {
        "method": "POST",
        "url": "Encounter"
      }
    },
    {
      "fullUrl": "http://example.org/fhir/receiver/Organization/organization02",
      "resource": {
        "resourceType": "Organization",
        "id": "organization02",
        "meta": {
          "versionId": "3",
          "lastUpdated": "2019-03-06T19:03:03.000+00:00",
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/organization-deqm"
          ]
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>identifier</b>: Tax ID number: 234567891 (OFFICIAL)</p><p><b>active</b>: true</p><p><b>type</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/organization-type prov}\">Healthcare Provider</span></p><p><b>name</b>: DaVinciHospital02</p><p><b>telecom</b>: ph: (+1) 551-555-1212</p><p><b>address</b>: 3 Sherwood St. Englewood NJ 07631 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": "234567891",
            "assigner": {
              "display": "www.irs.gov"
            }
          }
        ],
        "active": true,
        "type": [
          {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/organization-type",
                "code": "prov",
                "display": "Healthcare Provider"
              }
            ]
          }
        ],
        "name": "DaVinciHospital02",
        "telecom": [
          {
            "system": "phone",
            "value": "(+1) 551-555-1212"
          }
        ],
        "address": [
          {
            "line": [
              "3 Sherwood St."
            ],
            "city": "Englewood",
            "state": "NJ",
            "postalCode": "07631",
            "country": "USA"
          }
        ]
      },
      "request": {
        "method": "POST",
        "url": "Organization"
      }
    },
    {
      "fullUrl": "http://example.org/fhir/receiver/Encounter/encounter02",
      "resource": {
        "resourceType": "Encounter",
        "id": "encounter02",
        "meta": {
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"
          ]
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>status</b>: finished</p><p><b>class</b>: <span title=\"{http://terminology.hl7.org/CodeSystem/v3-ActCode IMP}\">inpatient encounter</span></p><p><b>type</b>: <span title=\"Codes: {http://snomed.info/sct 239279000}\">Fixation of fracture</span></p><p><b>subject</b>: <a href=\"#Patient_patient02\">See above (Patient/patient02)</a></p><p><b>period</b>: May 29, 2018, 3:00:00 PM --&gt; May 29, 2018, 3:00:00 PM</p><h3>Hospitalizations</h3><table class=\"grid\"><tr><td>-</td><td><b>DischargeDisposition</b></td></tr><tr><td>*</td><td><span title=\"Codes: {http://terminology.hl7.org/CodeSystem/discharge-disposition home}\">Home</span></td></tr></table></div>"
        },
        "status": "finished",
        "class": {
          "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
          "code": "IMP",
          "display": "inpatient encounter"
        },
        "type": [
          {
            "coding": [
              {
                "system": "http://snomed.info/sct",
                "code": "239279000",
                "display": "Fixation of fracture"
              }
            ]
          }
        ],
        "subject": {
          "reference": "Patient/patient02"
        },
        "period": {
          "start": "2018-05-29T11:00:00-04:00",
          "end": "2018-05-29T11:00:00-04:00"
        },
        "hospitalization": {
          "dischargeDisposition": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/discharge-disposition",
                "code": "home",
                "display": "Home"
              }
            ]
          }
        }
      },
      "request": {
        "method": "POST",
        "url": "Encounter"
      }
    },
    {
      "fullUrl": "http://example.org/fhir/receiver/MeasureReport/indv-measurereport02a",
      "resource": {
        "resourceType": "MeasureReport",
        "id": "indv-measurereport02a",
        "meta": {
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/indv-measurereport-deqm"
          ]
        },
        "text": {
          "status": "extensions",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><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>: id: 0015HQN9BD3304E</p><p><b>DEQM Reporting Vendor Extension</b>: <a href=\"#Organization_organization02\">See above (Organization/organization02)</a></p><p><b>status</b>: complete</p><p><b>type</b>: individual</p><p><b>measure</b>: <a href=\"http://hl7.org/fhir/us/davinci-deqm/Measure/measure-mrp-example\">http://hl7.org/fhir/us/davinci-deqm/Measure/measure-mrp-example</a></p><p><b>subject</b>: <a href=\"#Patient_patient02\">See above (Patient/patient02)</a></p><p><b>date</b>: Sep 5, 2018, 4:59:52 PM</p><p><b>reporter</b>: <a href=\"#Organization_organization01\">See above (Organization/organization01)</a></p><p><b>period</b>: 2018-08-01 --&gt; 2018-09-01</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><p><b>code</b>: <span title=\"Codes: {http://example.org/fhir/ mrp-group}\">MRP Group</span></p><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><p><b>measureScore</b>: 1</p></blockquote><p><b>evaluatedResource</b>: <a href=\"#Task_task02\">See above (Task/task02)</a></p></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/organization02"
            }
          }
        ],
        "status": "complete",
        "type": "individual",
        "measure": "http://hl7.org/fhir/us/davinci-deqm/Measure/measure-mrp-example",
        "subject": {
          "reference": "Patient/patient02"
        },
        "date": "2018-09-05T16:59:52.404Z",
        "reporter": {
          "reference": "Organization/organization01"
        },
        "period": {
          "start": "2018-08-01",
          "end": "2018-09-01"
        },
        "improvementNotation": {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/measure-improvement-notation",
              "code": "increase",
              "display": "Increased score indicates improvement"
            }
          ]
        },
        "group": [
          {
            "code": {
              "coding": [
                {
                  "system": "http://example.org/fhir/",
                  "code": "mrp-group",
                  "display": "MRP Group"
                }
              ],
              "text": "MRP Group"
            },
            "population": [
              {
                "id": "initial-population",
                "code": {
                  "coding": [
                    {
                      "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                      "code": "initial-population",
                      "display": "Initial Population"
                    }
                  ]
                },
                "count": 1
              },
              {
                "id": "numerator",
                "code": {
                  "coding": [
                    {
                      "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                      "code": "numerator",
                      "display": "Numerator"
                    }
                  ]
                },
                "count": 1
              },
              {
                "id": "denominator",
                "code": {
                  "coding": [
                    {
                      "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                      "code": "denominator",
                      "display": "Denominator"
                    }
                  ]
                },
                "count": 1
              }
            ],
            "measureScore": {
              "value": 1
            }
          }
        ],
        "evaluatedResource": [
          {
            "reference": "Task/task02"
          }
        ]
      },
      "request": {
        "method": "POST",
        "url": "MeasureReport"
      }
    },
    {
      "fullUrl": "http://example.org/fhir/receiver/Organization/organization03",
      "resource": {
        "resourceType": "Organization",
        "id": "organization03",
        "meta": {
          "versionId": "3",
          "lastUpdated": "2019-02-21T01:47:53.000+00:00",
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/organization-deqm"
          ]
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>identifier</b>: Provider number: 345678912 (OFFICIAL), Provider number: 082584 (SECONDARY)</p><p><b>active</b>: true</p><p><b>type</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/organization-type prov}\">Healthcare Provider</span></p><p><b>name</b>: DaVinciHospital03</p><p><b>telecom</b>: ph: (+1) 201-555-1212</p><p><b>address</b>: 94 Olive Ave. Union City NJ 07087 USA </p></div>"
        },
        "identifier": [
          {
            "use": "official",
            "type": {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                  "code": "PRN",
                  "display": "Provider number"
                }
              ]
            },
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "345678912",
            "assigner": {
              "display": "www.cms.gov"
            }
          },
          {
            "use": "secondary",
            "type": {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                  "code": "PRN",
                  "display": "Provider number"
                }
              ]
            },
            "system": "urn:oid:2.16.840.1.113883.4.336",
            "value": "082584",
            "assigner": {
              "display": "www.cms.gov"
            }
          }
        ],
        "active": true,
        "type": [
          {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/organization-type",
                "code": "prov",
                "display": "Healthcare Provider"
              }
            ]
          }
        ],
        "name": "DaVinciHospital03",
        "telecom": [
          {
            "system": "phone",
            "value": "(+1) 201-555-1212"
          }
        ],
        "address": [
          {
            "line": [
              "94 Olive Ave."
            ],
            "city": "Union City",
            "state": "NJ",
            "postalCode": "07087",
            "country": "USA"
          }
        ]
      },
      "request": {
        "method": "POST",
        "url": "Organization"
      }
    }
  ]
}

Response

HTTP/1.1 200 OK
[other headers]

{
"resourceType": "Bundle",
"id": "0f8c1be3-70e7-4b96-ad36-f4c408cc4e22",
"type": "transaction-response",
"link": [
{
"relation": "self",
"url": "http://hapi.fhir.org/baseR4"
}
],
"entry": [
{
"response": {
"status": "201 Created",
"location": "MeasureReport/223306/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:32:06.116+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Task/223307/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:32:06.116+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Coverage/223308/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:32:06.116+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Organization/223309/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:32:06.116+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Organization/223310/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:32:06.116+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "MeasureReport/223311/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:32:06.116+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Task/223312/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:32:06.116+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Coverage/223313/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:32:06.116+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "MeasureReport/223314/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:32:06.116+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Task/223315/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:32:06.116+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Coverage/223316/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:32:06.116+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Patient/223317/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:32:06.116+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Encounter/223318/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:32:06.116+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Practitioner/223319/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:32:06.116+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Organization/223320/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:32:06.116+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Location/223321/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:32:06.116+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Patient/223322/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:32:06.116+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Encounter/223323/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:32:06.116+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Practitioner/223324/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:32:06.116+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Patient/223325/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:32:06.116+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Encounter/223326/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:32:06.116+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Practitioner/223327/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:32:06.116+00:00"
}
}
]
}

Examples

Scenario:

Reporter X submits a MRP Individual Report for Patient P to Receiver Z. The body of the request is a transaction bundle including the Individual MeasureReport and Observation resources all the related resources containing the relevant data used to compute the CQM criteria. An HTTP Status success code and a transaction-response Bundle is returned on successful submission.

POST Summary Report

POST [base]

Request body

{
  "resourceType": "Bundle",
  "id": "single-indv-mrp-obs-report",
  "meta": {
    "source": "http://example.org/fhir/server"
  },
  "type": "transaction",
  "timestamp": "2019-12-06T06:28:44.902388Z",
  "entry": [
    {
      "fullUrl": "urn:uuid:a8f9c686-17f1-11ea-a072-4ccc6a181ed3",
      "resource": {
        "resourceType": "MeasureReport",
        "id": "a8f9c686-17f1-11ea-a072-4ccc6a181ed3",
        "meta": {
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/indv-measurereport-deqm"
          ]
        },
        "text": {
          "status": "extensions",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><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>: id: 0015HQN9BD3304E</p><p><b>DEQM Reporting Vendor Extension</b>: <a href=\"Organization-organization02.html\">Generated Summary: Tax ID number: 234567891 (OFFICIAL); active: true; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/organization-type prov}\">Healthcare Provider</span>; name: DaVinciHospital02; Phone: (+1) 551-555-1212</a></p><p><b>status</b>: complete</p><p><b>type</b>: individual</p><p><b>measure</b>: <a href=\"http://hl7.org/fhir/us/davinci-deqm/Measure/measure-mrp-example\">http://hl7.org/fhir/us/davinci-deqm/Measure/measure-mrp-example</a></p><p><b>subject</b>: <a href=\"#urnuuid6f0cef31-2235-4d66-82e2-fa861fc909a8\">See above (Patient/null)</a></p><p><b>date</b>: Sep 5, 2018, 4:59:52 PM</p><p><b>reporter</b>: <a href=\"#urnuuidebc3f5c4-6700-34af-8323-85621c313726\">See above (Organization/null)</a></p><p><b>period</b>: 2018-08-01 --&gt; 2018-09-01</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><p><b>code</b>: <span title=\"Codes: {http://example.org/fhir/ mrp-group}\">MRP Group</span></p><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><p><b>measureScore</b>: 1</p></blockquote><p><b>evaluatedResource</b>: <a href=\"#urnuuida8fa3b69-17f1-11ea-bd75-4ccc6a181ed3\">See above (Observation/null)</a></p></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/organization02"
            }
          }
        ],
        "status": "complete",
        "type": "individual",
        "measure": "http://hl7.org/fhir/us/davinci-deqm/Measure/measure-mrp-example",
        "subject": {
          "reference": "urn:uuid:6f0cef31-2235-4d66-82e2-fa861fc909a8"
        },
        "date": "2018-09-05T16:59:52.404Z",
        "reporter": {
          "reference": "urn:uuid:ebc3f5c4-6700-34af-8323-85621c313726"
        },
        "period": {
          "start": "2018-08-01",
          "end": "2018-09-01"
        },
        "improvementNotation": {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/measure-improvement-notation",
              "code": "increase",
              "display": "Increased score indicates improvement"
            }
          ]
        },
        "group": [
          {
            "code": {
              "coding": [
                {
                  "system": "http://example.org/fhir/",
                  "code": "mrp-group",
                  "display": "MRP Group"
                }
              ],
              "text": "MRP Group"
            },
            "population": [
              {
                "id": "initial-population",
                "code": {
                  "coding": [
                    {
                      "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                      "code": "initial-population",
                      "display": "Initial Population"
                    }
                  ]
                },
                "count": 1
              },
              {
                "id": "numerator",
                "code": {
                  "coding": [
                    {
                      "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                      "code": "numerator",
                      "display": "Numerator"
                    }
                  ]
                },
                "count": 1
              },
              {
                "id": "denominator",
                "code": {
                  "coding": [
                    {
                      "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                      "code": "denominator",
                      "display": "Denominator"
                    }
                  ]
                },
                "count": 1
              }
            ],
            "measureScore": {
              "value": 1
            }
          }
        ],
        "evaluatedResource": [
          {
            "reference": "urn:uuid:a8fa3b69-17f1-11ea-bd75-4ccc6a181ed3"
          }
        ]
      },
      "request": {
        "method": "POST",
        "url": "MeasureReport"
      }
    },
    {
      "fullUrl": "urn:uuid:a8fa147a-17f1-11ea-91ce-4ccc6a181ed3",
      "resource": {
        "resourceType": "Coverage",
        "meta": {
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/coverage-deqm"
          ]
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>status</b>: active</p><p><b>policyHolder</b>: <a href=\"#urnuuid6f0cef31-2235-4d66-82e2-fa861fc909a8\">See above (Patient/null)</a></p><p><b>subscriber</b>: <a href=\"#urnuuid6f0cef31-2235-4d66-82e2-fa861fc909a8\">See above (Patient/null)</a></p><p><b>subscriberId</b>: A123456789</p><p><b>beneficiary</b>: <a href=\"#urnuuid6f0cef31-2235-4d66-82e2-fa861fc909a8\">See above (Patient/null)</a></p><p><b>relationship</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/subscriber-relationship self}\">Self</span></p><p><b>payor</b>: <a href=\"#urnuuida8fa3b68-17f1-11ea-93ae-4ccc6a181ed3\">See above (Organization/null)</a></p></div>"
        },
        "status": "active",
        "policyHolder": {
          "reference": "urn:uuid:6f0cef31-2235-4d66-82e2-fa861fc909a8"
        },
        "subscriber": {
          "reference": "urn:uuid:6f0cef31-2235-4d66-82e2-fa861fc909a8"
        },
        "subscriberId": "A123456789",
        "beneficiary": {
          "reference": "urn:uuid:6f0cef31-2235-4d66-82e2-fa861fc909a8"
        },
        "relationship": {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
              "code": "self"
            }
          ]
        },
        "payor": [
          {
            "reference": "urn:uuid:a8fa3b68-17f1-11ea-93ae-4ccc6a181ed3"
          }
        ]
      },
      "request": {
        "method": "POST",
        "url": "Coverage"
      }
    },
    {
      "fullUrl": "urn:uuid:a8fa147b-17f1-11ea-9ba7-4ccc6a181ed3",
      "resource": {
        "resourceType": "Organization",
        "meta": {
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/organization-deqm"
          ]
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>identifier</b>: Tax ID number: 456789124 (OFFICIAL)</p><p><b>active</b>: true</p><p><b>type</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/organization-type other}\">Other</span></p><p><b>name</b>: DV Quality Measure Data Reporter</p><p><b>telecom</b>: ph: (+1) 616-555-1212</p><p><b>address</b>: 160 Glen Eagles Road Grand Rapids MI 49503 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": "456789124",
            "assigner": {
              "display": "www.irs.gov"
            }
          }
        ],
        "active": true,
        "type": [
          {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/organization-type",
                "code": "other",
                "display": "Other"
              }
            ]
          }
        ],
        "name": "DV Quality Measure Data Reporter",
        "telecom": [
          {
            "system": "phone",
            "value": "(+1) 616-555-1212"
          }
        ],
        "address": [
          {
            "line": [
              "160 Glen Eagles Road"
            ],
            "city": "Grand Rapids",
            "state": "MI",
            "postalCode": "49503",
            "country": "USA"
          }
        ]
      },
      "request": {
        "method": "POST",
        "url": "Organization"
      }
    },
    {
      "fullUrl": "urn:uuid:a8fa3b68-17f1-11ea-93ae-4ccc6a181ed3",
      "resource": {
        "resourceType": "Organization",
        "meta": {
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/organization-deqm"
          ]
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>identifier</b>: Tax ID number: 456789125 (OFFICIAL)</p><p><b>active</b>: true</p><p><b>type</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/organization-type ins}\">Insurance Company</span></p><p><b>name</b>: DVPayer04</p><p><b>telecom</b>: ph: (+1) 616-555-1212</p><p><b>address</b>: 160 Glen Eagles Road Grand Rapids MI 49503 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": "456789125",
            "assigner": {
              "display": "www.irs.gov"
            }
          }
        ],
        "active": true,
        "type": [
          {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/organization-type",
                "code": "ins",
                "display": "Insurance Company"
              }
            ]
          }
        ],
        "name": "DVPayer04",
        "telecom": [
          {
            "system": "phone",
            "value": "(+1) 616-555-1212"
          }
        ],
        "address": [
          {
            "line": [
              "160 Glen Eagles Road"
            ],
            "city": "Grand Rapids",
            "state": "MI",
            "postalCode": "49503",
            "country": "USA"
          }
        ]
      },
      "request": {
        "method": "POST",
        "url": "Organization"
      }
    },
    {
      "fullUrl": "urn:uuid:a8fa3b69-17f1-11ea-bd75-4ccc6a181ed3",
      "resource": {
        "resourceType": "Observation",
        "meta": {
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation"
          ]
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p></p><p><b>category</b>: <span title=\"Codes: {http://example.org/CodeSystem/observation-category measure}\">Measure</span></p><p><b>code</b>: <span title=\"Codes: {http://www.ama-assn.org/go/cpt 1111F}\">Medication Reconciliation</span></p><p><b>subject</b>: <a href=\"#urnuuid6f0cef31-2235-4d66-82e2-fa861fc909a8\">See above (Patient/null)</a></p><p><b>encounter</b>: <a href=\"#urnuuid1f33ae07-0891-4c2a-a376-fcd18800cb71\">See above (Encounter/null)</a></p><p><b>effective</b>: Sep 29, 2018, 2:15:04 PM</p><p><b>issued</b>: Sep 29, 2018, 2:15:04 PM</p><p><b>performer</b>: <a href=\"#urnuuid0000016d-235f-39b3-0000-0000000000fa\">See above (Practitioner/null)</a></p><p><b>value</b>: true</p></div>"
        },
        "status": "final",
        "category": [
          {
            "coding": [
              {
                "system": "http://example.org/CodeSystem/observation-category",
                "code": "measure",
                "display": "Measure"
              }
            ]
          }
        ],
        "code": {
          "coding": [
            {
              "system": "http://www.ama-assn.org/go/cpt",
              "code": "1111F",
              "display": "Medication Reconciliation"
            }
          ]
        },
        "subject": {
          "reference": "urn:uuid:6f0cef31-2235-4d66-82e2-fa861fc909a8"
        },
        "encounter": {
          "reference": "urn:uuid:1f33ae07-0891-4c2a-a376-fcd18800cb71"
        },
        "effectiveDateTime": "2018-09-29T14:15:04.424Z",
        "issued": "2018-09-29T14:15:04.424Z",
        "performer": [
          {
            "reference": "urn:uuid:0000016d-235f-39b3-0000-0000000000fa"
          }
        ],
        "valueBoolean": true
      },
      "request": {
        "method": "POST",
        "url": "Observation"
      }
    },
    {
      "fullUrl": "urn:uuid:6f0cef31-2235-4d66-82e2-fa861fc909a8",
      "resource": {
        "resourceType": "Patient",
        "meta": {
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient"
          ]
        },
        "text": {
          "status": "extensions",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><blockquote><p><b>US Core Race Extension</b></p><p><b>value</b>: <span title=\"{urn:oid:2.16.840.1.113883.6.238 2106-3}\">White</span></p><p><b>value</b>: White</p></blockquote><blockquote><p><b>US Core Ethnicity Extension</b></p><p><b>value</b>: <span title=\"{urn:oid:2.16.840.1.113883.6.238 2186-5}\">Not Hispanic or Latino</span></p><p><b>value</b>: Not Hispanic or Latino</p></blockquote><p><b>Mother's Maiden Name</b>: Freda902 Tillman293</p><p><b>US Core Birth Sex Extension</b>: F</p><p><b>Birth Place</b>: Faro Algarve PT </p><p><b>identifier</b>: id: 0156e3a9-c4e1-4c0a-a53e-03ce3984ac65, Medical Record Number: 0156e3a9-c4e1-4c0a-a53e-03ce3984ac65, Social Security Number: 999-61-8566, Driver's license Number: S99966861, Passport Number: X52208740X</p><p><b>name</b>: Debbie941 McDermott739 (OFFICIAL), Debbie941 Funk324 (MAIDEN)</p><p><b>telecom</b>: ph: 555-755-4280(HOME)</p><p><b>gender</b>: female</p><p><b>birthDate</b>: 1961-02-26</p><p><b>address</b>: 903 Wolff Ville Westfield MA 01085 US </p><p><b>maritalStatus</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/v3-MaritalStatus M}\">M</span></p><p><b>multipleBirth</b>: false</p><h3>Communications</h3><table class=\"grid\"><tr><td>-</td><td><b>Language</b></td></tr><tr><td>*</td><td><span title=\"Codes: {urn:ietf:bcp:47 pt}\">Portuguese</span></td></tr></table></div>"
        },
        "extension": [
          {
            "extension": [
              {
                "url": "ombCategory",
                "valueCoding": {
                  "system": "urn:oid:2.16.840.1.113883.6.238",
                  "code": "2106-3",
                  "display": "White"
                }
              },
              {
                "url": "text",
                "valueString": "White"
              }
            ],
            "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": "2186-5",
                  "display": "Not Hispanic or Latino"
                }
              },
              {
                "url": "text",
                "valueString": "Not Hispanic or Latino"
              }
            ],
            "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity"
          },
          {
            "url": "http://hl7.org/fhir/StructureDefinition/patient-mothersMaidenName",
            "valueString": "Freda902 Tillman293"
          },
          {
            "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex",
            "valueCode": "F"
          },
          {
            "url": "http://hl7.org/fhir/StructureDefinition/patient-birthPlace",
            "valueAddress": {
              "city": "Faro",
              "state": "Algarve",
              "country": "PT"
            }
          }
        ],
        "identifier": [
          {
            "system": "https://github.com/synthetichealth/synthea",
            "value": "0156e3a9-c4e1-4c0a-a53e-03ce3984ac65"
          },
          {
            "type": {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                  "code": "MR",
                  "display": "Medical Record Number"
                }
              ],
              "text": "Medical Record Number"
            },
            "system": "http://hospital.smarthealthit.org",
            "value": "0156e3a9-c4e1-4c0a-a53e-03ce3984ac65"
          },
          {
            "type": {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                  "code": "SS",
                  "display": "Social Security Number"
                }
              ],
              "text": "Social Security Number"
            },
            "system": "http://hl7.org/fhir/sid/us-ssn",
            "value": "999-61-8566"
          },
          {
            "type": {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                  "code": "DL",
                  "display": "Driver's license Number"
                }
              ],
              "text": "Driver's license Number"
            },
            "system": "urn:oid:2.16.840.1.113883.4.3.25",
            "value": "S99966861"
          },
          {
            "type": {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                  "code": "PPN",
                  "display": "Passport Number"
                }
              ],
              "text": "Passport Number"
            },
            "system": "http://standardhealthrecord.org/fhir/StructureDefinition/passportNumber",
            "value": "X52208740X"
          }
        ],
        "name": [
          {
            "use": "official",
            "family": "McDermott739",
            "given": [
              "Debbie941"
            ],
            "prefix": [
              "Mrs."
            ]
          },
          {
            "use": "maiden",
            "family": "Funk324",
            "given": [
              "Debbie941"
            ],
            "prefix": [
              "Mrs."
            ]
          }
        ],
        "telecom": [
          {
            "system": "phone",
            "value": "555-755-4280",
            "use": "home"
          }
        ],
        "gender": "female",
        "birthDate": "1961-02-26",
        "address": [
          {
            "extension": [
              {
                "extension": [
                  {
                    "url": "latitude",
                    "valueDecimal": 42.21379047108309
                  },
                  {
                    "url": "longitude",
                    "valueDecimal": -72.73951315911818
                  }
                ],
                "url": "http://hl7.org/fhir/StructureDefinition/geolocation"
              }
            ],
            "line": [
              "903 Wolff Ville"
            ],
            "city": "Westfield",
            "state": "MA",
            "postalCode": "01085",
            "country": "US"
          }
        ],
        "maritalStatus": {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus",
              "code": "M",
              "display": "Married"
            }
          ],
          "text": "M"
        },
        "multipleBirthBoolean": false,
        "communication": [
          {
            "language": {
              "coding": [
                {
                  "system": "urn:ietf:bcp:47",
                  "code": "pt",
                  "display": "Portuguese"
                }
              ],
              "text": "Portuguese"
            }
          }
        ]
      },
      "request": {
        "method": "POST",
        "url": "Patient"
      }
    },
    {
      "fullUrl": "urn:uuid:1f33ae07-0891-4c2a-a376-fcd18800cb71",
      "resource": {
        "resourceType": "Encounter",
        "meta": {
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter"
          ]
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>status</b>: finished</p><p><b>class</b>: <span title=\"{http://terminology.hl7.org/CodeSystem/v3-ActCode AMB}\">ambulatory</span></p><p><b>type</b>: <span title=\"Codes: {http://www.ama-assn.org/go/cpt 99221}\">Initial hospital care</span></p><p><b>subject</b>: <a href=\"#urnuuid6f0cef31-2235-4d66-82e2-fa861fc909a8\">Mrs. Debbie941 McDermott739. Generated Summary: id: 0156e3a9-c4e1-4c0a-a53e-03ce3984ac65, Medical Record Number: 0156e3a9-c4e1-4c0a-a53e-03ce3984ac65, Social Security Number: 999-61-8566, Driver's license Number: S99966861, Passport Number: X52208740X; Debbie941 McDermott739 (OFFICIAL), Debbie941 Funk324 (MAIDEN); Phone: 555-755-4280; gender: female; birthDate: 1961-02-26; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/v3-MaritalStatus M}\">M</span>; multipleBirth: false</a></p><h3>Participants</h3><table class=\"grid\"><tr><td>-</td><td><b>Individual</b></td></tr><tr><td>*</td><td><a href=\"#urnuuid0000016d-235f-39b3-0000-0000000000fa\">Dr. Manuel446 Granados71. Generated Summary: id: 250; active: true; Manuel446 Granados71 ; Manuel446.Granados71@example.com; gender: male</a></td></tr></table><p><b>period</b>: Jun 20, 1976, 5:41:49 PM --&gt; Apr 29, 2018, 5:41:49 PM</p><h3>Locations</h3><table class=\"grid\"><tr><td>-</td><td><b>Location</b></td></tr><tr><td>*</td><td><a href=\"#urnuuid8938e769-59f7-40ff-a541-50b0bfcd6742\">NOBLE HOSPITAL. Generated Summary: status: active; name: NOBLE HOSPITAL; Phone: 4135682811</a></td></tr></table><p><b>serviceProvider</b>: <a href=\"#urnuuidebc3f5c4-6700-34af-8323-85621c313726\">NOBLE HOSPITAL. Generated Summary: Provider number: 9999999999 (OFFICIAL); active: true; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/organization-type prov}\">Healthcare Provider</span>; name: NOBLE HOSPITAL; Phone: 4135682811</a></p></div>"
        },
        "status": "finished",
        "class": {
          "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
          "code": "AMB"
        },
        "type": [
          {
            "coding": [
              {
                "system": "http://www.ama-assn.org/go/cpt",
                "code": "99221",
                "display": "Initial hospital care"
              }
            ],
            "text": "Initial hospital care"
          }
        ],
        "subject": {
          "reference": "urn:uuid:6f0cef31-2235-4d66-82e2-fa861fc909a8",
          "display": "Mrs. Debbie941 McDermott739"
        },
        "participant": [
          {
            "individual": {
              "reference": "urn:uuid:0000016d-235f-39b3-0000-0000000000fa",
              "display": "Dr. Manuel446 Granados71"
            }
          }
        ],
        "period": {
          "start": "1976-06-20T10:41:49-07:00",
          "end": "2018-04-29T10:41:49-07:00"
        },
        "location": [
          {
            "location": {
              "reference": "urn:uuid:8938e769-59f7-40ff-a541-50b0bfcd6742",
              "display": "NOBLE HOSPITAL"
            }
          }
        ],
        "serviceProvider": {
          "reference": "urn:uuid:ebc3f5c4-6700-34af-8323-85621c313726",
          "display": "NOBLE HOSPITAL"
        }
      },
      "request": {
        "method": "POST",
        "url": "Encounter"
      }
    },
    {
      "fullUrl": "urn:uuid:0000016d-235f-39b3-0000-0000000000fa",
      "resource": {
        "resourceType": "Practitioner",
        "meta": {
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner"
          ]
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>identifier</b>: id: 250</p><p><b>active</b>: true</p><p><b>name</b>: Manuel446 Granados71 </p><p><b>telecom</b>: <a href=\"mailto:Manuel446.Granados71@example.com\">Manuel446.Granados71@example.com</a></p><p><b>address</b>: 115 WEST SILVER STREET WESTFIELD MA 01085 US </p><p><b>gender</b>: male</p></div>"
        },
        "identifier": [
          {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "250"
          }
        ],
        "active": true,
        "name": [
          {
            "family": "Granados71",
            "given": [
              "Manuel446"
            ],
            "prefix": [
              "Dr."
            ]
          }
        ],
        "telecom": [
          {
            "extension": [
              {
                "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-direct",
                "valueBoolean": true
              }
            ],
            "system": "email",
            "value": "Manuel446.Granados71@example.com",
            "use": "work"
          }
        ],
        "address": [
          {
            "line": [
              "115 WEST SILVER STREET"
            ],
            "city": "WESTFIELD",
            "state": "MA",
            "postalCode": "01085",
            "country": "US"
          }
        ],
        "gender": "male"
      },
      "request": {
        "method": "POST",
        "url": "Practitioner"
      }
    },
    {
      "fullUrl": "urn:uuid:ebc3f5c4-6700-34af-8323-85621c313726",
      "resource": {
        "resourceType": "Organization",
        "meta": {
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization"
          ]
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>identifier</b>: Provider number: 9999999999 (OFFICIAL)</p><p><b>active</b>: true</p><p><b>type</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/organization-type prov}\">Healthcare Provider</span></p><p><b>name</b>: NOBLE HOSPITAL</p><p><b>telecom</b>: ph: 4135682811</p><p><b>address</b>: 115 WEST SILVER STREET WESTFIELD MA 01085 US </p></div>"
        },
        "identifier": [
          {
            "use": "official",
            "type": {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                  "code": "PRN"
                }
              ]
            },
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999999999"
          }
        ],
        "active": true,
        "type": [
          {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/organization-type",
                "code": "prov",
                "display": "Healthcare Provider"
              }
            ],
            "text": "Healthcare Provider"
          }
        ],
        "name": "NOBLE HOSPITAL",
        "telecom": [
          {
            "system": "phone",
            "value": "4135682811"
          }
        ],
        "address": [
          {
            "line": [
              "115 WEST SILVER STREET"
            ],
            "city": "WESTFIELD",
            "state": "MA",
            "postalCode": "01085",
            "country": "US"
          }
        ]
      },
      "request": {
        "method": "POST",
        "url": "Organization"
      }
    },
    {
      "fullUrl": "urn:uuid:8938e769-59f7-40ff-a541-50b0bfcd6742",
      "resource": {
        "resourceType": "Location",
        "meta": {
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/core/StructureDefinition/us-core-location"
          ]
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>status</b>: active</p><p><b>name</b>: NOBLE HOSPITAL</p><p><b>telecom</b>: ph: 4135682811</p><p><b>address</b>: 115 WEST SILVER STREET WESTFIELD MA 01085 US </p><h3>Positions</h3><table class=\"grid\"><tr><td>-</td><td><b>Longitude</b></td><td><b>Latitude</b></td></tr><tr><td>*</td><td>-72.755911</td><td>42.138838</td></tr></table><p><b>managingOrganization</b>: <a href=\"#urnuuidebc3f5c4-6700-34af-8323-85621c313726\">NOBLE HOSPITAL. Generated Summary: Provider number: 9999999999 (OFFICIAL); active: true; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/organization-type prov}\">Healthcare Provider</span>; name: NOBLE HOSPITAL; Phone: 4135682811</a></p></div>"
        },
        "status": "active",
        "name": "NOBLE HOSPITAL",
        "telecom": [
          {
            "system": "phone",
            "value": "4135682811"
          }
        ],
        "address": {
          "line": [
            "115 WEST SILVER STREET"
          ],
          "city": "WESTFIELD",
          "state": "MA",
          "postalCode": "01085",
          "country": "US"
        },
        "position": {
          "longitude": -72.755911,
          "latitude": 42.138838
        },
        "managingOrganization": {
          "reference": "urn:uuid:ebc3f5c4-6700-34af-8323-85621c313726",
          "display": "NOBLE HOSPITAL"
        }
      },
      "request": {
        "method": "POST",
        "url": "Location"
      }
    }
  ]
}

Response

HTTP/1.1 200 OK
[other headers]

{
"resourceType": "Bundle",
"id": "acb38f7f-2fcc-4b74-b46b-2af1c20854dc",
"type": "transaction-response",
"link": [
{
"relation": "self",
"url": "http://hapi.fhir.org/baseR4"
}
],
"entry": [
{
"response": {
"status": "201 Created",
"location": "MeasureReport/224761/_history/1",
"etag": "1",
"lastModified": "2019-12-07T01:30:03.058+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Organization/224762/_history/1",
"etag": "1",
"lastModified": "2019-12-07T01:30:03.058+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Patient/224763/_history/1",
"etag": "1",
"lastModified": "2019-12-07T01:30:03.058+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Practitioner/224764/_history/1",
"etag": "1",
"lastModified": "2019-12-07T01:30:03.058+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Observation/224765/_history/1",
"etag": "1",
"lastModified": "2019-12-07T01:30:03.058+00:00"
}
}
]
}

Examples

Scenario:

Payer X who is acting in the role of a Reporter submits a MRP Individual Reports for Patients P, Q and R to Receiver Z. The body of the request is a transaction bundle including the Individual MeasureReport and Observation resources all the related resources containing the relevant data used to compute the CQM criteria. An HTTP Status success code and a transaction-response Bundle is returned on successful submission.

POST Summary Report

POST [base]

Request body

{
  "resourceType": "Bundle",
  "id": "multiple-indv-mrp-obs-report",
  "type": "transaction",
  "timestamp": "2020-07-08T22:17:14.187160Z",
  "entry": [
    {
      "fullUrl": "http://example.org/fhir/receiver/Observation/observation03",
      "resource": {
        "resourceType": "Observation",
        "id": "observation03",
        "meta": {
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation"
          ]
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p></p><p><b>category</b>: <span title=\"Codes: {http://example.org/CodeSystem/observation-category measure}\">Measure</span></p><p><b>code</b>: <span title=\"Codes: {http://www.ama-assn.org/go/cpt 1111F}\">Medication Reconciliation</span></p><p><b>subject</b>: <a href=\"#Patient_patient03\">See above (Patient/patient03)</a></p><p><b>encounter</b>: <a href=\"#Encounter_encounter03\">See above (Encounter/encounter03)</a></p><p><b>effective</b>: Sep 30, 2018, 2:15:04 PM</p><p><b>issued</b>: Sep 30, 2018, 2:15:04 PM</p><p><b>performer</b>: <a href=\"#Practitioner_practitioner02\">See above (Practitioner/practitioner02)</a></p><p><b>value</b>: true</p></div>"
        },
        "status": "final",
        "category": [
          {
            "coding": [
              {
                "system": "http://example.org/CodeSystem/observation-category",
                "code": "measure",
                "display": "Measure"
              }
            ]
          }
        ],
        "code": {
          "coding": [
            {
              "system": "http://www.ama-assn.org/go/cpt",
              "code": "1111F",
              "display": "Medication Reconciliation"
            }
          ]
        },
        "subject": {
          "reference": "Patient/patient03"
        },
        "encounter": {
          "reference": "Encounter/encounter03"
        },
        "effectiveDateTime": "2018-09-30T14:15:04.424Z",
        "issued": "2018-09-30T14:15:04.424Z",
        "performer": [
          {
            "reference": "Practitioner/practitioner02"
          }
        ],
        "valueBoolean": true
      },
      "request": {
        "method": "POST",
        "url": "Observation"
      }
    },
    {
      "fullUrl": "http://example.org/fhir/receiver/Encounter/encounter02",
      "resource": {
        "resourceType": "Encounter",
        "id": "encounter02",
        "meta": {
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"
          ]
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>status</b>: finished</p><p><b>class</b>: <span title=\"{http://terminology.hl7.org/CodeSystem/v3-ActCode IMP}\">inpatient encounter</span></p><p><b>type</b>: <span title=\"Codes: {http://snomed.info/sct 239279000}\">Fixation of fracture</span></p><p><b>subject</b>: <a href=\"#Patient_patient02\">See above (Patient/patient02)</a></p><p><b>period</b>: May 29, 2018, 3:00:00 PM --&gt; May 29, 2018, 3:00:00 PM</p><h3>Hospitalizations</h3><table class=\"grid\"><tr><td>-</td><td><b>DischargeDisposition</b></td></tr><tr><td>*</td><td><span title=\"Codes: {http://terminology.hl7.org/CodeSystem/discharge-disposition home}\">Home</span></td></tr></table></div>"
        },
        "status": "finished",
        "class": {
          "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
          "code": "IMP",
          "display": "inpatient encounter"
        },
        "type": [
          {
            "coding": [
              {
                "system": "http://snomed.info/sct",
                "code": "239279000",
                "display": "Fixation of fracture"
              }
            ]
          }
        ],
        "subject": {
          "reference": "Patient/patient02"
        },
        "period": {
          "start": "2018-05-29T11:00:00-04:00",
          "end": "2018-05-29T11:00:00-04:00"
        },
        "hospitalization": {
          "dischargeDisposition": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/discharge-disposition",
                "code": "home",
                "display": "Home"
              }
            ]
          }
        }
      },
      "request": {
        "method": "POST",
        "url": "Encounter"
      }
    },
    {
      "fullUrl": "http://example.org/fhir/receiver/Organization/organization02",
      "resource": {
        "resourceType": "Organization",
        "id": "organization02",
        "meta": {
          "versionId": "3",
          "lastUpdated": "2019-03-06T19:03:03.000+00:00",
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/organization-deqm"
          ]
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>identifier</b>: Tax ID number: 234567891 (OFFICIAL)</p><p><b>active</b>: true</p><p><b>type</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/organization-type prov}\">Healthcare Provider</span></p><p><b>name</b>: DaVinciHospital02</p><p><b>telecom</b>: ph: (+1) 551-555-1212</p><p><b>address</b>: 3 Sherwood St. Englewood NJ 07631 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": "234567891",
            "assigner": {
              "display": "www.irs.gov"
            }
          }
        ],
        "active": true,
        "type": [
          {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/organization-type",
                "code": "prov",
                "display": "Healthcare Provider"
              }
            ]
          }
        ],
        "name": "DaVinciHospital02",
        "telecom": [
          {
            "system": "phone",
            "value": "(+1) 551-555-1212"
          }
        ],
        "address": [
          {
            "line": [
              "3 Sherwood St."
            ],
            "city": "Englewood",
            "state": "NJ",
            "postalCode": "07631",
            "country": "USA"
          }
        ]
      },
      "request": {
        "method": "POST",
        "url": "Organization"
      }
    },
    {
      "fullUrl": "http://example.org/fhir/receiver/Practitioner/practitioner02",
      "resource": {
        "resourceType": "Practitioner",
        "id": "practitioner02",
        "meta": {
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/practitioner-deqm"
          ]
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>identifier</b>: Provider number: 9998266512 (OFFICIAL)</p><p><b>active</b>: true</p><p><b>name</b>: Emile Zieme(OFFICIAL)</p><p><b>telecom</b>: ph: 8605555555(WORK), ph: 8605555555(WORK)</p><p><b>address</b>: UCONN MEDICAL GROUP, FARMINGTON, CT 060300001(HOME)</p><p><b>gender</b>: male</p><p><b>birthDate</b>: 1964-06-19</p><p><b>communication</b>: <span title=\"Codes: {urn:ietf:bcp:47 es}\">English and Spanish</span></p></div>"
        },
        "identifier": [
          {
            "use": "official",
            "type": {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                  "code": "PRN",
                  "display": "Provider number"
                }
              ]
            },
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9998266512",
            "period": {
              "start": "2005-07-16T09:00:00-05:00"
            },
            "assigner": {
              "display": "www.cms.gov"
            }
          }
        ],
        "active": true,
        "name": [
          {
            "use": "official",
            "text": "Emile Zieme",
            "family": "Zieme",
            "given": [
              "Emile"
            ],
            "suffix": [
              "M.D."
            ]
          }
        ],
        "telecom": [
          {
            "system": "phone",
            "value": "8605555555",
            "use": "work",
            "rank": 1
          },
          {
            "system": "phone",
            "value": "8605555555",
            "use": "work",
            "rank": 2
          }
        ],
        "address": [
          {
            "extension": [
              {
                "extension": [
                  {
                    "url": "latitude",
                    "valueDecimal": 41.791776
                  },
                  {
                    "url": "longitude",
                    "valueDecimal": -72.718832
                  }
                ],
                "url": "http://hl7.org/fhir/StructureDefinition/geolocation"
              }
            ],
            "use": "home",
            "type": "both",
            "text": "UCONN MEDICAL GROUP, FARMINGTON, CT 060300001",
            "line": [
              "UCONN MEDICAL GROUP"
            ],
            "city": "FARMINGTON",
            "state": "CT",
            "postalCode": "060300001",
            "country": "USA"
          }
        ],
        "gender": "male",
        "birthDate": "1964-06-19",
        "communication": [
          {
            "coding": [
              {
                "system": "urn:ietf:bcp:47",
                "code": "es",
                "display": "Spanish",
                "userSelected": true
              }
            ],
            "text": "English and Spanish"
          }
        ]
      },
      "request": {
        "method": "POST",
        "url": "Practitioner"
      }
    },
    {
      "fullUrl": "http://example.org/fhir/receiver/Organization/organization03",
      "resource": {
        "resourceType": "Organization",
        "id": "organization03",
        "meta": {
          "versionId": "3",
          "lastUpdated": "2019-02-21T01:47:53.000+00:00",
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/organization-deqm"
          ]
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>identifier</b>: Provider number: 345678912 (OFFICIAL), Provider number: 082584 (SECONDARY)</p><p><b>active</b>: true</p><p><b>type</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/organization-type prov}\">Healthcare Provider</span></p><p><b>name</b>: DaVinciHospital03</p><p><b>telecom</b>: ph: (+1) 201-555-1212</p><p><b>address</b>: 94 Olive Ave. Union City NJ 07087 USA </p></div>"
        },
        "identifier": [
          {
            "use": "official",
            "type": {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                  "code": "PRN",
                  "display": "Provider number"
                }
              ]
            },
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "345678912",
            "assigner": {
              "display": "www.cms.gov"
            }
          },
          {
            "use": "secondary",
            "type": {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                  "code": "PRN",
                  "display": "Provider number"
                }
              ]
            },
            "system": "urn:oid:2.16.840.1.113883.4.336",
            "value": "082584",
            "assigner": {
              "display": "www.cms.gov"
            }
          }
        ],
        "active": true,
        "type": [
          {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/organization-type",
                "code": "prov",
                "display": "Healthcare Provider"
              }
            ]
          }
        ],
        "name": "DaVinciHospital03",
        "telecom": [
          {
            "system": "phone",
            "value": "(+1) 201-555-1212"
          }
        ],
        "address": [
          {
            "line": [
              "94 Olive Ave."
            ],
            "city": "Union City",
            "state": "NJ",
            "postalCode": "07087",
            "country": "USA"
          }
        ]
      },
      "request": {
        "method": "POST",
        "url": "Organization"
      }
    },
    {
      "fullUrl": "http://example.org/fhir/receiver/Practitioner/practitioner01",
      "resource": {
        "resourceType": "Practitioner",
        "id": "practitioner01",
        "meta": {
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/practitioner-deqm"
          ]
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>identifier</b>: Provider number: 345678912 (OFFICIAL), Provider number: 082583 (SECONDARY)</p><p><b>name</b>: Ronald Bone </p><p><b>address</b>: 1003 Healthcare Drive Amherst MA 01002 (HOME)</p></div>"
        },
        "identifier": [
          {
            "use": "official",
            "type": {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                  "code": "PRN",
                  "display": "Provider number"
                }
              ]
            },
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "345678912",
            "assigner": {
              "display": "www.cms.gov"
            }
          },
          {
            "use": "secondary",
            "type": {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                  "code": "PRN",
                  "display": "Provider number"
                }
              ]
            },
            "system": "urn:oid:2.16.840.1.113883.4.336",
            "value": "082583",
            "assigner": {
              "display": "www.cms.gov"
            }
          }
        ],
        "name": [
          {
            "family": "Bone",
            "given": [
              "Ronald"
            ],
            "prefix": [
              "Dr"
            ]
          }
        ],
        "address": [
          {
            "use": "home",
            "line": [
              "1003 Healthcare Drive"
            ],
            "city": "Amherst",
            "state": "MA",
            "postalCode": "01002"
          }
        ]
      },
      "request": {
        "method": "POST",
        "url": "Practitioner"
      }
    },
    {
      "fullUrl": "http://example.org/fhir/receiver/Patient/patient03",
      "resource": {
        "resourceType": "Patient",
        "id": "patient03",
        "meta": {
          "versionId": "4",
          "lastUpdated": "2019-02-07T18:47:34.000+00:00",
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"
          ]
        },
        "text": {
          "status": "extensions",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>US Core Birth Sex Extension</b>: F</p><blockquote><p><b>US Core Race Extension</b></p><p><b>value</b>: <span title=\"{urn:oid:2.16.840.1.113883.6.238 2054-5}\">Black or African American</span></p><p><b>value</b>: Black or African American</p></blockquote><blockquote><p><b>US Core Ethnicity Extension</b></p><p><b>value</b>: <span title=\"{urn:oid:2.16.840.1.113883.6.238 2186-5}\">Not Hispanic or Latino</span></p><p><b>value</b>: Not Hispanic or Latino</p></blockquote><p><b>identifier</b>: Medical record number: 34567 (USUAL)</p><p><b>active</b>: true</p><p><b>name</b>: Virginia Hartman (OFFICIAL)</p><p><b>gender</b>: female</p><p><b>birthDate</b>: 1983-09-12</p><p><b>deceased</b>: false</p><p><b>address</b>: 213 Lilac Ave. Freehold MI 48099 USA (HOME)</p><p><b>maritalStatus</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/v3-MaritalStatus U}\">unmarried</span></p><h3>Communications</h3><table class=\"grid\"><tr><td>-</td><td><b>Language</b></td><td><b>Preferred</b></td></tr><tr><td>*</td><td><span title=\"Codes: {urn:ietf:bcp:47 en-US}\">English (Region=United States)</span></td><td>true</td></tr></table><p><b>managingOrganization</b>: <a href=\"#Organization_organization03\">See above (Organization/organization03)</a></p></div>"
        },
        "extension": [
          {
            "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex",
            "valueCode": "F"
          },
          {
            "extension": [
              {
                "url": "ombCategory",
                "valueCoding": {
                  "system": "urn:oid:2.16.840.1.113883.6.238",
                  "code": "2054-5",
                  "display": "Black or African American"
                }
              },
              {
                "url": "text",
                "valueString": "Black or African American"
              }
            ],
            "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": "2186-5",
                  "display": "Not Hispanic or Latino"
                }
              },
              {
                "url": "text",
                "valueString": "Not 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.davinci.org",
            "value": "34567"
          }
        ],
        "active": true,
        "name": [
          {
            "use": "official",
            "family": "Hartman",
            "given": [
              "Virginia"
            ]
          }
        ],
        "gender": "female",
        "birthDate": "1983-09-12",
        "deceasedBoolean": false,
        "address": [
          {
            "use": "home",
            "line": [
              "213 Lilac Ave."
            ],
            "city": "Freehold",
            "state": "MI",
            "postalCode": "48099",
            "country": "USA"
          }
        ],
        "maritalStatus": {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus",
              "code": "U",
              "display": "unmarried"
            }
          ]
        },
        "communication": [
          {
            "language": {
              "coding": [
                {
                  "system": "urn:ietf:bcp:47",
                  "code": "en-US",
                  "display": "English (Region=United States)"
                }
              ]
            },
            "preferred": true
          }
        ],
        "managingOrganization": {
          "reference": "Organization/organization03"
        }
      },
      "request": {
        "method": "POST",
        "url": "Patient"
      }
    },
    {
      "fullUrl": "http://example.org/fhir/receiver/Encounter/encounter03",
      "resource": {
        "resourceType": "Encounter",
        "id": "encounter03",
        "meta": {
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"
          ]
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>status</b>: finished</p><p><b>class</b>: <span title=\"{http://terminology.hl7.org/CodeSystem/v3-ActCode IMP}\">inpatient encounter</span></p><p><b>type</b>: <span title=\"Codes: {http://snomed.info/sct 53950000}\">Respiratory therapy</span></p><p><b>subject</b>: <a href=\"#Patient_patient03\">See above (Patient/patient03)</a></p><p><b>period</b>: May 29, 2018, 3:00:00 PM --&gt; May 29, 2018, 3:00:00 PM</p><h3>Hospitalizations</h3><table class=\"grid\"><tr><td>-</td><td><b>DischargeDisposition</b></td></tr><tr><td>*</td><td><span title=\"Codes: {http://terminology.hl7.org/CodeSystem/discharge-disposition home}\">Home</span></td></tr></table></div>"
        },
        "status": "finished",
        "class": {
          "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
          "code": "IMP",
          "display": "inpatient encounter"
        },
        "type": [
          {
            "coding": [
              {
                "system": "http://snomed.info/sct",
                "code": "53950000",
                "display": "Respiratory therapy"
              }
            ]
          }
        ],
        "subject": {
          "reference": "Patient/patient03"
        },
        "period": {
          "start": "2018-05-29T11:00:00-04:00",
          "end": "2018-05-29T11:00:00-04:00"
        },
        "hospitalization": {
          "dischargeDisposition": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/discharge-disposition",
                "code": "home",
                "display": "Home"
              }
            ]
          }
        }
      },
      "request": {
        "method": "POST",
        "url": "Encounter"
      }
    },
    {
      "fullUrl": "http://example.org/fhir/receiver/MeasureReport/indv-measurereport02a",
      "resource": {
        "resourceType": "MeasureReport",
        "id": "indv-measurereport02a",
        "meta": {
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/indv-measurereport-deqm"
          ]
        },
        "text": {
          "status": "extensions",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><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>: id: 0015HQN9BD3304E</p><p><b>DEQM Reporting Vendor Extension</b>: <a href=\"#Organization_organization02\">See above (Organization/organization02)</a></p><p><b>status</b>: complete</p><p><b>type</b>: individual</p><p><b>measure</b>: <a href=\"http://hl7.org/fhir/us/davinci-deqm/Measure/measure-mrp-example\">http://hl7.org/fhir/us/davinci-deqm/Measure/measure-mrp-example</a></p><p><b>subject</b>: <a href=\"#Patient_patient02\">See above (Patient/patient02)</a></p><p><b>date</b>: Sep 5, 2018, 4:59:52 PM</p><p><b>reporter</b>: <a href=\"#Organization_organization01\">See above (Organization/organization01)</a></p><p><b>period</b>: 2018-08-01 --&gt; 2018-09-01</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><p><b>code</b>: <span title=\"Codes: {http://example.org/fhir/ mrp-group}\">MRP Group</span></p><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><p><b>measureScore</b>: 1</p></blockquote><p><b>evaluatedResource</b>: <a href=\"#Observation_observation02\">See above (Observation/observation02)</a></p></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/organization02"
            }
          }
        ],
        "status": "complete",
        "type": "individual",
        "measure": "http://hl7.org/fhir/us/davinci-deqm/Measure/measure-mrp-example",
        "subject": {
          "reference": "Patient/patient02"
        },
        "date": "2018-09-05T16:59:52.404Z",
        "reporter": {
          "reference": "Organization/organization01"
        },
        "period": {
          "start": "2018-08-01",
          "end": "2018-09-01"
        },
        "improvementNotation": {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/measure-improvement-notation",
              "code": "increase",
              "display": "Increased score indicates improvement"
            }
          ]
        },
        "group": [
          {
            "code": {
              "coding": [
                {
                  "system": "http://example.org/fhir/",
                  "code": "mrp-group",
                  "display": "MRP Group"
                }
              ],
              "text": "MRP Group"
            },
            "population": [
              {
                "id": "initial-population",
                "code": {
                  "coding": [
                    {
                      "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                      "code": "initial-population",
                      "display": "Initial Population"
                    }
                  ]
                },
                "count": 1
              },
              {
                "id": "numerator",
                "code": {
                  "coding": [
                    {
                      "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                      "code": "numerator",
                      "display": "Numerator"
                    }
                  ]
                },
                "count": 1
              },
              {
                "id": "denominator",
                "code": {
                  "coding": [
                    {
                      "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                      "code": "denominator",
                      "display": "Denominator"
                    }
                  ]
                },
                "count": 1
              }
            ],
            "measureScore": {
              "value": 1
            }
          }
        ],
        "evaluatedResource": [
          {
            "reference": "Observation/observation02"
          }
        ]
      },
      "request": {
        "method": "POST",
        "url": "MeasureReport"
      }
    },
    {
      "fullUrl": "http://example.org/fhir/receiver/Observation/observation02",
      "resource": {
        "resourceType": "Observation",
        "id": "observation02",
        "meta": {
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation"
          ]
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p></p><p><b>category</b>: <span title=\"Codes: {http://example.org/CodeSystem/observation-category measure}\">Measure</span></p><p><b>code</b>: <span title=\"Codes: {http://www.ama-assn.org/go/cpt 1111F}\">Medication Reconciliation</span></p><p><b>subject</b>: <a href=\"#Patient_patient02\">See above (Patient/patient02)</a></p><p><b>encounter</b>: <a href=\"#Encounter_encounter02\">See above (Encounter/encounter02)</a></p><p><b>effective</b>: Sep 30, 2018, 2:15:04 PM</p><p><b>issued</b>: Sep 30, 2018, 2:15:04 PM</p><p><b>performer</b>: <a href=\"#Practitioner_practitioner02\">See above (Practitioner/practitioner02)</a></p><p><b>value</b>: true</p></div>"
        },
        "status": "final",
        "category": [
          {
            "coding": [
              {
                "system": "http://example.org/CodeSystem/observation-category",
                "code": "measure",
                "display": "Measure"
              }
            ]
          }
        ],
        "code": {
          "coding": [
            {
              "system": "http://www.ama-assn.org/go/cpt",
              "code": "1111F",
              "display": "Medication Reconciliation"
            }
          ]
        },
        "subject": {
          "reference": "Patient/patient02"
        },
        "encounter": {
          "reference": "Encounter/encounter02"
        },
        "effectiveDateTime": "2018-09-30T14:15:04.424Z",
        "issued": "2018-09-30T14:15:04.424Z",
        "performer": [
          {
            "reference": "Practitioner/practitioner02"
          }
        ],
        "valueBoolean": true
      },
      "request": {
        "method": "POST",
        "url": "Observation"
      }
    },
    {
      "fullUrl": "http://example.org/fhir/receiver/MeasureReport/indv-measurereport02",
      "resource": {
        "resourceType": "MeasureReport",
        "id": "indv-measurereport02",
        "meta": {
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/indv-measurereport-deqm"
          ]
        },
        "text": {
          "status": "extensions",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><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>: id: 0015HQN9BD3304E</p><p><b>DEQM Reporting Vendor Extension</b>: <a href=\"#Organization_organization02\">See above (Organization/organization02)</a></p><p><b>status</b>: complete</p><p><b>type</b>: individual</p><p><b>measure</b>: <a href=\"http://hl7.org/fhir/us/davinci-deqm/Measure/measure-mrp-example\">http://hl7.org/fhir/us/davinci-deqm/Measure/measure-mrp-example</a></p><p><b>subject</b>: <a href=\"#Patient_patient01\">See above (Patient/patient01)</a></p><p><b>date</b>: Sep 5, 2018, 4:59:52 PM</p><p><b>reporter</b>: <a href=\"#Organization_organization01\">See above (Organization/organization01)</a></p><p><b>period</b>: 2018-08-01 --&gt; 2018-09-01</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><p><b>code</b>: <span title=\"Codes: {http://example.org/fhir/ mrp-group}\">MRP Group</span></p><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><p><b>measureScore</b>: 1</p></blockquote><p><b>evaluatedResource</b>: <a href=\"#Observation_observation01\">See above (Observation/observation01)</a></p></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/organization02"
            }
          }
        ],
        "status": "complete",
        "type": "individual",
        "measure": "http://hl7.org/fhir/us/davinci-deqm/Measure/measure-mrp-example",
        "subject": {
          "reference": "Patient/patient01"
        },
        "date": "2018-09-05T16:59:52.404Z",
        "reporter": {
          "reference": "Organization/organization01"
        },
        "period": {
          "start": "2018-08-01",
          "end": "2018-09-01"
        },
        "improvementNotation": {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/measure-improvement-notation",
              "code": "increase",
              "display": "Increased score indicates improvement"
            }
          ]
        },
        "group": [
          {
            "code": {
              "coding": [
                {
                  "system": "http://example.org/fhir/",
                  "code": "mrp-group",
                  "display": "MRP Group"
                }
              ],
              "text": "MRP Group"
            },
            "population": [
              {
                "id": "initial-population",
                "code": {
                  "coding": [
                    {
                      "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                      "code": "initial-population",
                      "display": "Initial Population"
                    }
                  ]
                },
                "count": 1
              },
              {
                "id": "numerator",
                "code": {
                  "coding": [
                    {
                      "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                      "code": "numerator",
                      "display": "Numerator"
                    }
                  ]
                },
                "count": 1
              },
              {
                "id": "denominator",
                "code": {
                  "coding": [
                    {
                      "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                      "code": "denominator",
                      "display": "Denominator"
                    }
                  ]
                },
                "count": 1
              }
            ],
            "measureScore": {
              "value": 1
            }
          }
        ],
        "evaluatedResource": [
          {
            "reference": "Observation/observation01"
          }
        ]
      },
      "request": {
        "method": "POST",
        "url": "MeasureReport"
      }
    },
    {
      "fullUrl": "http://example.org/fhir/receiver/Organization/organization01",
      "resource": {
        "resourceType": "Organization",
        "id": "organization01",
        "meta": {
          "versionId": "4",
          "lastUpdated": "2019-02-21T01:47:54.000+00:00",
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/organization-deqm"
          ]
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>identifier</b>: Tax ID number: 123456789 (OFFICIAL)</p><p><b>active</b>: true</p><p><b>type</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/organization-type prov}\">Healthcare Provider</span></p><p><b>name</b>: DaVinciHospital01</p><p><b>telecom</b>: ph: (+1) 401-555-1212</p><p><b>address</b>: 73 Lakewood Street Warwick RI 02886 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": "123456789",
            "assigner": {
              "display": "www.irs.gov"
            }
          }
        ],
        "active": true,
        "type": [
          {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/organization-type",
                "code": "prov",
                "display": "Healthcare Provider"
              }
            ]
          }
        ],
        "name": "DaVinciHospital01",
        "telecom": [
          {
            "system": "phone",
            "value": "(+1) 401-555-1212"
          }
        ],
        "address": [
          {
            "line": [
              "73 Lakewood Street"
            ],
            "city": "Warwick",
            "state": "RI",
            "postalCode": "02886",
            "country": "USA"
          }
        ]
      },
      "request": {
        "method": "POST",
        "url": "Organization"
      }
    },
    {
      "fullUrl": "http://example.org/fhir/receiver/MeasureReport/indv-measurereport02b",
      "resource": {
        "resourceType": "MeasureReport",
        "id": "indv-measurereport02b",
        "meta": {
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/indv-measurereport-deqm"
          ]
        },
        "text": {
          "status": "extensions",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><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>: id: 0015HQN9BD3304E</p><p><b>DEQM Reporting Vendor Extension</b>: <a href=\"#Organization_organization02\">See above (Organization/organization02)</a></p><p><b>status</b>: complete</p><p><b>type</b>: individual</p><p><b>measure</b>: <a href=\"http://hl7.org/fhir/us/davinci-deqm/Measure/measure-mrp-example\">http://hl7.org/fhir/us/davinci-deqm/Measure/measure-mrp-example</a></p><p><b>subject</b>: <a href=\"#Patient_patient03\">See above (Patient/patient03)</a></p><p><b>date</b>: Sep 5, 2018, 4:59:52 PM</p><p><b>reporter</b>: <a href=\"#Organization_organization01\">See above (Organization/organization01)</a></p><p><b>period</b>: 2018-08-01 --&gt; 2018-09-01</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><p><b>code</b>: <span title=\"Codes: {http://example.org/fhir/ mrp-group}\">MRP Group</span></p><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><p><b>measureScore</b>: 1</p></blockquote><p><b>evaluatedResource</b>: <a href=\"#Observation_observation03\">See above (Observation/observation03)</a></p></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/organization02"
            }
          }
        ],
        "status": "complete",
        "type": "individual",
        "measure": "http://hl7.org/fhir/us/davinci-deqm/Measure/measure-mrp-example",
        "subject": {
          "reference": "Patient/patient03"
        },
        "date": "2018-09-05T16:59:52.404Z",
        "reporter": {
          "reference": "Organization/organization01"
        },
        "period": {
          "start": "2018-08-01",
          "end": "2018-09-01"
        },
        "improvementNotation": {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/measure-improvement-notation",
              "code": "increase",
              "display": "Increased score indicates improvement"
            }
          ]
        },
        "group": [
          {
            "code": {
              "coding": [
                {
                  "system": "http://example.org/fhir/",
                  "code": "mrp-group",
                  "display": "MRP Group"
                }
              ],
              "text": "MRP Group"
            },
            "population": [
              {
                "id": "initial-population",
                "code": {
                  "coding": [
                    {
                      "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                      "code": "initial-population",
                      "display": "Initial Population"
                    }
                  ]
                },
                "count": 1
              },
              {
                "id": "numerator",
                "code": {
                  "coding": [
                    {
                      "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                      "code": "numerator",
                      "display": "Numerator"
                    }
                  ]
                },
                "count": 1
              },
              {
                "id": "denominator",
                "code": {
                  "coding": [
                    {
                      "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                      "code": "denominator",
                      "display": "Denominator"
                    }
                  ]
                },
                "count": 1
              }
            ],
            "measureScore": {
              "value": 1
            }
          }
        ],
        "evaluatedResource": [
          {
            "reference": "Observation/observation03"
          }
        ]
      },
      "request": {
        "method": "POST",
        "url": "MeasureReport"
      }
    },
    {
      "fullUrl": "http://example.org/fhir/receiver/Encounter/encounter01",
      "resource": {
        "resourceType": "Encounter",
        "id": "encounter01",
        "meta": {
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"
          ]
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>status</b>: finished</p><p><b>class</b>: <span title=\"{http://terminology.hl7.org/CodeSystem/v3-ActCode IMP}\">inpatient encounter</span></p><p><b>type</b>: <span title=\"Codes: {http://snomed.info/sct 56876005}\">Drug rehabilitation and detoxification</span></p><p><b>subject</b>: <a href=\"#Patient_patient01\">Jairo Webster. Generated Summary: Medical record number: 12345 (USUAL); active: true; Jairo Webster (OFFICIAL); gender: male; birthDate: 1946-12-16; deceased: false; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/v3-MaritalStatus M}\">Married</span></a></p><p><b>period</b>: May 29, 2018, 3:00:00 PM --&gt; May 29, 2018, 3:00:00 PM</p><h3>Hospitalizations</h3><table class=\"grid\"><tr><td>-</td><td><b>DischargeDisposition</b></td></tr><tr><td>*</td><td><span title=\"Codes: {http://terminology.hl7.org/CodeSystem/discharge-disposition home}\">Home</span></td></tr></table></div>"
        },
        "status": "finished",
        "class": {
          "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
          "code": "IMP",
          "display": "inpatient encounter"
        },
        "type": [
          {
            "coding": [
              {
                "system": "http://snomed.info/sct",
                "code": "56876005",
                "display": "Drug rehabilitation and detoxification"
              }
            ]
          }
        ],
        "subject": {
          "reference": "Patient/patient01",
          "display": "Jairo Webster"
        },
        "period": {
          "start": "2018-05-29T11:00:00-04:00",
          "end": "2018-05-29T11:00:00-04:00"
        },
        "hospitalization": {
          "dischargeDisposition": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/discharge-disposition",
                "code": "home",
                "display": "Home"
              }
            ]
          }
        }
      },
      "request": {
        "method": "POST",
        "url": "Encounter"
      }
    },
    {
      "fullUrl": "http://example.org/fhir/receiver/Observation/observation01",
      "resource": {
        "resourceType": "Observation",
        "id": "observation01",
        "meta": {
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation"
          ]
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p></p><p><b>category</b>: <span title=\"Codes: {http://example.org/CodeSystem/observation-category measure}\">Measure</span></p><p><b>code</b>: <span title=\"Codes: {http://www.ama-assn.org/go/cpt 1111F}\">Medication Reconciliation</span></p><p><b>subject</b>: <a href=\"#Patient_patient01\">See above (Patient/patient01)</a></p><p><b>encounter</b>: <a href=\"#Encounter_encounter01\">See above (Encounter/encounter01)</a></p><p><b>effective</b>: Sep 29, 2018, 2:15:04 PM</p><p><b>issued</b>: Sep 29, 2018, 2:15:04 PM</p><p><b>performer</b>: <a href=\"#Practitioner_practitioner01\">See above (Practitioner/practitioner01)</a></p><p><b>value</b>: true</p></div>"
        },
        "status": "final",
        "category": [
          {
            "coding": [
              {
                "system": "http://example.org/CodeSystem/observation-category",
                "code": "measure",
                "display": "Measure"
              }
            ]
          }
        ],
        "code": {
          "coding": [
            {
              "system": "http://www.ama-assn.org/go/cpt",
              "code": "1111F",
              "display": "Medication Reconciliation"
            }
          ]
        },
        "subject": {
          "reference": "Patient/patient01"
        },
        "encounter": {
          "reference": "Encounter/encounter01"
        },
        "effectiveDateTime": "2018-09-29T14:15:04.424Z",
        "issued": "2018-09-29T14:15:04.424Z",
        "performer": [
          {
            "reference": "Practitioner/practitioner01"
          }
        ],
        "valueBoolean": true
      },
      "request": {
        "method": "POST",
        "url": "Observation"
      }
    },
    {
      "fullUrl": "http://example.org/fhir/receiver/Patient/patient01",
      "resource": {
        "resourceType": "Patient",
        "id": "patient01",
        "meta": {
          "versionId": "5",
          "lastUpdated": "2019-02-11T14:19:25.000+00:00",
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"
          ]
        },
        "text": {
          "status": "extensions",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>US Core Birth Sex Extension</b>: M</p><blockquote><p><b>US Core Race Extension</b></p><p><b>value</b>: <span title=\"{urn:oid:2.16.840.1.113883.6.238 2106-3}\">White</span></p><p><b>value</b>: White</p></blockquote><blockquote><p><b>US Core Ethnicity Extension</b></p><p><b>value</b>: <span title=\"{urn:oid:2.16.840.1.113883.6.238 2186-5}\">Not Hispanic or Latino</span></p><p><b>value</b>: Not Hispanic or Latino</p></blockquote><p><b>identifier</b>: Medical record number: 12345 (USUAL)</p><p><b>active</b>: true</p><p><b>name</b>: Jairo Webster (OFFICIAL)</p><p><b>gender</b>: male</p><p><b>birthDate</b>: 1946-12-16</p><p><b>deceased</b>: false</p><p><b>address</b>: 7496 Beaver Ridge Ave Thornton NJ 07003 USA (HOME)</p><p><b>maritalStatus</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/v3-MaritalStatus M}\">Married</span></p><h3>Communications</h3><table class=\"grid\"><tr><td>-</td><td><b>Language</b></td><td><b>Preferred</b></td></tr><tr><td>*</td><td><span title=\"Codes: {urn:ietf:bcp:47 en-US}\">English (Region=United States)</span></td><td>true</td></tr></table><p><b>managingOrganization</b>: <a href=\"#Organization_organization01\">See above (Organization/organization01)</a></p></div>"
        },
        "extension": [
          {
            "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex",
            "valueCode": "M"
          },
          {
            "extension": [
              {
                "url": "ombCategory",
                "valueCoding": {
                  "system": "urn:oid:2.16.840.1.113883.6.238",
                  "code": "2106-3",
                  "display": "White"
                }
              },
              {
                "url": "text",
                "valueString": "White"
              }
            ],
            "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": "2186-5",
                  "display": "Not Hispanic or Latino"
                }
              },
              {
                "url": "text",
                "valueString": "Not 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.davinci.org",
            "value": "12345"
          }
        ],
        "active": true,
        "name": [
          {
            "use": "official",
            "family": "Webster",
            "given": [
              "Jairo"
            ]
          }
        ],
        "gender": "male",
        "birthDate": "1946-12-16",
        "deceasedBoolean": false,
        "address": [
          {
            "use": "home",
            "line": [
              "7496 Beaver Ridge Ave"
            ],
            "city": "Thornton",
            "state": "NJ",
            "postalCode": "07003",
            "country": "USA"
          }
        ],
        "maritalStatus": {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus",
              "code": "M",
              "display": "Married"
            }
          ]
        },
        "communication": [
          {
            "language": {
              "coding": [
                {
                  "system": "urn:ietf:bcp:47",
                  "code": "en-US",
                  "display": "English (Region=United States)"
                }
              ]
            },
            "preferred": true
          }
        ],
        "managingOrganization": {
          "reference": "Organization/organization01"
        }
      },
      "request": {
        "method": "POST",
        "url": "Patient"
      }
    },
    {
      "fullUrl": "http://example.org/fhir/receiver/Patient/patient02",
      "resource": {
        "resourceType": "Patient",
        "id": "patient02",
        "meta": {
          "versionId": "4",
          "lastUpdated": "2019-03-06T19:03:03.000+00:00",
          "source": "http://example.org/fhir/server",
          "profile": [
            "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"
          ]
        },
        "text": {
          "status": "extensions",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>US Core Birth Sex Extension</b>: M</p><blockquote><p><b>US Core Race Extension</b></p><p><b>value</b>: <span title=\"{urn:oid:2.16.840.1.113883.6.238 2028-9}\">Asian</span></p><p><b>value</b>: Asian</p></blockquote><blockquote><p><b>US Core Ethnicity Extension</b></p><p><b>value</b>: <span title=\"{urn:oid:2.16.840.1.113883.6.238 2186-5}\">Not Hispanic or Latino</span></p><p><b>value</b>: Not Hispanic or Latino</p></blockquote><p><b>identifier</b>: Medical record number: 23456 (USUAL)</p><p><b>active</b>: true</p><p><b>name</b>: Darien Bernard (OFFICIAL)</p><p><b>gender</b>: male</p><p><b>birthDate</b>: 1967-06-13</p><p><b>deceased</b>: false</p><p><b>address</b>: 6 Rockwell Street Lynnwood NJ 07420 USA (HOME)</p><p><b>maritalStatus</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/v3-MaritalStatus M}\">Married</span></p><h3>Communications</h3><table class=\"grid\"><tr><td>-</td><td><b>Language</b></td><td><b>Preferred</b></td></tr><tr><td>*</td><td><span title=\"Codes: {urn:ietf:bcp:47 en-US}\">English (Region=United States)</span></td><td>true</td></tr></table><p><b>managingOrganization</b>: <a href=\"#Organization_organization02\">See above (Organization/organization02)</a></p></div>"
        },
        "extension": [
          {
            "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex",
            "valueCode": "M"
          },
          {
            "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": "2186-5",
                  "display": "Not Hispanic or Latino"
                }
              },
              {
                "url": "text",
                "valueString": "Not 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.davinci.org",
            "value": "23456"
          }
        ],
        "active": true,
        "name": [
          {
            "use": "official",
            "family": "Bernard",
            "given": [
              "Darien"
            ]
          }
        ],
        "gender": "male",
        "birthDate": "1967-06-13",
        "deceasedBoolean": false,
        "address": [
          {
            "use": "home",
            "line": [
              "6 Rockwell Street"
            ],
            "city": "Lynnwood",
            "state": "NJ",
            "postalCode": "07420",
            "country": "USA"
          }
        ],
        "maritalStatus": {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus",
              "code": "M",
              "display": "Married"
            }
          ]
        },
        "communication": [
          {
            "language": {
              "coding": [
                {
                  "system": "urn:ietf:bcp:47",
                  "code": "en-US",
                  "display": "English (Region=United States)"
                }
              ]
            },
            "preferred": true
          }
        ],
        "managingOrganization": {
          "reference": "Organization/organization02"
        }
      },
      "request": {
        "method": "POST",
        "url": "Patient"
      }
    }
  ]
}

Response

HTTP/1.1 200 OK
[other headers]

{
"resourceType": "Bundle",
"id": "0b04c784-5983-4358-992f-7cd95a1cec05",
"type": "transaction-response",
"link": [
{
"relation": "self",
"url": "http://hapi.fhir.org/baseR4"
}
],
"entry": [
{
"response": {
"status": "201 Created",
"location": "MeasureReport/223377/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:34:14.739+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Coverage/223378/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:34:14.739+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Organization/223379/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:34:14.739+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Organization/223380/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:34:14.739+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Observation/223381/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:34:14.739+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "MeasureReport/223382/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:34:14.739+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Coverage/223383/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:34:14.739+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Observation/223384/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:34:14.739+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "MeasureReport/223385/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:34:14.739+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Coverage/223386/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:34:14.739+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Observation/223387/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:34:14.739+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Patient/223388/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:34:14.739+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Encounter/223389/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:34:14.739+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Practitioner/223390/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:34:14.739+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Organization/223391/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:34:14.739+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Location/223392/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:34:14.739+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Patient/223393/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:34:14.739+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Encounter/223394/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:34:14.739+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Practitioner/223395/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:34:14.739+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Patient/223396/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:34:14.739+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Encounter/223397/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:34:14.739+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Practitioner/223398/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:34:14.739+00:00"
}
}
]
}

Summary MeasureReport

The Payer (“Aggregator”) pushes the MRP Summary MeasureReport to the Receiver.

Figure 3-5 Summary Reporting Technical Workflow
mrp_summ_report.jpg

Examples

Scenario:

Payer X who is acting in the role of a Reporter submits a MRP Summary Report for MRP for period P to Receiver Z. The body of the request is MeasureReport resource containing the required summary data for MRP attestation for the period. (Note that this a simplified example and just populates the count for initial population. However, counts for all populations specified in an eCQM should be reported in a summary report) An HTTP Status success code is returned on successful submission.

POST Summary Report

POST [base]/MeasureReport

Request body

{
  "resourceType": "MeasureReport",
  "id": "summ-measurereport01",
  "meta": {
    "source": "http://example.org/fhir/server",
    "profile": [
      "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/summary-measurereport-deqm"
    ]
  },
  "text": {
    "status": "extensions",
    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>DEQM Measure Scoring Extension</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/measure-scoring proportion}\">Proportion</span></p><p><b>status</b>: complete</p><p><b>type</b>: summary</p><p><b>measure</b>: <a href=\"http://hl7.org/fhir/us/davinci-deqm/Measure/measure-mrp-example\">http://hl7.org/fhir/us/davinci-deqm/Measure/measure-mrp-example</a></p><p><b>date</b>: Sep 5, 2018, 4:59:52 PM</p><p><b>reporter</b>: <a href=\"Organization-organization01.html\">Generated Summary: Tax ID number: 123456789 (OFFICIAL); active: true; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/organization-type prov}\">Healthcare Provider</span>; name: DaVinciHospital01; Phone: (+1) 401-555-1212</a></p><p><b>period</b>: 2018-08-01 --&gt; 2018-09-01</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><p><b>code</b>: <span title=\"Codes: {http://example.org/fhir/ mrp-group}\">MRP Group</span></p><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>: 100</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>: 80</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>: 100</p></blockquote><p><b>measureScore</b>: 0.8</p></blockquote></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"
          }
        ]
      }
    }
  ],
  "status": "complete",
  "type": "summary",
  "measure": "http://hl7.org/fhir/us/davinci-deqm/Measure/measure-mrp-example",
  "date": "2018-09-05T16:59:52.404Z",
  "reporter": {
    "extension": [
      {
        "url": "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-reporterGroup",
        "valueReference": {
          "reference": "Group/group01"
        }
      }
    ],
    "reference": "Organization/organization01"
  },
  "period": {
    "start": "2018-08-01",
    "end": "2018-09-01"
  },
  "improvementNotation": {
    "coding": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/measure-improvement-notation",
        "code": "increase",
        "display": "Increased score indicates improvement"
      }
    ]
  },
  "group": [
    {
      "code": {
        "coding": [
          {
            "system": "http://example.org/fhir/",
            "code": "mrp-group",
            "display": "MRP Group"
          }
        ],
        "text": "MRP Group"
      },
      "population": [
        {
          "id": "initial-population",
          "code": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                "code": "initial-population",
                "display": "Initial Population"
              }
            ]
          },
          "count": 100
        },
        {
          "id": "numerator",
          "code": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                "code": "numerator",
                "display": "Numerator"
              }
            ]
          },
          "count": 80
        },
        {
          "id": "denominator",
          "code": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                "code": "denominator",
                "display": "Denominator"
              }
            ]
          },
          "count": 100
        }
      ],
      "measureScore": {
        "value": 0.8
      }
    }
  ]
}

Response

HTTP/1.1 200 OK
[other headers]

  1. Changes to QI Core and US Core Organization profiles are being proposed based on the DEQM Organization profile that may lead to this profiles being replaced by the QI Core profile.  2